Maintaining disulfiram ingestion among outpatient alcoholics: a security-deposit contingency contracting procedure

Disulfiram is frequently prescribed to alcoholic patients as a deterrent to drinking. Although ingestion of ethanol by a disulfiram patient quickly results in an intense dysphonc reaction, the drug is not generally credited with significant value in alcoholism treatment (Mottin, 1973). It is suggested that most alcoholics simply stop taking the medication (Gerrein et al., 1973). and review articles conclude that motivation for abstinence is the crucial variable involved in successful disulfiram treatment (Ditman, 1966: Mottin, 1973).Motivation may be a characteristic of environmental contingencies rather than of individuals. If so, environmental contingencies should permit one to design into a disulfiram treatment progrim the requisite motivation to achieve therapeutic success. Contingency management procedures supporting disulfiram ingestion reported to date (Liebson et al., 1973: Haynes, 1973) have been of the sort to be imposed upon difficult populations rather than offered to general treatment applicants. Contingency contracting may represent a technique for supporting disulfiram ingestion appropriate to the broader general population of voluntary alcoholism treatment applicants. Contingency contract treatment (Homme, 1969; Stuart, 1971) is a procedure in which client and therapist mutually agree to establish an incentive for the client to achieve a behavioral goal. Contingency contracts can be viewed as a form of self-control therapy, and have been applied in a wide variety of problem areas, including school problems (Homme, 1969: Cantrell, et al., 1969). delinquency (Stuart, 1971),weight control (Mann, 1972). smoking reduction (Elliott and Tighe, 1968: Winett, 1973), drug abuse (Boudin, 1972), and alcoholism (Miller, 1972).Frequently contingency contracting involves the client's posting of a financial security deposit to serve as his incentive for achieving the agreed-upon therapeutic goal (Tighe and Elliot, 1968). This security deposit can be earned back consequent upon achieving specific goals, or sacrificed consequent upon failure. Controlled studies by Mann (1972) and by Winett (1973) have demonstrated this security-deposit procedure to be effective in enhancing weight loss and smoking reduction, respectively.We report here on our experience with application of the security deposit contracting procedure to maintaining routine disulfiram ingestion among outpatients in an alcoholism treatment program.     

Fixed-ratio reinforcement of spaced responding

Responses by rats were reinforced with food under a second-order schedule involving fixed-ratio reinforcement of temporally spaced responses. Requirements of 20, 8, and 3 responses were examined. The typical characteristic of spaced responding was maintained under the ratio schedules: interresponse time distributions were similar to those typically seen, and were not noticeably affected by the ratio value. Comparison of total response rate, correct response rate, and accuracy showed correct response rate to be the most consistently affected by changes in the ratio value. Substantial evidence of schedule control was seen only for correct responses. Incorrect response records were erratic, but rates generally declined as reinforcement was approached. Correct response records were characterized by increasing rate as reinforcement was approached. It was suggested that the pattern of fixed-ratio performance revealed may be affected by the behavioral unit examined.     

An administrative model for close monitoring and managing high risk individuals.

The public expects central government to have immediate knowledge of the condition and circumstances of certain vulnerable or dangerous individuals such as insanity acquittees, and to take action in individual cases to protect the individual and the public. Therefore, such persons conditionally released to community settings require an unusual degree of close monitoring and management. Being immediately aware of the condition and circumstances of its assignees, together with other duties of a board or commission responsible for that monitoring and management, is largely an information management function. The Psychiatric Security Review Board in Oregon is used to illustrate this unique mission, operations, and information management. In this paper, the Psychiatric Security Review Board is described in terms of its core and secondary businesses, together with a model information system that is based on information and information management processes actually employed by the Board.     

非期望刺激的生态意义信息对无意视盲的影响:情绪效价和精细程度的作用

采用Most(2000)的持续动态的实验范式,以圆圈、抽象面孔和真实面孔为非期望刺激,研究其生态意义信息对无意视盲的影响。研究发现:(1)相对于正性面孔和中性面孔,被试对负性面孔作为非期望刺激时的觉察率更高;而对正性面孔和中性面孔作为非期望刺激时的觉察率无显著性差异;(2)相对于圆圈,抽象面孔和真实面孔作为非期望刺激的觉察率更高,而抽象面孔与真实面孔作为非期望刺激时的觉察率均无显著性差异。结果表明,负性的、精细的非期望刺激的无意视盲率更低,即生态意义信息强的非期望刺激更易捕获注意。     

伦理关怀与社区管理

社会结构在变化 ,我们的思想理念及社会有效管理也必须随之变化。社区是社会公民生养栖息的主要场所 ,又是一定生活群体的精神共同体的培养凝聚基地 ,更重要的是社区在现代已发展为社会管理中新的基层平台。伦理关怀在社区管理中的更多介入 ,在探索新的社会管理模式方面 ,尤其在凝聚整合社会向心力方面发挥着重要作用。     

整体加工方式下面孔结构与特征关系

探讨面孔整体性加工方式下结构信息和特征信息加工之间的关系。通过聚焦窗口技术在结构信息和特征信息的权变过程中考察二者对面孔整体性加工的影响, 从而进一步确定两类信息的加工关系模式。结果表明: 面孔以整体的方式进行加工; 结构信息加工系统和特征信息加工系统两者并行存在, 在当前实验任务中两类信息加工之间为竞争关系; 面孔以结构信息加工为主还是以特征信息加工为主取决于两类信息在当前任务中提取和加工难度。     

表象—认知吝啬原则：MHD问题另释

本文首先对MHD问题的研究现状进行了简要回顾,然后对MHD问题中出现的“概率错判”和“选择固着”两种现象给出了一种基于表象—认知吝啬视角的解释。该视角认为,人们无论采用的是顺向表征还是逆向表征,都采用了动态表象表征问题,而依照认知吝啬原则,动态表象要模拟轿车在门1、门2之间以1：2的比率出现的状态很难,却极容易模拟成轿车在门1门2间随机出现的状态;这导致了人们形成“概率错判”;对于“选择固着”问题该视角则认为,它的出现是不变比改变更符合认知吝啬原则的结果。     

幽门螺杆菌诊断方法评价

诊断幽门螺杆菌(Hp)感染有侵入性和非侵入性两类方法.前者需通过胃镜取胃粘膜活检,包括快速尿素酶试验(RUT)、病理组织学检查、细菌培养及基因检测等;非侵入性方法包括尿素呼气试验(UBT)、血清Hp抗体测定及Hp粪便抗原检测等.各种检测方法的敏感性及特异性不一,适用范围也不同,选择合适的检测方法需结合Hp感染特点、检测条件及费用情况等.     

循证医学与实事求是

循证医学主张"慎重、准确和明智地应用当前所能获得的最好的研究依据;结合临床医生的个人专业技能和多年临床经验;考虑患者的价值扣愿望,将三者完美地结合制定出患者的治疗措施."贯穿着临床医学对患者进行"以人为本"科学救死扶伤的实事求是理念.要使"循证医学"卓有成效,应当抓住二大关键:实事求是,维护"证据"的真实性,提高医术的可靠性.