Countering perfectionism in research on clinical practice I: Surveying rationality changes after a single intensive ret intervention

The failure of controlled experimental research on therapy out-come to produce findings of clinical as well as statistical significance seems at least partly due to irrational, perfectionistic, beliefs about how research can be used to infer causes of therapeutic change. Irrational beliefs about controlled experimental designs and about incomplete sampling, in particular, appear to prevent appropriate consideration of probatively valuable quasi-experimental research. Models of more rational alternatives are identified, and an example of the functional advantages of adopting these rational beliefs is explicated. The example demonstrates that single-shot pre-post survey data from self-selected catch-as-catch-can samples can permit legitimate, but not absolutely certain, conclusions about the efficacy and efficiency of RET.Albert Ellis, Ph.D. is executive director of the Institute for Rational-Emotive Therapy in New York City.     

Automation of learning-set testing: The video-task paradigm

Researchers interested in studying discrimination learning in primates have typically utilized variations in the Wisconsin General Test Apparatus (WGTA). In the present experiment, a new testing apparatus for the study of primate learning is proposed. In the video-task paradigm, rhesus monkeys (Macaca mulatta) respond to computer-generated stimuli by manipulating a joystick. Using this apparatus, discrimination learning-set data for 2 monkeys were obtained. Performance on Trial 2 exceeded 80% within 200 discrimination learning problems. These data illustrate the utility of the video-task paradigm in comparative research. Additionally, the efficient learning and rich data that were characteristic of this study suggest several advantages of the present testing paradigm over traditional WGTA testing.     

Dental phobias and anxieties: evidence for conditioning processes in the acquisition and modulation of a learned fear

The present study investigated some of the factors which differentiate individuals with dental anxieties and phobias from those without such fears. In particular, two questions were addressed: (i) What differentiates subjects who have never been anxious about dental treatment from subjects who at some time have been anxious? and (ii) What factors lead to subjects changing their attitudes either from anxious to relaxed or from relaxed to anxious? The results suggest that the factors which influence the acquisition and modulation of dental anxieties are consistent with the associative and representational processes portrayed in contemporary models of human conditioning. Subjects who reported never having had anxieties about dental treatment were less likely to have had a painful dental treatment than subjects who did report an anxiety. Subjects who did report a painful dental experience but did not acquire anxiety reported a history of dental treatment favourable to the operation of latent inhibition. Subjects who reported that they were good at enduring pain were more likely to report a longer interval between their very first dental treatment and their first painful dental treatment. Under some conditions in which latent inhibition should have precluded the acquisition of a dental fear, an anxiety appeared to be acquired because a very painful experience had attenuated the latent inhibition process. Subjects whose dental anxiety did not remit reported significantly more painful and traumatic dental experiences than subjects whose anxiety did remit.     

A controlled comparative investigation of psychological treatments for chronic sleep-onset insomnia

A sample of physician-referred chronic insomniacs was randomly allocated to either progressive relaxation, stimulus control, paradoxical intention, placebo or no treatment conditions. Treatment process and outcome were investigated in terms of mean and standard deviation (night to night variability) measures of sleep pattern and sleep quality. Only active treatments were associated with significant improvement, but the nature of treatment gains varied. In particular, stimulus control improved sleep pattern, whereas relaxation affected perception of sleep quality. All improvements were maintained at 17 month follow-up. Results are discussed with reference to previous research and guidelines are given for clinical practice.     

Adolescent suicide attempters presenting to a pediatric facility

This study profiles the characteristics of adolescent suicide attempters and the treatment they received in a pediatric emergency room (ER). A retrospective chart review of 4,072 adolescents seen in the ER at a children's hospital (CH) from July 1984 to June 1985 was undertaken. Twenty-seven adolescents who had deliberately injured themselves were identified. The average age was 14 years 7 months (range 11-19 years). Fifty-two percent of the patients were white and 78% were female. Ingestion was the most common method (78%), followed by attempted hanging (11%), and wrist laceration (7%). After evaluation by a pediatrician in the ER, 30% of the patients were treated and released, 11% were transferred directly to a psychiatric hospital, and 59% were admitted to the CH, with an average hospital stay of 1.88 days. Once hospitalized, consultations from psychiatry (81%), social service (50%), psychology (19%), and neurology (6%) were obtained. At the time of discharge from either the ER or CH, the patients had a variety of plans for ongoing care, with 52% being referred to outpatient counseling, 37% being transferred to a psychiatric hospital, and 11% having no documented plan for ongoing care. These results demonstrate that the evaluation of suicidal adolescents cared for in a pediatric facility may be episodic and suggest the need for a comprehensive program to approach the problem.     

Developmental psychopathology. Current research, issues, and directions

Developmental psychopathology refers to the study of clinical dysfunction in the context of maturational and developmental processes. Although the field encompasses the entire life span, the present focus is on childhood. Special characteristics make the study of childhood dysfunction somewhat unique, including the emergence, evolution, and attenuation of seemingly problematic behaviors over the course of development; the manner in which children are referred for clinical evaluation; and complexities in identifying the appropriate foci for clinical intervention. Notwithstanding these obstacles, recent work has advanced considerably in diagnosis, assessment, and treatment of childhood disorders. The present article highlights recent advances in these areas and promising extensions in current research. Many advances have relied heavily on the extension of paradigms developed in research with adults. Additional research is needed that draws on and integrates conceptual and empirical work from developmental psychology.     

Occult participation: its impact on adolescent development

This study investigated the relationship between occult participation, substance abuse, and level of self-esteem in adolescents. Data were collected from 50 adolescents who ranged in age from 12 to 19 years and who spoke English as their primary language. The combined group of adolescents consisted of 25 clinical and 25 nonclinical youth. Participants completed a three-part questionnaire package which included Rosenberg's Self-Esteem Scale, the Adolescent Magic Questionnaire, and the Drug and Alcohol Assessment Scale. Results indicated that adolescent substance abuse and occult participation were significantly related. High and low occult participation groups were determined, and significant differences were found between the high versus low occult groups when compared on the primary variables of self-esteem and substance abuse. Significant differences were also noted when comparing the high versus low occult groups with various psychosocial developmental variables. Included is a discussion of the impact of occult participation on the psychosocial elements of adolescent self-esteem, self-concept, tolerance for deviance, and religious involvement.