Smoking cessation with behaviour therapy or acupuncture—A controlled study

Five hundred and fifty-eight cigarette smokers (mean 31 cigarettes/day) were randomized in four groups: Acupuncture, Behaviour Therapy, Placebo Medication and Waiting-list Control. The life-table analysis of smoking cessation showed, at a 12-month follow-up, no difference between Acupuncture, Behaviour Therapy and Placebo. Differences appeared only in an analysis of the abstinent subjects at each data point. Behaviour Therapy and Acupuncture accounted for significantly more abstinent subjects than Placebo at the end of the 2-week therapeutic phase. However at 9 and 12 months Acupuncture had a statistically-significant greater number of abstinent subjects than Behaviour Therapy, but there was no difference between Acupuncture and Placebo. The percentage decrease in smoking from baseline appeared significantly greater at 12 months in the first three groups than in the Control conditions. However, as in most smoking-cessation studies, the overall effect was small and non-specific. The results reflect the importance of maintenance programmes and of the prevention of addiction.     

Analgesic and opioid involvement in the shock-elicited activity and escape deficits produced by inescapable shock

Three experiments examined the involvement of analgesic processes and endogenous opioids in the production of the shuttlebox escape acquisition and unconditioned activity deficits which follow exposure to inescapable shock. Experiment 1 found that the opiate antagonist naltrexone administered before the inescapable shock session interfered with the shuttlebox escape acquisition deficit which would normally follow. Experiment 2 found naltrexone to completely prevent the unconditioned activity deficit. The final experiment revealed that dexamethasone, a synthetic glucocorticoid which abolishes the analgesia produced by inescapable shock, reversed the activity deficit. These results indicate that endogenous opioids may be involved in the production of both the escape acquisition and activity deficits. They also suggest that the analgesia produced by these opioids may participate in the mediation of the activity deficit, even though analgesia is not involved in producing the shuttlebox acquisition deficit.     

Statewide Implementation of Cognitive Behavioral Therapy for Psychosis Through a Learning Collaborative Model

Cognitive Behavioral Therapy for Psychosis (CBTp) is an evidence-based psychotherapeutic intervention (EBPI) for adults with schizophrenia spectrum disorders that remains under-implemented in the United States (U.S.). There has been little empirical attention on implementation and dissemination strategies for this EBPI. The Learning Collaborative (LC) model is a method of implementing evidence-based practices across agencies and geographic regions that may facilitate CBTp implementation and dissemination in the US.We applied the LC model in an attempt to enhance the accessibility of CBTp in community mental health settings statewide. Providers (N = 56) from 12 agencies voluntarily participated in an in-person, CBTp workshop followed by 6 months of biweekly phone-based consultation sessions (Phase 1). Twenty-one providers opted to participate in an additional 6-month CBTp LC immediately following completion of the initial CBTp LC (Phase 2). Adoption, penetration, provider-perceived skill development, fidelity, as well as provider-perceived implementation barriers were re-assessed during and 6 months after completion of Phase 2.One year after the completion of the Phase 2 LC, 21% of the original trainee group across 3 of the 12 participating agencies continued to offer CBTp to clients. CBTp trainees were treating between one and two clients each. Self-assessed CBTp skills improved modestly over the Phase 2 consultation period. On average, both clinicians and supervisors reached an acceptable fidelity score on the sessions reviewed. Participating providers identified multiple barriers to CBTp implementation, including features of the training and consultation, the agency, the intervention itself, and psychosocial and clinical challenges associated with the client population.Few CBTp implementation studies have applied a framework to CBTp implementation. The authors adapted the LC model in an attempt to promote adoption of CBTp in community mental health clinics across a large, populous state with poor access to mental health services. Identified challenges and recommendations should be considered in future implementation efforts.     

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.     

A study of language functioning in Alzheimer patients

Language functioning in Alzheimer's disease is reviewed and the performance of 25 Alzheimer patients on a standard battery is reported. All these hospitalized patients were aphasic to some degree. As a group, they differed from normals on all language variables, and from stroke patients in terms of higher fluency and lower comprehension. Spontaneous speech showed high incidence of circumlocutions and semantic jargon, but no phonemic paraphasias or target approximations. Syllabic perseverations, shouting, inappropriate laughter, and mutism were late-appearing features. Transcortical Sensory, and Wernicke's aphasias were frequent, but Broca's and Transcortical Motor aphasias notably absent. Extent of language impairment correlated with current length of hospitalization but not age. Reading, writing, and performance scores except praxis, were lower than oral language scores. Findings were discussed in relation to previous results, methodology, and language organization in the brain.     

CONDITIONAL DISCRIMINATION VS. MATCHING TO SAMPLE: AN EXPANSION OF THE TESTING PARADIGM

A subject's performance under a conditional-discrimination procedure defines conditional relations between stimuli: “If A1, then B1; if A2, then B2.” The procedure may also generate matching to sample. If so, the stimuli will be related not only by conditionality, but by equivalence: A1 and B1 will become equivalent members of one stimulus class, A2 and B2 of another. One paradigm for testing whether a conditional-discrimination procedure has generated equivalence relations uses three sets of stimuli, A, B, and C, three stimuli per set. Subjects learn to select Set-B and Set-C comparisons conditionally upon Set-A samples. Having been explicitly taught six sample-comparison relations, A1B1, A1C1, A2B2, A2C2, A3B3, and A3C3, subjects prove immediately capable of matching the B- and C-stimuli; six new relations emerge (B1C1, B2C2, B3C3, C1B1, C2B2, C3B3). The 12 stimulus relations, six taught and six emergent, define the existence of three three-member stimulus classes, A1B1C1, A2B2C2, and A3B3C3. This paradigm was expanded by introducing three more stimuli (Set D), and teaching eight children not only the AB and AC relations but DC relations also—selecting Set-C comparisons conditionally upon Set-D samples. Six of the children proved immediately capable of matching the B- and D-stimuli to each other. By selecting appropriate Set-B comparisons conditionally upon Set-D samples, and Set-D comparisons conditionally upon Set-B samples, they demonstrated the existence of three four-member stimulus classes, A1B1C1D1, A2B2C2D2, and A3B3C3D3. These larger classes were confirmed by the subjects' success with the prerequisite lower-level conditional relations; they were also able to select Set-D comparisons conditionally upon samples from Sets A and C, and to do the BC and CB matching that defined the original three-member classes. Adding the three DC relations therefore generated 12 more, three each in BD, DB, AD, and CD. Enlarging each class by one member brought about a disproportionate increase in the number of emergent relations. Ancillary oral naming tests suggested that the subject's application of the same name to each stimulus was neither necessary nor sufficient to establish classes of equivalent stimuli.     

“‘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.     

Stimulus effects on concurrent performance in transition

Six experimentally naive pigeons were exposed to concurrent variable-interval variable-interval schedules in a three-key procedure in which food reinforcement followed pecks on the side keys and pecks on the center key served as changeover responses. In Phase 1, 3 birds were exposed to 20 combinations of five variable-interval values, with each variable-interval value consistently associated with a different color on the side keys. Another 3 pigeons were exposed to the same 20 conditions, but with a more standard procedure that used a nondifferential discriminative stimulus on the two side keys throughout all conditions. In Phase 2, the differential and nondifferential stimulus conditions were reversed for each pigeon. Each condition lasted for one 5-hr session and one subsequent 1-hr session. In the last 14 conditions of each phase, the presence of differential discriminative stimuli decreased the time necessary for differential responding to develop and increased the sensitivity of behavior to reinforcement distribution in the 1st hr of training; during the last hours of training in each condition, however, the effects of the differential discriminative stimuli could not be distinguished from the effects of reinforcement distribution per se. These results show the importance of studying transitions in behavior as well as final performance. They may also be relevant to discrepancies in the results of previous experiments that have used nonhuman and human subjects.     

Fixed-ratio pausing: Joint effects of past reinforcer magnitude and stimuli correlated with upcoming magnitude

Pigeons responded on fixed-ratio schedules ending in small or large reinforcers (grain presentations of different duration) interspersed within each session. In mixed-schedule conditions, the response key was lit with a single color throughout the session, and pausing was directly related to the past reinforcer (longer pauses after large reinforcers than after small ones). In multiple-schedule conditions, different colors accompanied the ratios ending in small and large reinforcers, and pausing was affected by the upcoming reinforcer as well as the past one. Pauses were shorter before large reinforcers than before small ones, but they continued to be longer after large reinforcers than after small ones. The influence of the past reinforcer was modulated by the magnitude of the upcoming reinforcer; in the presence of the stimulus before the small reinforcer, the effect of the past reinforcer was enhanced relative to its effect in the stimulus before the large reinforcer. These results show that pausing between ratios is jointly determined by two competing factors: past conditions of reinforcement and stimuli correlated with upcoming conditions.