Cognitive habilitation in schizophrenia: A theoretical review and model of treatment

Evidence has accumulated for information processing deficits in schizophrenia. The functional significance of these deficits is only beginning to be understood. There are indications that these deficits may respond to intervention. Training on deficient functions has been demonstrated to relate to improvements in performance. A treatment program of cognitive rehabilitation is deduced from the literature and induced from clinical experience. The treatment is designed to impact directly on the information processing deficits of schizophrenic patients and indirectly to ameliorate functional deficits.     

从情绪描述看青少年期到成人期认知结构的发展

该研究依据研究者制定的认知发展水平评价系统,对年龄范围在13—55岁之间的90名被试关于生气、害怕、伤心、高兴四种情绪的自我描述进行了评价分析。结果表明,青少年期的思维具有形式化、外在、抽象等特点,成人期的思维具有内在、具体、形象等特点,前者具有刻板性、封闭性,后者具有灵活性、开放性。     

场依存性与独立性认知方式对视动错觉的影响

为探讨认知方式对视动性错觉的影响,对100名男性军校学员进行了棒框测验,15名高分者和15名低分者分别作为场依存组和场独立组。每名被试随机给予一系列视动阶跃刺激(5,10,15,20,30,40,60,80,100,120度/秒),每个刺激持续20秒。记录被试视动错觉出现的潜伏期和错觉模糊量。研究结果表明:1.场依存组被试的错觉潜伏期短于场独立组,它与刺激速度呈幂函数关系,而场独立组潜伏期随刺激速度的增加呈直线下降;2.在5—120度/秒的范围内,两组被试错觉量回归成两条直线,两直线回归系数无显著性差异,而截距差别十分显著。因此,场依存性/独立性认知方式是视动错觉个体差异性的一种重要影响因素,它对军事飞行员的心理学选拔和训练有着重要的意义。     

Utility maximization and melioration: Internalities in individual choice

How do people go about choosing between alternatives in relatively simple settings? This study explores some of the variables that past work suggests may be relevant. Volunteer subjects worked for money in six procedures in which the probability of a payment from either of two alternatives was 1.0, but the rate of pay (i.e. the speed with which a payment was delivered or the size of the payment) interacted with the subjects recent allocation of choices, which we define as the ‘internalities’. Because of the internalities, choosing the currently more profitable alternative did not maximize total earnings. Subjects were more likely to fail to maximize when the interaction between present pay and past choices was spread over longer sequences of choices, or when the reward variable was the speed, rather than the value, of each payment. Subjects often disregarded the internalities and were instead guided by the current yields of the two alternatives, which is a frequently observed tendency, called ‘melioration’, in experiments on choices by animals. The tendency toward melioration was only partially counteracted by explicit instructions on how to maximize earnings. We discuss a theoretical framework for melioration that postulates both motivational and cognitive sources.     

Family preservation using multisystemic treatment: Long-term follow-up to a clinical trial with serious juvenile offenders

In a randomized clinical trial, multisystemic family preservation was shown to significantly reduce rates of criminal activity and incarceration in a sample of 84 serious juvenile offenders and their multi-need families. In the current study, archival records were searched for re-arrest an average of 2.4 years post-referral. Survival analysis showed that youths who received multisystemic family preservation were less likely to be re-arrested than were youths who had received usual services. Such results represent the first controlled demonstration that family preservation, when delivered via a clearly specified treatment model, has lasting effects with serious juvenile offenders. Implications for family preservation and juvenile justice research are discussed.     

Nonsuicidal physically self-damaging acts in adolescents

To determine the frequency and correlates of nonsuicidal physically self-damaging acts in 12–14 year olds, a two stage epidemiologic survey with a self-administered questionnaire (N=3283) followed by a psychiatric interview of a subsample of the adolescents and their parents (N=444) was used. Prevalence estimates of interview validated nonsuicidal physically self-damaging acts were 2.46% in males and 2.79% in females. Significant relationships were found between nonsuicidal physically self-damaging acts and suicidal ideation, major depression and undesirable life events. Data suggest that physically self-damaging acts occur at substantial rates during early adolescence. The strong correlation between nonsuicidal self-destructive acts and both suicidal ideation and major depression clarifies prior conflicting reports in the literature and suggests that a history of self-damaging acts should be taken into consideration when evaluating for possible depression and suicide risk.     

EXPERIMENTAL ANALYSIS AND TREATMENT OF MULTIPLY CONTROLLED SELF-INJURY

A functional analysis of the self-injurious behavior (SIB) of 3 adults with profound developmental disabilities showed that each engaged in SIB in more than one assessment condition. Such outcomes may result from a failure to isolate the variable maintaining SIB, or they may reflect multiple sources of control over SIB. In order to identify more clearly the determinants of SIB, each subject was exposed to a series of treatments appropriate to one or both of the apparent functions of SIB. These treatments, applied sequentially on baselines appropriate to each behavioral function, identified the maintaining variables for SIB through differential outcomes across baselines. Results indicated that the SIB of 2 subjects was multiply controlled, confirming the outcomes of the functional analysis. However, the SIB of the 3rd subject was eliminated using a treatment designed for a single function, suggesting spurious results of the original assessment. Alternative interpretations of undifferentiated assessment data are discussed, as are analysis and treatment issues related to multiply determined behavior disorders.     

STIMULUS (INSTRUCTIONAL) FADING DURING EXTINCTION OF SELF-INJURIOUS ESCAPE BEHAVIOR

Three individuals with developmental disabilities were exposed to a series of assessment conditions to identify the source of reinforcement for their self-injurious behavior. In each case, self-injury occurred most often in instructional (demand) situations containing a brief time-out from the task contingent on self-injury, indicating that the behavior was an escape response (i.e., maintained by negative reinforcement). Treatment was implemented in a multiple baseline across subjects design and consisted of extinction (prevention of escape) plus instructional fading (initial elimination of instructions followed by their gradual reintroduction). Results showed that the combined treatment produced immediate and large reductions in self-injury that were maintained as the frequency of instructions was increased across sessions to match the original baseline rate of presentation. Results of a component analysis conducted with 1 subject suggested that stimulus fading accelerated the behavior-reducing effects of extinction.     

INCREASING CALORIE CONSUMPTION IN CHILDREN WITH CYSTIC FIBROSIS: REPLICATION WITH 2-YEAR FOLLOW-UP

Three mildly malnourished children with cystic fibrosis and their parents participated in a behavioral group-treatment program that focused on promoting and maintaining increased calorie consumption. Treatment included nutritional education, gradually increasing calorie goals, contingency management, and relaxation training, and was evaluated in a multiple baseline design across four meals. Children's calorie intake increased across meals, and total calorie intake was 32% to 60% above baseline at posttreatment. Increased calorie consumption was maintained at the 96-week follow-up (2 years posttreatment). The children's growth rates in weight and height were greater during the 2 years following treatment than the year prior to treatment. Increases in pace of eating and calories consumed per minute were also observed 1 year posttreatment. These findings replicated and extended earlier research supporting the efficacy of behavioral intervention in the treatment of malnutrition in children with cystic fibrosis.     

EFFECTS OF MEMORY AIDS ON THE DYADIC CONVERSATIONS OF INDIVIDUALS WITH DEMENTIA

The effects of a prosthetic memory aid on the conversational content and social skills of dyads with dementia were evaluated. Six individuals with moderate to severe dementia served as either subject or partner in dyads during 5-min conversational probes conducted three times per week in daycare and nursing-home settings. During phases when a memory aid, consisting of personally relevant picture and sentence stimuli, was available, most subjects used their own aid to improve the quality of conversations by increasing the frequency of on-topic statements, diminishing nonproductive utterances, lengthening their conversational turn, and/or increasing the frequency of turns taken. Most partners demonstrated awareness of social discourse conventions by appropriately relinquishing conversational dominance, decreasing both content and nonproductive utterances, and increasing acknowledging or affirmative comments when subjects used memory aids. Naive judges' ratings of aided and unaided conversational samples on seven conversational dimensions reflected differences in perceptions of significant improvement as a function of the conversational discourse style of each dyad.