The rapid-smoking technique: Therapeutic effectiveness

The study examined the effectiveness of the rapid-smoking technique in terms of two measures of outcome—post-treatment abstinence rate and reduction in smoking achieved by non-abstinent subjects. A total of 75 volunteers (40 men and 35 women) participated in treatment and were randomly allocated to one of four conditions—rapid-smoking alone; rapid-smoking and relaxation training; rapid-smoking, relaxation and contingency contracting; or contingent rapid-smoking. No significant differences between treatment conditions were obtained. For the total sample, abstinence was achieved by 64% of the subjects immediately post-treatment but the probability of remaining abstinent 12 months later was only 0.33. Immediately post-treatment the non-abstinent subjects reduced their rate of cigarette consumption to 34.2% (SD = 29.3) of baseline smoking but by 12 months average consumption had increased to 82.4% (SD = 28.3) of baseline. It is concluded that rapid-smoking gives rise to substantial short-term changes in smoking behaviour but these effects are not sustained.     

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.     

A randomized controlled trial of contingency management for smoking cessation in substance use treatment patients

Background/ObjectiveContingency management (CM) is one of the most effective interventions for smokers with substance use disorder (SUD), and no empirical assessment of its long-term efficacy has been conducted so far in a real-world context. The objectives were: (1) examine the additive effectiveness of CM on cognitive-behavioral treatment (CBT) for smoking cessation, and (2) examine the relationship between smoking cessation and substance use abstinence.MethodA total of 80 participants (75.8% males; M_age = 45.31; SD = 9.64) were assigned to two smoking cessation treatments: CBT or CBT+CM. A set of generalized estimating equations were conducted to examine the effect of treatment condition on smoking outcomes, as well as the effect of smoking status on substance abstinence.ResultsAdding CM to CBT for smoking cessation improved tobacco abstinence rates at the end-of-treatment (p = .049). Tobacco abstinence rates declined over time (p = .012), but no significant effects of treatment condition were observed across follow-ups (p = .260). Smoking cessation was not significantly related to substance abstinence (p ≥ .488).ConclusionsCM facilitates early abstinence in smokers with SUD, although effects subside after treatment termination. The lack of association between smoking abstinence and substance use suggests no jeopardizing effects as a result of quitting smoking.     

Return of fear: The role of inhibition

In a previous study investigating the relationship between subjective, physiological and behavioural changes during treatment of specific phobias, a marked between-session increase was found in subjective fear after high, but not after low intensity phobic stimulation although the groups showed similar fear ratings and heart rates immediately after treatment (Grey et al, 1979). It was hypothesized that the high intensity stimulation led to ‘treatment fatigue’; a state of deactivation, the recovery from which led to a return of fear.In this study high intensity in vivo stimulation was used for the treatment of phobic subjects under conditions of distributed and massed practice. No differences emerged between treatment conditions. A small group of Ss with a conspicuously high heart rate (mean level 120 bpm) when rating zero fear, showed a significant increase in fear after one week's interval, although they had shown similar improvement to the Ss during treatment. Subjects in both treatment conditions showed lower heart rate at all post-treatment assessments than pre-treatment. The high initial heart rate Ss continued to have higher heart rate than other Ss throughout the experiment, although they showed a decrease after treatment. It was only these Ss with desynchronously high heart rate, i.e. high heart rate with zero fear ratings, who suffered a return of fear, whereas high heart rate during high fear did not predict either response to treatment or return of fear. A further finding was a lack of correlation between the behavioural and physiological indices of fear, namely, between distance and heart rate at high levels of fear.     

Interpreting inclusion: A contribution to the study of the child's cognitive and linguistic development

Six experiments are reported which examine the young child's ability to compare included and nonincluded sets. Results indicate that with certain forms of task presentation most 3- to 5-year-old children can compare part with whole. Further, errors which occur in inclusion tasks are similar to errors which occur in tasks involving comparison of nonincluded sets. Thus young children can solve inclusion problems, and their customary failure to do so does not arise because the problem requires comparison of a whole with an included part. Employing a distinction between intended tasks (those which the adult wishes the child to complete) and received tasks (those which the child, in fact, completes) the studies indicate how linguistic and perceptual aspects of the presented information may interact with the child's assumptions about the nature of the task to be completed.     

Is control a viable goal in the treatment of pathological gambling?

According to a report of National Gambling Impact Study Commission (National Gambling Impact Study Commission (1999). Final report. Washington, DC: Government Printing Office.), 97% of problem gamblers in the United States do not seek treatment. Within the small proportion of problem gamblers who enter into treatment, a high percentage drops out. Despite the fact that some researchers argue against abstinence as the only acceptable treatment goal and that regaining control over gambling behaviour appears to be possible for some pathological gamblers (PG), abstinence has been the only gambling intervention treatment goal. The primary goal of this study was to verify whether controlled gambling is a viable goal for pathological gamblers. The second goal was to identify the characteristics that predicted a successful outcome for treatment with a controlled gambling goal. Eighty-nine PGs were enrolled in cognitive-behavioural treatment aimed at controlled gambling. Six and twelve month follow-ups were conducted in order to evaluate the maintenance of therapeutic gains and to identify significant predictors of successful controlled gambling. Results showed that using the intent-to-treat procedure, 63% had a score of 4 or less on the DSM-IV at the end of treatment. That proportion was 56% and 51% at the 6- and 12-month follow-ups. If we retain only those who completed the treatment, these proportions increased to 92%, 80% and 71% at post-treatment, 6- and 12-month follow-ups, respectively. On the majority of the measures, significant improvements were found at post-treatment and the therapeutic gains were maintained at the 6- and 12-month follow-ups. However, few variables were identified to predict who would benefit from control rather than abstinence. The clinical and philosophical implications of these results are discussed in this paper.     

The effects of language conditioning on various aspects of anxiety

Staats' three-function learning theory provides the basis for investigating the effects of emotionally-relevant self-verbalizations (SV) on the physiological, subjective-affective and behavioural aspects of anxiety. Using aversive electric UCSs and slides of snakes (CS), anxiety was classically conditioned in 88 volunteer Ss. In 20 subsequent language-conditioning trials (without aversive electric UCSs), the same snakes slides were paired with UCS verbalizations having either positive or negative connotative meanings. Half of the Ss were exposed to a living snake prior to language conditioning. The results show a complete extinction of the conditioned anxiety response in groups with positive SV whereas negative SV impeded extinction; the latter effect could only be found in groups without exposure to snakes prior to language conditioning. In general, the affective evaluation of snakes improved in groups with positive SV and deteriorated in groups with negative SV. However, these effects were more pronounced in groups without exposure to snakes. Although the results indicate that Ss in all groups with positive SV exhibited more approach behaviours than Ss with negative SV, this trend was not statistically significant. The possible relevance of the results for a language-conditioning approach to anxiety reduction is briefly discussed.     

The aftermath of heresy: a response to Pendery et al.'s (1982) critique of "Individualized Behavior Therapy for Alcoholics"

A point-by-point response is presented to Pendery et al.'s (1982) critique of the study “Individualized Behavior Therapy for Alcoholics (IBTA)”. Two independent, external investigations have critically examined the original records from the IBTA study. The IBTA study compared two different techniques for treating poor-prognosis, chronic alcoholic state hospital patients. It was found that a broad-spectrum behavioral treatment oriented to controlled drinking was a more effective treatment than was the standard hospital treatment program based on conventional wisdom. The Pendery et al. critique gave the appearance of being a refutation by presenting findings for only one group of Ss in a comparative study. In this response, it is shown that the experimental and control Ss were justifiably classified as gamma alcoholics, that Ss were randomly assigned to groups, and that the two groups were comparable in terms of pretreatment characteristics. Moreover, as regards the originally reported 2-yr treatment outcome findings, it is shown that Pendery et al, reported no specific events which were not already documented in the original study records which formed the basis for publications about the IBTA study. Finally, even in terms of long-term outcomes, i.e. mortality rates 10–11 yr after treatment, the experimentally-treated group (20% mortality) continued to fare better than the traditionally-treated group (30% mortality). Ironically, rather than Pendery et al.'s report being a refutation of the original published accounts of the IBTA study, it is concluded that the data reported by Pendery el al. actually strengthen the validity of the original publications. The attack on the IBTA study can be meaningfully viewed as a reflection of the scientific revolution presently underway in the alcohol field. The central impetus for conceptual change in the alcohol field, however, derives less from controlled-drinking research than from the lack of empirical support for conventional wisdom. Ideas are changing because the traditional view no longer inspires progress.     

Informational and motivational components of social reinforcement

Thirty-six four-year-old children of each sex were tested in a two-choice marble dropping task. There were three Ss in each cell of a 3 × 2 × 2 × 2 factorial design. The factors investigated were: reinforcement condition (Contingent, Yoked, Nonreinforcement), sex, base preference level (strong vs weak), Base Rate Level (high vs low). The dependent variables were: base preference ratio, base rate, preference ratio change, rate change. The contingently reinforced Ss had significantly higher preference change scores than Ss in the other two reinforcement conditions but only at the high base preference level. The Ss in both the contingent and yoked groups had higher rate change scores than Ss in the nonreinforcement group. The results were interpreted as indicating social reinforcement may have two effects, one a cue function and the other an effect on S's motivational system. The results indicate that regression effects do not operate in the two-choice task and that crossing baseline levels of performance is an effective way to control baseline differences in analyses of change in the two-choice task.     

Does social support predict smoking abstinence in dual-smoker couples? Evidence from a dyadic approach

Background and Objectives: Romantic partners have a significant influence on their health behaviors. Evidence for the effectiveness of social support for smoking abstinence, however, is mixed and the role of social support for smoking abstinence in dual-smoker couples is understudied.

Design: 77 dual-smoker couples were assessed 30 days after a joint quit attempt using a dyadic approach.

Methods: Received and provided support, self-reported and objectively measured smoking abstinence were assessed from both partners. Actor and partner effects of received and provided support on self-reported and objectively measured smoking abstinence and their difference for men and women were investigated with the Actor–Partner Interdependence Model using multilevel modeling.

Results: A significant actor effect emerged: Higher reports of received emotional support were related to an increased likelihood of objective smoking abstinence for men and women alike. For men only, partner effects of women’s received emotional and instrumental support emerged (p?<?.10): Higher reports of women’s support receipt were associated with an increased likelihood of men’s self-reported abstinence.

Conclusion: Received emotional support seems to play a key role in dual-smoker couple’s abstinence, whereas provided support does not seem to make a difference in successful quitting in dual-smoker couples.     

Pilot Cases of Combined Cognitive Processing Therapy and Smoking Cessation for Smokers With Posttraumatic Stress Disorder

Posttraumatic stress disorder (PTSD) and smoking are often comorbid, and both problems are in need of improved access to evidence-based treatment. The combined approach could address two high-priority problems and increase patient access to both treatments, but research is needed to determine whether this is feasible and has promise for addressing both PTSD and smoking.We collected data from 15 test cases that received a treatment combining two evidence-based treatments: cognitive processing therapy–cognitive version (CPT-C) for PTSD and integrated care for smoking cessation (ICSC). We explored two combined treatment protocols including a brief (six-session) CPT-C with five follow-up in-person sessions focused on smoking cessation (n = 9) and a full 12-session CPT-C protocol with ICSC (n = 6). The combined interventions were feasible and acceptable to patients with PTSD making a quit attempt. Initial positive benefits of the combined treatments were observed. The six-session dose of CPT-C and smoking cessation resulted in 6-month bioverified smoking abstinence in two of nine participants, with clinically meaningful PTSD symptom reduction in three of nine participants. In the second cohort (full CPT-C and smoking treatment), both smoking and PTSD symptoms were improved, with three of six participants abstinent from smoking and four of six participants reporting clinically meaningful reduction in PTSD symptoms. Results suggested that individuals with PTSD who smoke are willing to engage in concurrent treatment of these problems and that combined treatment is feasible.     

Finite automata and S−R models

Suppes (1969, Journal of Mathematical Psychology, 6) apparently proved that any finite automaton could be mimicked by the asymptotic behavior of a stimulussampling S?R model, broadly implying that cognitive theory could be reduced to S?R theory. Here it is shown that the finite automata used by Suppes are more restricted and less powerful than finite automata in general. Furthermore, the S?R models proposed by Suppes are limited to producing the behavior of only these restricted automata, and cannot mimic all finite automata. Hence, the formal claim that S?R models are adequate to produce all behaviors obtainable from finite automata, and the informal claim that cognitive theory reduces to S?R theory, do not follow from Suppes's (1969) result. Some alternative S?R models and their problems are also briefly discussed.     

Spouse involvement and a possible long-term follow-up trap in weight loss

The present study was conducted to determine if husband attendance at treatment sessions and participation in behavioral contracting would produce greater weight losses than two other levels of spouse involvement. The three treatment groups investigated did not significantly differ at post-treatment but by 1-yr follow-up female Ss who attended treatment sessions alone and contracted with the counselor (HA) lost significantly more weight than women who attended sessions with their husbands and also contracted with the counselor (HNC). The Ss who attended sessions with their husbands and contracted with them (HC) did not significantly differ from Ss in the other two conditions. The total amount lost by Ss in the HA, HNC and HC conditions by 1-yr follow-up was 16.4, 4.4 and 15.5 lb, respectively. The study was also conducted to collect preliminary data about procedures Ss used during long-term follow-up to ascertain if weight losses during follow-up could be attributed to the behavioral weight-loss techniques learned during the treatment program. At all follow-up periods, many Ss reported using behavioral weight-loss techniques but 4 of the 36 Ss (11.1%) at 1-yr follow-up, 15 of the 23 (65.2%) and 24 of the 25 (96.0%) who responded, respectively, at 3- and 4-yr follow-up had used other weight-loss programs or methods. A possible confound for follow-up data was identified and suggestions for future research were presented.     

Training cooperation in the Prisoner's Dilemma

Female Ss' choices in two types of mixed-motive game situations were used to select Ss who had predominantly Own Gain and Ss who had predominantly Relative Gain goals. On the basis of simple reward notions, it was predicted that the former but not the latter would change from competitive to cooperative responding in decomposed Prisoner's Dilemma game situations when interacting with a conditionally cooperative other. Corresponding yoked controls were not expected to become cooperative. The availability of social comparison with an outcome which was smaller than the mutually cooperative outcome but larger than the mutually competitive out-come was expected to lead Own Gain Ss to more rapid learning of cooperation but not to affect the responses of corresponding yoked controls or of Relative Gain Ss. A 2 × 2 × 2 × 5 factorial design was used in which the factors were goal orientation (Own Gain vs Relative Gain), strategy of the other (conditionally cooperative vs yoked control), the availability vs unavailability of the social comparison, and trials. The results strongly supported each of the expectations. The results were discussed in terms of how the operation of the reward mechanism would be affected by the operation of some other social psychological processes.     

Bases of young children's judgments about more

While the young child's difficulties in correctly comprehending the term less are well known, it appears less widely recognized that young children may also encounter difficulties with the term more. The present study shows that in a task which requires judgments about more to be based on the relative numerosity of sets, 3–4-year-old children may base their judgments on other parameters, such as the extent to which the sets are homogenous with respect to the color of their components. The implications of such findings are briefly considered.     

A technique for controlling speech disfluencies induced by delayed auditory feedback

On the basis of cybernetic models of speech it was hypothesized that “stuttering” induced by delayed auditory feedback could be significantly reduced if the Ss were provided with an alternate input to which they could attend. The results of the experiment supported the hypothesis. The possible implications for the treatment stuttering are discussed.     

Changes in Hypothesized Mechanisms of Change Before and After Initiating Abstinence in Cognitive-Behavioral Therapy for Women With Alcohol Use Disorder

Abstinence self-efficacy, coping skills, and therapeutic alliance are hypothesized mechanisms of behavioral change (MOBCs) in cognitive-behavioral therapy (CBT) for alcohol use disorder (AUD). However, little is known about when these hypothesized MOBCs change during treatment or in relation to the initiation of abstinence from alcohol, which the current study investigated. Patient-reported abstinence self-efficacy, drinking-related coping skills, and therapeutic alliance were measured at every session throughout a 12-session clinical trial that previously showed equivalent drinking reductions in female-specific individual- and group-based CBT for AUD. Participants (N = 121 women) were classified into subgroups based on whether and when they first initiated 14 days of continuous abstinence from alcohol during treatment. Interrupted time-series analyses evaluated the magnitude and timing of change in MOBC variables in relation to the initiation of abstinence. All three MOBC measures showed gradual improvements throughout treatment (within-subjects d = 0.03 to 0.09 change per week). Participants who initiated abstinence during treatment experienced additional sudden improvements in abstinence self-efficacy (d = 0.47) and coping skills (d = 0.27), but not therapeutic alliance (d = -0.02), the same week they initiated abstinence. Participants who were already abstinent when treatment started maintained higher abstinence self-efficacy and coping skills, but not therapeutic alliance, throughout treatment compared to participants who never initiated abstinence. Initiating abstinence may help facilitate improvements in abstinence self-efficacy and drinking-related coping skills. Clinicians may help patients anticipate when and how much these variables are expected to improve during treatment and encourage initiation of abstinence to potentially help facilitate improvements in abstinence self-efficacy and coping skills.     

Randomized Controlled Trial of a Smartphone Application as an Adjunct to Acceptance and Commitment Therapy for Smoking Cessation

There is a major public health need for innovative and efficacious behavioral and cognitive interventions for smoking cessation. This randomized controlled trial evaluated the efficacy of an acceptance and commitment therapy (ACT) smartphone application in augmenting ACT group treatment for smoking cessation. One hundred fifty adults smoking 10 or more cigarettes per day were randomly assigned to 6 weekly group sessions of behavioral support, ACT, or ACT combined with the smartphone application. Access to the app was provided from the start of the in-person treatment until the 6-month follow-up assessment. Participants were encouraged to make their quit attempts after the third session, and the posttreatment assessment occurred 3 weeks later. Measures of smoking status and ACT processes were obtained at baseline, posttreatment, and 6-month follow-up. Biochemically verified quit rates in the combined, ACT, and behavioral support groups were 36% (p = .079 relative to ACT; p = .193 relative to behavioral support), 20% (p = .630 relative to behavioral support) and 24% at posttreatment, as compared with 24% (p = .630 relative to behavioral support), 24% (p = .630 relative to behavioral support) and 20% at follow-up. There was no significant difference (p = > .999) in the primary outcome of biochemically verified 7-day point-prevalence abstinence at 6-month follow-up between the combined and ACT groups. The combined group reported significantly greater smoking reduction, acceptance and present-moment awareness than the behavioral support group at posttreatment, but not at follow-up. There were no significant differences between the groups in positive mental health. Contrary to hypotheses, the ACT group did not display significant improvements in positive mental health or ACT processes relative to the behavioral support group at posttreatment or follow-up. Implications and directions for future research are discussed.     

Psychoticism and arousal: Possible evidence for a linkage of p and psychopathy

A study is described in which two postural conditions (standing, reclining) were used to induced high and low activation levels in normal Ss divided into high and low P groups ( (HP and LP). Electrodermal and heart rate (HR) measures were recorded during each of these activation conditions which included instructions, an initial rest period, a series of tones, a rtwo-flash threshold task and a final rest period. It was found that HP Ss tended to display significantly lower automatic arousability and poorer two-flash performance while undergoing the low activation (Recline) condition. There was a reliable tendency for HP Ss to evidence significantly slower recovery and rise times and to manifest significantly lower response criterion and sensory sensitivity. They also manifested a near significantly lower mean HR than LP Ss. The performance of HP and LP groups was compared to findings reported previously for schizophrenics and psychopaths for these tasks. It was posited that the performance of the HP Ss suggests that psychoticism may be more nearly akin to psychopathy than to schizophrenia.