Reinforcer pathology,probabilistic choice,and medication adherence in patients with multiple sclerosis

The reinforcer pathology model posits that core behavioral economic mechanisms, including delay discounting and behavioral economic demand, underlie adverse health decisions and related clinical disorders. Extensions beyond substance use disorder and obesity, however, are limited. Using a reinforcer pathology framework, this study evaluates medical adherence decisions in patients with multiple sclerosis. Participants completed behavioral economic measures, including delay discounting, probability discounting, and a medication purchase task. A medical decision-making task was also used to evaluate how sensitivity to mild side effect risk and efficacy contributed to the likelihood of taking a hypothetical disease-modifying therapy. Less steep delay discounting and more intense (greater) medication demand were independently associated with greater adherence to the medication decision-making procedure. More generally, the pattern of interrelations between the medication-specific and general behavioral economic metrics was consistent with and contributes to the reinforcer pathology model. Additional research is warranted to expand these models to different populations and health behaviors, including those of a positive health orientation (i.e., medication adherence).     

Further evaluation of prompt density,rate of reinforcement,and the persistence of manding

Previous research has evaluated the effects of prompt rates on the rate of communicative behavior. More recent research has suggested that dense prompting can result in communicative behavior that is more resistant to change. However, existing research has not considered the impact that higher response rates had on reinforcement rate, a variable known to impact response persistence. The current study systematically replicated previous research by evaluating communicative responding in contexts associated with dense- and lean-prompt schedules and extended existing research by (a) holding reinforcement rates similar across the two prompting schedules (lean and dense), and (b) evaluating the persistence of communicative responding in the contexts associated with each prompting schedule. The results for Experiment 1 clearly replicated and extended previous research. The results for Experiment 2 were equivocal and suggested that previous reinforcement history and response class size impacted outcomes.     

Teaching self-control to reduce overt food stealing by children with autism and developmental disorders

Food stealing is often a serious behavioral problem among children with diagnoses of autism and other developmental disorders. Very few empirical studies concerning this behavioral challenge have been reported. We applied a correspondence training procedure to teach self-control as replacement behavior to four children with autism and developmental disorders who displayed food stealing in the community. A changing criterion design embedded within a nonconcurrent multiple-probe across participants design was used. The treatment succeeded for all four participants by increasing latency to eating highly preferred food to a predetermined criterion and reducing occurrences of food stealing to zero. Three participants generalized the replacement behavior to natural settings and maintained the behavior for 2 weeks, 1 month, 2 months, 3 months, and 4 months. One participant without expressive language was taught successfully during treatment trials but failed to maintain and generalize the behavior. A functional relation between delaying food eating and Say-Do correspondence training was demonstrated.     

Telehealth parent training for a young child at risk for autism spectrum disorder

The global pandemic has highlighted the importance of telehealth to access behavioral interventions. Face-to-face parent training improves the development and behaviors of young children at risk for autism spectrum disorder (ASD). We evaluated a telehealth parent training intervention for a child at risk for ASD. Two parents identified possible early ASD symptoms in their 30-month-old son (lack of imitation, pointing, and vocal manding). Both parents simultaneously received telehealth behavioral skills training on the Parent Intervention for Children at Risk for Autism program for 1 hour per week over 29 weeks. Multiple baseline designs across parent and child behaviors showed that both parents improved their parent teaching fidelity above 80% and the child improved on all trained behaviors. This study expands the utility of telehealth behavioral parent training to young children at risk for ASD to mitigate early symptoms of ASD.     

“Being human”: A grounded theory approach to exploring how trainers on clinical psychology doctorate programmes decide whether or not to disclose personal experiences of psychological distress to clinical psychology doctorate trainees

Objective

Recent research and guidelines recommend that trainers on clinical psychology doctorate training programmes consider disclosing personal experiences of psychological distress to trainees. Disclosure is thought to promote cultures of openness, validate and normalise trainee distress, encourage trainee disclosure and help-seeking and challenge stigmatising narratives. However, little is known about how trainers decide whether, what or how to disclose. This study aims to address that gap by exploring the processes and factors involved in trainers deciding whether or not to disclose personal experiences of psychological distress to trainees, generating findings of relevance across counselling, psychotherapy and psychology training courses.

Methods

In-depth interviews were conducted with nine trainers on UK clinical psychology doctorate programmes from around the country and analysed in accordance with constructivist grounded theory methods.

Results

Findings indicated that participants valued disclosure personally and professionally but were wary of the dangers of disclosure. Disclosure decisions were made by judging the context against internally held criteria. If criteria were not met, then disclosures were not made. Outcomes, whether positive or negative, served to reinforce the value of disclosure and the importance of managing risks, creating a positive feedback loop.

Conclusions

The findings of this study suggest factors that are important for trainers to consider when deciding whether or not to disclose. The six-factor framework developed may be useful for trainers to consider within reflective practice, supervision or during guided self-reflection in order to make safe, helpful and ethical decisions.     

特质自我控制对食物线索注意偏向的影响及干预：来自眼动的证据

采用眼动技术,以BMI指数处于正常范围的女性为被试,考察特质自我控制对食物线索注意偏向的影响以及注意偏向训练在改变注意偏向强度上的干预效果。结果发现,对于高热量食物线索,低特质自我控制水平女性表现出了更强的注意偏向;注意偏向训练有效降低了低特质自我控制水平女性对高热量食物线索注意偏向的强度。上述结果表明,特质自我控制影响个体对食物线索的注意偏向,注意偏向训练能有效改变个体对食物线索注意偏向的强度。     

Examining Influences on Problem Recognition and Help-Seeking for Child Externalizing Behaviors Among African American Mothers

Childhood behavior problems are one of the most common clinical referrals. If left untreated, these behaviors can result in detrimental consequences to the child’s development (Wehmeier et al., 2010; Scholtens et al., 2012). Behavior parent training has been identified as first-line treatment for oppositional behavior; however, many racial minority families fail to enroll in behavior parent training. The current study examines maternal help-seeking for children displaying oppositional behavior in hopes to delineate variables that might influence parent training enrollment among African American families. Participants were 112 African American mothers who were provided child behavior vignettes and completed measures assessing factors related to problem recognition, parental attributions, child rearing values, mental health stigmatization, racial identity, and treatment utilization. Results found that when presented with a child displaying clinically significant externalizing child behaviors, slightly more than half of African American mothers recognized clinically significant child behavior problems. Mothers were more likely to engage in behavioral parent training if problematic behavior was recognized. Additionally, mothers’ attributions of child behavior, cultural values, and mental health stigmatization were influential to help seeking. This study supports the importance of considering cultural variables that impact problem recognition and subsequent treatment utilization among African American families.     

Behavioral Parent Training Engagement Among Young Children With Autism Spectrum Disorder

The purpose of the current study was to examine engagement with Behavioral Parent Training (BPT) for families of children with Autism Spectrum Disorder (ASD) and assess openness to novel delivery formats for BPT (e.g., telehealth, group). Participants were caregivers of 501 children with ASD (ages 2–6) enrolled in the SPARK (Simons Foundation Powering Autism Research for Knowledge) online national registry. The study assessed: (1) rates of child disruptive behavior diagnoses, (2) engagement and satisfaction with BPT, (3) parent and child factors (e.g., diagnostic history), and (4) openness to novel delivery formats. Almost 25% of young children with ASD in this sample had disruptive behavior problems rising to the level of a diagnosis of ADHD or ODD and thus would benefit from BPT. However, only one third of these families had actually been referred to BPT. Families indicated high level of interest in participating in BPT, with a particular interest in Parent Child Interaction Therapy (PCIT) as well as novel delivery formats such as telehealth and group. Specific components of the therapy and delivery formats were indicative of parent satisfaction (e.g. groups, longer treatment sessions, longer treatment length). Specific parent and child characteristics were predictive of openness to novel formats (e.g. parental depression, more severe behavioral challenges, lower verbal skills). Results underscore the need for increased referrals and access to BPT programs the ASD population. Both parent and child characteristics are important for determining appropriate delivery formats.     

“‘WE' AND ‘THEY'”: WHY MUST WE ENGAGE IN CROSS-CULTURAL CONVERSATION?

This article contains the principal ideas that I presented in four different sessions at the IRAS 2022 conference, on the theme “‘We' and ‘They’: Cross-Cultural Conversation on Identity.” Focusing on the central topic, the article begins with (i) the contents of my opening lecture; followed by (ii) a broad outline of the concerns discussed in my book, Cross-Cultural Conversation: A New Way of Learning, intertwined with glimpses of the intellectual journey that led me to CCC, delivered in the Book-discussion session; (iii) a summary of the main ideas about the importance of meeting of religions today, which formed the background for the CCC Panel discussion on religion, where I was in conversation with spokespersons of five world religions; and (iv) my comments on how science–religion dialogue can help promote a sense for human solidarity by combining knowledge with wisdom, in the concluding session.     

Implementation and evaluation of a juvenile mental health training for law enforcement in a medium-sized jurisdiction

The need for specialized training programs that are focused on youth mental health needs, awareness of community-based services, and de-escalation skills is growing across law enforcement agencies due to calls for service that involve youth in mental health crisis. The current study evaluates a juvenile mental health training for law enforcement that was developed based on agency needs. The training was completed by 159 officers and a pre-/post-test design was used. Findings suggest that officers were satisfied with the training and improvements were seen across several training constructs (confidence, preparedness, stigma, resource awareness, and de-escalation skills). Satisfaction with the training predicted change in confidence and preparedness. Recommendations for future research and the implementation of juvenile mental health trainings are discussed.