THE TREATMENT OF COVERT SELF-INJURY THROUGH CONTINGENCIES ON RESPONSE PRODUCTS

Assessment and treatment of covert self-injurious behavior are complicated because it is difficult to quantify and apply differential consequences to covert responses. In this study, both tangible and social reinforcers were identified using reinforcer assessment methods. These reinforcers were then provided contingent upon the absence of tissue damage identified during physical examinations, resulting in near 100% success in physical assessment checks that was maintained over 10 months.     

Compliant in a moment: a commentary on nevin

Nevin's scholarly and timely discussion attempts to maintain the precarious union of the experimentally derived theory of behavioral momentum with applications of the behavioral momentum construct to human subjects in applied settings. Nevin's discussion adds much-needed clarification to a process that at times has proven to be awkward for applied researchers. In this commentary, we will address three general questions: (a) Can the applications of behavioral momentum be derived from the theory as conceptualized by Nevin? (b) Could those applications have been developed had the theory not been formulated? (c) Does behavioral momentum theory add significantly to the compliance literature?     

Sensitizing Medical Residents to Fantasies and Alignments in the Family: Mastering Psychosocial Skills in the Medical Encounter

In this paper, it is proposed that a) psychosocial medicine is best taught in a setting that provides technical and emotional support, while seizing for teaching only those moments when the learner is most receptive; and b) that the setting should avoid the development of a separate psychosocial skills curriculum, but should take the student where he or she is and integrate the psychosocial skills into his or her everyday biomedical practice. The paper gives specific case examples in which family based psychosocial issues were preeminent in the clinical problem-solving medical residents faced.     

The effects of situational variations in role-play scenes on assertive behavior

The study was conducted to determine the extent to which variations in the situational parameters of role-play scenes affect subjects' levels of assertiveness. Thirty-six psychology undergraduate students were randomly assigned to one of three role-play conditions that differed in the situation-setting characteristics presented in the scenes: a Difficult condition, designed to inhibit assertive responding; an Easy condition, designed to facilitate assertive responding; and a Neutral condition. Subjects also completed a self-report assertion inventory. Videotapes of the role-played interactions were rated for a variety of component responses. Results indicate that subjects responded differently in the three conditions. Subjects in the Difficult and Neutral conditions were more compliant, and those in the Easy and Difficult conditions were more fluent. It is suggested that failure to specify the situational parameters of role-play scenes may affect the validity of this assessment procedure.This research was supported in part by NIMH Grant, MH28279 to the third author.     

THE CLASS SPECIFIC EFFECTS OF COMPLIANCE TRAINING WITH “DO” AND “DON'T” REQUESTS: ANALOGUE ANALYSIS AND CLASSROOM APPLICATION

Two experiments are reported in which the relationship between compliance with “do” and “don't” requests was examined with developmentally disabled children. In Experiment 1, a multiple baseline design across subjects with counterbalanced treatment conditions was used to evaluate a compliance training program composed of four phases: (a) baseline, during which no consequences were delivered for compliance, (b) reinforcement for compliance with one targeted “do” request, (c) reinforcement for compliance with one targeted “don't” request, and (d) follow-up with reinforcement on a variable ratio schedule for compliance with any “do” or “don't” request. Results of probes conducted before and after training within each condition indicated that generalized compliance occurred only with requests of the same type as the target exemplar (“do” or “don't”). In Experiment 2, these results were replicated in a classroom setting. Following collection of baseline probe data on student compliance, a teacher training program was successfully implemented to increase reinforcement of compliance first with one “do” and subsequently with one “don't” request of a target student. Results of multiple baseline probes across “do” and “don't” requests indicated that the teacher generalized and maintained reinforcement of compliance with other requests of the same type and to other students, with a resulting increase in student compliance with the type of requests reinforced. The impact of treatment on both teacher and student behavior was socially validated via consumer ratings. Implications of these findings with respect to response class formation and compliance training programs are discussed.     

Regret and disappointment in taxpayer reporting decisions: An experimental study

This paper reports on experiments which test whether factors such as regret or disappointment influence taxpayer compliance decisions. Previous tests of regret and disappointment theory have been based upon the common-ratio effect in which probabilities vary while outcomes are held fixed. In contrast, our experiments involved trials in which the outcomes were allowed to vary. Previous tests had mainly found evidence of regret effects and to a lesser extent were supportive of disappointment. In contrast, we were able to reject simple theories of both regret and disappointment. A second experiment produced evidence which indicates that whether or not rejected risky alternatives are resolved has no significant influence on subjects' choices. One would expect that regret could only occur when a subject learns the outcome of a non-chosen option. Hence this result can be seen as evidence against regret theory. We shall argue that there is a possible interpretation of regret theory which is compatible with this result.     

VISITING THE DENTIST: A BEHAVIORAL COMMUNITY ANALYSIS OF PARTICIPATION IN A DENTAL HEALTH SCREENING AND REFERRAL PROGRAM

One-hundred and twenty-five families in the Medicaid Early Periodic Screening, Diagnosis and Treatment Program were assigned to one of five treatments to encourage parents to obtain health care service following the dental screening of their children: (a) a control procedure, in which parents were given a dentist's name; (b) a multiple contact procedure, in which parents received a postcard and two telephone call reminders; (c) a problem-solve procedure, in which a social worker aide conducted a brief session with the parent; (d) an incentive procedure, in which parents selected among four gifts that were contingent on seeking care; (e) an incentive + problem-solve procedure, in which the latter two treatments were combined. The multiple contact, incentive, and incentive + problem-solve techniques were significantly more effective in initiating dental visits than the control procedures. Families assigned to the intensive strategies were most likely to complete treatment. A cost-efficiency analysis showed the multiple contact technique to be a low-cost and highly effective procedure.     

国内外医学专业杂志发表医学人文相关文章情况分析

总结分析了201 2年1月～2013年5月国外4种医学专业杂志(BMJ、JAMA、LANCET和NEJM)医学人文相关文章的发表情况,并与国内4种知名医学专业杂志(《中华医学杂志》、《中国实用内科杂志》、《中华内科杂志》和《中华外科杂志》)发表的医学人文类文章的情况进行对比分析,结果发现,国外医学专业杂志医学人文类文章比重较大,而且涉及的领域较广,包括医疗卫生政策管理、医学社会学、对患者及医生的人文关怀、医疗风险告知和医疗差错告知的文章.而国内与国外杂志相比存在较大差距.     

Flexible moral theories: Complexity,domination, and indeterminacy

In this article we identify three previously unnoticed problems with flexible moral theories, i.e., theories according to which different moral rules apply when there is full compliance and when there is partial compliance. The first problem is that flexible theories are necessarily very complex, which undermines their ability to motivate and guide action. The second problem is that flexible theories allow for a troubling kind of (moral) domination: the duties an agent has depend on other agents' willingness to comply. Finally, flexible theories introduce indeterminacy: it is sometimes impossible to determine which moral rules apply. When agents stand at the threshold—i.e., when a different rule would apply if a single additional act of noncompliance took place—it is impossible to determine which rule should apply.     

医疗信息的风险感知

从信息加工视角探究个体对医疗信息的风险感知过程, 通过医疗信息来源、医疗信息内容与呈现形式和信息加工主体三个方面归纳其影响因素, 并基于经验-分析式加工理论和字面-要义加工理论探讨医疗信息风险感知的认知机制。今后研究可更注重医疗信息风险感知的通用研究与特殊主题研究的平衡、风险感知测量工具的规范性与特异性的结合, 并立足于中国医疗体系建立具有循证依据的预防措施和配套政策。