Sleep-Related Problems in Pediatric Obsessive-Compulsive Disorder and Intensive Exposure Therapy

Limited research has examined sleep-related problems (SRPs) among children and adolescents with obsessive-compulsive disorder (OCD). The present study addresses this gap by investigating preliminary associations between SRPs, demographic factors (gender and age), family variables (family accommodation and parental stress), and clinical factors (medication status, internalizing and externalizing symptoms, OCD severity, OCD-related impairment), and treatment outcomes in a sample of 103 youth (aged 7 to 17 years; 53% female) with a primary diagnosis of OCD. Clinician, parent, and child measures were used to assess demographic, family, and clinical predictors. SRPs were assessed using an 8-item measure comprising items of the Child Behaviour Checklist, Child Depression Inventory, and Multidimensional Anxiety Scale for Children as used in previous studies. Results showed that SRPs were highly prevalent among this sample and that more SRPs were associated with younger age, internalizing problems, and functional impairment. However, SRPs were not an independent predictor of OCD severity, impairment, or treatment response. Preliminary findings suggest that SRPs among youth with OCD may be more strongly associated with broader internalizing symptoms than with OCD itself. Future longitudinal research is warranted to further explore the complexity of SRPs when co-occurring with pediatric OCD.     

Dissemination and Implementation of Cognitive Behavioral Therapy for Depression in the Kaiser Permanente Health Care System: Evaluation of Initial Training and Clinical Outcomes

Notwithstanding its empirical status and strong recommendation in clinical practice guidelines, cognitive behavioral therapy (CBT) continues to be delivered infrequently and with low fidelity on the clinical front lines. Recently, organized efforts and policies within the public sector to disseminate and implement CBT and other evidence-based psychotherapies have yielded encouraging results and provided optimism for bridging the research-to-practice-gap. Following from these efforts, the current article examines the initial impact and experience of the implementation of an individualized approach to CBT training and treatment within the Kaiser Permanente health care system. Initial training outcomes, including changes in general and specific competencies, were assessed using divergent assessment methods within the initial cohort of therapists undergoing training. Initial patient outcomes, including changes in depression and anxiety, were assessed among patients receiving treatment from therapists in training. Results revealed training in and implementation of CBT-D was associated with overall large improvements in therapist competencies and in clinically significant improvements in both depression and anxiety among patients. Findings from the initial phase of dissemination and implementation within a large private system provide support for, and extend recent findings related to, the feasibility and effectiveness of training in and implementation of CBT-D in a real-world context.     

Evaluating small‐scale simulation for training firearm safety skills

There is limited research using small‐scale simulation in applied behavior analysis. We used small‐scale simulation to train firearm safety skills to 3‐ to 5‐year‐old children and assessed whether the skills generalized to the natural environment through in situ assessment. Three participants completed the training, and all participants learned the safety skills from simulation training. Two of the participants acquired the safety skills after the first simulation training, and the third participant required one booster training before demonstrating the safety skills in the natural environment.     

Behavioral momentum and resistance to extinction across repeated extinction tests

The present experiments assessed whether resistance to extinction of pigeons' key pecking decreased across repeated extinction tests. An additional impetus for this research was to determine how the quantitative framework provided by behavioral momentum theory might be used to describe any such changes across tests. Pigeons pecked keys in two‐component multiple schedules (one component associated with a higher reinforcer rate and the other with a lower rate) in which baseline and extinction conditions alternated. In Experiment 1, baseline and extinction conditions alternated every session, and, in Experiment 2, these conditions lasted for 10 and 7 sessions, respectively. Resistance to extinction decreased across successive extinction conditions in both experiments. Fits of the behavioral‐momentum based model of extinction to the data returned uncertain results in Experiment 1 but implicated both generalization decrement and response–reinforcer contingency termination as the possible mechanisms responsible for behavior change in Experiment 2. Thus, these data suggest that experimental manipulations that affect discrimination of changes in reinforcement contingencies may influence resistance to extinction by modulating the disruptive impacts of removing reinforcers from the experimental context and of suspending response–reinforcer contingencies.     

脑内腺苷介导白介素-1β引起的大鼠的行为性抑郁

目的：研究腺苷在白细胞介素-1诱导的大鼠行为性抑郁中的作用。方法：应用Porsolt游泳试验观察大鼠脑室注射白介素-1β引起的行为性抑郁,通过注射非特异性腺苷受体拮抗剂咖啡因和特异性A1和A2腺苷受体拮抗剂,确定脑内腺苷在白细胞介素-1β引起的大鼠行为性抑郁中的作用以及介导这种作用的受体。结果：脑内注射白细胞介素-1β(8-32ng／kg,icv)可导致大鼠在Porsolt游泳试验中漂浮时间明显地延长,非特异性腺苷受体拮抗剂咖啡因(7mg／kg,ip)和特异性A2a腺苷受体拮抗剂(1mg／kg,ip)预处理能够缩短漂浮时间的延长。结论：脑内注射白细胞介素-1β可引起大鼠的行为性抑郁,脑内腺苷通过A2a受体介导白细胞介素-1β的这种作用。     

Attachment, Behavioral Inhibition, and Anxiety Disorders Symptoms in Normal Adolescents

The current study examined relationships between attachment style, behavioral inhibition, and anxiety disorders symptoms not only relying on youths' self-report but also including the parents' point of view. A large group of young adolescents aged 11–15 years and their parents (N = 280) completed measures of attachment style and behavioral inhibition and the Revised Children's Anxiety and Depression Scale, a questionnaire designed to measure symptoms of anxiety disorders in terms of the Diagnostic and Statistical Manual of Mental Disorders. Highly similar results were found for child and parent report. That is, attachment style and behavioral inhibition were found to be interrelated with insecure attachment being associated with higher levels of behavioral inhibition. Furthermore, adolescents who were classified as insecurely attached and/or high on behavioral inhibition displayed higher levels of anxiety disorders symptoms. Finally, attachment status and behavioral inhibition both accounted for a unique proportion of the variance of anxiety disorders symptomatology.     

The Rational Teacher: Rational Emotive Behavior Therapy in Teacher Education

Rational Emotive Behavior Theory and Therapy (REBT; Ellis, 1973) is a form of humanistic psychology that helps individuals live happier, more productive, more self-actualizing and more creative existences. Under what has been called Rational Emotive Education (REE), some (see, e.g., Bernard, 2001, 2000, 1990, 1984; Bernard & Ellis, 1983; DeVoge, 1983; DiGiuseppe, 1983; DiGiuseppe & Bernard, 1990; Ellis, 1975, 1974, 1973, 1972, & 1971; Knaus, 1977; Knaus & Bokor, 1975; Knaus & Eyman 1974; Knaus & McKeever, 1977; Vernon, 1998, 1997, 1996, 1994, 1993, 1990, & 1989) have applied REBT in various educational settings. Having been successful in clinical settings and in reducing both undesirable student behavior and teachers' stress, additional innovative applications of REBT are now being explored and used. This paper describes the incorporation of REBT into yet another unexplored setting within REE: teacher education. Undergraduate Education majors, taking a psychological foundations course and prior to their Student Teaching Practicum, learned REBT principles and methodology and applied them in both learning and teaching contexts. The learning context included situations the Undergraduate Education majors encountered in their college lives. The teaching context included situations they encountered while participating in their preschool field placement. The application of REBT to both contexts allowed the Education majors to address their personal and professional development, including their effectiveness as teachers in training.     

Life on the streets: the experiences of community researchers in a study of prostitution

Whilst community psychology has encouraged discussion of research processes and ways to improve studies, certain issues within community‐based research (particularly on sex topics) still require attention. This paper outlines a community study of women involved in street prostitution, and discusses issues arising from this research. By using extracts from the research report, along with researcher's diaries and taped conversations, the paper raises points for discussion concerning the process of sex‐research. For instance, training peer researchers, incorporating sex‐workers in research strategies, producing tangible results, and ethical issues. Strategies to improve research in general are then suggested. Copyright © 2002 John Wiley & Sons, Ltd.     

Anxiety Symptoms as Predictors of Nursing Home Placement in Patients with Alzheimer's Disease

Anxiety symptoms are fairly common among patients with Alzheimer's Disease (AD). Such symptoms are likely to make patient care more problematic and, therefore, increase the risk of nursing home placement. Anxiety symptoms were evaluated on the basis of physician examinations, in conjunction with caregiver interviews, in 372 community-dwelling AD patients. Patients received annual follow-up for 1–12 years (M = 4.4). Patients who exhibited anxiety symptoms at baseline assessment were significantly more likely to enter nursing homes, regardless of initial cognitive status or other risks for institutionalization. There was a 15% increase in risk for each point on a 0–5 scale. This study supports the hypothesis that anxiety symptoms increase the risk of nursing home placement in patients with AD. Consequently, there is a need for better understanding of the causes of anxiety in AD and for the development of effective methods of assessment and treatment.     

Strengthening the Capacity of Schools and Communities to Serve Students with Serious Emotional Disturbance

Target 2 of the National Agenda for Improving Results for Children and Youth with Serious Emotional Disturbance stipulates that communities and schools serve children and youth with emotional needs in their neighborhood homes and regular classrooms by developing the capacity of teachers, schools, and communities to provide supports and resources. This statement is partially based upon the idea that children and youth who are placed out-of-district for special needs and services are often alienated from their neighborhoods and their communities. The Westerly, RI, and Alliance, OH, school districts, service delivery agencies and families collaborated to implement system-wide change, so as to accomplish two main goals. First, they intended on retaining students with emotional needs in their neighborhood schools and in regular classrooms. Second, they aimed to increase their effectiveness in addressing the needs of all students by providing a range of integrated resources. Both communities were strongly driven by the underlying objective: to improve the educational, economic, and social outcomes for all children.