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Biomedical subjects

V B Van Hasselt

Publications and source records attributed to V B Van Hasselt.

At least 19 recordsLinked to original sources
PubMed2001

Treatment of reactivated post-traumatic stress disorder. Imaginal exposure in an older adult with multiple traumas.

A single-case analysis was used to assess the effects of imaginal exposure in a 57-year-old woman suffering from current and reactivated post-traumatic stress disorder (PTSD) following a transient ischemic attack. The client's responses to self-reported depression, anxiety, and PTSD symptoms were repeatedly recorded during four phases: (a) initial psychotherapy, (b) imaginal exposure, (c) skill generalization, and (d) fading of treatment. In addition to dramatic reduction in levels of depression and anxiety, results showed a significant improvement in PTSD symptoms relating to recent and remote traumatic experiences. Improvements were maintained approximately 16 months after imaginal exposure ended, despite ongoing external stressors.

Adolescent↗
PubMed2001

Social problem-solving skills training for incarcerated offenders. A treatment manual.

This article describes a social problem-solving skills intervention for incarcerated adult offenders. The program includes pragmatic, progressive skill building through the use of direct instructions, role-plays with performance feedback, modeling, behavior rehearsal, and positive reinforcement. In addition to these treatment components, the empirically derived approach employs standardized assessment measures to identify deficits and to evaluate treatment outcome. Assessment data are directly used to determine behavior change in such areas as conversational skills, positive and negative assertion, anger management, problem solving, empathy, and stress inoculation. Social skills training is included to modify verbal, nonverbal, and paralinguistic behavioral components. In addition, training elements related to anger reduction and stress management are utilized.

Adult↗
PubMed2001

Assessment of cognitive functioning in men who batter.

The present investigation examined neuropsychological functioning in 50 male batterers court-ordered into treatment and 23 nonpatient controls. Subjects were administered a neuropsychological screening battery consisting of the Screening Test for the Luria-Nebraska Neuropsychological Battery, the Stroop Color and Word Test, two memory subtests from the Luria-Nebraska Neuropsychological Battery-III (Figural Memory and Delayed Figural Memory), and two subtests from the Halstead-Reitan Neuropsychological Battery (Trails A & B). Subjects were categorized as having neuropsychological dysfunction if their scores exceeded the statistical cut offs on two or more subtests. Results indicated that 24 (48%) of the male batterers exhibited cognitive dysfunction, as compared to only 1 (4.3%) of the nonpatient controls. Inspection of individual neuropsychological measures indicated poorer performance across all subtests for impaired male batterers as compared to both nonimpaired batterers and normal controls. In contrast, no significant differences on any of these measures emerged between nonimpaired male batterers and normal controls. Implications for the appropriate screening and treatment of male batterers are discussed.

Adult↗
PubMed1999

Interpersonal and psychological correlates of marital dissatisfaction in late life: a review.

Developmental studies suggest that marital quality improves in old age (e.g., Guilford & Bengtson, 1979). However, many of the studies are replete with sampling biases that probably led to an overinflated positive report of marital satisfaction in older adults. Our review evaluated contemporary studies that have investigated interpersonal and psychological factors associated with dissatisfaction in long-term marriages. Recent investigations indicate that older marriages benefit from lower levels of conflict and greater sources of mutual pleasure following child-rearing cessation. Studies of social support in long-term marriages suggest that perceptions of spousal support are more strongly related to marital satisfaction and general well-being for older women than for men. A few investigations have found a significant relationship between depression and marital discord in older adult samples, and the causal flow between these two variables appears to be unidirectional in that depression has a detrimental impact on late-life marital quality. Indeed, depression has been found to mediate the link between many age-related stressors (e.g., ill health, retirement) and declines in marital adjustment. However, our preliminary analysis of marital adjustment within a depressed, older adult, outpatient sample of married individuals did not confirm statistically that marital discord is associated with depressive symptomatology. This, in part, was attributed to the very narrow range of older adults sampled (i.e., clinic patients suffering from depression). However, the majority of depressives characterized their marriages as discordant. The implications for these findings are discussed and future directions are offered.

Adult↗
PubMed1997

Validation of the Keane MMPI-PTSD Scale against DSM-III-R criteria in a sample of battered women.

The Keane, Malloy, & Fairbank (1984) MMPI-PTSD Scale has proven to be a reliable and valid measure of posttraumatic stress disorder (PTSD) in combat veterans. However, few studies have examined the MMPI-PTSD Scale's validity in civilian trauma victims, including battered women. In the present study, 46 battered women who completed the MMPI-PTSD Scale were assigned to PTSD-Positive and PTSD-Negative groups based on a structured diagnostic interview and then contrasted on the MMPI-PTSD Scale. Significantly higher scores on the scale were found in the PTSD-Positive group. Also, a cutoff score of 22 on the MMPI-PTSD Scale correctly classified 80.4% of the sample. Correlations between the MMPI-PTSD and DSM-III-R criteria suggest that the scale is moderately sensitive to many of the symptoms particularly those involving intrusion and psychological arousal, comprising the diagnosis of PTSD. This investigation provides further support for the validity of the MMPI-PTSD Scale and its utility in screening battered women for PTSD.

Adolescent↗
PubMed1996

Assessing the effects of violence on women in battering relationships with the Keane MMPI-PTSD Scale.

The Minnesota Multiphasic Personality Inventory (MMPI)-Keane Posttraumatic Stress Disorder (PTSD) Scale (PK) has proven to be a reliable and valid measure of PTSD in combat veterans. However, few studies have examined the scale's validity in battered women, who often present with PTSD. Using empirically derived cutoff scores for the PK Scale, 69 battered women were assigned to PTSD-Positive and PTSD-Negative groups and then compared on measures of PTSD, distress, social support, and history of abuse in and out of the battering relationship. The PTSD-Positive group scored significantly higher across all measures of PTSD and distress, supporting the concurrent validity of the PK Scale in this population. However, the two groups differed only for the frequency of death threats, suggesting that the PK Scale is only mildly sensitive to the level of trauma exposure. Finally, lower levels of perceived social support were found in the PTSD-Positive than the PTSD-Negative group. Implications of these findings for the assessment of PTSD in battered women are discussed.

Adolescent↗
PubMed1995

Social skills training for depressed, visually impaired older adults. A treatment manual.

Late-onset visual impairment due to cataracts, glaucoma, macular degeneration, or diabetic retinopathy afflicts approximately 10% of people older than 65, and often results in depression and social dysfunction. Whereas the majority of sighted older adults are active participants in their community, individuals suffering from progressively worsening vision experience heightened levels of isolation and reduced social support, and participate in fewer reinforcing recreational activities. This article describes our social skills training package for the treatment of depressed, visually impaired, older adults. Our treatment focuses on increasing the frequency and level of assertiveness with which visually impaired older adults interact with each other. In addition to specified treatment methods, our empirically derived program employs standardized assessment measures to evaluate therapeutic progress. Sessions are implemented to reinforce efforts to apply social skills in the environment and reestablish skills that have begun to fade.

Aged↗
PubMed1994

Remedying the Achilles heel of behavior research and therapy: prescriptive matching of intervention and psychopathology.

Recent calls for eclecticism in clinical practice have been fueled by the putative limitations of behavioral techniques in treating a variety of psychological problems. However, calls for such integration do not appear to be justified for two related reasons. First, the precise conditions under which behavioral interventions are and are not effective have not yet been adequately delineated. Consequently, rejection of behavioral interventions in favor of relatively indiscriminate application of cognitive strategies is premature. Second, behavior therapy has as its hallmark a thorough grounding in inductive empiricism, while cognitive/dynamic theories are wholly based in deductive rationalism. As a result, wholesale acceptance of alternative theories and techniques by behaviorists is both inconsistent and retrogressive. Cognitive interventions have their place, but only when cognitive distortions have been specifically identified. Therefore, refinement of behavioral treatments into prescriptive interventions is warranted. The parameters of prescriptive behavior therapy are described in this paper.

Behavior Therapy↗
PubMed1994

Behavioral assessment and treatment of social phobia. An evaluative review.

This article provides an empirically derived description of social phobia, including onset, prevalence, comorbidity, and issues of differential diagnosis. Assessment and behavioral treatment strategies for social phobia are reviewed. It was not until the past few years that structured clinical interviews and self-report inventories have been developed with adequate reliability and validity to specifically assess social phobia. Thus much of the treatment outcome research is confounded with heterogeneous samples that make generalization of results difficult to interpret. Heterogeneity of samples, lack of controlled comparisons with adequate statistical power to detect treatment differences, and inconsistent findings do not permit the drawing of any definitive conclusions concerning the efficacy of behavioral treatment procedures at this time. More treatment comparison studies for social phobia need to be performed using structured clinical interviews and standardized assessment devices specific for use with social phobia. Pre hoc power analyses should be performed to determine the number of subjects deemed adequate to detect differences when performing comparison studies. Assessment and treatment of social phobia with children is conspicuously nonexistent. Assessment and treatment procedures for social phobia need to be developed and standardized with children.

Anxiety Disorders↗
PubMed1994

Cognitive distortions and adolescent affective disorder. Validity of the CNCEQ in an inpatient sample. Children's Negative Cognitive Error Questionnaire.

Despite a proliferation of recent research examining childhood and adolescent depression, the area still lags behind the adult depression field, particularly in the investigation of cognitive correlates of affective psychopathology. To advance cognitive research with youth, the Children's Negative Cognitive Error Questionnaire (CNCEQ) was developed to provide a measure of cognitive distortions or errors in children and adolescents. Yet, few studies have employed the CNCEQ and no evidence exists supporting the validity of its four component cognitive error scales. The purpose of the present study was to examine the construct validity of the CNCEQ and its constituent scales through the use of factor analysis and criterion-group comparisons. Groups of adolescent psychiatric inpatients, diagnosed as affective or disruptive disordered, completed the CNCEQ following admission. Results failed to support the implicit four-factor structure of the CNCEQ, instead suggesting the appropriateness of a single-factor solution labeled "negative thinking." Despite no diagnostic group differences on the CNCEQ total or other scale scores, affective disordered patients evinced more cognitive errors on the Overgeneralizing scale. Findings suggest that the CNCEQ in its current stage of development holds promise, yet requires refinement to produce a valid measure of cognitive functioning in youth.

Adolescent↗
PubMed1993

Behavioral assessment of anxiety in older adults. Some comments.

The behavioral assessment of anxiety in older adults is reviewed in this article. Despite the high rate of anxiety symptoms uncovered during the course of large-scale epidemiological studies, the comprehensive evaluation of anxiety in this age group (55 and over) is not highly sophisticated at this juncture. In this review, diagnostic issues, psychometric evaluation, motoric assessment, and psychophysiological assessment are considered. Throughout the articles, gaps in the extant research are identified, and a research agenda for the future is developed.

Aged↗
PubMed1993

Behavioral interventions to reduce maladaptive responding in youth with dual sensory impairment. An analysis of direct and concurrent effects.

Many persons who have multiple sensory, physical, and developmental disabilities display behaviors that interfere significantly with adaptive functioning and social acceptance. In this investigation, the efficacy of multiple component behavioral interventions for reducing maladaptive responding exhibited by two individuals with dual sensory impairment and profound mental retardation was evaluated. Results indicated that differential reinforcement of other behavior (DRO) approaches were not effective in either case. However, when deceleration procedures (overcorrection or brief physical restraint) were added, target behaviors decreased quickly. Also, interventions were faded in such a way that gains were maintained for 6 months with only minimal effort by staff. Ongoing assessment of concurrent effects of behavior reduction strategies revealed increases in time on task or amount of work completed, even though these responses were not targeted specifically. Yet negative side effects (e.g., increases in self-stimulation) also were documented, highlighting the importance of evaluating multiple behaviors during intervention. Finally, despite the fact that objective assessments led to positive conclusions regarding treatment efficacy, ratings of baseline and treatment behavior samples by independent judges showed overall improvement in only one case. These findings suggest the need for multifaceted evaluation to determine the utility of interventions in applied settings.

Adolescent↗
PubMed1992

Maltreatment in psychiatrically hospitalized dually diagnosed adolescent substance abusers.

The medical charts of 150 consecutive admissions of dually diagnosed substance abusing adolescents admitted to a psychiatric hospital were examined to determine the extent and characteristics of maltreatment. Results indicated that 61% of the sample experienced or had a history that warranted suspicion of past and/or current maltreatment. Physical abuse was the most frequent form of maltreatment, followed by sexual abuse and neglect. Thirty-seven percent of patients experienced multiple forms of maltreatment. Maltreated patients had significantly more hospitalizations than their nonmaltreated counterparts on the same unit. Moreover, the age of maltreated patients was significantly lower than nonmaltreated patients, perhaps indicating an earlier age of onset of psychiatric illness and/or substance abuse. Analyses of parental substance abuse and psychiatric history among the maltreated and nonmaltreated groups revealed no significant findings. Results are discussed in terms of the following: (1) increased risk of subsequent substance abuse in maltreated children; (2) need for systematic assessment of child maltreatment in psychological or psychiatric evaluations; and (3) importance of treatment to deal with abuse or neglect as part of a comprehensive substance abuse intervention strategy.

Adolescent↗
PubMed1991

Parent-child problem-solving interactions in families of visually impaired youth.

Investigated problem-solving and conflict-resolution strategies, an important aspect of family functioning, in visually impaired adolescents and their parents. Visually impaired adolescents were compared to adolescents with spina bifida and a control group of adolescents without disabilities. Parent-adolescent dyads participated in a problem-solving discussion of topics reflecting family disagreement. Videotapes of these discussions were rated for patterns of interaction using the Marital Interaction Coding System (MICS-III). Examination of positive and negative reciprocal patterns of interaction using sequential analyses and contrasting frequencies of specific behavioral codes revealed no differences between groups for adolescents, mothers, and fathers on the problem-solving discussion. Results are discussed in terms of (a) the impact of visual impairment on family functioning and (b) the need to identify those subgroups of visually impaired and their families that may be at heightened risk for maladjustment.

Adaptation, Psychological↗
PubMed1989

Abuse and neglect in psychiatrically hospitalized multihandicapped children.

Medical charts of 150 consecutive admissions of multihandicapped children to a psychiatric hospital were examined to determine the extent and characteristics of abuse and neglect. Results indicated that 39% of the sample experienced or had a history that warranted suspicion of past and/or current maltreatment. Physical abuse was the most frequent type of maltreatment, followed by neglect and sexual abuse. Maltreated multihandicapped patients admitted to the psychiatric unit were less likely to receive diagnoses of organic brain syndrome or profound mental retardation than nonmaltreated multihandicapped counterparts on the same unit. Moreover, data indicated that less severely impaired patients were more likely to be maltreated than were the more severely impaired. Particularly striking was the severity of maltreatment in this multihandicapped sample and the relatively high percentage (40%) of sexually abused patients who were assaulted by multiple perpetrators.

Adolescent↗
PubMed1989

Psychometric properties and social correlates of assertion measures in chronic alcoholics.

Assertion is a major focus of many social skills interventions for alcoholics. The assessment of assertion often relies on self-report measures. However, few psychometric data are available on the most frequently used instruments. This study determined the internal characteristics and structure of two commonly employed measures of assertion: the Wolpe-Lazarus Assertion Inventory and the Callner-Ross Assertion Inventory. In addition, the relationship between responses on these devices and demographic variables, extent of substance abuse, and level of social functioning were examined. Results indicated that both inventories exhibit adequate internal consistency and test-retest reliability. Factor structures were relatively simple and represented general assertion situations. Results are discussed in terms of the need for further refinement of these instruments.

Adult↗
PubMed1988

A graduated guidance procedure for teaching self-dressing skills to multihandicapped children.

The effectiveness of a graduated guidance procedure for increasing independence in dressing was examined in a multiple baseline analysis across behaviors. Two multihandicapped children were trained to dress in socks, pants, and shirt. In training sessions, subjects completed the entire sequence of steps involved in putting on the training garment on each trial. Trainer assistance was provided as necessary, but was faded systematically according to a hierarchy of intrusiveness. Positive reinforcement was delivered contingent on dressing with increased independence. Assessment of independent responses followed each training session. Dependent measures were derived from a task analysis of each dressing behavior. Results showed that both children learned dressing skills, although rates of acquisition varied considerably. Generalization of treatment effects to similar garments was observed; maintenance of skills was evident at follow-up probes conducted at 36 weeks for one child and 18 weeks for the other.

Activities of Daily Living↗