Comparing the effectiveness of similar and dissimilar competing responses in evaluating the habit reversal treatment for oral-digital habits in children.

In the present study 26 children with chronic oral-digital habits were randomly assigned to 1 of 3 conditions. Group 1 received habit reversal using a similar competing response. Group 2 received habit reversal using a dissimilar competing response, and Group 3 served as a wait-list control group. Three videotaped observations were taken at pretreatment and again at posttreatment. In addition, social acceptability data were collected on the treatment groups at posttreatment. Results showed that the similar and dissimilar groups were engaging in significantly less oral-digital behavior at posttreatment when compared to the control group. However, the two treatment groups did not differ from each other in terms of treatment gains or acceptability. These results suggest that habit reversal is an effective treatment for oral digital habits in children. In addition, it appears that the competing response does not function as a physically incompatible behavior. Implications of the findings are discussed.

Applying behavior analysis to clinical problems: review and analysis of habit reversal.

This article provides a review and analysis of habit reversal, a multicomponent procedure developed by Azrin and Nunn (1973, 1974) for the treatment of nervous habits, tics, and stuttering. The article starts with a discussion of the behaviors treated with habit reversal, behavioral covariation among habits, and functional analysis and assessment of habits. Research on habit reversal and simplified versions of the procedure is then described. Next the article discusses the limitations of habit reversal and the evidence for its generality. The article concludes with an analysis of the behavioral processes involved in habit reversal and suggestions for future research.

Evaluation of the validity of the condom use self-efficacy scale (CUSES) in young men using two behavioral simulations.

Assessment of behavioral skills remains critical to the evaluation of HIV prevention interventions; however, investigators often rely upon participant reports of self-efficacy to estimate such skills. We evaluated the relationship between self-efficacy beliefs for condom use and behavioral performance. Forty-three men completed the Condom Use Self-Efficacy Scale (CUSES) and participated in 2 behavioral assessments. Regression analyses indicated that the CUSES subscales relevant to negotiation of condom use did not account for a significant amount of variability in interpersonal skills; similarly, the CUSES subscale relevant to technical condom use skill did not account for variability in the condom application scores. We caution investigators against the assumption that higher self-efficacy reflects behavioral competence for HIV-risk reduction.

PIP: It has been estimated that 1% of young men in the US are infected with HIV. Concern about AIDS has led to the development of theoretical models which address the determinants of behavior change. According to Bandura's self-efficacy theory, self-efficacy informs decisions to engage in risk-reducing behaviors, determines the amount of effort expended, and influences the extent to which an individual perseveres when obstacles are encountered. The Condom Use Self-Efficacy Scale (CUSES) assesses efficacy to purchase condoms, apply and remove them, and negotiate their use with partners. Evidence exists for the reliability of the CUSES. The authors investigated whether perceptions of condom use efficacy measured by the CUSES correlate with related skills when assessed by behavioral role-plays. 43 men completed the CUSES and participated in two behavioral assessments. Regression analyses indicated that the CUSES subscales relevant to the negotiation of condom use did not account for a significant amount of variability in interpersonal skills. Moreover, the CUSES subscale relevant to technical condom use skill did not account for variability in condom application scores. Caution is recommended before assuming that higher self-efficacy reflects behavioral competence for HIV risk reduction.

Predictors of condom use and human immunodeficiency virus test seeking among women living in inner-city public housing developments.

BACKGROUND AND OBJECTIVES: To examine prevalence and predictors of condom use and human immunodeficiency virus (HIV) test seeking among women living in inner-city housing developments. STUDY DESIGN: Between April and June 1994, 671 women living in low-income housing developments in five cities in the United States completed an anonymous self-report questionnaire eliciting information on acquired immune deficiency syndrome (AIDS) risk behavior and characteristics indicative of risk. RESULTS: Most participants were women of color who were economically disadvantaged. Fifteen percent reported multiple sex partners, and 30% of women with one sex partner believed he had sex with someone else in the past year. Predictors of condom use included increased rates of safe-sex negotiation, stronger risk reduction intentions, absence of condom barrier beliefs, and multiple sex partners. Women tested for HIV in the past year were younger, perceived themselves to be at risk for HIV infection, reported more conversations with other women about AIDS concerns, and had condoms readily available. CONCLUSIONS: HIV public health prevention interventions are urgently needed for women who live in low-income urban housing developments.

HIV risk behaviors among women living in low-income, inner-city housing developments.

OBJECTIVES: This study describes the prevalence and predictors of human immunodeficiency virus (HIV) risk behaviors among women living in low-income, inner-city housing developments. METHODS: Anonymous questionnaires were administered to 671 women living in 10 inner-city, low-income housing developments in five US cities to determine their levels of HIV risk behavior and predictors of HIV risk practices. RESULTS: Approximately one third of women were at high risk for HIV because of the risk behavior of their sexual partners. HIV risk was highest among women who accurately perceived themselves to be at increased HIV risk, held strong beliefs about barriers to condom use, and reported weak behavioral intentions to reduce risk. Women at higher risk were also younger and reported higher rates of alcohol and substance use. CONCLUSIONS: HIV prevention efforts are needed for inner-city women. Interventions should focus on overcoming women's barriers to condom use, strengthening their intentions to change behaviors, and managing the risk related to their use of substances.

Self- and cross-citations in the Journal of Applied Behavior Analysis and the Journal of the Experimental Analysis of Behavior: 1983-1992.

We examined self- and cross-citation practices in JABA and JEAB from 1983 through 1992. Mean levels of self-citation for JABA and for JEAB were 22.6% and 36.1%, respectively. Overall, 2.4% of JABA citations were JEAB articles, and 0.6% of JEAB citations were JABA articles, which suggests limited integration of basic and applied research.

Training breast self-examination: a research review and critique.

Despite an increase in knowledge about breast cancer, a relatively low percentage of women practice breast self-examination (BSE) regularly and competently. This article reviews the BSE literature with a focus on training of BSE components, discrimination training, and the effectiveness of training procedures. Methodological issues such as the absence of control groups, lack of criteria for termination of training and reliance on self-reports of BSE frequency are identified weaknesses of BSE training studies. A theoretical analysis of BSE highlights potential difficulties in maintaining regular practice of BSE. Recommendations regarding training of proficient BSE skills and promoting regular practice of BSE are offered, and suggestions for further refinement of BSE training and directions for future research are discussed. Promising avenues of research in BSE training technology include discrimination training (on real or simulated breast tissue) together with computerized assessment of skill proficiency.

The treatment of muscle tics with dissimilar competing response practice.

Prior research has shown that muscle tics can be suppressed by the performance of a competing response contingent on the occurrence of the muscle tics. In an effort to determine whether the topography of the competing response was important to the muscle tic suppressing effects of contingent competing response practice, we evaluated the effects of a competing response that was topographically dissimilar to the muscle tic. Three subjects engaged in dissimilar competing responses contingent on the occurrence of a muscle tic; 2 of these subjects subsequently engaged in similar competing response practice. The results showed a decrease in objective measures of muscle tic frequency with the introduction of dissimilar competing response practice for each subject; subsequent exposure to similar competing response practice for 2 subjects resulted in no additional decrement in the level of muscle tics. These results suggest that the topography of the competing response may not be crucial for the suppression of muscle tics. Discrepancies between the objective measures of muscle tics and self-recorded measures are noted and discussed.

Rumination and vomiting in the developmentally disabled: a critical review of the behavioral, medical, and psychiatric treatment research.

Medical and psychiatric research regarding the treatment of vomiting and rumination among developmentally disabled individuals was selectively reviewed. Because of serious methodological flaws which pervade the psychiatric literature, claims for the effectiveness of psychiatric interventions for vomiting and rumination cannot be justified. Medical interventions (e.g., pharmacological and surgical interventions) were found to be effective when rumination was attributable to a specific organic pathology. In the absence of identified organic pathology for rumination, medical interventions are of questionable efficacy and because of the risks and side effects associated with these procedures, are seldom the intervention of first choice for functional rumination. Behavioral procedures for the treatment of vomiting and rumination are described and critically reviewed for their efficacy, side effects, and the generalization and maintenance of their effects. Although methodological weaknesses limit conclusions regarding the efficacy of some behavioral interventions, several procedures have sound experimental support including oral hygiene, differential reinforcement of incompatible behaviors, and food satiation procedures. These behavioral interventions are the treatments of choice when organic causes of rumination cannot be identified. Suggestions for future research and applications are discussed.

Development and evaluation of an infant-care training program with first-time fathers.

We evaluated the effectiveness of a multicomponent package in training infant-care skills to first-time fathers. After developing and socially validating a set of infant-care skills, we assessed the effects of training in a hospital-based program with expectant fathers (Experiment 1) and in a home-based program with fathers having varied degrees of experience with their infants (Experiment 2). In both experiments, a multiple probe design demonstrated that the training package was responsible for producing criterion performance by the expectant and first-time fathers. A 1-month generalization probe in Experiment 1 showed that the effects transferred across training conditions (training doll to human infant) and settings (hospital to home). An increase in the number of infant-stimulation activities performed by fathers was also observed in both experiments.

A comparison of contingent vs non-contingent competing response practice in the treatment of nervous habits.

Previous research found that two components of the habit reversal procedure, the practice of a competing response (CR) and awareness training, suppressed muscle tics to the same degree as Azrin's entire habit reversal program. This study compared the effectiveness of two variations of the competing response procedure (contingent vs non-contingent practice) on the nervous habits of nine subjects. The results showed the non-contingent competing response to be largely ineffective in decreasing the target behaviors. The contingent competing response procedure greatly reduced the nervous habits of most subjects, and the complete habit reversal procedure further decreased the behavior for two subjects. This research indicates that the competing response procedure is most effective when used in a contingent fashion.

Eliminating selective stimulus control: a comparison of two procedures for teaching mentally retarded children to respond to compound stimuli.

Selective stimulus control occurs when behavior fails to come under control of all characteristics of a compound stimulus after discrimination training. Two different assessment procedures, one used in prior research and the other incorporating incorrect stimuli (S - 's) which differed minimally from the correct stimulus (S+), were used to detect stimulus control deficits characteristic of selective stimulus control. The efficacy of two training procedures in eliminating selective stimulus control observed with three trainable mentally retarded children was evaluated in Experiment 1. A training procedure using S - 's that were minimally different from the S+ was designed to reduce the probability that stimulus discriminations could be based on stimulus characteristics other than experimenter-specified characteristics defining the S+. This procedure proved more effective in preventing and eliminating selective stimulus control as measured by both assessment procedures than an alternate discrimination training procedure that failed to impact the more stringent measures of selective stimulus control. Experiment 2 indicated that these improvements in stimulus control were not a function of varying degrees of difficulty between stimulus sets or of a prior history of discrimination training with the less effective training procedure. The need for better assessment procedures to detect selective stimulus control and suggestions for further improvements in discrimination training procedures are discussed.

Evaluation of a training manual for the acquisition of behavioral assessment interviewing skills.

Two procedures were used to teach behavioral assessment interviewing skills: a training manual and one-to-one instruction that included modeling, rehearsal, and feedback. Two graduate students and two advanced undergraduates were trained with each procedure. Interviewing skills were recorded in simulated assessment interviews conducted by each student across baseline and treatment conditions. Each training procedure was evaluated in a multiple baseline across students design. The results showed that both procedures were effective for training behavioral interviewing skills, with all students reaching a level of 90%-100% correct responding. Finally, a group of experts in behavior analysis rated each interviewing skill as relevant to the conduct of an assessment interview and a group of behavioral clinicians socially validated the outcomes of the two procedures.