Behavioral neuropsychology: Past,present, and future direction with organically based affect/mood disorders

Affective/mood disturbances have been widely described in association with central nervous system dysfunction. There have been multiple divergent viewpoints regarding the origin of these disorders, however. This is not surprising, as theories evolve in relation to our degree of technological advancement. This review describes the evolution of some of these views, and discusses the advantages of behavioral neuropsychology as an effective approach to assessment/treatment in this context. Although there have been few articles published describing the use of behaviorally based approaches to treat these disorders, it is thought that this approach shows promise, particularly when combined with information based on neuropsychological assessment data. Future directions for the continued evolution of this field are outlined.     

Cross-situational inconsistency in the behavior of compulsive and histrionic personality disorders: An analogue study

The purpose of this study was to examine empirically the personologist assumptions underlying definitions of personality disorders. The behavioral consistency or inconsistency of subjects with histrionic (n=28)or compulsive (n =26)personality disorder analogues, as well as control subjects (n=28)was investigated across situations that varied in type of audience (public vs. private) and type of demand (neutral vs. high), using three tasks. It was predicted from an interactionist perspective that histrionics would respond differently to private vs. public situations but consistently across the three tasks and that compulsives would respond differently to neutral-vs. high-demand situations but consistently across the three tasks. In contrast, the results were most consonant with a situationist perspective, with situational factors affecting all subject groups similarly, thus raising questions about personologist assumptions of personality disorders.     

Bias and Millon clinical multiaxial inventory (MCMI-II) diagnosis

In the current study, the degree of bias is calculated for each of the personality disorder and clinical syndrome scales of the MCMI-II. In general, most of the MCMI-II scales are prone to only mild or moderate biases. However, the paranoid personality disorder, somatoform, bipolar: manic, thought disorder, and delusional disorder scales are prone to severe biases. When the MCMI-II is utilized to make diagnostic decisions, bipolar and schizophrenic disorders are apt to be grossly underestimated. The implications of bias in diagnostic prevalence rates are discussed and an equation is offered which provides for adjustments to be made when the percentage of positive MCMI-II test results are used to determine prevalence rates for clinical or research populations. The observation is made that imperfect sensitivity and specificity for the MCMI-II scales will result in inaccurate estimates of personality disorders and clinical syndromes when the MCMI-II is used to survey various populations.     

Archetypal defenses in the clinical situation: a vignette

Critical moments along the path of an analysis are presented in order to illustrate how dreams portray archaic and typical (archetypal) defenses against the re-experience of unbearable affect as it emerges. Inner defensive 'objects' functioning as a 'self-care system' threaten to uproot, kill or destroy the connections between the dream ego and various images of vulnerability as these emerge in response to healing life events or transference feelings. Over a series of dreams, transformations within this self-care system are observed, ending in a final healing dream which marks the patient's achievement of a 'depressive position' in relation to her otherwise persecutory anxieties.     

Classroom-based functional and adjunctive assessments: proactive approaches to intervention selection for adolescents with attention deficit hyperactivity disorder.

The present investigation evaluated the utility of classroom-based functional and adjunctive assessments of problem behaviors for 2 adolescents who met diagnostic criteria for attention deficit hyperactivity disorder (ADHD) and comorbid oppositional defiant disorder (ODD). For children with ADHD-ODD, environmental classroom variables, when systematically manipulated by teachers, were related to the occurrence and nonoccurrence of problem behaviors. Classroom interventions derived from information that was obtained during functional and adjunctive assessments and from subsequent analyses resulted in substantial reductions in problem behaviors. Teacher and student consumer satisfaction ratings indicated that the interventions were effective and feasible in the classroom setting.     

Personality Disorders and Treatment: A Therapeutic Conundrum

Of challenge to developmental psychologists and mental health practitioners is the importance of temperament, the intractable nature of personality, the complex psychodynamics of personality disorders, the fragile features of the therapeutic alliance, and the selection of appropriate therapy techniques. The intent of this article is to provide specific information pertinent to understanding personality disorders and to offer recommendations for effective treatment strategies.     

An analysis of the relationship of teachers' reported use of classroom management strategies on types of classroom interactions

The results of an investigation to determine teachers' reported use of classroom management strategies and their relationship to teacher and student interactions are presented. We interviewed 20 teachers to determine how they developed and used classroom management strategies, and then observed the interactions of these teachers with children with serious behavior disorders (SBD). Results identified two groups of teachers: one that scored high on planned use of the strategies, and one that scored low. Comparisons between the two groups of the interaction patterns revealed small, but statistically significant differences in the mean length and total percent time involved in positive interactions. The group reporting higher use of the management strategies engaged in positive interactions which were longer in duration than the interactions of the group reporting lower use. The results are discussed in terms of further research needs and implications for teacher training programs.     

Family involvement and empowerment in mental health service provision for children with emotional and behavioral disorders

Involvement of families is a critical component in effective systems of care for children with disabilities and their families. We investigated the sociodemographic correlates of family involvement in mental health services for children who have emotional and behavioral disorders. Further, we investigated the relationship between family involvement and family empowerment. The Family Involvement Scale-Family Version was used to measure involvement of families in the provision of mental services for their children and the Family Empowerment Scale was used to measure pempowerment in families with children who have emotional and behavioral disorders. In additions, demographic data concerming family composition, race, education, incone, membership in a parent support group, and the mental health status of the children were also collected. The results showed that mothers, as well as respondents with less formal education, reported greater involvement in services for their children than fathers and those who were more educated. Further, the knowledge subscale of empowerment was significantly correlated with all, subscales of family involvement and personal empowerment was significantly correlated with the treatment subscale of family involvement.     

Individualized services and supports through the wraparound process: Philosophy and procedures

The wraparound process is emerging as an alternative to the traditional treatment planning processes inherent in categorical services for children and adolescents with emotional and behavioral disorders. We describe the current practices which have been developed in the field. Key elements of the value and philosophical base for the wraparound process are discussed. Proposed procedural steps are described to aid communities in the implementation of the wraparound process. Due to social and policy pressures, it is likely that wraparound process implementations will continue to develop.     

VARIANT AND INVARIANT HIGH-PROBABILITY REQUESTS: INCREASING APPROPRIATE BEHAVIORS IN CHILDREN WITH EMOTIONAL-BEHAVIORAL DISORDERS

This study examined the effects of variant versus invariant high-probability (high-p) request sequences on the performance of requests to initiate a social bid by young children with emotional-behavioral disorders. In the initial phases of the investigation, a multiple baseline design showed that the delivery of invariant sequences (i.e., high-p requests delivered in the same sequence) produced initial increases in compliance to requests to initiate a social bid to a peer. However, increases were not maintained across the invariant condition. The delivery of variant high-p sequences produced increases in compliance to requests to initiate social bids that were maintained across the variant condition. In a follow-up condition, the number of requests within the pool of the variant and invariant high-p requests were controlled. Results of the follow-up condition replicated those found in the initial condition. Implications for applied use and future research are discussed.