A Randomized Trial of a Mental Health Consumer-Managed Alternative to Civil Commitment for Acute Psychiatric Crisis

This experiment compared the effectiveness of an unlocked, mental health consumer-managed, crisis residential program (CRP) to a locked, inpatient psychiatric facility (LIPF) for adults civilly committed for severe psychiatric problems. Following screening and informed consent, participants (n = 393) were randomized to the CRP or the LIPF and interviewed at baseline and at 30-day, 6-month, and 1-year post admission. Outcomes were costs, level of functioning, psychiatric symptoms, self-esteem, enrichment, and service satisfaction. Treatment outcomes were compared using hierarchical linear models. Participants in the CRP experienced significantly greater improvement on interviewer-rated and self-reported psychopathology than did participants in the LIPF condition; service satisfaction was dramatically higher in the CRP condition. CRP-style facilities are a viable alternative to psychiatric hospitalization for many individuals facing civil commitment.     

简单结构刺激非规则特征突显条件下的样例效应

用变化了的Allen和Brooks的实验范式,采用2(学习轮次:5轮、10轮)×2(项目类型:旧项目、新项目)×2(项目匹配性质:正向匹配、反向匹配)混合实验设计,研究对4个特征刺激分类时非规则特征突显条件下的样例效应。结果发现,无论是错误率还是反应时都取得了明显的样例效应,但是学习时间的影响不明显。     

Outcomes of training in supervision: Randomised controlled trial

There is little controlled research on the impact of supervisor training on supervision. The current study examined the effects of supervision training in a sample of 46 supervisor–supervisee pairs of mental health practitioners. It compared Immediate 2‐day workshop training of the pair, a wait‐list control in which workshop training was delayed 3 months, and a condition in which supervisors were trained 3 months before their partners (Split). Benefits of Immediate training were restricted to supervisors reporting fully specified agreements, and to reduction of some perceived problems. Self‐efficacy in providing effective supervision fell in the Split condition, relative to the other conditions. Across conditions in general there was a fall from baseline to post‐test assessment in the proportion of sessions where recommended supervision strategies were used, perhaps partly because the controlled trial extended across the summer vacation period. Results are consistent with other observations of the limited impact of workshop training on practice.     

Effectiveness of Cognitive/Behavioral Small Group Intervention for Reduction of Depression and Stress in Non-Hispanic White and Hispanic/Latino Women Dementia Family Caregivers: Outcomes and Mediators of Change

This study enrolled 184 middle-aged and older women (95 Non-Hispanic White and 89 Hispanic/Latino) who provided in-home hands-on care to an elderly relative with Alzheimer’s disease or another form of dementia. Within ethnic group they were randomly assigned to either a CBT-based small group intervention program called “Coping with Caregiving” (CWC) that taught a variety of cognitive and behavioral skills to reduce stress and depression, or to a minimal telephone based control condition (TSC). Intervention lasted about 4 months; one post-treatment assessment was completed 6 months after baseline by interviewers blind to the intervention condition. Interviews and interventions were conducted in English or Spanish by trained staff. Results indicated that those in the CWC (regardless of ethnicity) showed greater improvement from pre to post intervention than those in the TSC on measures of depressive symptoms, overall life stress, and caregiving-specific stress. In order to investigate if these changes may have been related to one proposed mechanism of change in CBT (skill utilization), a new measure was constructed. Change in frequency of use and perceived helpfulness of adaptive coping skills were assessed in all caregivers. Results indicated that caregivers in CWC reported greater frequency of use, and greater perceived helpfulness, of these skills at post intervention compared to caregivers in the TSC. Improvement measured by dependent measures was correlated with an increase in these indices for those in the CWC. Tests for mediation suggest that effective skill utilization may mediate the effect of treatment on outcome. Implications of these findings are discussed and recommendations provided for future research.     

相关维度数量对两种结构类别学习的影响

在多重系统理论研究基础上,运用即时反馈训练范式,以大学生为被试,考查相关维度数量对基于规则和信息整合两种结构的类别学习的影响.结果表明:(1)相关维度数量是影响类别学习的重要因素,基于规则单维度结构的学习显著优于信息整合结构和基于规则双维度结构的学习,基于规则双维度结构的学习与信息整合结构的学习没有显著差异.(2)反应策略受到规则复杂性的影响,当类别结构中隐含的规则比较简单时,学习者使用规则策略;当类别结构中隐含的规则比较复杂时,学习者难以掌握规则,就会使用相似性策略.研究结果支持"难度观",而不支持多重系统理论.     

Nodal structure and the partitioning of equivalence classes

By definition, all of the stimuli in an equivalence class have to be functionally interchangeable with each other. The present experiment, however, demonstrated that this was not the case when using post-class-formation dual-option response transfer tests. With college students, two 4-node 6-member equivalence classes with nodal structures of A-->B-->C-->D-->E-->F were produced by training AB, BC, CD, DE, and EF. Then, unique responses were trained to the C and D stimuli in each class. The responses trained to C generalized to B and A, while the responses trained to D generalized to E and F. Thus, each 4-node 6-member equivalence class was bifurcated into two 3-member functional classes: A-->B-->C and D-->E-->F, with class membership precisely predicted by nodal structure. A final emergent relations test documented the intactness of the underlying 4-node 6-member equivalence classes. The coexistence of the interchangeability of stimuli in an equivalence class and the bifurcation of such a class in terms of nodal structure was explained in the following manner. The conditional discriminations that are used to establish a class also imposes a nodal structure on the stimuli in the class. Thus, the stimuli in the class acquire two sets of relational properties. If the format of a test trial allows only one response option per class, responding on those trials will be in accordance with class membership and will not express the effects of nodal distance. If the format of a test trial allows more than one response option per class, responding on those trials will be determined by the nodal structure of the class. Thus, the relational properties expressed by the stimuli in an equivalence class are determined by the discriminative function served by the format of a test trial.     

Asymmetrical retention functions for sequences of light flashes or tone bursts in the rat

In Experiment 1, rats were trained in a symbolic delayed matching-to-sample task to discriminate sample stimuli that consisted of sequences of magazine light flashes. The intertrial interval was illuminated by the houselight for Group Light, and it was dark for Group Dark. Retention functions exhibited a choose-many response bias when the delay interval was illuminated by the houselight in both groups, and no consistent response bias when the delay interval was dark. In Experiment 2, rats were trained to discriminate sample stimuli that consisted of sequences of tone bursts. During delay testing, a different tone (i.e., different frequency and location than the sample tone) was present or absent during the delay interval. The retention functions exhibited a significant choose-many bias when tone was present during the delay and a choose-few bias when tone was absent. Asymmetrical retention functions for tone burst and light flash sequences are due to the similarity between the stimulus conditions of the delay interval and the modality of the sequential event being discriminated. These results are consistent with an instructional ambiguity explanation of response biases in memory for number.     

Rats’ anticipation of current and future trial outcomes in the ordered RNR/RNN serial pattern task

In the ordered RNR/RNN serial pattern task, rats often reduce their running speeds on trial 2 less within the RNR than within the RNN series. Initially, investigators (Capaldi, 1985; Capaldi et al., 1983) considered this trial 2 differential speed effect evidence for rats’ anticipation of inter-trial outcomes within each series. Later findings, however, suggest that this effect reflects some generalization of the ordinal position of trial 3 (Burns et al., 1986) or its similar runway cues during trial 2 (Capaldi et al., 1999). To test these generalization hypotheses, we made trial 2 more distinct from trial 3 in each series by forcing rats to alternate runways in a T-maze only on the last trial rather than on trial 2 in each series in Experiment 1, or by forcing rats to alternate runways between trials rather than to run down the same runway on all trials within each series in Experiment 2. Although enhancing the distinctiveness between these trials reduced the trial 2 differential speed effect, extensive training failed to eliminate it. Therefore, this residual difference between trial 2 speeds could reflect rats’ anticipation of trial 3 outcomes during trial 2 as originally proposed by Capaldi (1985) Experiment 3 was designed to determine whether we could enhance rats’ final trial outcome expectancies during trial 2 by making different trial 2 choices distinctive cues for each trial 3 outcome. The trial 2 speed effect was greater when rats were forced to alternate over all trials only within one of the series than when they were sometimes forced to do so in either series. Post-training probe tests revealed that both series position and the relevant within-series runway events contributed to this enhanced anticipation of trial 3 outcomes.     

A comparative effectiveness trial of functional behavioral assessment methods

Clinicians report primarily using functional behavioral assessment (FBA) methods that do not include functional analyses. However, studies examining the correspondence between functional analyses and other types of FBAs have produced inconsistent results. In addition, although functional analyses are considered the gold standard, their contribution toward successful treatment compared with other FBA methods remains unclear. This comparative effectiveness study, conducted with 57 young children with autism spectrum disorder, evaluated the results of FBAs that did (n = 26) and did not (n = 31) include a functional analysis. Results of FBAs with and without functional analyses showed modest correspondence. All participants who completed functional communication training achieved successful outcomes regardless of the type of FBA conducted.     

An in-Vivo Daily Self-Report Approach to the Assessment of Outcomes of Two Psychotherapies for Women With Posttraumatic Stress Disorder

Emotion regulation and interpersonal psychotherapies that do not require trauma memory processing have been shown to be effective in treating posttraumatic stress disorder (PTSD). This study used a novel method to assess in vivo outcomes in a randomized clinical trial with women (N = 147; ages 18–54; 61% of color; 94% low income) with full (79%) or partial (21%) PTSD. Participants were assigned to affect regulation or interpersonal therapy, or wait-list, and completed daily self-reports for 2 to 4 weeks at baseline and up to 30 days at posttest. Mixed model regression analyses tested pre-post change on five factor analytically derived aggregated daily self-report scores. Emotion regulation-focused therapy was associated with reduced PTSD symptoms, dysregulation, and negative affect, and improvement in adaptive self-regulation and positive affect. Interpersonal-focused therapy was associated with reduced PTSD symptoms and dysregulation. Although both therapies were associated with reduced PTSD symptoms, whether this was due to nonspecific factors rather than the treatments per se could not be determined. Daily self-report data warrant further investigation in psychotherapy research with disorders such as PTSD, in order to assess affective and interpersonal dysregulation and adaptive regulation as they occur in daily life.