Nonsuicidal physically self-damaging acts in adolescents

To determine the frequency and correlates of nonsuicidal physically self-damaging acts in 12–14 year olds, a two stage epidemiologic survey with a self-administered questionnaire (N=3283) followed by a psychiatric interview of a subsample of the adolescents and their parents (N=444) was used. Prevalence estimates of interview validated nonsuicidal physically self-damaging acts were 2.46% in males and 2.79% in females. Significant relationships were found between nonsuicidal physically self-damaging acts and suicidal ideation, major depression and undesirable life events. Data suggest that physically self-damaging acts occur at substantial rates during early adolescence. The strong correlation between nonsuicidal self-destructive acts and both suicidal ideation and major depression clarifies prior conflicting reports in the literature and suggests that a history of self-damaging acts should be taken into consideration when evaluating for possible depression and suicide risk.     

EXPERIMENTAL ANALYSIS AND TREATMENT OF MULTIPLY CONTROLLED SELF-INJURY

A functional analysis of the self-injurious behavior (SIB) of 3 adults with profound developmental disabilities showed that each engaged in SIB in more than one assessment condition. Such outcomes may result from a failure to isolate the variable maintaining SIB, or they may reflect multiple sources of control over SIB. In order to identify more clearly the determinants of SIB, each subject was exposed to a series of treatments appropriate to one or both of the apparent functions of SIB. These treatments, applied sequentially on baselines appropriate to each behavioral function, identified the maintaining variables for SIB through differential outcomes across baselines. Results indicated that the SIB of 2 subjects was multiply controlled, confirming the outcomes of the functional analysis. However, the SIB of the 3rd subject was eliminated using a treatment designed for a single function, suggesting spurious results of the original assessment. Alternative interpretations of undifferentiated assessment data are discussed, as are analysis and treatment issues related to multiply determined behavior disorders.     

STIMULUS (INSTRUCTIONAL) FADING DURING EXTINCTION OF SELF-INJURIOUS ESCAPE BEHAVIOR

Three individuals with developmental disabilities were exposed to a series of assessment conditions to identify the source of reinforcement for their self-injurious behavior. In each case, self-injury occurred most often in instructional (demand) situations containing a brief time-out from the task contingent on self-injury, indicating that the behavior was an escape response (i.e., maintained by negative reinforcement). Treatment was implemented in a multiple baseline across subjects design and consisted of extinction (prevention of escape) plus instructional fading (initial elimination of instructions followed by their gradual reintroduction). Results showed that the combined treatment produced immediate and large reductions in self-injury that were maintained as the frequency of instructions was increased across sessions to match the original baseline rate of presentation. Results of a component analysis conducted with 1 subject suggested that stimulus fading accelerated the behavior-reducing effects of extinction.     

EFFECTS OF MEMORY AIDS ON THE DYADIC CONVERSATIONS OF INDIVIDUALS WITH DEMENTIA

The effects of a prosthetic memory aid on the conversational content and social skills of dyads with dementia were evaluated. Six individuals with moderate to severe dementia served as either subject or partner in dyads during 5-min conversational probes conducted three times per week in daycare and nursing-home settings. During phases when a memory aid, consisting of personally relevant picture and sentence stimuli, was available, most subjects used their own aid to improve the quality of conversations by increasing the frequency of on-topic statements, diminishing nonproductive utterances, lengthening their conversational turn, and/or increasing the frequency of turns taken. Most partners demonstrated awareness of social discourse conventions by appropriately relinquishing conversational dominance, decreasing both content and nonproductive utterances, and increasing acknowledging or affirmative comments when subjects used memory aids. Naive judges' ratings of aided and unaided conversational samples on seven conversational dimensions reflected differences in perceptions of significant improvement as a function of the conversational discourse style of each dyad.     

Schedule-induced defecation by rats during ratio and interval schedules of food reinforcement.

Lever pressing in rats was maintained by continuous and intermittent schedules of food while defecation was monitored. In Experiment 1, reinforcement densities were matched across variable-ratio and variable-interval schedules for three pairs of rats. Defecation occurred in all 3 rats on the variable-ratio schedule and in all 3 rats on the yoked variable-interval schedule. In Experiment 2, fixed-ratio and fixed-interval schedules with similar reinforcement densities maintained lever pressing. Defecation occurred in 3 of 4 rats on the fixed-ratio schedule and in 4 of 4 rats on the fixed-interval schedule. Almost no defecation occurred during continuous reinforcement in either experiment. These results demonstrate that defecation may occur during both ratio and interval schedules and that the inter-reinforcement interval is more important than the behavioral requirements of the schedule in generating schedule-induced defecation.     

Swedish translations of the Suicide Probability Scale, Perceived Social Support from Friends and Family Scales, and the Scale for Interpersonal Behavior: A reliability analysis

The Suicide Probability Scale (SPS), the Perceived Social Support (PSS) from Friends (PSS-Fr) and Family (PSS-Fa) scales, and the Scale for Interpersonal Behavior (SIB) were translated into Swedish and their reliability was estimated in a university student sample. The reliability coefficients indicated that both subscales and the total scales of the SPS, PSS, and SIB possess highly adequate reliabilities. The intercorrelations among the subscales and between the subscales and the total scales were found to be highly significant. The results of the study supported the use of SPS, PSS-Fr and PSS-Fa, and the SIB as reliable methods for assessing suicide risk, perceived social support from friends and family, and assertive behavior.     

Health behavior, knowledge and attitudes among Swedish university students

A range of health behaviors was related to beliefs concerning health practices and health knowledge. A questionnaire dealing with health-related practices, health beliefs and knowledge of health risk factors was answered by 166 male and 179 female students aged 18–30 years at Stockholm University. Female students reported engaging in better health behavior than males. Beliefs about the importance of health behaviors were closely related to their frequency of occurrence. There was only a weak relationship between health behaviors and knowledge of specific health matters. It is concluded that health attitudes rather than health knowledge determine health behavior.     

EFFECTS OF CHOSEN VERSUS ASSIGNED JOBS ON THE WORK PERFORMANCE OF PERSONS WITH SEVERE HANDICAPS

We evaluated the effects of several choice-related variables on the work performance of adults with severe handicaps. After assessing client work preferences, three choice-related situations were presented: (a) providing clients with the opportunity to choose a work task, (b) assigning a preferred task, and (c) assigning a nonpreferred task. Results indicated that clients attended to work tasks almost twice as much when they chose their tasks and when assigned to work on preferred tasks versus when assigned to work on nonpreferred tasks. Results are discussed regarding the need to assess systematically the effects of choice-related variables.     

EXTENDED REDUCTIONS IN STEREOTYPIC BEHAVIOR OF STUDENTS WITH AUTISM THROUGH A SELF-MANAGEMENT TREATMENT PACKAGE

The literature suggests that self-management treatment packages have two potential strengths for the reduction or elimination of stereotypic behavior: (a) Self-management may be used for extended periods of time in the absence of a treatment provider, and (b) self-management techniques are easily adapated and used in a wide variety of natural settings. We assessed whether students with severe autistic disabilities could learn to use a self-management treatment package to reduce their stereotypic behavior within a multiple baseline across subjects design with withdrawals. The results showed that all of the students learned to use self-management procedures to reduce greatly levels of stereotypic behavior (typically to zero), and improvement occurred for extended periods of time in new settings without the presence of a treatment provider. The results are discussed in terms of the practical value of the treatment package and in terms of the implications for understanding autism.