Expanding Treatment Options for Children With Selective Mutism: Rationale,Principles, and Procedures for an Intensive Group Behavioral Treatment

Children with selective mutism (SM) experience significant challenges in a variety of social situations, leading to difficulties with academics, peers, and family functioning. Despite the extensive evidence base for cognitive-behavioral interventions for youth anxiety, the literature has seen relatively limited advancement in specialized treatment methods for SM. In addition, geographic disparities in SM treatment expertise and the roughly 6-month duration of some of the supported SM treatment protocols can further restrict the accessibility and acceptability of quality SM care. Intensive group behavioral treatment (IGBT) for SM was developed to expand the portfolio of evidence-based SM treatment options by offering brief, but high-dose, expert SM intervention in a group format for youth ages 3–10 years that can be completed in 1 week. In this article, we outline IGBT for SM program, which has already received initial support in a waitlist-controlled trial. Our presentation is organized around the five main components of the treatment model: (1) individual “lead-in” sessions, (2) camp (i.e., all-day group sessions for children held in a simulated classroom setting, with an emphasis on graduated exposures and structured reinforcement), (3) parent training, (4) school outreach, and (5) booster treatment, as needed. We conclude with a discussion of clinical considerations and future directions for further IGBT refinement and evaluation.     

A Single-Session Workshop to Enhance Emotional Awareness and Emotion Regulation for Graduate Students: A Pilot Study

Emerging adults are at substantial risk for developing or worsening psychopathology and university students appear to be particularly vulnerable. Interventions targeted at these young adults that can mitigate transdiagnostic causal risk factors or burgeoning mental health problems have the potential to make a large impact. We aimed to develop and pilot test an accessible, single-session, transdiagnostic group intervention with the goals of enhancing emotion regulation skills and reducing risk for mental health problems in graduate students. The intervention included psychoeducation, skills instruction (e.g., mindful emotion awareness, cognitive flexibility, countering emotion-driven behaviors), group discussion, and supervised practice based on content from the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders. The pilot program demonstrated strong feasibility and acceptability. Baseline, 1-month, and 3-month follow-up surveys also suggested benefits for reducing emotional avoidance and suppression, increasing use of cognitive reappraisal, and reducing symptoms of depression and neuroticism. Graduate students have seldom been the beneficiaries of university-based intervention and prevention research. Furthermore, most college and university mental health centers do not have the capacity to provide psychoeducation, preventative, or early intervention services to the many students who need or could benefit from them. Results suggest that future iterations of this intervention could address such barriers to meaningfully supporting emerging adults in graduate school.     

Re-exposure to reinforcement in Context A during treatment in Context B reduces ABC renewal

Previous work from our laboratory showed that intermittently re-exposing rats to reinforcement for lever pressing in a training (A) context, while eliminating lever pressing in a second (B) context, increased ABA renewal of lever pressing relative to rats that experienced only Context B during response elimination. In the current study, we replicated these procedures while assessing renewal in the presence of a novel context (i.e., ABC renewal). Unlike the findings described above, renewal was reduced in the group that experienced re-exposure to Context A during lever-press elimination relative to rats that experienced only Context B. These findings suggest that alternating between contexts associated with reinforcement and extinction during treatment reduces the probability that organisms will respond in novel contexts. These outcomes may be the result of discrimination and/or generalization processes. Moreover, this training procedure may offer a potential mitigation strategy for ABC renewal.     

Assessment and treatment of elopement maintained by chase

Elopement can have serious or fatal consequences associated with leaving the presence of an adult or getting lost (e.g., traffic injury and drowning). Given the dangers associated with elopement, caregivers are likely to chase after their child when elopement occurs. Like other forms of attention that follow problem behavior, chasing and retrieving the child may serve as a reinforcer and therefore maintain elopement. However, no study to date has evaluated whether elopement is sensitive to positive reinforcement in the form of chase. We evaluated the effects of chase on elopement with an 8‐year old boy diagnosed with autism. Elopement was maintained, at least in part, by chase. We then conducted a treatment evaluation in which we tested the effects of various antecedent‐ and consequence‐based treatment components within a multiple schedule.     

Scale invariance in near space: pointing under influence of context

This paper describes the results of a pointing task close to the observer. Unlike most research reported in literature, the stimuli were composed of real solid objects in an unambiguous context, free of any cue conflict. Moreover, the stimuli were either within arm-reach or just beyond arm-reach, thus having strong binocular depth cues. Surprisingly, systematic errors up to four times the standard deviation were found. These errors depended mainly on the variations in context and hardly on egocentric distance. In good first approximation, the results were scale invariant. These results are in direct conflict with classic theories about visual space. The stimuli were unambiguous real 3-D equivalents of the computer-generated stimuli we used in a previous experiment. A comparison of the results did not reveal a clear effect of a depth cue conflict between accommodation and disparity.     

Specifying the impulsivity of female inmates with borderline personality disorder

Impulsivity is regarded as a core feature of borderline personality disorder (BPD; M. C. Zanarini, J. G. Gunderson, & F. R. Frankenburg, 1989) despite lack of evidence from laboratory research (D. M. Dougherty, J. M Bjork, H. C. G. Huckabee, F. G. Moeller, & A. C. Swann, 1999). This study examined impulsivity in incarcerated women with BPD using a passive avoidance task (J. P. Newman & W. A. Schmitt, 1998) and the Impulsiveness-Monotony Avoidance-Detachment inventory (IMD; D. Schalling, 1978). As predicted, incarcerated women diagnosed with BPD committed more passive avoidance errors and reported more impulsivity on the IMD than controls. These findings identify disinhibition as a potentially important component of the impulsivity that characterizes BPD. Specifying the impulsive behavior identified with BPD may contribute to the effective assessment and management of the disorder.     

Sex differences in communication with close friends: testing Tannen's claims

In 1990 Tannen reported that men have fewer close friends than women, men discuss less intimate topics with their friends than women, and men and women respond differently to close friends' problems. 168 students completed a three-page survey designed to examine Tannen's claims. Consistent with Tannen's observations, men discussed less intimate topics (politics and school or work) with their five closest friends and reportedly were less likely to comfort or listen to their friends' problems than women were. Inconsistent with Tannen's statements, these women and men did not differ in the number of close friends they reported having or in the likelihood of offering advice when presented with a friend's problem. Present self-reports corroborate other researchers who questioned Tannen's findings and concluded that sex differences in interpersonal communication are small.     

Perceptions of another person's heavy drinking as a function of one's relationship to the drinker a pilot study

Of 301 participants in a telephone survey, 201 could identify a problem drinker within their social networks. In 67 cases the drinker was a partner, in 45 another family member, in 61 a friend, and in 28 a work colleague. Another person's heavy drinking was reported as most disrupting to one's life when that person was a partner or other family member or if one was living in the same residence as the drinker. The exception to this was that reported disruption to respondents' work life was greatest when the drinker was a work colleague. While there appear to be problems for friends and work colleagues, partners and other family members appear to report the most disruption so providing services to family members seems appropriate.     

Money Doesn't Talk, It Swears: How Economic Stress and Resistance Resources Impact Inner-City Women's Depressive Mood

We examined the differential impact of chronic versus acute economic stress on depressive mood among a sample of 1241 low-income, single, European and African American women. Based on Hobfoll's (1988, 1989) conservation of resources (COR) theory, we predicted that acute resource loss would be more distressing than chronic economic lack. That is, although chronically impoverished conditions are stressful, the attendant resource losses created will be more distressing. We further predicted that mastery and social support would be more beneficial in offsetting the negative consequences of acute resource loss than the negative consequences of chronic economic lack, because acute loss creates identifiable demands that resources may address. Hence, we hypothesized that mastery and social support would show stress buffering effects only for material loss, not chronic lack. The findings generally supported the hypotheses, but mastery buffered only European American women's resource loss and social support buffered only African American women's resource loss. The findings are discussed in light of implications for prevention within theoretical and cultural contexts.