Behavior Modification

In this article, literature concerning the quantitative synthesis (meta-analysis) of single-subject research literature is reviewed. First, the general rationale for such an approach is discussed. Next, procedures for synthesizing single-subject literature are described, followed by comments and critiques of those procedures. Finally, a review is presented of the results of applications of those procedures. The authors suggest that procedures based on percentage of nonoverlapping data (PND) between baseline and treatment are justifiable, meaningful, and-across nine applications have produced results that are highly meaningful and faithful to the original research reports.

The purpose of this study was to examine the trainability of anticipation in intermediate tennis players. In particular, the study examined whether video presentations could improve on-court tennis serve returns. A series of separate A-B designs across 6 participants was implemented, with baseline and intervention scores for on-court serve-return performance being recorded. Intervention consisted of 2 phases: a training phase and an on-court testing phase. The training phase, which employed a changing criterion design, consisted of a series of tennis-serve video presentations that were replayed with gradually increasing speed. All serves were occluded on racquet/ball contact, and participants were asked to predict the type, depth, and width of serve. Following completion of the training phase, participants were again tested on their ability to return tennis serves on the tennis court. On-court results suggested that anticipation ability and performance did improve as a result of the intervention.

The aim of this work was to test the contribution of cognitive therapy to exposure in vivo in the group treatment of generalized social phobia. Seventy-one severely disabled social phobics, selected according to DSM-III-R criteria, were assigned at random to: (a) self-exposure in vivo, (b) self-exposure in vivo with cognitive therapy, or (c) a waiting-list control group. A multigroup experimental design with repeated measures of assessment (pretreatment, posttreatment, and 1-, 3-, 6-, and 12-month follow-ups) was used. Additionally, half of the patients in both therapeutic groups were given self-help manuals for managing anxiety. Most patients that were treated (64%) showed significant improvement at the 12-month follow-up, but there were no differences between the two therapeutic modes. No improvement was shown by the control-group participants at the 6-month follow-up. The results of the present trial do not support the beneficial effects of adding cognitive therapy or a self-help manual to exposure alone. Finally, several topics that may contribute to future research in this field are discussed.

This article reports the effects of a cognitive-behavioral group therapy program for social phobia (N = 25 outpatients) on several psychometric measures. It is the first study to simultaneously examine three newer and promising social-phobia measures: the Social Phobia Scale (SPS) and accompanying Social Interaction Anxiety Scale (SIAS), the Social Phobia and Anxiety Inventory (SPAI), and the Liebowitz Social Anxiety Scale (LSAS). More traditional measures of social phobia were also included, along with measures of anxious and depressed mood. Among the newer scales, the SPAI and SPS/SIAS were found to have good sensitivity to treatment. There was limited support for the LSAS. Intercorrelations among all of the outcome measures are presented both before and after cognitive-behavioral therapy. Strengths and weaknesses of each of the newer social-phobia measures are discussed.

The efficacy of two treatment approaches was compared for functional skill acquisition in individuals with severe and profound mental retardation. Participants included 22 residents from a large developmental center (Pinecrest) in central Louisiana. Treatment including staff training, feedback, and edible reinforcement in addition to prompting, modeling, and physical guidance was more effective than prompting, modeling, and physical guidance alone. Additionally, daily documentation of teaching did not enhance treatment effectiveness. Implications of the findings are discussed.

Factors influencing diagnostic reliability were examined using a sample of 267 patients who underwent two independent administrations of the Anxiety Disorders Interview Schedule-Revised (ADIS-R). Several potential mediators were examined in terms of their association with interrater agreement as measured by kappa coefficients. These included comorbidity, disorder severity, diagnostician training, patient education, presence of behavioral features, and time separating interviews. Results suggest that several factors appear to have an important effect on diagnostic agreement, most notably, the presence or absence of comorbidity and the presence or absence of overt behavioral symptoms. Details of these influences and the impact of other selected mediators on the diagnosis of anxiety disorders are presented.

Stereotypies are high-frequency, highly repetitive, nonfunctional behaviors that are also often characterized as rhythmic. Rhythmicity suggests that the behavior is periodic, occurring at fixed intervals. Few studies, however, have rigorously demonstrated periodicity in stereotypy. This study examined various topographies of stereotypy in 9 participants and used spectral methods to detect existence of periodicities. TWo general patterns emerged in the spectral analysis. Participants who engaged in stereotypic rocking showed peaks in their power spectra; participants who engaged in other topographies of stereotypy did not show peaks. Thus, it appears that although some stereotypies-notably, rocking-have a periodic component, rhythmicity does not appear to be a characteristic of stereotypy in general.

The impact of simultaneous changes in biological and social context on the mental health of adolescents was examined by testing the hypothesis that normative developmental transitions can be associated with increased dysphoria if they occur in close temporal proximity. Girls experiencing physical changes associated with middle or later stage pubertal development during the initial high school or college year were predicted to experience more dysphoria than those experiencing these changes during non-transitional times, with negative pubertal attitudes exacerbating the relation. Pubertal status and dysphoria of high school and college students were assessed. Among females experiencing pubertal changes, dysphoria was indeed highest for the 15 and 19 year olds, and lower for the 16, 17, and 18 year olds with females viewing menstrual onset as negative experienced depressive symptoms of moderate clinical severity. This pattern did not emerge for males, or females not experiencing pubertal changes. In contrast, the hypothesis was not supported when transition time was operationalized using grade level. Implications for psychopathology risk are discussed.

Despite very successful treatments for social phobia, with many studies reporting as many as 75% of social phobics making clinically significant gains with 3 months of treatment or less, some social phobics fail to respond to treatment. This case presents a woman with social phobia who received several trials of treatment for severe public-speaking fears but failed to improve, as demonstrated by persistent reports of fear and avoidance equal to those before treatment. With the assistance of a speech language pathologist, this client received combined therapy that included cognitive-behavioral therapy to treat her public-speaking fear and avoidance and voice therapy to treat excessive muscle contractions in the respiratory and phonatory systems. Overall, the combined treatment was successful, with the client's self-reported levels of fear and avoidance of public speaking decreasing dramatically. Specific improvements during voice therapy and implications for the treatment of social phobia are also discussed.

This article begins with a brief review of the current literature on the structure and measurement of perfectionism. It is concluded from this review that two major types can be distinguished, a normal/healthy form and a pathological form. These two forms are then defined as positive and negative perfectionism and related directly to Skinnerian concepts of positive and negative reinforcement. The positive/negative distinction is then further elaborated on in terms of approach/avoidance behavior, goal differences, self-concept involvement, emotional conrelates, and the promoting environment. Finally, some of the more obvious theoretical and practical implications are briefly explored.

To analyze the effects of matching the prompting procedure used in training to the specific behavior chain to be taught, 3 students with mild to moderate retardation were taught four independent tasks: making a bagged lunch, playing a matching game with a peer, ordering food at a restaurant, and participating in a social conversation. Following baseline, all 3 students were exposed to one of two types of training procedures for each task: a least-to-most prompting procedure or a most-to-least prompting procedure. The type of training procedure was counter-balanced across students and tasks, whereas performance on the tasks was evaluated within a combination of a multiple-baseline design across participants and multiple-probe design across tasks. When the method of prompting was matched to the naturally occurring discriminative stimulus (SD) of the training stimulus, it greatly affected acquisition and maintenance of the skill in terms of differences in levels and variability of performance. The most-to-least method of prompting, the matched method in these cases, was more efficient and effective for acquisition and generalization of the bagged-lunch and matching-game skills. The least-to-most method, the matched method in these cases, was more efficient and effective for social-questions and ordering-food skills.

An experiment was conducted to investigate the influence of Captain's Log (a computerized cognitive-training system) on the behaviors and performance capabilities of 4 severely emotionally disturbed children with Attention Deficit Hyperactivity Disorder (ADHD), ages 7 to 11. Behavioral scales, spectral electroencephalograms, and intelligence and performance tests were assessed pre-and posttreatment. A behavioral point system and monitoring of progress on computer tasks were used throughout treatment to evaluate ongoing improvements. There were 64 training sessions administered over a 16-week period. Outcome of treatment was determined by computer advancement, changes in behavioral points, and pre-and postmeasures. Results support the expectation that children who were most successful in the training would demonstrate the highest levels of generalization of those skills that were the focus of treatnent.