Training sequence effects on emergent conditional discriminations: Replication and extension to selection-based training

We examined the replicability and generality of a previously reported training sequence effect on emergent conditional discriminations in the intraverbal naming task. In Experiment 1, a tact–intraverbal (TI) group learned first to vocally label 6 visual patterns and then to intraverbally relate pairs of verbal labels, whereas an intraverbal–tact (IT) group received the same training in the opposite sequence. Emergent conditional discriminations among pattern stimuli were assessed in match-to-sample (MTS) format. Experiment 2 was identical, except vocal tact and intraverbal training were replaced with selection-based training in which the verbal labels were text stimuli. Compared to the IT sequence, the TI sequence resulted in greater mean accuracy at test (Experiment 1), higher yields (Experiment 2), and shorter reaction times (Experiment 2). Experiment 2 data suggested the TI group's performance might be less dependent on intact intraverbal relations relative to the IT group, but related to participants' reports of visualization during intraverbal training. The results suggest the sequence effect is replicable and occurs in experimental preparations commonly used to study derived stimulus relations. They also provide novel support for the hypothesis that participant behavior during training alters sources of stimulus control available at test.     

Psychosocial Treatment Strategies in the MTA Study: Rationale, Methods, and Critical Issues in Design and Implementation

The Collaborative Multimodal Treatment Study of Children with Attention Deficit Hyperactivity Disorder (ADHD), the MTA, is the first multisite, cooperative agreement treatment study of children, and the largest psychiatric/psychological treatment trial ever conducted by the National Institute of Mental Health. It examines the effectiveness of Medication vs. Psychosocial treatment vs. their combination for treatment of ADHD and compares these experimental arms to each other and to routine community care. In a parallel group design, 579 (male and female) ADHD children, aged 7–9 years, 11 months, were randomly assigned to one of the four experimental arms, and then received 14 months of prescribed treatment (or community care) with periodic reassessments. After delineating the theoretical and empirical rationales for Psychosocial treatment of ADHD, we describe the MTA's Psychosocial Treatment strategy applied to all children in two of the four experimental arms (Psychosocial treatment alone; Combined treatment). Psychosocial treatment consisted of three major components: a Parent Training component, a two-part School Intervention component, and a child treatment component anchored in an intensive Summer Treatment Program. Components were selected based on evidence of treatment efficacy and because they address comprehensive symptom targets, settings, comorbidities, and functional domains. We delineate key conceptual and logistical issues faced by clinical researchers in design and implementation of Psychosocial research with examples of how these issues were addressed in the MTA study.Deceased     

Family Processes and Treatment Outcome in the MTA: Negative/Ineffective Parenting Practices in Relation to Multimodal Treatment

To elucidate processes underlying therapeutic change in a large-scale randomized clinical trial, we examined whether alterations in self-reported parenting practices were associated with the effects of behavioral, medication, or combination treatments on teacher-reported outcomes (disruptive behavior, social skills, internalizing symptoms) in children with attention-deficit hyperactivity disorder (ADHD). Participants were 579 children with Combined-type ADHD, aged 7–9.9 years, in the Multimodal Treatment Study of Children with ADHD (MTA). We uncovered 2 second-order factors of parenting practices, entitled Positive Involvement and Negative/Ineffective Discipline. Although Positive Involvement was not associated with amelioration of the school-based outcome measures, reductions in Negative/Ineffective Discipline mediated improvement in children's social skills at school. For families showing the greatest reductions in Negative/Ineffective Discipline, effects of combined medication plus behavioral treatment were pronounced in relation to regular community care. Furthermore, only in combination treatment (and not in behavioral treatment alone) was decreased Negative/Ineffective Discipline associated with reduction in children's disruptive behavior at school. Here, children in families receiving combination treatment who showed the greatest reductions in Negative/Ineffective Discipline had teacher-reported disruptive behavior that was essentially normalized. Overall, the success of combination treatment for important school-related outcomes appears related to reductions in negative and ineffective parenting practices at home; we discuss problems in interpreting the temporal sequencing of such process-outcome linkages and the means by which multimodal treatment may be mediated by psychosocial processes related to parenting.     

Parenting and Family Stress Treatment Outcomes in Attention Deficit Hyperactivity Disorder (ADHD): An Empirical Analysis in the MTA Study

Parenting and family stress treatment outcomes in the MTA study were examined. Male and female (579), 7–9-year-old children with combined type Attention Deficit Hyperactivity Disorder (ADHD), were recruited at six sites around the United States and Canada, and randomly assigned to one of four groups: intensive, multi-faceted behavior therapy program alone (Beh); carefully titrated and monitored medication management strategy alone (MedMgt); a well-integrated combination of the two (Comb); or a community comparison group (CC). Treatment occurred over 14 months, and assessments were taken at baseline, 3, 9, and 14 months. Parenting behavior and family stress were assessed using parent-report and child-report inventories. Results showed that Beh alone, MedMgt alone, and Comb produced significantly greater decreases in a parent-rated measure of negative parenting, Negative/Ineffective Discipline, than did standard community treatment. The three MTA treatments did not differ significantly from each other on this domain. No differences were noted among the four groups on positive parenting or on family stress variables. Results are discussed in terms of the theoretical and empirically documented importance of negative parenting in the symptoms, comorbidities and long-term outcomes of ADHD.     

Modification of verbal behavior through variable interval reinforcement in a quasi-therapy situation

Principles from the operant conditioning laboratory were applied to the verbal behavior of female college students. An experimental setting was designed to replicate a psychotherapist's office, and subjects were seen daily in a study using a functional research design. Variable interval reinforcement was employed to modify the rate of emission of positive self-reference statements. Results demonstrated that the verbal, scheduled reinforcement exerted a definite, marked effect on the verbal behavior of the subjects. All subjects conditioned to the schedules. Sequence of scheduling did not appear to be a significant variable. The feasibility of employing such techniques in actual psychotherapy is discussed.     

Psychiatric correlates of childhood shyness in a nationally representative sample

Relations between adult anxiety and mood disorders and retrospective reports of excessive childhood shyness were investigated in the US National Comorbidity, Survey (n=5877). Results indicated that 26% of women and 19% of men described themselves as 'very shy' when they were growing up. Of these shy individuals, 53% of women and 40% of men met criteria for a lifetime diagnosis of one or more anxiety or mood disorders. Relations between excessive shyness and each of the anxiety and mood disorders were examined after adjusting for elevated neuroticism, self-criticism, and low maternal care. The largest odds ratios were found for social phobia in both men and women, particularly for the complex subtype of this disorder. Significant associations also emerged for posttraumatic stress disorder in women and for major depressive disorder in men. Childhood shyness remained significantly associated with a lifetime history of social phobia when individuals with current (past year) social phobia were excluded from the analysis. The results of this study suggest that childhood shyness is strongly related to the complex subtype of social phobia in the general population. Excessive shyness does not appear to be strongly associated with other anxiety and mood disorders when related psychosocial and developmental dimensions are statistically controlled. Finally, many individuals who report excessive childhood shyness do not meet criteria for any anxiety or mood disorder. In a similar fashion, approximately 50% of individuals with a lifetime history of complex social phobia did not view themselves as very shy when growing up.