AUGMENTING SIMPLIFIED HABIT REVERSAL IN THE TREATMENT OF ORAL-DIGITAL HABITS EXHIBITED BY INDIVIDUALS WITH MENTAL RETARDATION

We investigated whether a simplified habit reversal treatment eliminates fingernail biting and related oral-digital habits exhibited by individuals with mild to moderate mental retardation. Although simplified habit reversal did little to decrease the target behaviors for 3 of 4 participants, simplified habit reversal plus additional treatment procedures decreased the behavior to near-zero levels for all participants. These procedures included remote prompting, remote contingencies involving differential reinforcement plus response cost, and differential reinforcement of nail growth. Limitations of habit reversal for individuals with mental retardation along with directions for future research involving therapist-mediated treatment procedures, particularly those involving remote prompting and remote contingencies, are discussed.     

Evaluating the duration of the competing response in habit reversal: a parametric analysis.

The effectiveness of habit reversal was compared across three different competing response (CR) durations. Results showed that 1‐min and 3‐min CR durations were associated with short‐term and long‐term increases in nail length for people who bit their nails. A 5‐s CR duration produced immediate increases in nail length that were not maintained. Social validity data were consistent with these findings.     

Treating nailbiting: a comparative analysis of mild aversion and competing response therapies.

This study compared two methods of treating nail-biting. One method involved the use of a mild aversive stimulus in which subjects painted a bitter substance on their nails, and the other required the subject to perform a competing response whenever they had the urge to bite or found themselves biting their nails. Both methods included self-monitoring of the behaviour, and a third group of subjects performed self-monitoring alone as a control condition. The study lasted four weeks. Twenty-one subjects, seven per group, participated. Both methods resulted in significant improvements in nail length, with the competing response method showing the most beneficial effect. There was no significant improvement for the control group. The competing response condition also yielded significant improvements along other dimensions such as degree of skin damage and subjects own ratings of their control over their habit. These were not seen for the other two conditions. The benefits of this abridged version of Azrin and Nunn's (Behaviour Research and Therapy, 11, 619-628, 1973) habit reversal method in terms of treatment success, use of therapist time and client satisfaction, are discussed.     

The Design and Evaluation of a Hope Enhancement Programme for Adults

The study evaluated the effectiveness of a hope enhancement programme for a group of adults and its impact on general psychological well-being. The intervention programme focused on participants' abilities to set feasible goals, planning ways to reach those goals (pathways) and increase determination and motivation (agency) to reach these goals. The workshop-format programme, consisted of six two-hour sessions conducted over five days. A pre and post-test design included an experimental group (n = 8), control group (n = 8) and ‘chat group’ (n = 8). Findings indicated that the programme increased hope levels of the experimental group as indicated by the Hope Scale and the Hopefulness Subscale of the Hunter Opinions and Personal Expectations Scale. Well-being also improved as indicated by a significant increase in sense of coherence along with a positive change in satisfaction with life. Recommendations for future research were made.     

Relax and try this instead: abbreviated habit reversal for maladaptive self-biting.

We evaluated the effectiveness of an abbreviated habit reversal procedure to reduce mal-adaptive oral self-biting in an adolescent boy in residential care. Treatment involved a combination of relaxation and two competing responses. Results of a withdrawal design and two posttreatment medical evaluations indicated that the intervention eliminated the biting and the tissue damage it caused.     

Habit reversal treatment of thumbsucking

About 40% of young children suck their thumbs, an action which is associated with dental problems and for which intra-oral devices have been the most effective treatment. The present study of 30 thumbsucking children evaluated the habit reversal treatment which included competing response training, parental support, and stimulus identification during a single session plus follow-up maintenance by the parent. Habit reversal training reduced thumbsucking by 92% in the first week, 95% in the fourth month, and 89% at the 20-month follow-up. A comparison treatment by a bitter tasting substance produced a reduction of about 35%.     

Reducing speech disfluencies during public speaking using brief habit reversal

Recent research has evaluated the effects of brief habit reversal, consisting of either awareness training (AT) and competing response training (Mancuso & Miltenberger, 2016), or AT alone (Spieler & Miltenberger, 2017) in reducing speech disfluencies during public speaking. Although both formats of brief habit reversal reduced rates of speech disfluencies, results suggested that teaching a competing response (CR) may produce better outcomes. We aimed to replicate and extend those studies by evaluating the effects of AT and instructing the use of a CR (a silent pause) on rates of speech disfluencies and CRs during public speaking. Following training, all 4 participants demonstrated a reduction of speech disfluencies, and 1 participant demonstrated moderate levels of CRs when giving a speech in front of both a single experimenter and small audience. For 1 participant, generalized effects were demonstrated when presenting in front of a class.     

Citizens of the World and their Religion

Abstract

The notion of a ‘cosmopolites’ has diverged quite far from its philosophical origins, but may eventually serve a similar function. The hope of a global peace or any sort of global management is probably better fulfilled in a federation or complex network of self-governing communities than in a global empire. With or without such an empire though we need some widely shared ‘morale’ or ‘religion’ that will sustain cooperation and obedience to the common good. There are many such competing ‘religions’ and utopian ideals, such that an ongoing global war between superficially distinct but also alarmingly similar power blocks (as described by Orwell) may seem inevitable. A more hopeful future would be one where bourgeois values, a new respect for other terrestrial life, and an awareness of the vastness and strangeness of the cosmos provide a backdrop for such cooperation, on Earth or out among the stars, as we can manage. The rules of trade and transport in such a future may be in the hands of something like Kipling’s Aerial Board of Control, staffed by a new sort of cosmopolitan, subject to occasional popular rebuke. Whether such an order would avoid division must be doubtful still.     

Counselling in general practice: Clients' perceptions of significant events and outcome

An investigation of clients' perceptions of the change process and outcome of counselling in primary care is presented. Significant events were identified by 51 clients post-session for a mean of 4.7 counselling sessions. Outcome was assessed by clients, through their perceptions of goal attainment and change in quality of life from pre-to post-counselling. Four-hundred-and-nine events were categorized by use of the Therapeutic Impact Content Analysis System (TICAS) and a content analysis system was created to categorize clients' goals. Results showed that ‘reassurance’, ‘problem solution ’, ‘insight’ and ‘involvement’ impacts were reported most frequently by clients. No category of significant events was related to change in quality of life. For 11 clients who set goals in the ‘expression’ category, more ‘reassurance’ and fewer ‘problem solution’ impacts were related to attainment of ‘expression’. Some suggestions are made for the lack of significant relationships with overall measures of outcome and it was suggested that more qualitative analysis of the process of outcome is needed.     

Evaluation of a cognitive-behavioural program for the management of chronic tic and habit disorders

The aim was to evaluate the efficacy of a manualized cognitive-behavioural program based on habit reversal for the management of chronic tic disorder (CTD) and habit disorder (HD). Forty-seven CTD and 43 HD received a 4-month treatment program. Thirty-eight (22 CTD, 16 HD) were placed on a waitlist control group, which subsequently received treatment. The treatment approach combined awareness training, relaxation (including modification of a tension-producing style of action), and habit-reversal training, with more general cognitive restructuring of anticipations linked to ticcing. Sixty-five percent of completers reported between 75 and 100% control over the tic. At 2-year follow-up, 52% rated 75-100% control. There were also significant changes post-treatment in measures of self-esteem, anxiety, depression and style of planning action. Successful tic/habit modification was associated in CTD and HD groups with successful change in style of planning action. There were no consistent differences in any outcome measures between CTD and HD groups.     

The group as a self-active system: Outline of a theory of group action

Human social systems, and groups in partlcular, are conceived as units which, as a whole, actively strive towards the achievement of external and internal goals. This ‘group action’ consists of simultaneous integrated processes on various individual and social levels. Our theory comprises four groups of constructs, which refer to task structure, group structure, information processing and execution. In an ongoing group action, the task structure is projected on the group structure; according to the resulting pattern, the group processes its action related information and executes the act. The latter two processes proceed on two levels, on an individual and on a group level. There are cognition, emotion and volition on the individual, and communication on the group level of information processing; execution proceeds in individual action and in cooperation. A specific part of the theory concerns analogies between individual cognition and intragroup communication.     

Interactive effects of training condition and septal lesions on perseverative responding in the rat.

Rats that had received septal lesions either prior to acquisition of a position habit (Group SAR) or immediately after position habit acquisition (Group SR) were tested on two reversals of the task. Compared with control-operated rats, both groups of rats with septal lesions exhibited position-habit reversal deficits. The two groups with septal lesions could not be distinguished in terms of the total number of errors made during reversal learning, but could be distinguished on the basis of the type of error committed. Compared with Group SR, Group SAR made significantly more perservative errors on the first reversal and significantly fewer perserverative errors on the second reversal. Group SR made significantly more nonperservative errors than Group SAR on both reversals.     

SIMPLIFIED HABIT REVERSAL TREATMENT FOR CHRONIC HAIR PULLING IN THREE ADOLESCENTS: A CLINICAL REPLICATION WITH DIRECT OBSERVATION

Three developmentally normal adolescents with chronic hair pulling were treated with a simplified habit reversal procedure consisting of awareness training, competing response training, and social support. Treatment resulted in an immediate reduction to near-zero levels of hair pulling, with one to three booster sessions required to maintain these levels. The results were maintained from 18 to 27 weeks posttreatment, although 1 participant reported difficulty at follow-up. The effectiveness of simplified habit reversal and suggestions for future research are discussed.     

Inside it was orange squash concentrate: trainees’ experiences of reflective practice groups within clinical psychology training

Despite many clinical psychology training programmes utilising reflective practice groups (RPGs) to develop reflective practice (RP) skills, there remains little research examining how trainees experience these groups. This study uses interpretative phenomenological analysis (IPA) to explore the experiences of eight qualified clinical psychologists who attended RPGs on one United Kingdom (UK) clinical psychology training programme. A purposive sample was recruited for single, semi-structured interviews. Five superordinate themes were identified: ‘The process: there were so many layers’; ‘The impact: an ongoing process’; ‘Commitment: I hated it, but I still went’; ‘The facilitator: a presence who was not always present’; and ‘Getting through it: finding ways to cope’. The findings illustrate the varied and complex experiences of the participants. Whilst the experience was often difficult, the participants were committed to attending and sought out ways to navigate it. The results are conceptualised in terms of existing psychological theory and literature. A critique of the research and suggestions for future studies are offered, including exploring the views of group facilitators and comparing how groups are utilised within different training programmes. Recommendations are made on the development of future RPGs, which include consideration of the facilitation style and the groups’ frequency and size.     

Testing Theoretical Explanations of Intention to Seek Care for a Breast Cancer Symptom1

The purpose of this research was to test theoretical explanations of intention to seek care promptly for a breast cancer symptom. Psychosocial variables (affect, expectations, values, and norms), habit, and facilitating conditions (e.g., insurance) regarding care seeking were proposed to influence intention to seek care promptly. Whether psychosocial variables and habit influenced intention directly or in interaction with facilitating conditions remained unclear. Other variables (i.e., clinical and demographic) were proposed to influence intention by mediation through the theoretical variables. Community-dwelling women without history of breast cancer (N= 99) responded to a questionnaire to assess study variables. In a hierarchical set regression, intention was first regressed on psychosocial variables, habit, and full insurance coverage for care, then on terms representing interactions of insurance coverage with psychosocial variables and habit, and lastly on clinical and demographic variables. Findings revealed that (a) anxiety (measure of affect), utility, (the product of expectations and values), and habit were related to intention, (b) having full insurance coverage did not moderate these relationships, and (c) after controlling for theoretical variables, family history of breast cancer was related inversely to intention. Implications for theory, research, and practice are delineated.     

Change in the relative contributions of habit and working memory facilitates serial reversal learning expertise in rhesus monkeys

Functionally distinct memory systems likely evolved in response to incompatible demands placed on learning by distinct environmental conditions. Working memory appears adapted, in part, for conditions that change frequently, making rapid acquisition and brief retention of information appropriate. In contrast, habits form gradually over many experiences, adapting organisms to contingencies of reinforcement that are stable over relatively long intervals. Serial reversal learning provides an opportunity to simultaneously examine the processes involved in adapting to rapidly changing and relatively stable contingencies. In serial reversal learning, selecting one of the two simultaneously presented stimuli is positively reinforced, while selection of the other is not. After a preference for the positive stimulus develops, the contingencies of reinforcement reverse. Naïve subjects adapt to such reversals gradually, perseverating in selection of the previously rewarded stimulus. Experts reverse rapidly according to a win-stay, lose-shift response pattern. We assessed whether a change in the relative control of choice by habit and working memory accounts for the development of serial reversal learning expertise. Across three experiments, we applied manipulations intended to attenuate the contribution of working memory but leave the contribution of habit intact. We contrasted performance following long and short intervals in Experiments 1 and 2, and we interposed a competing cognitive load between trials in Experiment 3. These manipulations slowed the acquisition of reversals in expert subjects, but not naïve subjects, indicating that serial reversal learning expertise is facilitated by a shift in the control of choice from passively acquired habit to actively maintained working memory.     

Mediating between international knowledge and local knowledge: The critical role of local field officers in an HIV prevention intervention

The outcomes of health interventions are co‐constructed through negotiation between the competing knowledges of different stakeholders. In such a context, local implementing partners – who mediate between international donors/programme managers and local beneficiary communities – have a critical ‘knowledge brokering’ role to play. With appropriate support, they can facilitate integration of internationally established knowledge with local beliefs and practices in ways that support health‐enhancing behaviour change. This paper focuses on the local field officers of an HIV prevention programme with Cambodian military couples. The paper asks: (1) what are the outcomes of knowledge encounters between international organizations and local field officers, as expressed in field officers' interpretation of programme goals, strategies and messages? (2) To what extent does the intervention context support the field officers' knowledge brokering efforts? Data collected includes semi‐structured interviews, observations of programme meetings and activities, and textual materials. The findings demonstrate that field officers privilege international knowledge, particularly in interactions with international manager–partners. However, in the field, they both hybridize programme messages and struggle to resolve dilemmas provoked by conflicting international and local knowledges. Material and symbolic asymmetries within the intervention context are shown to undermine their knowledge brokering efforts, as field officers attempt to claim identities and futures as health development professionals. Implications for programme practices and accountability systems are discussed. Copyright © 2010 John Wiley & Sons, Ltd.     

Experiments on habit reversal in the white rat following electro-convulsive treatment

Rats in a T-maze were taught two opposite habits successively, the first being heavily over learned compared to the second. One group of 14 rats was then given a series of 6 electroconvulsive shocks. The control group of 11 rats underwent a dummy procedure.

Tested subsequently the control group maintained the second habit but among the shocked animals some adopted the second habit and some the first. This was no evidence of habit reversal, however, for the behaviour of the shocked animals at the choice point was not distinguishable statistically from random behaviour.

The data of earlier workers are re-examined and, in all cases, animals said to have undergone habit reversal act as if at random.     

The Effect of Learning vs. Outcome Goals on Self-Efficacy, Satisfaction and Performance in an MBA Program

Dans cette expérience de terrain, on applique la théorie de la fixation des objectifs au sentiment d’efficacité personnelle d’étudiants, à leur satisfaction envers le programme du MBA aussi bien qu’à leur performance (GPA). Immédiatement après leur avoir fixé des objectifs spécifiques élevés, nous avons mesuré le sentiment d’efficacité personnelle des étudiants en MBA. Celui des étudiants de la condition “objectifs de résultats pour la fin de l’année” (long terme) était inférieur à celui de sujets qui étaient dans la condition “faites de votre mieux” ou dans celle “but d’apprentissage”. Les sujets présentant des difficultés spécifiques en ce qui concerne les buts d’apprentissage sont plus satisfaits du programme MBA que ceux des autres conditions expérimentales. Le GPA était significativement plus élevé dans la condition “but d’apprentissage” que dans celle “but de performance”à long terme. Les sujets qui ont des objectifs à court terme et un objectif de résultat à long terme ont un GPA plus élevé que ceux qui ont seulement un objectif à long terme ou que ceux qui sont dans l’urgence de faire de leur mieux. Les implications de ces résultats pour la théorie et la pratique sont discutées. The present field experiment examined the application of goal setting theory on student self‐efficacy, satisfaction with the MBA program, as well as performance (i.e. GPA). Immediately after setting specific high goals, the self‐efficacy of MBA students who set year end (distal) outcome goals was lower than participants in either the “do your best” or the learning goal conditions. Participants who set specific difficult learning goals had higher satisfaction with the MBA program than those in other experimental conditions. GPA was significantly higher in the learning goal condition relative to the distal performance goal condition. Participants who set proximal goals, in addition to a distal outcome goal, had a higher GPA than those who only set a distal goal or those who were urged to do their best. Implications of these findings for theory and practice are discussed.