Which training method works best? A randomized controlled trial comparing three methods of training clinicians in dialectical behavior therapy skills

This study evaluated the efficacy of three methods of training community mental health providers (N = 150) in Dialectical Behavior Therapy skills, including a written treatment manual; an interactive, multimedia online training (OLT); and a two-day instructor-led training workshop (ILT). A hybrid design was utilized that incorporated aspects of efficacy and effectiveness trials. Assessments were completed at baseline, post-training, and 30- and 90-days following training. The results indicate that learner satisfaction with the training was highest in OLT and ILT, and both resulted in significantly higher satisfaction ratings than the manual. OLT outperformed ILT and the manual in increasing knowledge of the treatment, whereas ILT and the manual did not differ. All three training methods resulted in comparable increases in clinicians' ability to apply course content in clinical simulations. Overall, the results provide strong support for the efficacy of technology-based OLT methods in disseminating knowledge of empirically supported treatments to community mental health providers, suggesting that OLT may be a high-quality, easily accessible, and affordable addition to traditional training methods.     

Interpersonal trust and organizational citizenship behavior

This study investigates the relationship between certain individual level determinants of interpersonal trust and its impact on organizational citizenship behavior. The participants (N=303) were top, middle, and lower level executives from manufacturing and services sectors. The results indicate that interaction frequency, consistency, and competence are significant predictors of interpersonal trust. Interpersonal trust is positively associated with organizational citizenship behavior, and it also partially mediated the relationship between individual level factors and organizational citizenship behavior. The results imply that the development of trust at the interpersonal level may be used as a strategy to motivate the employees to engage in extra role behaviors to ensure improved individual and organizational performance.     

A systematic examination of different parameters of presession exposure to tangible stimuli that maintain problem behavior

We examined the effects of three different presession conditions on tangibly maintained problem behavior for 2 students with autism, using individual-participant multielement designs. First, an analogue functional analysis demonstrated that problem behavior was maintained by access to tangible items. Next, topographies of item rejection were identified. Finally, students were exposed to (a) brief access, (b) no access, and (c) satiation to the tangible items prior to tangible sessions. The results demonstrated high levels of problem behavior following the brief-access and no-access presession conditions and low levels of problem behavior following the satiation condition. The findings are discussed in the context of how satiation might best be defined for these sorts of evaluations.     

AN EVALUATION OF RESURGENCE DURING TREATMENT WITH FUNCTIONAL COMMUNICATION TRAINING

Extinction‐induced resurgence is the recurrence of previously reinforced behavior when another behavior is placed on extinction (Lieving, Hagopian, Long, & O'Connor, 2004). This phenomenon may account for some instances of treatment relapse when problem behavior recovers during extinction‐based treatments. The current study sought to determine whether resurgence of problem behavior would reliably occur with 5 participants who received treatment with FCT. Results showed that problem behavior reemerged for all but 1 participant when the communicative response was exposed to extinction or thin schedules of reinforcement. These findings suggest that resurgence may account for some instances of response recovery during treatment, and that the described procedure may be useful for the further study of resurgence and eventual prevention of this phenomenon.     

USE OF LATENCY TO PROBLEM BEHAVIOR TO EVALUATE DEMANDS FOR INCLUSION IN FUNCTIONAL ANALYSES

Few direct‐assessment procedures are designed to identify potential negative reinforcers (e.g., including demands in the escape condition of functional analyses). Two participants were systematically exposed to a series of demands nominated by caregivers as potential negative reinforcers. Sessions ended following the first instance of problem behavior, and a hierarchy of demand aversiveness was created based on the latency to the first problem behavior. Subsequent functional analyses confirmed the predictive value of the hierarchy, with shorter latency demands consistently producing more differentiated functional analysis outcomes.     

FUNCTIONAL ANALYSIS AND TREATMENT OF SELF‐INJURY IN A CAPTIVE OLIVE BABOON

Self‐injurious behavior (SIB), such as self‐biting and head banging, has been reported to occur in approximately 10% of captive, individually housed nonhuman primates. Accounts of the etiology of SIB in primates range from ecological to physiological. However, to date, no research has examined the possible influence of social consequences delivered by handlers and keepers in the maintenance of SIB in this population. The current study investigated the effects of social contact as a potentially reinforcing consequence for the SIB displayed by an olive baboon (Papio hamadryas anubis). Results indicated that the behavior was maintained by attention from humans. As treatment, reinforcement was arranged for an appropriate alternative response, resulting in increases in the appropriate alternative behavior and decreases in SIB.     

REALISM WITHOUT TRUTH: A REVIEW OF GIERE'S SCIENCE WITHOUT LAWS AND SCIENTIFIC PERSPECTIVISM

An increasingly popular view among philosophers of science is that of science as action—as the collective activity of scientists working in socially‐coordinated communities. Scientists are seen not as dispassionate pursuers of Truth, but as active participants in a social enterprise, and science is viewed on a continuum with other human activities. When taken to an extreme, the science‐as‐social‐process view can be taken to imply that science is no different from any other human activity, and therefore can make no privileged claims about its knowledge of the world. Such extreme views are normally contrasted with equally extreme views of classical science, as uncovering Universal Truth. In Science Without Laws and Scientific Perspectivism, Giere outlines an approach to understanding science that finds a middle ground between these extremes. He acknowledges that science occurs in a social and historical context, and that scientific models are constructions designed and created to serve human ends. At the same time, however, scientific models correspond to parts of the world in ways that can legitimately be termed objective. Giere's position, perspectival realism, shares important common ground with Skinner's writings on science, some of which are explored in this review. Perhaps most fundamentally, Giere shares with Skinner the view that science itself is amenable to scientific inquiry: scientific principles can and should be brought to bear on the process of science. The two approaches offer different but complementary perspectives on the nature of science, both of which are needed in a comprehensive understanding of science.     

Comparing persistent juvenile delinquents and normative peers with the Five-Factor Model of Personality

Recent research suggests that personality traits are associated with delinquency. T-tests were run to identify which traits and facets of the Five-Factor Model of Personality contributed to differentiate persistent juvenile delinquents (n = 48) from normative peers (n = 48). Results showed that two traits, namely Agreeableness and Neuroticism, and 12 facets differed significantly between the groups. Observed effect sizes varied from medium to large.     

How Are Traits Related to Problem Behavior in Preschoolers? Similarities and Contrasts Between Temperament and Personality

The lack of empirical research relating temperament models and personality hinders conceptual integration and holds back research linking childhood traits to problem behavior or maladjustment. This study evaluates, within a sample of 443 preschoolers, the relationships between children’s maladaptation and traits measured by three temperament models (Thomas and Chess, Buss and Plomin, and Rothbart), and a Five-Factor based personality model. Adequate reliabilities and expected factor structures are demonstrated for most scales. A joint principal component analysis combining 28 temperament and 18 personality scales indicates a six-factor model, distinguishing Sociability, Activity, Conscientiousness, Disagreeableness, Emotionality, and Sensitivity. Regression analyses reveal that although single temperament and personality scales explain from 23% to 37% of problem behavior variance, the six components explain from 41% to 49% and provide a clearer differentiation among CBCL-problem scales. This age-specific taxonomy refines and corroborates conclusions based on narrative reviews and furnishes a more balanced view of trait–maladjustment relationships.

Community vs. Clinic-Based Modular Treatment of Children with Early-Onset ODD or CD: A Clinical Trial with 3-Year Follow-Up

This study examines the treatment outcomes of 139, 6–11 year-old, clinically referred boys and girls diagnosed with Oppositional Defiant Disorder (ODD) or Conduct Disorder (CD) who were randomly assigned to a modular-based treatment protocol that was applied by research study clinicians either in the community (COMM) or a clinic office (CLINIC). To examine normative comparisons, a matched sample of 69 healthy control children was included. Multiple informants completed diagnostic interviews and self-reports at six assessment timepoints (pretreatment to 3-year follow-up) to evaluate changes in the child’s behavioral and emotional problems, psychopathic features, functional impairment, diagnostic status, and service involvement. Using HLM and logistic regression models, COMM and CLINIC showed significant and comparable improvements on all outcomes. By 3-year follow-up, 36% of COMM and 47% of CLINIC patients no longer met criteria for either ODD or CD, and 48% and 57% of the children in these two respective conditions had levels of parent-rated externalizing behavior problems in the normal range. We discuss the nature and implications of these novel findings regarding the role of treatment context or setting for the treatment and long-term outcome of behavior disorders. This study was supported by grants to the first author from the National Institute of Mental Health (MH 57727) and to the second author by the National Institute of Nursing Research (NR 07615). The fourth author was supported by grant K01 MH078039 from the National Institute of Mental Health. The authors acknowledge the research and clinical staff of the Resources to Enhance the Adjustment of Children (REACH) program, and Drs. David Brent, Tammy Chung, William Gardner, John Lochman, and Wayne Osgood. Reprints may be obtained from Dr. Kolko, WPIC, 3811 O’Hara St., Pittsburgh, PA 15213.