Biomedical subjects
Publications and source records attributed to R C Winkler.
Insomnia is a common problem in medical practice. When the patient says 'Doctor I can't sleep at night' the cause should be identified from stress, psychological disturbance, physical symptoms, disease, drugs or environmental or idiopathic factors. A behavioural strategy focusing on relaxation and methods for stimulus control is presented.
Criteria used to determine community adjustment of mentally retarded adults were rated for importance by two groups of their employers, two groups of service-agency staff members, and one group of parents to determine whether normative criteria differed across the groups. In a second study case descriptions, varying on the adjustment criterion of personal responsibility, were presented to an additional sample from the five groups. Results of discriminant fuction analysis showed that parents and service-agency staff members differed markedly on the importance given to personal responsibility. This discrepancy was confirmed in the second study. Employers stressed work-related criteria more than did the other groups. The relevance of discrepancies between the criteria of adjustment used by parents, employers, and service-agency staff members to the measurement of adjustment and to social-validation programs were discussed.
Six cases in which, unknown to the therapist, psychotherapy apparently initiated or exacerbated child abuse are reviewed. Once the connection between therapy and child abuse was recognized and pointed out to the patients, further therapy led to a significant clinical improvement. The necessity for additional support, such as is offered by Prevention, is emphasized.
In several studies of token economies, it has been observed repeatedly that chronic psychiatric patients conform to the same economic principles as explain the activities of presumably normal participants in the national consumer economy. Such observations are consistent with behavior therapy's assumptions that those labeled mentally ill follow the same psychological and social lows as those considered normal and that behavior is responsive to specific situational determinants. Although they disprove nothing, these observations may pose problems for more traditional approaches which view psychopathology as the result of central disorders or deficits with diffuse effects across a wide range of ordinary life situations.
Rekers and Lovaas (1974) reported a study using reinforcement procedures aimed at modifying the behavior of a 5-yr-old who engaged in cross-gender behavior. The use of traditional sex-role concepts in forming target behaviors is criticized and androgynous behavior is suggested as an empirically based alternative. The pathological nature of the behavior that the study was designed to prevent is also questioned, as is the ability to predict sex-role behavior from a 5-yr-old child's current behavior. These issues are raised in the context of the more general question, whom should the therapist serve?
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The current research methods of behavioral economics are characterized by inadequate empirical foundations. Psychologists involved in the experimental analysis of behavior with their research strategies and their experimental technology, particularly that of the Token Economy, can assist in providing empirical foundations for behavioral economics. Cooperative research between economists and psychologists to this end should be immediately fruitful and mutually beneficial.
Classrooms have recently been criticized as total institutions where there is a rigid preoccupation with order and control, and where children are required to be still, to be silent, and to obey. Behavior modification has been described as a major source of change in the classroom. A review of this journal's papers on behavior modification in the classroom indicated that inappropriate behavior has been consistently defined as behavior that interferes with order, quiet, and stillness. It is argued therefore, that behavior modification has supported rather than changed the questionable status quo. Alternative areas for behavior modification in traditional classrooms and the role of behavior modification in the development of open classrooms are discussed.
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A token reinforcement system for the reduction of institutionalized behavior in a chronic psychiatric ward is described. Quantitative assessments were made of the effects of the system on five types of positively reinforced behavior, two types of unreinforced behavior, and two types of fined behavior. To assess whether these effects were a function of the token procedures, three experiments were carried out, the first removing tokens for a brief period, the second making tokens non-contingent on behavior, and the third removing fines in one area while maintaining them in another. The token procedures were found to be the source of the observed improvements.