Teaching safety skills to children to prevent gun play

Research has shown that children often engage in gun play when they find a firearm and that this behavior is often involved in unintentional firearm injuries. Previous research has shown existing programs to be ineffective for teaching children safety skills to reduce gun play. This study examined the effectiveness of a behavioral skills training (BST) program supplemented with in situ training for teaching children safety skills to use when they find a gun (i.e., don't touch, leave the area, tell an adult). Eight 4- to 5-year-old children were trained and assessed in a naturalistic setting and in a generalized setting in a multiple baseline across subjects design. Results showed that 3 of the children performed the skills after receiving BST, whereas 5 of the children required supplemental in situ training. All children in the study learned to perform the skills when assessed in a naturalistic setting and when assessed in a generalization setting. Performance was maintained at 2- to 8-week follow-up assessments.     

Cognitive Barriers to Successful Weight Management: 7 Stymie Beasts

This paper focuses on one of the most significant barriers, especially for teenagers and their families, to the effectiveness of cognitive behavioral therapy (CBT) for weight management: high rates of attrition. Cognitive barriers contribute to attrition and to decreasing commitment to full engagement in the process (deliberate practice). Excuses capture the essence of one type of those cognitive barriers. Excuses are defined as shifts in attribution from self-focused causes of struggles to achieve goals to more externally-focused causes—resulting in decreasing full engagement. Those excuses (shifts in attribution) do not just happen. People make decisions to implement those shifts away from personal responsibility. Ten cognitive biases lie at the heart of such problematic delusional decision making. This paper identifies seven excuses created by that biased decision making as anthropomorphisms called Stymie Beasts. Such unique simply worded visually distinctive creatures may help improve recall and focus on these powerful antagonists to successful weight control. Then, the use of two CBT techniques, Therapeutic Understanding of Science (TUS) and Rational Emotive Therapy (RET), illustrated with examples for all seven Stymie Beasts, shows how CBT may prevent and dismantle those Beasts (excuses). Ideas for future research using randomized controlled trials to test these notions are also presented.     

Adaptations of an Integrated Behavioral Health Program During COVID-19

The coronavirus disease 2019 (COVID-19) pandemic has consistently been described as an “unprecedented” global health crisis. While the focus has been primarily on the medical and economic impact of the pandemic, psychological sequelae are anticipated. Primary care is the main point of access for mental health care in the United States, making it the ideal locale to provide psychological services for a larger proportion of the population than traditional mental health care settings. The aim of this paper is to describe how our multi-state, multi-site integrated primary care program adapted and applied cognitive behavioral therapy in the context of COVID-19. Access to mental health care was disrupted despite burgeoning mental health concerns, necessitating novel approaches to providing care. A stepped-care approach was implemented within our primary care practice, which consisted of a combination of low-intensity, high-yield stress management and resiliency building resources and cognitive behavioral therapy that were delivered flexibly based on patient preference, technological capabilities, state ordinances, insurance coverage, and institutional policies. The lessons learned from this experience can inform other integrated primary care clinics in responding to the current and future pandemics.     

Using behavioral skills training with preservice teachers in the university classroom

Preservice and novice teachers often identify behavior management as an area of weakness that they attribute to a lack of sufficient instruction during their teacher preparation. Behavioral skills training (BST) is an evidence‐based teaching methodology based on the principles of applied behavior analysis used to teach new skills. This study investigated the use of BST in the university setting to teach undergraduate preservice teachers enrolled in a field‐based special education course to implement a token economy during small group instruction with children. A single‐case research design was used to assess the effectiveness of using BST by evaluating accuracy of implementation before and after BST. Results showed BST was an effective teaching procedure and social validity measures collected from the preservice teachers indicated BST was acceptable to all participants. Limitations and needs for future research are discussed.     

Does Dissociation Among Adolescents Predict Difficulties? A Panel Study in Japan

Dissociation has been reported to be associated with emotive-relational and behavioral difficulties; however, the temporal relationship between dissociation and these difficulties is unclear. Accordingly, this study investigated whether dissociation predicts difficulties (including emotional symptoms, conduct problems, hyperactivity, and peer problems) in adolescents. A two-wave cross-lagged panel study (Time 1: September–November 2016, Time 2: February–March 2017) was conducted among 1,773 Japanese junior high and high school students at two private schools (995 boys and 778 girls; M_age = 14.79 years at Time 1 and 15.09 years at Time 2). Dissociation was assessed using the Japanese version of the Adolescent Dissociative Experiences Scale and perceived difficulties were assessed via the Strengths and Difficulties Questionnaire. A cross-lagged effects model analysis indicated that high dissociation scores at Time 1 predicted high difficulties scores at Time 2. These findings suggest that dissociation could effectively predict difficulties in junior high and high school students. This study expands the field's understanding of the temporal relationship between behavioral problems and dissociation, which could help prevent problem behaviors.     

Outcomes of a practical approach for improving conversation skills in adults with autism

Many individuals with autism spectrum disorder (ASD) have deficits in conversation skills that can interfere with the development of personal and professional relationships. Further research is needed on efficient interventions for targeting conversation skills in adults with ASD and for evaluating the social validity of the outcomes. In this study, 2 practitioners implemented a 4‐week training program for 5 adults with ASD that combined individualized computer‐based instruction (CBI) and practice with peers to promote the acquisition, maintenance, and generalization of conversation skills. Training was associated with improvements in 12 of 13 skills across participants. These findings, along with peer ratings of the participants' conversation skills, suggest that this model is a promising, socially valid approach for improving conversation skills in adults with ASD.     

CBT对社交焦虑障碍有效干预的神经预测因子及机器学习应用

认知行为疗法（CBT）是社交焦虑障碍的标准疗法,对其疗效的神经预测因子研究有利于个性化诊疗方案选择。初步证据表明,干预前高级视皮层、背侧前扣带回、背内/外侧前额叶及眶额皮层的功能激活,杏仁核与情绪调节相关脑区的结构与功能连接,情绪性刺激诱发的晚期正成分与治疗后症状的改善有关,因而是潜在的预测因子。基于机器学习的个体化预测存在样本量小的突出问题。未来研究应考虑跨研究机构合作共享大数据,在多模态、多任务条件下收集数据,并在独立样本中验证预测的有效性。     

OBSERVATION AND COMPARISON OF MEALTIME BEHAVIORS IN A SAMPLE OF CHILDREN WITH AVOIDANT/RESTRICTIVE FOOD INTAKE DISORDERS AND A CONTROL SAMPLE OF CHILDREN WITH TYPICAL DEVELOPMENT

Despite widespread use of behavioral observations to evaluate child feeding behaviors in research and clinical practice, few studies have comprehensively characterized mealtimes or identified features that differentiate children with and without disordered feeding; these were the aims of the current study. Mealtime observations were conducted for 18 children with avoidant restrictive food intake disorder (ARFID) and 21 typically developing children. Observations were coded inductively, and associations between disorder and observed mealtime actions were examined. Most behaviors were observed across both clinical and nonclinical mealtimes, and many did not differ in frequency between children with and without ARFID. However, significant group differences were observed in the frequencies of behaviors relating to food intake, visual and physical engagement with feeding, and movement during mealtimes. The comparability of behaviors across clinical and nonclinical groups suggests that eating behaviors exist on a continuum from “normal” to “abnormal,” with group differences relating to frequency rather than type of behavior. The behavioral differences observed in this study suggest that identification of children with ARFID should focus on child engagement with food and restlessness during mealtimes. Reliance on emotional and escape‐maintained behaviors will lead to underrecognition of families in need of clinical support.     

Parent reports of children’s working memory,coping, and emotional/behavioral adjustment in pediatric brain tumor patients: A pilot study

Neurocognitive problems in childhood survivors of brain tumors are well documented. Further, research has shown that problems in cognitive functioning may be associated with impairment in the use of complex strategies needed to cope with stress, including secondary control coping strategies (e.g., acceptance and cognitive reappraisal) which have been associated with fewer adjustment problems. The present study measured cognitive function, coping strategies, and adjustment in children ages 6–16 years at the time of brain tumor diagnosis and at two follow-up time-points up to 1 year post-diagnosis. In a prospective design, working memory was assessed in a total of 29 pediatric brain tumor patients prior to undergoing surgery, child self-reported coping was assessed at 6 months post-diagnosis, and parent-reported child adjustment was assessed at 12 months post-diagnosis. Significant correlations were found between working memory difficulties and secondary control coping. Secondary control coping was also negatively correlated with child attention and total problems. Regression analyses did not support secondary control coping mediating the association between working memory difficulties and child attention or total problems. These findings represent the first longitudinal assessment of the association between working memory, coping, and adjustment across the first year of a child’s brain tumor diagnosis and suggest a possible role for early interventions addressing both working memory difficulties and coping in children with brain tumors.     

Examining the Effectiveness of Integrated Behavioral and Primary Health Care Treatment

Using a quasi‐experimental, pre–post test design of 196 persons diagnosed with serious mental illness, the authors compared the effectiveness of an integrated behavioral and primary health care (IBPH) treatment approach vs. a treatment‐as‐usual approach over a 12‐month period. A profile analysis of 5 mean difference scores, each representing a separate component of client holistic functioning, indicated that individuals receiving IBPH experienced a 24‐times greater improvement in overall functioning. Recommendations for treatment and client care are provided.