The importance of assessing treatment integrity: An example in the anxiety disorders

One purpose of this investigation was to examine the importance of assessing treatment integrity in a study evaluating a treatment for specific anxiety disorders. Three subjects, two social phobics and one simple phobic, received self-instruction training (Phase I) followed by exposure and self-instruction training (Phase II) in a multiple baseline across subjects design. All subjects were assessed during a pretreatment baseline and throughout treatment using measures of treatment integrity and measures of change in phobic severity. Improvement took place at different times for different subjects. Measures of treatment integrity, which consisted of monitoring of self-statements as well as practice outside the session, indicated that treatment was not always received as intended and that improvement was correlated with practice. The usefulness of measures of treatment integrity in both clinical and research settings is highlighted.     

Arousal and T-maze choice behavior in mice: A convergent paradigm for neophobia constructs and optimal arousal theory

Three experiments investigating the effects of arousal on the T-maze choice behavior of inbred mouse strains are reported. In Experiment 1, CBA and NZB mice were administered unrewarded free choice alternation tests on 10 consecutive days under either No Shock, Shock Start (shocked in the start box), or Shock Choice (shocked at the choice point) treatment conditions. Both strain and treatment effects were observed: In the No-Shock condition, the nonreactive CBA strain alternated, but the reactive NZB strain did not. In the Shock Start condition the CBA strain showed only a suppressed alternation, while the NZB strain administered the same treatment perseverated. Both strains perseverated in the Shock Choice condition. In Experiment 2, NZB mice administered identical shocks in the start box and goal arms on both trials of five consecutive tests conducted once a day perseverated to the same goal arm in which they had been shocked on the first trial. In Experiment 3, NZB mice punished for perseverating (with shock continuation) and simultaneously reinforced for alternating (with shock termination) showed a “punishment paradox”; they perseverated despite the reinforcement contingencies. These results, which are congruent with the optimal arousal theory and several characteristics the theory shares with the emergent neophobia construct, support the contention that arousal mediates a symmetrical relationship between approach and avoidance along a novelty-familiarity continuum.