The use of a resident daily scheduling procedure to increase appropriate social,ward, and scheduling behavior in adult psychiatric residents (patients)

The purpose of the present experiment was to investigate the efficacy of a goal orientation procedure in their treatment of apathy, isolation, and insufficient goal setting skills in chronic psychiatric residents. The experiment was conducted in a behaviorally-oriented deinstitutionalization program in a state psychiatric hospital. Three male and four female chronic psychiatric residents served as research participants. A group repeated measures design with four within-participant phases (ABA‘B’) was utilized. The goal orientation procedure included a written schedule that was completed by each research participant daily. This Daily Living Schedule required that a behavior be specified by the participant for every half-hour period during the day (8:30 a.m. to 9:00 p.m.). During all four phases of the experiment, research participants were observed on the ward from 8:30 a.m. to 12:00 noon and 1:00 p.m. to 5:00 p.m. for engagement in scheduled target behaviors. The daily scheduling procedure produced substantial increases in appropriate behavior such as social activities, ward jobs, and participation in treatment programs, whereas decrease were produced in inappropriate behavior such as isolation and day time sleeping.     

Obsessional slowness: a meticulous replication.

The treatment of an apparently authentic case of obsessional slowness is described. The relationship between behaviour change and emotional events is discussed. The findings replicate those of Rachman (1974).     

Relational suffering and the moral authority of love and care

Suffering is a ubiquitous yet elusive concept in health care. In a field devoted to the pursuit of objective data, suffering is a phenomenon with deep ties to subjective experience, moral values, and cultural norms. Suffering’s tie to subjective experience makes it challenging to discern and respond to the suffering of others. In particular, the question of whether a child with profound neurocognitive disabilities can suffer has generated a robust discourse, rooted in philosophical conceptualizations of personhood as well as the academic and experiential expertise of practiced health-care professionals. The issue remains unresolved because it is difficult, perhaps impossible, to ever truly know an infant’s lived experience. But what if this is not the best question? What if instead of asking “can this infant suffer?” the discourse is broadened to ask “is there suffering here?” This latter question demands attention to patients’ subjective experiences of suffering, but also to the web of relationships that envelop them. Without losing sight of the importance of patients’ experiences, consideration of their relationships may elucidate the presence of suffering when the patients themselves are unable to provide the same clarity. In this essay, care ethics frames an examination of how suffering manifests in the loving and caring relationships that surround an infant with profound neurocognitive disabilities, changing those relationships and affecting the individuals within them. Exploring suffering through these relationships may offer clarity on the presence and content of suffering for infants with profound cognitive disabilities, in turn offering moral guidance for responding to suffering and supporting flourishing in this context.

     

Developing a treatment manual for attention management in chronic pain

This article reports the development of a protocol for the therapeutic application of "attention control" for chronic pain. Attention control is the limitation of the impact of pain by switching or retunning attention. An expert systems approach was used to develop the protocol. In the first stage an extensive literature search retrieved published and unpublished accounts of attention control strategies and a draft treatment manual was prepared. In the second stage 6 experts were recruited and they independently read and reviewed the draft manual. They were interviewed using a semi-structured protocol to elicit their views on the draft manual. The manual was then revised to accommodate the information and expertise. In addition to providing expert opinion on the manual the experts also raised issues about the process of change in psychological treatment for chronic pain. These issues were organized into a process model of change in chronic pain.     

Perceptions of physical and psychological aggression in close relationships: A review

This review of the literature examines the effect of contextual variables (i.e., characteristics of the perpetrator and victims, observer characteristics) on perceptions of physical and psychological aggression in close relationships. Observers view physical aggression as more serious, harmful, abusive, and more deserving of punishment than psychological aggression, male aggression as more serious than female aggression, and aggression in committed, exclusive relationships as more serious than aggression in casual ones. Victims of psychological aggression, however, perceive it as more harmful than physical aggression and consider the effects to be longer-lasting. The disparity between observer and victim perceptions of physical and psychological aggression extends to mental health professionals, who tend to judge the severity of aggressive behaviors based on frequency and duration of the actions instead of perpetrator intent. This difference of opinion may influence the reporting of and intervention in physically or psychologically aggressive situations, and how these types of aggression are treated by legal professionals, especially if those legal professionals are informed about aggressive romantic relationships by third-party observers whose opinions of the situation differ from those of the victims.     

Low diversity and low frequency of participation in leisure activities compromise working memory efficiency in young adults

People perform leisure activities (LA) every day; pursuits that entail applying cognitive, physical and social abilities. As in old age, doing LA during early and middle adulthood is related to a reduced risk of dementias, probably by generating a cognitive reserve. As it is possible that a relation between doing LA and working memory (WM) efficiency exists in young adults, we assessed whether the diversity and frequency of LA are related to WM efficiency in this population. Ninety-three healthy young subjects solved the n-back task at two levels of difficulty (2, 3), and answered an LA questionnaire on the activities in which they had participated in the month prior to the experiment. Subjects were classified separately on their scores for (1) diversity (high/low) and (2) frequency (high/low) in order to test the relation between each variable and WM efficiency. Though no differences were found, a subsequent analysis of the average of diversity and frequency ratios of LA performance taken together-the diversity/frequency index-showed that low diversity plus low frequency was significantly associated with reduced WM efficiency at this age; results that suggest that frequent participation in diverse LA during youth is related to WM efficiency.     

The effects of modifying interpretation bias on worry in generalized anxiety disorder

This study investigated whether facilitating a benign interpretive bias decreases negative thought intrusions in generalized anxiety disorder (GAD). Clients were randomly allocated to an interpretation modification condition in which they repeatedly accessed benign meanings of emotionally ambiguous homographs and scenarios, or to a control condition in which they accessed threat and benign meanings with equal frequency. Worry frequency was assessed using a breathing focus task that involved categorising the valence of thought intrusions before and after an instructed worry period. Interpretation bias was assessed during the modification tasks, and on a different measure of interpretation bias (sentence completion) following a period of worry. The experimental procedure modified interpretations made during training, and in the later sentence completion task. Furthermore, compared to the control group, the benign group showed fewer negative thought intrusions during breathing focus (as rated by both participants and an assessor). These findings show that it is possible to induce a more benign interpretive bias in GAD clients and that this reduces negative thought intrusions.