Winter Depression Recurrence One Year After Cognitive-Behavioral Therapy, Light Therapy, or Combination Treatment

The central public health challenge in the management of seasonal affective disorder (SAD) is prevention of depression recurrence each fall/winter season. The need for time-limited treatments with enduring effects is underscored by questionable long-term compliance with clinical practice guidelines recommending daily light therapy during the symptomatic months each year. We previously developed a SAD-tailored group cognitive-behavioral therapy (CBT) and tested its acute efficacy in 2 pilot studies. Here, we report an intent-to-treat (ITT) analysis of outcomes during the subsequent winter season (i.e., approximately 1 year after acute treatment) using participants randomized to CBT, light therapy, and combination treatment across our pilot studies (N = 69). We used multiple imputation to estimate next winter outcomes for the 17 individuals who dropped out during treatment, were withdrawn from protocol, or were lost to follow-up. The CBT (7.0%) and combination treatment (5.5%) groups had significantly smaller proportions of winter depression recurrences than the light therapy group (36.7%). CBT alone, but not combination treatment, was also associated with significantly lower interviewer- and patient-rated depression severity at 1 year as compared to light therapy alone. Among completers who provided 1-year data, all statistically significant differences between the CBT and light therapy groups persisted after adjustment for ongoing treatment with light therapy, antidepressants, and psychotherapy. If these findings are replicated, CBT could represent a more effective, practical, and palatable approach to long-term SAD management than light therapy.     

Further Evidence of the Reliability and Validity of the Multidimensional Anxiety

The psychometric properties of the Multidimensional Anxiety Scale for Children (MASC) were examined in adolescent psychiatric inpatient samples. In Study 1 (n = 287), confirmatory factor analyses provided satisfactory fit for the four-factor (comparative fit index; CFI = 0.856) and higher-order (CFI = 0.854) solutions. Using parcels as items, the fit of the four-factor model was improved substantially (CFI = 0.935). Next, in the bifactor analyses, support was attained for a model that included a general factor and four domain specific subfactors. In Study 2 (n = 195 inpatient youths), the MASC showed good scale reliability and concurrent validity. Results of the receiver operating characteristic curve and binary logistic regression analyses provided adequate evidence for discriminative validity. In Study 3 (n = 40), test–retest reliability of scores on the MASC-10 scale over a 3-week period was adequate (r _tt = 0.83, p < 0.001) for children ages 8 to 11 years.     

Brief Behavioral Intervention for Young Children with Disruptive Behaviors

Parent reported behavioral difficulties in young children are relatively common. Without adequate intervention, some children will later present with more severe problem behaviors. Parent management training is one of the best methods of treatment for behavior problems; however, existing treatments can be lengthy and difficult to conduct outside of a research setting. The Brief Behavioral Intervention was designed as a briefer version of a manualized parent management training treatment package. Thirty-one parents of children aged 2–6.5 presenting with behavior problems were included in this initial study of treatment effectiveness. Based on parent and teacher report, treatment was effective in a mean of 7.2 sessions.     

Facilitation of learning spatial relations among locations by visual cues: Implications for theoretical accounts of spatial learning

Human participants searched in a real environment or interactive 3-D virtual environment open field for four hidden goal locations arranged in a 2 × 2 square configuration in a 5 × 5 matrix of raised bins. The participants were randomly assigned to one of two groups: cues 1 pattern or pattern only. The participants experienced a training phase, followed by a testing phase. Visual cues specified the goal locations during training only for the cues 1 pattern group. Both groups were then tested in the absence of visual cues. The results in both environments indicated that the participants learned the spatial relations among goal locations. However, visual cues during training facilitated learning of the spatial relations among goal locations: In both environments, the participants trained with the visual cues made fewer errors during testing than did those trained only with the pattern. The results suggest that learning based on the spatial relations among locations may not be susceptible to cue competition effects and have implications for standard associative and dual-system accounts of spatial learning.     

THERAPIST‐ AND SELF‐MONITORED DRO CONTINGENCIES AS A TREATMENT FOR THE SELF‐INJURIOUS SKIN PICKING OF A YOUNG MAN WITH ASPERGER SYNDROME

The use of differential reinforcement of other behavior (DRO) has decreased, at least partially due to the development of less effortful alternative behavioral interventions (e.g., noncontingent reinforcement; Vollmer, Iwata, Zarcone, Smith, & Mazaleski, 1993). The effort associated with DRO contingencies may be lessened by incorporating self‐monitoring components in which clients are responsible for the delivery of reinforcers for their own behavior. The current study evaluates the effectiveness of DRO in the treatment of self‐injury when implemented first by the therapist and subsequently by the client.     

Development of the other-race effect during infancy: Evidence toward universality?

The other-race effect in face processing develops within the first year of life in Caucasian infants. It is currently unknown whether the developmental trajectory observed in Caucasian infants can be extended to other cultures. This is an important issue to investigate because recent findings from cross-cultural psychology have suggested that individuals from Eastern and Western backgrounds tend to perceive the world in fundamentally different ways. To this end, the current study investigated 3-, 6-, and 9-month-old Chinese infants’ ability to discriminate faces within their own racial group and within two other racial groups (African and Caucasian). The 3-month-olds demonstrated recognition in all conditions, whereas the 6-month-olds recognized Chinese faces and displayed marginal recognition for Caucasian faces but did not recognize African faces. The 9-month-olds’ recognition was limited to Chinese faces. This pattern of development is consistent with the perceptual narrowing hypothesis that our perceptual systems are shaped by experience to be optimally sensitive to stimuli most commonly encountered in one’s unique cultural environment.     

WITHIN‐SESSION TRANSITIONS IN CHOICE: A STRUCTURAL AND QUANTITATIVE ANALYSIS

The present study used within‐session transitions between two concurrent schedules to evaluate choice in transition. Eight female Long‐Evans rats were trained to respond under concurrent schedules of reinforcement during experimental sessions that lasted 22 hr. The generalized matching equation was used to model steady‐state behavior at the end of each session, while transitional behavior that emerged following the change in reinforcement schedules was modeled using a logistic equation. The generalized matching and logistic equations were appropriate models for behavior generated during single‐session transitions. A local analysis of behavior on the two response alternatives during acquisition was used to determine the source of preference as revealed in response ratios. The number of “low‐response” visits, those containing three to five responses, remained stable. Preference ratios largely reflected a sharp increase in the number of visits with long response bouts on the rich alternative and a decrease in the number of such visits to the leaner alternative.     

Contrastivism and Lucky Questions

There’s something deeply right in the idea that knowledge requires an ability to discriminate truth from falsity. Failing to incorporate some version of the discrimination requirement into one’s epistemology generates cases of putative knowledge that are at best problematic. On the other hand, many theories that include a discrimination requirement thereby appear to entail violations of closure. This prima facie tension is resolved nicely in Jonathan Schaffer’s contrastivism, which I describe herein. The contrastivist take on relevant alternatives is implausible, however, and this then threatens to undermine contrastivism’s anti-skeptical results.

Functional analysis and generalized treatment of disruptive behavior during dental exams

Patient disruption during dental visits can impede treatment and may result in invasive approaches to care. The current study evaluated the efficacy of graduated exposure with and without extinction to decrease disruption during dental treatment for 4 young men with autism spectrum disorder (ASD). Modified functional analyses confirmed that disruption was maintained by escape from dental demands for all four young men. Initial treatment consisted of graduated exposure, whereby exam steps were initially removed and then gradually reintroduced as disruption remained low; throughout this phase, disruption resulted in a break from the exam. During the subsequent treatment phase, graduated exposure procedures continued and extinction for disruption was added. Graduated exposure alone did not result in sufficient treatment effects; however, the addition of extinction resulted in greater reductions in disruption and increases in exam completion for all 4 young men, and treatment effects generalized to a dental clinic setting.     

An evaluation of resurgence following functional communication training conducted in alternative antecedent contexts via telehealth

Treatments based on differential reinforcement may inadvertently increase the recurrence of problem behavior in the face of challenges because reinforcers for appropriate behavior occur in the same context as problem behavior. The current study evaluated one potential approach to mitigating these problems with differential reinforcement treatments based on behavioral momentum theory. Specifically, appropriate behavior was trained in contexts without a history of reinforcement prior to intervening with problem behavior. Participants were 4 children with autism spectrum disorder. Treatment used telehealth to implement functional communication training (FCT) in three alternative contexts with minimal or no history of reinforcement for problem behavior before initiating FCT in the treatment context. Evaluations of the effects of treatment and tests of resurgence were conducted intermittently during treatment to evaluate maintenance. When FCT treatment was initiated in alternative contexts, initial results were comparable to more typical implementations of FCT. Resurgence was reduced to similar levels during tests of resurgence for all participants when compared to more typical previously published implementations of FCT, but clinically significant reductions in resurgence occurred more quickly in the present study. These findings support training appropriate behavior in an alternative context to mitigate the resurgence of problem behavior during differential reinforcement treatments.