The evolution of a therapy group for vietnam veterans on a general psychiatry unit

The evolution of a therapy group for hospitalized Vietnam veterans with post-traumatic stress disorder (PTSD) and related symptomatology is described. The literature on group treatment for this population is briefly reviewed and discussed in relation to an inpatient psychiatry setting. The prevailing conditions at the time of group inception are recalled along with the initial goals of the therapeutic intervention. Problems encountered are also discussed, along with the changes made in response to these identified difficulties. The results of three and one-half years of experience with this group are described in detail.The authors would like to thank Cynthia Sturm, Ph.D. for her helpful editorial assistance.     

SERIOUS DELINQUENT BEHAVIOR AS PART OF A SIGNIFICANTLY HANDICAPPING CONDITION: CURES AND SUPPORTIVE ENVIRONMENTS

The past 20 years have been productive ones for the field of applied behavior analysis. A brief review of our own efforts during this period reveals that we have accomplished several but not all of our goals for the Teaching-Family approach. In this context, we note that the setting of realistic and appropriate goals is important for the field and for society. Moreover, we suggest that the realistic goal for some persons with serious delinquent behavior may be extended supportive and socializing treatment rather than permanent cure from conventional short-term treatment programs. We base this suggestion on the accumulating evidence that serious delinquent behavior may often be part of a significantly disabling and durable condition that consists of multiple antisocial and dysfunctional behaviors, often runs in families, and robustly eludes effective short-term treatment. Like other significant disabilities such as retardation, autism, and blindness, the effects of this condition may be a function of an interaction of environmental and constitutional variables. We argue that our field has the wherewithal to construct effective and humane long-term supportive environments for seriously delinquent youths. In this regard, we explore the dimensions, rationales, logistics, and beginnings of a new treatment direction that involves long-term supportive family treatment. We contend that such supportive families may be able to provide long, perhaps even lifetime, socializing influences through models, values, and contingencies that seem essential for developing and maintaining prosocial behavior in these high-risk youths.     

APPARENT COVARIATION BETWEEN CHILD HABIT DISORDERS: EFFECTS OF SUCCESSFUL TREATMENT FOR THUMB SUCKING ON UNTARGETED CHRONIC HAIR PULLING

We evaluated the effects of aversive taste treatment of thumb sucking on untreated trichotillomania (habitual hair pulling) in two children who chronically pulled their hair and sucked their thumbs. A combination of withdrawal and nonconcurrent multiple baseline designs showed that, concomitant with the successful treatment of thumb sucking, hair pulling was also eliminated. The results suggest an efficient method for changing behaviors that are difficult to treat directly.     

Target Groups for Preventing AIDS Among Intravenous Drug Users

The acquired immune deficiency syndrome (AIDS) has rapidly become the most serious medical consequence of injecting illicit drugs. Its potential impact on intravenous (IV) drug use is enormous. Human immunodeficiency virus (HIV, also known as HTLV-III and LAV), the virus that causes AIDS, appears, usually, to lead to lifelong infection. At present there is no effective treatment, and the treatments under development may require lifelong antiviral therapy. Since most of the antibody produced in response to HIV infection does not neutralize the virus, and since there is substantial genetic variation in the virus, it will be difficult to develop a vaccine. Even after vaccines are developed, testing their safety and efficacy will be formidable problems. Until either effective treatment or vaccines are developed, control of the epidemic among IV drug users must be attempted through behavior change/prevention efforts. In this paper we will review the epidemiology of AIDS among IV drug users and characteristics of the IV drug-use subculture relevant to prevention efforts. We will then identify different target groups for these prevention efforts, present available evidence about behavior change in these groups, and then briefly discuss how to prevent transmission of HIV to heterosexual partners who are not themselves IV drug users and to the children of IV drug users.     

PROMOTING AUTOMOBILE SAFETY BELT USE BY YOUNG CHILDREN

A program using behavioral practice, assertiveness training, and social and contrived reinforcers was developed to establish and maintain automobile safety belt use by young children. Sixteen children (ages 4.8 to 7 years) who never used their safety belts during a 5-day preexperimental observation period were randomly assigned to two groups of eight each. A multiple baseline design across groups was used to evaluate the effectiveness of the training program. During the 8-day baseline period for Group 1, no children used their safety belts when unobtrusively observed while being driven from school. During the 26-day intervention period, the children were buckled up on 96% of the observations. Follow-up probes conducted 2–3 months after program discontinuance found safety belt use to range from 86% to 100%. For Group 2, the 14-day baseline safety belt use averaged 6% and increased to a mean of 81% during the 20-day training and maintenance program. Follow-up probes 2–3 months later found safety belt use to occur during 75% to 96% of the observations. Parent questionnaires indicated the generalizability and social validity of the program.     

Unprogrammed effects of training high-status peers to interact with severely handicapped children.

We examined the effects of a peer initiation intervention with high- and low-status nonhandicapped students on the behavior of untrained peers toward handicapped students. In the context of a counterbalanced withdrawal design, high- and low-status nonhandicapped students were taught to direct social initiations to eight severely handicapped students during recess activities. The interactions of the high-status students resulted in higher levels of initiations by untrained peers toward the handicapped students than did the interactions of the low-status students. Social response levels were also differentially affected by the status of the peer initiator.     

Saying and doing: A contingency-space analysis

Correspondences between verbal responding (saying) and nonverbal responding (doing) may be organized in terms of the classes of verbal/nonverbal relations into which particular instances of verbal/nonverbal response sequences can enter. Contingency spaces, which display relations among events in terms of the probability of one event given or not given another, have been useful in analyses of nonverbal behavior. We derive a taxonomy of verbal/nonverbal behavior relations from a contingency space that takes into account two conditional probabilities: the probability of a nonverbal response given a verbal response and that probability given the absence of the verbal response. For example, positive correspondence may be said to exist as a response class when the probability of doing is high given saying but is otherwise low. Criteria for other generalized classes, including negative correspondence, follow from this analysis.     

Histories of sexual abuse in adolescent male runaways

In this study, data on sexual victimization in the histories of 89 Canadian male runaways as well as information on physical victimization, family structure, family financial stability, delinquent and criminal activities, and reasons for running away from home were evaluated. The population of male runaways evidenced dramatically higher rates of sexual and physical abuse than did randomly sampled populations. Sexually abused and nonsexually abused male runaways shared characteristics noted in the literature as common to runaways: problem families, high rates of delinquency, depression, tension, low self-image, and history of physical abuse. Sexually abused male runaways differed from nonsexually abused runaways in their reactions to their runaway event, with sexually abused male runaways responding in highly avoidant patterns coupled with extreme withdrawal from all types of interpersonal relationships. These differences are explained as consistent with known sequelae of sexual abuse, and the implications for treatment by runaway shelters and for further research are suggested.     

How adolescents perceive their relationships

In order to determine how adolescents perceive their relationships, a set of eight drawings representing one, two or three characters, whose sex and relationships where not clearly defined, were shown to 403 Parisian adolescents (227 girls and 176 boys) aged 15 to 19. The majority of data converge for all subjects, regardless of the sex, curriculum or socioeconomic factors. The subjects consistently identify more mixed-sex dyads and triads than same-sex in all pictures. This predominance does not imply that the adolescents perceived all relationships as having a romantic connotation. Some data seem consistent with the traditional sex role stereotypes. The subjects' responses do not seem to reflect the reality of their own peer relationships.