Connections among symptoms of obsessive-compulsive disorder and posttraumatic stress disorder: a case series

Theoretical, clinical, and empirical implications of the functional connections between symptoms of obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) are abundant. As such, four cases are presented here of men and women who met criteria for comorbid OCD and PTSD. All had been diagnosed with treatment-resistant OCD and were seeking treatment from an OCD specialty clinic or institute, all reported a history of traumatic experiences prior to the onset of OCD, and all appeared to demonstrate negative treatment outcomes. Upon examination, it appeared that symptoms of OCD and PTSD were connected such that decreases in OCD-specific symptoms related to increases in PTSD-specific symptoms, and increases in OCD-specific symptoms related to decreases in PTSD-specific symptoms. Speculations about the function of OCD symptoms in relation to post-traumatic psychopathology are put forth; and theoretical, research, and treatment implications are discussed.     

EFFECTS OF CAFFEINE ON CLASSROOM BEHAVIOR,SUSTAINED ATTENTION,AND A MEMORY TASK IN PRESCHOOL CHILDREN

The effects of caffeine on the behavior of young children is an important issue, as children in our society consume considerable amounts of caffeine, primarily in soft drinks. This study investigated the effects of normative amounts of caffeine on the behavior of 6 normal children in a kindergarten setting. Using a reversal design, counterbalanced for order of conditions, children's behavior was examined during a baseline condition, a caffeinated beverage condition, and a noncaffeinated beverage condition. Measures included direct observation of off-task and gross motor activity, actometer readings of movement, a Continuous Performance Test, a Paired Associates Learning Test, and teacher ratings of classroom behavior. Results suggest that caffeine exerts only small and inconsistent effects on the classroom behavior of kindergarten children. These results cast doubt on the importance of caffeine as a variable controlling the classroom behavior of normal kindergartners.     

SOCIAL VALIDITY ASSESSMENTS: IS CURRENT PRACTICE STATE OF THE ART?

The use of evaluative feedback from consumers to guide program planning and evaluation is often referred to as the assessment of social validity. Differing views of its role and value in applied behavior analysis have emerged, and increasingly stereotyped assessments of social validity are becoming commonplace. This paper argues that current applications of social validity assessments are straying from the point originally proposed for them. Thus, several suggestions for improving current social validity assessment are proposed, including (a) expanding the definition of consumers to acknowledge the variety of community members able and likely to affect a program's survival, (b) increasing the psychometric rigor of social validity assessments, (c) extending assessment to heretofore underrepresented populations, (d) implementing widespread application of well-designed social validity assessments, (e) increasing meaningful consumer involvement in the planning and evaluation of behavioral programs, and (f) educating consumers to make better informed programming decisions.     

“DO I HAVE TO BE GOOD ALL DAY?” THE TIMING OF DELAYED REINFORCEMENT AS A FACTOR IN GENERALIZATION

Delayed reinforcement, sometimes delivered just after the setting in which the critical behavior had occurred (Early), and sometimes delivered only after several further settings had been encountered (Late), was used to improve a variety of behaviors in seven preschool children, and to control their generalization. Performance of those behaviors was measured in two classroom settings: the Contingent setting, within which performance of the specified behavior determined the later (Early or Late) reinforcement, and the Generalization setting, in which there were no experimental contingencies, immediate or delayed, for the performance of the same behavior. Performances by all children in the Contingent setting were controlled by delayed reinforcement, whether Early or Late. All children showed consistent generalization from the Contingent setting to the Generalization setting during the Late condition, when reinforcement was delivered at the end of the school day. Generalization did not occur during the Early condition, when reinforcement was provided immediately after the Contingent setting (prior to the Generalization setting), unless that condition had been preceded by a Late condition (as it was for S₆ and S₇). The results suggest that the Late timing of delayed reinforcement was an effective and efficient generalization-promotion technique for performances that did not generalize spontaneously.     

TEACHERS' GENERALIZED USE OF DELAY AS A STIMULUS CONTROL PROCEDURE TO INCREASE LANGUAGE USE IN HANDICAPPED CHILDREN

In Experiment 1, classroom teachers were taught to delay their offers of help in naturally occurring situations, and thereby to provide additional opportunities for language use by six moderately retarded language-delayed children. The teachers introduced this delay technique in a multiple-baseline design across the six children. As delays were used, child verbal initiations increased. Follow-up assessment showed that teachers were maintaining greater than baseline levels of the delay technique after 10 weeks. Experiment 2 replicated the findings of Experiment 1, and included a more thorough maintenance assessment, while focusing on teachers' generalization of the delay technique. Teachers were found to generalize their use of delay to 56% of their monitored untaught opportunities. The two experiments show that (a) the delay technique is quick to teach and simple to implement, (b) delays do provide opportunities for children to initiate, (c) teachers can generalize their use of delay to novel self-selected situations, and (d) teachers can maintain their use of delays over time.     

Sex-role expectations of socially desirable first names

This study was an attempt to investigate the relationship between child-naming practices and the perpetuation of traditional sex-role expectations of masculine and feminine behaviors. It was hypothesized that desirable male and female first names would be rated as more sex-typed the more frequently they occurred in the culture. No relationship on a cross-sex-typed effect was predicted for undesirable first names. Psychology undergraduates (N=149) nominated desirable and undesirable male and female first names. The frequency of nomination was correlated with ratings of masculinity or femininity of the names, and the results supported the hypotheses. A significant correlation was found between frequency and degree of stereotypy of first names rated as desirable, but no effect was found for undesirable first names. These results were discussed in terms of role-conflict theory. Secondary issues raised were the use of androgynous first names and the effects of first names on affirmative action procedures.     

Peer facilitation of generalization in a preschool classroom

Two 5-year-old deviant preschoolers taught each other, as peer-tutors, to identify pictorial figures describing prepositional relationships. During training sessions monitored by the experimenter, the child in the peer-tutor role presented stimulus materials and provided consequences for the responses of the child in the tutee role. An assessment of generalization by each child to an academic classroom setting occurred each day. The data showed that the peer-tutor could facilitate generalization, when the tutee was probed in the peer-tutor's presence. However, it was found that the salience of the peer-tutor's presence was critical to this effect. In particular, when the peer presented the stimuli or offered occasional consequences for some correct responses, generalization was greatly enhanced.This research was supported in part by PHS Training Grant HD 00183, Research Grant MH 11739, and a Dissertation Fellowship from the University of Kansas. Appreciation is expressed to the classroom teachers, Scott Simmons, Janet Wedel, Sue Parker, and Tena McEachern, for their patience and cooperation in the implementation of these procedures, and to Merril Stokes, for her help and encouragement during this study.