Cognitive and behavioral targets in a self-control therapy program for depression.

One-hundred-four women who met Research Diagnostic Criteria for nonpsychotic, nonbipolar Major Affective Disorder were treated in 21 therapy groups for 10 weekly 1? hr sessions. Three versions of the self-control therapy program for depression, one with a behavioral target, one with a cognitive target, and one with a combined target, were used to treat 7 groups each. All conditions improved significantly and equally on self-report and clinician rating scales of depression. All conditions improved equally on measures of both behavioral and cognitive target variables, and initial level on these variables was not related to outcome. (41 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive-behavioral self-control therapy for children: A components analysis.

27 non-self-controlled 8–12 yr olds (as measured by the Self-Control Rating Scale) were randomly assigned to a cognitive-behavioral treatment, a behavioral treatment, or an attention-control condition. Ss were administered the Peabody Picture Vocabulary Test, Matching Familiar Figures Test, Piers-Harris Children's Self-Concept Scale, and Wide Range Achievement Test. All Ss received 12 sessions of individual therapist contact focusing on psychoeducational, play, and interpersonal tasks and situations, with the cognitive-behavioral treatment including self-instructional training via modeling and behavioral contingencies and the behavioral treatment involving modeling and contingencies. The cognitive-behavioral intervention improved teachers' blind ratings of self-control, and both the cognitive-behavioral and behavioral treatments improved teachers' blind ratings of hyperactivity. Several performance measures (cognitive style, academic achievement) showed improvements for the cognitive-behavioral and behavioral conditions, whereas only the cognitive-behavioral treatment improved children's self-concept. Normative comparisons and 10-wk follow-up provided additional support for the efficacy of the cognitive-behavioral treatment; 1-yr follow-up did not show significant differences across conditions. (35 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Toward the use of self-control in behavior modification.

Analyzes the concept of self-control in terms of a 2-stage process: general cognitive set and specific self-controlling responses. The incorporation of the cognitive set into a fuller understanding of behavior modification is emphasized. The set labeled commitment to change is viewed as an important motivational and mediating component in self-directed or therapist-guided therapy programs. A number of characteristics of this set are posited, and the problems of measuring such a commitment are discussed. Several programs describing techniques oriented to commitment are briefly reviewed. The cognitive set analysis seems especially important for discovering factors contributing to the frequent relapse following treatment for addictions. (20 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparison of cognitive therapy and behavior therapy in the treatment of depression.

Evaluated the therapeutic efficacy of A. T. Beck's cognitive treatment and P. M. Lewinsohn's behavioral treatment of depression. A multiple criteria (self-report, objective, and subjective clinical ratings) approach was used in the selection of 8 college students each for the following groups: cognitive modification, behavior modification, an attention/assessment (nondirective), and waiting list. Eight 2-hr group sessions were held over 4 wks. The cognitive modification group was the most effective in alleviating depression as measured by self-report and the objective clinical rating. Cognitive modification resulted in significantly fewer depressive symptoms after treatment than all other groups. The behavior modification and nondirective procedures were more effective than no treatment based on the self-report data. (28 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Behavioral self-control program for Windows: Results of a controlled clinical trial.

Forty nonalcoholic heavy drinkers were randomly assigned to receive a computer-based version of behavioral self-control training either immediately after pretreatment assessment or after a 10-week waiting period. Results at each of 3 follow-ups strongly support the study hypotheses. Participants in the immediate treatment group significantly reduced their drinking relative to their pretreatment levels and relative to those in the delayed treatment condition at the initial follow-up, 10 weeks after the pretreatment assessment. The delayed group did not change their drinking behaviors during this period of time. However, they significantly reduced their drinking by the second follow-up conducted after they received training. At the 12-month follow-up, participants maintained the gains they had achieved during treatment. There were no interactions involving participant ethnicity or gender. Although use of other drugs was not specifically addressed, such use did not increase, and there was some evidence of a decline. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Generalization and maintenance of appropriate behavior through self-control.

8 7-11 yr old disruptive children attended an after school reading tutorial program 1 hr a day for 72 days. After baseline, Ss evaluated their academic and social behavior. A token program was instituted and then modified to include the following procedures: (a) Points and backup reinforcers were made contingent upon accurate self-ratings; (b) the requirement of accurately matching teacher ratings was faded until the children had complete control over point distribution; and (c) backup reinforcers were also faded and eliminated. While there was a lack of generalization of appropriate social behavior to the regular classroom situation, generalization was demonstrated in the 15-min control period of every class, and maintenance was demonstrated in the final week of the program after all backup reinforcers were withdrawn. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Concept for a behavior therapy treatment program in primary insomnia

Cutaneous recordings of gastric electrical activity (electrogastrography (EGG)) could become a valuable non-invasive tool for recognising gastric electrical abnormalities. Although signals obtained with internally implanted electrodes deliver quantitative information, this technique cannot be used for diagnostic purposes because of its invasive nature. On the other hand, the objectivity of electrogastrography is still in question. The aims of this work are to develop computer techniques for extracting quantitative information from digital electrogastrograms, and to evaluate quantitatively EGG recordings from healthy volunteers. The dynamics of all four EGG parameters are studied: amplitude, frequency, time shift between different channels, and waveform. Four separate two-dimensional computer plots are developed using specially designed digital signal-processing procedures. Each parameter is evaluated in a study of 20 healthy volunteers. Frequency is found to be the only EGG parameter that shows quantitative consistency and merit.     

The role of homework in cognitive behavior therapy of depression.

Homework is particularly important in the cognitive-behavioral treatment of depression because the pervasive nature of the characteristic cognitive, affective, and motivational disturbances undercut the impact of didactic and supportive verbal interventions. Despite the importance of homework, a relatively small number of studies have quantified the causal relationship between homework completion and symptomatic outcome. Most of these studies have limited power to detect small-to-moderate effect sizes and rely on retrospective or incomplete measurements of homework that do not distinguish between the quantity and quality of the assigned tasks. Nevertheless, there is relatively consistent evidence from correlational studies to conclude that homework adherence is associated with significantly better outcomes. These findings point to new questions for research (i.e., does ongoing use of homework decrease the likelihood of relapse following termination of time-limited therapy?) and have implications for clinical practice. Examples of homework assignments are provided and strategies to improve homework adherence are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Freedom and therapy: From self-liberation to self-control.

This article focuses on how subjective feelings of freedom and lack of freedom can influence a client's motivation to change. Freedom can be expressed as a positive desire to act (freedom to), or by the negative impulse escape constraints (a freedom from). More often, it is the negative aspect that brings client to therapy: the desire to be liberated from the burden of thoughts and emotions which restrict their freedom to be, or to act, as they wish. In therapy, the positive aspect of freedom is often raised in the context of establishing autonomy and self-regulation as desirable goals. But shifting from notions of self-liberation to those of self-control involves exploring the complex interaction between subjective feelings of freedom, and objective limits on freedom to act. Clients may become fearful at what they perceive as too much freedom to act, in the absence of meaningful limits on choice and behavioral possibilities. This "freedom anxiety" as a clinical condition can inhibit the potential for change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ambulatory computer-assisted therapy for obesity: A new frontier for behavior therapy.

Implemented a behavioral treatment program for obesity and tested an interactive microcomputer system small enough to be carried by Ss throughout their normal daily routines. Treatment effects observed in 6 30–50 yr old females (at least 35% overweight) who received this experimental treatment were compared with those observed in 6 matched female controls (also at least 35% overweight) who received a similar treatment program implemented without computer assistance. The self-monitoring, goal-setting, and feedback treatment packages were computer-assisted or involved paper and pencil. Mean weight loss after the 8 postbaseline study weeks was 8.1 lb for the experimental Ss compared with 3.3 lb for the control Ss. Mean weight loss 8 mo posttreatment was 17.7 lb for the experimental Ss compared with 2.3 lb for the control Ss. It is concluded that ambulatory computer-assisted therapy provides important new opportunities for conducting behavior therapy and research in real-life settings. (5 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A system for evaluative research in behavior therapy.

A system of monitoring outcome of clinical behavior therapy interventions is proposed so that comprehensive data from these treatments may be used to establish their actual clinical efficacy. All primary problems, broadly categorized as behavioral excesses, deficits, and psychosomatic disorders, treated at the Behaviour Therapy Service had corresponding dependent variables established. Any patient treated is followed pre- and posttreatment and at follow-up with respect to these variables. A patient data collection card was devised to contain these dependent variables and demographic and psychological test data. A session report form was instituted to record these data at each session and to assist in the supervision of the therapists performing the treatment. The system of dependent variable collection will allow for the comparison of the outcome of patients treated for the same symptom for the purpose of establishing outcome probabilities and patient selection criteria. (9 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Integrative cognitive therapy for depression: A randomized pilot comparison.

This pilot study examined the efficacy of an integrative form of cognitive therapy (ICT) for depression that incorporates specific strategies for addressing alliance ruptures. Although a previous study on depression found that ICT was superior to a wait-list condition (L. G. Castonguay et al., 2004), the current study provides the 1st direct comparison between ICT and traditional cognitive therapy (CT). Twenty-two depressed adults were randomly assigned to ICT or CT (11 patients per condition), which were delivered by clinicians in training. Outcome was assessed with a specific depression measure and a global symptomatology measure. The groups were also compared on patient-perceived alliance quality and therapist empathy. Effect size estimates revealed that ICT patients evidenced greater posttreatment improvement on both outcome measures (with small to medium effects) and more clinically significant change than did CT patients. ICT patients also had higher alliance and empathy scores across treatment (with medium to large effects). The findings, albeit very preliminary, support the potential viability of ICT and the potential causal influence of the rupture-repair interventions on treatment process and outcome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A meta-analysis of the efficacy of cognitive therapy for depression.

In meta-analysis format the effectiveness of Beck's cognitive therapy for depression was reviewed. Twenty-eight studies were identified that used a common outcome measure of depression, and comparisons of cognitive therapy with other therapeutic modalities were made. The results document a greater degree of change for cognitive therapy compared with a waiting list or no-treatment control, pharmacotherapy, behavior therapy, and other psychotherapies. The degree of change associated with cognitive therapy was not significantly related to the length of therapy or the proportion of women in the studies, and although it was related to the age of the clientele, a lack of adequate representativeness of various age groups renders these results equivocal. Implications for further outcome and process studies in cognitive therapy are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rapid smoking and self-control in the modification of smoking behavior.

Investigated the efficacy of combining rapid smoking aversion and training in self-control skills for maintaining nonsmoking. 50 habitual smokers (26 males, 24 females; mean age 33 yrs) were assigned to a 3-wk treatment program emphasizing rapid smoking plus self-control, rapid smoking plus filler discussion, normal-paced (placebo) smoking plus self-control, or the placebo smoking procedure plus filler discussion. At the 13-wk follow-up, the performance of the combined rapid smoking plus self-control program was not superior to rapid smoking plus discussion. In fact, Ss in the combined program performed worse (had a higher mean smoking rate and a smaller percentage of abstinence) at both treatment termination and follow-up. Self-control did improve performance in placebo smoking Ss. Differences associated with self-control were not statistically significant. Rapid smoking was found to be significantly more effective than the placebo smoking when data from non-married treatment pairs were considered. Possible explanations for the negative impact of self-control on rapid smoking are outlined. Locus of control scores and extended experimenter–S contact after termination were not related to treatment performance. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A matching-to-sample feedback technique for training self-control of tinnitus.

Treated 30 individuals (aged 24–82 yrs) with subjective tinnitus aurium with a matching-to-sample feedback procedure. Ss' tinnitus sounds were reproduced audiometrically on all characteristics and were presented to them in the noninvolved ear or in both ears when the tinnitus was binaural. This experimental sound was then reduced in 5-db steps within sessions, and Ss had the task of concentrating on reducing the loudness of their tinnitus until a match was achieved between it and the experimental sound at each new db level. Results show a significant difference in db levels from baseline to final training session. Nearly all Ss demonstrated a marked reduction in tinnitus loudness, with several eliminating it completely. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Analyzing nonverbal behavior in depression.

Describes the use of time-series notation as an objective approach to a refined analysis of nonverbal behavior in depression, using behavioral samples taken from doctor–patient interviews. The movement patterns of 13 26–67 yr old depressed patients were studied twice, first when the patients were diagnosed to be in a severely depressed state, and second, when they were judged to be nearly recovered. The movements of head, trunk, shoulders, upper arms, hands, upper legs, and feet were transcribed as a series of positions over time for the 1st 3 min of each of 26 doctor–patient interviews. Codings were obtained from video recordings, at half-second intervals, for 55 coding dimensions. Three parameters, the mobility, the complexity, and the dynamic activation of body movement, were defined and quantified on the basis of these data matrixes. Findings demonstrate that the time-series notation of nonverbal interaction offers new possibilities in the quantitative study of behavior, especially in the assessment of behavioral features of potential importance in determining diagnostic subgroup and therapeutic response. (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Selective recall of positive and negative feedback, self-control behaviors, and depression.

Tested 2 sets of hypotheses, derived from cognitive–behavioral theories of depression, that (a) compared to a sample of nondepressed controls, depressed Ss would underestimate the frequency of reinforcement and overestimate the frequency of punishment received during an ambiguous laboratory task; and (b) when given the opportunity to self-reinforce or self-punish, depressed Ss would self-reinforce less often and self-punish more often than controls. Three of these predictions were supported. In an experiment with 24 depressed and 21 nondepressed undergraduates (Beck Depression Inventory), depressed Ss recalled less positive and more negative feedback than controls. As expected, these differences were significant only at a high rate of reinforcement and at a low rate of punishment. In the latter condition, however, depressed Ss were accurate in their recall, while nondepressed Ss underestimated the frequency of negative feedback. Depressed Ss self-reinforced less often than controls, but there were no differences in rates of self-punishment. Implications for cognitive and behavioral theories of depression are discussed. (22 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of reframing and self-control directives on loneliness, depression, and controllability.

57 female undergraduates who scored at least 1 standard deviation above the mean (47 or above) on the UCLA Loneliness Scale and who scored as moderately depressed (8–26) on the Beck Depression Inventory also completed the Causal Dimension Scale and were randomly assigned to 1 of 3 groups: reframing, self-control directives, and a waiting-list control. Treatment groups met for 2 weekly ?-hr interviews. Interviewer responses in the reframing group focused on ways to experience loneliness more positively, whereas self-control responses involved encouraging Ss to overcome loneliness. All 3 groups were again administered the 3 measures posttreatment and 2-wk follow-up. Results indicate that Ss in the reframing group experienced a more significant reduction in depression than Ss in the self-control or control groups. All Ss became less lonely over time, but no treatment was more effective than another in reducing loneliness. No differences were found for controllability. (15 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Challenges for behavior therapy: 1975.

Notes that due to a combination of forces including a growing public concern with the impact of science upon daily life and the publication of abuses of human subjects' rights by scientists, there has been an intensified demand placed upon behavior therapists in particular to develop new programs adequate to the task of protecting the rights of human subjects. Following a definition of behavior therapy, this paper presents an outline of one proposal for these ethical guidelines and suggests additional procedural principles which might guide the practice of behavior therapy. Suggestions are made for the development of behaviorally oriented approaches to macrosocial problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)