Discovering what it all means

This article deals with appropriate communication and interpersonal skills that nurses may use in order to support patients who are experiencing self-concept changes related to their health problems. Three areas of patient need related to self-concept are explored. The stages of adaptation to loss and the crucial task of grief work are reviewed, and nursing interventions designed to strengthen the self-concept and support patients as they adapt to loss are suggested. Sensitive communication, although a low-visibility nursing skill, is cited as critical in assisting the patient to achieve an optimum level of wellness.     

Toward the Formation of a “Cultural Mosaic”: A Case Study

This study describes an intervention designed to promote integration between Ethiopian and Israeli students (N = 93) in Grades 2 to 5 and adaptation of these immigrants to school norms of behavior and to discipline. The metaphor of cultural mosaic was used for describing the goal state. To achieve a comprehensive school reform, the curriculum was enacted on four levels: individual student, school and classroom, staff, and community (parents and local council). The intervention effects were evaluated in three domains via questionnaires, interviews, and observations – the domains being the academic, behavioral, and personal-social realms. Four stages were identified in the process: an opening stage, the euphoria stage, the setback stage, and the final stage of a new equilibrium. Results suggest that both the natives' and the immigrants' needs and difficulties have to be attended to in each of the stages. The social domain was found to be the most salient in the integration process, although integration within it may take less time and be more feasible than academic accommodation.     

The role of attentional resources in automatic detection

The question of whether an automatic detection task requires the use of limited-capacity resources was investigated in a series of dual-task experiments. The automatic task required subjects to detect a consistently mapped target digit in a display of letters. This task was paired with a variety of concurrent visual discriminations that could either occur in close proximity to the automatic target or in a disparate display area. The main finding was that accuracy in each task was higher in conditions allowing attention to be shared than when it had to be divided between separate areas. These results indicate that detection of automatic targets depends on the allocation of spatial attention to the target's area.     

A preliminary evaluation of treatment duration on the resurgence of destructive behavior

Quantitative models of resurgence (e.g., Behavioral Momentum Theory, Resurgence as Choice) suggest that resurgence is partly a function of the duration of extinction exposure, with longer histories of extinction producing less resurgence. This prediction is supported by some laboratory research and has been partially supported by clinical translations that did not isolate the effects of extinction exposure prior to testing for resurgence. The degree to which different histories of extinction impact the likelihood of treatment relapse in therapeutic applications of differential reinforcement is of great interest to the clinical community, including insurance carriers and other financial providers. In the present study, we isolated the effects of extinction history for severe destructive behavior across 6 participants referred for treatment services and examined resurgence of destructive behavior when alternative reinforcement terminated. Our within-subject evaluation showed no difference in the level of resurgence or persistence of destructive behavior following short and long exposures to differential reinforcement with extinction. We discuss our failure to replicate in relation to experimental-design considerations for investigating this and other relapse phenomena in future research with clinical populations.     

Noncontingent and differential reinforcement in the treatment of pediatric feeding problems

We conducted functional analyses of the inappropriate mealtime behavior of 5 children diagnosed with feeding problems. Then, we compared the effects of differential and noncontingent reinforcement, and the relative effects of escape extinction with and without differential or noncontingent reinforcement, when escape extinction appeared necessary. Both reinforcement procedures were effective without escape extinction to treat food refusal for 1 child, but only differential reinforcement was effective without escape extinction to treat the child's liquid refusal. Escape extinction was necessary for 4 of 5 children. The addition of positive reinforcement resulted in beneficial effects (i.e., more stable acceptance, decreased inappropriate mealtime behavior or negative vocalizations) with 3 of 4 children. With escape extinction, differential reinforcement was more effective to treat food refusal for 2 children and noncontingent reinforcement was more effective for 1 child.     

Escape from rich‐to‐lean transitions: Stimulus change and timeout

Extended pausing during discriminable transitions from rich‐to‐lean conditions can be viewed as escape (i.e., rich‐to‐lean transitions function aversively). In the current experiments, pigeons’ key pecking was maintained by a multiple fixed‐ratio fixed‐ratio schedule of rich or lean reinforcers. Pigeons then were provided with another, explicit, mechanism of escape by changing the stimulus from the transition‐specific stimulus used in the multiple schedule to a mixed‐schedule stimulus (Experiment 1) or by producing a period of timeout in which the stimulus was turned off and the schedule was suspended (Experiment 2). Overall, escape was under joint control of past and upcoming reinforcer magnitudes, such that responses on the escape key were most likely during rich‐to‐lean transitions, and second‐most likely during lean‐to‐lean transitions. Even though pigeons pecked the escape key, they paused before doing so, and the latency to begin the fixed ratio (i.e., the pause) remained extended during rich‐to‐lean transitions. These findings suggest that although the stimulus associated with rich‐to‐lean transitions functioned aversively, pausing is more than simply escape responding from the stimulus.     

Using statistical risk information to assess oral contraceptive safety

The effect of variations in the presentation of oral contraceptive risk information on perceived safety was investigated. Four tests of the hypothesis that consumers focus on the absolute value of the numbers presented when assessing risk probabilities were performed with the following results: (1) when base rates are given, risks are perceived as less likely than when base rates are not given; (2) risks seem smaller when the information provided focuses on the number that will not die than when the number of expected deaths is presented; (3) contrary to our expectation, respondents do not focus on foreground numbers when risk was represented in an ‘X out of Y occurrences’ format; (4) respondents judged a risk of ‘4.15 times greater’ as less likely than when the information was presented as ‘415% greater risk’. We concluded that consumers convert statistical risk information into judgements about the magnitude of the number presented (small or large number) and utilize this more meaningful information when making risk judgements.     

Visual and semantic factors in recognition from long-term memory

In recognition tests, physical and semantic relationships between targets and distractors have been shown, in separate manipulations, to affect the latency of subject's decision. Recognition was tested for distractors which were visually similar or dissimilar to targets and which belonged to the target categories or to nontarget categories in order to examine the interaction of these dimensions. Rejection latency was longer for target category than for nontarget category distractors. Latency was also longer for visually similar than visually dissimilar distractors, but only when combined with target category probes. This interaction can be explained by the hypothesis that word recognition depends on the analysis of several dimensions of the probe stimulus, and rejection can occur before all such analyses have been completed.     

On the predictive validity of behavioral momentum theory for mitigating resurgence of problem behavior

We summarize the results of four recent translational studies from our lab that used the predictions of behavioral momentum theory to inform the development of more durable treatments for destructive behavior. Treatments informed by behavioral momentum theory generally showed better suppression of target responding during an extinction challenge than did a comparison treatment. We reanalyze data from each of the four studies to show that this general finding is apparent both at the aggregate (i.e., proportion of baseline response rates averaged across participants) and within participant (i.e., percentage reduction in proportion of baseline response rates, difference in raw response rates during the extinction challenge). Interestingly, participants who experienced multiple cycles of the extinction challenge generally showed less differentiation in target responding between the treatment informed by behavioral momentum theory and the comparison treatment. Overall results suggest that applications of behavioral momentum theory can substantially improve the durability of common treatments for destructive behavior.