Augmentation of in vivo exposure treatment for agoraphobia by the formation of neighbourhood self-help groups

The advantages of selecting agoraphobic patients for treatment by group exposure according to their residential geographic neighbourhood were evaluated in terms of facilitation of ‘homework’ practice and increased social contact. Both ‘zoned’ and ‘unzoned’ groups showed gains in ability to perform hierarchy items after 11 sessions of exposure, relative to a no-treatment control group. However only zoned subjects showed significant reductions in experienced anxiety when executing such items. Self-ratings of overall phobic severity also suggested a zoned group was superior to unzoned while assessors' ratings indicated both groups as equally improved. Only zoned subjects showed a significant increase in social range. Improvements were maintained at 3-months follow-up. No effect of treatment was found on either the Zung measure of anxious mood or on social integration.These results suggest that, where practical, zoning might offer the means for desirable continuation of intensive clinic-based group treatment as well as the benefit of extending treatment into the patients' environment as in home-based treatments. Crucial levels of group cohesion might also be increased although therapists should be prepared to negotiate resistance to a socially demanding programme from patients with significant additional social phobias.     

AN ECOBEHAVIORAL EXAMINATION OF A SIMPLE STRATEGY FOR INCREASING MEALTIME LANGUAGE IN RESIDENTIAL FACILITIES

Typically in large residential facilities for retarded persons, meals are served in an institutional style that does not appear to encourage appropriate peer interactions. An ecological program alternative is serving meals in a family style. The present study was designed to examine both the feasibility of serving family style meals and the effects of family style meal service on mealtime language. Five retarded young adult male residents, who had some conversational skills and appropriate table manners, participated in this study. The experimental design involved a multiple baseline analysis across meals (dinner, lunch, and breakfast). Observers coded the youths' mealtime verbalizations according to the type, content, and direction of the verbalizations and they recorded the length of the meals. The analysis of the verbalization data indicated that during family style meals the participants spoke substantially more often than during institutional style meals. Increases in peer-directed conversation about the meals primarily accounted for the verbalization changes. Family style serving also resulted in the youths spending more time with their meals. In addition, social validation measures suggested that the family style procedures were preferred by the consumers (participants, staff, and concerned community members).     

“Sleeper effects” in development: Fact or artifact?

The evolution of the concept of “sleeper effects” is traced from the work of J. Kagan and H. A. Moss (Birth to Maturity. New York: Wiley, 1962) to the present time. The phenomenon was originally inferred, without cross-validation, in the domain of personality, from correlations with early events which were stronger late in development than earlier. More recently it has been extended to account for long-term attainment differences associated with the presence or absence of preschool intervention. It seems possible that the original evidence may have capitalized upon chance fluctuations of few among many correlations. What is more certain, however, is that as currently used the term is imprecise, usually unjustified, and irrelevant to the supposed later effects of brief early intervention.     

Contextual potentiation of acquired behavior after devaluing direct context-US associations

In two experiments, water-deprived rats were exposed to tone-footshock pairings in a particular conditioning context. In Experiment 1, the training parameters were selected on the basis of parametric pilot data so as not to produce direct associations between the conditioning context and footshock. Despite independent evidence of no appreciable direct association between the conditioning context and footshock, animals tested in the conditioning context exhibited more lick suppression to the tone than other animals tested with the tone outside of the conditioning context. Thus, the conditioning context potentiated suppression to the tone in the absence of appreciable fear of the conditioning context. In Experiment 2, training parameters were used that permitted the formation of direct associations between the conditioning context and footshock; however, for half the animals, these associations to the context were then extinguished. With the tone absent, a comparison of extinguished animals tested either in the conditioning context or outside the conditioning context detected no differences in suppression, demonstrating the effectiveness of the extinction manipulation. However, other animals also subjected to extinction of direct context-footshock associations displayed greater suppression to the tone within the conditioning context than comparable animals tested outside the context. Collectively the data indicate that the superior retention-test performance seen within the training context can arise both from the commonly assumed direct associations between the training context and the unconditioned stimulus and from the potentiation by the training context of the associations between the nominal conditioned stimulus and unconditioned stimulus.     

The effect of phonemic processing on the retention of graphemic representations for words and nonwords

The three experiments reported in this study were each conducted in two phases. The first phase of Experiment 1 involved a same-different comparison task requiring “same” responses for both mixed-case (e.g., MAIN main) and pure-case (e.g., near near) pairs. This was followed by Phase 2, a surprise recognition test in which a graphemic effect on word retention was indicated by the superior recognition accuracy obtained for pure-case compared with mixed-case pairs. The first phases of Experiments 2 and 3 involved pronounceability and imageability judgment tasks, respectively. Graphemic retention was assessed by contrasting recognition accuracy for letter strings presented, during Phase 2, in their original Phase 1 case, with letter strings presented, during Phase 2, in. a graphemically dissimilar new case. The experiments provided evidence that there was minimal retention of the graphemic representations from which the phonemic representations of words are generated and, further, that the locus of this effect is probably postlexical. Nonwords were recognized more accurately than words in all three experiments. The latter result was attributed to differences between nonwords and words in both graphemic retention and semantic distinctiveness.     

THE UNIT PLAY MANAGER AS FACILITATOR OF PURPOSEFUL ACTIVITIES AMONG INSTITUTIONALIZED PROFOUNDLY AND SEVERELY RETARDED BOYS

Child care workers were trained in specified techniques (play manager routines) in an effort to increase purposeful activity among a group of profoundly and severely retarded institutionalized boys. A system of prompts, increasing the availability of toys and regular staff monitoring, were alternated with normal institutional routines in an ABA reversal design. On the average, activity level increased from 10% to a mean of 70% during treatment conditions. Correspondingly, stereotyped or harmful behaviors decreased from an average of 20% to 70% during treatment.     

Rape trauma syndrome

The relationship of rape trauma syndrome to the official diagnostic nomenclature of Post-Traumatic Stress Disorder in the DSM-III is extensively discussed. The theoretical and practical clinical issues involved in rape trauma are reviewed as well as the early court rulings on the admissibility of rape trauma syndrome in criminal and civil cases.     

The EPPI family therapy outcome study

Information was evaluated from 1014 families seen in an eight-year period by therapists connected with the Department of Family Psychiatry at Eastern Pennsylvania Psychiatric Institute in Philadelphia. Statistical analysis revealed several factors that had some predictive value in relation to outcome of therapy; these were race, past psychiatric hospitalization, type of presenting family problem, and number of sessions held. There was a rather good chance of improvement being noted by the therapist if the family stayed in treatment for eight or more sessions. About 90% of the cases were seen for less than 20 interviews. Only about 3% were seen for longer than 35 interviews. The vast majority of EPPI cases were short-term. Black families tended to present different problems from white, and therapy was terminated with blacks sooner than for whites. About 35% of families terminated after one to two interviews, and another 30% after three to seven sessions. Since families tended to benefit most after eight or more sessions, the need for better methods or techniques to engage families is highlighted.The research was supported in part by a Career Development Award from the University of California, San Francisco, to the first author.     

Stress,coping, and life change in the single-parent family

Self-perceived competence in three roles (parent, social participant, self-supporter) was examined in relation to life satisfaction in a sample of 47 divorced, employed, single parent, middle-income women. Parenting was found to be the role of greatest perceived competence, and self-supporter the role of lowest perceived competence. Competence as a self-supporter was the strongest predictor of life satisfaction. Life satisfaction did not differ significantly between groups defined by length of time as single parents. For women separated less than 3 years, the social participant was the role of least perceived competence and the best predictor of life satisfaction. For those separated more than 3 years, the three roles were nearly equal in perceived competence, but competence as self-supporter was the best predictor of life satisfaction.     

Alcoholics in inpatient,short-term interactional group psychotherapy: an outcome study

The differential outcome of 100 psychiatric inpatients distinguished by the presence/absence of secondary alcoholism was examined in shortterm closed group psychotherapy. Alcoholics did not differ from the general sample in outcome, but displayed distinct active/aggressive personality features. Group outcome was not affected by the presence/absence of alcoholic members.