ACCEPTABILITY OF ALTERNATIVE TREATMENTS FOR DEVIANT CHILD BEHAVIOR

The acceptability of alternative treatments for deviant child behavior was evaluated in two experiments. In each experiment, clinical cases were described to undergraduate students along with four different treatments in a Replicated Latin Square Design. The treatments included reinforcement of incompatible behavior, time out from reinforcement, drug therapy, and electric shock and the treatments were described as they were applied to children with problem behaviors. Experiment 1 developed an assessment device to evaluate treatment acceptability and examined whether treatments were rated as differentially acceptable. Experiment 2 replicated the first experiment and examined whether the severity of the presenting clinical problem influenced ratings of acceptability. The results indicated that treatments were sharply distinguished in overall acceptability. Reinforcement of incompatible behavior was more acceptable than other treatments which followed, in order, time out from reinforcement, drug therapy, and electric shock. Case severity influenced acceptability of alternative treatments with all treatments being rated as more acceptable with more severe cases. However, the strength of case severity was relatively small in relation to the different treatment conditions themselves which accounted for large portions of variance.     

EVALUATION OF BIOFEEDBACK IN THE TREATMENT OF BORDERLINE ESSENTIAL HYPERTENSION1

Direct biofeedback of blood pressure was compared with frontal EMG biofeedback and with self-instructed relaxation for the treatment of essential hypertension in a controlled group outcome study. Patients were followed up for four months after the end of treatment. Generalization of treatment effects was assessed through pre- and posttreatment measurements of blood pressure under clinical conditions in a physician's office. There were no significant reductions in diastolic blood pressure. The systolic blood pressure (SBP) of the patients receiving blood pressure biofeedback decreased 8.1 mm mercury (p = 0.07) and the SBP of the patients in the relaxation condition decreased 9.5 mm mercury (p = 0.05). In the generalization measures, there were significant reductions in SBP for the relaxation group. The results are discussed in terms of the general lack of replicability within the area of biofeedback treatment of hypertension.     

New assessment systems for residential treatment,management, research,and evaluation: A symposium

An introduction and overview are presented to new observational assessment systems for ongoing assessment and monitoring of both staff and resident (client or patient) functioning in residential treatment programs for emotionally disturbed and mentally retarded adults.Preparation of articles and the research and development on which the articles are based was supported, in part, by Public Health Service Grants MH-15553 and MH-25464 from the National Institute of Mental Health, and by grants from the Joyce Foundation and the Illinois Department of Mental Health and Developmental Disabilities.A symposium presented at the 87th Annual Meetings of the American Psychological Association, New York City, September 1979.     

Systems use to objectify program evaluation,clinical, and management decisions

The utility of the observational assessment systems at different levels — from local clinical to systemwide management — is outlined. An overview is provided of TSBC information applied to individualized problem identification and programming/monitoring, discharge and competency determinations, and both absolute and comparative program evaluation. The utility of SRIC information for prgoramming/monitoring and for staff training and evaluation is outlined in addition to the applied uses of the information of the assessment systems in combination. Once implemented, the continuous data from the systems allow for empirically based self-corrective improvements in the quality of mental health services while automatically providing a basis for legal documentation and accurate cost/effectiveness comparisons of mental health programs.Preparation of this article and the research and development on which the article is based were supported, in part, by Public Health Service Grants MH-15553 and MH-25464 from the National Institute of Mental Health, and by grants from The Joyce Foundation and the Illinois Department of Mental Health and Developmental Disabilities.Presented at the 87th Annual Meetings of the American Psychological Association, New York City, September 1979, as part of a symposium on New assessment systems for residential treatment, management, research, and evaluation.     

COMPARING TREATMENT TACTICS WITH A HYPERACTIVE PRESCHOOL CHILD: STIMULANT MEDICATION AND PROGRAMMED TEACHER INTERVENTION1

Two treatment tactics, food and praise contingent on appropriate play and varying doses of methylphenidate (Ritalin), were evaluated for their effects on a preschool child's activity changes. In addition, other social, verbal, and academic behaviors were monitored to examine possible side effects of the two treatment tactics. Fewer free-play activity changes occurred during contingent reinforcement phases while medication had variable effects: increasing attention to tasks but, at higher doses, decreasing intelligibility of speech and responsiveness to mands. The study outlines a replicable model for comparing medication with alternative behavioral strategies to control hyperactivity and enhance skill development.     

BEHAVIOR ANALYSIS APPLIED TO ENVIRONMENTAL/ECOLOGICAL PROBLEMS; A REVIEW1

Recent applications of operant technology, including the manipulation of environmental conditions and response consequences, have been directed toward the improvement of man-environment relations. This document summarizes the research designs, procedures, results, and conclusions of these recent behavioral interventions for ecological rebalance. Each of the 32 studies reviewed was undertaken since 1970; all studies were relatively successful in changing the probability of an ecology-related response; all studies incorporated basic methodologies applicable for large-scale, community programs; most of the investigations were conducted in field settings (e.g., college campuses, grocery stores, mobile-trailer parks, homes, movie theaters, public campgrounds, and a football stadium). Several of the studies are as yet unpublished. Sources for receiving documentation of the unpublished research are provided in this document. About 50% of the investigations reviewed were designed to influence behaviors related to environmental litter; the others were of behavior-modification programs that substantially increased bus-ridership, decreased lawn-trampling, promoted the purchase of drinks in returnable rather than throwaway containers, initiated a recycling process, or reduced energy consumption. Essentially, the interventions were either preventive in nature (i.e., designed to discourage environment-destructive behaviors before they occur), or remedial (i.e., designed to encourage behaviors that correct an existing environmental problem). Usually, the preventive measures emphasized responses priming (or prompting), while the corrective measures applied some form of positive reinforcement. Response priming was accomplished with modelling techniques, or with written and/or verbal prompts presented either publicly or on a personal, one-to-one basis. Among the positive reinforcement procedures were field applications of token economies, lottery systems, feedback programming, and intergroup contests, as well as individual contingency contracting. Some experimental designs provided for comparisons between the behavioral effects of response priming and positive reinforcement.     

The effects of instructions, incentive, and feedback on a community problem: dormitory noise

A reinforcement system utilizing instructions, modelling, feedback, and group reinforcement was employed in an attempt to reduce disruptive noise on three university residence halls. A fourth hall received the same treatment program without the reinforcement component. Noise scores were determined by recording the number of discrete noise occurrences over a criterion decibel level. On all four residential floors, noise scores during treatment conditions were lower than initial and final baseline levels. Additionally, periods of noise reduction corresponded to the changing criterion multiple-baseline and reversal designs utilized. Pre- and posttreatment questionnaire responses from the three reinforcement floors paralleled changes in objective noise data. At posttreatment, residents reported less noise disturbance of study and sleep and more control over the noise situation and floor problems in general. These results indicated that a comprehensive behavior-modification treatment package was effective in reducing disruptive noise in university residence halls. Difficulties in data collection and anomalies in the data are discussed. Future directions for field-based behavior-modification research are outlined.     

Facilitating paper recycling: effects of prompts, raffles, and contests

The effects of prompts and reinforcement to promote paper recycling were compared in six university dormitories. For a Prompt condition, residents were urged to recycle paper for ecological reasons via flyers distributed to each room. For a Raffle contingency, residents were given one raffle ticket for every pound of paper brought to a collection center. For a Contest contingency, two dorms were paired and the dorm whose residents delivered the most paper won $15 for its treasury. Contingency awareness was strengthened via a flyer placed under the door of each resident's room. Flyers alone had little effect in increasing paper-recycling behaviors, but the raffle (substantially) and the contest (somewhat) increased the amount of paper brought to a dorm's recycling center. Students whose rooms were closest to the collection center showed the greatest participation. Removal of the reinforcement contingencies resulted in a return to baseline levels.     

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.     

Changes in Anxiety Control Beliefs Following a Brief CBT Treatment and Their Association With Anxiety Symptom Reduction

Anxiety control beliefs (i.e., beliefs regarding one’s ability to cope with external, fear-inducing threats and internal reactions to those perceived threats) have been found to negatively predict anxiety symptoms in children and adults and to be modifiable by cognitive-behavioral therapy for anxiety disorders. The current study examines whether changes in anxiety control beliefs were seen following a brief, intensive treatment for specific phobias, and whether those changes were associated with improvements in the targeted phobia and comorbid anxiety disorder symptoms. Participants were 135 children and adolescents (M age = 9.01 years, 49% male) who received one-session treatment (OST) with or without parental involvement for their primary specific phobia. Results indicated that self-reported anxiety control beliefs significantly increased following treatment and that these increases significantly predicted reductions in specific phobia severity and symptoms of comorbid anxiety disorders 6 months and 1 year following treatment. Findings illustrate that involvement in a single 3-hour OST was associated with changes in anxiety control beliefs and demonstrate the potential importance of targeting control beliefs in pediatric anxiety treatment.