Effectiveness of the Wraparound Process for Children with Emotional and Behavioral Disorders: A Meta-Analysis

Wraparound is a team-based service planning and coordination process intended to improve outcomes for children and youth with serious emotional and behavioral disorders and support them in their homes, schools, and communities. Given the substantial resources devoted to implementing wraparound, a meta-analysis of outcome studies was conducted to better understand current empirical support for this process. A literature search identified seven studies between 1986 and 2008 that documented the effects of youth receiving wraparound compared to control groups. Mean treatment effects across outcome domains ranged from medium for youth living situation (0.44) to small for mental health outcomes (0.31), overall youth functioning (0.25), school functioning (0.27), and juvenile justice-related outcomes (0.21). The overall mean effect size across studies was 0.33. Interpretation of results was complicated by the lack of consistent documentation of implementation fidelity across studies and conditions, variations in target population and intended outcomes, and methodological concerns. The authors conclude that, though the published wraparound research base is expanding and findings are largely positive, it continues to be in a preliminary state of development. However, there are insufficient data to support calls for wraparound’s acceptance or dismissal based on the strength of existing studies.     

Resolving Nationalist Conflicts: Promoting Overlapping Identities and Pooling Sovereignty—The 1998 Northern Irish Peace Agreement

Nationalist and ethnic conflicts are a continuing source of tension in the post–Cold War period. The underlying factors affecting such conflicts are threat perception, ethnic security dilemmas, and lack of trust between nationalist/ethnic groups. The challenge is to find solutions to these conflicts. International institutions can establish trust and reduce the ethnic security dilemma by providing multiple forums of representation, promoting overlapping identities, and pooling sovereignty. Pooling sovereignty across a number of international representative bodies leads to increased access to governmental policymaking, with each party having a stake in government, and leads to a reduction in political tension and conflict. Thus, international parliamentary institutions may provide a solution to these conflicts. The British-Irish Peace Agreement (Good Friday Agreement) of 1998 is examined as an illustration of this argument.     

Assessing the process of desensitization therapy: Five practical measures

Assessment of phobic behavior has included self-report, physiological, and in vivobehavioral measures. While self-report measures are convenient, they suffer from subject bias and a low predictive validity. Physiological and in vivobehavioral measures are often too cumbersome to implement in standard clinical practice. The current study investigated the validity of five convenient measures of phobic behavior during the process of desensitization therapy. Responses of 14 clinically phobic patients were compared on phobic and neutral scenes presented within the context of systematic desensitization therapy. Phobic scenes resulted in less clarity of scene visualization, a longer latency to clear scene visualization, higher subjective units of discomfort (SUDs) at clear visualization, a longer latency to relaxation, and higher SUDs at relaxation. The measures seemed to reflect accurately the process and stages of desensitization therapy and showed low to high intercorrelations. The pragmatic value of these measures is discussed, as well as suggestions for future validational research.     

Demonstration of an Integrated Treatment for Smoking Cessation and Anxiety Symptoms in People With HIV: A Clinical Case Study

Despite high rates of co-occurring tobacco use and anxiety symptoms and disorders among persons with HIV, evidence-based interventions for these individuals are not yet available. The present study sought to evaluate an integrated treatment model addressing smoking cessation and anxiety sypmtoms among HIV-positive smokers. Treatment was an 8-week intervention integrating a standard smoking cessation protocol (i.e., cognitive-behavioral therapy [CBT], nicotine replacement therapy) with CBT for anxiety. Inclusion criteria were 18–65 years of age, ≥ 10 cigarettes/day, State–Trait Anxiety Inventory [STAI-T] score of > 39, and moderate motivation (i.e., ≥ 5 out of 10 on a 10-point Likert scale) to quit smoking. Primary outcomes included scores on the Anxiety Sensitivity Index (ASI) and cigarettes smoked per day. Self-reported abstinence was biochemically verified by carbon monoxide breath analysis. Three male participants (mean age 49.3, SD = 9.1) completed through 2-month follow-up. At baseline all participants reported smoking an average of 20 cigarettes per day. Two participants quit smoking and maintained abstinence by the 2-month follow-up, and demonstrated a reduction in ASI scores. Participant 3 continued to smoke but at a reduced rate. Participants’ response to cognitive and behavioral strategies (e.g., creating balanced thoughts, interoceptive exposures) will be discussed. Clinical lessons learned include use of a flexible approach to cognitive restructuring, use of imaginal and in vivo exposures in session to better prepare patients for homework practice, and flexibility in delivering the treatment in an individual or group format. This clinical presentation provides preliminary support for the feasibility and initial effectiveness of an integrated treatment to reduce anxiety symptoms and aid in smoking cessation in anxious, HIV-positive smokers.     

Can Bayesianism Solve Frege’s Puzzle?

Philosophia - Chalmers (Mind, 125, 499–510, 2016), responding to Braun (Mind, 125, 469–497, 2016), continues arguments from Chalmers (Mind, 120, 587–636, 2011a) for the conclusion...     

Feedback functions, optimization, and the relation of response rate to reinforcer rate

The present experiment arranged a series of inverted U-shaped feedback functions relating reinforcer rate to response rate to test whether responding was consistent with an optimization account or with a one-to-one relation of response rate to reinforcer rate such as linear system theory's rate equation or Herrnstein's hyperbola. Reinforcer rate was arranged according to a quadratic equation with a maximum at a unique response rate. The experiment consisted of two phases, during which 6 Long Evans rats lever pressed for food. In the first phase of the experiment, the rats responded on six fixed-interval-plus-quadratic-feedback schedules, and in the second phase the rats responded on three variable-interval-plus-quadratic-feedback schedules. Responding in both phases was inconsistent with a one-to-one relation of response rate to reinforcer rate. Instead, different response rates were obtained at equivalent reinforcer rates. Responding did vary directly with the vertex of the feedback function in both phases, a finding consistent with optimization of reinforcer rate. The present results suggest that the feedback function relating reinforcer rate to response rate imposed by a reinforcement schedule can be an important determinant of behavior. Furthermore, the present experiment illustrates the benefit of arranging feedback functions to investigate assumptions about the variables that control schedule performance.     

Exploring the process of progressive disorientation

While an increasing number of behavioral studies examining spatial cognition use experimental paradigms involving disorientation, the process by which one becomes disoriented is not well explored. The current study examined this process using a paradigm in which participants were blindfolded and underwent a succession of 70° or 200° passive, whole body rotations around a fixed vertical axis. After each rotation, participants used a pointer to indicate either their heading at the start of the most recent turn or their heading at the start of the current series of turns. Analyses showed that in both cases, mean pointing errors increased gradually over successive turns. In addition to the gradual loss of orientation indicated by this increase, analysis of the pointing errors also showed evidence of occasional, abrupt loss orientation. Results indicate multiple routes from an oriented to a disoriented state, and shed light on the process of becoming disoriented.     

Effects of adding a second reinforcement alternative: implications for Herrnstein's interpretation of r(e)

Herrnstein's hyperbola describes the relation between response rate and reinforcer rate on variable-interval (VI) schedules. According to Herrnstein's (1970) interpretation, the parameter r(e) represents the reinforcer rate extraneous to the alternative to which the equation is fitted (the target alternative). The hyperbola is based on an assumption that extraneous reinforcer rate remains constant with changes in reinforcer rate on the target alternative (the constant-r(e) assumption) and that matching with no bias and perfect sensitivity occurs between response and reinforcer ratios. In the present experiment, 12 rats pressed levers for food on a series of 10 VI schedules arranged on the target alternative. Across conditions, six VI values and extinction were arranged on a second alternative. Reinforcer rate on the second alternative, r2, negatively covaried with reinforcer rate on the target alternative for five of the six VI values on the second alternative, and significant degrees of bias and undermatching occurred in response ratios. Given covariation of reinforcer rate on the second and target alternatives, the constant-r(e) assumption can be maintained only by assuming that reinforcer rate from unmeasured background sources, rb, covaries with reinforcer rate on the second alternative such that their sum, r(e), remains constant. In a single-schedule arrangement, however, r(e) equals rb and thus rb is assumed to remain constant, forcing a conceptual inconsistency between single- and concurrent-schedule arrangements. Furthermore, although an alternative formulation of the hyperbola can account for variations in bias and sensitivity, the modified equation also is based on the constant-r(e) assumption and therefore suffers from the same logical problem as the hyperbola when reinforcer rate on the second alternative covaries with reinforcer rate on the target alternative.