The coregulatory effects of emotionally focused therapy

This study examined the heart rate synchrony between a single couple in emotionally focused therapy (EFT) as a method of measuring coregulatory effects over the course of treatment. A clinician who is an EFT certified therapist, supervisor, and trainer administered all eight sessions in a private practice setting. Surrogate synchrony analysis assessed heart rate synchrony between partners, indicating that significant heart rate synchrony was more likely over time. Significant heart rate synchrony was more likely during sessions that focused on clients’ sharing attachment injuries, bonds, and longings with their partner compared to sessions more focused on cognitive processing of the relationship. Additionally, there were delays in heart rate synchrony that occurred between the couple, which may be indicative of the emotional processing speed of the empathic response of each partner. Understanding the physiological synchrony patterns between dyads in treatment could clarify the potential of coregulation in the therapeutic process.     

Concordance Between Measures of Anxiety and Physiological Arousal Following Treatment of Panic Disorder in Adolescence

This study examined the concordance (or synchrony/desynchrony) between adolescents' self-reports of anxiety and physiological measures of arousal (heart rate) both prior to and after treatment for panic disorder. Results indicated a decline in reported subjective units of distress (SUDS) for the treatment group only at the post-treatment measurement for two of three tasks. Within the treatment group, heart rate changes during the Behavioral Approach Test (BAT) were observed following treatment for one task only. Implications of this apparent desynchrony between self-report and physiological measures in adolescent panic disorder are discussed, with cognitive changes in participants' perception of anxiety after treatment suggested as an important factor in recovery.     

Parent–Child Synchrony in Children with Oppositional Defiant Disorder: Associations with Treatment Outcomes

Oppositional defiant disorder (ODD), characterized by angry/irritable mood, and argumentative/defiant behavior, is associated with significant negative outcomes in childhood and beyond. Researchers posit that these behaviors arise from poor parenting and/or an incompatibility between characteristics of the child and the child’s parents, resulting in strained interaction styles. The present study examines parent–child synchrony, the inverse of parent–child incompatibility as a predictor of children’s emotional lability, aggression, and overall functioning following psychosocial treatment. Participants were 75 treatment-seeking families with children diagnosed with ODD (46 boys). Families received one of two empirically supported treatments for ODD (Parent Management Training or Collaborative and Proactive Solutions). Findings indicated that pre-treatment parent–child synchrony was associated with decreased emotional lability and aggression following both treatments, as well as improvement in overall functioning, irrespective of treatment condition. These results reflect the importance of parent–child relations at the onset of treatment in predicting response to treatment and suggest potential treatment targets within parent–child relationships.     

Job Stress and Dyadic Synchrony in Police Marriages: A Preliminary Investigation

Despite reports documenting adverse effects of stress on police marriages, few empirical studies focus on actual emotional behaviors of officers and spouses. In this preliminary investigation, 17 male police officers and their nonpolice wives completed daily stress diaries for 1 week and then participated in a laboratory‐based discussion about their respective days. Conversations were video‐recorded and coded for specific emotional behaviors reflecting hostility and affection, which are strong predictors of marital outcomes. We examined associations between officers' job stress (per diaries and the Police Stress Survey) and couples' emotional behavior (mean levels and behavioral synchrony) using a dyadic repeated measures design capitalizing on the large number of observations available for each couple (1020 observations). When officers reported more job stress, they showed less hostility, less synchrony with their wives' hostility, and more synchrony with their wives' affection; their wives showed greater synchrony with officers' hostility and less synchrony with officers' affection. Therefore, for officers, greater job stress was associated with less behavioral negativity, potentially less attunement to wives' negativity, but potentially greater attunement to wives' affection—perhaps a compensatory strategy or attempt to buffer their marriage from stress. These attempts may be less effective, however, if, as our synchrony findings may suggest, wives are focusing on officers' hostility rather than affection. Although it will be important to replicate these results given the small sample, our findings reveal that patterns of behavioral synchrony may be a key means to better understand how job stress exacts a toll on police marriages.     

Tonal synchrony in mother–infant interaction based on harmonic and pentatonic series

This study reports the occurrence of ‘tonal synchrony’ as a new dimension of early mother–infant interaction synchrony. The findings are based on a tonal and temporal analysis of vocal interactions between 15 mothers and their 3-month-old infants during 5 min of free-play in a laboratory setting. In total, 558 vocal exchanges were identified and analysed, of which 84% reflected harmonic or pentatonic series. Another 10% of the exchanges contained absolute and/or relative pitch and/or interval imitations. The total durations of dyads being in tonal synchrony were normally distributed (M = 3.71, SD = 2.44). Vocalisations based on harmonic series appeared organised around the major triad, containing significantly more simple frequency ratios (octave, fifth and third) than complex ones (non-major triad tones). Tonal synchrony and its characteristics are discussed in relation to infant-directed speech, communicative musicality, pre-reflective communication and its impact on the quality of early mother–infant interaction and child's development.     

Assessment and significance of behavioral avoidance in agoraphobia

Two behavioral avoidance tests were administered, before and after in vivo exposure treatment, to 39 female patients with chronic and severe agoraphobia. The first test consisted of walking alone along a standard course covering several city blocks, and the second of entering and remaining in five different, individually selected phobic situations. Although significant improvement on the tests was observed in the sample as a whole, neither test had a high nosographic sensitivity (nearly two-thirds of the patients completed them initially) and subgroups of avoiders and nonavoiders, classified simultaneously on both tests, did not differ significantly in their clinical characteristics or response to treatment. The difficulty for the behavioral test to account for the majority of variance in phobic avoidance, and the severity of agoraphobia in general, is discussed with particular reference to the differences between the going to and the being in types of phobic situations and the essentially anticipatory nature of anxiety and fear.This research was supported by Grants MH40141 and MH34177 from the National Institute of Mental Health.     

Habituation during exposure treatment: Distraction vs attention-focusing

To investigate the effects of distraction and attention-focusing during in-vivo exposure to feared stimuli, the responses of 16 obsessive-compulsives with washing rituals were studied. A cross-over design was employed in which 6 of the subjects underwent exposure with attention focusing on the first day followed by exposure with distraction on the second day. The remaining subjects received the reverse order. Habituation of both heart rate and subjective anxiety was observed under both conditions, the rate of habituation tending to remain constant throughout the 90-min exposure. Greater between-session habituation and greater synchrony between the psychophysiological and the subjective measures of anxiety was observed when attention-focusing preceded distraction. Since habituation and synchrony have previously been found to be positively related to treatment outcome, the present results suggest that treatment by exposure to feared stimuli may be more effective if attention-focusing is promoted.     

The relationship between parent-youth interaction and delinquency in group homes

Interactions between the youths and group home parents in 10 group homes were directly observed during a 2-hour session in each home. These observations were compared to questionnaire measures of the youths' self-reported delinquency while in the group home, and their evaluation of the group home program. The results indicated that over the 10 homes there was a strong inverse correlation between mean self-reported delinquency and the average amount of time youths spent taking to (r _s =–.95)and in proximity to (r _s =–.81)their group home parents. Talking to group home parents also showed a positive correlation with the youths' evaluation of their group home program. Similar trends were found when the correlations were computed over individual youths, although the magnitudes were reduced. These data may have implications for our understanding of the relationship between parenting behaviors and delinquency, as well as for the improvement of group-home treatment programs.This research was supported by Grant MH20030 and by a postdoctoral research fellowship (Grant MH15200, awarded to the first author) from the National Institute of Mental Health (Center for Studies in Crime and Delinquency). These grants were made to the Bureau of Child Research and the Department of Human Development, University of Kansas. The authors wish to thank Susan Whitely for her statistical consultation, and Jay Atwater, Carol Cramer, and Lynette Forbes for their help in the data analysis. Appreciation is also extended to the many teaching-parents whose cooperation made the research possible.     

Patterns of desynchrony in agoraphobia: A preliminary report

Changes in heart rate in three moderate to severe agoraphobic women were monitored by a Holter Recorder, used for obtaining portable EKGs. These data were collected before, half-way through, and at the end of a 12 session, group therapy program consisting of exposure and cognitive restructuring while subjects walked, or in one case, were driven along a standard 1.2 km course leading away from the treatment setting. Self-reports of anxiety were collected simultaneously. Despite substantial behavioral improvement in all cases, markedly different patterns of synchrony or desynchrony were noted between heart rate and self-reports of anxiety and substantial increases in heart rate were noted in one subject.     

Discrepancies among mother,child, and teacher reports: Examining the contributions of maternal depression and anxiety

The relationship between maternal affective symptomatology and discrepancies in maternal reports of child symptoms, relative to teacher and child reports, was evaluated in a community sample of 188 children ages 9–12 years. Mothers, teachers, and children were administered a structured interview about child psychopathology. In general, mothers reported more child behavior problems than children and teachers, regardless of maternal symptomatology. However, maternal affective symptoms were associated with discrepancies between mothers' and daughters' reports and between mothers' and teachers' reports of girls' externalizing symptoms. Furthermore, mothers who reported high levels of both anxiety and depressive symptomatology tended to report a large number of symptoms that were not confirmed by either their daughters or teachers. Findings are discussed as possible evidence of the role of maternal affective symptomatology in both actual increases in child symptomatology and maternal reporting distortions. Although maternal depressive and anxiety symptoms shared variance in reporting discrepancies, only anxiety explained unique variance. Consistent with previous studies, cross-informant agreement was modest to moderate (r= .16 to .50) and all informants reported more behavior problems in boys than in girls. This work was undertaken with the support of National Institute of Mental Health Grants MH43909 and MH46717.     

The role of individual differences,response profiles,and treatment consonance in anxiety disorders

The importance of individual differences, response profiles, and treatment consonance in anxiety-disorders clinical research is reviewed. Anxiety-disorders assessment, synchrony, and concordance phenomena are examined within the framework of the tripartite model. Issues regarding response stereotypy, response specificity, and etiological vs. current response typologies are discussed. Interactions of varying response profiles with different treatment modalities are addressed, in terms of both previous and prospective studies. A preliminary classification schema is offered, for illustrative purposes, with empirical support for the differential outcome of anxiety patients receiving consonant vs. nonconsonant response profile × treatment type pairings. Hypotheses are presented regarding predicted effects of consonant vs. nonconsonant subject-treatment interactions. Recommendations for programmatic research are offered to accelerate scientific inquiry into the role of individual differences and response profiles in anxiety-disorders assessment, treatment, and research.Preparation of this paper was supported in part by National Institute of Mental Health Grant MH 36299.     

Patterns of psychophysiological change in the treatment of agoraphobia

Patterns of change and synchrony were studied in a group of 26 agoraphobics under-going a 12-week treatment program. Clinical, behavioral, physiological and subjective measures were taken at pre-, 4, 8 and 12 weeks of treatment and at 1-month follow-up.Clinically and statistically significant changes were found in all response systems and our results tentatively suggest that the order of change starts with behavioral and clinical measures followed by psychophysiological measures of which psysiological responsivity has the longest lag.Although the group as a whole changed synchronously, there was evidence of individual desynchrony between physiological and subjective measures of anxiety. The most common form this look was for SUDS to decline while heart rate increased. A closer look at desynchrony in the various time sequences revealed that both the form and occurrence of desynchrony vary according to phase of treatment and that time interval between assessment points might-be of crucial importance in the determination of synchrony-desynchrony.     

Acceptability of aversive procedures and medication as treatment alternatives for deviant child behavior

The present investigation evaluated the acceptability of alternative treatments for deviant child behavior. Clinical cases of children who displayed severe behavioral problems at home and at school were described along with three different treatments. The treatments, time-out from reinforcement, locked seclusion, and medication, were rated by psychiatric inpatient children and parents in a 3 × 3 replicated Latin-square design. The investigation also evaluated whether acceptability ratings were influenced by the clinical effectiveness of treatment in altering behavior. Although children and parents did not differ overall in acceptability ratings, they differed in their ranking of different treatments. Children viewed medication as the most acceptable treatment, whereas parents viewed time out as the most acceptable treatment. For both children and parents, treatments described as producing marked effects were rated as more acceptable than treatments producing weaker effects. The results indicated that disturbed children and their parents can readily distinguish the acceptability of alternative treatments. The implications of treatment acceptability for clinical applications of treatment are discussed.Completion of this investigation was facilitated by a Research Scientist Development Award (MH00353) and a grant (MH35408) from the National Institute of Mental Health. The author is grateful for the assistance of the clinical research team of the Child Psychiatric Treatment Service, especially that of Irene Heidish, M.A., who assisted with the data analyses.     

Symptom and substance use reporting consistency over two years for offspring at high and low risk for depression

We examined 2-year recall of reports of lifetime symptomatology and substance use questions on the K-SADS-E in a sample of offspring at high and low risk for depression. Comparisons were made between those who forgot and those who remembered reports of screening symptoms made at the initial interview. In general, recall for symptoms of internalizing disorders (depression and anxiety disorder) was much worse than recall for symptoms of externalizing disorders (conduct disorder and substance use). Less than two-thirds of those initially meeting the lifetime depression screening criteria provided reports which met the lifetime screening criteria at followup. Significant correlates of screening criteria recall included the following variables (measured at the initial interview): history of treatment for any disorder, impairment on the GAS (a score less than 61), and the presence of hypersomnia and suicidal symptoms (thoughts or ideation). Logistic regression suggested that a prior report of suicidal symptoms (including thoughts, ideation, or behavior) was the most important correlate of screen recall.This research was supported in part by grants from the National Institute on Drug Abuse (grant R29DA07995), the National Institute of Mental Health (grant P50MH43878-03) and from the University of Illinois Campus Research Board. The authors would like to thank Dr. Myrna Weissman for making the data available and acknowledge the data analytic assistance provided by Yanchun Xu.     

Community vs. Clinic-Based Modular Treatment of Children with Early-Onset ODD or CD: A Clinical Trial with 3-Year Follow-Up

This study examines the treatment outcomes of 139, 6–11 year-old, clinically referred boys and girls diagnosed with Oppositional Defiant Disorder (ODD) or Conduct Disorder (CD) who were randomly assigned to a modular-based treatment protocol that was applied by research study clinicians either in the community (COMM) or a clinic office (CLINIC). To examine normative comparisons, a matched sample of 69 healthy control children was included. Multiple informants completed diagnostic interviews and self-reports at six assessment timepoints (pretreatment to 3-year follow-up) to evaluate changes in the child’s behavioral and emotional problems, psychopathic features, functional impairment, diagnostic status, and service involvement. Using HLM and logistic regression models, COMM and CLINIC showed significant and comparable improvements on all outcomes. By 3-year follow-up, 36% of COMM and 47% of CLINIC patients no longer met criteria for either ODD or CD, and 48% and 57% of the children in these two respective conditions had levels of parent-rated externalizing behavior problems in the normal range. We discuss the nature and implications of these novel findings regarding the role of treatment context or setting for the treatment and long-term outcome of behavior disorders. This study was supported by grants to the first author from the National Institute of Mental Health (MH 57727) and to the second author by the National Institute of Nursing Research (NR 07615). The fourth author was supported by grant K01 MH078039 from the National Institute of Mental Health. The authors acknowledge the research and clinical staff of the Resources to Enhance the Adjustment of Children (REACH) program, and Drs. David Brent, Tammy Chung, William Gardner, John Lochman, and Wayne Osgood. Reprints may be obtained from Dr. Kolko, WPIC, 3811 O’Hara St., Pittsburgh, PA 15213.     

The interview for antisocial behavior: Psychometric characteristics and concurrent validity with child psychiatric inpatients

The present study evaluated psychometric features and correlates of the Interview for Antisocial Behavior (IAB), a new measure designed to assess antisocial child behavior. Parents of 264 psychiatric inpatients (ages 6–13 years) completed the measure to evaluate antisocial behavior of their children. The investigation evaluated the relation of IAB scores to clinically derived diagnoses and to aggression and externalizing behaviors, as measured by different raters (parents, teachers), across different settings (home, school, hospital), and with different assessment methods (rating scales, behavioral role-play test). The results indicated that the IAB showed acceptable levels of internal consistency. A priori scores (severity, duration, total antisocial behavior) and factor analytically derived scales (Arguing/Fighting, Covert Antisocial Behaviors, Self-Injury) distinguished children with a DSM III diagnosis of conduct disorder, and scores on the IAB were more consistently related to other measures of aggression and externalizing behavior than to measures of internalizing behavior or overall severity of dysfunction. The implications of the results for use of the measure, particularly in relation to evaluation of the overt-covert dimension of antisocial behavior, are discussed.Completion of this research was facilitated by a Research Scientist Development Award (MH00353) and by grants (MH35408, MH39642) from the National Institute of Mental Health and the Rivendell Foundation.     

Relative efficacy of methylphenidate and behavior modification in hyperkinetic children: An interim report

Children reported to be hyperactive in school and with behavior difficulties at home were randomly assigned to methylphenidate, behavior therapy and placebo, or behavior therapy with methylphenidate for an 8-week period. Rating scales were obtained from teachers and parents. Independent blind observers rated childrens' classroom behavior on a weekly basis. A behavior therapy program was implemented in the home and at school. Methylphenidate dosage was individualized. Ratings of behavior deviance were significantly reduced by all treatments. However, a significant advantage for the groups receiving methylphenidate was found over the group receiving behavior therapy and placebo. No significant differences between methylphenidate alone and methylphenidate combined with behavior therapy were obtained. Global ratings of improvement done by teachers favored the combined treatment of behavior therapy and methylphenidate over behavior therapy and placebo. No differences among treatments were found in the mothers' global ratings of improvement. The results indicate that though all three treatments were effective, methylphenidate was significantly superior to behavior therapy alone.This study was supported in part by grant MH 18579, and by grant No. 3-621 from the Long Island Jewish-Hillside Medical Center. The authors wish to thank the behavior therapists, Drs. Jeffrey Felixbrod and Marion Pheterson, as well as Ms. Patricia Ramsey, who was responsible for data analysis.     

Direct versus indirect response-reinforcer relationships in teaching autistic children

One possibility suggested by the literature for maximizing the efficiency of behavior modification procedures concerns the relationship between target behaviors and their reinforcers. Therefore, in this experiment three severely autistic children were taught a total of six new target behaviors (in a multiple baseline design) employing two different response-reinforcer relationships: (1) those where the target behaviors were a direct part of the response chain required to procure a reinforcer (e.g., opening the lid of a container to obtain a food reward inside the container); and (2) those where the target behavior was an indirect part of the chain leading to the reinforcer (e.g., the therapist handing the child a food reward after the child had opened the lid of an empty container). In all cases, the results showed rapid acquisition only when the target behavior was a direct part of the chain leading to the reinforcer. The results are discussed in terms of several possible conceptualizations concerning efficient reinforcement contingencies, and in terms of their implications for teaching autistic children.This investigation was supported by U.S. Public Health Service Research Grants MH 28210 and MH 28231, and by U.S. Office of Education Research Grant G007802084 from the Bureau for the Education of the Handicapped. Portions of the results described in this article were discussed in a presentation at the 13th Annual AABT Convention in San Francisco, 1979. The authors are particularly grateful to Andrew Egel, Roberta Elman, Janis Costello, and Karen Britten, for their helpful comments, and to Jody Fisher and Gina Richman, for their assitance in the data collection.     

Feature synchrony-asynchrony and rate of change in visual search

ABSTRACT

Attention is known to be sensitive to the temporal structure of scenes. We initially tested whether feature synchrony, an attribute with potential special status because of its association with objecthood, is something which draws attention. Search items were surrounded by colours which periodically changed either in synchrony or out-of synchrony with periodic changes in their shape. Search for a target was notably faster when the target location contained a unique synchronous feature change amongst asynchronous changes. However, the reverse situation produced no search advantage. A second experiment showed that this effect of unique synchrony was actually a consequence of the lower rate of perceived flicker in the synchronous compared to the asynchronous items, not the synchrony itself. In our displays it seems that attention is drawn towards a location which has a relatively low rate of change. Overall, the pattern of results suggested the attentional bias we find is for relative temporal stability. Results stand in contrast to other work which has found high and low flicker rates to both draw attention equally [Cass, J., Van der Burg, E., & Alais, D. (2011). Finding flicker: Critical differences in temporal frequency capture attention. Frontiers in Psychology, 2, 320]. Further work needs to determine the exact conditions under which this bias is and is not found when searching in complex dynamically-changing displays.