Behavior Modification

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The Influence of Depression on the Progression of HIV: Direct and Indirect Effects

Wed, 2012-02-15 00:27

The authors suggest a theoretical model of pathways of HIV progression, with a focus on the contributions of depression—as well as secondary, behavioral and emotional variables. Literature was reviewed regarding (a) comorbid depression and the direct physiological effects on HIV progression and (b) intermediary factors between HIV and disease progression. Intermediary factors included (a) substance use, (b) social support, (c) hopelessness, (d) medication nonadherence, and (e) risky sexual behavior and the contraction of secondary infections. The authors suggest direct physiological pathways from depression to HIV progression and indirect pathways (e.g., behavioral, social, and psychological). In addition to depression, substance use, poor social support, hopelessness, medication nonadherence, and risky sexual behavior seem to be integral in HIV progression. Based on the individual relationships of these variables to depression and HIV progression, a comprehensive multipath model, incorporating all factors, serves to explain how severe emotional distress may lead to accelerated progression to AIDS.

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Vocal Stereotypy in Individuals With Autism Spectrum Disorders: A Review of Behavioral Interventions

Wed, 2012-02-15 00:27

Vocal stereotypy is a common problem behavior in individuals with autism spectrum disorders that may interfere considerably with learning and social inclusion. To assist clinicians in treating the behavior and to guide researchers in identifying gaps in the research literature, the authors provide an overview of research on vocal stereotypy in individuals with autism spectrum disorders. Specifically, the authors review the research literature on behavioral interventions to reduce engagement in vocal stereotypy with an emphasis on the applicability of the procedures in the natural environment and discuss the clinical implications and limitations of research conducted to date. Researchers have shown that several antecedent-based and consequence-based interventions may be effective at reducing vocal stereotypy. However, the review suggests that more research is needed to assist clinicians in initially selecting interventions most likely to produce desirable changes in vocal stereotypy and collateral behavior in specific circumstances.

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Long-Term Effects of Brief Acceptance and Commitment Therapy for Psychosis

Wed, 2012-02-15 00:27

A previous report explored the impact of a brief (four session) acceptance and commitment therapy (ACT) intervention as compared with treatment as usual (TAU) on rehospitalization over 4 months in a sample of 80 inpatients with psychosis. The present study extended the follow-up period to 1 year and used a more sophisticated survival analysis to take previous hospitalization and length of the current hospitalization into account. Those in the ACT condition showed reduced hospitalization as compared to those in TAU at 4 months post discharge and again at 1 year post discharge. A test of proportionality of hazard showed that survival curves continued to diverge in the 5- to 12-month postdischarge period after adjusting for differences in the 0 to 4 month period. Future directions are discussed.

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An Evaluation of the Effects of Experimenter Control of Objects on Individuals' Engagement in Object Stereotypy

Wed, 2012-02-15 00:27

In two experiments, the authors evaluated the extent to which (a) individuals preferred engaging in object stereotypy versus observing an experimenter while the experimenter engaged in object stereotypy and (b) an experimenter’s engagement in object stereotypy decreased the participants’ engagement in object stereotypy. Results of Experiment 1 indicated that behaver-controlled (BC) object stereotypy was preferred over experimenter-controlled (EC) object stereotypy by three of four participants. Results of Experiment 2 indicated that EC object stereotypy decreased object stereotypy for only one of three participants. Implications of these findings for determining the relative importance of control over stimulation generated by stereotypy are briefly discussed.

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A Pilot Study Examining the Initial Effectiveness of a Brief Acceptance-Based Behavior Therapy for Modifying Diet and Physical Activity Among Cardiac Patients

Wed, 2012-02-15 00:27

Approximately 90% of cardiac events are attributable to a small number of modifiable behavioral risk factors that, if changed, can greatly decrease morbidity and mortality. However, few at-risk individuals make recommended behavioral changes, including those who receive formal interventions designed to facilitate healthy behavior. Given evidence for the potential of specific psychological factors inherent in acceptance-based behavior therapy (ABBT; that is, intolerance of discomfort, mindfulness, and values clarity) to impact health behavior change, the authors evaluated the feasibility and initial effectiveness of an ABBT pilot program designed to increase adherence to behavioral recommendations among cardiac patients. Participants (N = 16) were enrolled in four, 90-min group sessions focused on developing mindfulness and distress tolerance skills, and strengthening commitment to health-related behavior change. Participants reported high treatment satisfaction and comprehension and made positive changes in diet and physical activity. This was the first evaluation of an ABBT program aimed at increasing heart-healthy behaviors among cardiac patients.

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Comparing the Effectiveness of Error-Correction Strategies in Discrete Trial Training

Wed, 2012-02-15 00:27

Error-correction strategies are essential considerations for behavior analysts implementing discrete trial training with children with autism. The research literature, however, is still lacking in the number of studies that compare and evaluate error-correction procedures. The purpose of this study was to compare two error-correction strategies: Independent Probe and Delay across learners with autism in an intensive intervention program. Two studies were conducted. The first study compared the two procedures across receptive tasks for 3 individuals, and differential effects were seen across learners. The second study compared the two procedures across tact trials with two of the same learners and found that individual differences were noted, but in addition, the more effective error-correction strategy was consistent across the two verbal operants (i.e., receptive in Study 1, tacts in Study 2). These combined studies suggest the effectiveness of error-correction strategies may be individualized to the learner but may generalize across operants.

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Virtual Reality Cognitive-Behavior Therapy for Public Speaking Anxiety: One-Year Follow-Up

Wed, 2012-02-15 00:27

Public speaking anxiety (PSA) is a common social phobia. Although cognitive-behavior therapy (CBT) is the treatment of choice, difficulties arise with both in vivo and in vitro exposure (lack of therapist control, patient’s inability to imagine, self-flooding, and a lack of confidentiality resulting from public exposure). Virtual reality CBT (VRCBT) enables a high degree of therapist control, thus overcoming these difficulties. In a previous publication, the authors reported on their findings that VRCBT (n = 28) and CBT (n = 30) groups were significantly more effective than a wait-list control (WLC; n = 30) group in anxiety reduction on four of five anxiety measures as well as on participant’s self-rating of anxiety during a behavioral task. No significant differences were found between VRCBT and CBT. However, twice as many clients dropped out of CBT (15) than from VRCBT (6). Results demonstrated that VRCBT is an effective and brief treatment regimen, equal to CBT. This brief report examined durability of these changes. They found that both VRCBT (25) and CBT (24) groups maintained their improvement from post treatment to follow-up, on all five measures. In addition, they found that the CBT group continued to improve from post treatment to follow-up on Liebowitz Social Anxiety Scale (LSAS) fear. Thus, treatment gains were maintained at a 1-year follow-up.

Categories: Journals