Improving Delivery Behaviors During Exposure for Pediatric OCD: A Multiple Baseline Training Trial With Community Therapists

This study tested whether a new training tool, the Exposure Guide (EG), improved in-session therapist behaviors (i.e., indicators of quality) that have been associated with youth outcomes in prior clinical trials of exposure therapy. Six therapists at a community mental health agency (CMHA) provided exposure therapy for 8 youth with obsessive–compulsive disorder (OCD). Using a nonconcurrent multiple baseline design with random assignment to baseline lengths of 6 to 16 weeks, therapists received gold-standard exposure therapy training with weekly consultation (baseline phase) followed by addition of EG training and feedback (intervention phase). The primary outcome was therapist behavior during in-session exposures, observed weekly using a validated coding system. Therapist behavior was evaluated in relation to a priori benchmarks derived from clinical trials. Additional outcomes included training feasibility/acceptability, therapist response to case vignettes and beliefs about exposure, and independent evaluator-rated clinical outcomes. Three therapists reached behavior benchmarks only during the EG (intervention) phase. Two therapists met benchmarks during the baseline phase; one of these subsequently moved away from benchmarks but met them again after starting the EG phase. Across all therapists, the percentage of weeks meeting benchmarks was significantly higher during the EG phase (86.4%) vs. the baseline phase (53.2%). Youth participants experienced significant improvement in OCD symptoms and global illness severity from pre- to posttreatment. Results provide initial evidence that adding the EG to gold-standard training can change in-session therapist behaviors in a CMHA setting.     

The information for catching fly balls: judging and intercepting virtual balls in a CAVE

Visually guided action implies the existence of information as well as a control law relating that information to movement. For ball catching, the Chapman Strategy--keeping constant the rate of change of the tangent of the elevation angle (d(tan(alpha))/dt)--leads a catcher to the right location at the right time to intercept a fly ball. Previous studies showed the ability to detect the information and the consistency of running patterns with the use of the strategy. However, only direct manipulation of information can show its use. Participants were asked to intercept virtual balls in a Cave Automated Virtual Environment (CAVE) or to judge whether balls would pass behind or in front of them. Catchers in the CAVE successfully intercepted virtual balls with their forehead. Furthermore, the timing of judgments was related to the patterns of changing d(tan(alpha))/dt. The advantages and disadvantages of a CAVE as a tool for studying interceptive action are discussed.     

Recognising facial expression from spatially and temporally modified movements

We examined how the recognition of facial emotion was influenced by manipulation of both spatial and temporal properties of 3-D point-light displays of facial motion. We started with the measurement of 3-D position of multiple locations on the face during posed expressions of anger, happiness, sadness, and surprise, and then manipulated the spatial and temporal properties of the measurements to obtain new versions of the movements. In two experiments, we examined recognition of these original and modified facial expressions: in experiment 1, we manipulated the spatial properties of the facial movement, and in experiment 2 we manipulated the temporal properties. The results of experiment 1 showed that exaggeration of facial expressions relative to a fixed neutral expression resulted in enhanced ratings of the intensity of that emotion. The results of experiment 2 showed that changing the duration of an expression had a small effect on ratings of emotional intensity, with a trend for expressions with shorter durations to have lower ratings of intensity. The results are discussed within the context of theories of encoding as related to caricature and emotion.     

Exteroceptive control of response under delayed reinforcement

Three white rats, after 50 continuous reinforcements, were exposed successively, under dim illumination, to reinforcement delays of 1, 3, 5, 7.5, 10, 15, and 20 sec, with prolonged training at the 20-sec level. Behavior was maintained at each level, and an increase in interval was accompanied by an increase in post-reinforcement pause. Subsequently, under both 20- and 30-sec delays, the animals were tested during half of each daily session to determine the effect of introducing darkness during each delay interval. The result of this stimulus “support” was to regularize and increase response rate for each animal at both interval values.     

The Future of Psychology in Medicaid's Health Delivery System for People with Disabilities

State Medicaid programs are rapidly converting fee-for-service health delivery systems to managed care for people with disabilities. In theory, managed care models of health delivery will substantially improve the quality of care for people with disabilities, but in reality, few successful models exist. This period of transition holds both opportunities and challenges for psychologists in medical settings. Because Medicaid reforms for people with disabilities may herald similar reforms for both the public and the private sectors, psychology's response will determine its role in the future of health care delivery for this population. Changes in training and increased attention to outcomes research, innovations in practice, and advocacy will be the keys to success.     

An information processing system for the psychiatric emergency room

An information processing system for a psychiatric emergency room is described. Several studies are presented that show the utility of the system. In the first study, variables involved in diagnosis are explicated. The second study attempts to determine the characteristics that distinguish recidivists from nonrecidivists at an emergency room. The third study attempts to find patient variables related to success in short-term treatment programs. The final study is aimed at discovering whether there are psychopathological effects related to the use of inhalants. Together, these studies show the potential of a mental health information system for learning more about the nature of mental disorders and their treatment.     

Singles ads: Gender,social class,and time

The contents of 800 singles ads were examined. They were compared by the gender of the advertiser, the year of appearance (1991 and 1986), and the SES of the target readership (affluent and general). There were very few advertisers who listed themselves as black, so these ads were not included in the study. Gender differences were most important. Men were more likely to offer financial security and seek attractiveness. Women were more likely to offer attractiveness and seek financial security. The gender differences were in agreement with those reported for over a decade and from many geographical areas, although less than half of the advertisers mentioned either finances or attractiveness. Contrary to our hypotheses, the contents of mens' and womens' ads were more different in 1991 than they had been in 1986 and more in conformity with sexual stereotypes. Ads in a paper with an affluent readership were more likely to mention educational and financial status while ads in a paper with a readership throughout the metropolitan area were more likely to mention physical characteristics.