Psychological Factors Behind Truancy,School Phobia,and School Refusal: A Literature Study

Truancy is a problem that normally leads to treatment interventions within different organizations. Within these organizations different perspectives on the causes and consequences of the above problem can be found. The purpose of this literature study is to map out and describe the current state of research within the fields of school refusal, truancy, and school phobia. The investigation was carried out in the form of a systematic review of the relevant research literature. Research shows that approximately 90% of all young people who refuse to go to school have some form of psychiatric diagnosis.     

Temporal context, preference, and resistance to change

According to behavioral momentum theory, preference and relative resistance to change in concurrent-chains schedules are correlated and reflect the relative conditioned value of discriminative stimuli. In the present study, we explore the generality of this relation by manipulating the temporal context within a concurrent-chains procedure through changes in the duration of the initial links. Consistent with previous findings, preference for a richer terminal link was less extreme with longer initial links across three experiments with pigeons. In Experiment 1, relative resistance to change and preference were related inversely when responding was disrupted with response-independent food presentations during initial links, replicating a previous finding with rats. However, more food was presented with longer initial links, confounding the disrupter and initial-link duration. In Experiment 2, presession feeding was used instead and eliminated the negative relation between relative resistance to change and preference, but relative resistance to change was not sensitive to relative terminal-link reinforcement rates. In Experiment 3, with more extreme relative terminal-link reinforcement rates, increasing initial-link duration similarly decreased preference and relative resistance to change for the richer terminal link. Thus, when conditions of disruption are equal and assessed under the appropriate reinforcement conditions, changes in temporal context impact relative resistance to change and preference similarly.     

Resurgence of temporal patterns of responding

The resurgence of temporal patterns of key pecking by pigeons was investigated in two experiments. In Experiment 1, positively accelerated and linear patterns of responding were established on one key under a discrete-trial multiple fixed-interval variable-interval schedule. Subsequently, only responses on a second key produced reinforcers according to a variable-interval schedule. When reinforcement on the second key was discontinued, positively accelerated and linear response patterns resurged on the first key, in the presence of the stimuli previously correlated with the fixed- and variable-interval schedules, respectively. In Experiment 2, resurgence was assessed after temporal patterns were directly reinforced. Initially, responding was reinforced if it approximated an algorithm-defined temporal pattern during trials. Subsequently, reinforcement depended on pausing during trials and, when it was discontinued, resurgence of previously reinforced patterns occurred for each pigeon and for 2 of 3 pigeons during a replication. The results of both experiments demonstrate the resurgence of temporally organized responding and replicate and extend previous findings on resurgence of discrete responses and spatial response sequences.     

A self-help book is better than sleep hygiene advice for insomnia: a randomized controlled comparative study

The objective was to compare the effects of two types of written material for insomnia in a randomized trial with follow-up after three months. Insomniacs were recruited through newspaper advertisements to a web-based survey with validated questionnaires about sleep, anxiety, depression, and use of sleep medications. A self-help book focusing on cognitive behavioral therapy for insomnia was compared to standard sleep hygiene advice; 77 and 78 participants were randomized to self-help book or sleep hygiene advice, respectively. The response rate was 81.9%. The self-help book gave significantly better scores on the sleep questionnaires compared to sleep hygiene advice. The proportion using sleep medications was reduced in the self-help book group, whereas it was increased in the sleep hygiene group. Compared to pre-treatment, the self-help book improved scores on the sleep (effect sizes 0.61-0.62) and depression (effect size 0.18) scales, whereas the sleep hygiene advice improved scores on some sleep scales (effect sizes 0.24-0.28), but worsened another (effect size -0.36). In addition, sleep hygiene advice increased the number of days per week where they took sleep medications (effect size -0.50). To conclude, in this randomized controlled trial, the self-help book improved sleep and reduced the proportion using sleep medications compared to sleep hygiene advice. The self-help book is an efficient low-threshold intervention, which is cheap and easily available for patients suffering from insomnia. Sleep hygiene advice also improved sleep at follow-up, but increased sleep medication use. Thus, caution is warranted when sleep hygiene advice are given as a single treatment.     

Comparing the predictive capacity of observed in-session resistance to self-reported motivation in cognitive behavioral therapy

Self-report measures of motivation for changing anxiety have been weakly and inconsistently related to outcome in cognitive behavioral therapy (CBT). While clients may not be able to accurately report their motivation, ambivalence about change may nonetheless be expressed in actual therapy sessions as opposition to the direction set by the therapist (i.e., resistance). In the context of CBT for generalized anxiety disorder, the present study compared the ability of observed in-session resistance in CBT session 1 and two self-report measures of motivation for changing anxiety (the Change Questionnaire & the Client Motivational for Therapy Scale) to (1) predict client and therapist rated homework compliance (2) predict post-CBT and one-year post-treatment worry reduction, and (3) differentiate those who received motivational interviewing prior to CBT from those who received no pre-treatment. Observed in-session resistance performed very well on each index, compared to the performance of self-reported motivation which was inconsistent and weaker relative to observed resistance. These findings strongly support both clinician sensitivity to moments of client resistance in actual therapy sessions as early as session 1, and the inclusion of observational process measures in CBT research.     

Psychosomatic disorders: the canalization of mind into matter

Psychosomatic disorders represent a therapeutic conundrum. Despite compelling evidence to suggest the integrity of mind and body, humans are famously prone to experiencing them as separate. This paper explores the scientific challenges posed by psychosomatic disorders and how changing cultural notions contribute to their perplexing presentations. Excerpts of cases from patients with chronic pelvic pain, chronic fatigue, and a factitious disorder are presented as examples of the challenges that these patients pose in analysis. An explanatory model of mind/body interaction based on early maternal-infant interactions and the placebo response complex is proposed as the basis for how psychosomatic pathologies may develop. Finally, therapeutic approaches to the psychological treatment of patients with psychosomatic issues are considered.     

Behavioral momentum theory: equations and applications

Behavioral momentum theory provides a quantitative account of how reinforcers experienced within a discriminative stimulus context govern the persistence of behavior that occurs in that context. The theory suggests that all reinforcers obtained in the presence of a discriminative stimulus increase resistance to change, regardless of whether those reinforcers are contingent on the target behavior, are noncontingent, or are even contingent on an alternative behavior. In this paper, we describe the equations that constitute the theory and address their application to issues of particular importance in applied settings. The theory provides a framework within which to consider the effects of interventions such as extinction, noncontingent reinforcement, differential reinforcement of alternative behavior, and other phenomena (e.g., resurgence). Finally, the theory predicts some counterintuitive and potentially counterproductive effects of alternative reinforcement, and can serve as an integrative guide for intervention when its terms are identified with the relevant conditions of applied settings.     

Resistance to disruption in a classroom setting

Substantial experimental evidence indicates that behavior reinforced on a denser schedule is more resistant to disruption than is behavior reinforced on a thinner schedule. The present experiment studied resistance to disruption in a natural educational environment. Responding during familiar activities was reinforced on a multiple variable-interval (VI) 7-s VI 30-s schedule for 6 participants with developmental disabilities. Resistance to disruption was measured by presenting a distracting item. Response rates in the disruption components were compared to within-session response rates in prior baseline components. Results were consistent with the predictions of behavioral momentum theory for 5 of 6 participants.     

Behavior-analytic research on dementia in older adults

It is estimated that 1 in 10 adults aged 65 years and older have been diagnosed with dementia, which is associated with numerous behavioral excesses and deficits. Despite the publication of a special section of the Journal of Applied Behavior Analysis (JABA) on behavioral gerontology (Iwata, 1986), there continues to be a paucity of behavior-analytic research with this population. This review compares the research published before and after the behavioral gerontology special section and evaluates the most recently published aging articles in JABA.     

Increasing response diversity in children with autism

Repetitive and invariant behavior is a diagnostic feature of autism. We implemented a lag reinforcement schedule to increase response diversity for 6 participants with autism aged 6 to 10 years, 4 of whom also received prompting plus additional training. These procedures appeared to increase the variety of building-block structures, demonstrating that an intervention that includes differential reinforcement can increase response diversity for children with an autism spectrum disorder.