Social skills training and systematic desensitization in reducing dating anxiety.

Cooper et al. (1969) have criticized the types of target behavior chosen for therapy analogue studies for being irrelevant to clinical practice. A potential target behavior which appears to be pervasive, complex and directly relevant to clinical practice is interpersonal anxiety. Of special concern to college students is the interpersonal anxiety elicited by members of the opposite sex. especially in dating situations (Martinson and Zerface, 1970).An individual may experience interpersonal anxiety because of a deficit in social skills (reactive anxiety) or because of prior conditioning (conditioned anxiety) or because of some combination of both reactive and conditioned components. While it is possible that a treatment program aimed at a reduction of either of these anxiety components may be instrumental in ameliorating the other component, it would appear that a comprehensive treatment program would attempt to teach social skills as well as reduce conditioned anxiety.Desensitization procedures have demonstrated success in alleviating conditioned anxiety for a wide variety of clinical problems (Paul, 1969a. 1969b) and appears to be a logical choice for the conditioned component of dating anxiety. A number of outcome studies have reported some success in the use of in vivo desensitization (Rehm and Marston, 1968; Martinson and Zerface, 1970) and systematic desensitization (Stark, 1970) in reducing anxiety in date anxious subjects.The literature on treatment programs aimed at social skills training for date anxious subjects is meager. Melnick (1973) reported success in improving the appropriateness of the social behavior of subjects who had experienced a minimal dating history by the use of modeling, behavioral rehearsal and self-observation techniques.The present study was designed to test the relative effectiveness of two different types of treatment programs in alleviating interpersonal dating anxiety. The two experimental groups consisted of a systematic densensitization program which focused on the condition anxiety component and a social skills training program which focused on the reactive anxiety component.     

The effect of duration of exposure on systematic desensitization and extinction.

An important variable which has only recently received attention (Proctor, 1968; Watts, 1971) is the influence of intra-item exposure time to aversive stimuli on systematic desensitization. Long single exposure to hierarchy items was more effective in reducing avoidance behavior than short exposure (Ross and Proctor, 1973). It is possible, therefore, for duration of exposure to be a confounding variable in previous desensitization research.In studies where exposure only conditions were ineffective (Davison, 1968; Lomont and Edwards, 1967), the visualization time was less than 15 sec. Successful utilization of extinction-like procedures employed longer exposure times (Vodde and Gilner, 1971 for 20–30 sec; Crowder and Thornton, 1970 for 30 sec; Sue, 1972 for 20 sec; Nawas, Welsch and Fishman, 1970 for 60 sec: Wolpin and Raines, 1966 for up to 10 min).Intra-item exposure time may also account for the discrepant findings on the influence of cognitive variables on the efficacy of systematic desensitization. In the studies where expectations or therapeutic instructions were important (Leitenberg et al., 1969; Valins and Ray, 1967), subjects were exposed to aversive stimuli for 10–15 sec. Where positive expectations were unimportant, the exposure time was longer (McGlynn and Mapp, 1970 for 20–30 sec; McGlynn, Gaynor and Puhr, 1972 for 20–30 sec; McGlynn, Reynolds and Linder, 1971 for 20–40 sec; Lomont and Brock, 1971 for 60 sec). Therapeutic expectations, relaxation, and other variables may assume importance during periods of short exposure.So far, there has been no adequate investigation of intra-item exposure time on both extinction and desensitization. The procedures employed by Watts (1971) and Proctor (1968) do not allow such a comparison to be made. The purpose of the present study is to examine the influence of short (5 sec) and lengthy (30 sec) exposure to aversive stimuli on extinction and desensitization conditions.In line with the results of Davison (1968) and Lomont and Edwards (1967), it was predicted that exposure of short duration would be less effective than exposure of longer duration under the extinction condition (Vodde and Gilner, 1971 ; Crowder and Thronton, 1970; Nawas et al., 1970; Wolpin and Raines, 1966). No specific predictions were made on the desensitization groups. There were four experimental groups: (1) two exposure only groups (visualization for either 5 sec or 30 sec), and (2) two systematic desensitization groups (visualization for 5 sec or 30 sec). A no-treatment control group was also employed.     

Play desensitization of fear of darkness in preschool children.

Systematic desensitization therapy (SDT) is considered to be a technique of established effectiveness in reducing monosymptomatic fears (Paul, 1969a, 1969b), yet little systematic research has been done to investigate the merit of desensitization procedures in modifying children's behavior. The few available controlled studies (Miller et al., 1972; Obler and Terwilliger, 1970; Oliver, 1971) on desensitization with children have produced equivocal results. Although imagery and relaxation have been reported of benefit when used separately (Graziano and Kean, 1971; Lazarus and Abramovitz, 1962), evidence suggests that the usual combination of imagery and relaxation is not effective in reducing children's fears (Miller et al., 1972). Investigators in this area have often modified traditional SDT to include alternatives to imagery such as pictures, drawings, play (Cassell, 1965; Lazarus, 1960; Obler and Terwilliger, 1970; Patterson, 1965), or in vivo exposure to the feared stimulus (Obler and Terwilliger, 1970). Relaxation has often been replaced with other responses thought to be incompatible with anxiety such as eating (Jones, 1924). Another deviation from traditional SDT has been the delivery of positive reinforcement (food, praise, or toys) contingent upon the child's approaching the feared object (Obler and Terwilliger, 1970; Patterson, 1965). On the basis of such varied techniques, it is impossible to determine which of these procedures constitutes an effective treatment method for children. In the following study, three desensitization procedures involving graded exposure to the feared stimulus (darkness) through symbolic play, were compared to no-treatment and placebo control groups under differing instructional sets. Treatments were designed to determine the therapeutic efficacy of play as a method of stimulus presentation with children, and to determine whether reciprocal inhibition, extinction, operant reinforcement, or instructional set contribute to fear reduction in desensitization with children.     

The contribution of relaxation to symbolic modeling in the modification of dental fears.

Studies of symbolic modeling suggest that it is a technique which is at least as effective and more efficient (faster) than imaginal desensitization in the treatment of fears (Bandura el al., 1969; Woody and Schaible, 1969). Bandura et al. (1969) assessed the contributions of relaxation to the procedure and found less subjective anxiety and greater positive attitude change with relaxation but no significant differences in oven behavior nor in generalized anxiety reduction. In this study the ‘symbolic modeling only’ subjects received their treatment after they and the other subjects had received the original post-testing assessment. The present experiment was an attempt to assess the contributions of deep muscle relaxation to symbolic modeling without such confounding and with a more nearly clinical population. Dental fear represents a ‘near clinical’ phobia which satisfies Bernstein and Paul's (1971) criteria for analogue desensitization research. That is. dental phobics exhibit a strong, costly and distressing avoidance response which increases in strength as a function of exposure despite high demand.     

Sensitivity to phobic imagery: a sensory decision theory analysis

The effects of deep muscle relaxation on anxiety were studied in a systematic desensitization context. A Sensory Decision Theory analysis of anxiety ratings to controlled imagery showed that relaxed Ss were significantly more sensitive to phobic properties of the controlled imagery than nonrelaxed Ss. The results are discussed in terms of Wolpe's theoretical basis for systematic desensitization. Sensory Decision Theory is presented as a useful technique for measuring the effects of therapy on emotional states.     

Modification of excessive drinking by cue exposure

The value of an individual case study depends to a large extent on the nature of the predictions which are tested. If, for example, behaviour is modified by a method which flies in the face of current theory and practice, then it is worth reporting, and if detailed predictions about day-to-day changes are confirmed, so much the better. This individual case study was designed to test the possibility that excessive drinking behaviour can be modified by prolonged exposure to drinking cues.Our approach is based on the hypothesis that addictive behaviour is analogous to discriminated operants. We are also making the assumption that drinking, in the alcoholic, is frequently reinforced through the avoidance of unpleasant consequences (e.g. an escalation in anxiety, frustration or withdrawal symptoms) and that these avoidance responses are discriminated since they are triggered only by certain cues.Avoidance learning has been investigated in humans and animals for at least 50 years but in recent years strong evidence has accumulated which suggests a particular modification procedure. First, it has now been demonstrated that, in animals, a very effective extinction procedure involves exposure to the discriminative stimulus (i.e. cue) whilst blocking the avoidance response (Baum, 1969). Second, psychologists have considered obsessive-compulsive rituals to be analogous to avoidance responses (Hodgson and Rachman, 1972). Compulsive gas-tap checking, for example, avoids both catastrophic events and also unpleasant emotional states. During the last ten years an effective method of modifying obsessive-compulsive rituals has been developed which involves exposure to significant cues followed by response prevention which is either supervised (Meyer, 1966) or self-imposed (Rachman et al., 1971; Hodgson et al., 1972). The same method has also been successful in the modification of compulsive masturbation (Hodgson and Rachman, 1975).     

Stimulus hierarchy generalization in systematic desensitization

A group of snake phobic Ss were desensitized to the first 5 items of a standard 7 item snake fear hierarchy in which the items were ordered on the basis of distance from a snake. This group and a no-treatment control group (which did not receive the desensitization) were treated for fear of all the hierarchy stimuli in terms of ratings both before and after the desensitization. The Ss rated their fear responses to all the stimuli as presented to them in (1) real form (2) by slide, and (3) in imaginal form. The results verified all four experimental hypotheses: (1) The experimental Ss showed greater fear reduction than the control Ss to both the training stimuli (the stimuli on which desensitization done) and the generalization stimuli (the other two stimuli), (2) The systematic desensitization (SD) group showed (a) more fear reduction to the last training stimuli than to the lower generalization stimulus and (b) more to the latter than to the higher generalization stimulus, (3) The SD group showed less fear reduction to the generalization stimuli in their real form than in both the slide and imaginai modalities (in the desensitization each stimulus presentation was done first in slide form and then in imaginal form), and (4) There were significant overall individual differences in generalization of fear reduction to the generalization stimuli.     

Transfer of fear reduction through systematic desensitization

Systematic desensitization therapy involves the presentation of fear-provoking situations through visualization As the visualizations cease to evoke emotional responses, the fear-provoking potential of the real situations decreases. Research has clearly shown that such transfer does indeed occur with a wide variety of fears. Transfer has been demonstrated, for example, with fear of small animals (Lang and Lazovik, 1963), interpersonal performance anxiety (Paul, 1966), classic phobias (Lazarus, 1961), test anxiety (Katahn, Strenger and Cherry, 1966), impotence (Wolpe, 1958) and frigidity (Lazarus, 1963). However, the nature of transfer has received little attention. Wolpe (1963) has claimed that transfer from therapy to the real life situation is almost complete and direct: “There is almost invariably a one-to one relationship between what the patient can imagine without anxiety and what he can experience in reality without anxiety”. This claim has received support from Rachman (1966) who found that fear reduction transferred immediately to the real situation in 82 per cent of his observations. Hoenig and Reed (1966) reported that after a brief delay, transfer effects were observed in the case of words representing fearful stimuli but were inconsistent in the case of the real stimuli. Agras (1967) found transfer to be delayed in all his cases. He further reported that, though all patients improved, a direct relationship between therapeutic progress and symptom reduction was not found. Both Hain et al. (1966) and Meyer and Crisp (1966) have described the failure of therapeutic effects to transfer to real life.These somewhat inconsistent reports may stem in part from the measurement of transfer effects at different times. Another possibility is that more fearful Ss may evidence less transfer than less fearful Ss. Lang and Lazovik (1963) reported that Ss who completed less than 75 per cent of the hierarchy showed little improvement although direct transfer effects were observed for less fearful Ss (those who complete 75 per cent or more hierarchy items). The present study of transfer effects was designed to remove confoundingof level of fear with extent of progress in systematic desensitization.     

The effects of unavoidable shocks on a multiple schedule having an avoidance component

Two dogs were maintained on a multiple schedule having both a food reinforced and an avoidance component (Mult VI 1′ S^Δ Avoid_{SS20 RS20} S^Δ). The effects of superimposing an Estes-Skinner procedure for delivering unavoidable shocks on all components of the multiple schedule were observed. The buzzer-shock pairing of the Estes-Skinner procedure produced an increased rate of responding on the avoidance component of the schedule and also on the S^Δ components. No persistent change in rate was observed on the food component during the pre-shock stimulus. Control performances on all components could be regained by either extinguishing or eliminating the buzzer-shock pairing. Extinction of the avoidance responding had little effect on the increased rates of responding produced by the Estes-Skinner procedure on the S^Δ and avoidance extinction components and did not lead to a conditioned suppression of the food reinforced responding. Rate of responding during the pre-shock stimulus was observed to be relatively independent of changes in the maintaining schedules. Responding during the pre-shock stimulus could be conditioned and maintained after an extensive history of avoidance extinction.     

Treatment of nocturnal headbanging by behavior modification techniques: a case report

The application of behavior modification techniques to the alleviation of maladaptive behavior occurring during the waking state is well documented (Bandura, 1969; Franks, 1969). Recently, several case studies have been reported which demonstrate the successful extension of behavior modification techniques such as the desensitization procedure to the modification of sleep state maladaptive behavior, e.g. recurrent nightmares (Cautela, 1968; Geer and Silverman 1966; Silverman and Geer, 1968) and sleep walking (Clement, 1969). The present case study illustrates that other sleep state maladaptive behavior, in this case nocturnal headbanging, is amenable to the same behavior modification techniques which are used to modify maladaptive behavior during the waking state. Case background     

A psychoanalytic reinterpretation of the effectiveness of systematic desensitization: Fact or fiction?

Silverman, Frank and Dachinger (1974) found support for their hypothesis that the effectiveness of systematic desensitization (SD) resides in its activation of unconscious, merging fantasies. Their subjects were subjected to a variant of SD. in which a procedure aimed at stimulating a fantasy of ‘merging with mother’ was substituted for muscle relaxation. This pro- cedure consisted of the tachistoscopic subliminal exposure of the symbiotic gratification stimulus mommy and i are one(experimental) or neutral stimulus people walking (control). The aim of the present study was to replicate their work with special reference to demand characteristics. using as subjects snake phobics. SD with a symbiotic gratification stimulus was not more effective than SD with a neutral stimulus, which may be explained by the fact that the neutral stimulus in the present study snake and I are one was more relevant than the neutral stimulus in the Silverman et al. study. Moreover, subjects with a therapy-set improved significantly more than subjects with a research-set.     

A Pursuit Device for Obtaining both Quantitative and Qualitative Records

Fifth and sixth grade students (N = 87) were divided into High Test Anxious and Low Test Anxious groups on the basis of galvanic skin responses (GSR). Ss identified as High Anxious responded positively to group systematic desensitization procedures, exhibiting significantly (p < .05) lower autonomic indices of test anxiety and significantly (p < .001) improved criterion test scores. Low Anxious Ss exposed to the systematic desensitization program demonstrated no significant change in criterion test scores.     

Parameters affecting the acquisition of Sidman avoidance

Four studies were conducted to investigate the source of reinforcement of Sidman avoidance. First it was found that the acquisition of avoidance was seriously impaired if there was no immediate stimulus consequence of responding, i.e., proprioceptive and auditory feedback. The second study showed that if the shock-shock interval was split so that only responses occurring in one half of the interval were effective in postponing shock, then learning was impaired. It made little difference which half of the interval was used. The third study demonstrated that Ss learn Sidman avoidance more quickly with a variable shock-shock interval than with the usual fixed-interval procedure. The results of the second and third experiments argue against the view that avoidance is reinforced by the decrease in conditioned aversiveness that occurs at long post-shock times. The final experiment indicated that Ss do not learn Sidman avoidance if the response-produced delay of shock is preceded by a shock, hence it seems unlikely that the crucial source of reinforcement is merely an overall reduction in shock density. All of the findings are consistent with the hypothesis that the avoidance response is reinforced by the decrease in conditioned aversiveness of stimuli at short post-response times. This seems to be the case even at the beginning of acquisition.     

Self-directed desensitization for acrophobia

Acrophobic outpatients received therapist- or self-directed (tape-recorded) desensitization in a study of (a) treatment effectiveness with diminished therapist contact ; (b) subject characteristics ‘predicting’ outcome; and (c) generalization of change. At Post-test, treated Ss (N=16) had improved significantly more than Waiting List Ss (N=13) on self-report measures of acrophobia and general anxiety, while the treatment methods were equally effective. An 8-month follow-up found that self-directed Ss had attempted more specific behavioral situations than therapist-directed Ss, and showed additional gains on self-report measures while therapist-directed Ss maintained post-test levels. Results suggested: (a) desensitization provides effective treatment even with reduced therapist contact; (b) some subject characteristics relate to outcome and (c) treatment effects generalize to other anxiety indices.     

The Treatment of Social Phobia in a Young Boy With Asperger's Disorder

Anxiety disorders, including social phobia, occur often in children with autism spectrum disorders (ASD; Gillott, Furniss, & Walter, 2001; Leyfer et al., 2006; Simonoff et al., 2008); however, little is known about the conceptualization and treatment of social phobia in this population. The current study presents the case of “James,” a 6-year-old male with comorbid Asperger's disorder and social phobia. A cognitive-behavioral treatment (CBT) package, including parent training, psychoeducation, graduated exposure, and reinforced practice, was implemented to decrease avoidance behaviors in social settings. Results showed that James's avoidance behaviors were reduced significantly following intervention, suggesting that a CBT approach may be effective in treating social phobia in children with ASD. The significant influence of CBT on decreasing avoidance behavior in comorbid social phobia and ASD highlights the need for continued investigation of adapting CBT for use with children with ASD.     

Extinction of avoidance in rats: response availability and stimulus presentation effects

A conditioned a versive stimulus presented in prolonged, continuous fashion is said to be flooded. Using a two-way shuttle avoidance task. Polin (1959) found that animals allowed to respond to flooded stimuli extinguish faster than animals prevented from responding to discrete stimuli of equal total duration. But, as Shearman (1970) noted, the CS presentation and response availability factors were confounded. He arranged them factorially, in a 2 × 2 design, again utilizing two-way avoidance, but found no differences between any of the experimental groups, although all groups extinguished faster than a regular extinction control group, the only group for which CS termination was response-contingent. Since there is evidence from one-way avoidance studies that response prevention facilitates extinction of avoidance with CS exposure held constant (Shipley et al., 1971). we repeated the Shearman design, using a one-way avoidance paradigm, and including a group for whom the aversive CS would be presented in discrete trials at increasing intensities. A separate aspect of the present investigation concerned the measurement of a fear response as well as the avoidance response. Results of several investigations have shown (e.g. Coulter et al. 1969; Linton et al.. 1970) that avoidance behaviour can be extinguished without the extinction of fear. It was thought useful to assess the generality of this result, since in two-factor theory, fear and avoidance are related.Two supplementary experiments replicated important conditions of the initial one, while examining whether response prevention and response non-availability have similar effects (II), and the relation between the fear test and the test for extinction (III).     

Summation of food and shock based responding

In a multiphase experiment, dogs first received discriminative, discretetrial, barrier-jumping training with two tones (S^D, S^Δ) in a shuttle box reinforced by either shock avoidance (Group I) or by food (Group II). Then the dogs were trained on free-operant barrier-jumping reinforced by the qualitatively opposite reinforcer—food in Group I and shock avoidance in Group II. Finally, test presentations of the tone stimuli were superimposed on the free-operant behavior. The tone S^Ds markedly facilitated responding in all animals. This experiment demonstrates a summation of responding maintained by shock avoidance and food reinforcement and casts doubt on explanations of conditioned suppression outcomes that appeal solely to incompatible motivational states within the organism.     

Vicarious desensitization of test anxiety

students fail in the university environment due to an inability to perform in testing situations because of anxiety associated with tests (Suinn, 1968). Systematic desensitization has been found to be effective in the treatment of test anxiety, and attempts are being made to improve both the efficiency and effectiveness of this procedure (Mann and Rosenthal, 1969; Suinn and Hall, 1970). This study evaluates the relative effectiveness of four methods of systematic desensitization in the treatment of test anxiety. Specifically, two changes were investigated which may lead to: (a) more rapid forms of treatment (massed treatment versus distributed treatment); (b) more easily administered forms of treatment (vicarious desensitization versus active desensitization).     

Differential reinforcement of vocal duration

The effects of differential reinforcement of vocal duration were examined in a series of experiments in which each of 28 subjects (Ss) emitted a vowel whenever a light was flashed. In the first phase of each experiment, a penny was dispensed after each of 20 responses. In the second and subsequent phases, only those responses whose durations exceeded a criterion were reinforced; when 10 successive reinforcements were presented, one phase was terminated and the next begun. The criterion for reinforcement in each phase was determined by a different schedule in each of six experiments; it ranged from 80 to 120 per cent of the mean duration of the 10 terminal responses in the prior phase. Differential reinforcement effected a large and systematic change in the duration of vocal responses as long as the responses selected for reinforcement had a sufficiently high probability of occurrence. This requirement was formulated as the difference between the criterion duration and the mean duration of the terminal responses in the prior phase, divided by their standard deviation. This statistic, named the shaping index, was correlated with the number of responses emitted before each phase was terminated. It was found to be large whenever the shaping process failed. Many Ss failed to tact the reinforcement contingency despite marked changes in their vocal behavior and extensive probing by a questionnaire, administered at the end of each session.