Stephen W. Holborn

A comparison of relaxation training and competing response training to eliminate hair pulling and nail biting

A 17-year-old female with a 14-year history of hair pulling and nail biting was treated with relaxation training and competing response training. While introduction of relaxation training produced an initial decline in hair pulling, there was a gradual recovery of the maladaptive behavior to baseline levels. The competing response procedure consisted of clenching fists for 3 min whenever hair pulling or nail biting occurred or were likely to occur. By the use of the competing response hair pulling and nail biting decreased, eventually to zero. Follow-up over a 2-year period revealed that the treatment effects were maintained.

A rapid multi-component treatment for an obsessive-compulsive disorder

A 67-yr-old woman with a 45-yr history of obsessive-compulsive problems related to fear of contamination was treated rapidly by a multi-component intervention. Questionnaire data following treatment showed the patient to be free of obsessive-compulsive complaints, and these were corroborated by behavioral observations. Follow-up probes conducted 6, 12 and 18 months later revealed continued maintenance of treatment gains. Patient-therapist contact time totalled 6 hr, about one-third of the time employed by Marks for exposure and response prevention, indicating the cost-effectiveness of a multi-component treatment intervention.

An Operant Blocking Interpretation of Instructed Insensitivity to Schedule Contingencies

Undergraduates pressed computer keys to move a cursor through a visual matrix under a multiple fixed ratio 18/differential-reinforcement-of-low-rate 6-s schedule. In Experiment 1, instructions to “Go Fast” or “Go Slow” produced schedule¬insensitive performances for the majority of participants. Subsequent manipulations designed to increase reinforcer magnitude and to place social contingencies on effective cursor movement failed to undermine instructed insensitivity. Such instructed insensitivity may be caused by operant blocking, that is, response-rate instructions prevented acquisition of control by stimulus features associated with the reinforcement schedule. In Experiment 2, participants showing original compliance with response-rate instructions were exposed to the schedule contingencies without instructions. Participants thus exposed to both reinforcer points and schedule-discriminative stimuli were unlikely to show insensitivity upon reintroduction of the instructions, consistent with an operant blocking interpretation of insensitivity. The importance of examining instructional effects in terms of basic principles of stimulus control was emphasized.

Effects of Fixed-Interval and Fixed-Ratio Schedules of Token Reinforcement on Exercise with Obese and Nonobese Boys

The effects of fixed-interval (FI) and fixed-ratio (FR) schedules of reinforcement for pedaling on a stationary exercise bicycle were examined. Two obese and two nonobese boys were individually tested 5 times weekly for 10 weeks. An ABCB single-case research design was used where A = Baseline, B = FI 1 min, and C = FR × (a schedule matched in reinforcement frequency to that obtained by each subject under FI). The results indicated that although the introduction of FI 1 min produced increases of over 300% above the end of baseline in exercise duration for all subjects; the obese subjects’ response rate rapidly declined whereas the nonobese boys’ response rate increased. Implementation of the FR schedule produced dramatic increases in the two obese and one nonobese subjects’ response rates; high stable responding was maintained by the other nonobese subject. Response rates decreased for all subjects during the return to FI phase. Increased duration of exercising was maintained during all contingency phases. Cumulative records demonstrated high stable responding with no discernible pausing for nonobese boys. In contrast pausing and accelerating were evident in the obese boys’ records with the development of transitory scalloping for one obese subject. Postexperiment physical fitness tests indicated a reduction in percentage of body fat for the two obese and one nonobese subjects.

Cost-effectiveness of home relaxation training for tension headaches

Taped home relaxation training was evaluated in a single-case replication design across three patients suffering from tension headaches. Data from daily headache diaries indicated that headache frequency decreased substantially for two of the patients. For the third patient who reported almost continual headache pain, intensity was reduced by over 50%. When compared with results of our previous research taped home relaxation training appeared as effective as (and therefore, more cost-effective than) live clinic relaxation training.

An experimental test of stimulus estimation theory: danger and safety with snake phobic stimuli.

The stimulus estimation model (Taylor & Rachman, 1994) asserts that fear overprediction stems from: (a) overprediction of the danger elements of a phobic stimulus, and (b) underprediction of existing safety resources. Using a 2x2 factorial design, with danger (high vs low) and safety (high vs low) as between-subjects variables, an experimental test of the model was conducted with 25 snake-fearful participants per condition. The four experimental conditions were matched on initial levels of snake fearfulness, as assessed by the Snake Questionnaire (SNAQ). For the 51 participants who demonstrated overprediction of fear, high danger led to reliably more fear overprediction than low danger; and low safety led to reliably more fear overprediction than high safety. The interaction between danger and safety was not statistically significant. The results offer the first convincing experimental support for the stimulus estimation model of fear overprediction.

Cognitive-behavioral treatment for panic disorder with gastrointestinal symptoms: a case study.

A 25-year-old woman with a 12-year history of panic disorder with agoraphobia and gastrointestinal symptoms was treated using a cognitive-behavioral program which included: (a) correcting misconceptions about normal bowel functioning, (b) graduated in vivo exposure to internal stimuli which she misinterpreted as precursors of loss of bowel control, (c) graduated in vivo exposure to external stimuli associated with fears of loss of bowel control, (d) establishment of regular eating patterns, and (e) bowel control training. Self-ratings of avoidance and distress, frequency of panic attacks, diazepam use, and negative cognitions decreased with treatment. Treatment gains were maintained at 18-month follow-up. Tailoring of cognitive-behavioral treatment to panic with fears of loss of bowel control was emphasized.

Determinants of Human Fixed-Interval Performance Following Varied Exposure to Reinforcement Schedules.

Undergraduates given accurate instructions pressed keys for token points under either a variety of reinforcement schedules (variety training) or under a single schedule. Response rates on a fixed-interval (FI) test schedule then were assessed. Experiment 1 compared variety training inclusive of Fl-optimal rates (functional) to training excluding such rates (nonfunctional). Participants provided functional training showed low test rates relative to those provided nonfunctional and single-instruction training, implicating response- rate history as a determinant of subsequent Fl performance. Experiment 2 manipulated functional and nonfunctional variety training, and the correspondence of Fl test-phase point densities with those of high-, low-, or both high- and low-rate training components. Performances under Fl were affected by density correspondence, suggesting discriminative control of response rate by point density.

Computer-interfaced operant measurement in treating insomnia

A sleep assessment method consisting of a computer-interfaced hand-held microswitch and bedswitch was tested in an A-B case study with a 22-year-old male insomniac. A comprehensive stimulus control package was used as part of the treatment package (Azrin, 1977). Computer-generated and self-report data were collected and compared on sleep onset latency and time slept. Computer data also indicated time spent awake at night. Both sets of data showed that treatment was followed by clinically significant decrease in sleep onset latency and an increase in time slept. Computer data indicated a reduction in time spent awake. Twelve-month follow-up self-report data revealed continued improved sleeping.