Depression After Traumatic Brain Injury: A Review of Evidence for Clinical Heterogeneity

Depression represents a major source of disability among individuals who have suffered a traumatic brain injury (TBI), with estimates of prevalence in this population ranging over 50%. In comparison with other sequelae of TBI, depression is often poorly conceptualized and treated among acute care and rehabilitation professionals. One reason for this is the lack of clear etiological models for the development of depression following TBI. This paper argues that post-TBI depression actually represents a heterogeneous category, with multiple etiologic pathways and clinical implications. The literature in this area is reviewed, with an emphasis on an appreciation of the diversity within this clinical population. Conclusions focus on suggestions for differential diagnosis and treatment options.     

Parental assessment and treatment of food selectivity in natural settings

This study evaluated the effects of a parent-conducted functional analysis and treatment consisting of differential reinforcement of an alternative behavior, escape extinction, and demand fading on food selectivity in a young child with autism. Increases in food acceptance at home and in a restaurant were obtained.     

MULTICOMPONENT ASSESSMENT AND TREATMENT OF CIGARETTE PICA

We conducted a multicomponent assessment and treatment for 4 individuals who engaged in cigarette pica. During Phase 1, three stimulus preference assessments were conducted to identify (a) the reinforcing component of the cigarette, (b) potential alternative reinforcers that may be used during treatment, and (c) whether the alternative reinforcer would compete effectively with cigarettes. Results were successful in identifying the reinforcing component of the cigarette and suggested the feasibility of using alternative reinforcers during treatment to eliminate cigarette pica. During Phase 2, the effects of two treatment procedures were evaluated. Noncontingent reinforcement (NCR) with the alternative edible reinforcer reduced the pica of 2 of the participants, but effects were not maintained when the initial dense schedule of NCR was thinned. Subsequently, differential reinforcement of alternative behavior with the alternative edible reinforcer was effective in reducing pica for 3 participants. An evaluation of nine treatment procedures failed to identify an effective intervention for the remaining participant; consequently, preventive measures were designed to minimize occurrences of cigarette pica.     

A quantitative interresponse-time analysis of DRL performance differentiates similar effects of the antidepressant desipramine and the novel anxiolytic gepirone.

We describe an interresponse-time analysis of performance on a differential-reinforcement-of-low-rate 72-s schedule. This analysis compares the obtained interresponse-time distribution of individual rats to a corresponding random interresponse-time distribution. The random interresponse-time distribution is a negative exponential probability function; it predicts the relative distribution of interresponse times if the rat emitted the same number of responses randomly (i.e., with a constant probability) with respect to time. The analysis provides quantitative measures of peak location and dispersion of the interresponse times toward random performance. In Experiment 1, an unexpected outcome of this analysis was that the rats would have obtained more reinforcers had they responded at the same rate but randomly. Based on the interresponse-time analysis in Experiment 1, it was shown that rats trained on the differential-reinforcement-of-low-rate 72-s schedule could increase the number of reinforcers obtained in two ways: first, by a coherent shift of the interresponse-time distribution toward longer durations and, second, by dispersal of the interresponse times toward a random interresponse-time distribution. Experiment 2 applied the analysis described in Experiment 1 to the effects of desipramine and gepirone. Both drugs decreased response rate and increased reinforcement rate, but their effects on the distribution of interresponse times were different. The increase in reinforcement rate observed with desipramine was accompanied by a coherent shift of the reinforcement rate observed with gepirone was accompanied by dispersal of the interresponse-time distribution toward the random negative exponential prediction.     

THE ROLE OF ATTENTION IN THE TREATMENT OF ATTENTION-MAINTAINED SELF-INJURIOUS BEHAVIOR: NONCONTINGENT REINFORCEMENT AND DIFFERENTIAL REINFORCEMENT OF OTHER BEHAVIOR

Because there are potentially serious limitations to differential reinforcement of other behavior (DRO) (which is probably the most widely used treatment procedure for behavior problems), we examined an alternative procedure—noncontingent reinforcement (NCR). Three females with developmental disabilities, all of whom engaged in severe self-injurious behavior, participated. During a pretreatment functional analysis, each subject's self-injury was shown to be differentially sensitive to social attention as a maintaining consequence. Next, each subject was exposed to a DRO treatment and an NCR treatment. During DRO, attention was delivered contingent on the absence of self-injury for prespecified intervals. During NCR, attention was delivered on a fixed-time schedule that was not influenced by the subject's behavior. Results showed that both procedures were highly effective in reducing self-injury, probably because the functional reinforcer for self-injury was used during treatment. Furthermore, there was evidence that NCR attenuated several of the limitations of DRO. These results are particularly interesting in light of the long experimental history of NCR as a control rather than as a therapeutic procedure.     

Graded differential reinforcement: Response-dependent reinforcer amount

After key pecking had been autoshaped, six pigeons were exposed to a condition in which the duration of grain availability at the end of an 8-second trial depended on the number of responses emitted during the trial (0.25-second access to grain per response). This procedure, called correlated reinforcement, alternated across conditions with the automaintenance baseline in which the 8-second trial terminated with a constant 2.5-second access to grain. Two control procedures were run; in both, the reinforcer durations were yoked to those obtained in the last correlated session. In the yoked control no responses were required, but in the single-response yoked control at least one response was required to receive the yoked duration. The correlated condition maintained response rates above those produced by the two control conditions. These results may be accounted for by differential reinforcement.     

情绪调节灵活性对负性情绪的影响：来自经验取样的证据

情绪调节灵活性是指个体根据不断变化的情境需求灵活部署情绪调节策略的能力。本研究采用经验取样方法,通过拟合个体在日常生活事件(如,未通过考试)和突发公共卫生事件(COVID-19)中的策略使用剖面结构和情境负性程度与策略使用程度的共变关系测量个体的情绪调节灵活性水平,并探讨其对个体后续负性情绪(抑郁和焦虑)的影响。两个独立样本结果表明：单一策略使用偏好(如沉浸偏好和表达抑制偏好)的个体在负性生活事件中和疫情期间经历了更高水平的抑郁和焦虑情绪。此外,当个体随情境负性程度提高使用更多分心策略,而随情境负性程度降低使用更多认知重评策略(意味较高的情绪调节灵活性),其抑郁和焦虑情绪水平更低。以上结果共同证实了情绪调节灵活性有利于减少个体的负性情绪体验。     

Brief assessment and treatment of pica using differential reinforcement,response interruption and redirection,and competing stimuli

Pica is a life threating form of challenging behavior displayed by individuals with intellectual and developmental disabilities. In most cases, pica is maintained by automatic reinforcement. Common interventions for pica use some combination of response blocking, response interruption and redirection (RIRD), differential reinforcement of alternative behavior (DRA), and noncontingent reinforcement with competing stimuli. However, there is need for additional research regarding DRA procedures that emphasize skills acquisition by teaching alternative behaviors that modify the established behavioral chain of pica responses that occur in the presence of non-edible stimuli. There is also a need to examine the generality of recent advances in competing stimulus assessment (CSA) methodologies—namely, the augmented-CSA (A-CSA)—to pica. Thus, the purpose of the present investigation was to systematically replicate and extend previous research for the assessment and treatment of pica in an individual with IDD. First, we conducted a functional analysis to identify environmental variables associated with pica. Next, taught Patrick a differential response (i.e., discard pica items in trash receptacle) to earn reinforcers in conjunction with a RIRD procedure. Finally, we conducted an A-CSA for pica. Overall, low rates of pica were maintained over time with a combination of these procedures, and treatment was generalized across settings and people.     

A comparison of fixed momentary differential reinforcement of other behavior to variable momentary differential reinforcement of other behavior to reduce challenging behavior

Differential reinforcement of other behavior (DRO) is commonly used to reduce behavioral excesses. Momentary DRO schedules involve delivery of reinforcement contingent upon the absence of the target behavior at a given moment. Two variations of momentary DRO exist: fixed-momentary (FM) DRO and variable-momentary (VM) DRO. In the current study, we directly compared FM-DRO and VM-DRO schedules to reduce challenging behavior maintained by automatic reinforcement exhibited by four children with autism spectrum disorder. The results suggest that both the DRO schedules were equally effective to reduce challenging behavior. A social validity measure showed that most caregivers rated the VM-DRO as a preferred schedule and noted the potential for FM-DRO schedule to become more discriminable over time, which could reduce its effectiveness. However, most caregivers also commented that the FM-DRO schedule was easier to implement.     

Self-transcendent emotions and their influence on organizational effectiveness: A literature review and synthesis

Self-transcendent emotions are positive emotions that arise out of other-focused appraisals. These emotions shift attention from the self to the needs and concerns of others. Limited work, however, focuses on self-transcendent emotions and the underlying cognitive and behavioural mechanisms by which they benefit organizations. We review the disparate streams of research on self-transcendent emotions and detail the thought-action repertoires of four self-transcendent emotions (compassion, gratitude, inspiration, and awe), explaining how each contributes to effective organizational functioning. Central to achieving this aim is the broaden-and-build theory. We show how the four self-transcendent emotions broaden cognitive processes and build the necessary resources leading to specific positive organizational outcomes. We conclude our review with four themes: (a) the importance of delineating levels of analysis in self-transcendent emotion research, (b) acknowledging contextual and cross-cultural differences shaping the experience of self-transcendent emotions, (c) addressing measurement concerns, and (d) the examination of other self-transcendent emotions. In effect, we synthesize the positive psychology and organizational behaviour literature, generating a framework that prompts theoretical and practical considerations for the role of self-transcendent emotions in organizations.