Contextual effects on the ability of divers to use decompression tables

The present study compared the ability of novice divers to apply decompression tables having learnt how to use them in either the same or a different environment. Those subjects who had learnt how to use the tables in a different environment (i. e. had learnt on dry land and were tested underwater or vice-versa) performed on average 64 percent worse than those who had the same environment for both learning and test. This effect could not be ascribed to the disruption brought about by changing environments. The results show that contextual effects on memory extend beyond the recall of word lists (Godden and Baddeley, 1975) to the ability to implement potentially important instructions.     

Persuasion criteria in research and practice: Gathering more meaningful psychotherapy data

Psychotherapy research should ultimately benefit the psychotherapy client. Unfortunately, traditional psychotherapy research continues to have little influence on practicing clinicians and, therefore, does not benefit psychotherapy clients. As behavior analysts begin to show interest in this area of research, they may be in a position to improve its quality. We argue that traditional psychotherapy researchers have become prematurely wedded to a methodology that does not address the concerns of clinical audiences. Furthermore, we make a case for defining and evaluating psychotherapy data in terms of its capacity to influence both researchers and clinicians. We also suggest several alternative methods for gathering psychotherapy data based on the case formulation approach. We argue that this approach may be one of the most promising methods for gathering useful psychotherapy data.     

Predictors of stress in adolescents: an exploratory study of pregnant and of parenting females

A study of 152 adolescents enrolled in school-based programs for pregnant and parenting youth in Colorado in 1987-88 found no differences in overall stress levels between these two groups; however, salient predictors of stressful life events for pregnant teens were not the same as those for teen mothers. The mean age of study subjects was 16.5 years (range 14-19 years); most were living with a parent rather than the child's father. The dependent variable, level of stress, was measured through use of an abbreviated Life Events Questionnaire. Independent variables were assessed through administration of the Inventory of Social Supportive Behaviors, Rosenberg Self-Esteem Scale, and the Adolescent Coping Orientation for Problem Experiences scale. Of the 5 sources of stress measured (family, accidents, autonomy, deviance, relocation, and distress), only stress related to accidents differed significantly between pregnant and parenting adolescents. For pregnant adolescents, self-esteem was the only significant predictor of the overall level of stress; among parents, the only significant predictor was objective social support. Among adolescents, self-esteem was associated with more frequent use of social support and coping strategies. For parenting adolescents, self-esteem was correlated with the frequency of use of social support, satisfaction resulting from such use, and frequent use of coping strategies. Overall, the independent variables of social support, self-esteem, coping, and age were stronger predictors of stress in pregnant than in parenting adolescent females. This finding suggests that parenting teens may have successfully negotiated the multiple transitions involved in this new stage of the life-cycle. An important implication of this study is the need to design separate counseling components of school-based programs for pregnant versus parenting adolescents rather than to use a single curriculum.     

Family preservation using multisystemic treatment: Long-term follow-up to a clinical trial with serious juvenile offenders

In a randomized clinical trial, multisystemic family preservation was shown to significantly reduce rates of criminal activity and incarceration in a sample of 84 serious juvenile offenders and their multi-need families. In the current study, archival records were searched for re-arrest an average of 2.4 years post-referral. Survival analysis showed that youths who received multisystemic family preservation were less likely to be re-arrested than were youths who had received usual services. Such results represent the first controlled demonstration that family preservation, when delivered via a clearly specified treatment model, has lasting effects with serious juvenile offenders. Implications for family preservation and juvenile justice research are discussed.     

The aggression-coercion cycle: Use of seclusion and restraint in a child psychiatric hospital

The widespread use of seclusion and restraint in child psychiatric hospitals to manage aggression and noncompliance is based on the assumption that coercive consequences reduce the frequency of undesirable behaviors exhibited by the patients. We report a study of the use of seclusion and restraint in a public child psychiatric hospital during a 3-year period. Twenty-eight percent of the patients had been secluded or restrained a total of 1670 times. About 25% of these patients had been secluded more than five times during their hospitalization, and 32% had been placed in restraints more than once. Behaviors that typically resulted in repeated seclusion included physical aggression toward staff, verbal aggression toward peers, non-compliant or oppositional behavior, and self-harm. Variables that predicted patients most at risk for repeated seclusion included age, gender, and psychiatric diagnosis. The predictor variables for those most at risk for repeated restraint included age, property destruction, and self-harm. The high rates of use of seclusion and restraint suggest that these methods for controlling the behavior of children and adolescents in this child psychiatric hospital may not have been therapeutic. We suggest that staff in such hospitals engage in a pattern of behavior characterized by an aggression-coercion cycle, in which increasingly aggressive and coercive behaviors are exhibited by both patients and staff.     

Development of knowledge bases and the reliability of a decision support system for behavioral treatment consultation for persons with mental retardation: The Mental Retardation-Expert

The development of expert and decision support systems requires the collection, organization, codification, and storage of a body of specialized knowledge. The development, using reconstructive methods, of two such knowledge bases, the first containing the current scientific literature and the second containing an expert’s knowledge, is described for an automated decision support system, the Mental Retardation-Expert. This system provides practitioners with assistance in the treatment of aggressive, self-injurious, and destructive behaviors displayed by individuals with mental retardation or developmental disabilities. The average interobserver reliability of the expert knowledge base ranged from 92.5% to 95.0% when calculated across four clinicians’ assessments of 31 abstracted cases.     

Praxis makes perfect: Illness as a bridge between biological concepts of disease and social conceptions of health

Analyses of biological concepts of disease and social conceptions of health indicate that they are structurally interdependent. This in turn suggests the need for a bridge theory of illness. The main features of such a theory are an emphasis on the logical properties of value terms, close attention to the features of the experience of illness, and an analysis of this experience as action failure, drawing directly on the internal structure of action. The practical applications of this theory are outlined for a number of problems in each of the three main practical areas, clinical work, teaching and research. In each case the resources of the theory suggest new models and generate new results. The full practical significance of the theory, however, is shown to consist in the way in which it ties together biological and social theories into an integrated picture of the conceptual structure of medicine as a whole. It is argued, finally, that practical efficiency of this kind is a test of theory not only in the philosophy of medicine but also in general philosophy.     

Disordered Communication and Grieving in Deaf Member Families

When a deaf child is born to hearing parents, a grieving process is initiated in the parents. Unresolved grieving over their child's deafness often makes it difficult for hearing parents to accept the importance of signing, thus increasing the child's problems — further source of grief for these parents. Clinical illustrations are provided of (1) the reciprocal relationship between disruption of the mourning process and disturbance of communication between family members, and (2) the transmission of the dysfunctional relationship between hearing parents and deaf children to the subsequent relationship between the deaf children, when they reach adulthood, and their hearing children.