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PubMedDate not supplied

Efficacy of behavioral interventions for reducing problem behavior in persons with autism: a quantitative synthesis of single-subject research.

The efficacy of behavioral interventions for problem behavior in persons with autism was reviewed. One hundred and seventeen published articles representing 181 individuals with autism were examined. Articles were selected from 15 journals. Participant, treatment, and experimental variables were evaluated. Three effect sizes were calculated for each article. Behavioral treatments are effective in reducing problematic behaviors in individuals with autism. Type of target behavior and type of treatment did not moderate the average effect of treatment. As measured by percentage of zero data (PZD), three variables were predictive of behavioral suppression beyond that accounted for by behavioral topography and treatment type. Reliability of observation and number of treatment data points were positively related to PZD scores. Treatments based on experimental functional analysis (EFA) produced higher average PZD scores than treatments that did not include an EFA. The implications of the findings, study limitations, and suggestions for future research are discussed.

Autistic Disorder↗

PubMed1989

Cognitive-behavioral therapy and relationship therapy in the treatment of children referred for antisocial behavior.

The present study evaluated alternative treatments for children (N = 112, ages 7-13) referred for severe antisocial behavior. Children were randomly assigned to one of three treatments: problem-solving skills training (PSST), problem-solving skills training with in vivo practice (PSST-P), which included therapeutically planned activities to extend training to settings outside of treatment, or client-centered relationship therapy (RT). PSST and PSST-P children showed significantly greater reductions in antisocial behavior and overall behavior problems, and greater increases in prosocial behavior than RT children. These effects were evident on measures obtained immediately after treatment and at a 1-year follow-up, and on measures of child performance at home and at school. PSST-P children showed greater changes than PSST children on measures of functioning at school at posttreatment, but these differences were no longer evident at follow-up. Children in both PSST conditions showed significant reductions in deviant behavior and improvements in prosocial behavior from pretreatment to follow-up, whereas RT children tended to remain at their pretreatment level of functioning. Notwithstanding the significant improvements, comparisons with nonclinic (normative) samples revealed that the majority of youth remained outside of the normal range of deviant behavior. Possible directions for improving treatment for antisocial youth are highlighted.

Adolescent↗

PubMed2004

Do people agree about the causes of behavior? A social relations analysis of behavior ratings and causal attributions.

Two studies examined consistency and agreement in behavior ratings and causal attributions. In Study 1, participants (N = 280) engaged in a series of getting-acquainted conversations in one of 3 communication media (face-to-face, telephone, computer mediated); in Study 2, participants (N = 120) engaged in a competitive group task. In both studies, participants rated themselves and their interaction partners on a set of behaviors and then made attributions about the causes of those behaviors. The major findings were that (a) participants consistently favored some causal factors over others in explaining both their own and their partners' behavior, supporting the existence of generalized attributional styles; and (b) participants showed moderate self-partner and partner-partner agreement about behavior but virtually no agreement about the causes of behavior. Thus, in brief interactions people tend to see themselves and others through the lens of their stable patterns of perceiving and interpreting behavior.

Adult↗

PubMed1999

Use of stage of change (SOC) to develop an STD/HIV behavioral intervention: phase 1. A system to classify SOC for STD/HIV sexual risk behaviors--development and reliability in an STD clinic.

This paper reports on the initial phase in the development, program implementation, and inter-rater reliability of an application of Stage of Change (SOC) behavioral theory for use in STD/HIV risk reduction. SOC was adapted to assess readiness for sexual behavior change in an urban STD clinic in Rochester, New York. A standardized staging grid and protocol were developed and implemented as part of HIV pre- and post-test counseling. A "client instructor" methodology was used to assess standardization and staff inter-rater reliability. Percent agreement for stage assessment for target behaviors was calculated. The Rochester STD/HIV Behavioral Counseling (RoSHBeC) Staging Grid and Protocol was used to train staff and this staging system was implemented in the STD clinic. After training, staff identified the correct behavioral target and stage 90% of the time. Inter-rater agreement for SOC classification was greater than 70%. Our experience demonstrates that it is possible to develop, implement, and sustain an integrated provider-delivered STD/HIV behavioral intervention in a busy urban STD Clinic. This staging system has the potential for use in other settings and for other health-related behaviors.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Chronic disease-related behaviors in U.S. older women: Behavioral Risk Factor Surveillance System, 2003.

OBJECTIVES: To estimate the prevalence of selected behaviors related to chronic diseases among women > or =65 years old using the 2003 Behavioral Risk Factor Surveillance System (BRFSS) data. METHODS AND RESULTS: Seven behaviors were assessed: having a healthy weight, current cigarette smoking status, consumption of at least five fruits or vegetables daily, leisure time physical activity in the the past month, moderate-to-vigorous physical activity during the average week, influenza immunization in the past year, and lifetime pneumococcal immunization. With increasing age, women > or =65 years old were more likely to have a healthy weight, to be a nonsmoker, and to consume at least five fruits or vegetables daily and less likely to participate in any leisure time or moderate-to-vigorous physical activities. Women with higher incomes and educational attainment were more likely to engage in most healthful behaviors and to have a healthy weight. However, black non-Hispanic women were less likely than white women or those of other race or ethnicity to engage in most healthful behaviors and to have a healthy weight. Women who rated their health as fair or poor were more likely to receive a pneumococcal immunization, and those who rated their health as excellent were least likely to receive an influenza immunization in the past year. CONCLUSIONS: BRFSS data can be used to monitor the prevalence of behaviors related to chronic disease of women aged > or =65 years and to develop programs and polices that promote and reinforce healthful behaviors. These measures have the potential to help reduce morbidity and morality from chronic disease in older women, thereby minimizing the discrepancy between years of healthy life expectancy and life expectancy.

Aged↗

PubMedDate not supplied

Behavioral outcome of preschoolers exposed prenatally to cocaine: role of maternal behavioral health.

OBJECTIVE: To examine the impact of prenatal cocaine exposure and maternal behavioral health (recent drug use and psychological functioning) on child behavior at age 5 years. METHOD: In this longitudinal investigation, maternal report of child behavior was assessed using the Achenbach Child Behavior Checklist (CBCL) in 140 cocaine-exposed and 181 noncocaine-exposed (61 alcohol, tobacco, and/or marijuana-exposed, and 120 nondrug-exposed) low-income, African American children. Structural equation modeling was used to estimate suspected causal relationships between indicators of maternal behavioral health at 5-year follow-up, according to self-report on a modified Addiction Severity Index (ASI) and CBCL scores. RESULTS: Prenatal cocaine exposure was not related to child behavior at age 5. Recent maternal drug use and psychological functioning had relationships with CBCL Internalizing and Externalizing scores. However, when considered within a combined model, only maternal psychological functioning remained significant. CONCLUSIONS: Findings highlight the importance of maternal functioning in the behavioral outcome of children exposed prenatally to cocaine.

Black or African American↗

PubMedDate not supplied

Effects of behavioral interventions on disruptive behavior and affect in demented nursing home residents.

BACKGROUND: Disruptive behaviors are prevalent in nursing home residents with dementia and often have negative consequences for the resident, caregiver, and others in the environment. Behavioral interventions might ameliorate them and have a positive effect on residents' mood (affect). OBJECTIVES: This study tested two interventions-an activities of daily living and a psychosocial activity intervention-and a combination of the two to determine their efficacy in reducing disruptive behaviors and improving affect in nursing home residents with dementia. METHODS: The study had three treatment groups (activities of daily living, psychosocial activity, and a combination) and two control groups (placebo and no intervention). Nursing assistants hired specifically for this study enacted the interventions under the direction of a master's prepared gerontological clinical nurse specialist. Nursing assistants employed at the nursing homes recorded the occurrence of disruptive behaviors. Raters analyzed videotapes filmed during the study to determine the interventions' influence on affect. RESULTS: Findings indicated significantly more positive affect but not reduced disruptive behaviors in treatment groups compared to control groups. CONCLUSIONS: The treatments did not specifically address the factors that may have been triggering disruptive behaviors. Interventions much more precisely designed than those employed in this study require development to quell disruptive behaviors. Nontargeted interventions might increase positive affect. Treatments that produce even a brief improvement in affect indicate improved quality of mental health as mandated by federal law.

Activities of Daily Living↗

PubMedDate not supplied

Continuity and discontinuity of behavioral inhibition and exuberance: psychophysiological and behavioral influences across the first four years of life.

Four-month-old infants were screened (N = 433) for temperamental patterns thought to predict behavioral inhibition, including motor reactivity and the expression of negative affect. Those selected (N = 153) were assessed at multiple age points across the first 4 years of life for behavioral signs of inhibition as well as psychophysiological markers of frontal electroencephalogram (EEG) asymmetry. Four-month temperament was modestly predictive of behavioral inhibition over the first 2 years of life and of behavioral reticence at age 4. Those infants who remained continuously inhibited displayed right frontal EEG asymmetry as early as 9 months of age while those who changed from inhibited to noninhibited did not. Change in behavioral inhibition was related to experience of nonparental care. A second group of infants, selected at 4 months of age for patterns of behavior thought to predict temperamental exuberance, displayed a high degree of continuity over time in these behaviors.

Acoustic Stimulation↗

PubMedDate not supplied

Behavioral approach-inhibition in toddlers: prediction from infancy, positive and negative affective components, and relations with behavior problems.

In this study, 126 children were observed at 6 months, 12 months, and 2 years. During infancy, latencies to reach for novel objects were measured. At 2 years, positive and negative affect, and behavioral approach-inhibition to low- and high-intensity situations were coded, and mothers assessed behavior problems. Confirmatory factor analysis indicated a 3-dimension model of positivity, negativity, and behavioral approach-inhibition. Positivity was related to low- and high-intensity behavioral approach-inhibition, whereas negativity was linked only to low-intensity behavioral approach-inhibition. Shorter 12-month latencies to reach were predictive of low negativity, high positivity, and behavioral approach at 2 years. Positivity and negativity were correlated with externalizing and internalizing behaviors, respectively. Finally, cluster analysis identified an exuberant group high in externalizing and an inhibited group high in internalizing.

Adult↗

PubMed2003

Neonatal behavioral characteristics and later behavioral problems.

The purposes of this study were (1) to evaluate the usefulness of the Neonatal Behavioral Assessment Scale (NBAS) as a tool to assess the risk of later behavioral problems, (2) to analyze the relationship between neonatal behavioral characteristics and behavioral problems in childhood. Subjects were 77 very-low-birth-weight infants admitted to the NICU at the Nagasaki University Hospital, Nagasaki, Japan. The results suggest that behavioral characteristics such as poor motor performance, poor state regulation, and poor interaction ability in the neonatal period are risk factors for behavioral problems in childhood. The NBAS could help clinicians to identify neonates at risk of later behavioral problems.

Child↗

PubMed2005

Applying the interpersonal circumplex to children's behavior: parent-child interactions and risk behaviors.

This article examined the applicability of the interpersonal circumplex (IC) to the observable social behaviors of children during parent-child interactions. In Study 1, the observational ratings of behaviors of 117 children (mean age = 9.88 years) were examined. Randomization tests of hypothesized order relations found that these behaviors tended to occur in the circular pattern predicted by the IC. To illustrate the applicability of the IC to children's behavior, Study 2 (n = 94) used the circular structure of children's behavior to longitudinally examine children's participation in two risk behaviors, smoking cigarettes and consuming alcohol. Results indicated that children who behaved in an arrogant-calculating manner were at risk for smoking cigarettes and children who behaved in an assured-dominate manner were at risk for drinking alcohol 1 year later. Implications of these results are discussed in terms of their relevance for helping researchers better understand and categorize children's interpersonal behaviors.

Alcohol Drinking↗

PubMed1998

HIV sex and drug risk behavior and behavior change in a national sample of injection drug and crack cocaine using women.

This paper describes HIV sex and drug risk behavior and behavior change of injection drug and crack cocaine using women enrolled in a national multi-site Cooperative Agreement program. Baseline data on the 1,403 women who were randomly assigned to a two session intervention that was standardized across sites indicate that sex and drug risk behavior for becoming infected with HIV was considerable. Six-month post intervention follow-up data for the same sample of women show that significant reductions in sex and drug risk behavior were observed for the entire sample of women for the risk variables under study. Significant reductions were also demonstrated for various sub-groups of women enrolled in the study on most of the sex and drug risk variables. Given these findings, it appears that the standard intervention was effective in assisting drug using women reduce their behaviors that put them at risk of becoming infected with HIV. Further research in needed on the development and evaluation of HIV interventions that target specific risk behaviors and various HIV risk behavior profiles of women.

Adult↗

PubMed1977

What types of sex-role behavior should behavior modifiers promote?

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?

Adaptation, Psychological↗

PubMed2002

Identification of environmental determinants of behavior disorders through functional analysis of precursor behaviors.

Experimental analysis procedures have been shown to be effective means for identifying the environmental determinants of problem behaviors. A potential limitation of these procedures is that it is necessary to produce and document patterns in the occurrence of the problem behavior during the assessment. In the case of severe behavior disorders, this may place the participant or therapist at such risk as to preclude the analysis. The current study arranged experimental analysis contingencies for precursor behaviors that had been observed to reliably precede the occurrence of problem behaviors targeted for reduction. For each of the 4 participants, it was possible to infer the maintaining variables for problem behaviors based on the outcomes of precursor analysis. These results suggest that the current procedures represent a promising alternative method for reducing risk during functional analysis of problem behaviors.

Adult↗

PubMedDate not supplied

Exercising for two: examining pregnant women's second trimester exercise intention and behavior using the framework of the theory of planned behavior.

Research examining the motivational determinants of exercising during pregnancy is mostly atheoretical, despite the need for theory-based designs. The study's main objective was to prospectively examine women's exercise intention and behavior from their second to third pregnancy trimester using the theory of planned behavior (TPB). Participants were 89 pregnant women who completed self-reported measures of their exercise attitude, subjective norm, perceived behavioral control, intention, and behavior. Hierarchical regression analyses indicated: 1) intention and not perceived behavioral control significantly predicted exercise behavior; and 2) attitude was the strongest determinant of exercise intention, followed by perceived behavioral control, and subjective norm. The study findings provide preliminary support for the TPB as an effective framework for examining exercising during pregnancy. Understanding women's thoughts, feelings, and beliefs about exercise can assist intervention specialists with developing and implementing effective programs promoting exercise during pregnancy.

Adult↗

PubMedDate not supplied

Behavior management conference panel I report--Rationale for behavior management techniques in pediatric dentistry.

Panel I comprised of pediatric dentists, an attorney, child psychologists, parents, a specialist in early childhood education, and a pediatrician. The purpose of this panel was to discuss: (1) 8 questions that dealt with the appropriateness and effectiveness of current behavior management techniques; (2) the scientific support for those techniques; and (3) the role of the pediatric dentist in managing the difficult child. Issues of cultural diversity, access to care, and parental attitudes toward behavior management were also explored. Nonpediatric dentist members of the panel offered insights into how other health care professionals view the behavior management techniques used by pediatric dentists. The panel sought input from the conference attendees as part of its deliberations. The major recommendations of the panel included: (1) re-evaluate the definitions of child behavior in the dental setting, including definitions of appropriate behavior; (2) develop training in effective communication with parents for pediatric dentists and their staffs; (3) seek further information on the impact that changing parental attitudes towards behavior management techniques may have on the quality and accessibility of treatment; and (4) conduct research in specific areas of behavior management, particularly in communicative techniques.

Attitude to Health↗

PubMed2005

A comparative study of the behavioral, personality, and fire history characteristics of residential and outpatient adolescents (ages 12-17) with firesetting behaviors.

Juvenile firesetting behavior has received relatively little research attention and previous attempts to systematically classify this heterogeneous population of children has been only partially successful. Currently there is no literature available that defines treatment and intervention needs of adolescents in residential treatment with problematic firesetting behavior and whether these needs differ from their outpatient cohorts. Data were gathered from a residential (N=17) and outpatient (N=30) sample detailing firesetting history, behavioral functioning, aggression, and personality traits associated with behavioral difficulties. Study subjects were asked to complete the Youth Self Report (Achenbach), Aggression Questionnaire, and Jesness Inventory and to participate in a structured firesetting history interview by project directors. Parents/guardians were asked to complete a Child Behavior Checklist (Achenbach). Adolescents in residential care were significantly more likely to come from a single-parent home, display increased delinquent behaviors, greater depressive symptoms, and report significantly more aggressive thoughts and attitudes than those in outpatient settings. Few differences were found on personality characteristics associated with behavior and conduct problems and few differences were found relative to fire history and firesetting characteristics. Implications for treatment and intervention within a residential setting are discussed as well as factors possibly associated with delaying and/or avoiding initial residential placement.

Adolescent↗

PubMed2006

Healthy lifestyle behaviors among older U.S. adults with and without disabilities, Behavioral Risk Factor Surveillance System, 2003.

INTRODUCTION: Little is known about the relationship between healthy behaviors and the prevalence of chronic diseases in older adults with disabilities. This study examines the prevalence of selected healthy lifestyle behaviors related to chronic diseases among adults aged 65 years and older with and without disabilities. METHODS: Data from the 2003 Behavioral Risk Factor Surveillance System (BRFSS) were used to assess having a healthy weight and six behaviors: current cigarette smoking status, consumption of at least one alcoholic beverage daily, consumption of at least five fruits or vegetables daily, physical activity during the average week, influenza immunization in the past year, and lifetime pneumococcal immunization. RESULTS: People with a disability were less likely than people without a disability to have a healthy weight (28.5% vs 37.2%) and to engage in the recommended level of weekly physical activity (14.7% vs 26.2%). However, people with a disability were more likely than those without a disability to be nonsmokers (91.8% vs 89.9%), to consume up to one alcoholic beverage daily (95.1% vs 91.5%), to have received their influenza immunization in the past year (72.7% vs 69.0%), and to have received a lifetime pneumococcal immunization (72.1% vs 63.0%). There was no difference between people with and without a disability in the prevalence rates of consuming at least five fruits or vegetables daily. CONCLUSION: The prevalence of having a healthy weight and six chronic-disease related behaviors among adults aged 65 years and older varies by disability status and by specific modifiable lifestyle behavior. Screening older adults with and without disabilities and counseling them about health behaviors should be integrated into every interaction between older adults and their health care providers to potentially lower the rates of morbidity and mortality related to chronic diseases in the later years.

Aged↗