An Instrumental Variable Estimator for Mixed Indicators: Analytic Derivatives and Alternative Parameterizations

Psychometrika - Methodological development of the model-implied instrumental variable (MIIV) estimation framework has proved fruitful over the last three decades. Major milestones include...     

Using e-learning modules to teach ongoing-visual inspection of functional analyses

Despite the effectiveness of function-based treatments, most clinicians do not conduct functional analyses (FA). The time required to conduct an FA is a major barrier preventing their use. One way to increase FA efficiency is to discontinue the analysis as soon as it has produced clear results. Saini et al. (2018) evaluated a structured procedure for ongoing-visual inspection of FAs and found that it produced accurate interpretations while averaging 40% fewer sessions than author interpretation. This study evaluated the efficacy of an e-learning module for training registered behavior technicians (RBTs) to implement ongoing visual inspection of FAs. Following training, 5 of the 6 participants showed mastery of ongoing visual inspection, and the final participant did so with the addition of supplemental procedures. We discuss how this training may increase the efficiency of FAs by teaching individuals who are less experienced in FA methodology when to seek supervision from a supervising Board Certified Behavior Analyst® (BCBA).     

Treating destructive behavior reinforced by increased caregiver compliance with the participant's mands

Functional analyses sometimes do not identify momentary fluctuations in the function of destructive behavior (Bowman, Fisher, Thompson, & Piazza, 1997). In such cases, individuals may mand for the reinforcer that is currently most preferred and display destructive behavior if that mand goes unreinforced. In this study, we conducted a mand analysis to test whether destructive behavior functioned as a precurrent response that increased reinforcement for the participant's mands. We then evaluated a treatment that matched this function of destructive behavior by providing differential or time-based reinforcement of participant mands in accordance with multiple or chained schedules with reinforcement-schedule thinning. Decreases in destructive behavior averaged 97.4% across cases. We discuss these results relative to the importance of matching treatments for destructive behavior to operant functions for both traditional and idiosyncratic functions of destructive behavior.     

Injury characteristics across functional classes of self-injurious behavior

Self-injurious behavior (SIB) is inherently problematic because it can lead to injuries, including those that are quite severe and may result in loss of function or permanent disfigurement. The current study replicated and extended Rooker et al. (2018) by classifying the physical characteristics of injuries across groups of individuals with automatically maintained SIB (ASIB Subtypes 2 and 3) and socially maintained SIB. Individuals with Subtype 2 ASIB had the most frequent and severe injuries. Further, an inverse relation was found between the level of differentiation in the functional analysis and the number of injuries across groups. Studying the response products of SIB (the injuries) documents the risks associated with SIB, justifies the need for research and the intensive intervention, and advances knowledge of SIB. Additional research is needed to replicate these findings, and determine the variables that produce different characteristics of injury secondary to SIB.     

Comparisons of standardized and interview-informed synthesized reinforcement contingencies relative to functional analysis

We compared the functions of problem behavior identified by (a) a functional analysis (FA), (b) an interview-informed synthesized contingency analysis (IISCA) that was informed by the results of an open-ended interview and a structured observation, and (c) a standardized-synthesized contingency analysis (SSCA) in which we synthesized three common functions of problem behavior across 12 individuals in a controlled consecutive case series. We then compared outcomes across assessments. The FA was sufficient in identifying the variables maintaining problem behavior for 11 of the 12 participants, replicating the findings of Fisher, Greer, Romani, Zangrillo, and Owen (2016). Error type (i.e., false positives, false negatives) and error prevalence were similar across functions identified by the IISCA and the SSCA, calling into question the utility of the open-ended interview and the structured observation that informed the IISCA.     

Mitigating resurgence of destructive behavior using the discriminative stimuli of a multiple schedule

Results of several recent translational studies have suggested that correlating contextual or discriminative stimuli with the delivery and withholding of reinforcement for the functional communication response (FCR) may mitigate resurgence of destructive behavior, but few, if any, have isolated the effects of those stimuli. In the present study, we first trained the FCR, brought it under stimulus control of a multiple schedule, and thinned its reinforcement schedule in one stimulus context. Next, we conducted resurgence evaluations (i.e., baseline, functional communication training [FCT], extinction challenge) in two novel contexts to test the effects of the discriminative stimuli on resurgence. We programmed one context to include the (a) S^D during the FCT phase to signal the availability of reinforcement for the FCR and (b) S^Δ during a subsequent extinction challenge to signal the unavailability of reinforcement for the FCR. The other context did not include the S^D during the FCT phase, nor the S^Δ during the extinction challenge. We expected to see greater persistence of the FCR in the context that included the S^D during FCT and less persistence of the FCR and less resurgence of destructive behavior in the context that included the S^Δ during the extinction challenge. Obtained results confirmed this latter prediction, but we observed no reliable difference when the S^D was present or absent during the FCT phase. Our results have relevance for practitioners in that they provide further empirical support for the use of discriminative stimuli when treating destructive behavior.     

Reasoning Continuously: A Formal Construction of Continuous Proofs

We begin with the idea that lines of reasoning are continuous mental processes and develop a notion of continuity in proof. This requires abstracting the notion of a proof as a set of sentences ordered by provability. We can then distinguish between discrete steps of a proof and possibly continuous stages, defining indexing functions to pick these out. Proof stages can be associated with the application of continuously variable rules, connecting continuity in lines of reasoning with continuously variable reasons. Some examples of continuous proofs are provided. We conclude by presenting some fundamental facts about continuous proofs, analogous to continuous structural rules and composition. We take this to be a development on its own, as well as lending support to non-finitistic constructionism.

     

Have Broad‐Based Community and Professional Education Programs Influenced Mental Health Literacy and Treatment Seeking of those with Major Depression and Suicidal Ideation?

Mental health literacy is the knowledge and beliefs about mental disorders that aid in their recognition, management, or prevention; it is also a determinant of help seeking. As such, it is presumed to be important in community suicide prevention programs. In Australia there have been a number of government, professional, and charitable organizations as well as pharmaceutical company suicide prevention initiatives which have been designed to enhance public and professional knowledge about mental disorders, particularly depression. This naturalistic study conducted between 1998 and 2004 in a random and representative population sample examined the changes in mental health literacy and treatment seeking of those with major depression, both with and without suicidal ideation, and those who were neither depressed nor suicidal. Results indicated that there was marked improvement in mental health literacy for all three groups, although there was less change for those most in need of intervention (i.e., those with major depression and suicidal ideation). Furthermore, there were fewer changes in appropriate treatment seeking in those with major depression and suicidal ideation. These findings are consistent with literature reporting limited problem solving and decision making in those who are suicidal, and indicate that there are limits to broadbased community education programs. More focused suicide prevention initiatives are required, specifically for those who are depressed and suicidal.     

An Innovative Treatment Approach for Children With Anxiety Disorders and Medically Unexplained Somatic Complaints

Anxiety disorders in children and adolescents are largely undetected and the majority of youth do not receive services. Given the deleterious consequences of anxiety disorders, early identification and intervention have public health implications. In order to increase identification and treatment of anxious youth, expansion to nonpsychiatric settings (i.e., pediatric medical settings, schools) is necessary. Pediatric medical offices represent ideal settings for detection and intervention for several reasons: (1) access to large numbers of children, (2) high prevalence of unrecognized anxiety disorders in medical settings, and (3) an association between anxiety disorders and medically unexplained somatic symptoms. This paper describes a cognitive-behavioral intervention for youth who present to pediatric medical settings with nonmedical somatic symptoms and undiagnosed anxiety disorders. We explain the rationale for and focus of our treatment approach, present two case studies illustrating the treatment process, and conclude with a discussion of implementation considerations.