Interrupted time-series analysis and its application to behavioral data

This paper uses a question-and-answer format to present the technical aspects of interrupted time-series analysis (ITSA). Topics include the potential relevance of ITSA to behavioral researchers, serial dependency, time-series models, tests of significance, and sources of ITSA information.     

Rate dependency, behavioral mechanisms, and behavioral pharmacology.

Behavioral pharmacology has become increasingly independent of the experimental analysis of behavior. At its beginning, behavioral pharmacology was closely related to the experimental analysis of behavior, with developments in each field aiding the other. Early attempts to systematize data in behavioral pharmacology culminated with the development of the rate-dependency concept, but as this principle was found to have more limited generality than originally was hoped, a theoretical void developed. This circumstance was followed by increased reliance on pharmacological theory as a basis for experimentation and interpretation, with an attendant decrease in emphasis on environmental variables and behavioral interpretations. Lack of interplay between behavioral pharmacology and the experimental analysis of behavior is detrimental to both disciplines because each could contribute significantly to the other. The current trend might be reversed if more research were directed at elucidating behavioral mechanisms of drug action.     

Dependency, temporal contiguity, and response-independent reinforcement

A comparison was made of the effects of variable-interval, variable-time, and tandem variable-interval fixed-time schedules on key-peck responding of pigeons. The variable-interval component of the tandem schedule retained the response-reinforcement dependency; the fixed-time component allowed the temporal proximity between responding and reinforcement to vary, constrained only by the duration of the fixed-time interval. Response rates were highest during the variable-interval and lowest during the variable-time schedule. Intermediate response rates occurred during the tandem schedule. The results of a yoked control condition showed that the effects of the tandem schedule were not due simply to changes in reinforcement distribution or frequency. The results suggest that substantial reductions in responding occur when reinforcement is response-dependent but not necessarily contiguous with the response required to produce reinforcement.     

Differential diagnosis of steroid-dependent nephrotic syndrome with psychosis: Practical and ethical issues

The present case illustrates practical and ethical issues that can be encountered by clinical psychologists providing consultation services in medical settings. The neuropsychological consultation service was asked to evaluate a 22-year-old male with psychosis, steroid-dependent nephrotic syndrome, and a family history of schizophrenia. MRI revealedmarked cortical atrophy. Clinical findings were consistent with (1) steroid inducedapparent atrophy, which has been shown to be reversible with withdrawal of steroids; (2) uremia secondary to steroid withdrawal; (3) cortical atrophy, found in some schizophrenics; or (4) an atypical, diffuse degenerative disorder. Clinical interview and psychological testing revealed significant thought disorder, prominent delusions, somatic hallucinations, and mood disturbance. Deterioration in social and academic functioning was also present. Except for impaired attention and concentration, neuropsychological evaluation showed no clear evidence of brain-based dysfunction. Further, neuropsychological results effectively ruled out a degenerative process and were not consistent with a steroid effects profile. A conclusive differential diagnosis of steroid induced psychosis versus severe psychopathology would require withdrawal from steroids and antipsychotics. In addition to the practical and ethical issues of withholding antipsychotics, steroid withdrawal would require either dialysis or renal transplant surgery. Decision making regarding dialysis dependency and the possibility of postsurgical psychosis secondary to true psychopathology were salient issues to both the patient and the treatment team.     

Short‐term psychodynamic infant–parent interventions at Child health centers: Outcomes on parental depression and infant social–emotional functioning

Randomized controlled trials (RCTs) demonstrate efficacy of parent–infant psychotherapy, but its applicability and effectiveness in public health care are less known. The method followed is Naturalistic study evaluating Short‐term Psychodynamic Infant–Parent Interventions at Child Health Centers (SPIPIC) in Stockholm, Sweden. One hundred distressed mothers with infants were recruited by supervised nurses. Six therapists provided 4.3 therapy sessions on average (SD = 3.3). Sessions typically included the mothers, often with the baby present, while fathers rarely attended sessions. The Edinburgh Postnatal Depression Scale (EPDS) and the Ages and Stages Questionnaire: Social–Emotional (ASQ: SE) were distributed at baseline and at 3 and 9 months later. Data from a nonclinical group were collected simultaneously to provide norm data. Multilevel growth models on the mothers’ questionnaire scores showed significant decreases over time on both measures. Nine months after baseline, 50% achieved a reliable change on the EPDS and 14% on the ASQ: SE. Prepost effect‐sizes (d) were 0.70 and 0.40 for EPDS and ASQ: SE, figures that are comparable to results of other controlled studies. Psychotherapists integrated with public health care seem to achieve good results when supporting distressed mothers with brief interventions in the postnatal period. SPIPIC needs to be compared with other modalities and organizational frameworks.     

A Mixed Model to Disentangle Variance and Serial Autocorrelation in Affective Instability Using Ecological Momentary Assessment Data

Affective instability, the tendency to experience emotions that fluctuate frequently and intensively over time, is a core feature of several mental disorders including borderline personality disorder. Currently, affect is often measured with Ecological Momentary Assessment protocols, which yield the possibility to quantify the instability of affect over time. A number of linear mixed models are proposed to examine (diagnostic) group differences in affective instability. The models contribute to the existing literature by estimating simultaneously both the variance and serial dependency component of affective instability when observations are unequally spaced in time with the serial autocorrelation (or emotional inertia) declining as a function of the time interval between observations. In addition, the models can eliminate systematic trends, take between subject differences into account and test for (diagnostic) group differences in serial autocorrelation, short-term as well as long-term affective variability. The usefulness of the models is illustrated in a study on diagnostic group differences in affective instability in the domain of eating disorders. Limitations of the model are that they pertain to group (and not individual) differences and do not focus explicitly on circadian rhythms or cycles in affect.     

Interactional justice and the fair process effect: The role of outcome uncertainty

This paper reconciles the inconsistent findings on the interactive effect of interactional justice and social comparison information on outcome evaluation. We distinguish two different effects of interactional justice and examine outcome uncertainty as a qualifying factor. Three hundred and fifty-seven undergraduates participated in a scenario experiment. It is found that, due to the functional quality effect, interactional justice significantly influences outcome evaluation, regardless of the social comparison information that is available, in situations of low outcome uncertainty. However, due to the fair process effect, interactional justice, as with procedural justice, interacts with social comparison information to influence outcome evaluation in situations of high outcome uncertainty. Implications for comparison referents and social comparison motives in social justice research are discussed.     

Meeting the challenges in the delivery of child and adolescent mental health services in the next millennium: The continuous quality improvement approach

Managed care and concerns about the effectiveness of services are major pressures on mental health services. An approach to dealing with the challenges of providing high-quality, cost-effective services is continuous quality improvement or CQI. This article describes four major themes that motivate the CQI approach. However, we also describe the major obstacles in using an approach originally designed for manufacturing for human services. The need to accurately measure both treatment processes and outcomes is emphasized.     

Female aggression as a response to sexual jealousy: A sex role reversal?

Sexual jealousy can be interpreted as a strategy which serves to retain the partner and defend exclusive sexual relationships. Because of the asymmetry in paternity confidence, it should be a more important strategy for males than for females. Indeed, male sexual jealousy is apparently a cross-cultural phenomenon and is often the proximate cause of violence against the female partner. The objective of this study was to investigate through self-report whether male “victims” of partner infidelity are expected to react more aggressively than female “victims,” how subjects themselves say they would react to a partner's infidelity, and whether these expectations vary across the sexes. Contrary to our predictions, subjects expected females more than males to react aggressively and revengefully when confronted with infidelity. These expectations were mainly sustained by the female subjects. Females were also more likely than males to declare that they themselves would verbally and physically abuse the partner. In addition, female subjects anticipated that they would cry, feign indifference, and try to look attractive and cool. Males were more likely than females to report that they would get drunk. Our results on aggressive reactions represent a departure from traditional sex roles. It is argued that emancipatorial development, as well as the levelling influence of contraceptives on the sexes' parental certainty, have triggered this change in sex roles. © 1993 Wiley-Liss, Inc.