Affect Behavior Change Research Articles

Trainees, Teams, and Timely Performance Feedback

Trainees, Teams, and Timely Performance Feedback

Relative efficiency of response-contingent and response--Independent stimulation on child learning and concomitant behavior.

Observations of teachers' use of noncontingent stimulation to elicit behavior from young children with multiple disabilities and profound developmental delays led us to evaluate the relative efficiency of response-contingent and response-independent stimulation to affect child behavior change. Data from three children (2 females, 1 male) with multiple disabilities and delays were analyzed to determine how many child contingency, visual attention, and social affective behavior would be produced per 100 learning opportunities under contrasting stimulus conditions (contingent vs. noncontingent). Results showed for all three child behaviors, response-contingent stimulation was overwhelmingly more efficient in affecting behavior change compared to response-independent stimulation. Implications for intervention are described. Keywords: Response-contingent stimulation, response-independent stimulation, child operant learning, concomitant child behavior, efficiency ********** More than 25 years ago, we initiated a line of research and practice investigating the value of response-contingent learning opportunities with young children with multiple disabilities and profound developmental delays (e.g., Dunst, 1981; Dunst, Cushing, & Vance, 1985; Dunst & Didoha, 1976; Laub & Dunst, 1974). This work was begun in response to experience showing that traditional early intervention and therapy was not effective in promoting the learning and development of these children. Observations of many practitioners over many years have found that the interventions they used with young children with profound developmental delays more often than not involved response-independent or noncontingent stimulation to elicit or evoke child behavior. In most cases, the more disabled and delayed the children, the greater the likelihood that practitioners would spend large amounts of time using noncontingent stimulation to attempt to affect changes in child behavior. The influences of response-contingent and response-independent stimulation on child learning and behavior has been the focus of investigation for many years (e.g., Dunst, 1984; O'Brien, 1992; Utley, Duncan, Strain, & Scanlon, 1983; Vietze, Foster, & Friedman, 1974). Response-contingent stimulation involves the provision of stimulation contingent upon a child's behavior, whereas response-independent stimulation involves the provision of stimulation that is noncontingent or nondependent upon a child's behavior. Findings from studies indicate that noncontingent stimulation at least initially elicits child attention and increased behavior responding, but that children habituate to the response-independent stimulation the longer it is available. In contrast, response-contingent stimulation elicits and maintains child behavior responding for longer periods of time and is often associated with positive social-emotional behavior following contingency detection and awareness (see e.g., Dunst, 2003). The purpose of the analyses in this brief report was to determine the relative efficiency of response-contingent and response-independent stimulation on child operant learning and two concomitant child behavior (visual attention and affective behavior). The analyses were completed on data collected as part of a study promoting teachers' use of contingency games as a form of early childhood intervention with young children with multiple disabilities and profound developmental delays (Raab, Dunst, Wilson, & Parkey, 2007). During the baseline condition of the study, teachers were observed using noncontingent stimulation to elicit child behavior. The effect appeared to be behavior suppression rather than behavior enhancement. The extent to which this observation was confirmed in a secondary analysis of the study data was the focus of this report. The conduct of the original study was guided by a conceptual and operational framework that postulated both immediate and extended benefits of contingency learning opportunities (Dunst et al. …

Motivational Interviewing and Diabetes: What Is It, How Is It Used, and Does It Work?

Motivational interviewing (MI) has recently become a topic of great interest in the diabetes behavioral field, having been the focus of workshops and research presentations at national meetings such as the Society of Behavioral Medicine, the American Diabetes Association, the North American Association for the Study of Obesity, and the Behavioral Research in Diabetes Exchange. The Motivational Interviewing Network of Trainers (MINT) was founded in 1995 and sponsors a website (www.motivationalinterviewing.org) through which MI trainers and researchers share information and ideas. This site provides information, research findings, and training opportunities and is a good starting point for further exploration of MI. According to Miller and Rollnick,1 MI has been applied to the management of a wide range of target behaviors, including addictive behaviors, HIV risk reduction, eating disorders, criminal justice case management, fruit and vegetable intake, exercise, and major psychiatric disorders. MI is a coherent, teachable, evidence-based approach to behavior change counseling that serves as an amalgam of philosophies, principles, and techniques drawn from several existing models of psychotherapy and health behavior change theory.2 For example, its patient-centered approach and focus on empathy and strong reflective listening skills are principally drawn from the client-centered therapy of Carl Rogers and his belief in the “force of life,” the natural self-actualizing tendency of healthy people.3 Other theoretical influences include Bem's Self-Perception Theory,4 Janis and Mann's Decisional Balance Theory,5 and the Transtheoretical Model of Prochaska et al.6 The handbook Motivational Interviewing: Preparing People for Change 1 provides more detail for those interested in the theoretical underpinnings of MI. Hettema et al.7have cogently reported on the emerging theory of how MI affects behavior change. They reviewed evidence suggesting that practitioners who practice MI elicit increased levels of verbalization in support of change, known as “change talk,” and …

Phosphorylated cyclic AMP response element binding protein expression induced in the periaqueductal gray by predator stress: its relationship to the stress experience, behavior and limbic neural plasticity

Electrophysiological studies in cats and recently in rats implicate neuroplasticity in the periaqueductal gray (PAG) and its afferents in stressor-induced increases in fearful behavior and anxiety-like behavior (ALB). Such increases may model aspects of affective changes following traumatic stress in humans. The present study explored the role of neuroplasticity in PAG and its connection with the central nucleus of the amygdala (ACE) in male rodent anxiety-like response to predator stress. In the first of two studies, the effects of predator stress on the induction of phosphorylated cyclic AMP response element binding protein (pCREB) were investigated. pCREB expression in the PAG and ventromedial hypothalamus (VMH) was examined immunohistochemically. Predator stress increased the degree of pCREB expression in PAG cells (measured densitometrically) but did not increase the number of cells expressing pCREB (measured stereologically). Moreover, predator stress-specific increase in pCREB-like immunoreactivity (lir) was restricted to the right lateral column of the PAG. In addition, pCREB lir in the right lateral column likely reflects aspects of the stress experience because the stressor (cat behavior) and the response to the stressor (rat defensive behavior) are highly predictive of degree of pCREB expression. There was no effect of predator stress on pCREB lir in the VMH. Because pCREB expression has been associated with long-lasting potentiation (LLP) of neural transmission, we examined the effects of predator stress on transmission in the ACE-PAG pathway in a second study. Predator stress elevated evoked potential measures of ACE-PAG transmission in the right hemisphere but not in the left hemisphere 11–12 days after predator stress. This finding is consistent with the longer-lived effects of pharmacological stress on amygdalo-PAG transmission in the right hemisphere but not in the left hemisphere in cats. Of interest is the fact that the same aspects of the stressor experience and reaction to it, which are predictive of the degree of pCREB expression, are also highly predictive of the degree of potentiation of measures of ACE-PAG transmission. Behavioral analyses revealed that the most consistent effects of predator stress are on behavior in the plus maze (open arm exploration and risk assessment) and on startle. In addition, covariance analysis suggests that ACE-PAG potentiation mediates some but not all of the changes in ALB produced by predator stress. Because pCREB expression may be a precursor to neuroplastic changes in certain forms of memory and LLP, the present findings complement studies in the cat, showing that neuroplastic changes in the PAG underlie changes in affect following stress. Furthermore, these findings suggest that neuroplastic changes in PAG may be important mediators of predator stress-induced changes in affective behavior in rodents. Finally, consistent with cat and human studies, the right hemisphere appears particularly important in long-term response to stress.

Modification of provider behavior to achieve improved asthma outcomes

Despite an abundance of scientific evidence supporting the use of guidelines, adherence to asthma practice guidelines by physicians generally is low, regardless of provider and patient characteristics. As a result, scientific information, obtained with great effort and at huge expense, is not being translated into clinical practice. To remedy this, we developed a disease management program that emphasizes alteration of provider behavior using operant conditioning. We did this by placing asthma educators in private offices for up to 8 weeks. The educators used a combination of problem-based learning, role modeling, and operant conditioning with positive reinforcement to affect behavior change. As a result of these behavior changes, by the end of 8 weeks the cost to treat asthma patients decreased, despite an increase in the cost of medications. We concluded that behavior-oriented programs targeted at provider offices can lead to improved asthma care while reducing costs.

Acute tryptophan depletion induced by a gelatin-based mixture impairs object memory but not affective behavior and spatial learning in the rat

One manner to study the role of serotonin (5-HT) in behavioral functions is through nutritional manipulation of its precursor tryptophan (TRP). By means of the method of acute TRP depletion, plasma TRP levels can be reduced in a reversible way in both humans and rats. In the present study a TRP-free protein–carbohydrate mixture was used to investigate the behavioral effects of lowering TRP and 5-HT concentrations in adult male rats. These animals were tested in models of anxiety (open field, home cage emergence test), depression (forced swimming test) and cognition (object recognition test and Morris water escape test). The TRP-free protein–carbohydrate mixture substantially reduced the ratio TRP/ΣLNAA within 2 and 4 h by 75 and 60%, respectively. It was found that 4 h after administration, the treatment did not affect anxiety-related behavior nor did it cause depressive-like behavior. Also, no treatment effect was found on spatial learning performance in a Morris water escape test. On the other hand, performance in an object recognition test was clearly impaired after TRP depletion. Taken together, these data suggest that acute lowered central 5-HT levels are not associated with changes in affective behavior (i.e. anxiety and depression), but do impair object memory in adult rats.

"Risk, respect, responsibility": educational strategies to promote safe medicine use.

Nearly four billion outpatient prescriptions will be dispensed in the United States by 2005. Many people using these medicines will be targeted for educational programs promoting their safe, appropriate use. Such programs have been, or soon will be, developed by virtually all major health care system stakeholders, including: government agencies, the pharmaceutical industry, non-profit organizations and coalitions. After examining changes in 1) health professionals' communication of patient medicine information, and 2) consumers' roles and attitudes, an overview of recent U.S. and international consumer education programs is presented. Despite the proliferation of these programs, most share a weak link in evaluating success and in affecting behavior change. Finally, suggestions for future initiatives are offered, particularly regarding improving evaluation methods.

Progestins influence performance on cognitive tasks independent of changes in affective behavior

In this study, the effects of progestins on various cognitive and affective tasks were investigated. Ovariectomized rats (N = 72) received subcutaneously 0.0, 4.0, or 8.0 mg/kg of progesterone (P), dihydroprogesterone (DHP), or 5α-pregnan-3α-ol-20-one (3α,5α-THP) suspended in 10% ethanol/sesame oil v/v. For the cognitive tasks (Y-maze, inhibitory avoidance, and object recognition), the subjects were injected after habituation and training trials and were tested 24 h later. For the nociception and affective tasks (open field, elevated plus-maze, and tailflick), the subjects were injected 1 or 24 h before testing. P reduced latencies to the goal arm in the Y-maze, enhanced latencies to the shock-associated side of the inhibitory avoidance chamber, and increased the percentage of time with a novel object. DHP reduced latencies to the goal arm, increased the percentage of correct choices in the Y-maze, and increased crossover latencies in the inhibitory avoidance task. 3α,5α-THP administration enhanced performance in the inhibitory avoidance task. P, DHP, and 3α,5α-THP increased the number of entries into the central squares of a brightly lit open field, open arm time in the elevated plus-maze, and tailflick latencies, when administered 1 h, but not 24 h, prior to testing. These data suggest that some progestins, when administered following habituation and training and 24 h prior to testing, produce changes in cognitive performance that do not coincide with overt changes in the affective behaviors examined.

An Examination of Learning and Affective Behaviours In a Didactic Dietetics Program Suggests The Need For Innovative Curricula

The purpose of this study was to identify cognitive and affective behavior changes in dietetic students progressing through a didactic dietetics program. Construct measurements were taken from the Cognitive Behavior Survey, Rosenberg Self-Esteem Scale, and Rotter Internal-External Locus of Control Scale. After obtaining informed consent, 58 survey sets were administered early Fall 1995 during an introductory dietetics course. Identical survey sets were re-administered Fall 1997 to the 24 continuing students; 19 of these 24 survey sets were returned. Data were analyzed using SPSS for Windows, 6.1 and Epilnfo 6.0. The median age was 23 years (ranging from 20–50) and grade point average was greater than 3.5 or between 3.49 and 3.0 for eight and seven subjects respectively. Comparisons between the 1995 class (n=58) and the 1996 introductory dietetics class (n=41), between the continuing students (n=24) and program drop-outs, and between continuing students who completed retest surveys (n=19) with those who didn’t, verified that this sample represented dietetic students at this university. Changes in the use of memory (t 0.24, df 17, p 0.81), reflection (t 0.07, df 17, p 0.95), and conceptualization (t .13, df 17, p 0.89) were not significant. Self-esteem and locus of control, which were high and internal, respectively, remained stable (t 0.50, df 17, p 0.63; t 0.31, df 15, p 0.76 respectively), however positive learning experience (PLE) scores decreased over the two year period (t 3.79, df 17, p 0.002). An examination of variables and specific PLE scale items was unable to explain this decrease. At least one-half of the subjects found the current experience to be less motivating, enjoyable, rewarding, and felt their experience was more tedious, and less likely to lead to new questions. An educational environment that nurtures student-centered learning behaviors may result in a more positive learning experience.

Teaching The Food Guide Pyramid to Kindergartners: Does it Affect Their Choices During School Lunch?

This study set out to determine if kindergartners can learn nutrition information from the Food Guide Pyramid, and if they put this information into practice during school lunch. Seventy kindergarten students from two public schools were involved, two classes from one school served as the experimental group, and two classes from the other school served as the control. Subjects completed oral pre- and posttests of Pyramid knowledge, before and after 13 weeks of nutrition lessons were given to the experimental classes. Tray waste data were collected for one week before and after the intervention, and two days were selected to use for comparison. Paired samples t-tests were used to compare pre- and post-intervention knowledge scores and to compare pre- and post-intervention tray waste data. Independent samples t-tests were used to compare the two schools to each other. A statistically significant difference was found between the experimental and control schools’ nutrition knowledge scores on posttests, and between the two experimental classes on posttests. A significant difference was found between the experimental and control schools during the pre-intervention tray waste survey; therefore, they could not be directly compared to each other. There were no significant differences found in meat, vegetable, fruit, or bread consumption. The only significant difference was an increase in milk waste for both intervention classes from pre- to post-intervention. Teaching the Food Guide Pyramid to kindergartners increases their knowledge; however, it has no effect on the proportion of waste they leave on their tray. Dietitians could be instrumental in developing ways to affect behavior change. As dietitians, we need to continue looking for creative ways to help children translate their knowledge into practice.

Music therapy as a nursing intervention.

1. Music, a universal language with many purposes, can be used in the health care setting to aid in stress reduction and anxiety. 2. When used in the psychiatric setting, music can elicit emotion and affect behavior change. 3. Nurses in the psychiatric setting can include music in a group session that evokes thoughts, feelings, and memories for the clients.

Respecifying the Social Marketing Model for Unique Populations

Social marketing strategies are deployed in social change campaigns around the world. Yet the usefulness of social marketing strategies to affect behavior change among unique population members is not well known. Social marketing is efficient and cost-effective when a campaign targets a sufficiently large audience so as to achieve economies of scale. Unique population groups, however, typically consist of few members. How can efficiency be achieved with small target audiences? To solve this conundrum we suggest that certain social marketing strategies (environmental mapping, formative evaluation, interpersonal communication channels, and the nonmonetary costs of adoption) should be emphasized, and others (program management and target audience segmentation) deemphasized, in program design. We use examples drawn from a recent study of HIV prevention programs in San Francisco to illustrate this point.

Physician Assessment of Patient Motivation: Influence on Disposition for Follow-up Care

This study of 3,318 outpatient visits evaluated the influence of the physician-assessed level of patient motivation on the level of physician involvement in follow-up care. Data collected included patient demographics, health risk factors, physician-assessed level of patient motivation, and the disposition for follow-up care (return office visit or self-care). Physicians more frequently scheduled patients for a return office visit, regardless of assessed level of patient motivation, when they presented with a traditional biomedical problem. Patients with health promotion-disease prevention problems were more frequently relegated to self-care; patients physicians judged to be poorly motivated were four times as likely to be relegated to self-care. We discuss the implications of physician overuse of self-care strategies on the health status of poorly motivated patients. Factors influencing such physician behavior may include prior unrewarding experiences with poorly motivated patients, perceived lack of skill in affecting behavior change, time constraints, lack of reimbursement for preventive care services, and the actual process of physician education and professional socialization.

The impact of increasing intensity of health promotion intervention on risk reduction.

The HealthWise Stepped Intervention Study (1988-1990) at Pacific Gas and Electric was conducted to evaluate how a health promotion program affects behavior change and whether increasing levels of preventive interventions improve health status. The basic intervention components consisted of health risk assessment and health newsletter (Levels 1, 2, 3, and 4). Additional interventions were health resource center and self-care books (Levels 2, 3, and 4), behavioral change workshops and Division Healthwise team (Levels 3 and 4), and case management and environmental policy (Level 4). The study employed a quasi-experimental design with nonequivalent control groups. The overall risk status has significantly improved at all four intervention levels. The comparison across the four intervention levels found that Level 4, combining environmental policy with "high risk" targeting, showed the most impressive performance. Participants in Level 4 consistently showed significantly greater improvement in life-style factors, and their overall risk status also showed the greatest improvement.

An Observationally Based Rating Scale for Affective Symptomatology in Child Psychiatry

There is growing dissatisfaction with current methods for rating affective symptoms in children. We report findings from a preliminary psychometric study of an alternative approach, that of direct observational ratings. The Emotional Disorders Rating Scale (EDRS) is an observation-based instrument containing 59 items divided into eight subscales. The results of this study indicate that measurement of nonverbal components of affective symptoms in children is feasible. Interrater reliability and internal consistency of the EDRS subscales were high. The EDRS also has potential as a measurement of state-related changes in affective behavior and as a technique for examining treatment response.

The status of evaluation research in communication training programs

The purpose of this study was to determine the frequency and types of evaluation research methods used in communication training programs. A random sample of internal or in‐house human resource (HR) trainers were surveyed and asked to respond to a series of questions concerning evaluation practices used in planning, implementing, and assessing communication training programs. The findings suggest that: (1) HR trainers, for the most part, do not conduct needs analyses while planning communication training programs; (2) the majority of HR trainers collect data on trainees’ attitudes toward communication training programs; (3) the majority of HR trainers do not measure changes in cognitive, affective and psychomotor behaviors or job performance that may occur as a result of participation in communication training programs; (4) experimental and quasi‐experimental designs are used by only a very small percentage of HR trainers; and (5) cost benefit analyses are seldom used to assess the economic effects of com...

Effects of bicuculline infusions in the ventromedial hypothalamus and amygdaloid complex on food intake and affective behavior in mother rats.

The mother rat is hyperphagic, aggressive toward other adults, and less fearful than non-maternal rats. The present experiments were conducted to examine whether GABAergic (gamma-aminobutyric acid) mechanisms in the ventromedial hypothalamus and amygdala participate in the control of these behavioral changes. Unilateral infusions of the GABA receptor blocker bicuculline (60 ng/0.5 microliter) into the ventromedial hypothalamus depressed food intake and lowered aggression. Similar infusions into the amygdaloid complex did not affect eating, but they did reduce aggressive behavior. Freezing behavior, a natural fear response, was not affected by the hypothalamic or the amygdaloid bicuculline infusions. These data support previous evidence suggesting a role for GABA in the regulation of postpartum changes in food intake and affective behavior.

Affective behavior and weight changes among hospitalized failure-to-thrive infants

The affective behavior and weight change of 12 nonorganic failure-to-thrive, 12 organic failure-to-thrive, and 12 control infants (M age = 8 months) were compared across their hospitalization. Infant affect was evaluated at approximately the beginning, middle, and endpoints of hospitalization using the Behavioral Assessment Scale. Among the failure-to-thrive infants, positive responses to stimulation at the initial assessment were related to weight loss across the course of hospitalization, while positive responses to the same stimulation at the middle assessment were related to weight gain. These unexpected results coupled with the finding that 70% of the failure-to-thrive infants gained weight and 30% lost weight across hospitalization led to a comparison between infants who gained and infants who lost weight. An increase in positive affect across hospitalization occurred only for the infants who gained weight. Paradoxically, the losers may have experienced hospital stimulation as less adequate than maternal stimulation, while the gainers may have experienced hospital stimulation as more adequate than home stimulation.

Hunger in humans induced by 2-deoxy-D-glucose: glucoprivic control of taste preference and food intake.

Intracellular glucopenia induced by 2-deoxy-D-glucose (2DG) administration in man produces increased hunger ratings and magnitude estimates of pleasantness for sucrose solutions. Augmented food intake substantiates these changes in affective behavior and relieves experimentally induced hunger. Intracellular glucopenia activates counterregulatory mechanisms to raise plasma glucose concentrations. Inducing hunger experimentally with 2DG provides a useful method for studying appetitive behavior in humans. The neurohumoral control of pituitary hormone release and other hypothalamic functions may be examined after 2DG infusion.

Affective behavior changes in cats following operant conditioning of amygdaloid EEG activity

Enhanced agonistic behaviors were observed in cats following training, using biofeedback techniques, which increased the EEG activity recorded from the lateral amygdaloid nucleus. The animals' affective behavior returned to pretraining baseline levels after the elevated EEG activity had been extinguished. Results are discussed in the context of the significance of high frequency electrical activity of the brain.