CLINICAL BEHAVIORAL PHARMACOLOGY: METHODS FOR EVALUATING MEDICATIONS AND CONTINGENCY MANAGEMENT

We evaluated methods for comparing the effects of dextroamphetamine (Dexedrine), thioridazine (Mellaril), and contingency management in the control of severe behavior problems. A reversal design was used in which medications were systematically titrated and assessed in unstructured as well as structured settings with three clients. Subsequently, behavioral procedures including timeout, differential reinforcement of other behavior, and visual screening, were used in a multiple-baseline design across settings. The assessment and design methods were useful in comparing the interventions. Dextroamphetamine decreased inappropriate behaviors and improved academic behaviors in one client, but no reliable effects were observed in the other two clients. Thioridazine was variable across clients, settings, behaviors, and dosages. Contingency management produced consistent decreases in inappropriate behaviors and small improvements in academic performance.     

Expectations,procedural justice,and alternative reactions to being deprived of a desired outcome

People often find that they do not have some positive outcome they once expected to obtain, while others around them have attained that outcome. Two experiments were conducted to assess how four possible responses to such a situation are affected by procedural justice (i.e., the fairness of the procedures by which the object was denied) and by one's expectations about obtaining the outcome in the future. The four possible responses examined were anger responses, achievement strivings, devaluation of the object (X), and self-deprecation. A repeated-measures analysis revealed that the dependent variables were differentially affected in Study 1, but less so in Study 2. Analyses further revealed effects of procedural justice, such that unfair procedures led to more anger, lower achievement strivings, greater devaluation of X, and (in Study 1 only) marginally less self-deprecation. Expectations had only a marginal affect on achievement strivings in Study 1, and an effect on self-deprecation in Study 2, with higher expectations leading to lower achievement strivings and less self-deprecation, respectively. Procedural justice and expectations interacted to affect subjects' derogation of the agent who deprived them (Study 1) and their devaluation of X (Study 2). Implications for future research and for theoretical development are discussed.     

Expectancy,integration, and interactional processes: Age differences in the nature of words affected by sentence context

Two experiments investigated sentence context effects on the naming times of sentence completion words by third-grade children and college students. Across both experiments, the largest age difference in contextual facilitation was obtained for highly predictable, best completion words. Pronounced age differences in facilitation effects were also present for semantically acceptable target words which were much less predictable in the sentence context than the best completion words. However, age differences in contextual facilitation were negligible for target words which were associatively related to the best completion word, but which were not also semantically acceptable in the sentence context. Thus, the semantic acceptability of the word in the sentence context had a much greater influence on children's as compared to adults' word identification times, both when the word was highly predictable, as well as when it was much less predictable in the sentence context.     

The effects of sound duration on newborns' head orientation

Two experiments assessed the importance of sound duration for eliciting head orientation responses from newborn infants. In Experiment 1, thirty infants turned with equal frequency toward 20-s continuous rattle sounds and 20-s trains of rattle segments. The duration of the rattle segments--14 and 100 ms (2/s), or 500 ms (1/s)--did not influence the likelihood of turning. Response latencies and durations proved quite similar for all stimuli. In Experiment 2, twenty-four infants heard continuous rattle sounds of four different durations: 1, 5, 10, and 20 s. They turned reliably to all stimulus durations; furthermore, the magnitude and temporal characteristics of head orientation responses did not differ for the four stimulus durations. These results suggest that the newborn's head orientation response may reflect a motor program that is initiated by auditory input and then executed in a similar fashion regardless of further stimulation.     

Sex roles, gender, and fear

Male and female college students classified as masculine, feminine, androgynous, or undifferentiated on the Bem (1974) Sex Role Inventory (N = 199) were given the Wolpe (1969) Fear Inventory. Significant differences in average fear scores were seen between men and women and between the four sex-role categories, with sex role and gender contributing equally to the variability. The argument is raised here that excessive fearfulness or fearlessness might be as much a product of sex-role conditioning as a product of gender.     

Spiritual support for caregivers of dementia patients

Dementia is considered the major psychiatric disorder of old age and affects over 4 million people in the United States. As Alzheimer's disease and other dementias progress, the patient can become increasingly dependent on the family for care. This dependency can place the caregiver in a role that is both difficult and demanding. In this study coping strategies used by family caregivers of dementia patients and caregivers' sense of burden were assessed. Burden scores were significantly correlated with spiritual support, an external coping strategy. When spiritual well-being is integrated with medical and psychosocial needs, the clergy and spiritual community can play an integral role in the care for families and dementia patients.     

A reappraisal of Teresa of Avila's supposed hysteria

This essay offers a reassessment of Teresa's severe seizures which were such a characteristic feature of her mysticism. The diagnosis of hysteria is no longer viable, at the very least given its abandonment by clinicians. An alternative analysis is developed by phenomenologically comparing Teresa's seizures to parallel experiences of subjects in LSD-assisted psychotherapy. Using Stanislav Grof's categories, it is argued that Teresa's seizures are perinatal symptoms. As such, they represent the emergence and reintegration of extremely primitive psychological systems and might be described as the growing pains of transpersonal consciousness. They reflect not degenerative psychopathology but progressive movement toward higher states of consciousness.He has published articles in the fields of metaphor and the psychology of mysticism. An earlier version of this paper was presented at the national meeting of the American Academy of Religion in New York in 1982.     

Meaning in life: Discovered or created?

Against the background claims that a meaningful life is more likely to be the product of creation than discovery and that a meaningful life must involve both subjective satisfaction and an objective moral component, three foundations of a meaningful life are discussed. These include the quality of one's relationships, the integrative power of one's goals and projects, and the role of story or stories. Concerning the role of story, the theological challenge is to choose that story or those stories that place life in a genuinely ultimate context.     

Stressful events and coping responses among older adults in two sociocultural groups

In this study of the way 32 men and women between the ages of 60 to 90 coped with stressful situations, two instruments were used: the Life Experiences Survey and the Ways of Coping Checklist. Overall, health-related concerns were more frequently reported by older adults than any other stressful event. When coping responses were categorized according to four modes--intrapsychic, inaction, direct action, and information seeking--the Appalachian group was found to use the information-seeking mode; the Cherokee group, the intrapsychic mode. Significant differences were found between males and females in coping modes and life-stress categories. When groups were combined, significant correlations were noted between life stress, particularly health-related stress, and the coping modes of intrapsychic and information seeking.