A controlled evaluation of acceptance and commitment therapy plus habit reversal for trichotillomania

This randomized trial compared a combined Acceptance and Commitment Therapy/Habit Reversal Training (ACT/HRT) to a waitlist control in the treatment of adults with trichotillomania (TTM). Twenty-five participants (12 treatment and 13 waitlist) completed the trial. Results demonstrated a significant reduction in hair pulling severity, impairment ratings, and hairs pulled, along with significant reductions in experiential avoidance and both anxiety and depressive symptoms in the ACT/HRT group compared to the waitlist control. Reductions generally were maintained at a 3-month follow-up. Decreases in experiential avoidance and greater treatment compliance were significantly correlated with reductions in TTM severity, implying that targeting experiential avoidance may be useful in the treatment of TTM. Other implications and suggestions for future research are noted.     

Exposure therapy for social anxiety disorder in people who stutter: An exploratory multiple baseline design

Background & objectives: Social anxiety disorder (SAD) is a debilitating condition, and approximately half of adults who stutter have SAD. Cognitive-behavioral therapy (CBT) has shown promise in decreasing social anxiety symptoms among adults who stutter, but exposure, arguably the essential component for successful CBT for SAD, has been understudied and underemphasized. Aims of this study were to develop an exposure therapy protocol designed specifically for people who stutter and have SAD and evaluate its potential efficacy in reducing social anxiety and stuttering severity using a multiple baseline design.Methods: Six participants received ten sessions of exposure therapy. Participants reported daily social anxiety, and social distress and stuttering severity were evaluated at major assessment points.Results: There were substantial reductions in social anxiety and considerable improvements in affective, behavioral, and cognitive experiences of stuttering. No consistent change was observed for stuttering frequency. Gains were mostly maintained after six-months.Conclusions: Results suggest that the novel exposure approach may decrease social distress, but not necessarily influence speech fluency. These findings underscore the importance of the assessment and treatment of SAD among adults who stutter and suggest that the integration of care between clinical psychologists and speech-language pathologists may prove beneficial for this population.     

Behavioral and pharmacological treatments for tourette syndrome: A review

This article reviews the published treatment outcome research on pharmacological and behavioral treatments for Gilles de la Tourette syndrome (TS). Controlled group outcome studies of pharmacological treatments show about a 50–60% reduction in tics with haloperidol and pimozide and about a 20% reduction with clonidine. A controlled group outcome study and several within-subject design studies of behavioral treatments show about a 90% reduction in tics with habit reversal training. A large number of case studies generally confirm these results and also show benefits from other behavioral treatments such as relaxation training, self-monitoring, and contingency management. Clinical limitations of TS drugs are that they produce side effects in 50–85% of the patients and require continuous use, and long-term compliance with the medications is limited. The primary limitation of behavioral treatments is that they require a large initial time commitment. The methodological strengths of the controlled drug studies are the use of double-blind and group designs. For the behavioral studies, the strengths are rigorous recording and controlled within-subject designs.     

Selective attention for masked and unmasked threatening words in anxiety: Effects of trait anxiety, state anxiety and awareness

We investigated the effects of awareness on selective attention for masked and unmasked verbal threat material using a computerised version of the emotional Stroop. Participants were assigned to the high trait anxious (HTA) and low trait anxious (LTA) groups on the basis of questionnaire scores, and state anxiety was manipulated within participants through the threat of electric shock. To investigate the effects of awareness on responses to threat, the mode of exposure was blocked such that half the participants received masked trials before the unmasked trials, whereas the other half received the reverse order. The results revealed that there was no difference between the HTA and LTA groups in responses to threat for those who received the masked trials before the unmasked trials. However, when unmasked trials were presented before the masked trials HTA individuals were significantly slower to respond to both masked and unmasked threat words compared to the LTA group, and these effects were not further modified by participants' state anxiety status. The results are discussed in terms of the automatic nature of threat processing in anxiety.     

Long-term memory for performed and observed actions: Retrieval awareness and source monitoring

The self-performed task (SPT) paradigm was employed to investigate incidental memory for action events, focusing on states of awareness at retrieval (Remembering–Knowing) and source monitoring in performed and observed actions, at delays of 1 and 2 weeks. Recognition was better for performed than observed actions, but this effect was visible only after 1 week of retention. Conversely, observed actions were associated with better source memory at both delays. When the source was correctly identified, performed and observed actions were accompanied by equal proportions of Remember judgements. However, when source monitoring was incorrect, performed actions were more frequently associated with a feeling of re-experiencing the original event, thus suggesting an enactment-related recollective superiority, although secondary to the availability of reliable contextual information.     

The challenge of raising ethical awareness: A case-based aiding system for use by computing and ICT students

Students, the future Information and Communication Technology (ICT) professionals, are often perceived to have little understanding of the ethical issues associated with the use of ICTs. There is a growing recognition that the moral issues associated with the use of the new technologies should be brought to the attention of students. Furthermore, they should be encouraged to explore and think more deeply about the social and legal consequences of the use of ICTs. This paper describes the development of a tool designed to raise students’ awareness of the social impact of ICTs. The tool offers guidance to students undertaking computing and computer-related courses when considering the social, legal and professional implications of the actions of participants in situations of ethical conflict. However, unlike previous work in this field, this tool is not based on an artificial intelligence paradigm. Aspects of the theoretical basis for the design of the tool and the tool’s practical development are discussed. Preliminary results from the testing of the tool are also discussed. An earlier version of this paper was presented by one of the authors at the First International Conference on Teaching Applied and Professional Ethics in Higher Education, Federal University of Surrey Centre for Applied Ethics, Southlands College, Roehampton, London, 2–4 September, 2003.     

A Survey of Rewards for Teens: Extension and 25-Year Follow-Up

Extant reward surveys and item preferences assessments have shown to be a reliable mode of ascertaining potential reinforcers for various populations; however, many are outdated and may comprise of items or rewards that contemporary populations may not value. The purpose of this research is to extend upon the Houlihan, Jesse, Levine, and Sombke (1991 Houlihan, D., Jesse, V. C., Levine, H. D., &; Sombke, C. (1991). A survey for use with teenage children. Child &; Family Behavior Therapy, 13(1), 1–11.[Taylor &; Francis Online], [Web of Science ®] , [Google Scholar]) Survey of Rewards for Teens (SORT) and assess whether there is evidence of a potential, generational shift in reward preferences in high school students from 1991 to 2016. This inquiry is of particular importance to behavior analysts due to the idiosyncratic nature of reward preference, a tendency for rewards to shift over time, and the salient role played by rewards in behavior therapy programs. Results suggest that the reward preferences of contemporary high school students differ when compared to the sample of adolescents in Houlihan et al. (1991 Houlihan, D., Jesse, V. C., Levine, H. D., &; Sombke, C. (1991). A survey for use with teenage children. Child &; Family Behavior Therapy, 13(1), 1–11.[Taylor &; Francis Online], [Web of Science ®] , [Google Scholar]) study. In addition, a proposed revision of the SORT is provided, whose development was derived based on the resulting component structure from a principal components analysis (PCA) and inspection of component psychometric properties.     

Comparison of behavioral and cognitive-behavioral one-session exposure treatments for small animal phobias

This study evaluated the efficacy of behavioral and cognitive-behavioral one-session exposure treatment procedures with and without programmed generalization for participants with small animal phobias. Forty participants were randomly assigned to the treatment and generalization conditions. Both treatments produced significant improvements from pre-test to post-test and these results were maintained for 1 year. The treatment effect sizes ranged from large to very large across behavioral, self-report, and subjectively rated measures. Participants in the behavioral treatment condition reported that the treatment was significantly more intrusive than participants in the cognitive-behavioral treatment group. The programmed generalization condition did not produce additional measured benefit. The results are discussed in terms of the overall effectiveness of one-session exposure treatment components for small animal phobias.     

A real-time phoneme counting algorithm and application for speech rate monitoring

Adults who stutter can learn to control and improve their speech fluency by modifying their speaking rate. Existing speech therapy technologies can assist this practice by monitoring speaking rate and providing feedback to the patient, but cannot provide an accurate, quantitative measurement of speaking rate. Moreover, most technologies are too complex and costly to be used for home practice. We developed an algorithm and a smartphone application that monitor a patient’s speaking rate in real time and provide user-friendly feedback to both patient and therapist. Our speaking rate computation is performed by a phoneme counting algorithm which implements spectral transition measure extraction to estimate phoneme boundaries. The algorithm is implemented in real time in a mobile application that presents its results in a user-friendly interface. The application incorporates two modes: one provides the patient with visual feedback of his/her speech rate for self-practice and another provides the speech therapist with recordings, speech rate analysis and tools to manage the patient’s practice. The algorithm’s phoneme counting accuracy was validated on ten healthy subjects who read a paragraph at slow, normal and fast paces, and was compared to manual counting of speech experts. Test-retest and intra-counter reliability were assessed. Preliminary results indicate differences of −4% to 11% between automatic and human phoneme counting. Differences were largest for slow speech. The application can thus provide reliable, user-friendly, real-time feedback for speaking rate control practice.