Evaluation of a finger prompt variation in the treatment of pediatric feeding disorders

Children with feeding disorders often engage in refusal behavior to escape or avoid eating. Escape extinction combined with reinforcement is a well-established intervention to treat food refusal. Physical guidance procedures (e.g., jaw prompt, finger prompt) have been shown to increase food acceptance and decrease inappropriate mealtime behavior when more commonly employed escape extinction (e.g., nonremoval of the spoon) procedures are ineffective. The finger prompt, however, has not been extensively evaluated as a treatment adjunct to target food refusal, thus necessitating further examination. The purpose of this prospective study was to assess a variation of a finger prompt procedure to treat food refusal and to assess caregivers' acceptability of the procedure. Three children age 1 to 4 years admitted to an intensive feeding disorders program and their caregivers participated. The finger prompt was effective in increasing bite acceptance across all participants and decreasing or maintaining low levels of inappropriate behavior for 2 participants. The procedure was also acceptable to all caregivers.     

A comparison of methods for assessing preference for social interactions

Researchers have evaluated a variety of methods for assessing preference for social interactions, and generally have found that such assessments accurately identify differentially reinforcing, preferred interactions. However, few researchers have compared methods for assessing preference for social interactions, and none have done so with participants across different skill levels. The current study compared the stability and validity of hierarchies produced by social interaction preference assessments (SIPA) and picture-based multiple stimulus without replacement preference assessments (MSWO) with 8 individuals diagnosed with autism spectrum disorder (ASD). The MSWO most often produced valid hierarchies for participants who could match, identify, and tact pictures of social interactions and that the SIPA most often produced valid hierarchies for participants who could not identify or tact pictures of social interactions. A vocal paired-stimulus preference assessment (PSPA) was also conducted with a subset of participants who communicated vocally, and it produced valid hierarchies. Considerations and recommendations for selecting a method of assessing preference for social interactions are discussed.     

Utilizing in-vivo feedback for caregiver training of pediatric feeding protocols

Researchers have used multicomponent behavioral skills training packages including written and verbal instructions, modeling, rehearsal, and feedback when teaching caregivers to implement pediatric feeding treatment protocols (e.g., Anderson & McMillan, 2001; Seiverling et al., 2012). Some investigators have shown that fewer behavioral skills training components may be necessary for effective training (e.g., Mueller et al., 2003; Pangborn et al., 2013). We examined the use of in-vivo feedback following written instructions to train caregivers to implement pediatric feeding treatment protocols using a multiple baseline design across 3 caregiver dyads. Correct implementation of the feeding treatment procedures was low during baseline (written instructions only), increased with only the addition of in-vivo feedback, and remained high during follow-up sessions for all caregivers. Results are discussed in terms of clinical implications and caregiver satisfaction.     

The self and eating disorders

In our review, we focus on self-related constructs in the context of eating disorders with four aims. First, we examine a variety of self-related constructs that have been theoretically and empirically linked to the development and course of eating disorders. In addition to the more well-researched constructs of self-esteem and self-efficacy, we also report on findings related to selflessness, contingent self-worth, self-objectification, ego-syntonicity, self-concept clarity, self-compassion, social comparison, self-oriented perfectionism/self-criticism, and narcissism. Second, we discuss self-related constructs that may be especially relevant to comorbidities common among those with eating disorders. Third, we review intervention and prevention programs where self-related constructs play a prominent role. Lastly, we share future research directions regarding self-related constructs and eating disorders that we believe will advance a deeper understanding of the role of the self in the eating disorders.     

Differential association between food craving,food addiction and eating-related characteristics in persons at risk for eating disorders

IntroductionFood craving is a key feature of eating disorders, but its association with medical and psychological outcome might depend on the type of eating disorder.ObjectivesThis study investigated the factors associated with food craving in individuals at risk for DSM-5 eating disorder.MethodSeventy-six women were recruited from a non-clinical population (n = 372) based on their positive screening (EDDS, QEWP-R) for binge eating disorder (BED; n = 29), anorexia nervosa (AN; n = 28) or bulimia nervosa (BN; n = 19). They completed self-administered questionnaires assessing food craving (FCQ- T-r), Body Mass Index (BMI), eating behaviour (DEBQ), food addiction (YFAS 2.0), and anxiety and depressive symptoms (HADS).ResultsIndividuals at risk for BED or BN had higher food craving than those at risk for AN. Food craving was associated with BMI only in the BED group. Food craving was positively correlated with external eating in all groups, and with emotional eating in the AN and BED groups and correlated with anxiety only in BN. Food addiction prevalence was higher in the BN group than in the AN or BED groups (respectively 94.7%, 46.4% and 65.5%; p < 0.01). In this non-clinical population, we demonstrated that food craving was differentially associated with BMI and eating-related characteristics according to the type of eating disorder.ConclusionThis suggests that food craving is a transdiagnostic dimension that should be differentially targeted depending on the type of eating disorder; future studies should test this hypothesis in clinical populations.     

Safety equipment use and crash involvement among cyclists – Behavioral adaptation,precaution or learning?

The present study has investigated relationships between cyclists’ safety equipment use, crash involvement, and other safety relevant behavior. The main focus is on relationships that indicate either behavioral adaptation (safety equipment use leads to riskier behavior) or precautionary behavior (safety equipment is used for cycling in risky situations). Three consecutive surveys were conducted in 2015, 2016, and 2017 years among 650 Norwegian cyclists. Most items were dichotomized and analyzed with logistic regression models. In contrast to the behavioral adaptation hypothesis, regular use of safety equipment (bicycle lights, high-visibility clothing, and helmets) was found to be negatively related to some types of high-risk behavior (listening to music and taking chances while cycling). Regular use of bicycle lights and high-visibility clothing is also negatively related to collision involvement. Safety equipment use was found to be positively related to regular winter cycling and cycling in mixed traffic (not on sidewalks), and it is most likely used as a precautionary measure in such situations. Some cyclists learn from crash involvement by starting to use safety equipment after a crash, but the results do not indicate that crash involvement deters from cycling. The main conclusion from the study is that recommending, promoting or even mandating safety equipment for cyclists can be expected to improve safety and that behavioral adaptation is not likely to occur, at least not to an extent that will outweigh the positive safety effects. The results do not support reservations against the use of “sporty” (well-equipped) models in campaigns for promoting cycling.     

The Harvard Pigeon Lab under Herrnstein

The history of the Harvard Pigeon Lab is a history of two periods of remarkable productivity, the first under Skinner's leadership and the second under Herrnstein's. In each period, graduate students flocked to the leader and then began stimulating one another. Chance favored Herrnstein's leadership, too, because an unusually large number of graduate students were admitted in the fall of 1962. In each period, productivity declined as the leader lost interest in the laboratory and withdrew. Directly and indirectly, the laboratory finally died as a result of the cognitive "revolution." Skinner and his students saw the possibility of a natural science of behavior and set about establishing that science based on concepts such as response rate, stimulus control, and schedules of reinforcement. Herrnstein and his students saw that the science could be quantitative and set about making it so, with relative response rate, the matching law, and the psychophysics of choice (analogous to S. S. Stevens' psychophysics). The history might provide a golden research opportunity for someone interested in the impact of such self-organizing research groups on the progress of science.     

Taxonicity of anxiety sensitivity: an empirical test among youth

Taxometric coherent cut kinetic analyses were used to test the latent structure of anxiety sensitivity (AS) among 371 youth. Anxiety sensitivity was indexed by the 18-item Childhood Anxiety Sensitivity Index (CASI; Silverman et al., J. Clin. Child Psychol. (1991), 20, 162-168). Two sets of manifest indicators of AS were constructed using the CASI: (1) three item-parcel manifest indicators: disease concerns, unsteady concerns, and mental illness concerns; and (2) nine single-item indicators representing each of these three facets of AS. Results from standard and short-scale MAXCOV procedures, internal consistency tests, analyses of simulated Monte Carlo data, and MAMBAC external consistency tests indicated that the latent structure of anxiety sensitivity among youth was taxonic. Estimated base rate of the observed AS taxon ranged between 13.6 and 16.5%. The present findings are discussed in terms of theoretical implications for the study of AS and vulnerability for anxiety psychopathology.     

An abbreviated PTSD checklist for use as a screening instrument in primary care

Although the importance of recognizing posttraumatic stress disorder (PTSD) in primary care has been well-established, routine screening for PTSD remains unfeasible for many primary care clinics because of the length of the available screening instruments. Thus, the purpose of this work was to develop and validate a brief screening tool for PTSD. In Study 1, four short forms of the PTSD Checklist-civilian version were identified that captured a majority of the variance in the measure. In Study 2, the performance of these short forms was evaluated in a separate sample of primary care patients. We found that both two-item and six-item versions have adequate psychometric properties for screening purposes and suggest that the selection of one version over the other depends on the specific needs of each primary care clinic.