Case study: Use of propranolol to reduce aggressive behavior in a woman who is mentally retarded

Although neuroleptic medications are frequently used to treat the aggressive behavior of persons with mental retardation, little empirical support exists for their efficacy. In the case study reported here, the beta-blocker propranolol was used to treat the aggressive behavior of a 23-year-old woman with severe mental retardation. Initiation of treatment was correlated with a dramatic decrease in aggression and a less pronounced improvement in self-injurious behavior (SIB). An increase in resting heart-rate was associated with a significant increase in aggression, and progressive increases in propranolol dosage were correlated with reductions in heart rate and in significant behavioral improvement. Consideration of propranolol as a less intrusive, and possibly more effective, pharmacologic treatment for the aggressive behavior of persons with mental retardation is discussed.     

Prospective writing: Randomized controlled trial of an intervention for facilitating growth after adversity

Little is known about how posttraumatic growth (PTG) can be fostered and controversy surrounds how it is best measured. We designed and tested an intervention, prospective writing, to facilitate PTG by encouraging people to explore new possibilities after adversity. Adults (N = 188) with recent adverse experiences were randomly assigned to do prospective writing, factual writing, or no writing weekly for one month. PTG was assessed with both retrospective and current-standing measures. Hierarchical linear modeling and response profile analysis were used to assess the intervention’s impact, and latent growth curve modeling was used to test mediation. Prospective writing participants showed the greatest gains in PTG as assessed by the current-standing measure, but did not reliably show greater retrospective PTG than controls. Although large effect sizes for the mediation paths suggested that engagement with new possibilities may be a plausible mechanism, this result fell short of statistical significance. Prospection-based interventions merit further investigation.