Biofeedback, cognitive training and relaxation techniques as multimodal adjunct therapy for hospitalized adolescents: a pilot study

Modifications and adjuncts to traditional therapy techniques appear to be necessary for successfully treating hospitalized adolescents with impaired social and verbal skills, and a history of acting-out behavior. Modified therapy groups were combined with a structured biofeedback and cognitive training program to help these adolescents control anger and modify their behavior. Used in conjunction with training and practice in relaxation techniques, this multimodal treatment approach appeared to be helpful in both reducing incidents of acting out on residential units, and in reaching individualized therapeutic goals. The present paper describes use of this multimodal approach within selected residential settings, and outlines the structured materials developed by the authors.     

Variables which differentiate placement of adolescents into juvenile justice or mental health systems

Studies of the variables that determine whether an adolescent is placed in the mental health or juvenile justice system for treatment have led to conflicting conclusions based on impressionistic data. The primary hypothesis of this study--that demographic variables would and personality/psychopathology variables would not differentiate into which system a youth will be placed--was supported. Adolescents were studied at intake into both the juvenile justice system and the mental health system. Data were collected on demographics (structured interviews), personality/psychopathology (MMPI), social adjustment (CAAP), and academic achievement (PIAT). A discriminant function analysis identified eight statistically significant variables which differentiated the two groups. In order of decreasing importance they are: ethnicity, gender, MMPI-depression, previous mental health history, CAAP-productivity, drug use, parental marital history, and parental religious preference.     

Programming maintenance after correspondence training interventions with children

Interventions were employed to program maintenance following correspondence training. The use of reinforcement of verbalization and a mixed sequence of procedures designed to establish indiscriminable contingencies was evaluated in multiple-baseline designs across subjects and behaviors. The results indicated that target behaviors were maintained under less intrusive interventions and in the absence of programmed contingencies during extended follow-up conditions. The results are discussed in terms of changes in reinforcement schedules established in maintenance interventions.     

Discriminant validity of the General Behavior Inventory: an outpatient study

Recent studies have provided strong support for the convergent validity of the General Behavior Inventory (GBI), a case identification inventory for chronic subsyndromal affective disorders (cyclothymia and dysthymia). Fewer data are available, however, on the ability of the GBI to distinguish chronic subsyndromal affective disorders from other forms of psychopathology. In order to address this issue, outpatients with cyclothymia (n = 9), dysthymia (n = 26), nonchronic major depression (n = 16), and nonaffective psychiatric disorders (n = 30) were compared on the GBI. Diagnoses were derived blind to GBI scores using structured diagnostic interviews and DSM-III criteria. The inventory significantly discriminated cyclothymes and dysthymes from patients with nonchronic major depressions and nonaffective disorders. Using the cutoff score that maximized GBI-diagnosis concordance, the inventory correctly classified 88% of the sample. All of the cyclothymes, 92% of the dysthymes, 87% of the patients with nonaffective psychiatric disorders, and 75% of the nonchronic major depressives were correctly classified by the inventory. These data provide strong support for the discriminant validity of the GBI.     

FUNCTIONAL ANALYSIS AND TREATMENT OF SEVERE PICA

A two-phase functional analysis of a profoundly retarded 19-year-old male's pica facilitated the design of an effective intervention containing no aversive components. In the first analysis, frequent staff-client interaction resulted in 25% and 66% less pica than limited and no interaction, respectively. Paradoxical effects were obtained in the second analysis, where no protective helmet resulted in 38% and 26% less pica than the helmet with face shield and helmet without face shield, respectively. On the basis of these analyses, limited interaction and no helmet conditions were combined in an effective, staff-implemented treatment at a medium-sized institution.