The importance of assessing treatment integrity: An example in the anxiety disorders

One purpose of this investigation was to examine the importance of assessing treatment integrity in a study evaluating a treatment for specific anxiety disorders. Three subjects, two social phobics and one simple phobic, received self-instruction training (Phase I) followed by exposure and self-instruction training (Phase II) in a multiple baseline across subjects design. All subjects were assessed during a pretreatment baseline and throughout treatment using measures of treatment integrity and measures of change in phobic severity. Improvement took place at different times for different subjects. Measures of treatment integrity, which consisted of monitoring of self-statements as well as practice outside the session, indicated that treatment was not always received as intended and that improvement was correlated with practice. The usefulness of measures of treatment integrity in both clinical and research settings is highlighted.     

All's well that ends well? Outcome bias in pilots during instrument flight rules

The objective of the present study was to examine if the Outcome Bias also occurs in pilots flying under instrument flight rules (IFR). In a scenario-based survey, 60 pilots evaluated weather-related decisions made by hypothetical pilots. Participants rated the decisions as better, less risky, and regarded the probability that they would have made the same decision as higher when they were followed by a positive outcome, than when they were followed by a negative outcome. This effect showed likewise for novice pilots and for experienced pilots. These findings could be relevant for the flight-related decision-making of pilots, which sometimes is affected by the decisions made by third-party pilots. In particular, decisions made by other pilots that have led to positive outcomes might be hastily followed, whereas those that have led to negative outcomes might be hastily rejected.     

Cognitive rehabilitation of chronic alcohol abusers

The current literature suggests that individuals who chronically abuse alcohol exhibit a wide variety of cognitive deficits resulting from cerebral dysfunction that is either directly or indirectly related to their alcohol consumption history. Cognitive deficits have been hypothesized as having implications for standard alcohol treatment efficacy as they may directly affect cognitively impaired individuals’ abilities to utilize various treatment modalities. Although evidence is accumulating that suggests this is actually the case, the majority of alcohol treatment programs neither directly consider the impact cognitive deficits have on treatment efficacy nor do they employ cognitive rehabilitation treatment strategies to remediate identified cognitive deficits. Few studies exist that investigate the remediability of neurobehavioral deficits or the efficacy of integrating cognitive rehabilitation strategies into more traditional treatment programs. Empirical investigations conducted to date indicate that some cognitive deficiencies secondary to alcoholism are amenable to cognitive rehabilitation and this remediation is generalizable. Rigorous well-controlled treatment outcome investigations are needed in order to determine the efficacy of cognitive rehabilitation techniques in naturalistic settings using ecological outcome measures. Also, emphasis should be placed on integrating cognitive rehabilitation techniques with proven efficacy into traditional alcoholism treatment programs.     

5-11岁儿童元知觉发展的实验研究

本项研究旨在探索 5 -1 1岁儿童元认知发展的规律 ,2 80名昆明市及路南县汉、撒尼族儿童参与了三项知觉实验 ,实验结果表明 :1儿童随年龄的增长 ,有关知觉组织策略的知识及自我监察的能力也逐渐发展 ,表现为系统观察、选取有效策略及计划性的增强。 2儿童对信息的加工不断深入 ,从表浅的加工过渡到详尽的加工 ,不仅要求补充必要的信息 ,而且主动搜索隐蔽的线索以促进识辨。3儿童自我评价从笼统、含糊逐渐向客观、全面发展。4路南儿童元知觉的发展晚于昆明儿童两年 ,但在路南的汉族儿童和撒尼族儿童之间不存在显著差异 ,说明文化教育对儿童元知觉发展的重要影响。     

Three years follow-up of panic disorder patients: A naturalistic study

Forty Danish panic disorder patients participating in a placebo controlled study of alprazolam and imipramine (The Cross National Collaborative Panic Study, Phase II) were followed up by a telephone interview three years later, with essentially the same battery of evaluation procedures applied at baseline, end of study, and follow-up. The main finding was that panic disorder is a chronic disorder, but fluctuating in form and severity in the course of time. Twenty-five percent of the patients no longer fulfilled the DSM-III criteria for panic disorder, but had substantial disability due to a variety of symptoms, including panic attacks at infrequent rate, generalized anxiety symptoms, affective symptoms, and phobic avoidance behavior. Nearly three fourths of the patients were under treatment at follow-up. Benzodiazepines were the drugs most often prescribed, usually in combination with supportive psychotherapy. It was concluded that the different types of treatment offered were insufficient. Variables predicting panic disorder or substantial disability at 3-years follow-up were few.     

Evaluating children's mental health service systems: An analysis of critical behaviors and events

A lack of studies which evaluate system change by tracking client outcomes is noted in the children's mental health area. This deficit may be a result of the inability of researchers to define outcomes and to draw conclusions about which measures reflect the efficacy of services and service delivery systems. This paper reviews five social validation surveys which examined children's mental health outcome measures. Based on the results of the five surveys, a model of critical behaviors and events is presented. This model will assist evaluators and researchers in understanding which critical events and behaviors should be measured to assess the impact of community-based mental health services for children.     

结果预期与结果反应对儿童意图认知和道德判断的影响

考察了结果预期与结果反应对儿童意图认知和道德判断的影响。结果表明,结果预期影响幼儿园和小学儿童的意图认知,结果反应仅影响幼儿园儿童的意图认知;结果预期和结果反应显著地影响幼儿园和小学儿童的道德判断,但结果预期对小学儿童道德判断的影响要比结果反应大。     

Relations between neonatal states and 8-month developmental outcome in preterm infants

This study investigated longitudinal relations between measures of neonatal state behavior and developmental outcome in a sample of preterm infants (N = 16). Results indicate that irritability/reactivity in the neonatal period is positively associated with Bayley scores and exploratory play at 8 months. Conversely, neonatal alertness was not associated with these developmental measures. These preliminary findings, based on a small sample, are discussed in the context of preterm function.     

青少年结果预期与评价的ERP研究

大脑不断地对环境事件产生预期并将这些预期与实际结果进行比较, 通过对反馈刺激的结果评价以优化后续行为。采用抽奖式赌博任务范式, 操纵得奖的确定性程度, 利用事件相关电位技术(ERP), 研究青少年结果预期与评价的认知和神经电生理过程, 以成人作为对照组进行比较分析。研究结果表明：(1)在反映自动、快速结果评价的FRN上, 无论在高确定性还是在低确定性条件下, 青少年与成人均未表现出显著性差异; (2)组别与确定性程度在P300波幅上表现交互作用显著, 简单效应分析表明, 在高确定性条件下, 青少年组输、赢的P300波幅表现出差异; 而成人组输、赢的P300波幅无显著性差异。青少年对反馈刺激自动的快速结果评价能力已接近成人水平, 而对反馈刺激功能意义评价的控制加工能力还未发展成熟。