Randomized Trial Comparing Two Treatment Strategies Using Prize-Based Reinforcement of Abstinence in Cocaine and Opiate Users

We compared two strategies of prize-based contingency management (CM) in methadone-maintained outpatients. Urine was tested thrice weekly for 5 weeks pre-CM, 12 weeks CM, and 8 weeks post-CM. Participants were randomly assigned to a cocaine contingency (four prize draws for each cocaine-negative urine, N  =  29) or an opiate-cocaine contingency (one draw for each urine negative for opiates or cocaine, four draws if negative for both, N  =  38). There were no group differences in cocaine abstinence during CM or post-CM and no differences in opiate abstinence during CM. Opiate abstinence was greater in the opiate-cocaine group post-CM, and heroin craving was reduced in this group during and post-CM. Draws earned per cocaine-negative urine (four vs. one) did not affect cocaine use.     

Pilot Evaluation of Outcomes of Combined Parent-Child Cognitive-Behavioral Group Therapy for Families at Risk for Child Physical Abuse

Child physical abuse (CPA) is not only a highly prevalent public health problem, but it has been associated with a wide range of debilitating psychosocial sequelae that may develop during childhood and persist into adulthood. This paper outlines a treatment model, Combined Parent-Child Cognitive-Behavioral Therapy (CPC-CBT), that addresses the complex needs of the parent who engages in physically abusive behavior and the traumatized child. This pilot program was conducted to examine the feasibility of a CBT group approach that incorporates the child into the offending parent's treatment. It highlights the use of gradual exposure, developing a trauma narrative and abuse clarification to address PTSD symptoms in children. Parent components include motivational interviewing and consequence review, cognitive and behavioral anger-control strategies, and the examination of parent-child interactions to assist parents in modulating their emotions, remaining calm, and using effective problem-solving during child-rearing situations. Pilot data examining pre- to posttreatment changes for parents and children participating in the 16-week group treatment program are presented. Participants were 12 caregivers, ages 25 to 54, and their 21 children, ages 4 to 14, who were referred for the treatment of issues related to CPA. About 48% of participating parents were referred for substantiated CPA against their children, while the other parents were deemed to be at-risk for CPA. Both parents and children reported significant pre- to posttreatment reductions in the use of physical punishment. Results also demonstrated pre- to posttreatment improvements in parental anger toward their children, and consistent parenting as well as children's posttraumatic stress symptoms and behavioral problems. Clinical and research implications for these preliminary findings are discussed.     

Gray matter and intelligence factors: Is there a neuro-g?

Heterogeneous results among neuro-imaging studies using psychometric intelligence measures may result from the variety of tests used. The g-factor may provide a common metric across studies. Here we derived a g-factor from a battery of eight cognitive tests completed by 6929 young adults, 40 of whom also completed structural MRI scans. Regional gray matter (GM) was determined using voxel-based-morphometry (VBM) and correlated to g-scores. Results showed correlations distributed throughout the brain, but there was limited overlap with brain areas identified in a similar study that used a different battery of tests to derive g-scores. Comparable spatial scores (with g variance removed) also were derived from both batteries, and there was considerable overlap in brain areas where GM was correlated to the respective spatial scores. The results indicate that g-scores derived from different test batteries do not necessarily have equivalent neuro-anatomical substrates, suggesting that identifying a “neuro-g” will be difficult. The neuro-anatomical substrate of a spatial factor, however, appears more consistent and implicates a distributed network of brain areas that may be involved with spatial ability. Future imaging studies directed at identifying the neural basis of intelligence may benefit from using a psychometric test battery chosen with specific criteria.     

Hempel's Paradox, Law-likeness and Causal Relations

It is widely thought that Bayesian confirmation theory has provided a solution to Hempel's Paradox (the Ravens Paradox). I discuss one well-known example of this approach, by John Mackie, and argue that it is unconvincing. I then suggest an alternative solution, which shows that the Bayesian approach is altogether mistaken. Nicod's Condition should be rejected because a generalisation is not confirmed by any of its instances if it is not law-like. And even law-like non-basic empirical generalisations, which are expressions of assumed underlying causal regularities, are not so confirmed if they are absurd in the light of our causal background knowledge or if their instances are not also possible instances of the relevant causal claim.     

Factorial structure of traits delineating personality disorders in clinical and general population samples.

Categorical and dimensional models for classifying personality disorders were evaluated by comparing the structure of personality pathology in a clinical sample (n = 158) with the structure in a general population sample (n = 274). Subjects completed 100 personality scales. Separate factor analyses revealed similar structures in the 2 samples. An underlying structure in a combined sample showed limited agreement with the concepts of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1987). Fifteen factors were retained: Generalized Distress, Rejection, Restricted Expression, Compulsivity, Stimulus Seeking, Insecure Attachment, Diffidence, Intimacy Problems, Oppositionality, Interpersonal Disesteem, Conduct Problems, Cognitive Dysfunction, Affective Reactivity, Narcissism, and Social Apprehensiveness. The results are consistent with a dimensional representation of personality disorder.     

A microcomputer-based cardiotachometer with video display

A KIM-1 single board microcomputer implementation of a cardiotachometer that provides a low-cost versatile heart-rate data acquisition system is described. Unique features include telemetry, a composite video output signal of a video frame displaying elapsed time and heart-rate, and a TV camera signal of the behavior. Data is videotape- and/or audiotape-recorded for further analysis with a larger computer.     

Transfer of fear reduction through systematic desensitization

Systematic desensitization therapy involves the presentation of fear-provoking situations through visualization As the visualizations cease to evoke emotional responses, the fear-provoking potential of the real situations decreases. Research has clearly shown that such transfer does indeed occur with a wide variety of fears. Transfer has been demonstrated, for example, with fear of small animals (Lang and Lazovik, 1963), interpersonal performance anxiety (Paul, 1966), classic phobias (Lazarus, 1961), test anxiety (Katahn, Strenger and Cherry, 1966), impotence (Wolpe, 1958) and frigidity (Lazarus, 1963). However, the nature of transfer has received little attention. Wolpe (1963) has claimed that transfer from therapy to the real life situation is almost complete and direct: “There is almost invariably a one-to one relationship between what the patient can imagine without anxiety and what he can experience in reality without anxiety”. This claim has received support from Rachman (1966) who found that fear reduction transferred immediately to the real situation in 82 per cent of his observations. Hoenig and Reed (1966) reported that after a brief delay, transfer effects were observed in the case of words representing fearful stimuli but were inconsistent in the case of the real stimuli. Agras (1967) found transfer to be delayed in all his cases. He further reported that, though all patients improved, a direct relationship between therapeutic progress and symptom reduction was not found. Both Hain et al. (1966) and Meyer and Crisp (1966) have described the failure of therapeutic effects to transfer to real life.These somewhat inconsistent reports may stem in part from the measurement of transfer effects at different times. Another possibility is that more fearful Ss may evidence less transfer than less fearful Ss. Lang and Lazovik (1963) reported that Ss who completed less than 75 per cent of the hierarchy showed little improvement although direct transfer effects were observed for less fearful Ss (those who complete 75 per cent or more hierarchy items). The present study of transfer effects was designed to remove confoundingof level of fear with extent of progress in systematic desensitization.