Exam 3 Flashcards by Morgan Clark

alcohol use disorder

Brain disorder ranging from mild to severe

Affects ~7% of adult men and ~4% of adult women, but up to ~20% of college students

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4 functions of cognitive behavior

conditioned stimuli that elicit autonomic and emotional responses
discriminative stimuli that signals reinforcement, occasion specific responses (self instruction, problem solving)
motivating operations that influence potency of specific reinforcers/punishers
punishing or reinforcing consequences of behavior

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how to identify an alcohol use disorder

DSM-V includes 11 criteria, any isolated or combination of which indicate a problem

Drink more than planned

Have wanted to cut back but could not

Drink despite negative effects on relationships

Cut back on personally important or interesting activities to drink

Interference with home, school, or work

Tolerance

Withdrawal

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AUD risk factors

Starting to drink before age 21 (Research suggests those who start drinking at age 15 may be 5x more likely to develop AUD after 26
, Brain development continues until ~24 years)

Genetics and family history
(Nature and nurture appear to play a role)

Childhood trauma

Diagnosis of anxiety

depression

schizophrenia

PTSD

ADHD

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EB treatments

medication

behavioral interventions/therapy

mutual support groups (12-step programs)

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alcohol on college campuses: Why prevent / address heavy drinking in college?

Leading cause of accidents including death

Leading cause of sexual violence

Negative effects on academic performance,
relationships, wellbeing

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alcohol on college campuses: Common misperceptions among educated adults

“All college students drink all the time”

“At least I drink less than most people I know”

“If a little is fun, more will be more fun”

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diagnostic criteria for autism: persistent deficits in social communication and social interaction across multiple contexts

social-emotional reciprocity
nonverbal communicative behaviors used for social interaction
developing, maintaining, and understanding relationships

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diagnostic criteria for autism: restricted, repetitive patterns of behavior, interests, or activities

stereotyped or repetitive motor movements, use of objects, or speech
insistence on sameness, inflexible adherence to routines, or ritualized patterns or verbal nonverbal behavior
highly restricted, fixated interests that are abnormal in intensity or focus
hyper - or hyporeactivity to sensory input or unusual interests in sensory aspects of the environment

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risks of the rigid, non-social view

limited research support for rigidity/ non-social as traits beyond observed symptoms of ASD

caregivers, educators sometimes create rigid/non-social contexts for people with ASD

“rule” of rigid/ non-social behavior as a trait may influence how NTs interact, accord dignity

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Dougherty et al. (2014)

Effects of contingency management (monetary incentive) over ~4-week period per condition

26 “at risk” drinkers, ages 21-39 years

Measurement:
* transdermal alcohol monitoring (TAC)

Weekly clinic visit with self-reported alcohol use

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first description of people with autistic behaviors…

viewed as subtype of schizophrenia

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some criticisms of ABA for autism

ABA teaches people with autism to comply with adults (like robots), but not the meaning or internal motivation underlying their actions

ABA targets change in behaviors that are essential, personally valued features of autism (e.g., eye contact, repetitive behavior or restricted interests)

Discrete-trial teaching involves intense, potentially traumatizing repetition of trials over many hours even in presence of signs that child has withdrawn their assent (e.g., crying, hitting, eloping)

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Recs for ABA and All Autism Services

Focus on skills that benefit the learner, including self-determination

Seek oversight and guidance from autistic individuals

Continue studying a range of treatment methods until we understand which options work for whom under which conditions

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habilitation

improving adaptive skills or abilities; making fit for a particular goal

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personal liberties

To do what you please within the legal constraints of society

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uncoerced selection/choice

To select between two or more options based solely on characteristics of those options, not other actual or implied consequences of selecting

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countercontrol

Refusal, ignoring, making excuses; any safe behavior that helps you escape or avoid something aversive

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incorporating choice

Teach safe, effective forms of countercontrol

Seek client input on goals, methods FIRST
Vocal and non-vocal
“Vote with your feet”

Support self-determination
Vocal and non-vocal
E.g., low engagement / off task, delay

Self as Observer / Listener

We not only engage in cognitive / covert behavior, we also observe and react to those behaviors (similarly to overt behavior)

One challenge for humans is that covert behaviors are much harder to control than overt behaviors
* Covert thoughts / feelings v. overt actions

Axel is trying to date again after a terrible breakup; what will it look like if he responds to the following thoughts with rigidity/compliance?

All-or-nothing - If this next person isn’t the right one, I’m done with dating for good

Jumping to conclusions - My feelings are never reciprocated

Magnification - My ex was the most perfect possible match for me and I lost them

Restructuring v. Acceptance

Similarities:
* Both therapies involve defining painful thoughts, when they occur, and what we do to avoid or weaken them

Both therapies involve practicing strategies that will change the function of painful thoughts (e.g., from SD for avoidance to SD for choosing)
Both therapies aim to decrease avoidance behaviors / attempts to prevent thinking painful thoughts

Key difference:
Acceptance-based therapies do not make a goal of replacing painful thoughts with more rational thoughts; acceptance-based therapies build a person’s willingness to sit with discomfort of painful thoughts and then choose values-directed action

steps of self instruction

Identify overt and covert problem behavior as well as desirable alternatives

Develop self instructions for navigating the problem situation

Use behavioral skills training to teach the self instructions

overt

visible and measurable

ex. screaming, yelling, kicking

covert

hidden, occur inside the mind, cannot be directly observed by others ex. thinking, feeling emotions

behavioral contracts: one party

focuses on behavior change of one person supported by contract manager

behavioral contracts: two party

focuses on behavior change of two people supported by contract manager Quid-pro-quo --> If I do X, you agree to do Y Parallel --> Person 1 does X = consequence A; Person 2 does Y = consequence B

Components of a Behavioral Contract

Relevant target behavior(s) to increase or decrease How you will measure that behavior (e.g., permanent product, automated recording, observation) Daily/weekly deadline for the behavior to occur / not occur including required level of that behavior Reinforcement or punishment contingency you give other parties permission to implement that will support desired behavior change

Mechanisms of Action for Effective Behavioral Contracts

Increased cues for behavior change Increased consequences for behavior Rule-governed behavior - Defined as behavior controlled by a verbal statement of a contingency (i.e., behavior and its consequence) - General example: If you run red lights, ___________ - Contracting example: If Dan finishes his homework and gets home by curfew, we will not demand that he comes home for supper

Based on course materials, what is the main problem with the statement, "Amanda often worries about her family members’ safety on winter roads because she has high anxiety." Please rewrite a more precise and actionable version of this observation about Amanda's cognitive behavior.

“…because of her anxiety” is mentalistic; it describes but does not explain worrying In the winter, Amanda sees more news reports of serious accidents which prompts her to spend more time thinking about her family’s safety on the roads

Fern has a new job in the area of medical billing and finds that she becomes very nervous and scattered when insurance companies require her to meet and discuss a specific claim. Lately Fern has been studying a flashcard of dos and don'ts for these meetings, and she covertly repeats the rules to herself before speaking aloud during any tense moments that arise. Fern's cognitive behavior in this case is most likely serving the function of: Discriminative stimuli (SD) Reinforcement Nothing Task Analysis

Discriminative stimuli (SD)

A therapist is working with Carter who is going through a recent breakup and frequently has the thought, "I lost the best possible match for me and it's all my fault". His therapist helps him change this thought to, "We didn't work out for a reason. There are billions of people and it is very possible that I will find a connection with somebody". Carter's initial thought is a_____ and his therapist used _____ to address it. cognitive flaw; acceptance cognitive distortion; acceptance cognitive distortion; restructuring cognitive flaw; restructuring

cognitive distortion; restructuring

Sam and Lemi are roommates who agree to start a fitness training program. Sam's boss agrees to serve as the contract manager, and Sam and Lemi agree to take a date- and time-stamped picture of themselves at the gym each week. If Sam or Lemi go to the gym 3 times each week, Sam's boss pays that individual $10 towards new workout shoes. If Sam or Lemi go to the gym three times or less in a week, the boss takes back all the money in that person's shoes fund. What type of behavioral contract is illustrated? Public commitment contract Quid-pro-quo contract Unidirectional contract Parallel contract

Parallel contract

If Sam and Lemi's behavioral contract to increase gym sessions works, this is most likely due to rule-governed behavior is what is true? In the past, Lemi and Sam have followed rules yet experienced unwanted consequences Lemi and Sam have limited language abilities In the past, Lemi and Sam have avoided unwanted consequences by following rules Lemi and Sam trust eachother to give their best effort

In the past, Lemi and Sam have avoided unwanted consequences by following rules

Which of the following statements is most likely to cue an acceptance-based therapist to help their client develop the psychological flexibility skill of being present? "My heart is racing and I'm having the thought that I might pass out" "If I get close to someone again, they will just end up rejecting me eventually" "I'm looking for a partner who shares my love of the outdoors" "I feel a bit sleep deprived today, and I notice my mood is a little low"

"If I get close to someone again, they will just end up rejecting me eventually"

Reggie has been practicing for a very important dance competition next month. Some nights after rehearsal, he lays in bed imagining what he will look like making errors or injuring himself and receiving a low score from the judges. Reggie feels dread and worry as he imagines these scenes. Reggie’s cognitive behavior in this example is most likely serving a function of: Discriminative stimuli Consequences Conditioned eliciting stimuli Antecedents

Conditioned eliciting stimuli

An example of a cognitive behavior is... Telling my brother he's stupid Thinking, "I'm too stupid to try a new activity" My heart racing Forgetting something at home

Thinking, "I'm too stupid to try a new activity"

Which of the following illustrates “referring to basic principles of behavior,” a defining practice of ABA? Monetary incentives worked best for participants with high self-efficacy Male participants engaged in heavy drinking more than female participants Participants were less likely to drink when wearing the TAC device Monetary incentives differentially reinforced harm reduction behaviors

Monetary incentives differentially reinforced harm reduction behaviors

Which of the following illustrates “pinpointing measurable behavior,” a defining practice of ABA? Using transdermal monitoring to detect whether people are above or below 0.03 g/DL blood alcohol level each day Asking people to rate their alcohol consumption Asking people whether they drank more or less than 2 beers in a day (equivalent of 0.03 g/dL blood alcohol level) Using observational monitoring to detect whether people act more or less tipsy

Using transdermal monitoring to detect whether people are above or below 0.03 g/DL blood alcohol level each day

Which of the following misconceptions (or myths) of alcohol use are addressed by Motivational Interviewing, a preventive intervention adopted by some university campuses: At least I don't drink as much as most people my age. Drinking contributes to accidental deaths and sexual violence on college campuses Red wine is good for your heart Underage drinking is more culturally acceptable in France than in the US

At least I don't drink as much as most people my age.

Which of the following illustrates “focusing on current behavior-environment relations,” a defining practice of ABA? Providing social support for coping without drinking Discussing career aspirations Discussing clients’ adverse childhood experiences (ACES) Providing psychoeducation about the impact of alcohol use on sleep, immune functioning, and heart disease

Providing social support for coping without drinking

According to your readings, what is one thing that ABA providers should do to ensure their services are effective and humane? Seek oversight and guidance from autistic adults Stop using discrete-trial teaching Combine ABA with speech, OT, and music therapy Teach society to accept all forms of challenging behavior

Seek oversight and guidance from autistic adults

What is one major reason that autistic advocates criticize ABA-based early intervention for people with autism? Early developers of ABA described the goal of making people with autism behave "normally" Brain scans suggest that people who receive ABA "lose" some of their autism Most implementers of ABA use punitive consequences such as noxious odors and reprimands Twenty hours per week is too many hours of intervention for kids under 5 years old

Early developers of ABA described the goal of making people with autism behave "normally"

Which of the following was NOT an option for children with autism and other disabilities until disability rights activists influenced the passing of laws such as the Individuals with Disabilities Education Act (IDEA) in 1975: Psychoanalysis for "refrigerator mothers" Institutionalization Pseudoscientific interventions such as holding therapy Inclusive early childhood programs

Inclusive early childhood programs

Based on course materials (Dougherty et al.), which of the following statements is true of financial incentives for drinking less than 1-2 beers per day: Large financial incentives produce greater reductions in alcohol use over the short term Financial incentives to reduce alcohol use are unethical Financial incentives to reduce alcohol use decrease internal motivation for sobriety Small and large financial incentives produce similar reductions in alcohol use over the short term

Financial incentives to reduce alcohol use decrease internal motivation for sobriety