Extinction of a phobia of physical examination in a seven-year-old mentally retarded boy—A case study

Counterconditioning is a process in which aversive stimuli that ordinarily evoke emotional or avoidance responses are paired with positive stimuli which evoke incompatible activities. Several sets of operations have been employed to induce these incompatible activities (e.g. food, Jones, 1924; relaxation. Grossberg, 1964; positive imagery, Lazarus and Abramowitz, 1962; pharmacological agents, Friedman, 1966; laughter, Ventis, 1973).Although the Counterconditioning process has been successfully applied to a wide variety of emotional disorders, special problems arise when the procedure is applied to the mentally retarded. First, because of the limitations in cognitive abilities, it is generally impossible to train the subject in either relaxation or positive imagery processes. Consequently, it is necessary to place the child in direct contact with the anxiety-inducing situation. Secondly, it is often difficult to find an anxiety-free situation which is incompatible with the anxiety-arousing situation and which can be practically implemented, particularly when the phobia involved is complex.The purpose of this paper is to describe a case whereby a phobic response of physical examination by male doctors in a 7–yr-old mentally retarded boy was extinguished by pairing the examination with an anxiety-free situation, i.e. an extremely comfortable relationship between the patient and a nurse on the ward. Previous research had indicated that parents and people who have positive relationships with a person might possibly serve as effective anxiety reducers in fear-provoking situations (Jersild and Holmes, 1935).     

Human social defeat and approach–avoidance: Escalating social-evaluative threat and threat of aggression increases social avoidance

Basic research on avoidance by Murray Sidman laid the foundation for advances in the classification, conceptualization and treatment of avoidance in psychological disorders. Contemporary avoidance research is explicitly translational and increasingly focused on how competing appetitive and aversive contingencies influence avoidance. In this laboratory investigation, we examined the effects of escalating social-evaluative threat and threat of social aggression on avoidance of social interactions. During social-defeat learning, 38 adults learned to associate 9 virtual peers with an increasing probability of receiving negative evaluations. Additionally, 1 virtual peer was associated with positive evaluations. Next, in an approach–avoidance task with social-evaluative threat, 1 peer associated with negative evaluations was presented alongside the peer associated with positive evaluations. Approaching peers produced a positive or a probabilistic negative evaluation, while avoiding peers prevented a negative evaluation (and forfeited a positive evaluation). In an approach–avoidance task with social aggression, virtual peers gave and took money away from participants. Escalating social-evaluative threat and aggression increased avoidance, ratings of feeling threatened and threat expectancy and decreased ratings of peer favorableness. These findings underscore the potential of coupling social defeat and approach–avoidance paradigms for translational research on the neurobehavioral mechanisms of social approach–avoidance decision-making and anxiety.     

A Prospective Study of Maternal Exposure to Smoking during Pregnancy and Behavioral Development in the Child

Prenatal smoke exposure (PSE) is a risk factor for adverse outcomes in the offspring, including those affecting psychological development. However, it is uncertain whether these associations are the direct result of PSE or other confounding factors. The aim of this study was to examine the possible relationship between PSE and behavioral development in children at 7.5 years of age, considering several prenatal, neonatal and postnatal covariates. A cohort of 266 mother-child pairs was followed from the first trimester of pregnancy until the children reached 7.5 years of age. PSE was assessed using a questionnaire from prenatal clinical records and corroborated by plasma cotinine determinations in the first and second trimesters and in the cord. Mother-child pairs were classified into one of four groups: unexposed, exposed to passive smoking, first trimester active smoking only and active smoking throughout pregnancy. Child behavior was assessed using the Child Behavior Checklist for ages 6–18 and the Childhood Autism Spectrum Test. In multiple linear regression models, smoking during pregnancy was associated with higher scores in affective problems (β?=?0.298; p?=?0.004). No significant associations were found between smoking during pregnancy and externalizing problems. Findings indicate that PSE is negatively associated with behavioral development in childhood.

     

Children's reasoning about responses to peer aggression: Victim's and witness's expected and prescribed behaviors

This research examined children's reasoning about expected (i.e., what a peer would do) and prescribed (i.e., what a peer should do) responses to unprovoked, intentional aggressive actions in two contexts: as a victim of such a transgression and as a witness to the incident. Physical harm and property damage items were used in a structured interview format. There were 90 subjects drawn from three elementary school grades (2nd, 4th, and 6th). Children differentiated between the expected and prescribed responses of peers and significant developmental differences in children's evaluations were found. Although the majority of the subjects in all grades denounced retaliation on the basis of concerns about others' welfare, older children stated that peers were likely to retaliate against the perpetrator nonetheless. Across different contexts, older children's responses appeared to reveal a greater independence from authority in negotiating peer interactions. In evaluating the witness's responses to aggressive acts, younger children's expected and prescribed responses were less disparate than that of the older children. The utility of including different vantage points of the child in examining children's social reasoning about aggression and the application of the present findings to social information-processing models are discussed. © 1996 Wiley-Liss, Inc.