Non-accidental injury to children—I: A review of behavioural interventions

The history of the growth of interest in child abuse in the Western World over the last two decades is described chronologically. Problems of definition of a phenomenon which is a deviation from social norms are discussed, including the problem of distinguishing acceptable discipline from abuse. The literature on parent-training approaches to the treatment of abusive parents is reviewed. It is argued that researchers in the U.S.A. and the U.K. are working within different statutory frameworks, from different definitional criteria and with different conceptualizations of successful outcome. The need for multiple outcome measures, in terms of quality of life for the abused child, and for long-term follow-up is stressed, together with the importance of clinical experience in the planning and execution of evaluative treatment research.     

Health-related behavioural change—a test of a new model

Abstract

Numerous studies have demonstrated that planned health education and health promotion interventions are not particularly successful in bringing about behavioural change. It is suggested that the reasons for this are the fallacious theoretical assumptions underlying many intervention strategies and the failure to place sufficient emphasis on the context in which health-related behaviours occur. Studies of self-initiated behavioural change suggest that the antecedents of change are often events or processes which bring a previously routinised and unremarked behaviour into new focus.

This paper describes a preliminary test of a new model of behavioural change in which a group of lay people were recruited to act as paid interviewers on a food survey in their own area. The survey was particularly concerned with the consumption of high fibre foods. he and post-test measures of the interviewers' own food habits as compared with those of a control group indicated modest support for the proposed model. Implications of this study for health education and promotion are discussed.     

Aging: a switch from automatic to controlled processing of sounds?

In this article, the authors show that aging differentially affects peoples' ability to automatically and voluntarily process auditory information. Young, middle-aged, and older adults matched behaviorally in an auditory discrimination task showed similar patterns of neural activity indexing the voluntary and conscious detection of deviant (i.e., target) stimuli. In contrast, a negative wave indexing automatic processing (the mismatch negativity) was elicited only in young adults for near-threshold stimuli. These results indicate that aging affects the ability to automatically register small changes in a stream of homogeneous stimuli. However, this age-related decline in automatic detection of small change in the auditor environment can be compensated for by top-down controlled processes.     

The behavioural treatment of school refusal—A comparative study

A consecutive series of 30 school refusers received behavioural treatment (BTA). Their outcome is compared with that of 16 school refusers who were hospitalized and 20 who received psychotherapy and home tuition. The BTA group showed superior outcome compared to the other two groups. The Home-tuition group did very badly. There was no evidence of symptom substitution in the 28 cases treated successfully by behaviour therapy.     

Resistance to extinction: a measure of orbitofrontal function suitable for children?

Extinction of operantly conditioned responses, which provides a measure of the ability to adapt to changes in the reinforcement value of stimuli, has been linked to orbitofrontal cortex (OFC) in human and non-human animals. This article examines the feasibility of using extinction as a measure of the development of OFC function in preschool-age children. If extinction serves as a measure of OFC function, resistance to extinction should decrease during this age range. In Part 1, we review the literature on extinction as related to OFC, and summarize what is known regarding age-related changes in extinction in young children. In Part 2, we report results of a study assessing extinction in children between 3 and 6 years of age. Results revealed age-related increases in responding during extinction, with girls (particularly, 6-year-old girls) exhibiting stronger resistance to extinction. Some relations were found with temperament and normative compulsive-like behavior. The findings of this study question the utility of extinction of operant responding as a measure of OFC function in young children.     

Maternal personality and injury in children: is stability a protective factor?

Measures of injury were obtained in a birth cohort of 953 children in Wales along with maternal Eysenck Personality Inventory (EPI) and children's Behaviour Screening Questionnaire (BSQ) data. While there was no relationship between maternal E and child injury, children of low-N mothers had significantly fewer injuries than those of medium of high-N mothers. The magnitude of this trend remained after controlling for the BSQ variables also relating to injury, but was no longer significant in the case of management disorder or of sex. Moreover, while the association was observed for families with only one or two children, this was not the case for families with three or more children.     

A cluster-analytically derived typology: Feasible alternative to clinical diagnostic classification of children?

Despite numerous studies of the relationships among symptoms manifested by children and adolescents, there have been few systematic attempts to group individuals on the basis of the syndromes identified. In the course of a treatment evaluation project requiring classification of both child patients and untreated controls, the present study was conducted to determine whether replicable types of children and adolescents could be identified by the cluster analysis of their IJR Behavior Checklist profiles. One clinical sample (N=185) and two mixed clinical and normal subsamples (Ns of 358 and 373) were cluster-analyzed separately. Seven types that replicated across at least two subsamples were identified: (1) High Assets, Flat Symptom Profile; (2) Sociopathic, Academic Problems; (3) Moderate Assets, Egocentric, Incontinent; (4) Insecure, Somaticizing, Underachieving; (5) Aggressive, Overreactive; (6) Schizoid, Withdrawn, Anxious, Bizarre; and (7) Diffuse, Mixed Pathology. The issue posed by the title of the article was explored in the light of the findings.     

Born to kill? A critical evaluation of homicide adaptation theory

Given the enormous harm that results from the intentional killing of humans by other humans, the development of etiological theories of homicide is an important task. Homicide Adaptation Theory (HAT) is one such attempt to explain why homicide occurs. In short, the proponents of HAT propose that humans possess a number of specific, evolved adaptations for killing that have been selected for because they managed to successfully solve recurrent adaptive problems in our ancestral past. In this paper it is argued that, although evolutionary approaches can potentially advance our understanding of homicide in important ways, the available evidence does not support the existence of specific adaptations for killing in humans. Specifically, I argue that the proponents of HAT have not provided: (a) a thorough analysis of the evolutionary costs and benefits of killing; (b) evidence for ‘special design’ features of homicide; or (c) a systematic comparative appraisal of killing among different species. Given this lack of evidence, HAT suffers in terms of its explanatory worth, relative to alternative evolutionary hypotheses, such as the idea that homicide is a by-product of other evolved adaptations.     

A new vision of a classical question: How to become a mother?

Abstract

This article offers a reflection on conception, pregnancy, and the first mother–infant relationships of mothers with motoric and sensory disabilities. Based on more than 13 years of experience with women with motoric and sensory disabilities who had a desire for a child, the author analyzes this unusual situation from three different points of view: the medical help to procreate, meeting a partner for the mother, and the link with the initial maternal family, i.e. the mother’s mother. The last part concerns the possibility of the development of a mother–infant relationship when bodily function is lacking.     

Piloting ‘Clever Kids’: A randomized-controlled trial assessing feasibility,efficacy, and acceptability of a socioemotional well-being programme for children with dyslexia

Children with dyslexia are at elevated risk of internalizing (emotional) and externalizing (behavioural) problems. Clever Kids is a nine-week socioemotional well-being programme developed specifically for upper primary school children with dyslexia. In a small randomized-controlled trial, we tested the feasibility, efficacy, and acceptability of the Clever Kids programme. ‘Forty children (M_age = 10.45 years, 65% male) with clinically diagnosed dyslexia too part in the study. Children were randomized to either attend Clever Kids (n = 20) or to a wait-list control condition (n = 20). Coping skills, self-esteem, resilience, emotion regulation, and internalizing and externalizing symptoms were measured at pre-programme, post-programme, and at three-month follow-up. Recruitment and retention rates indicate high feasibility for further evaluation of the programme. There was a significant interaction between intervention condition and time for non-productive coping [F(2, 76) = 4.29, p = 0.017, f² = 0.11]. Children who attended Clever Kids significantly reduced their use of non-productive coping strategies, and this was maintained at three-month follow-up assessment. For all other outcomes, the interactions between intervention condition and time were non-significant. The programme appears acceptable to children with dyslexia and their families, but may be improved by further reducing the number of activities involving reading and writing. Clever Kids improved the coping skills of children with dyslexia; however, a larger trial is needed to replicate this finding and investigate whether programme attendance is associated with additional improvements in children’s socioemotional well-being.     

Do children have to remember to reason? A fuzzy-trace theory of transitivity development

An idea that has become commonplace in the literature on cognitive development is that the solution of thinking and reasoning problems requires that children retain accurate representations of certain background facts in short-term memory. This reasoning/remembering hypothesis is reexamined with reference to the one childhood cognitive task for which the validity of the hypothesis seems to be firmly established, transitive inference. Although the hypothesis says that children's transitive inferences are critically dependent on memory for the initial premise information, it is shown in six experiments that transitivity and premise memory are independent abilities in children. A fuzzy-trace theory is developed to explain this surprising independence effect. The theory assumes that children retain only degraded, schematic representations (fuzzy traces) of the overall pattern of an ordered series and that performance on subsequent test trials is mediated by processing operations that flesh out vague pattern information. Some further experiments that were designed to test various predictions of the fuzzy-trace theory are reported. Last, it is shown that reasoning and remembering are independent abilities in some other childhood cognitive tasks for which the initial background facts are not logically inescapable components of the eventual solution. These reasoning/remembering independence effects argue for an increased emphasis on encoding selectivity in theories of cognitive development.     

Occupational violence: Armed holdup—A risk management approach

Workplace violence covers a wide spectrum of incidents of aggression that may occur at work. One area of particular concern relates to holdups. This study reviewed all incidents of robbery (holdups and bag snatches) occurring in a quasi-government wagering organization throughout Queensland, Australia between 1990 and August 1993. The study covered 30 robberies, at 28 sites with 34 subjects, 22 of whom consented to complete a questionnaire related to the stressfulness and impact of the event. Most robberies occurred at opening or closing time, at sites situated on a main thoroughfare, predominantly on a Monday. Single males (n =15) or a pair (n =15) mostly carrying a gun were the perpetrators. Nineteen of the 22 victims attended critical incident debriefing and most found this valuable. Only one subject interviewed lost time for stress (and this was the fourth time she had been robbed). One subject not interviewed was hospitalized. Other subjects had minor physical injuries, but suffered emotionally for up to a year after the incident. Recommendations focused on the hierarchy of control (environmental and engineering controls in preference to people-focused change). Additionally training in the normal processes of grief and trauma was recommended.     

Assessment of agoraphobia—II: Measurement of clinical change

This paper reviews conceptual and methodological assessment issues germane to agoraphobia outcome research, and a core set of agoraphobia measures and uniform clinical change criteria are proposed. The limitations of physiological measurement for treatment outcome purposes are discussed, and suggestions are offered for effective utilization of triple response measurement for agoraphobia research.     

Materials used to support cognitive behavioural therapy for depression: a survey of therapists’ clinical practice and views

ABSTRACT

Use of supporting materials in cognitive behavioural therapy (CBT) is widely advocated, and homework increases effectiveness. The study aimed to identify materials most frequently used by CBT therapists to support CBT for depression, and those perceived clinically most effective. Questionnaires were sent to 3665 accredited CBT therapists asking about their use of resources commonly described in CBT manuals, and their views on effectiveness. Of 3665 approached by post/email, 994 (27%) responded. Another 33 completed the questionnaire via the study website. 818/1027 (80%) of respondents were accredited practitioners who deliver one-to-one therapy. Symptom measures, lists of problems/goals, activity schedules, behavioural activation diaries/plans, and case formulation worksheets were used “frequently” or “very frequently” by over 85% of respondents. Sleep diaries and computerised CBT were used least. Most resources were used within and between sessions. Activity schedules, behavioural activation diaries/plans, case formulation worksheets, thought records, and resources to support the identification of conditional beliefs were regarded as most effective. Symptom measures, sleep diaries, and computerised/online materials were considered only moderately effective. Therapists use a wide range of materials to support individual CBT. For delivering CBT, technology-enabled approaches should incorporate a range of materials to enable therapists to tailor treatment effectively.     

Correcting distorted perception of sleep in insomnia: a novel behavioural experiment?

Patients with primary insomnia overestimate their sleep onset latency (SOL) and underestimate their total sleep time (TST). The present study aimed to test the utility of a novel behavioural experiment designed to correct distorted perception of sleep among patients diagnosed with primary insomnia. Individuals with primary insomnia were asked to wear an actigraph and keep a sleep diary for three nights. On the following day, half were shown the discrepancy between the data recorded on the actigraph and their sleep diary (Shown-Discrepancy Group), the other half were not shown the discrepancy (No-Demonstration Group). Participants were then asked to wear the actigraph and keep a sleep diary for three further nights. Following the behavioural experiment, the Shown-Discrepancy Group estimated their SOL more accurately and reported less anxiety and preoccupation about sleep compared to the No-Demonstration Group. The theoretical and clinical implications of these findings are discussed.     

How to assess children’s virtue literacy: methodological lessons learnt from the Knightly Virtues programme

Character education is of growing importance in educational discourse. The Knightly Virtues programme draws on selected classic stories to teach eight moral virtues to nine- to 11-year-olds; it has proved to be hugely popular with UK schools. A finding of the trial was the different levels of ‘virtue literacy’ in faith and non-faith schools. This article outlines the key features of this trial which yielded the positive results and details its methodological strengths and potential shortcomings. Overall, statistical concerns are less problematic than the practical concerns of running trials designed to measure the impact of character education interventions. Of greatest theoretical interest is the conflation of general and virtue-specific literacy; in addition, we tease apart differences in understanding and motivation. The article highlights and discusses the challenges of running trials designed to measure character education, as well as providing insights into promising methodological approaches.     

Maintenence of improvement in agoraphobic patients treated by behavioural methods—a four-year follow-up

Fifty-six agoraphobic patients who had shown clinical improvement when treated by behavioural methods were followed-up between 3.0 and 6.3 yr (mean 4.3 yr) later. Comparison of pre- and post-treatment and follow-up self-assessment data showed that improvement had been maintained on all the variables assessed—main symptom, other phobias, depression, social relationships and disruption at work. Only one patient reported the emergence of new psychological symptoms. However, only 10 (18%) of the sample described themselves as completely symptom-free, although most of the remainder reported that their symptoms caused them only slight distress, and little disruption in their lives.     

Rules all the way down: Consumer behaviour from the standpoint of the ‘ONE behavioural’ research programme

This article sets out a unified behavioural research programme that integrates compatible elements of old, new and evolutionary behavioural approaches to economics as an alternative to the dominant unified approach to economics based on rational choice theory and a Walrasian view of market coordination. However, the proposed programme can also be viewed as a general framework for interdisciplinary research on consumer behaviour. It employs the view of scientific research programmes proposed by Lakatos, setting out groups of ‘hard-core’ propositions and their associated ‘do’ and ‘do not’ rules for the conduct of researchers. The unifying theme is that evolution in the economy (and in human systems more generally) entails the creation, adoption and abandonment of rules for dealing effectively with open-ended choice problems that are bedevilled by infinite regress problems and cognitive challenges that people seek to address via personal repertoires of hierarchically related rules. To anticipate behaviour, researchers need to develop knowledge of these rules (including heuristics and routines), their functionality and the processes by which they get changed or prove difficult to change even where they cause problems.