BEHAVIORAL CUSPS: A DEVELOPMENTAL AND PRAGMATIC CONCEPT FOR BEHAVIOR ANALYSIS

Most concepts of development explain certain behavior changes as products or markers of the invariable succession of emerging periods, stages, refinements, or achievements that define and order much of an individual's life. A different but comparable concept can be derived from the most basic mechanisms of behavior analysis, which are its environmental contingencies, and from its most basic strategy, which is to study behavior as its subject matter. From a behavior-analytic perspective, the most fundamental developmental questions are (a) whether these contingencies vary in any systematic way across the life span, and thus make behavior change in a correspondingly systematic way; and (b) whether some of these contingencies and their changes have more far-reaching consequences than others, in terms of the importance to the organism and others, of the behavior classes they change. Certain behavior changes open the door to especially broad or especially important further behavior change, leading to the concept of the behavioral cusp. A behavioral cusp, then, is any behavior change that brings the organism's behavior into contact with new contingencies that have even more far-reaching consequences. Of all the environmental contingencies that change or maintain behavior, those that accomplish cusps are developmental. Behavior change remains the fundamental phenomenon of development for a behavior-analytic view; a cusp is a special instance of behavior change, a change crucial to what can come next.     

DIRECT AND COLLATERAL EFFECTS OF RESTRAINTS AND RESTRAINT FADING

Mechanical restraints are commonly used to reduce the risks associated with severe self-injurious behavior (SIB), but may result in movement restriction and adverse side effects (e.g., bone demineralization). Restraint fading may provide a method for decreasing SIB while increasing movement and reducing these side effects. In the current investigation, rigid arm sleeves and restraint fading (gradually reducing the rigidity of the sleeves) were used with 3 clients who engaged in hand-to-head SIB. Restraints and fading reduced the hand-to-head SIB of all clients. However, for 1 client, the addition of a water mist procedure further reduced SIB to near-zero levels. For a 2nd client, another form of SIB developed that was not prevented by the rigid sleeves. For a 3rd client, a topography of SIB that was not physically prevented by the rigid sleeves was also reduced when restraints and fading were introduced.     

HYPOTHESIS-BASED INTERVENTIONS FOR TANTRUM BEHAVIORS OF PERSONS WITH DEVELOPMENTAL DISABILITIES IN SCHOOL SETTINGS

We conducted a functional assessment of problem behaviors of 2 students with developmental disabilities in their classroom environments. Results of the assessments showed that although there were more tantrums in demand than in no-demand conditions, the function of the behavior was to gain attention (positive reinforcement) rather than to avoid or escape demands (negative reinforcement); demand conditions apparently served a discriminative function for the availability of attention. Therefore, intervention was based on the positive reinforcement hypothesis, resulting in a substantial reduction of tantrums for both subjects.     

INCREASING REQUESTS BY ADULTS WITH DEVELOPMENTAL DISABILITIES USING INCIDENTAL TEACHING BY PEERS

A peer-delivered incidental-teaching procedure was used to instruct appropriate requesting in adults with moderate to severe mental retardation or autism. Three pairs of group-home residents participated in an incidental-teaching procedure to increase appropriate requesting, prompting, and responding of residents during lunch-preparation sessions. An increase in the number of incidental-teaching episodes during dinner was obtained, and remained high when lunch-making training sessions were withdrawn. In addition, during the incidental-teaching phase, an increase in appropriate requests and overall verbalizations occurred for the peer learners. Changes in appropriate requesting and overall verbalizations also remained higher than baseline when training was withdrawn.     

A PRELIMINARY COMPARISON OF REINFORCER ASSESSMENT METHODS FOR CHILDREN WITH ATTENTION DEFICIT HYPERACTIVITY DISORDER

We evaluated the relative treatment utility of a verbal forced-choice questionnaire, child nomination, and direct observation for identifying the most potent reinforcers for children with attention deficit hyperactivity disorder. Results demonstrated that all three methods were more likely to disagree than to agree, that a forced-choice format may enhance verbal reinforcer assessment, and that further development and evaluation of verbal reinforcer-assessment methods are needed.     

An investigation of the effects of comorbid Axis II pathology on outcome of inpatient treatment for unipolar depression

DSM-based research on comorbidity has suggested thatdepression andpersonality disorder frequently occur together and that the combination of syndromes is associated with a poor response to treatment for depression. The present study was designed to explore the effect of comorbid Axis II pathology for a sample of 45 inpatients who received treatment for major depression. Both categorical and dimensional ratings of personality disorder were used in the statistical analysis. Positive categorical diagnosis of Cluster C (anxious-avoidant) disorder, as well as higher dimensional rating of Cluster A (odd-eccentric) pathology, was predictive of a poor response to treatment (p<.05), as measured by change in pre-post clinical ratings on the Montgomery-Asberg Depression Rating Scale. These results were construed as indicative of a significant Axis II comorbidity effect in the context of an inpatient, multimodal treatment setting for depression. The results also spotlight the influence of techniques of measurement in determining the outcome of statistical analysis.     

Analysis of long-term stress reactions in emergency room patients: An initial study

The psychological stress reactions of 44 family medicine patients who were treated in the emergency room were examined approximately a year after the event. Patients were assessed on several psychological measures, including one for posttraumatic stress disorder (PTSD), and on their perception of how stressful the event was initially and now. Results show continuing stress reactions related to the emergency room event. Three patients endorsed symptoms indicating full PTSD and 13 appeared to have at least partial PTSD. Age appeared to be a factor in the presence of stress symptoms and in degree of perceived communication with the physician.     

Three years follow-up of panic disorder patients: A naturalistic study

Forty Danish panic disorder patients participating in a placebo controlled study of alprazolam and imipramine (The Cross National Collaborative Panic Study, Phase II) were followed up by a telephone interview three years later, with essentially the same battery of evaluation procedures applied at baseline, end of study, and follow-up. The main finding was that panic disorder is a chronic disorder, but fluctuating in form and severity in the course of time. Twenty-five percent of the patients no longer fulfilled the DSM-III criteria for panic disorder, but had substantial disability due to a variety of symptoms, including panic attacks at infrequent rate, generalized anxiety symptoms, affective symptoms, and phobic avoidance behavior. Nearly three fourths of the patients were under treatment at follow-up. Benzodiazepines were the drugs most often prescribed, usually in combination with supportive psychotherapy. It was concluded that the different types of treatment offered were insufficient. Variables predicting panic disorder or substantial disability at 3-years follow-up were few.     

Personality disorder correspondence between the million behavioral health inventory (MBHI) and the minnesota multiphasic personality inventory (MMPI)

The MBHI and MMPI personality disorder scales were analyzed for convergent and discriminant validity. Correlational data demonstrated that six of the eight scales were significantly related, while the remaining two scales approached significance. Further analyses of these data, however, demonstrated that none of the scales correlated significantly better with its convergent scale compared to nonconvergent scales. The MBHI classified significantly more of the sample as personality disordered (93%) compared to the MMPI personality disorder scales (17%). Furthermore, the MBHI tended to describe the sample as falling within the Anxious cluster of personality disorders, whereas the MMPI described them within the Dramatic cluster. Single scale codetype correspondence was found to be 15%, while two-point concordance was 12.5%, indicating very low congruence between personality style codetypes. These two measures do not appear to be measuring the same personality style constructs.     

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.