Paradoxical intention in the treatment of urinary retention

Although most cases of psychogenic urinary retention can be ameliorated by a program composed of various behavioral techniques, there is a small percentage of cases which resists the behavioral treatment of choice. The present multiple case paper focused on the treatment of several resistant cases of functional urinary retention. Following a two week baseline period, each individual was exposed to eight weekly behavioral sessions. Whereas most cases of urinary retention have significantly improved by this time, the five individuals chosen for the present study were dissatisfied with their progress. Thus, following the eighth week, paradoxical intention was employed. Within six weeks treatment for the urinary problem was terminated as all clients were comfortable with this aspect of their daily behavior. It was hypothesized that cases of psychogenic urinary retention which resist behavioral techniques are possibly exacerbated by performance anxiety. Such anxiety can be efficiently handled by paradoxical intention.     

Cognitive-behavioural approaches in the treatment of hypochondriasis: six single case cross-over studies.

This study evaluates a cognitive and a behavioural treatment protocol for hypochondrical complaints. In a cross-over design, six patients with a primary diagnosis of hypochondriasis were treated. Three of them first received a block of behavioural therapy (exposure in vivo and response prevention), followed by a block of cognitive therapy. The other three patients were first treated with cognitive therapy followed by behavioural therapy. The results were promising: four patients made significant improvements. The behavioural therapy sessions appeared to account more often for improvement than did the cognitive sessions. The sequence of behavioural therapy followed by cognitive therapy tended to be more successful than the other way around. The results of these six case studies suggest that exposure in vivo with response prevention and cognitive therapy may both be useful in the treatment of hypochondriasis. A journal controlled study is recommended.     

一例运用催眠疗法治疗失眠症的案例报告

本次案例主要采用催眠疗法,并结合行为疗法和认知疗法对个案进行了心理问题的矫正,尤其是将系统脱敏和认知疗法融入到催眠疗法之中,在对求助者的心理进行整合式治疗后,其睡眠状况明显改善,精神状况得到提高,抑郁情绪消除,焦虑程度显著降低。再次进行问卷自测后分数明显下降,该咨询取得了较好的效果。     

Paradoxical intervention using a polarization model of cotherapy in the treatment of elective mutism: A case study

A case history is presented of a four and-a-half year-old electively mute child who was successfully treated by the authors. The treatment approach involved paradoxical interventions in the context of a polarization model of cotherapy in combination with behavioral techniques in a family therapy framework.     

Developmental dyslexics do not fit in boxes: Evidence from six new case studies

Abstract

Six subjects with a reading problem were tested on a variety of reading and other tasks including tests of phonological awareness and processing, short-term memory, visual analysis and synthesis, memory for faces and pictures, and matching of letters and shapes. The subjects demonstrated differences in their reading strategies, but these showed no relation to any differences in the patterns of deficit on non-reading tasks. Five of them showed severe problems on tasks involving phonological processing and short-term memory but the seventy of these was unrelated to reading strategy. There were some indications of visual weaknesses, but these were severe in only one subject who had a pronounced defect in memory for faces; there was no evidence that the visual weaknesses were consistently related to reading ability or strategy.

It is concluded that all the subjects in this sample (with one 'possible exception) had a deficit in phonological processing but adopted different strategies to cope with this when faced with the task of converting print to sound. Differences in strategy are likely to be affected by the relative efficiency of other cognitive processes, personality and introdctional factors.     

Therapist factor in the treatment of insomnia

This quasi-experiment attempted to replicate the finding of Turner and Ascher (1979) in contrasting progressive relaxation, stimulus control and paradoxical intention therapies for the treatment of insomnia using clinicians-in-training as therapists. Progressive relaxation and stimulus control were again shown to be effective, paradoxical intention instructions were not. A significant therapist effect was found which is discrepant with previous findings in the field.     

Four process studies in the behavioral treatment of chronic headache

Four studies of ‘process’ variables in the behavioral treatment of chronic headache are examined. No relation between headache activity-level reduction and therapist variables such as level of experience (study 1) or warmth, competence or helpfulness as perceived by the patient (Study 2) was found from treatments using relaxation training and/or biofeedback. A significant relation was found, however, between regularity of relaxation practice at home (Study 4) and headache-activity reduction and between regularity of showing some degree of hand warming in thermal biofeedback treatment for vascular headache and headache activity-level reduction (Study 3). Finally, no relation was found between changes in EMG and headache activity-level for tension-headache sufferers treated with frontal EMG biofeedback.     

Employing paradoxical intention in the treatment of agoraphobia

The present study assessed the efficacy of paradoxical intention in ameliorating the travel restriction of agoraphobics. A combined score indicating proximity to two difficult target locations represented the dependent variable. A multiple baseline across subjects was used with each of two groups of five clients. This was accomplished by sequentially staggering introduction of treatment. At the conclusion of baseline phase. Group A received 6 weeks of gradual exposure followed by paradoxical intention to criterion. Group B received paradoxical intention to criterion immediately after baseline. Results indicated that paradoxical intention produced greater movement toward targets for clients in Group B when compared both with their baseline and with the performance of Group A following an equal period of gradual exposure.     

Examining outcome variability: correlates of treatment response in a child and adolescent anxiety clinic

Examined correlates of treatment response in a clinic providing cognitive-behavioral therapy for children with anxiety disorders. Youth (ages 7 to 15) with a primary Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev., or 4th ed.; American Psychiatric Association, 1987, 1994) anxiety-disorder diagnosis (overanxious disorder, generalized anxiety disorder, separation anxiety disorder, social phobia, or avoidant disorder) participated. After completing a full course of treatment and posttreatment (n = 135) and 1-year follow-up (n = 107) assessments, participants were classified into 1 of 2 groups--poor treatment response and good treatment response--using parent diagnostic reports. Discriminant function analyses indicated that higher levels of maternal- and teacher-reported child-internalizing psychopathology at pretreatment, higher levels of maternal self-reported depressive symptoms, and older-child age were all associated with less favorable treatment response. Other factors, such as child ethnicity, child sex, family income, family composition (i.e., dual parent vs. single parent), child-reported symptomatology, and maternal-reported level of child-externalizing behavior problems did not predict treatment response. Both practical and conceptual implications of the findings are discussed.     

Articulatory suppression and the treatment of insomnia

The prominence of intrusive thoughts in insomnia suggests the relevance of cognitive techniques to control them. It is suggested that the technique of Articulatory Suppression derived from Baddeley's model of Working Memory provides a relevant approach. The technique is presented as it was developed with a preliminary uncontrolled case series. A single-case experiment is then reported in which Articulatory Suppression was compared with other techniques. The preliminary indications are that it may be particularly helpful for sleep maintenance problems.     

Paradoxical drug response and the placebo effect: a discussion of Grunbaum's definitional scheme

Grunbaum claims that the remedial failure of atreatment's characteristic factors is thegeneric, objective property of a placebo. Hestipulates that a treatment is placebic if thisremedial failure exacerbates the targetdisorder. This stipulation can subsume asplacebic effects that might be solelypharmacological, e.g., paradoxical reactions tocertain psychiatric drugs. If that exacerbationcan be explained pharmacologically, then wemight question whether Grunbaum's definitionalscheme captures the core identity of what weusually intend by the placebo concept. Ipropose that this core identity is bestcaptured by a symbolic meaning hypothesis inwhich psychological factors exert thedeterminative influence.     

Extending overjustification: the effect of perceived reward-giver intention on response to rewards

The perceived intention model incorporates a new moderator, beliefs about reward-giver intention, into the overjustification paradigm. In 2 simulated shopping studies featuring products paired with promotional rewards, consumers who believed the marketer was promotion focused (reward used to encourage purchase) reported lower purchase intentions and brand attitudes for promoted products after promotion, whereas consumers who believed the marketer was reward focused (promotion used to distribute the reward) showed no attitude change. Promotion-focus beliefs lowered attitudes by heightening the contingency between the promotion and purchase and thereby increasing the perceived causal role of the reward. This effect was contingent on initial behavior--postpromotion attitude change occurred for consumers who actively engaged in product decisions but not for consumers who passively observed the choice sets.     

Interpretive biases in chronic insomnia: an investigation using a priming paradigm

Disorder-congruent interpretations of ambiguous stimuli characterize several psychological disorders and have been implicated in their maintenance. Models of insomnia have highlighted the importance of cognitive processes, but the possibility that biased interpretations are important has been minimally investigated. Hence, a priming methodology was employed to investigate the presence of an interpretive bias in insomnia. A sample of 78 participants, differing in the presence of a diagnosis of insomnia, severity of sleep disturbance, and sleepiness, was required to read ambiguous sentences and make a lexical decision about target words that followed. Sleepiness at the time of the experiment was associated with the likelihood with which participants made insomnia and threat consistent interpretations of ambiguous sentences. The results suggest that there is a general bias towards threatening interpretations when individuals are sleepy and suggests that cognitive accounts of insomnia require revision to include a role for interpretative bias when people are sleepy. Future research is required to investigate whether this interpretive bias plays a causal role in the maintenance of insomnia.