Treatment of obsessive-compulsive patients: The contribution of self-instructional training to the effectiveness of exposure

Fifteen obsessive-compulsive patients were given treatment consisting of ten sessions of gradual exposure in vivo. For half of the patients gradual exposure in vivo was preceded by self-instructional training.Treatment resulted in significant improvement on anxiety and avoidance scales, Leyton Obsessional Inventory, Self-rating Depression Scale and on ratings for anxious mood and depression. Neither the post-test nor the follow-ups 1 month and 6 months later indicated a difference between the effects of the two conditions. Self-instructional training did not enhance the effectiveness of gradual exposure in vivo.     

Medicine as a trade

The doctor-patient relationship is usually seen and accepted as a giving-taking association, in which the doctor is a giver and the patient is a taker. The paper challenges such a one-way relationship, and stresses the patient as a giver and the doctor as a receiver. The patient is described as a source for the emotional development of the doctor, and as a source of knowledge. He is also a source for what could be called ‘life experience’. By serving as a source for these three elements, the patient is also seen as a source for reward. There is a danger of under-utilisation of this reward by the doctor, when (1) he is engaged only in giving, (2) he wilfully obstructs the channel of information, and (3) he feels ‘saturation’ called by the doctor ‘experience’. This under-utilisation will ultimately lead to ‘medical parasitism’. This parasitism is seldom recognised by the patient, because the arrest of development of a doctor is usually hardly noticed, and this will lead to neglect of the patient, so that the ‘trade’ between doctor and patient becomes unfair, as the long-term investment which the patient has placed in the doctor, does not pay off any longer.     

TEACHING THE HANDICAPPED TO EAT IN PUBLIC PLACES: ACQUISITION,GENERALIZATION AND MAINTENANCE OF RESTAURANT SKILLS

This study examined classroom-based instruction in restauranting skills for handicapped persons. Three male students were taught each of four skill components in sequential order: locating, ordering, paying, and eating and exiting. Training was implemented in a multiple baseline design across subjects and consisted of modeling and role playing in conjunction with photo slide sequences and a simulated ordering counter. The use of a menu containing general item classes and a finger matching procedure for identifying errors in the delivery of change greatly reduced the reading and math skills necessary to enter and complete the program. Periodic probes were conducted in a McDonald's restaurant prior to, during, and up to one-year following the termination of training. In addition, two probes (overt and covert observation) were conducted in a Burger King restaurant to assess further generalization to a location different from the one depicted throughout training. Results showed that students' performance on restaurant probes improved as a result of training, generalized to novel settings, maintained over an extended period of time, and was comparable to that of a normative sample of nonretarded persons.     

Foveal diplopia thresholds and fixation disparities

Comparison of the magnitude and intrinsic spread of foveal diplopia thresholds with the accuracy of ocular alignment as determined with a subjective alignment method shows that: the accuracy of alignment in the vertical direction (within 1–2 min) is remarkably good and much better than in the horizontal direction; the largest disparities occurring due to restricted alignment accuracy are usually substantially smaller than the foveal diplopia thresholds; interindividual variability in the magnitude of foveal diplopia thresholds is not due only to interindividual variability in the alignment accuracy; and the spread of foveal diplopia thresholds exceeds the spread of ocular alignment, which implies that the noise in the foveal disparity domain is not only due to the restricted alignment accuracy but also to sensory processes. Finally, the data confirm that, unlike the case with diplopia thresholds, the spread of stereoscopic thresholds is not affected by the restricted alignment accuracy.     

The linear utility model for optimal selection

A linear utility model is introduced for optimal selection when several subpopulations of applicants are to be distinguished. Using this model, procedures are described for obtaining optimal cutting scores in subpopulations in quota-free as well as quota-restricted selection situations. The cutting scores are optimal in the sense that they maximize the overall expected utility of the selection process. The procedures are demonstrated with empirical data.     

On the meaning of indexicals

The approach adopted in the paper is based on the theory known as Montague grammar. Accepting, in general, that theory — especially in its modified version, which is due to Thomason and Kaplan — the author points out certain inadequacy in its treatment of the meaning of some indexical expressions and suggests some modification of its theoretical framework in order to avoid that shortcoming. It is claimed that to do justice to the meaning of so-called indefinite indexicals (such as “we”, “you”, “now”) two kinds of dependence of their semantic values upon the context of use must be taken into account — a semantic (or lexical) and a pragmatic (or extralexical) one.     

Attitude extremity,consensus and diagnosticity

Studied the effects of attitude extremity on perceived consensus and willingness to ascribe trait terms to others with either pro or anti nuclear attitudes. Results showed that attitude extremity affected consensus estimates. Trait attributions revealed a clear effect for valence, especially for the extreme attitude groups. Subjects with extreme attitudes also ascribed more traits to both pro and anti others than subjects with relatively moderate attitudes.     

Feature-specific interference in letter identification

It is a well documented finding that letter identification may be impaired by the presence of neighboring characters. There is much less agreement about the exact nature of such lateral interference. Evidence has been obtained for feature-specific interference, and even feature-specific facilitation. Santee and Egeth (1980) suggested that feature-specific interference will mainly be observed in data-limited situations where stimuli are presented for short durations and positional uncertainty is involved. They further suggested that interference would be revealed in accuracy rather than latency measures.In our first experiment, similar exposure conditions were used to those suggested by Santee and Egeth. In a second experiment, however, a longer exposure duration was used, and latency measurements were also collected. In a third experiment, positional uncertainty was removed by foveal presentation, and with this high quality stimulus presentation only latency measurements could be obtained.In all these experiments clear evidence for feature-specific interference was found, both in accuracy and latency data, and these results also held up under the detectability/criterion analysis proposed by Estes (1982). From these findings it can be concluded that feature-specific interference occurs under a wide range of conditions, including those representative of normal reading.     

Assertive training for agoraphobics

Twenty-one unassertive agoraphobic patients were assigned to one of three treatments: (1) prolonged exposure in vivo, (2) assertive training and (3) a combination of assertive training and prolonged exposure in vivo. Each treatment was conducted in groups which were led by two therapists. Assessments involved both phobic targets and assertiveness, and were made before and after treatment, and at 1-month follow-up. Exposure in vivo was found to be superior to assertive training on phobic targets. Assertive training produced greater gains in assertiveness than exposure in vivo. The combination of treatments produced results comparable to exposure in viro. Results indicated that the type of change produced by the treatments is a rather specific one and is related to the specific target of treatment.