Exposure plus response-prevention treatment of bulimia nervosa.

A controlled study evaluating the effectiveness of exposure plus response-prevention treatment of bulimia nervosa was conducted in a sample of 47 women. This was a four-group comparison involving three treatment conditions and a waiting-list control group. The three treatment conditions were (a) exposure plus response prevention conducted in a single setting (clinic), (b) exposure plus response prevention conducted in multiple settings (clinic, patients' homes, and restaurants), and (c) cognitive–behavioral therapy without exposure plus response prevention. All treatment was provided to groups of 3 patients at a time. Outcome was evaluated at posttreatment and at a 6-month follow-up. The three treatment groups improved significantly on most outcome measures, whereas the waiting-list control group showed little change. At follow-up, there was a slightly better outcome on vomiting behavior and amount of food consumed in one of the test meals for the exposure plus response-prevention groups relative to the no-exposure group. However, on all other measures, the degree of improvement from pretreatment to follow-up was the same for all three treatment groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Physical, Mental, and Social Catastrophic Cognitions as Prognostic Factors in Cognitive-Behavioral and Pharmacological Treatments for Panic Disorder.

The authors explored the prognostic value of 3 different types of catastrophic cognitions in the treatment of panic disorder with and without mild-to-moderate agoraphobia using a sample of 143 participants who received either cognitive-behavioral therapy (CBT) or imipramine in a randomized controlled trial. Stronger fears of social catastrophes both prior to and following treatment with CBT or imipramine were associated with a poorer outcome. In contrast, cognitions involving physical or mental catastrophes were unrelated to outcome, regardless of whether these thoughts were measured prior to or following treatment. These findings are consistent with the notion that although the intensity of physical catastrophe cognitions may best discriminate between panic disorder and other anxiety disorders, it is the intensity of social catastrophe cognitions that is most closely tied to success in treating this disorder. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adolescent sex offenders.

In this article, we review the research literature on sexual offenses committed by adolescents. Given the large number of adolescent sex offenders and the even larger number of their victims, most of whom are younger children, this is a subject matter in need of much more empirical study than it has so far received. Topics covered are incidence statistics, offense and victim characteristics, offender characteristics, and recidivism and treatment. Gaps between the clinical and research literature are highlighted and recommendations for future research are suggested. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relation between methods of coping during adulthood with a history of childhood sexual abuse and current psychological adjustment.

With a community sample of 192 women who had been sexually abused during childhood, the investigators determined if methods of coping in adulthood with the aftermath of child sexual abuse were associated with current symptoms of psychological distress. Multiple regression analyses indicated that disengagement methods of coping with the sexual abuse accounted for unique variance in general psychological distress even after controlling for characteristics of the abuse and methods of coping with other stressors. Disengagement methods of coping were also used more often to deal with the stressful aspects of having been sexually abused than to deal with other stressful events. In contrast, engagement methods of coping were used more often to deal with the other stressors than with sexual abuse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Feedback and therapist praise during treatment of phobia.

In the context of a "reinforced practice" treatment paradigm, the present 5 experiments analyzed whether or not feedback superimposed upon contingent praise would have an additive therapeutic effect. In each of 5 18-56 yr old phobic patients (brief case histories are given) behavioral progress in the initial praise-alone phase was either slow or nonexistent. When precise feedback of performance was added to praise in the 2nd phase, however, rate of improvement increased dramatically. Withdrawal of feedback did not slow down this rate. Feedback was apparently more important than therapist praise in getting approach behavior underway, but once gains had been made, praise plus the repeated graduated practice procedure per se was able to sustain continuing improvement on its own. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Is time-out from positive reinforcement an aversive event? A review of the experimental evidence.

Experiments concerning the aversive properties of time-out (TO) from positive reinforcement are reviewed. A discussion of experimental designs employed and problems encountered in defining aversive stimuli precedes the review. The major topics covered are: avoidance of TO, escape from TO, escape from stimuli which previously signalled TO, punishment with TO, effects on ongoing behavior of pre-TO stimuli, escape from conditions of positive reinforcement into TO. In general, TO satisfied sufficient criteria to conclude that it belongs to the class of stimuli called "aversive." However, this conclusion is only tentative. (2 p. ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sexual fantasy.

This article reviews the research literature on sexual fantasy, a central aspect of human sexual behavior. Topics include (a) gender similarities and differences in the incidence, frequency, and content of sexual fantasies and how they relate to sociocultural and sociobiological theories of sexual behavior; (b) the association between frequency or content of sexual fantasies and variables such as age, sexual adjustment and satisfaction, guilt, sexual orientation, personality, and sexual experience; and (c) "deviant" sexual fantasies (i.e., what they are, whether they play a role in the commission of sexual crimes, and whether they can be modified). The article ends with a summary of major findings and suggestions for future research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Aversion therapy for sexual deviation: Contingent shock and covert sensitization.

Studied 2 different aversion therapy approaches to the treatment of sexual deviation (e.g., homosexuality) in 6 clinical referrals. Covert sensitization, which provides an imagined aversive event following imagined sexual behavior, was compared with contingent shock, which provides a physical aversive event following erection to slides depicting sexually deviant material. Replicated, counterbalanced within-S presentations of each technique were used. Treatment effects were monitored by measurement of penile circumference changes during slides presented prior to treatment sessions, and by daily subjective recording of sexual urges and fantasies as well as masturbation and sexual acts. No clear difference was found between the treatments on the penile circumference measure. On suppression of subjective measures of sexual arousal, however, covert sensitization appeared to be more effective than contingent shock. Follow-up of 4-18 mo. is reported for the individual cases. (37 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship between heart rate and behavioral change during the treatment of phobias.

Obtained simultaneous measures of heart rate and approach behavior in the feared situation during treatment of 9 15-56 yr. Old phobic ss. In some cases heart rate increased as phobic avoidance behavior decreased. In other cases there was a parallel decline, a decline in phobic behavior without any change in heart rate, or a decreased heart rate only after phobic behavior had declined. Results suggest that physiologically defined anxiety need not always be inhibited in order to obtain desired behavioral change during treatment of phobia. In fact, anxiety reduction may sometimes be a consequence rather than a cause of behavioral change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)