REX FOREHAND, GENE H. BRODY, LISA ARMISTEAD, SHANNON DORSEY, EDWARD MORSE, PATRICIA SIMON MORSE, AND MARY STOCK.
The Role of Community Risks and Resources in the Psychosocial Adjustment of At-Risk Children: An Examination Across Two Community Contexts and Two Informants

JOAN M. ROMANO, MARK P. JENSEN, JUDITH A. TURNER, AMY B. GOOD, AND HYMAN HOPS.
Chronic Pain Patient-Partner Interactions: Further Support for a Behavioral Model of Chronic Pain

HELGA NAUTA, HARM HOSPERS, GERJO KOK, AND ANITA JANSEN.
A Comparison Between a Cognitive and a Behavioral Treatment for Obese Binge Eaters and Obese Non–Binge Eaters

CHRISTINE BOWMAN EDMONDSON, JUDITH COHEN CONGER, AND BETH TESCHER.
Anger Behavioral Competence in Anger-Prone Individuals

JENNIE C. I. TSAO AND MICHELLE G. CRASKE.
Timing of Treatment and Return of Fear: Effects of Massed, Uniform-, and Expanding-Spaced Exposure Schedules

STEFAN G. HOFMANN AND PATRICIA MARTEN DIBARTOLO.
An Instrument to Assess Self-Statements During Public Speaking: Scale Development and Preliminary Psychometric Properties

JONATHAN S. ABRAMOWITZ, MARTIN E. FRANKLIN, GORDON P. STREET, MICHAEL J. KOZAK, AND EDNA B. FOA.
Effects of Comorbid Depression on Response to Treatment for Obsessive-Compulsive Disorder

The Role of Community Risks and Resources in the Psychosocial Adjustment of At-Risk Children: An Examination Across Two Community Contexts and Two Informants

Rex Forehand and Gene H. Brody, University of Georgia, Lisa Armistead, Georgia State University, Shannon Dorsey, University of Georgia, Edward Morse, Tulane University, and Patricia Simon Morse and Mary Stock, Louisiana State University School of Medicine

Relative to the attention given to the family, the larger environmental context in which children live has received little attention. This study examined 277 African American children from single-parent families living in two community contexts: rural and urban. Resources and risks within each community were compared across communities. Furthermore, the relations of community, community environment (a resource-risk index), and the interaction of these two variables to child psychosocial adjustment were examined. Finally, the role of informant (mother or child) was examined. The results indicated that the mothers and children from the urban community reported more risks than those from the rural community. The community environment, but not community (rural vs. urban), related consistently to child psychosocial adjustment but only when the same informant (mother or child) reported both the resource-risk index and child psychosocial adjustment. Community did not qualify this relationship. Implications for prevention and intervention programs are considered.



Chronic Pain Patient-Partner Interactions: Further Support for a Behavioral Model of Chronic Pain

Joan M. Romano, Mark P. Jensen, Judith A. Turner, and Amy B. Good, and University of Washington, and Hyman Hops, Oregon Research Institute

This study tested hypotheses derived from behavioral theory concerning relationships between patient pain behaviors and partner responses. Before beginning a multidisciplinary pain treatment program, 121 patients (67 women, 54 men) with chronic musculoskeletal pain and their spouses or partners completed self-report measures of pain, pain behaviors, partner responses, physical disability, depression, and relationship satisfaction, and were videotaped while participating together in seven household activities. The videotapes were coded by trained observers for patient verbal and nonverbal pain behaviors and partner solicitous and negative behaviors using the Living in Family Environments (LIFE) coding system. As predicted, partner solicitous and negative behaviors were associated significantly with the rate of patient pain behaviors, after controlling for patient age, gender, and pain intensity. The findings provide further support for behavioral models of chronic pain.



A Comparison Between a Cognitive and a Behavioral Treatment for Obese Binge Eaters and Obese Non–Binge Eaters

Helga Nauta, Harm Hospers, Gerjo Kok, and Anita Jansen, Maastricht University, Maastricht, The Netherlands

The purpose of this study was to evaluate the effectiveness of a cognitive and a behavioral treatment for obese binge eaters and obese non–binge eaters. Seventy-four participants, 37 binge eaters, and 37 non–binge eaters were randomly assigned to one of the two treatment conditions taking binge status into account. Both treatments took place in groups and all groups met for 15 weekly sessions of 150 minutes each. Participants in the cognitive treatment learned to change dysfunctional cognitions and participants in the behavior treatment learned a regular eating pattern. The cognitive treatment was more effective in reducing concerns about shape, weight, and eating, as well as restraint and in improving self-esteem. These results were maintained at 6-month follow-up. The behavioral treatment was more effective in reducing weight, but at 6-month follow-up participants in the behavioral treatment regained weight. Binge eating was reduced in both treatments equally effectively, but at 6-months participants who received cognitive treatment were more abstinent from binge eating.



Anger Behavioral Competence in Anger-Prone Individuals

Christine Bowman Edmondson, California State University, Fresno, and Judith Cohen Conger and Beth Tescher, Purdue University

Anger-prone and non-anger-prone research participants completed a modified role-play to assess their anger management strategies. Peer judges rated their responses in terms of competency variables: appropriateness, effectiveness, anger display, and effects on others. Results indicated that anger-prone individuals reported less appropriate and less effective anger management strategies that had a higher amount of anger displayed and a more negative effect on other people. There were significant interactions between situation type and gender for all dependent variables. Women reported more appropriate and more effective behavior in roommate situations than men. Men and women were perceived as displaying more anger associated with more negative effects on others in romantic partner and roommate situations than in family, friend, and school situations. Implications and assumptions of a proposed "competence approach" to conceptualizing anger behavior are discussed.



Timing of Treatment and Return of Fear: Effects of Massed, Uniform-, and Expanding-Spaced Exposure Schedules

Jennie C. I. Tsao and Michelle G. Craske, University of California, Los Angeles

Although exposure treatment has been shown to be highly effective in ameliorating phobias, the return of fear (ROF) is often evidenced (see Rachman, 1989). The present study compared the effects of massed (single session), uniform-spaced (5, 5, 5 intervening days), and expanding-spaced (1, 4, 10 intervening days) schedules on fear reduction and ROF in an analog sample with self-reported public-speaking anxiety. Treatment utilized a standardized speech exposure task. It was predicted that although massed treatment would produce the greatest fear reduction by posttreatment, it would yield the greatest ROF at 1-month follow-up. The uniform schedule was expected to produce intermediate fear reduction by posttreatment and at follow-up, whereas the expanding schedule was predicted to generate the lowest fear reduction by posttreatment, but the least ROF at follow-up. All groups unexpectedly demonstrated comparable fear reduction by posttreatment, but, as predicted, massed treatment produced the greatest ROF at follow-up—fear ratings in this group no longer differed from pretreatment levels. Expanding and uniform treatments showed an impressive lack of ROF at follow-up; possible explanations for the unexpectedly robust performance of the uniform group are discussed. Given the high rates of attrition for the uniform schedule (50%), results provide preliminary support for the utility of an expanding schedule. Limitations of the present study, and theoretical and practical issues regarding spacing of treatment, are discussed.



An Instrument to Assess Self-Statements During Public Speaking: Scale Development and Preliminary Psychometric Properties

Stefan G. Hofmann, Boston University, and Patricia Marten DiBartolo, Smith College

Public speaking is the most commonly reported fearful social situation. Although a number of contemporary theories emphasize the importance of cognitive processes in social anxiety, there is no instrument available to assess fearful thoughts experienced during public speaking. The Self-Statements During Public Speaking (SSPS) scale is a 10-item questionnaire consisting of two 5-item subscales, the Positive Self-Statements (SSPS-P) and the Negative Self-Statements subscale (SSPS-N). Four studies report on the development and the preliminary psychometric properties of this instrument.



Effects of Comorbid Depression on Response to Treatment for Obsessive-Compulsive Disorder

Jonathan S. Abramowitz, Martin E. Franklin, and Gordon P. Street, University of Pennsylvania School of Medicine, Michael J. Kozak, Medical College of Pennsylvania, and Edna B. Foa, University of Pennsylvania School of Medicine

We examined the effects of comorbid depression on response to treatment for obsessive-compulsive disorder (OCD) using cognitive-behavioral therapy with and without medication. Eighty-seven OCD patients were divided into nondepressed and mildly, moderately, and severely depressed groups on the basis of their pretreatment Beck Depression Inventory (BDI) scores. Each received an intensive cognitive-behavioral treatment program involving exposure with response prevention (EX/RP); 59 (68%) were also taking medication for OCD. Patients with severe initial depression (BDI > 30) showed significantly less improvement compared to those less depressed or nondepressed; yet, even highly depressed patients showed moderate treatment gains. Failure to habituate to anxiety-evoking stimuli during exposure and a lack of motivation for therapy are considered possible causes of attenuated outcome.



Trichotillomania: Conceptualization, Measurement, and Treatment

Amy J. Elliott and R. Wayne Fuqua, Western Michigan University

Trichotillomania (TCM), a condition characterized by chronic hair pulling, has received increased attention in the behavioral literature of late. Because TCM has typically been conceptualized as a psychiatric, rather than a behavioral, psychological, or pediatric concern, behavior therapists may have little background information about the disorder and its treatments. This paper presents a review of the nature of TCM and the current conceptualizations of the disorder. We review recent research on the measurement and treatment of TCM. Limitations of the current research, suggestions for further study, and implications for treatment of TCM are discussed.



Treatment of Stuttering With Regulated Breathing: Strengths, Limitations, and Future Directions

Douglas W. Woods and Michael P. Twohig, University of Wisconsin-Milwaukee, and R. Wayne Fuqua and John M. Hanley, Western Michigan University

In this paper a treatment for stuttering known as Regulated Breathing (Azrin & Nunn, 1974) is described, and studies investigating the original procedure and its variations are evaluated. The studies conducted to simplify the procedure are also evaluated. This review demonstrates that both the original and simplified procedures reduce stuttering and increase speech rate. In addition to discussing the efficacy of the original procedure and simplifications, the efficacy of Regulated Breathing is compared to that of other treatments common in speech-language pathology. Finally, a number of limitations of past research and areas for future research are offered.



Group Dialectical Behavior Therapy for Binge-Eating Disorder: A Preliminary Uncontrolled Trial

Christy F. Telch and W. Stewart Agras, Stanford University School of Medicine, and Marsh M. Linehan, University of Washington

This study provides preliminary data regarding the efficacy of dialectical behavior therapy (DBT) adapted for the treatment of binge-eating disorder (BED). Eleven women with BED participated in this uncontrolled trial and were administered the Eating Disorder Examination together with measures of weight, mood, and affect regulation at baseline and posttreatment. Data on binge eating and weight were also collected at 3- and 6-month follow-up. There were no dropouts from treatment and 82% of the women were no longer binge eating by treatment end. Improvement in emotion regulation was also evidenced posttreatment. The improvement in binge eating was maintained during follow-up. These results lend support for continued research into the applications of DBT for treating binge eating disorder.



Virtual Reality in the Treatment of Claustrophobic Fear: A Controlled, Multiple-Baseline Design

Cristina Botella, Universitat Jaume I, Castellón, Spain, Rosa M. Baños
Universidad de Valencia, Spain, and Helena Villa, Conxa Perpiñá, and Azucena García-Palacios, Universitat Jaume I, Castellón, Spain

The aim of this study was to determine the effectiveness of virtual reality (VR) exposure in the treatment of claustrophobic fear. We evaluated the intervention following a controlled, multiple-baseline design across 4 participants with claustrophobic fear who sought psychological help in our anxiety disorders clinic. The treatment consisted of 8 individual VR graded exposure sessions. Data were obtained at pretreatment, posttreatment, and 3-month follow-up on several clinical measures: Behavioral Avoidance Test, Self-Efficacy Toward Closed Spaces, Problem-Related Impairment Questionnaire, Beck Depression Inventory ( Beck, 1978), and Anxiety Sensitivity Index (Peterson & Reiss, 1992). Results support the effectiveness of the VR procedure for the treatment of claustrophobic fear. An important change appeared in all measures after treatment completion. It can be concluded that VR exposure was effective in reducing fear and avoidance in closed spaces and in increasing self-efficacy in claustrophobic situations. Moreover, changes were maintained at 3-month follow-up.