Competing stimulus assessments: A systematic review

The current review summarizes the literature on competing stimulus assessments (CSAs). CSAs are pretreatment assessments designed to systematically identify stimuli that reduce problem behavior (PB), ostensibly through reinforcer competition or substitution. We report on the participant characteristics, outcomes, and predictive validity of published CSAs that included (a) no-stimulus control trial(s), (b) test trials during which each stimulus was available singly and noncontingently, and (c) measurement of PB and stimulus engagement or contact. Results showed that CSAs have broad utility across a variety of topographies and functions of PB. In the majority of CSA applications for which extended analyses, or validations, were performed, stimuli shown to reduce PB during the CSA produced similar reductions during extended analysis. This was the case regardless of topography or function of PB, or whether the stimuli were assumed to be “matched” to the stimulation thought to be produced by PB. Implications for future research are discussed.     

EFFECTIVENESS OF FUNCTIONAL COMMUNICATION TRAINING WITH AND WITHOUT EXTINCTION AND PUNISHMENT: A SUMMARY OF 21 INPATIENT CASES

Functional communication training (FCT) is a frequently used treatment for reducing problem behavior exhibited by individuals with developmental disabilities. Once the operant function of problem behavior is identified by a functional analysis, the client is taught to emit an appropriate communicative response to obtain the reinforcer that is responsible for behavioral maintenance. Studies on FCT have typically used small numbers of participants, have reported primarily on clients for whom FCT was successful, and have varied with respect to their use of other treatment components. The main purposes of the present study were to evaluate the efficacy of FCT for treating severe problem behavior in a relatively large sample of individuals with mental retardation (N = 21) and to determine the contribution of extinction and punishment components to FCT treatment packages. FCT with extinction was effective in reducing problem behavior for the majority of clients and resulted in at least a 90% reduction in problem behavior in nearly half the applications. However, when demand or delay-to-reinforcement fading was added to FCT with extinction, treatment efficacy was reduced in about one half of the applications. FCT with punishment (both with and without fading) resulted in at least a 90% reduction in problem behavior for every case in which it was applied.     

Pathological narcissism and serial homicide: Review and case study

Serial homicide, as a psychopathological condition, has been described as long ago as 1886. The traits and characteristics of serial murderers are varied, as are the theories that attempt to explain their motivation. Theorists have emphasized, for example, traumatic events in early life, sexual disturbance and dynamics, and neurobiological abnormalities. In the past fifteen years, as narcissistic disturbance in general has been better understood, a relationship has been noted between pathological narcissism and serial homicide. Narcissistic personality disorder, narcissistic injury, underlying feel-ings of inadequacy and humiliation, self-glorifying compensatory fantasies, and the erection of narcissistic defenses have all been mentioned as important factors in un-derstanding the serial killer. An illustrative case report, which encompasses many of these characteristics, is presented here along with a review of clinical research, theory, and findings.     

Understanding and Treating Pain in Ethnically Diverse Patients

A revolution has taken place during the past 25 years in the understanding and treatment of chronic pain. Psychologists have contributed tremendously to this revolution. However, the primary psychological models of pain treatment have failed to adequately integrate the empirical findings and theoretical understanding of the role of ethnic factors. The goal of this paper is to address this problem by demonstrating the importance of understanding ethnic factors in treating pain, providing an overview of ethnic factors in pain, and proposing guidelines for Clinical Psychologists who treat pain patients from ethnically diverse backgrounds.