Negative Reinforcement Research Articles

Concurrent and lagged associations among pain medication use, pain, and negative affect: a daily diary study of people with chronic low back pain.

People with chronic pain often attempt to manage pain and concurrent emotional distress with analgesic substances. Habitual use of such substances-even when not opioid-based-can pose side effect risks. A negative reinforcement model has been proposed whereby relief of pain and emotional distress following medication consumption increases the likelihood that the experience of elevated pain and distress will spur further medication use. People with chronic low back pain (N = 105) completed electronic diary assessments 5 times/day for 14 consecutive days. Lagged and cross-lagged analyses focused on links between time 1 pain and negative affect (NA) and time 2 analgesic medication use and vice versa. Sex differences were also explored. Primary results were as follows: (1) participants on average reported taking analgesic medication during 41.3% of the 3-hour reporting epochs (29 times over 14 days); (2) time 1 within-person increases in pain and NA predicted time 2 increases in the likelihood of ingesting analgesic medications; (3) time 1 within-person increases in medication use predicted time 2 decreases in pain and NA; and (4) lagged associations between time 1 pain/NA and time 2 medication use were strongest among women. Findings suggest that the use of analgesic medications for many people with chronic pain occurs frequently throughout the day. Results support the validity of a negative reinforcement model where pain and distress lead to pain medication use, which in turn leads to relief from pain and distress.

Methods and functions of non-suicidal self-injury in an adolescent and young adult clinical sample

BackgroundNon-suicidal self-injury (NSSI) is an emerging critical medical condition among adolescents and young adults worldwide. They use different methods for expressing their emotional needs. The aim of this study was to identify the methods of NSSI used by adolescents and young adults who presented with different psychiatric disorders, and their utilized functions.Subjects/materials and methodsA case–control study was done on 100 late adolescent and young adult patients who attended Suez Canal University with psychiatric disorders. Sociodemographic data was obtained then they were assessed by the Mini-International Neuropsychiatric Interview and the Brief Non-suicidal Self-Injury Assessment Tool.ResultsAmong the case group, 54% used scratching for self-harm while 36% used cutting. The most common body areas were hands (44%) and arms (42%). Eighty percent of the case group endorsed non-suicidal self-harm for dealing with anger, while 78% to cope with uncomfortable feelings and 72% to relieve stress with no statistically significant difference between males or females, nor among psychiatric comorbidities.ConclusionThe most common method of NSSI was scratching and it was followed by cutting and banging. The most common body areas were hands and arms. Patients endorsed NSSI for various motives and several functions. However, Items on the automatic negative reinforcement scales were the most common functions, especially when dealing with anger.

Latent Change Trajectories in Mood During Focused CBT Enhanced for Eating Disorders Are Associated With Global Eating Pathology at Posttreatment and Follow-Up Among Individuals With Bulimia Nervosa Spectrum Disorders: A Preliminary Examination

Bulimia nervosa (BN) is characterized by recurrent loss of control over eating (LOC) and inappropriate compensatory behaviors. Although cognitive-behavioral therapy (CBT) is efficacious for BN, many patients continue to experience symptoms at posttreatment. One potential driver of this low treatment response may be low mood, which maintains BN symptoms through negative reinforcement. Thus, it is important to understand how mood changes over enhanced cognitive-behavioral therapy (CBT-E) and whether these changes are associated with improved treatment outcomes. Participants (N = 56) with BN-spectrum eating disorders (EDs) received 16 sessions of the focused version of CBT-E. The Eating Disorder Examination (EDE) was used to measure ED symptoms (global ED pathology, frequency of binge episodes, and compensatory behaviors) at pre- and posttreatment. Latent growth mixture modeling (LGMM) of affective ratings via digital self-monitoring identified latent growth classes. Kruskal–Wallis H tests examined the effect of trajectory of change in mood on pre- to posttreatment symptom change. LGMM yielded a four-class model that best fit the data representing distinct mood trajectories over the course of treatment: (a) highest baseline mood, linear improving; (b) moderate baseline mood, stable; (c) moderate baseline mood, quadratic worsening; and (d) lowest baseline mood, quadratic improving. Participants who demonstrated worsening mood over treatment (i.e., individuals in the “moderate baseline mood, quadratic worsening” class) had significantly higher EDE global scores at posttreatment and follow-up compared to participants with stable mood across treatment. Change in LOC eating frequency and compensatory behaviors across treatment did not significantly differ by mood class. The main effect of mood class or interaction effect between time and mood class on objective binge episodes, subjective binge episodes, and compensatory behaviors was not significant. There were no significant differences in global ED pathology at either posttreatment or follow-up for any other class comparisons. These results suggest that certain trajectories of change in mood during treatment are particularly associated with change in pre- to posttreatment EDE global score. If replicated, our findings could suggest that future iterations of CBT-E should target mood early in treatment in order to maximize reductions in global eating pathology.

Mastering minds: Unleashing the power of Neuro-Linguistic Programming in workplaces and schools

Neuro-Linguistic Programming (NLP) intricately examines the visual, auditory, and kinesthetic representation systems, traversing the transformative trajectory from superficial to profound linguistic structures. This comprehensive paradigm elucidates the sophisticated cognitive processes through which the brain interprets events, molding emotions and behaviors through filters such as values, beliefs, memories, decisions, and meta-programs. As a potent catalyst for excellence and success, NLP empowers individuals and organizations to realize their aspirational objectives, nurturing flexibility, creativity, and autonomous behaviors. In educational contexts, practitioners adeptly employ NLP techniques to navigate conflicts, enhance leadership acumen, and inspire personnel toward organizational goals. NLP assumes a crucial role as a foundational element for ongoing learning, development, and the cultivation of dynamic capabilities within professional environments. Its applications extend beyond conventional business domains, seamlessly integrating with behavior modification models employed in psychotherapeutic settings. In the realm of child psychiatry, NLP addresses neurodevelopmental disorders, such as oppositional defiant disorder, with the potential to mitigate triggers in educational milieus. The Behavior Modification Model, anchored in the ABC (antecedents, behavior, and consequences) framework, meticulously shapes behaviors through positive and negative reinforcement and punishment. NLP is a versatile professional instrument applicable across personal development, therapeutic interventions, and diverse organizational landscapes. It is pivotal in elevating communication effectiveness, facilitating conflict resolution, and propelling individual and collective success to new heights. Applying NLP in schools proves invaluable by elevating teaching methodologies, cultivating effective communication, and nurturing essential skills for conflict resolution and leadership. Integrating NLP in educational settings can offer a holistic approach to learning, providing support for educators and students alike in navigating intricate situations and fostering an environment of continuous improvement. Implementing NLP should be approached with a balanced understanding of both its potential benefits and the need for empirical validation and ethical considerations.

행동활성화체계 및 행동억제체계가 SNS 중독경향성에 미치는 영향

Objectives The purpose of the study examines the effects of the behavioral activation system(BAS) and the be-havioral inhibition system(BIS) on social network service(SNS) addiction proneness, the mediation effect of SNS use motives, and the moderated mediation effect of self-control and distress tolerance in the link between BAS, BIS, SNS use motives, and SNS addiction proneness. Methods BAS, BIS, SNS use motives, self-control, distress tolerance, and SNS addiction proneness of 342 adults were measured online. Results First, BAS and BIS predicted SNS addiction proneness. Second, positive reinforcement motives mediated the relationship between BAS and SNS addiction proneness, and negative reinforcement motives mediated the relationship between BIS and SNS addiction proneness. Third, self-control moderated the mediation effect of positive reinforcement motives between BAS and SNS proneness among passive users. Fourth, distress tolerance moderated the path from negative reinforcement motives to SNS addiction proneness in the mediation model. Conclusions These results expanded the understanding of the effect of the organic and motivational factors on SNS addiction proneness, and suggested that distress tolerance could have a significant role in reducing the effect of BIS on SNS addiction proneness.

Emotion Dysregulation and E-Cigarette Expectancies among College Student E-Cigarette Users

Background: E-cigarette outcome expectancies (i.e., beliefs about the expected consequences of e-cigarette use) are a key factor in motivating use. Emotion regulation difficulties have demonstrated significant associations with outcome expectancies; however, there has yet to be an examination of associations between specific emotion regulation difficulties and specific e-cigarette outcome expectancies, which could serve as targets for intervention efforts. Therefore, the current study sought to examine the unique predictive ability of specific emotion regulation difficulties in terms of e-cigarette outcome expectancies. Methods: Participants were 116 college student e-cigarette users (Mage = 19.72, SD = 1.88; 71.6% female) who completed self-report questionnaires for course credit. Results: Greater difficulties engaging in goal-directed behavior when experiencing negative emotions and fewer difficulties accessing effective emotion regulation strategies were associated with positive reinforcement outcome expectancies. Greater emotion regulation difficulties in general were also associated with negative reinforcement outcome expectancies, though there were no significant individual predictors. Conclusion: These results suggest that greater emotion regulation difficulties are associated with mood-related e-cigarette outcome expectancies, and targeting emotion regulation difficulties, particularly difficulty engaging in goal-directed behavior when upset, may be useful to incorporate into intervention efforts.

Effects of mint, menthol, and tobacco-flavored e-cigarettes on tobacco withdrawal symptoms in adults who smoke menthol cigarettes: A laboratory pilot study

BackgroundMenthol cigarette smoking has remained stable or increased in certain groups, despite an overall decline in cigarette smoking rates in the U.S. Understanding whether e-cigarettes alter patterns of menthol cigarette use is critical to informing efforts for reducing the public health burden of menthol cigarette smoking. This 2019–2020 laboratory pilot study evaluated whether self-administration of mint-, menthol-, or tobacco-flavored e-cigarettes would differentially impact tobacco withdrawal symptoms in e-cigarette-naïve adults who smoke menthol cigarettes daily. MethodsParticipants (N=17; 35.3% Female; mean age=51.8) attended three laboratory sessions after 16-hours of tobacco abstinence. Participants self-administered a study-provided JUUL e-cigarette (0.7mL with 5% nicotine by weight) at each session in which flavor was manipulated (mint vs. menthol vs. tobacco; order randomized). Participants completed pre- and post-e-cigarette administration self-report assessments on smoking urges, nicotine withdrawal, and positive and negative affect states. Multilevel linear regression models tested differences between the three flavor conditions for individual study outcomes. ResultsFollowing overnight tobacco abstinence, vaping either a mint or menthol (vs. tobacco) flavored e-cigarette led to significantly greater reductions in smoking urges over time; menthol (vs. tobacco) flavored e-cigarettes also suppressed urges to smoke for pleasure. Notably, no differences in nicotine withdrawal, positive affect, or negative affect were observed. ConclusionsIn this laboratory pilot study, mint and menthol (vs. tobacco) flavored e-cigarettes provided some negative reinforcement effects via acute reductions in smoking urges during tobacco abstinence, yet only menthol flavored e-cigarettes demonstrated suppressive effects on smoking urges for pleasure in adults who smoke menthol cigarettes daily.

Functional analysis screening for inappropriate mealtime behavior

AbstractInappropriate mealtime behavior (IMB) is a class of food refusal behavior that is commonly observed in children with neurodevelopmental disorders or avoidant/restrictive food intake disorder. An abundance of research has demonstrated that IMB is commonly maintained by negative reinforcement in the form of escape from food or drink presentation. Given the common association between IMB and escape as a reinforcer, more efficient methods of conducting functional analyses have been called for. The present study examined the extent to which indirect assessments and a functional analysis screening process reliably predicted an escape function in three children with autism spectrum disorder who engaged in IMB. The results of the two assessments were then compared to a standard functional analysis. For all participants, the functional analysis identified an escape function, which corresponded with both the indirect assessment and screening. Additionally, within‐session analyses of screening sessions further validated the screening process. The functional analysis screening of IMB is discussed in terms of its efficiency, practicality, and experimental design. The results of this study offer a framework for efficiently assessing the function of IMB, while providing recommendations for future research.

Sleep quality impacts the link between reactivity to uncertain threat and anxiety and alcohol use in youth.

Individual differences in reactivity to unpredictable threat (U-threat) have repeatedly been linked to symptoms of anxiety and drinking behavior. An emerging theory is that individuals who are hyper-reactive to U-threat experience chronic anticipatory anxiety, hyperarousal, and are vulnerable to excessive alcohol use via negative reinforcement processes. Notably, anxiety and alcohol use commonly relate to disruptions in sleep behavior and recent findings suggest that sleep quality may impact the link between reactivity to U-threat and psychiatric symptoms and behaviors. The aim of the current study was to examine the unique and interactive effects of reactivity to U-threat and sleep quality on anxiety symptoms and drinking behavior in a cohort of youth, ages 16-19 years. Participants (N = 112) completed a well-validated threat-of-shock task designed to probe individual differences in reactivity to U-threat and predictable threat (P-threat). Startle eyeblink potentiation was recorded during the task as an index of aversive reactivity. Participants also completed well-validated self-report measures of anxiety and depression symptoms, lifetime alcohol use, and current sleep quality. Results revealed significant startle reactivity to U-threat by sleep quality interactions on anxiety symptoms and lifetime drinking behavior. At high levels of sleep disturbance (only), greater reactivity to U-threat was associated with greater anxiety symptoms and total number of lifetime alcoholic beverages. These results suggest that sensitivity to uncertainty and chronic hyperarousal increases anxiety symptoms and alcohol use behavior, particularly in the context of poor sleep quality.

Childhood maltreatment and engaging in NSSI for automatic-negative reinforcement: The mediating role of alexithymia and moderating role of help-seeking attitudes

BackgroundThere is evidence indicating that childhood maltreatment is linked to the occurrence of non-suicidal self-injury (NSSI). Nevertheless, the association between childhood maltreatment and the automatic-negative reinforcement aspect of NSSI remains understudied. Chapman's (2006) experiential avoidance model posits that the main factor in sustaining NSSI is negative reinforcement, specifically through the avoidance or escape from distressful emotional experiences. The current study examines a conceptual framework based on this theory and the available literature that explores the potential mediation role of alexithymia in the relation between childhood maltreatment and the automatic-negative reinforcement of NSSI. Additionally, this study investigates how this process may be influenced by individuals' attitudes toward seeking professional help. Methods3657 adolescents (1616 females) completed questionnaires regarding childhood maltreatment, alexithymia, help-seeking attitudes, the NSSI, and its functions. ResultsThe findings of the study exposed a positive link between childhood maltreatment and the automatic-negative reinforcement of NSSI, with the mediating role of alexithymia. Interestingly, it was unexpected to discover that individuals with high help-seeking attitudes experienced an intensification of the relationship between childhood maltreatment and both alexithymia and the automatic-negative reinforcement of NSSI. LimitationThe study's cross-sectional design hindered the inference of causality. ConclusionThe present study demonstrated that it is crucial to consider the impact of both alexithymia and help-seeking attitudes in adolescents who have experienced maltreatment. These findings hold implications for preventive interventions that target the reduction of NSSI behaviors driven by automatic-negative reinforcement.

The Effect of Using Some Applied Behavior Analysis Techniques (Positive and Negative Reinforcement) in Teaching Practical Life Skills in Mentessori Approach for Children with Autism spectrum disorder (ASD)

The Effect of Using Some Applied Behavior Analysis Techniques (Positive and Negative Reinforcement) in Teaching Practical Life Skills in Mentessori Approach for Children with Autism spectrum disorder (ASD)

Co-occurring trauma- and stressor-related and substance-related disorders in youth: A narrative review

Adolescence is characterized by ongoing neurodevelopment and psychosocial development, resulting in a unique window to the adverse effects of traumatic events and substance use. In addition, trauma- and stressor-related disorders and substance use disorders (SUDs) commonly co-occur in adolescents. Youth with interpersonal violence and who have experienced multiple past traumas, or poly-victimization, are at the highest risk of developing these co-occurring disorders. There is a strong bidirectional relationship between traumatic events and substance use that predisposes youth to developing post-traumatic stress symptoms (PTSS) and SUDs. PTSD and states of substance intoxication and withdrawal also exhibit overlap in symptomatology. High rates of comorbidity may be explained in part by the self-medication hypothesis, that posits that individuals use substances to temporarily alleviate trauma-related symptoms. However, this results in negative reinforcement, often with increasing patterns of substance use and worsening symptoms of hyperarousal, dysphoria, and anxiety. In addition, PTSS and substance use problems share common risk factors and neurobiologic etiology, conceptualized as the susceptibility hypothesis. Youth who experience traumatic events and/or have substance use problems access the healthcare system at multiple levels, including through acute care and crisis services. Notably, substance use in adolescence increases the likelihood of experiencing a traumatic event, and youth presenting to the emergency department for substance-related problems are at higher risk of having a PTSD. Youth presenting for mental health, behavioral, or substance-related problems should be screened for PTSS and substance use problems. Given the strong clinical overlap and bidirectional relationship, evidence-based treatment integrates management of both disorders. An interdisciplinary approach with psychotherapy, psychopharmacologic therapy, and case management is often vital to engaging and maintaining youth in treatment.

Impact Responses and Wave Dissipation Investigation of a Composite Sandwich Shell Reinforced by Multilayer Negative Poisson's Ratio Viscoelastic Polymer Material Honeycomb.

This analysis investigated the impact wave response and propagation on a composite sandwich shell when subjected to a low-velocity external shock, considering hygrothermal effects. The sandwich shell was crafted using face layers composed of functional gradient metal-ceramic matrix material and a core layer reinforced with negative Poisson's honeycomb. The honeycomb layer consisted of a combination of viscoelastic polymer material and elastic material. The equivalent parameters for the functional gradient material in the face layers were determined using the Mori-Tanaka and Voigt models, and the parameters for the negative Poisson's ratio honeycomb reinforcement core layer were obtained through Gibson's unit cell model. Parameters relevant to a low-velocity impact were derived using a modified Hertz contact law. The internal deformations, strains, and stress of the composite sandwich shell were described based on the higher-order shear deformation theory. The dynamic equilibrium equations were established using Hamilton's principle, and the Galerkin method along with the Newmark direct integration scheme was employed to calculate the shell's response to impact. The validity of the analysis was confirmed through a comparison with published literature. This investigation showed that a multilayer negative Poisson's ratio viscoelastic polymer material honeycomb-cored structure can dissipate impact wave energy swiftly and suppress shock effectively.

Age-related variations of the psychosocial determinants of problematic alcohol consumption

Objective As alcohol consumption generally occurs in interpersonal contexts, many studies have examined the psychosocial mechanisms underlying drinking habits. However, most have focused on young/student populations, and far less is known regarding how these psychosocial determinants evolve through adulthood. We thus compared the weight of psychosocial factors in problematic alcohol consumption among young, middle-aged and older people from the general population. Methods A general population sample completed an online survey (N = 614, M age = 34.44, Range= 18–85). We measured demographic variables, problematic alcohol consumption and alcohol-related psychosocial factors (i.e. expectations, motives, norms, social identity, anxiety and depression). We performed dominance analyses to rank the importance of these psychological factors in explaining problematic alcohol consumption across young (18–24, n = 252), middle-aged (25–40, n = 179), and older (>40, n = 183) individuals. Results In young adults, enhancement motives were the most important determinant of problematic alcohol consumption, followed by social drinking identity, coping and social motives. In the middle-aged group, social identity had the highest contribution, followed by social and enhancement motives. Finally, problematic alcohol consumption among older adults was mainly related to coping motives and social identity. Discussion We showed that the psychosocial determinants of problematic alcohol consumption differ with age. While social drinking identity has a significant influence throughout the age groups, we documented a progressive shift from positive (social/enhancement) to negative (coping) reinforcement between younger and older individuals. This study provides a better understanding of the profiles of consumers according to age, and offers guidelines to adapt prevention and interventions to the age group targeted.

PKM. PEMBERIAN REINFORCEMENT DALAM PEMBELAJARAN DAN PERKEMBANGAN MORAL ANAK DI PAUD III SARASWATI DENPASAR

This PKM is motivated by the absence of a real solution regarding providing reinforcement at PAUD III Saraswati Denpasar school. This service aims to provide a solution for how to provide reinforcement for the moral development of early childhood in preschool education. The methods used are socialization and mentoring. In the implementation of the 1st and 2nd stages of PKM socialization, much progress has been achieved. Data was obtained through free interviews, observation and documentation. Data sources were obtained through school principals, class teachers who functioned as informants. The results of the service found included: In learning aspects of moral development, there were several reinforcements provided by other educators/teachers at PAUD III Saraswati Denpasar, namely: the use of positive reinforcement and the use of negative reinforcement. Learning aspects of moral development at PAUD III Saraswati Denpasar is carried out through all activities including: habituation, singing songs, shouting moral messages, stories, and so on. The impact that occurs after reinforcement is given to children is: positive reinforcement includes: children become happy, enthusiastic about following lessons. Meanwhile, negative reinforcement includes: not repeating bad actions. Providing reinforcement can improve the moral development of early childhood because after being given reinforcement, children who have good moral development increasingly increase their moral development, while children who have less moral development gradually experience positive development over time after being given continuous negative reinforcement.

An experimental analysis of task refusal: A comparison of negative reinforcement contingencies and transitions between academic tasks

AbstractThe purpose of the study was to do an experimental analysis of academic task refusal for one girl with a developmental disability. Task refusal was analyzed in two experimental analyses. First, an analysis testing if the behavior was maintained by negative reinforcement, and the second, an analysis testing if the behavior was the result of transitioning between academic tasks differing in preference. Task refusal did not occur in the demand condition of the functional analysis, indicating that the behavior was not maintained by escape from demands. Conversely, task refusal occurred solely in the second experimental analysis when transitioning from a high‐preferred to a low‐preferred academic task. In this case, the context of terminating a preferred academic task and transitioning to a less preferred academic task was aversive but not the demand itself. In addition, when an embedded break condition was compared to a no break condition in a multielement design, task refusal was reduced to zero levels.

Unshadowing the Stories of Yesterday’s Failed Battle of Let Examinees

This phenomenological study aimed to unshadow the failed experiences of the Licensure Examinations for Teachers (LET) examinees, how the examinees cope with the failed experience during the LET, and the insights they have on their experience. The study utilized a qualitative design using a descriptive phenomenology approach, with ten failed LET examinees selected through snowball sampling. The researchers used Colaizzi’s Method of Data Analysis as a data analysis tool. The results revealed that the experiences of failed LET examinees are associated with themes such as Time Management, Unpreparedness, Learning Environment, and The Effect of the Support System. Moreover, the study revealed the coping mechanism of failed LET examinees with the themes: Negative Reinforcement, Diverting attention to other things, and Good Support. Furthermore, the failed LET examinee’s insights showed the themes: Setting goals, Health and Expectations, and Integration of Optimism and Pessimism. The analyzed findings of this study unveil the various experiences encountered by the failed LET examinees and how they cope. Thus, this study contributes significant knowledge to examinees who will take the LET in the future and will retake the LET.

Higher education responses to accountability

This paper estimates the impact of accountability scores on Brazilian higher education. We implement a regression discontinuity design to explore a natural experiment resulting from the federal rules for assigning quality levels to undergraduate programs. We test whether program quality is sensitive to negative reinforcement, such as punishments imposed when a minimum threshold is not attained. The findings indicate that program administrators exhibit a positive response to the prospect of punishment by enhancing program quality in the subsequent evaluation cycle. The primary drivers of this advancement – infrastructure, teaching and learning evaluations, faculty dedication, and the proportion of faculty with a Ph.D. degree – are largely under the administrators’ direct control. However, quality indicators less subject to administrative manipulation, such as student performance and value-added measures, exhibit minimal change.

Offline Model-Learning by Learning Legal Moves in Othello through Synthetic Negative Reinforcement

One of the biggest dependencies of reinforcement learning is sample efficiency since reinforcement learning agents tend to use an excessively large number of episodes to train. These episodes can be expensive, especially when they are conducted in an online manner. Model-Based Reinforcement Learning (MBRL) and offline learning are two methods to aid this problem; MBRL has been shown to improve sample efficiency while offline learning can reduce the number of online episodes needed by substituting them with less expensive offline ones. However, the use of these two methods together is more challenging, encountering issues such as training off of incomplete distributions. We explore these challenges by testing different combinations of offline and online model-learning through learning the legal moves in the board game Othello. During this process, we encounter the additional challenge of only positive reinforcement where offline episodes only provide information about legal moves. To address this problem, we propose a method named synthetic negative reinforcement which uses pre-existing agent knowledge to make up for the lack of information on illegal moves. Our results demonstrate the efficacy of offline learning using synthetic negative reinforcement on robust distributions of offline data, with agents achieving greater than 97% accuracy predicting the legality of moves. We also demonstrate the evident obstacle that skewed distributions provide to offline model-learning.

Boundaries on Parent Involvement in Their Child's Anxiety Cognitive-Behavioral-Treatment Outcome: Parent Reinforcement and Relationship Behaviors Moderate Outcome.

Extending a recent parent mediation efficacy trial, we identified parent reinforcement and relationship behaviors as setting boundary conditions, or moderators, of youth anxiety outcome in 254 youths and their parents, who were randomized to: (1) Cognitive Behavioral Treatment (CBT) with parent reinforcement behavior training (CBT + Reinf); (2) CBT with parent relationship behavior training (CBT + Relat); or (3) individual youth CBT - a comparator control arm. Findings revealed that parents with high baseline negative reinforcement levels and acceptance levels (i.e., above the mean) report their children as having lower anxiety at outcome, when assigned to CBT + Reinf, and CBT + Relat, respectively, versus CBT. No moderation effects were found for either parent positive reinforcement or parent psychological control. Implications for treating anxiety disorders and moving toward precision treatment approaches in youth are discussed, and the importance of research replication and extension.