Treatment of covert food stealing in an individual with Prader-Willi syndrome

Covert food stealing is common among individuals with Prader-Willi syndrome. We found that verbal reprimands, delivered contingent upon eating prohibited foods, were sufficient to decrease the food stealing of a girl with Prader-Willi syndrome. Warning stimuli were then used to help her discriminate between permitted and prohibited foods during sessions in which food stealing was not directly observed. This procedure resulted in decreases in food stealing from containers labeled with the warning stimuli.     

Testing the ability of children with attention deficit hyperactivity disorder to accurately report the effects of medication on their behavior

Children with attention deficit hyperactivity disorder (ADHD) are often treated with central nervous system stimulants, making the evaluation of medication effects an important topic for applied behavior analysts. Because assessment protocols emphasize informant reports and direct observations of child behavior, little is known about the extent to which children themselves can accurately report medication effects. Double-blind placebo-controlled procedures were used to examine whether 6 children with ADHD could recognize the effects of their medication. The children were given math worksheets to complete for 15 min during each of 14 sessions while on medication and placebo. Children completed a self-evaluation form at the end of each session, and ratings were compared to observed behavior and academic performance. Results indicated that 3 children were able to accurately report their medication status at levels greater than chance, whereas the accuracy of reports by all children was related to dosage level, differences in behavior, and the presence of adverse effects. The implications of these results for placebo-controlled research, self-monitoring of dosage levels, and accuracy training are discussed.     

Progressive-ratio schedules: effects of later schedule requirements on earlier performances

Four rats were studied with variants of a progressive-ratio schedule with a step size of 6 in which different terminal components followed completion of the 20th ratio: (a) a reversal of the progression, (b) a fixed-ratio 6 schedule, or (c) extinction. Responding in the progressive-ratio components of these schedules was compared to performances under conventional progressive-ratio baselines. Under baseline conditions, postreinforcement pauses increased exponentially as a function of increasing ratio size, whereas running rates showed modest declines. The procedure of linking the progressive-ratio schedule to the reversed progression or to the fixed-ratio component resulted in decreased pausing. Linking the progressive-ratio schedule to the extinction component had the opposite effect, that of producing weakened progressive-ratio performances as evidenced by increased pausing. Subjects whose responses were reinforced on half of the ratios also showed exponential increases; however, pauses were substantially shorter following ratios on which the reinforcer was omitted. The results suggested that progressive-ratio pausing reflects the influence of remote as well as local contingencies.     

Timeout postponement without increased reinforcement frequency

Three experiments were conducted to examine pigeons' postponement of signaled extinction periods (timeouts) from a schedule of food reinforcement when such responding neither decreased overall timeout frequency nor increased the overall frequency of food reinforcement. A discrete-trial procedure was used in which a response during the first 5 s of a trial postponed an otherwise immediate 60-s timeout to a later part of that same trial but had no effect on whether the timeout occurred. During time-in periods, responses on a second key produced food according to a random-interval 20-s schedule. In Experiment 1, the response-timeout interval was 45 s under postponement conditions and 0 s under extinction conditions (responses were ineffective in postponing timeouts). The percentage of trials with a response was consistently high when the timeout-postponement contingency was in effect and decreased to low levels when it was discontinued under extinction conditions. In Experiment 2, the response-timeout interval was also 45 s but postponement responses increased the duration of the timeout, which varied from 60 s to 105 s across conditions. Postponement responding was maintained, generally at high levels, at all timeout durations, despite sometimes large decreases in the overall frequency of food reinforcement. In Experiment 3, timeout duration was held constant at 60 s while the response-timeout interval was varied systematically across conditions from 0 s to 45 s. Postponement responding was maintained under all conditions in which the response-timeout interval exceeded 0 s (the timeout interval in the absence of a response). In some conditions of Experiment 3, which were designed to control for the immediacy of food reinforcement and food-correlated (time-in) stimuli, responding postponed timeout but the timeout was delayed whether a response occurred or not. Responding was maintained for 2 of 3 subjects, suggesting that behavior was negatively reinforced by timeout postponement rather than positively reinforced by the more immediate presentation of food or food-correlated (time-in) stimuli.     

Therapeutic Implications of a Social Interaction Model of Posttraumatic Stress

Out of the many aspects of posttraumatic adaptation the role of self-process is emphasized, where self is conceptualized as the representation of social interaction: Not only the messages conveyed by others, but also a person's inner response to that messages, forms ongoing self-processes. Traumatic experiences lead to distorted self-processes, to a great extent due to posttraumatic inner dialogues. Therapeutic implications and experiences from Bosnia are discussed, where this model has been applied.     

Joyce's Argument with Himself/Or, Reading Joyce's Inside Narrative

James Joyce's argument with himself about where he should practice his art and with what literary tradition he should identify—Irish, British, or European—is represented by several of the characters and episodes in his short story The Dead.In the main character, Gabriel Conroy, Joyce represented the conflicts that he himself experienced. But in many of the minor characters Joyce also reflected parts of his own wishes and fears.In this story, Joyce rejects the possibilities of artistic identification with Ireland and England, and, in the dynamics of the tale, arrives at the understanding that to fulfill his artistic aspirations, he must make an identification with the great European tradition, and also live in Europe; if he stays in Ireland or attempts to be an English author, he will be, as he portrays Gabriel to be, paralyzed, imitative, and a failure as an artist. Joyce himself took the decisive path that Gabriel could not choose.     

Sustained efficacy of dialectical behaviour therapy for borderline personality disorder

Dialectical Behaviour Therapy (DBT) is considered one of the most promising treatments for borderline personality disorder (BPD). Recently, we reported significantly positive effects of 12 months DBT on parasuicidal behaviour and impulsivity in a mixed group of female BPD patients with and without substance abuse. Fifty-eight women with BPD were randomly assigned to either 52 weeks of DBT or treatment as usual (TAU). Follow-up assessment took place at 78 weeks, i.e., 6 months after discontinuation of DBT. Participants were clinical referrals from addiction treatment and psychiatric services. Outcome measures included parasuicidal behaviour, impulsivity and substance abuse. Six months after treatment discontinuation, the benefits of DBT over TAU in terms of lower levels of parasuicidal and impulsive behaviours, and in alcohol use, sustained. No differences between the treatment conditions were found for drug abuse. In conclusion, DBT seems to have a sustained effect on some of the core symptoms of BPD and on alcohol problems in a mixed population of female borderline patients with and without substance abuse problems.     

An evaluation of a brief multiple-stimulus preference assessment with adolescents with emotional-behavioral disorders in an educational setting

Brief multiple-stimulus-without-replacement (MSWO) preference assessments were conducted with 3 adolescent boys with emotional-behavioral disorders in the context of their public school educational program. The reinforcing effects of stimuli identified as high, medium, and low preference were then evaluated using an alternating treatments design in which, following an initial baseline, stimuli were delivered contingent on on-task behavior. High-preference stimuli produced the highest percentages of on-task behavior for all 3 participants.     

Reverie: between thought and prayer

Abstract:  Taking inspiration from a quotation by Lao Tzu, this paper considers 'reverie' as a dynamic process of containment as well as a state of mind. Reverie as a quality of thought akin to prayer is explored in the relationship between self and other. In infant observation, the paper contemplates the development of a baby's capacity to reach beyond the personal world to an archetypal experience of being held, where the creation of an internal space in mind could indicate the beginnings of spiritual awareness. 'Maternal/analytic reverie' views the passage of unconscious communication between patient and analyst as the result of a 'window' opening in the meniscus of the analyst's self. 'Paternal/supervisory reverie' reflects on the impact on a patient of an extra containing mind of a supervisor. 'Archetypal reverie' considers the transforming impact of numinous dreams on the psyche, and reflects on the power of prayer. Drawing on clinical examples from these four areas, the aim is to demonstrate the usefulness of the 'void within' and the perceptive function of emptiness in the 'doors and windows' of our mind.     

MORPHINE TOLERANCE AS A FUNCTION OF RATIO SCHEDULE: RESPONSE REQUIREMENT OR UNIT PRICE?

Key pecking by 3 pigeons was maintained by a multiple fixed-ratio 10, fixed-ratio 30, fixed-ratio 90 schedule of food presentation. Components differed with respect to amount of reinforcement, such that the unit price was 10 responses per 1-s access to food. Acute administration of morphine, l-methadone, and cocaine dose-dependently decreased overall response rates in each of the components. When a rate decreasing dose of morphine was administered daily, tolerance, as measured by an increase in the dose that reduced response rates to 50% of control (i.e., the ED50 value), developed in each of the components; however, the degree of tolerance was smallest in the fixed-ratio 90 component (i.e., the ED50 value increased the least). When the l-methadone dose-effect curve was redetermined during the chronic morphine phase, the degree of cross-tolerance conferred to l-methadone was similar across components, suggesting that behavioral variables may not influence the degree of cross-tolerance between opioids. During the chronic phase, the cocaine dose-effect curve shifted to the right for 2 pigeons and to the left for 1 pigeon, which is consistent with predictions based on the lack of pharmacological similarity between morphine and cocaine. When the morphine, l-methadone, and cocaine dose-effect curves were redetermined after chronic morphine administration ended, the morphine and l-methadone ED50s replicated those obtained prior to chronic morphine administration. The morphine data suggest that the fixed-ratio value (i.e., the absolute output) determines the degree of tolerance and not the unit price.