In search of the true amok: amok as viewed with the Malay culture.

In an attempt to discover how the phenomenon of amok is viewed within its indigenous culture, the authors studied and interviewed 21 subjects in West Malaysia who were labeled as amok. This investigation showed that both the subjects and the Malay culture view amok as psychopathology, that amok cases are disposed of in line with this view, and that the behavior of the amok person conforms to social expectations of the phenomenon. Despite cultural proscriptions, however, the act is purposive and motivated and is subtly sanctioned by Malay society.

Competing responses for the treatment of Tourette syndrome and tic disorders.

A brief history of the competing response practice treatment for motor and phonic tic reduction is presented, as well as a basic explanation of the procedure. A table defining the competing responses of various tics that have been systematically studied over the past twenty years is also presented. This table is designed to be a reference tool for clinicians and researchers in the treatment of Tourette syndrome and tic disorders.

A brief behavior therapy protocol for Tourette syndrome.

The purpose of this study was to examine the efficacy of a brief behavior therapy protocol for Tourette Syndrome. The nasal tic frequency of a 9-year-old male was assessed using a nine-session protocol with alternating treatments and reversal-design components. The results indicated that the participant's tics were reduced by approximately 70%. The behavior change was successfully maintained at a one-month follow-up. Social validity and consumer satisfaction measures confirmed the social significance of the behavior change.

Recent advances in the assessment of aberrant behavior maintained by automatic reinforcement in individuals with developmental disabilities.

Many aberrant behaviors exhibited by individuals with developmental disabilities are maintained by "automatic reinforcement". These behaviors are often difficult to treat, with the most effective behavioral interventions often resulting in only moderate success. However, a series of recent studies has advanced our ability to understand and treat these behaviors through the innovative use of behavioral assessment. We review the recent development of three categories of assessments: (a) nonhypothesis-based stimulus preference assessments, (b) hypothesis-based stimulus preference assessments, and (c) hypothesis-based assessments incorporating noncontingent reinforcement and sensory extinction procedures. We consider each category's contribution to both our ability to prescribe effective behavioral interventions and our ability to more fully understand the concept of automatic reinforcement.

Overview of the treatment of rumination disorder for adults in a residential setting.

Rumination, or the chewing and re-swallowing of regurgitated stomach contents, can be found in up to 10% of institutionalized individuals with severe or profound mental retardation. Serious physical consequences, including death, can result from the disorder. Unfortunately, rumination can be subtle and difficult to observe and often continues untreated. Additionally, the research literature has provided divergent results without clear treatment guidance for clinicians. We present an overview of the history of rumination, a review of the literature on its etiology and treatment, and recommendations for future research.

The standard deviation as an informative measure of variability in reporting interobserver agreement means.

The range is the measure of variability typically presented with the means of interobserver agreement scores of behavioral data. However, the range by itself yields little information about the individual interobserver agreement scores before they were averaged. The standard deviation, on the other hand, is a measure of variability that provides the researcher and reader with information regarding the dispersion of scores, allowing a more thorough interpretation of the interobserver agreement mean. The case is presented for the adoption of the standard deviation as an adjunct to the range in reporting the mean of interobserver agreement scores.

A functional-analytic approach to the diagnosis of a transient tic disorder.

The diagnostic utility of functional analyses has been demonstrated with a variety of behaviors including tics. Whereas previous analyses have focused on the discovery of maintaining variables to aid in treatment prescription, we employed a functional analysis to confirm a clinical diagnosis. An 11 year old male student, who had not been previously diagnosed with a tic disorder, exhibited multiple vocal tic-like behaviors which had persisted over a period of time. Teacher reports conflicted regarding the possible etiology of these behaviors. Hence, a functional analysis was conducted in the classroom to determine if the behaviors were maintained by operant variables. Our hypothesis stated that the occurrence of vocal behaviors across experimental conditions would strongly indicate the presence of a tic disorder. The functional analysis included the following conditions: attention, escape, alone, freeplay, and high sensory stimulation. We used a multi-element design to evaluate the effects of the different stimulus conditions on vocal-behavior frequency. Data indicated the student exhibited vocal behaviors in all conditions. However, the behaviors were partially exacerbated in the attention and escape conditions. Results supported the diagnosis of a transient tic disorder affected by operant variables.

Using real-time recording to enhance the analysis of within-session functional analysis data.

Functional analysis methods have become standard practice for determining the maintaining variables of problem behavior. The analysis of within-session response patterns has been proposed as a useful adjunct to the functional analysis. Many within-session analyses have been conducted on data obtained from interval scoring methods. However, interval methods only provide an estimate of within-session data. The authors briefly describe a real-time recording method and provide a rationale for its use. The authors then provide descriptions of several research studies from their lab in which real-time data were crucial in determining behavioral function from experimental analyses.

The effects of pictorial versus tangible stimuli in stimulus-preference assessments.

Recent research in the area of stimulus-preference assessment has progressively improved the accuracy and efficiency of this technology for predicting reinforcer potency. One way to potentially improve the efficiency of the procedure might be to use pictorial representations of stimuli in the assessment rather than the stimuli themselves. To determine the feasibility of using pictorial stimuli in preference assessments, multiple-stimulus preference assessments were conducted with two adults diagnosed with mental retardation using both tangible stimuli and pictorial cards representing these same stimuli. The tangibles stimulus assessment produced greater variations in selection percentages than the pictorial assessment. Subsequent reinforcer assessments confirmed that stimuli predicted by the tangibles assessment were more potent reinforcers than those predicted by the pictorial assessment. The results are discussed in the context of improving stimulus-preference assessment technology.

Further evaluation of the multiple-stimulus preference assessment.

Previously researchers have shown that multiple-stimulus preference assessments can produce results comparable to those achieved using the paired-stimulus presentation format. However, extensive experimental validation of this procedure has not yet been accomplished. The purpose of this study was to provide a systematic extension of a study reported by DeLeon and Iwata (1996). We conducted brief stimulus preference assessments with nine participants diagnosed with severe or profound mental retardation. The highest ranked stimuli were then delivered contingent on a target behavior in a multielement format. The stimulus identified as most highly preferred functioned as a reinforcer in six of the nine participants. The results of this study are discussed in the context of current stimulus preference assessment findings.

A variation of noncontingent reinforcement in the treatment of aberrant behavior.

We examined the effectiveness of a variation of noncontingent reinforcement (NCR) that incorporated a stimulus-delay procedure in the reduction of aberrant behavior maintained by positive reinforcement. Functional analyses for three individuals diagnosed with developmental disabilities indicated that their behaviors were maintained by positive reinforcement: one in the form of access to a tangible item, another by attention, and the third by physical contact. We implemented NCR with the delay procedure with two participants using reversal designs to evaluate effects. We also compared this NCR variation and DRO with the third participant to evaluate reinforcer-delivery rates. The variation of NCR was successful in reducing all aberrant behavior to near-zero levels. A comparison of reinforcer delivery between NCR with the stimulus-delay procedure and DRO demonstrated that the participant accessed more reinforcement with NCR. Results are discussed in the context of enhancing decelerative interventions with emphases on minimizing response effort for caregivers and maximizing access to reinforcement for the individuals.

Functional analysis of aberrant behavior maintained by automatic reinforcement: assessments of specific sensory reinforcers.

The purpose of this study was to develop a systematic functional assessment package for aberrant behaviors maintained by nonsocial (automatic) reinforcement. The assessment package included four components: (1) functional analysis, (2) antecedent assessment of specific automatic reinforcement sources, (3) stimulus preference assessment, and (4) treatment evaluation. Functional analysis data indicated automatic reinforcement functions of the stereotypy exhibited by a 10-year-old male and the self-injury (SIB) exhibited by a 30-year-old male. Antecedent assessments of sensory classes indicated that auditory stimulation and tactile stimulation were associated with stereotypy and SIB, respectively. A multiple-stimulus-without-replacement procedure was conducted with each participant to identify the most- and least-preferred stimuli within the identified sensory classes. In an attempt to validate the assessment package for each participant, a DRO procedure was implemented using a reversal design with a multielement component. DRO procedures using stimuli within the targeted sensory classes were successful in eliminating the aberrant behaviors of both participants. The results are discussed in the context of improving the methodology for assessing and treating automatically reinforced behaviors.

A review of "noncontingent" reinforcement as treatment for the aberrant behavior of individuals with developmental disabilities.

The term noncontingent reinforcement (NCR) refers to the delivery of an aberrant behavior's known reinforcer on a response-independent basis. The typical result is a decrease in responding from baseline (i.e., reinforcement) levels. NCR has become one of the most reported function-based treatments for aberrant behavior in the recent literature. The purpose of this review is to briefly discuss the history of the procedure and summarize the findings from the treatment research literature. The review is organized into the following sections: (a) basic research on NCR, (b) NCR as a control procedure, (c) NCR as a function-based treatment, (d) considerations in the programming of NCR schedules, (e) behavior-change mechanisms underlying NCR effects, and (t) directions for future research.

Behavior therapy and the treatment of flight phobia.

Research since 1960 was reviewed to compare the relative efficacy of behavior therapy and other therapy modalities in the treatment of flight phobias in trained military aircrew, commercial flight crews, and civilian air travellers. Results indicated that treatment programs involving behavior therapy techniques appeared to have a higher success rate than treatment programs not involving these techniques, especially in cases of focal fear with acute onset under stressful conditions. Other conditions for optimal outcome are outlined and hypotheses for a more programmatic research effort discussed.

The role of cognitive process in social interaction.

This paper reports on a series of studies designed to investigate the hypothesis that the success of a social interaction is function of the compatibility among the participants in complexity or degree of differentiation of their cognitive structure. Patient-therapist cognitive compatibility is shown to predict the success of treatment outcome. Its role in the teacher-student relationship in mental health training is more complex: the teacher's cognitive structure appearing to be a primary variable. In community action groups, cognitive compatibility determines the nature and type of decisions or behaviors carried out by the group. The resarch emphasizes the need for increased familiarity with cognitive research among social psychiatrists.

On the displacement of leisure items by food during multiple-stimulus preference assessments.

Previous studies have demonstrated that when food and leisure stimuli are combined in multiple-stimulus preference assessments, individuals typically select food more often, although the leisure stimuli also have known reinforcing properties. The purpose of the current study was to replicate this effect and determine its durability by examining the effect after mealtimes. Four adults who had been diagnosed with severe mental retardation were given three initial multiple-stimulus (without replacement) preference assessments (i.e., food, leisure stimuli, and combined). All participants selected food items as the most preferred stimuli in the combined assessments. Combined assessments were then administered immediately before and after the evening meal for each participant for 1 week. The results showed similar data both before and after mealtimes.

The reductive effects of noncontingent reinforcement fixed-time versus variable-time schedules.

The effects of fixed-time (FT) and variable-time (VT) schedules on responding were evaluated with 2 adults with mental retardation. Multielement and reversal designs were used to compare the effects of FT and VT schedules in reducing responses previously maintained on variable-ratio reinforcement schedules. The schedules were equally effective in reducing the target behavior.

Evaluation of a brief multiple-stimulus preference assessment in a naturalistic context.

We evaluated a brief multiple-stimulus preference assessment within the context of an early intervention program for 3 children who had been diagnosed with autism. Subsequent curriculum-based reinforcer evaluations confirmed the predictions of the preference assessments. In addition, eight additional preference assessments that were conducted over a period of 1 month indicated generally stable preferences for 2 of the 3 participants.

On the effects of noncontingent delivery of differing magnitudes of reinforcement.

We conducted a parametric analysis of response suppression associated with different magnitudes of noncontingent reinforcement (NCR). Participants were 5 adults with severe or profound mental retardation who engaged in a manual response that was reinforced on variable-ratio schedules during baseline. Participants were then exposed to NCR via multielement and reversal designs. The fixed-time schedules were kept constant while the magnitude of the reinforcing stimulus was varied across three levels (low, medium, and high). Results showed that high-magnitude NCR schedules produced large and consistent reductions in response rates, medium-magnitude schedules produced less consistent and smaller reductions, and low-magnitude schedules produced little or no effect on responding. These results suggest that (a) NCR affects responding by altering an establishing operation (i.e., attenuating a deprivation state) rather than through extinction, and (b) magnitude of reinforcement is an important variable in determining the effectiveness of NCR.

Using fixed-time schedules to maintain behavior: a preliminary investigation.

The purpose of this study was to evaluate the potential of fixed-time (FT) schedules to maintain behavior. Two children who had been diagnosed with autism were taught a functional task. Subsequently, three different FT schedules (i.e., yoked, thin, dense) were compared to determine their capacity to maintain task responding. Results suggested that FT schedules may be used to maintain previously acquired behavior.