Showing papers in "Behavior Modification in 2006"

An alternative method for quantitative synthesis of single-subject researches: Percentage of data points exceeding the median

Abstract: The purpose of the present study is twofold: (a) to compare the validation of percentage of nonoverlapping data approach and percentage of data points exceeding the median of baseline phase (PEM) approach, and (b) to demonstrate application of the PEM approach in conducting a quantitative synthesis of single-subject research investigating the effectiveness of self-control. The results show that the PEM had higher Spearman correlation with original authors' judgment than PND did. The results of applying the PEM approach to synthesize the effect of self-control training on academic and social behavior showed that the treatment was highly or at least moderately effective.

Positive Versus Negative Perfectionism in Psychopathology: A Comment on Slade and Owens's Dual Process Model.

Abstract: This article reviews the concepts of positive and negative perfectionism and the dual process model of perfectionism outlined by Slade and Owens (1998). The authors acknowledge that the dual process model represents a conceptual advance in the study of perfectionism and that Slade and Owens should be commended for identifying testable hypotheses and future research directions. However, the authors take issue with the notion that there are two types of perfectionism, with one type of perfectionism representing a "normal" or "healthy" form of perfectionism. They suggest that positive perfectionism is motivated, at least in part, by an avoidance orientation and fear of failure, and recent attempts to define and conceptualize positive perfectionism may have blurred the distinction between perfectionism and conscientiousness. Research findings that question the adaptiveness of positive forms of perfectionism are highlighted, and key issues for future research are identified.

The good behavior game: 1969-2002.

Abstract: The Good Behavior Game (GBG), a type of interdependent group-oriented contingency management procedure, was first introduced in 1969 and has been used with overwhelming success in classrooms and other settings. Since its inception, the "game" has utilized team competition and peer influence combined with reinforcement procedures. It has been found to be popular, easy-to-use, time-efficient, and widely applicable and versatile. This review describes the game and its numerous variations and adaptations, as well as empirical findings specific to the variety of target behaviors and participants to which it has been applied. In addition, different types of reinforcers used, information on consumer acceptance, and issues related to implementation are considered.

Pediatric Procedural Pain

Abstract: This article reviews the various settings in which infants, children, and adolescents experience pain during acute medical procedures and issues related to referral of children to pain management teams. In addition, self-report, reports by others, physiological monitoring, and direct observation methods of assessment of pain and related constructs are discussed and recommendations are provided. Pharmacological, other medical approaches, and empirically supported cognitive behavioral interventions are reviewed. Salient features of the interventions are discussed, and recommendations are made for necessary components of effective treatment interventions.

Multiple Effects of Joint Attention Intervention for Children with Autism.

Abstract: Joint attention refers to an early developing set of behaviors that plays a critical role in both social and language development and is specifically impaired in children with autism. In a series of three studies, preschool teachers demonstrated the effectiveness of discrete trial instruction and pivotal response training strategies to teach joint attention to 5 children with autism (Study 1). Parents of 2 of the 5 children also taught joint attention at home and in the community (Study 2). Several additional dependent measures demonstrated collateral improvements in expressive language and social-communicative characteristics that were socially validated by parent raters (Study 3). Results are discussed with respect to the importance of addressing different forms of joint attention, the necessity to extend intervention to naturalistic contexts and joint attention partners, the pivotal nature of joint attention, and whether intervention adequately addresses both the form and social function of joint attention.

The Relationship Between Visual Analysis and Five Statistical Analyses in a Simple AB Single-Case Research Design:

Abstract: This study explored some practical issues for single-case researchers who rely on visual analysis of graphed data, but who also may consider supplemental use of promising statistical analysis techniques. The study sought to answer three major questions: (a) What is a typical range of effect sizes from these analytic techniques for data from “effective interventions”? (b) How closely do results from these same analytic techniques concur with visual-analysis-based judgments of effective interventions? and (c) What role does autocorrelation play in interpretation of these analytic results? To answer these questions, five analytic techniques were compared with the judgments of 45 doctoral students and faculty, who rated intervention effectiveness from visual analysis of 35 fabricated AB design graphs. Implications for researchers and practitioners using single-case designs are discussed.

Predicting Outcome in Parent-Child Interaction Therapy Success and Attrition

Abstract: This study explored predictors of treatment response and attrition in Parent-Child Interaction Therapy (PCIT). Participants were 99 families of 3- to 6-year-old children with disruptive behavior disorders. Multiple logistic regression was used to identify those pretreatment child, family, and accessibility factors that were predictive of success or attrition. For all study participants, waitlist group assignment and maternal age were the significant predictors of outcome. For treatment participants (study participants excluding those who dropped out after the initial evaluation but before treatment began), only maternal ratings of parenting stress and maternal inappropriate behavior during parent-child interactions were significant predictors of treatment outcome. These results suggest that for treatment studies of disruptive preschoolers, the benefits of using a waitlist control group may be outweighed by the disproportionate number of dropouts from this group. Once families begin PCIT, however, parent-related variables become salient in predicting treatment outcome.

Phenomenological characteristics, social problems, and the economic impact associated with chronic skin picking.

Abstract: In this study, the authors collected data on the demographic characteristics, phenomenology, and social and economic impact of skin picking. A total of 92 participants completed an anonymous, Internet-based survey through a link to the Trichotillomania Learning Center's home page. Results indicated that skin pickers experienced social, occupational, and academic impairment, a number of medical or mental health concerns, and financial burdens, which they attributed to skin picking. Results also revealed moderate, statistically significant relationships between skin picking severity and symptoms of depression, anxiety, and experiential avoidance. Subsequent mediational analyses demonstrated that the relationship between skin picking severity and symptoms of anxiety and depression was partially mediated by experiential avoidance. Implications, conclusions, and future areas of research are discussed.

Behavioral treatments for pediatric feeding disorders

Abstract: The effectiveness of behavioral interventions for pediatric feedings problems has been well documented. However, the application of these procedures in the real world is often more complex and difficult than research reports reveal. Multiple factors such as the child's medical condition and history, medical monitoring requirements, and the need to adjust treatment procedures as intervention progresses make it difficult to follow the best-laid plans developed from reading structured and highly controlled experimental applications. This article details factors to be considered in the actual clinical-based application of behavioral procedures in the treatment of pediatric feeding problems. A description of how referrals are generated and initial assessment is conducted, and a model for inpatient treatment is presented. In addition, the need for efficient and effective treatment in the real world is stressed.

Habit reversal as a treatment for chronic skin picking: a pilot investigation.

Abstract: The purpose of this study was to compare the effectiveness of habit reversal (HR) to a wait-list control as a treatment for chronic skin picking in adults. Twenty-five adults with a chronic skin-picking problem were randomly assigned to a wait-list control or HR group. At pretreatment, posttreatment, and a 3-month follow-up, self-reported skin picking was assessed, and photographs were taken of the damaged areas and later rated by independent observers. Treatment acceptability data were collected at posttreatment only. Results showed that HR produced a greater decrease in skin picking at posttreatment and follow-up when compared to the wait-list control group. Data from the independent raters confirmed these findings. HR was also viewed as an acceptable intervention by the participants.

The Effects of Self-Management in General Education Classrooms on the Organizational Skills of Adolescents With ADHD:

Abstract: Self-management procedures have been used in school settings to successfully reduce problem behaviors, as well as to reinforce appropriate behavior. A multiple-baseline across participants design was applied in this study to evaluate the effects of using a self-management procedure to enhance the classroom preparation skills of secondary school students with attention-deficit/ hyperactivity disorder (ADHD). Three male students enrolled in a public secondary school were selected for this study because teacher reports suggested that these students were insufficiently prepared for class and inconsistently completed assignments. The intervention involved training in self-management procedures focusing on the improvement of classroom preparation skills. Following the intervention, the training process was systematically faded. Results were consistent across the 3 participants in enhancing classroom preparation behaviors. Implications for practice and future research are discussed.

Retaining Pathological Gamblers in Cognitive Behavior Therapy Through Motivational Enhancement: A Pilot Study

Abstract: Treatment for pathological gambling is in its infancy. Several cognitive and behavioral interventions have shown promise, but high attrition and relapse rates suggest that gamblers requesting treatment are not uniformly committed to change. This article describes an exploratory study with 9 severe pathological gamblers—in their majority horse race bettors—who were recruited from a community treatment center. The gamblers were treated with a hybrid intervention consisting of motivational enhancement and cognitive behavior therapy. All gamblers were retained in treatment and during a 12-month follow-up period. This retention rate was significantly higher than that of a control group of gamblers who received treatment as usual in the same community setting. Of the gamblers who received the experimental treatment, 6 maintained total abstinence during the 12-month follow-up period, 2 were significantly improved, and 1 remained unimproved. In addition to changing their gambling behavior, many clients made succe...

Improving Dyadic Coping in Couples with a Stress-Oriented Approach: A 2-Year Longitudinal Study.

Abstract: This study sought to assess the effectiveness of a marital distress prevention program for couples by examining how marital quality, especially marital competencies such as dyadic coping, could be improved by means of a prevention program focusing on the enhancement of coping resources (Couples Coping Enhancement Training). The study consisted of 59 couples in the intervention group and 59 couples in the matched comparison group. The results reveal that it is possible to improve marital quality, especially marital competencies, by means of one short-term intervention lasting 18 hr. However, the effects decreased after 2 years, raising the importance of booster sessions in helping to maintain effects over a longer period of time.

Emotions and golf performance: An IZOF-based applied sport psychology case study.

Abstract: A multiple case study investigation is reported in which emotions and performance were assessed within the probabilistic individual zone of optimal functioning (IZOF) model (Kamata, Tenenbaum,& Hanin, 2002) to develop idiosyncratic emotion-performance profiles. These profiles were incorporated into a psychological skills training (PST) intervention, with a focus on three emotional dimensions, that is, arousal, pleasantness, and functionality, and several psychological strategies employed during practice and competition. Two female varsity golfers at a major Division I university in the Southeast participated in the case study during the Spring 2002 season. The PST intervention resulted in enhanced emotional self-regulation skills and improved golf performance. Directions for future research into the IZOF model and implications for practical application of the model are discussed.

Measuring homework compliance in cognitive-behavioral therapy for adolescent depression: review, preliminary findings, and implications for theory and practice.

Abstract: Despite the importance placed on completion of extra-session homework in cognitive-behavioral therapy (CBT), a review of the available literature suggests there is much about the nature of homework compliance that remains to be empirically evaluated. This is especially true among youth receiving CBT. The present study begins to address how best to measure homework compliance and offers a fine-grained, single-case analysis of homework compliance during acute treatment with depressed adolescents. The results demonstrate that 56% of homework assignments were completed. Also observed was substantial within-subject temporal variability in homework compliance and a tendency for compliance to decrease during the course of treatment. These data call into question the adequacy of any static aggregate measure of homework compliance and have implications for both researchers and clinicians.

Behavioral assessment and intervention in pediatric diabetes.

Abstract: This article reviews the empirical research literature on behavioral assessment and intervention methods in the context of diabetes mellitus in children and adolescents. The review summarizes the pathophysiology, medical management, and monitoring of pediatric type 1 and type 2 diabetes. Next, the article describes common behavioral barriers to acceptable diabetes management and adequate metabolic control and the role of behavior change agents in evaluation and intervention for these problems. Validated approaches to the assessment of diabetes-specific behavioral problems are described for the measurement of treatment adherence, diabetes-related fears and avoidance behaviors, diabetes-specific social skills, and disease-related stressors. Behavioral interventions that have empirical support are discussed, including treatments that target treatment adherence, social skills, coping skills, family communication and problem solving, anxiety and stress management, and weight control. The article concludes with clinical practice recommendations for behavior change specialists who have the opportunity to work with this population.

The relationship of comorbid problem behaviors to social skills in persons with profound mental retardation.

Abstract: Research into behavior problems among individuals with mental retardation has been well developed. However, few studies have addressed the effect of multiple problem behaviors on social skills. In the present study, the authors examined the relationship between two problem behaviors, stereotypy and self-injury, and social skills among individuals with profound mental retardation. A total of 120 participants were divided into four groups based on the presence of stereotypic and self-injurious behavior. Persons with comorbid stereotypy and self-injury evinced more negative nonverbal social skills than did those with self-injury alone or no problem behaviors. In the past, researchers examined behavior problems as isolated phenomena. However, a recent shift in the conceptualization of problem behaviors has exposed the lack of research regarding the nature of social and adaptive skills in the face of multiple topographies of problem behaviors using broader conceptualizations.

Enhancing Treatment Team Process Through Mindfulness-Based Mentoring in an Inpatient Psychiatric Hospital:

Abstract: The authors investigated changes in treatment team functioning in an adult inpatient psychiatric hospital after the implementation of a mindfulness-based mentoring intervention. Using a multiple baseline across treatment teams design, the authors assessed levels of functioning of three treatment teams using a 50-item rating scale and then introduced mindfulness-based mentoring successively across the treatment teams. Following intervention, four follow-up assessments at 3-month intervals were undertaken to assess the durability of the enhanced treatment team functioning levels in the absence of mentoring. Results showed that with the introduction of mindfulness-based mentoring, treatment team performance was enhanced, patients'attendance at therapeutic groups and individual therapy sessions was maximized, and patient and staff satisfaction with treatment team functioning was substantially increased, with patient satisfaction showing greater gains than staff satisfaction. Mindfulness-based mentoring may be an efficient and effective intervention for enhancing and maintaining the performance of treatment teams in adult psychiatric hospitals.

Two-Year Follow-Up of Bibliotherapy and Individual Cognitive Therapy for Depressed Older Adults

Abstract: This study examined the stability of treatment gains after receiving either cognitive bibliotherapy or individual cognitive psychotherapy for depression in older adults. A 2-year follow-up of 23 participants from Floyd, Scogin, McKendree-Smith, Floyd, and Rokke (2004) was conducted by comparing pre-and posttreatment scores with follow-up scores on the Hamilton Rating Scale for Depression (HRSD) and the Geriatric Depression Scale (GDS). Results indicated that treatment gains from baseline to the 2-year follow-up period were maintained on the HRSD and GDS, and there was not a significant decline from posttreatment to follow-up. There were no significant differences between the treatments on the GDS or HRSD at the 2-year follow-up; however, bibliotherapy participants had significantly more recurrences of depression during the follow-up period.

Physical Exercise as a Reinforcer to Promote Calmness of an ADHD Child

Abstract: Age-appropriate reinforcers have been found to be effective in promoting attentiveness and calmness with children with attention deficit hyperactivity disorder (ADHD). The present study with a 4-year-old ADHD boy found attentive calmness was substantially increased from a mean of about 3 seconds per trial to the maximum scheduled duration of 60 seconds by using a scheduled period of physical activity as the reinforcer for the attentive-calmness. These results suggest the possible use of this type of reinforcer as an addition or substitution for the usual reinforcers in contingency management with ADHD children.

Screening and identification in pediatric primary care.

Abstract: This article reviews issues related to behavioral screening in pediatric primary care settings. Structural-organizational issues affecting the use of pediatric primary care screening are discussed. This study also reviewed selected screening instruments that have utility for use in the primary care setting. Clinical and research issues related to screening for behavior problems in pediatric primary care are presented.

Effect of intense lifestyle modification and cardiac rehabilitation on psychosocial cardiovascular disease risk factors and quality of life.

Abstract: This study examined the effect of the Ornish Program for Reversing Heart Disease and cardiac rehabilitation (CR) on psychosocial risk factors and quality of life in patients with confirmed coronary artery disease. Participants had previously undergone a revascularization procedure. The 84 patients self-selected to participate in the Ornish Program for Reversing Heart Disease (n = 507 28), CR (n = 28), or a control group (n = 28). Twelve psychosocial risk factors and quality of life variables were collected from all three groups at baseline, 3 months, and 6 months. At 3 and 6 months, Ornish group participants demonstrated significant improvements in all 12 outcome measures. The rehabilitation group improved in 7 of the 12, and the control group showed significant improvements in 6 of the variables. Intensive lifestyle modification programs significantly affect psychosocial risk factors and quality of life.

Questions about behavioral function in mental illness (QABF-MI): a behavior checklist for functional assessment of maladaptive behavior exhibited by individuals with mental illness

Abstract: The Questions About Behavioral Function (QABF), a 25-item rating scale, was developed to identify the function(s) of maladaptive behavior in individuals with developmental disabilities. The authors adapted it for use with individuals with serious mental illness who engage in maladaptive behavior and assessed the psychometric characteristics of the new scale (Questions About Behavioral Function in Mental Illness; QABF-MI) in a sample of 135 adults with serious mental illness from three inpatient psychiatric hospitals. Staff most familiar with each person rated each item on a 5-point Likert-type rating scale, and the ratings were subjected to a number of psychometric analyses. The results of factor analyses provided a conceptually meaningful five-factor solution: physical discomfort, social attention, tangible reinforcement, escape, and nonsocial reinforcement. Congruence between the five factors derived with the QABF-MI and the corresponding factors in the original QABF was perfect. The results indicated that the QABF-MI has robust psychometric properties and may be useful as a screening tool for determining the nature of the variables that maintain maladaptive behavior exhibited by individuals with serious mental illness.

Behavioral Assessment and Treatment of Pediatric Headache

Abstract: Headaches are quite common in children and adolescents, and they appear to persist into adulthood in a sizable number of individuals. Assessment approaches (interview, pain diaries, and general and specific questionnaires) and behavioral treatment interventions (contingency management, relaxation, biofeedback, and cognitive behavior therapy) are reviewed, as is the evidence base for their use. The article concludes with practical suggestions for headache management.

The effects of celeration lines on visual data analysis

Abstract: Previous visual analysis research reported that the overall agreement between visual analysis and statistical analysis was poor. In response, some researchers suggested the use of celeration lines to improve the accuracy and reliability of visual analysis. However, subsequent research reported little or no improvement in accuracy with such lines. The present study presented 5 board-certified behavior analysts with a series of behavioral graphs. The participants were asked to answer questions similar to those posed in previous studies but were also asked to talk aloud as they viewed each graph. Results indicate that the participants made accurate decisions for only 72% of the graphs and that celeration lines did not improve overall accuracy. The verbal protocol analysis suggests that participants were as likely to attend to trend when celeration lines were absent as they were when they were present, with the most differences attributable to varying participant competencies and not graph (i.e., celeration line) characteristics.

Spanish Version of the Savings Inventory-Revised: Adaptation, Psychometric Properties, and Relationship to Personality Variables.

Abstract: The factor structure, psychometric properties, and relationship with personality variables of a Spanish version of the Savings Inventory-Revised (SI-R) are investigated in a sample of 381 undergraduate students. A maximum likelihood factor analysis suggests a three-factor structure, which is similar but not identical to that of the original English version. The three factors mirror the three hypothesized domains of compulsive hoarding: acquisition, difficulty discarding, and clutter. The Spanish SI-R demonstrates acceptable high internal consistency and test-retest reliability, but its divergent validity is weaker than expected because of a significant overlap with depressive symptoms. Different SI-R factors are associated with different personality traits: Whereas the difficulty discarding dimension is predominantly associated with susceptibility to punishment, the acquisition dimension is predominantly associated with susceptibility to reward. The authors conclude that the Spanish SI-R is a promising instrument to measure hoarding symptoms.

Classroom intervention for illness-related problem behavior in children with developmental disabilities.

Abstract: There is growing evidence of an association between physical illness and problem behavior in children with developmental disabilities. Such behavior can compromise school performance. Therefore, the purpose of the present study was to evaluate, using a group design, the effectiveness of medical intervention alone (N = 11) versus behavioral plus medical intervention (N = 10) for illness-related problem behavior in a school setting. Following intervention, the behavioral plus medical intervention group showed lower levels of problem behavior and completed more academic tasks than did the medical intervention alone group. The results are discussed with respect to the concept of illness and pain as a setting event for problem behavior. The need for research to develop algorithms that allow one to select the best combination of medical and behavioral interventions for specific illnesses and contexts is noted.

The Semistructured Interview for Consideration of Ethnic Culture in Therapy Scale: Initial Psychometric and Outcome Support.

Abstract: There has been recent pressure for practitioners to consider cultural variables when implementing evidence-based interventions. Therefore, the Semistructured Interview for Consideration of Ethnic C...

Microswitch clusters promote adaptive responses and reduce finger mouthing in a boy with multiple disabilities

Abstract: The authors assessed new microswitch clusters (i.e., combinations of two microswitches) and contingent stimulation to increase adaptive responses (i.e., foot and head movements) and reduce aberrant behavior (i.e., finger mouthing)in a boy with multiple disabilities. Initially, intervention was directed at increasing the frequency of each adaptive response, individually, through contingent use of preferred stimuli. Subsequently, adaptive responses led to preferred stimuli only if they occurred in the absence of finger mouthing. Postintervention checks occurred 1, 2, and 3 months after the end of the intervention. Data showed that the boy (a) increased the frequency of the adaptive responses extensively, (b) learned to perform these responses largely free from finger mouthing, and (c) maintained these changes over time. The importance of microswitch clusters to simultaneously pursue the dual objective of promoting adaptive responses and reducing aberrant ones is underlined.

Reducing pica by teaching children to exchange inedible items for edibles.

Abstract: Assessment results indicated that pica exhibited by two boys with developmental disabilitieswas not associated with environmental contingencies. Consistent with previous research, an oral stimulation function was hypothesized. A related intervention that taught participants to exchange inedible items for edibles was developed. Findings showed that the intervention resulted in reductions in pica for both participants. When the interventionwas introduced across settings, reductions in pica were observed for one participant. However, additional training with alternative pica itemswas necessary to produce reductions in pica across settings with the second participant. Reductions in pica were maintained as the intervention was systematically thinned.