Family Characteristics and Posttraumatic Stress Disorder: A Follow-Up of Israeli Combat Stress Reaction Casualties

This study assessed the role of family status and family relationships in the course of combat-related posttraumatic stress disorder (PTSD). The sample consisted of 382 Israeli soldiers who suffered a combat stress reaction episode during the 1982 Lebanon War. Results showed that one year after the war married soldiers had higher rates of PTSD than did unmarried soldiers. Furthermore, higher rates of PTSD were associated with low expressiveness, low cohesiveness, and high conflict in the casualties' families. Theoretical, methodological, and clinical implications are discussed.     

Families of Adolescent Drug Abusers Are “Rigid”: Are These Families Either “Disengaged” or “Enmeshed,” or Both?

The FACES instrument, based on Olson's Circumplex Model of family functioning, was administered to 96 adolescent drug-abuse clients and their parents. The majority of these families categorized themselves as "disengaged" (rather than "enmeshed") on the cohesion dimension, and as "rigid" (rather than "chaotic") on the adaptability dimension. These findings were unexpected as they were substantially different from published findings on families with other types of problems. Family therapists, utilizing Olson's Clinical Rating Scale for the Circumplex Model, characterized significantly more of these same families as "enmeshed," rather than "disengaged." Possible explanations for the difference between the therapists' perceptions and the families' self-perceptions are discussed.     

The Social Psychology of Caregiving: Physical and Psychological Costs of Providing Support to the Disabled1

The emphasis of much of the existing research on social support-health relationships has been on the availability and impact of support on the recipient, but social psychologists have paid little attention to the costs to the caregiver of providing that support. In an earlier study (Schulz & Decker, 1985), we found that the long-term coping of individuals experiencing chronic disability as a result of spinal-cord injury was facilitated by the availability of a primary support person, or caregiver. In this study we examined the determinants of well-being of the primary caregiver of the middle-aged and elderly spinal-cord-injured persons. Psychological well-being, life satisfaction, and depression were the dependent measures. The availability of social support, social contact, and feelings of control over one's life were important determinants of caregiver well-being, even after controlling for health and income. In addition, the amount of time spent each day assisting the disabled person was a strong independent correlate of depression, and the extent to which the caregiver felt burdened by the victim was significantly and negatively related to life satisfaction. These results are discussed in the context of a comprehensive stress-coping model. Since data were available from both disabled individuals and their primary support persons, we had the unique opportunity to compare the perspectives of both those giving and receiving daily care. We found no relationship in levels of psychological well-being and depression reported by the disabled person and caregiver; however, caregivers attributed to the victims affective levels similar to their own.     

Stability and Change in Type A Components and Cardiovascular Reactivity in Medical Students During Periods of Academic Stress1

This study examined the effects of academic stress upon components of Type A behavior and cardiovascular reactivity. In a longitudinal design, heart rate and blood pressure responses to the Type A Structured Interview (SI) and additional laboratory challenges were measured in medical students at three points during an academic semester. Sessions 1 and 3 were scheduled during vacation periods; Session 2 took place during an intensive examination week. Results indicated that three “stylistic” components of Pattern A derived from the SI—loud and explosive speech, short response latency, and potential for hostility—increased significantly during the exam period. Similar increases achieved marginal significance for another stylistic component, rapid and accelerated speech. By contrast, global Type A assessments did not increase with academic demands. Cardiovascular reactivity was significantly but only moderately stable across the three sessions, showing less consistency than has been reported in previous research. In addition, there was little evidence in this study that cardiovascular reactivity was potentiated by academic stress or by Type A behavior. These results demonstrate the influence of naturalistic environmental factors on overt behavioral components that have recently been suggested as coronary risk factors. Therefore, it is advisable for future experimental and epidemiological research to examine the social and environmental context in which these behaviors occur.     

SERIOUS DELINQUENT BEHAVIOR AS PART OF A SIGNIFICANTLY HANDICAPPING CONDITION: CURES AND SUPPORTIVE ENVIRONMENTS

The past 20 years have been productive ones for the field of applied behavior analysis. A brief review of our own efforts during this period reveals that we have accomplished several but not all of our goals for the Teaching-Family approach. In this context, we note that the setting of realistic and appropriate goals is important for the field and for society. Moreover, we suggest that the realistic goal for some persons with serious delinquent behavior may be extended supportive and socializing treatment rather than permanent cure from conventional short-term treatment programs. We base this suggestion on the accumulating evidence that serious delinquent behavior may often be part of a significantly disabling and durable condition that consists of multiple antisocial and dysfunctional behaviors, often runs in families, and robustly eludes effective short-term treatment. Like other significant disabilities such as retardation, autism, and blindness, the effects of this condition may be a function of an interaction of environmental and constitutional variables. We argue that our field has the wherewithal to construct effective and humane long-term supportive environments for seriously delinquent youths. In this regard, we explore the dimensions, rationales, logistics, and beginnings of a new treatment direction that involves long-term supportive family treatment. We contend that such supportive families may be able to provide long, perhaps even lifetime, socializing influences through models, values, and contingencies that seem essential for developing and maintaining prosocial behavior in these high-risk youths.     

CORRESPONDENCE TRAINING: AN EXAMPLE OF RULE-GOVERNED BEHAVIOR?

Two groups of six mentally retarded adults were exposed to either a “say/do” correspondence training program or a “do only” reinforcement procedure to evaluate the suggestion of Rogers-Warren and Baer (1976) that reinforcement of the nonverbal target behavior in the absence of the relevant verbal behavior may account for the behavior changes seen in correspondence training. The participants worked in an experimental setting on a variety of manipulatory responses leading to various auditory and visual consequences. Analysis of individual patterns of responding indicated no apparent differences between the groups during training; four individuals in each group appeared to develop generalized correspondence skills. We conclude that the outcome of correspondence training may not necessarily be verbal regulation of behavior as is assumed. Rather, we suggest that the notion of rule-governed behavior can best account for the type of behavior changes seen in correspondence studies.     

Certifying Juveniles for Adult Court: An Attribution Analysis1

Certification is the process whereby older juveniles who have committed felony offenses are transferred from juvenile courts to adult courts. The present study examined the variables that influence decisions in these cases and used attribution theory to conceptualize the process. Data were obtained from files of 150 youths on whom certification petitions had been filed from January 1981 to October 1984. Of these, 125 had been certified and 25 had not. The sample comprised 148 males and 2 females. Data included seriousness of the offense, previous offenses, potential for aggressiveness, level of involvement in the offense, age, court in which the case was heard, year in which the case was heard, IQ, family income and sex. Level of involvement, seriousness of the offense and potential for aggressiveness had the strongest association with certification outcomes, with those high on these measures significantly more likely to be certified. The cluster that predicted outcomes best included level of involvement, seriousness of the offense, potential for aggressiveness, IQ, year in which the case was heard, court in which the case was heard, sex and previous offenses. The most explicitly behavioral variable—how actively the child participated in the offense—was the best single predictor of outcomes.     

SOCIAL INFLUENCES ON “SELF-STIMULATORY” BEHAVIOR: ANALYSIS AND TREATMENT APPLICATION

We tested the hypothesis that the “self-stimulatory” behaviors exhibited by some individuals may be socially mediated. Four developmentally disabled children who exhibited hand flapping and body rocking participated in a series of three experiments conducted to assess the influence of social variables on stereotyped behavior and to develop a treatment based on the assessment. Experiment 1 used an assessment procedure to determine the relative influences of social attention and task demands on stereotyped behavior. For all four children, hand flapping and body rocking increased when difficult academic tasks were introduced. Experiment 2 involved the use of a procedural time-out and demonstrated that removing task demands contingent on stereotyped behavior resulted in increased rates of hand flapping and body rocking. In Experiment 3, these results were used to develop a communication treatment that consisted of teaching the children to request assistance on the difficult tasks. This treatment resulted in significant reductions in self-stimulatory behavior. These results are consistent with the hypothesis that some forms of repetitive stereotyped behavior may come to serve social functions (e.g., escape from aversive situations). Teaching a functionally equivalent communicative alternative to escape-motivated stereotyped behavior can be an effective form of intervention for this problem.