一例唐氏综合征儿童课堂退缩行为的个案研究

目的:探讨行为改变技术对克服课堂退缩行为问题的可行性。方法:采用促进、代币治疗、差别强化等行为改变技术对一例唐氏综合征患儿的课堂退缩行为进行干预。结果:干预期、追踪期个案的问题行为日平均发生次数显著低于基线期(χ2=5.556,P<0.025,χ2=11.267,P<0.005),干预期和追踪期差异不显著。结论:行为改变技术可明显降低个案的问题行为次数且追踪效果理想,干预方法值得特教工作者及家长借鉴。     

行为契约法促进小学生课堂学业自立行为发展的个案研究

目的：探讨行为契约法对小学生课堂学业自立行为的干预效果。方法：采用单被试A-B实验设计对两名小学生的课堂学业自立行为进行干预，在基线期、干预期和追踪期综合运用观察法、访谈法、问卷法等多种方法对其课堂学业自立行为进行评估。结果：两名被试在干预期和追踪期的课堂学业自立水平均高于基线期，课堂学业自立水平均有所提升。结论：行为契约法能有效提升小学生课堂学业自立水平，且干预效果可持续一定时间。     

1例大学生抑郁焦虑认知行为治疗的个案概念化报告

目的:探讨认知行为治疗技术对于大学生抑郁焦虑个案的干预效果，以及个案概念化对个案干预的重要指导作用。方法:以1例抑郁焦虑状态大学生为对象，利用认知行为技术对其进行为期15周共15次的咨询。通过思维情绪记录练习、箭头向下技术的使用、三级信念的挖掘(自动思维、中间信念、核心信念)对个案进行概念化。采用贝克抑郁量表、贝克焦虑量表、主观困扰程度量表进行基线和干预后评估。结果:干预后来访者抑郁状态从“中度抑郁”变为“轻度抑郁”,焦虑状态从“存在焦虑”变为“不存在焦虑”,主观困扰程度评分总体呈降低趋势。来访者自动思维改善，核心信念松动，社会功能提升。结论:认知行为疗法能显著改善大学生抑郁焦虑状态，且个案概念化能够有效指导和促进个案干预。     

依恋游戏促进小班幼儿社会自立-社交行为发展的个案研究

目的：探究依恋游戏对小班幼儿社会自立-社交行为的干预效果。方法：采用单被试A-B基线实验设计，综合访谈法、观察法及问卷法对三名小班幼儿在基线期（1～4周）、干预期（5～12周）、追踪期（13～14周）的社会自立-社交行为进行评估。结果：两名幼儿在干预期和追踪期的社会自立-社交行为水平高于基线期水平，一名幼儿的社会自立-社交行为水平因家长未按游戏设计要求充分投入和配合以及因家长专制型教养方式的影响无明显提高。结论：依恋游戏可以有效促进小班幼儿社会自立-社交行为的发展。     

代币制增进注意缺陷多动障碍学童注意力的个案研究

目的通过代币制行为矫正法能有效降低注意缺陷多动障碍学童在课堂上的不注意行为的发生率。方法采用A-B-A倒反实验设计,应用代币制行为矫正法(Token Economy Therapy)对一名患有注意缺陷多动障碍的9岁学童的课堂不注意行为进行矫正干预。结果1被试在实验处理期的课堂不注意行为发生率均低于基线期和实验撤退期的课堂不注意行为发生率。2被试在整个实验过程中课堂不注意行为的发生率与对照者的不注意行为发生率进行比较,前者在3个阶段都有很大变化,而后者基本没有变化。结论代币制行为矫正法在改进注意缺陷多动学童的课堂不注意行为方面是一种有效的方法。     

行为契约法改善小学生学业拖延的个案研究

目的:探讨行为契约法对小学生学业拖延的干预效果。方法:单个被试实验设计,用行为契约法对一名小学生的学业拖延进行干预,采用A-B基线设计,分为基线期(1-6天)、干预期(7-26天)和追踪期(27-33天)三个阶段,并综合观察法、访谈法和问卷法等多种方法对学业拖延进行评估。结果:行为契约法的干预使个案的学业拖延水平有所降低,个案在干预期、追踪期出现学业拖延的频次均低于基线期。结论:行为契约法对改善小学生的学业拖延是有效的,且这一效果具有保持的作用。     

大学生强迫行为的临床技术干预与效果分析

目的探讨大学生强迫行为的心理机制及其干预方法,为强迫症的临床治疗提供借鉴。方法采用多基线个案实验研究设计,采用观察法、访谈法、认知疗法及行为疗法中的放松训练,并结合元认知行为干预技术中情感组织者技术对一名患有强迫症的来访者进行个案实验研究。结果治疗前耶鲁布朗量表评分为28分。在没有使用任何辅助药物的情况下,通过6天共6次放松训练,治疗后评分为8分,病人强迫行为已经基本消除。结论元认知行为干预技术治疗强迫行为临床效果显著,适合于普遍推广和使用。     

心理行为干预与卵巢癌患者T淋巴细胞亚群的动态变化

目的：探讨心理行为干预对卵巢癌患者T淋巴细胞亚群功能影响的动态变化，并进一步探讨心理干预的最佳时间。方法：运用病例对照实验设计，对62例卵巢癌患者进行比较研究。用免疫组化碱性磷酸酶桥联酶标法（APAAP）测定心理行为干预前及心理行为干预后一个月、二个月、三个月的T淋巴细胞亚群CD3^＋、CD4^＋,CD8^＋,CD4^＋／CD8^＋数值的动态变化。结果：心理行为干预一个月后CD3^＋、CD4^＋有显著性提高；干预2个月后各免疫参数均有显著变化，且干预2个月与3个月相比各免疫参数变化不明显。干预组与对照组相比，不同时间点的各种免疫参数有显著性差异（P〈0．05），干预与时间点见明显的交互作用（P〈0．05），除CD8^＋（P〉0．05）外，两组患者各免疫参数存在显著性差异。结论：心理行为干预可以提高卵巢癌患者T淋巴细胞亚群的免疫功能，且干预2个月后患者免疫功能维持在较高水平。     

行为问题儿童的智力水平配对研究

目的：探讨行为问题儿童的智力水平及特征。方法：采用Achenbach儿童行为问卷（CBCL）（父母问卷）和中国联合型瑞文测验第二版（CRT－C2）在小学1－5年级学龄儿童中筛选行为问题儿童。从同性别非行为问题儿童中选择与问题儿童年龄最接近的儿童组成对照组，配对比例为1：2。采用韦氏儿童智力量表（WISC－CR）测验儿童智力水平。结果：（1）行为问题儿童的IQ基本在正常范围，与对照组水平接近。译码是儿童行为问题的保护因素，智力不平衡是危险因素。（2）智力不平衡是内向行为问题的危险因素；CRT－C2IQ是外向行为问题的保护因素；译码是混合问题的保护因素。结论：行为问题儿童虽然智力发育在正常水平，但智力不平衡者较多，提示行为问题儿童半球功能不平衡，有脑功能损伤的可能。     

简短认知行为压力管理对结直肠癌患者益处发现及生活质量的影响

目的：探究简短认知行为压力管理用于促进结直肠癌患者益处发现和生活质量的可行性及效果。方法：招募80例结直肠癌患者,随机分为干预组（40例,完成38例）和对照组（40例,完成36例）。对照组给予常规治疗护理及心理健康教育,干预组在对照组的基础上给予简短认知行为压力管理干预（共5次课程,每周1次,每次约120分钟。其中压力管理90分钟,放松训练30分钟）,在干预前后采用益处发现量表中文版和肿瘤生存质量测定量表对两组进行测评。结果：干预前,两组的益处发现总分、各维度评分及生活质量的各维度评分差异均无统计学意义（P>0.05）;干预后,干预组益处发现总分及接受、家庭关系、世界观、个人成长、社会关系和健康行为各维度的评分均高于干预前,且与对照组比较,除社会关系维度评分外,差异均有统计学意义（P<0.05）;干预组生活质量的躯体功能、角色功能、情绪功能、社会功能和认知功能各维度评分均高于干预前,且与对照组比较,差异均有统计学意义（P<0.05）。结论：简短的认知行为压力管理干预是可行的,可提高结直肠癌患者的益处发现水平,改善其生活质量。     

The Effects of Stimulant Medication and Training on Sports Competence Among Children With ADHD

The current study examined the relative efficacy of behavioral sports training, medication, and their combination in improving sports competence among youth with attention deficit/hyperactivity disorder (ADHD). Participants were 73 youth (74% male; 81% Hispanic) between the ages of 5 and 12 diagnosed with Diagnostic and Statistical Manual of Mental Disorders (4th ed.) ADHD enrolled in a Summer Treatment Program (STP). The study consisted of a 2 (medication: methylphenidate, placebo) × 2 (sports training: instruction and practice, recreational play) between-groups design and was conducted over a 3-week period during the STP. Sports training was conducted with a novel sport, badminton, to limit previous sport knowledge and to differentiate it from concurrent sports training that occurred within the STP. Objective and subjective measures of sports skills, knowledge, and behavior were collected. Results indicated that, relative to recreational play, brief sports training improved observed and counselor-rated measures of sports competence including sports skills, knowledge, game awareness, effort, frustration, and enjoyment. During sports training, medication incrementally improved children’s observed rule following behavior and counselor-rated sportsmanship relative to placebo. In the absence of sports training, medication improved behavior, effort, and sport knowledge. Training in sports skills and rules produced the largest magnitude effects on sports-related outcomes. Therefore, skills training, rather than medication alone, should be used in conjunction with behavioral intervention to teach sports to youth with ADHD. It is recommended that medication be used only as an adjunct to highly structured sports skills training for youth who display high rates of negative behavior during sports activities.     

Social skills training with mildly retarded young adults

Described a social skills assessment and training model for use with mildly retarded young adults (N = 20). The assessment procedure examined social behavior in three types of social situations (e. g., conversational situation, cooperative task and assertive situation) with both male and female respondents. Group behavioral social skills training was compared with a no treatment control condition using various dependent measures collected in the in-vivo social situations. Group behavioral social skills trining was more effective than the control condition in increasing positive social behavior, attention to the transaction, and degree of empathy. It was also more effective than a control condition in decreasing negative social skill behavior. A situation effect also was observed, which suggests a need for more focus on particular social skills and a need to address issues of generalization. A comprehensive social skills assessment and training model is discussed.     

Genetic selection for avoidance behavior in the rat

Long-Evans rats were selectively bred for over 20 generations using two behavioral criteria: (1) limited responding to the warning signal during ten pretest trials and (2) either good or poor avoidance behavior during 60 avoidance training trials in a two-way shuttlebox. The results suggest that avoidance behavior in the rat is a heritable characteristic that may be selected independently of activity level.This research was supported in part by Research Grant MH-14350, Research Scientist Development Award MH-38660 (F. R. B.), and Training Grant GM-01495 from the National Institutes of Health, by a Research Grant from the Senate Research Committee, Syracuse University, and by the Experimental Psychology Laboratory, Department of Psychology, Syracuse University.     

The effectiveness of EEG-feedback on attention,impulsivity and EEG: A sham feedback controlled study

EEG-feedback, also called neurofeedback, is a training procedure aimed at altering brain activity, and is used as a treatment for disorders like Attention Deficit/Hyperactivity Disorder (ADHD). Studies have reported positive effects of neurofeedback on attention and other dependent variables. However, double-blind studies including a sham neurofeedback control group are lacking. The inclusion of such group is crucial to control for unspecific effects. The current work presents a sham-controlled, double-blind evaluation. The hypothesis was that neurofeedback enhances attention and decreases impulsive behavior. Participants (n = 27) were students selected on relatively high scores on impulsivity/inattention questionnaires (Barrat Impulsivity Scale and Broadbent CFQ). They were assigned to a neurofeedback treatment or a sham group. (sham)Neurofeedback training was planned for 15 weeks consisting of a total of 30 sessions, each lasting 22 min. Before and after 16 sessions (i.e., interim analyses), qEEG was recorded and impulsivity and inattention was assessed using a stop signal task and reversed continuous performance task and two questionnaires. Results of the interim analyses showed that participants were blind with respect to group inclusion, but no trend towards an effect of neurofeedback on behavioral measures was observed. Therefore in line with ethical guidelines the experiment was ceased. These results implicate a possible lack of effect of neurofeedback when one accounts for non-specific effects. However, the specific form of feedback and application of the sham-controlled double-blind design may have diminished the effect of neurofeedback.     

The effects of a behavioral approach on modifying social behavior in incarcerated male delinquents

Investigated the effects of increasing the emission of Positive Attention Behaviors (PABs) on the social behavior of 30 incarcerated male delinquents, divided in an attention/control and an experimental group. Groups were subdivided further into dominant behavioral pattern (passive, middle, and aggressive). PABs were measured during a 2-week baseline period, followed by 2 weeks of behavioral training for experimentals, then three 2-week followups. Results indicated the effectiveness of behavioral training for significantly increasing and maintaining the emission of PABs.     

A primary preventive approach to children's drug refusal behavior: the impact of rehearsal-plus

The effectiveness of a short-term prevention program to increase drug refusal behavior in a school-age population was assessed. Forty-two third-grade children were randomly assigned to one of three groups: rehearsal-plus, traditional, or attention control. Children in the rehearsal-plus group were taught specific drug refusal techniques and appropriate social skills, and were provided a rationale for each response. This procedure included behavioral training and elaborative rehearsal. Training occurred in four socially validated situations corresponding to settings where children were likely to be offered drugs. The traditional procedure consisted of instructions derived from a "Just Say No" drug program. Assessment focused on specific refusal behaviors, procedural knowledge, and self-efficacy. Significant gains in desired functioning and appropriate behavioral and social skills were found. The effectiveness of the rehearsal-plus procedure as a method of increasing adaptive responding in dangerous and/or anxiety-arousing situations is discussed.     

Executive Functioning in Hyperactive Children as Young Adults: Attention,Inhibition, Response Perseveration,and the Impact of Comorbidity

Tests of several executive functions (EFs) as well as direct observations of symptoms of attention deficit hyperactivity disorder (ADHD) during testing were collected at the young adult follow-up (M = 20 years) on a large sample of hyperactive (H; N = 147) and community control (CC; N = 71) children. The EF tasks included tests of attention, inhibition, and response perseveration. The H group was subdivided into those with and without ADHD (+ or w/o) at follow-up. The H+ADHD group made significantly more inhibition errors than the CC group on a Continuous Performance Test (CPT) and showed more ADHD symptoms while performing the CPT. The H+ADHD group also displayed more ADHD symptoms during a letter cancellation task than did both the hyperactive w/o ADHD and CC groups. Both H groups showed slower reaction times during a Card Playing Task. That subset of hyperactive probands with Conduct Disorder (CD) displayed significantly more perseverative responding on that task than did those without CD, but otherwise it did not differ on any other measures. Current level of anxiety contributed adversely to both CPT commission errors and ADHD behavior during the CPT. Comorbid depression did not contribute to any group differences on these tests. Although developmental improvements were found in both the H and the CC groups in their CPT inattention and inhibition scores since adolescence, the H groups remained distinguishable from the CC groups over this period. We conclude that formerly hyperactive children manifest greater EF deficits at follow-up in the areas of inattention, disinhibition, and slowed reaction time and greater ADHD behavior during testing, but these problems are mostly confined to those with current ADHD. Response perseveration, however, was limited to those hyperactive children with CD by follow-up, consistent with Quay's theory of these two disorders.     

Executive functioning in hyperactive children as young adults: attention, inhibition, response perseveration, and the impact of comorbidity

Tests of several executive functions (EFs) as well as direct observations of symptoms of attention deficit hyperactivity disorder (ADHD) during testing were collected at the young adult follow-up (M = 20 years) on a large sample of hyperactive (H; N = 147) and community control (CC; N = 71) children. The EF tasks included tests of attention, inhibition, and response perseveration. The H group was subdivided into those with and without ADHD (+ or w/o) at follow-up. The H+ADHD group made significantly more inhibition errors than the CC group on a Continuous Performance Test (CPT) and showed more ADHD symptoms while performing the CPT. The H+ADHD group also displayed more ADHD symptoms during a letter cancellation task than did both the hyperactive w/o ADHD and CC groups. Both H groups showed slower reaction times during a Card Playing Task. That subset of hyperactive probands with Conduct Disorder (CD) displayed significantly more perseverative responding on that task than did those without CD, but otherwise it did not differ on any other measures. Current level of anxiety contributed adversely to both CPT commission errors and ADHD behavior during the CPT. Comorbid depression did not contribute to any group differences on these tests. Although developmental improvements were found in both the H and the CC groups in their CPT inattention and inhibition scores since adolescence, the H groups remained distinguishable from the CC groups over this period. We conclude that formerly hyperactive children manifest greater EF deficits at follow-up in the areas of inattention, disinhibition, and slowed reaction time and greater ADHD behavior during testing, but these problems are mostly confined to those with current ADHD. Response perseveration, however, was limited to those hyperactive children with CD by follow-up, consistent with Quay's theory of these two disorders.     

Problem-solving treatment in general practice residency: A focus group study of registrars’ views

Objective

General practitioner (GP) registrars often express the need for more expertise of non-pharmacological treatments for patients with mental health problems. Problem-solving treatment (PST) could be an attractive option. We aimed to explore GP registrars’ views on PST-training during residency and on the actual use of PST in general practice.

Methods

We performed a qualitative study with four focus groups, interviewing 18 Dutch registrars who had been trained in PST during residency. Data were analysed according to the principles of constant comparative analysis.

Results

Registrars thought that PST-training during residency was feasible, interesting and helpful, but found that it took too much time in everyday practice and was not a GP's task. All registrars, however, said they would use specific elements in a variety of consultations, for instance concretising problems, brainstorming about practical solutions, and activating patients.

Conclusion

Registrars regarded PST-training during residency feasible and helpful. In daily practice they would apply specific elements of the treatment.

Practice implications

We recommend residency programmes to offer training in PST or another psychological treatment with comparable elements. Training should fit in with the registrars’ needs and level of training and experience.