Case Study Analysis: Early Childhood

Case Study Analysis: Early Childhood

For this assignment, you will complete an analysis of a case study that deals with the early childhood stage of development.

Select one of the following case studies from your Broderick and Blewitt textbook to complete an analysis of the developmental and contextual issues related to the selected case:

  • Angela and Adam, page 165.
  • Dawn, page 199.

Each of the case studies includes a set of questions that can guide your analysis of the pertinent issues for the particular case.

Expectations

Address the following in your case study analysis:

  • Analyze lifespan development theories to determine the most appropriate theory or theories to apply to the case study.
  • Apply the appropriate lifespan development theory to support an identified intervention process.
  • Describe the potential impact of individual and cultural differences on development for the current age and context described in the case study.
  • Write in a manner that is scholarly, professional, and consistent with expectations for graduate-level composition and expression.

Content

The case study analysis should be a maximum of 5 pages in length, including the introduction and conclusion, each of which should be approximately one half-page in length. The body of the paper should not exceed 4 pages.

Provide the following content in your paper:

  • An introduction that includes an overview of the paper contents, including a brief summary and background information regarding the case study.
  • The body of the case study, including:
    • The presenting challenge or challenges and primary issue or issues.
    • The appropriate lifespan development theory and research-based alternatives that explain the presenting challenges.
    • The potential impact of individual and cultural differences on development for the current age and context described in the case study.
    • Evidence-based support from lifespan development theory and current scholarly research to support appropriate interventions.
  • A conclusion that summarizes what was introduced in the body of the paper, with respect to the case study context, challenges, and interventions.

Requirements

Submit a professional document, in APA style, that includes the following required elements identified with headings and subheadings:

  • Title page.
  • Introduction (half page).
  • Case study analysis (4 pages).
  • Conclusion (half page).
  • Reference page: Include a minimum of 5 scholarly resources from current peer-reviewed journals as references, in addition to referencing the textbook in which the case study is embedded.
  • Font: Times New Roman, 12 point.

Resources

  • Case Study Analysis: Early Childhood Scoring Guide.
  • APA Guide: The Title Page: Course Papers.
  • APA Style and Format.
  • Professional Communications and Writing Guide.CASE STUDY

    Angela is a White 17-year-old girl who is also the mother of a baby named Adam, now 11 months of age. Both Angela and her baby live with Angela’s mother, Sarah, in a small rented house in a semirural community in the Midwest. Sarah, a single mother herself, works as a food server in a local restaurant. Sarah has another child, David, who is 13. Angela’s father abandoned the family when she was 7 years old. Wayne, Angela’s boyfriend and Adam’s father, has also become estranged primarily because Sarah refuses to allow him in her house. She is angry that Angela became pregnant and views Wayne as incapable of, and uninterested in, taking on his share of the responsibility. During her pregnancy, Angela continued to attend classes at her high school. She dropped out, however, when she was 7 months pregnant. She had grown increasingly depressed about the prospect of caring for an infant, and she found dealing with schoolwork and her pregnancy overwhelming. Following Adam’s birth, Angela tried hard to be a good mother to her son. She took on most of the caretaking responsibilities by herself, which gave her some measure of satisfaction. However, she also felt deeply ambivalent. Above all, she resented the restrictions that the baby placed on her life. Adam’s frequent crying for no apparent reason was particularly frustrating. According to Angela, Adam cried even when he was not hungry or wet. Sometimes she handled Adam roughly, when he wouldn’t quiet down after a feeding or around bedtime. At other times, Angela was upset that Adam didn’t seem to smile enough at her when she wanted to play with him. Sometimes, Adam paid no attention to her when she wanted interaction. At these times, she would raise her voice and hold his face in her hands to make him look at her. She was beginning to feel that she was not a very good mother to her son after all. Sarah and Angela’s already strained relationship grew more hostile as Adam approached his first birthday. Angela felt that her mother wasn’t interested in helping her. Angela always idealized her father and believed that it was her mother’s frequent outbursts of anger that led to her father’s leaving home. For her part, Sarah believed that her daughter wasn’t doing enough to help herself. Angela chose not to go back to school, even though she could have access to school-based child care services. All through Angela’s high school years, Sarah had expected her daughter to find a steady job after graduation and to contribute to the family financially. Instead, Sarah found herself in the role of financial provider for another child. She was very angry and hurt that Angela didn’t seem to appreciate all she had done for her over the years. Whenever the mother and daughter had an argument, Angela would say that she felt her mother never really cared about her. What was even worse for Sarah was that Angela had begun seeing Wayne again, without her mother’s permission. She made it clear to Angela that she and the baby would need to move out if she ever got pregnant again.

     

    Discussion Questions

    1. Comment on the quality of the attachment relationship between Angela and Adam and between Sarah and Angela. Do you think that Adam is at risk for developmental problems? Discuss.

    2. Using the model of intergenerational transmission of attachment presented in this chapter, discuss the transmission sequence as it applies in this case.

    3. What kinds of interventions could you suggest to help the members of this family?

     

    CASE STUDY

    Terry and Bill, married for 5 years, are a Black couple who live in a small suburban community. Terry graduated from high school and worked as a receptionist before her marriage to Bill, a communications company manager. Because both of them believed that mothers should stay at home with young children, Terry quit her job when she had her first child, who is now an intense and active 4-year-old daughter named Dawn. Both parents were very attentive to their daughter and enjoyed caring for and playing with her when she was a baby. As Dawn got older, she became more active and assertive. When Dawn fussed, resisted, or showed frustration, Terry was patient and affectionate with her. She was able to coax Dawn out of her bad temper by making up little games that Dawn enjoyed. Both Terry and Bill liked Dawn’s spirited personality. Because her parents wanted her to have access to playmates, Dawn attended a church-related program for toddlers and preschoolers three mornings a week. When Dawn was 3 years old, Terry gave birth to the couple’s second child, a son named Darren. Soon after the baby’s birth, the family learned that Darren had a congenital heart problem that would require ongoing medical treatment and a specific regimen of care at home. Darren was an irritable baby. He fussed for long periods and was very difficult for Terry to soothe. Because of Darren’s need for medical care and the limitations of Bill’s medical insurance, the couple soon found themselves in financial difficulty. Bill began to take on overtime work at the company to subsidize some of the bills and was away from the home several nights a week and part of each weekend. Terry found the care of two demanding young children and the worries about money to be increasingly more stressful. She was always tired and seemed to have less patience with her family. whereas she once had the leisure time to read to Dawn, to take her for walks, and to help her master tasks that proved frustrating, Terry now had to shift her attention to the care of her medically fragile infant. Because Dawn looked so grown-up compared to the vulnerable newborn, Terry began to perceive her daughter as able to do many things for herself. When Dawn demonstrated her neediness by clinging or whining, Terry became abrupt and demanded that Dawn stop. Many battles revolved around Terry’s new rule that Dawn have a nap or “quiet time” each afternoon so that mother and baby could get some rest. One day, Dawn’s preschool teacher, Mrs. Adams, asked to speak with Terry. Mrs. Adams noted that Dawn’s behavior was becoming a problem in the morning preschool sessions. Dawn had begun throwing toys when she became upset and often refused to cooperate in group activities. Terry was greatly embarrassed to hear about her daughter’s misbehavior. Dawn was the only Black child in the small class, and her mother wondered if this was part of the problem. When Terry got home, she put her tearful, clinging daughter in her room for time-out for being bad at school. She loved Dawn, but she could not tolerate this kind of behavior, especially when Darren needed so much of her time. She began to wonder if she and Bill had spoiled their daughter. Terry feared that Dawn would have problems when it came time for her to enter kindergarten if they didn’t take a strong stand with her now.

    Discussion Questions 1. Explain Dawn’s behavior from an attachment point of view. How would you describe Dawn’s attachment history?

    2. Describe Terry’s parenting style. Has the style changed? What suggestions would you make to Terry and Bill about handling this problem?

    3. What are some of the contextual influences on Dawn’s behavior?

The Aging Process

DISCUSSION 1:

 

The Aging Process

 

As individuals grow older, they experience biological changes, but how they experience these changes varies considerably. Senescence, or the process of aging, “affects different people, and various parts of the body, at different rates” (Zastrow & Kirst-Ashman, 2016, p. 658).

 

What factors affect the aging process? Why do some individuals appear to age faster than others? In this Discussion you address these questions and consider how, you, as a social worker, might apply your understanding of the aging process to your work with older clients.

 

To prepare for this Discussion, read “Working With the Aging: The Case of Francine” in Social Work Case Studies: Foundation Year.

 

Post a Discussion in which you:

 

o   Apply your understanding of the aging process to Francine’s case. How might Francine’s environment have influenced her aging process? How might you, as Francine’s social worker, apply your knowledge of the aging process to her case?

 

o   Identify an additional strategy you might use to apply your knowledge of the aging process to social work practice with older clients in general. Explain why you would use the strategy.

 

 

Be sure to support your posts with specific references to the resources. If you are using additional articles, be sure to provide full APA-formatted citations for your references

 

References

 

Plummer, S. -B., Makris, S., & Brocksen, S. M. (Eds.). (2014). Social work case studies: Foundation year. Baltimore, MD: Laureate International Universities Publishing. [Vital Source e-reader].

 

Zastrow, C. H., & Kirst-Ashman, K. K. (2016). Understanding human behavior and the social environment (10th ed.)Boston, MA:  Cengage Learning.

 

 

 

Working With the Aging: The Case of Francine

Francine is a 70-year-old, Irish Catholic female. She worked for 40 years as a librarian in an institution of higher education and retired at age 65. Francine has lived alone for the past year, after her partner, Joan, died of cancer. Joan and Francine had been together for 30 years, and while Francine personally identifies as a lesbian, she never came out to her family or to her colleagues. When speaking to all but her closest confidantes, Francine referred to Joan as her “best friend” or her “roommate.” Francine’s bereavement was therefore complicated because she did not feel she could discuss the true nature of her partnership with Joan. She felt that there was little recognition from her family, and even some of her close associates, of the impact and meaning of Joan’s death to Francine. There is a history of alcohol abuse in Francine’s family, and Francine abused alcohol from late adolescence into her mid-30s. However, Francine has been in recovery for several decades. Francine has no known sexual abuse history and no criminal history.

Francine sought counseling with me for several reasons, including an ongoing depressed mood, a lack of pleasure or enjoyment in her life, and loneliness and isolation since Joan’s death. She also reported that she had begun to drink again and that while her drinking was not yet at the level it had been earlier in her life, she was concerned that she could return to a dependence upon alcohol. Francine came to counseling with several considerable strengths, including a capacity to form intimate relationships, a successful work history, a history of having maintained her sobriety in the past for many years, as well as insight into the factors that had contributed to her current difficulties.

During our initial meetings, Francine stated that her goals were to feel less depressed, to reduce or stop drinking, and to feel less isolated. In order to ensure that no medical issues were contributing to her depression symptoms, I referred Francine to her primary care physician for an evaluation. Francine’s physician did not find any medical cause of her symptoms, diagnosing Francine with moderate clinical depression and recommending that Francine begin a course of antidepressant medication. Francine was reluctant to take medication and first wanted to try a course of counseling.

In order to help Francine meet her goal of reducing her depression symptoms, I employed a technique called behavioral activation (BA), which is drawn from principles of cognitive behavioral therapy and helps to reengage people in pleasant physical, social, and recreational activities. We began with a small initial goal of having Francine dedicate at least 5 minutes of each day to an activity she found pleasant or rewarding. Over the following weeks, we increased the time. Francine’s treatment progress was monitored through weekly completion of the Patient Health Questionnaire (PHQ-9) in order to determine whether or not her depressive symptoms were improving.

I helped Francine address her drinking by reconnecting her with effective coping strategies she had used in the past to achieve and maintain her sobriety. These included identifying triggers for the urge to drink and exploring her motivations for both continuing to drink and for stopping her use of alcohol. Francine began attending regular meetings of Alcoholics Anonymous (AA) and found several meetings that were specifically for older women and for lesbians. In addition, Francine spoke regularly with a sponsor who helped her to remain abstinent during particularly stressful moments during her reengagement in sobriety.

Finally, in order to address Francine’s goal of feeling less lonely and isolated, we explored potential avenues to increase her social networks. In addition to spending time with her family, friends, and her AA sponsor, Francine began to visit the local lesbian, gay, bisexual, and transgender (LGBT), center for the first time in her life and attended a support group for women who had lost their partners. Francine also began spending time at her local senior center and went there at least three times a week for exercise classes, other recreational activities, and lunch. She also began to do volunteer work at her local library once a week.

Over several months of counseling, Francine stopped drinking; significantly increased her daily involvement in pleasant and rewarding activities, including social and recreational activities; and reported feeling less lonely, despite still missing her partner a great deal. Francine’s scores on the PHQ-9 gradually decreased over time, and after 16 weeks of counseling, Francine reported that she no longer felt she needed the session to move on with her life. In addition, Francine visited her primary care physician, who found upon evaluation that her depression had lifted considerably and that an antidepressant was no longer indicated. By the end of counseling, Francine’s focused work on identifying her depression symptoms and her triggers for drinking equipped her to better recognize when she might need support in the future and to whom she could reach out for help if she needed it.

 

 

 

 

 

Discussion 2: Mental Health Care

 

Mental health care is a primary concern to social workers, who are the main providers of care to populations with mental health diagnoses. The system that provides services to individuals with mental health issues is often criticized for being reactive and only responding when individuals are in crisis. Crisis response is not designed to provide on-going care and is frequently very expensive, especially if hospitalization is involved.

 

Critics suggest a comprehensive plan, which involves preventive services, as well as a continuum of care. However, there are few, if any, effective and efficient program models. Social work expertise and input are vital to implementing effective services. Targeting services to individuals with a diagnosis of mental illness is one strategy. Another approach includes providing an array of services that are also preventative in nature. How might these suggestions address potential policy gaps in caring for individuals such as the family members in the Parker Family case?

 

For this Discussion, review this week’s resources, including the Parker Family video. Then consider the specific challenges or gaps in caring for individuals with a chronic mental illness might present for the mental health system based on the Parker case. Finally, think about how environmental stressors, such as poverty, can aggravate mental illness and make treatment more challenging.

 

·      Post an explanation of the specific challenges or gaps in the mental health care system for the care of individuals with chronic mental illnesses.

 

·      Base your response on the Parker case.

 

·      Then, describe how environmental stressors, such as poverty, can aggravate mental illness and make treatment more challenging.

 

Support your post with specific references to the resources. Be sure to provide full APA citations for your references.

 

 

References

 

Popple, P. R., & Leighninger, L. (2015). The policy-based profession: An introduction to social welfare policy analysis for social workers. (6th ed.). Upper Saddle River, NJ: Pearson Education.

World Health Organization. (2004). Mental health policy and service guidance package: Mental health policy, plans and programmes. Retrieved from http://www.who.int/mental_health/policy/en/policy_plans_revision.pdf

 

Plummer, S. -B., Makris, S., & Brocksen, S. (Eds.). (2014). Sessions: Case histories. Baltimore: MD: Laureate International Universities Publishing. [Vital Source e-reader].

 

 

Parker Family Episode 5 Program Transcript

 

COUNSELOR: So you’ve been hospitalized, let’s see, four times altogether.

 

FEMALE CLIENT: Well actually, I should have only been in the hospital three times.

 

COUNSELOR: Why do you say that?

 

FEMALE SPEAKER: Well, on the third hospital visit they kicked me out before I was ready to leave. They said I was just in there to get away from my mom, but I told them they were wrong. My sister even backed me up on this. But they didn’t care. They just checked me out, and home sweet home I went. I was barely gone like a month and I was back in their monkey house. So technically, for me, hospital visits three and four are the same. I remember going back to that hospital seeing the same docs and nurses, and I just smiled and waved and said, see, I told you so. I mean, we picked up right where we left off.

 

COUNSELOR: What do you mean your sister backed you up?

 

FEMALE CLIENT: Jane, that’s my sister. Jane, she knew how crazy my mom is, so she took pictures of all that mess and all that junk my mom hoards, and she showed them to the social worker in the hospital.

 

COUNSELOR: What happened?

 

FEMALE CLIENT: You know what the social worker said? She said that there was nothing that she can do about it, that her job was to only make sure that patients have a place to go when they leave the hospital. Translation, when you’re out the door, good riddance and good luck. Some policy, huh?

 

 

 

 

 

 

 

Discussion 3: Emerging Issues in Mental Health Care

 

Like so many areas of practice in social work, mental health is dynamic and ever-evolving. Research continues to provide new information about how the brain functions, the role of genetics in mental health, and evidence to support new possibilities for treatment. Keeping up with these developments might seem impossible. However, being aware of and responsive to these developments and incorporating them into both your practice and social policy is essential to changing the lives of individuals and families who live with a mental health diagnosis and the impact it brings to their daily lives.

 

For this Discussion, review this week’s resources. Search the Library and other reputable online sources for emerging issues in the mental health care arena. Think about the issues that are being addressed by social policy and those that are in need of policy advocacy and why that might be the case. Then, consider what social workers can do to ensure that clients/populations receive necessary mental health services. Also, think about the ethical responsibility related to mental health care social workers must uphold in host settings when they encounter conflicts in administration and home values. Finally, search your state government sites for the mental health commitment standards in your state and reflect on the mental health services covered under your state’s Medicaid program.

 

·      Post an explanation of those emerging issues in the mental health care arena that the policymakers address and those that are in need of policy advocacy and why.

 

·      Then, explain what strategies social workers might use to ensure that clients/populations receive necessary mental health services.

 

·      Finally, explain the mental health commitment standards and mental health services in your state. In your explanation, refer to the services covered under your state’s Medicaid program.

 

Support your post with specific references to the resources. Be sure to provide full APA citations for your references.

 

References

 

Popple, P. R., & Leighninger, L. (2015). The policy-based profession: An introduction to social welfare policy analysis for social workers. (6th ed.). Upper Saddle River, NJ: Pearson Education.

World Health Organization. (2004). Mental health policy and service guidance package: Mental health policy, plans and programmes. Retrieved from http://www.who.int/mental_health/policy/en/policy_plans_revision.pdf

 

Plummer, S. -B., Makris, S., & Brocksen, S. (Eds.). (2014). Sessions: Case histories. Baltimore: MD: Laureate International Universities Publishing. [Vital Source e-reader].

 

 

Mental Health America. (n.d.). Retrieved October 10, 2013, from www.mentalhealthamerica.net

Test Review(Becks Depression)

I’ve added an example of how it should look like when completed. I also added the actual review form two reviewers. all the data is collected, the questions below will need to be answered. PLEASE LOOK AT THE EXAMPLE THAT I ATTACHED AND LOOK/READ OVER THE ACTUAL REVIEW.

 

1)The Test- cost, time to take the test, theory behind the test, number of items, age appropriateness, and any other information relevant to teaching me about the test ( Approximately one page double spaced)

2)Reviewer #1- norm sample, practicality and cultural fairness, validity, reliability, final comments  ( At a Minimum, one page double spaced)

3)Reviewer #2- norm sample, practicality and cultural fairness, validity, reliability, final comments ( At a Minimum, one page double spaced)

4) Your thoughts on norm sample, practicality and cultural fairness validity, reliability, final comments about using the test. Why or why not. (At a Minimum, one page double spaced).  I want your thoughts based on specific information and not just opinions such as “I don’t like the GRE’s” or “I don’t think it’s fair to subject students to standardize testing.”  I want to know what you think about the norm sample, practicality and cultural fairness validity, reliability based   specifically on what you learned from both reviewers and any other source.

Accession Number

14122148
Classification Code Personality [12]
Database Mental Measurements Yearbook
Mental Measurements Yearbook The Fourteenth Mental Measurements Yearbook 2001
Title Beck Depression Inventory-II.
Acronym BDI-II.
Authors Beck, Aaron T.; Steer, Robert A.; Brown, Gregory K.
Purpose “Developed for the assessment of symptoms corresponding to criteria for diagnosing depressive disorders listed in the … DSM IV”.
Publisher The Psychological Corporation, 555 Academic Court, San Antonio, TX 78204-2498
Publisher Name The Psychological Corporation
Date of Publication 1961-1996
Population Ages 13 and over
Scores Total score only.
Administration Group or individual
Manual Manual, 1996, 38 pages.
Price 1999 price data: $57 per complete kit including manual and 25 recording forms; $27 per manual; $29.50 per 25 recording forms; $112 per 100 recording forms; $29.50 per 25 Spanish recording forms; $112 per 100 Spanish recording forms.
Special Editions Available in Spanish.
Cross References See T5:272 (384 references); for reviews by Janet F. Carlson and Niels G. Waller, see 13:31 (1026 references); see also T4:268 (660 references); for reviews by Collie W. Conoley and Norman D. Sundberg of an earlier edition, see 11:31 (286 references).
Time (5-10) minutes.
Reviewers Arbisi, Paul A. (University of Minnesota); Farmer, Richard F. (Idaho State University).
Review Indicator 2 Reviews Available
Comments Also available in Spanish; hand-scored or computer-based administration, scoring, and interpretation available; “revision of BDI based upon new information about depression.”
Full Text Review of the Beck Depression Inventory-II by PAUL A. ARBISI, Minneapolis VA Medical Center, Assistant Professor Department of Psychiatry and Assistant Clinical Professor Department of Psychology, University of Minnesota, Minneapolis, MN: After over 35 years of nearly universal use, the Beck Depression Inventory (BDI) has undergone a major revision. The revised version of the Beck, the BDI-II, represents a significant improvement over the original instrument across all aspects of the instrument including content, psychometric validity, and external validity. The BDI was an effective measure of depressed mood that repeatedly demonstrated utility as evidenced by its widespread use in the clinic as well as by the frequent use of the BDI as a dependent measure in outcome studies of psychotherapy and antidepressant treatment (Piotrowski & Keller, 1989; Piotrowski & Lubin, 1990). The BDI-II should supplant the BDI and readily gain acceptance by surpassing its predecessor in use. Despite the demonstrated utility of the Beck, times had changed and the diagnostic context within which the instrument was developed had altered considerably over the years (Beck, Ward, Mendelson, Mock, & Erbaugh, 1961). Further, psychometrically, the BDI had some problems with certain items failing to discriminate adequately across the range of depression and other items showing gender bias (Santor, Ramsay, & Zuroff, 1994). Hence the time had come for a conceptual reassessment and psychometrically informed revision of the instrument. Indeed, a mid-course correction had occurred in 1987 as evidenced by the BDI-IA, a version that included rewording of 15 out of the 21 items (Beck & Steer, 1987). This version did not address the limited scope of depressive symptoms of the BDI nor the failure of the BDI to adhere to contemporary diagnostic criteria for depression as codified in the DSM-III. Further, consumers appeared to vote with their feet because, since the publication of the BDI-IA, the original Beck had been cited far more frequently in the literature than the BDI-IA. Therefore, the time had arrived for a major overhaul of the classic BDI and a retooling of the content to reflect diagnostic sensibilities of the 1990s. In the main, the BDI-II accomplishes these goals and represents a highly successful revamping of a reliable standard. The BDI-II retains the 21-item format with four options under each item, ranging from not present (0) to severe (3). Relative to the BDI-IA, all but three items were altered in some way on the BDI-II. Items dropped from the BDI include body image change, work difficulty, weight loss, and somatic preoccupation. To replace the four lost items, the BDI-II includes the following new items: agitation, worthlessness, loss of energy, and concentration difficulty. The current item content includes: (a) sadness, (b) pessimism, (c) past failure, (d) loss of pleasure, (e) guilty feelings, (f) punishment feelings, (g) self-dislike, (h) self-criticalness, (i) suicidal thoughts or wishes, (j) crying, (k) agitation, (l) loss of interest, (m) indecisiveness, (n) worthlessness, (o) loss of energy, (p) changes in sleeping pattern, (q) irritability, (r) changes in appetite, (s) concentration difficulty, (t) tiredness or fatigue, and (u) loss of interest in sex. To further reflect DSM-IV diagnostic criteria for depression, both increases and decreases in appetite are assessed in the same item and both hypersomnia and hyposomnia are assessed in another item. And rather than the 1-week time period rated on the BDI, the BDI-II, consistent with DSM-IV, asks for ratings over the past 2 weeks. The BDI-II retains the advantage of the BDI in its ease of administration (5-10 minutes) and the rather straightforward interpretive guidelines presented in the manual. At the same time, the advantage of a self-report instrument such as the BDI-II may also be a disadvantage. That is, there are no validity indicators contained on the BDI or the BDI-II and the ease of administration of a self-report lends itself to the deliberate tailoring of self-report and distortion of the results. Those of us engaged in clinical practice are often faced with clients who alter their presentation to forward a personal agenda that may not be shared with the clinician. The manual obliquely mentions this problem in an ambivalent and somewhat avoidant fashion. Under the heading, “Memory and Response Sets,” the manual blithely discounts the potential problem of a distorted response set by attributing extreme elevation on the BDI-II to “extreme negative thinking” which “may be a central cognitive symptom of severe depression rather than a response set per se because patients with milder depression should show variation in their response ratings” (manual, p. 9). On the other hand, later in the manual, we are told that, “In evaluating BDI-II scores, practitioners should keep in mind that all self-report inventories are subject to response bias” (p. 12). The latter is sound advice and should be highlighted under the heading of response bias. The manual is well written and provides the reader with significant information regarding norms, factor structure, and notably, nonparametric item-option characteristic curves for each item. Indeed the latter inclusion incorporates the latest in item response theory, which appears to have guided the retention and deletion of items from the BDI (Santor et al., 1994). Generally the psychometric properties of the BDI-II are quite sound. Coefficient alpha estimates of reliability for the BDI-II with outpatients was .92 and was .93 for the nonclinical sample. Corrected item-total correlation for the outpatient sample ranged from .39 (loss of interest in sex) to .70 (loss of pleasure), for the nonclinical college sample the lowest item-total correlation was .27 (loss of interest in sex) and the highest (.74 (self-dislike). The test-retest reliability coefficient across the period of a week was quite high at .93. The inclusion in the manual of item-option characteristic curves for each BDI-II item is of noted significance. Examination of these curves reveals that, for the most part, the ordinal position of the item options is appropriately assigned for 17 of the 21 items. However, the items addressing punishment feelings, suicidal thought or wishes, agitation, and loss of interest in sex did not display the anticipated rank order indicating ordinal increase in severity of depression across item options. Additionally, although improved over the BDI, Item 10 (crying) Option 3 does not clearly express a more severe level of depression than Option 2 (see Santor et al., 1994). Over all, however, the option choices within each item appear to function as intended across the severity dimension of depression. The suggested guidelines and cut scores for the interpretation of the BDI-II and placement of individual scores into a range of depression severity are purported to have good sensitivity and moderate specificity, but test parameters such as positive and negative predictive power are not reported (i.e., given score X on the BDI-II, what is the probability that the individual meets criteria for a Major Depressive Disorder, of moderate severity?). According to the manual, the BDI-II was developed as a screening instrument for major depression and, accordingly, cut scores were derived through the use of receiver operating characteristic curves to maximize sensitivity. Of the 127 outpatients used to derive the cut scores, 57 met criteria for either single-episode or recurrent major depression. The relatively high base rate (45%) for major depression is a bit unrealistic for nonpsychiatric settings and will likely serve to inflate the test parameters. Cross validation of the cut scores on different samples with lower base rates of major depression is warranted due to the fact that a different base rate of major depression may result in a significant change in the proportion of correct decisions based on the suggested cut score (Meehl & Rosen, 1955). Consequently, until the suggested cut scores are cross validated in those populations, caution should be exercised when using the BDI-II as a screen in nonpsychiatric populations where the base rate for major depression may be substantially lower. Concurrent validity evidence appears solid with the BDI-II demonstrating a moderately high correlation with the Hamilton Psychiatric Rating Scale for Depression-Revised (r = .71) in psychiatric outpatients. Of importance to the discriminative validity of the instrument was the relatively moderate correlation between the BDI-II and the Hamilton Rating Scale for Anxiety-Revised (r = .47). The manual reports mean BDI-II scores for various groups of psychiatric outpatients by diagnosis. As expected, outpatients had higher scores than college students. Further, individuals with mood disorders had higher scores than those individuals diagnosed with anxiety and adjustment disorders. The BDI-II is a stronger instrument than the BDI with respect to its factor structure. A two-factor (Somatic-Affective and Cognitive) solution accounted for the majority of the common variance in both an outpatient psychiatric sample and a much smaller nonclinical college sample. Factor Analysis of the BDI-II in a larger nonclinical sample of college students resulted in Cognitive-Affective and Somatic-Vegetative main factors essentially replicating the findings presented in the manual and providing strong evidence for the overall stability of the factor structure across samples (Dozois, Dobson, & Ahnberg, 1998). Unfortunately several of the items such as sadness and crying shifted factor loadings depending upon the type of sample (clinical vs. nonclinical). SUMMARY. The BDI-II represents a highly successful revision of an acknowledged standard in the measurement of depressed mood. The revision has improved upon the original by updating the items to reflect contemporary diagnostic criteria for depression and utilizing state-of-the-art psychometric techniques to improve the discriminative properties of the instrument. This degree of improvement is no small feat and the BDI-II deserves to replace the BDI as the single most widely used clinically administered instrument for the assessment of depression. REVIEWER’S REFERENCES Meehl, P. E., & Rosen, A. (1955). Antecedent probability and the efficiency of psychometric signs, patterns, or cutting scores. Psychological Bulletin, 52, 194-216. Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561-571. Beck, A. T., & Steer, R. A. (1987). Beck Depression Inventory manual. San Antonio, TX: The Psychological Corporation. Piotrowski, C., & Keller, J. W. (1989). Psychological testing in outpatient mental health facilities: A national study. Professional Psychology: Research and Practice, 20, 423-425. Piotrowski, C., & Lubin, B. (1990). Assessment practices of health psychologists; Survey of APA Division 38 clinicians. Professional Psychology: Research and Practice, 21, 99-106. Santor, D. A., Ramsay, J. O., & Zuroff, D. C. (1994). Nonparametric item analyses of the Beck Depression Inventory: Evaluating gender item bias and response option weights. Psychological Assessment, 6, 255-270. Dozois, D. J. A., Dobson, K. S., & Ahnberg, J. L. (1998). A psychometric evaluation of the Beck Depression Inventory-II. Psychological Assessment, 10, 83-89. Review of the Beck Depression Inventory-II by RICHARD F. FARMER, Associate Professor of Psychology, Idaho State University, Pocatello, ID: The Beck Depression Inventory-II (BDI-II) is the most recent version of a widely used self-report measure of depression severity. Designed for persons 13 years of age and older, the BDI-II represents a significant revision of the original instrument published almost 40 years ago (BDI-I; Beck, Ward, Mendelson, Mock, & Erbaugh, 1961) as well as the subsequent amended version copyrighted in 1978 (BDI-IA; Beck, Rush, Shaw, & Emery, 1979; Beck & Steer, 1987, 1993). Previous editions of the BDI have considerable support for their effectiveness as measures of depression (for reviews, see Beck & Beamesderfer, 1974; Beck, Steer & Garbin, 1988; and Steer, Beck, & Garrison, 1986). Items found in these earlier versions, many of which were retained in modified form for the BDI-II, were clinically derived and neutral with respect to a particular theory of depression. Like previous versions, the BDI-II contains 21 items, each of which assesses a different symptom or attitude by asking the examinee to consider a group of graded statements that are weighted from 0 to 3 based on intuitively derived levels of severity. If the examinee feels that more than one statement within a group applies, he or she is instructed to circle the highest weighting among the applicable statements. A total score is derived by summing weights corresponding to the statements endorsed over the 21 items. The test authors provide empirically informed cut scores (derived from receiver operating characteristic [ROC] curve methodology) for indexing the severity of depression based on responses from outpatients with a diagnosed episode of major depression (cutoff scores to index the severity of dysphoria for college samples are suggested by Dozois, Dobson, & Ahnberg, 1998). The BDI-II can usually be completed within 5 to 10 minutes. In addition to providing guidelines for the oral administration of the test, the manual cautions the user against using the BDI-II as a diagnostic instrument and appropriately recommends that interpretations of test scores should only be undertaken by qualified professionals. Although the manual does not report the reading level associated with the test items, previous research on the BDI-IA suggested that items were written at about the sixth-grade level (Berndt, Schwartz, & Kaiser, 1983). A number of changes appear in the BDI-II, perhaps the most significant of which is the modification of test directions and item content to be more consistent with the major depressive episode concept as defined in the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV; American Psychiatric Association, 1994). Whereas the BDI-I and BDI-IA assessed symptoms experienced at the present time and during the past week, respectively, the BDI-II instructs the examinee to respond in terms of how he or she has “been feeling during the past two weeks, including today” (manual, p. 8, emphasis in original) so as to be consistent with the DSM-IV time period for the assessment of major depression. Similarly, new items included in the BDI-II address psychomotor agitation, concentration difficulties, sense of worthlessness, and loss of energy so as to make the BDI-II item set more consistent with DSM-IV criteria. Items that appeared in the BDI-I and BDI-IA that were dropped in the second edition were those that assessed weight loss, body image change, somatic preoccupation, and work difficulty. All but three of the items from the BDI-IA retained for inclusion in the BDI-II were reworded in some way. Items that assess changes in sleep patterns and appetite now address both increases and decreases in these areas. Two samples were retained to evaluate the psychometric characteristics of the BDI-II: (a) a clinical sample (n = 500; 63% female; 91% White) who sought outpatient therapy at one of four outpatient clinics on the U.S. east coast (two of which were located in urban areas, two in suburban areas), and (b) a convenience sample of Canadian college students (n = 120; 56% women; described as “predominantly White”). The average ages of the clinical and student samples were, respectively, 37.2 (SD = 15.91; range = 13-86) and 19.58 (SD = 1.84). Reliability of the BDI was evaluated with multiple methods. Internal consistency was assessed using corrected item-total correlations (ranges: .39 to .70 for outpatients; .27 to .74 for students) and coefficient alpha (.92 for outpatients; .93 for students). Test-retest reliability was assessed over a 1-week interval among a small subsample of 26 outpatients from one clinic site (r = .93). There was no significant change in scores noted among this outpatient sample between the two testing occasions, a finding that is different from those often obtained with college students who, when tested repeatedly with earlier versions of the BDI, were often observed to have lower scores on subsequent testing occasions (e.g., Hatzenbuehler, Parpal, & Matthews, 1983). Following the method of Santor, Ramsay, and Zuroff (1994), the test authors also examined the item-option characteristic curves for each of the 21 BDI-II items as endorsed by the 500 outpatients. As noted in a previous review of the BDI (1993 Revised) by Waller (1998), the use of this method to evaluate item performance represents a new standard in test revision. Consistent with findings for depressed outpatients obtained by Santor et al. (1994) on the BDI-IA, most of the BDI-II items performed well as evidenced by the individual item-option curves. All items were reported to display monotonic relationships with the underlying dimension of depression severity. A minority of items were somewhat problematic, however, when the degree of correspondence between estimated and a priori weights associated with item response options was evaluated. For example, on Item 11 (agitation), the response option weighted a value of 1 was more likely to be endorsed than the option weighted 3 across all levels of depression, including depression in the moderate and severe ranges. In general, though, response option weights of the BDI-II items did a good job of discriminating across estimated levels of depression severity. Unfortunately, the manual does not provide detailed discussion of item-option characteristic curves and their interpretation. The validity of the BDI-II was evaluated with outpatient subsamples of various sizes. When administered on the same occasion, the correlation between the BDI-II and BDI-IA was quite high (n = 101, r = .93), suggesting that these measures yield similar patterns of scores, even though the BDI-II, on average, produced equated scores that were about 3 points higher. In support of its convergent validity, the BDI-II displayed moderately high correlations with the Beck Hopelessness Scale (n = 158, r = .68) and the Revised Hamilton Psychiatric Rating Scale for Depression (HRSD-R; n = 87, r = .71). The correlation between the BDI-II and the Revised Hamilton Anxiety Rating Scale (n = 87, r = .47) was significantly less than that for the BDI-II and HRSD-R, which was cited as evidence of the BDI-II’s discriminant validity. The BDI-II, however, did share a moderately high correlation with the Beck Anxiety Inventory (n = 297; r = .60), a finding consistent with past research on the strong association between self-reported anxiety and depression (e.g., Kendall & Watson, 1989). Additional research published since the manual’s release (Steer, Ball, Ranieri, & Beck, 1997) also indicates that the BDI-II shares higher correlations with the SCL-90-R Depression subscale (r = .89) than with the SCL-90-R Anxiety subscale (r = .71), although the latter correlation is still substantial. Other data presented in the test manual indicated that of the 500 outpatients, those diagnosed with mood disorders (n = 264) had higher BDI-II scores than those diagnosed with anxiety (n = 88), adjustment (n = 80), or other (n = 68) disorders. The test authors also cite evidence of validity by separate factor analyses performed on the BDI-II item set for outpatients and students. However, findings from these analyses, which were different in some significant respects, are questionable evidence of the measure’s validity as the test was apparently not developed to assess specific dimensions of depression. Factor analytic studies of the BDI have historically produced inconsistent findings (Beck et al., 1988), and preliminary research on the BDI-II suggests some variations in factor structure within both clinical and student samples (Dozois et al., 1998; Steer & Clark, 1997; Steer, Kumar, Ranieri, & Beck, 1998). Furthermore, one of the authors of the BDI-II (Steer & Clark, 1997) has recently advised that the measure not be scored as separate subscales. SUMMARY. The BDI-II is presented as a user-friendly self-report measure of depression severity. Strengths of the BDI-II include the very strong empirical foundation on which it was built, namely almost 40 years of research that demonstrates the effectiveness of earlier versions. In the development of the BDI-II, innovative methods were employed to determine optimum cut scores (ROC curves) and evaluate item performance and weighting (item-option curves). The present edition demonstrates very good reliability and impressive test item characteristics. Preliminary evidence of the BDI-II’s validity in clinical samples is also encouraging. Despite the many impressive features of this measure, one may wonder why the test developers were not even more thorough in their presentation of the development of the BDI-II and more rigorous in the evaluation of its effectiveness. The test manual is too concise, and often omits important details involving the test development process. The clinical sample used to generate cut scores and evaluate the psychometric properties of the measure seems unrepresentative in many respects (e.g., racial make-up, patient setting, geographic distribution), and other aspects of this sample (e.g., education level, family income) go unmentioned. The student sample is relatively small and, unfortunately, drawn from a single university. Opportunities to address important questions regarding the measure were also missed, such as whether the BDI-II effectively assesses or screens the DSM-IV concept of major depression, and the extent to which it may accomplish this better than earlier versions. This seems to be a particularly important question given that the BDI was originally developed as a measure of the depressive syndrome, not as a screening measure for a nosologic category (Kendall, Hollon, Beck, Hammen, & Ingram, 1987), a distinction that appears to have become somewhat blurred in this most recent edition. Also, not reported in the manual are analyses to examine possible sex biases among the BDI-II item set. Santor et al. (1994) reported that the BDI-IA items were relatively free of sex bias, and given the omission of the most sex-biased item in the BDI-IA (body image change) from the BDI-II, it is possible that this most recent edition may contain even less bias. Similarly absent in the manual is any report on the item-option characteristic curves for nonclinical samples. Santor et al. (1994) reported that for most of the BDI-IA items, response option weights were less discriminating across the range of depression severity among their college sample relative to their clinical sample, an anticipated finding given that students would be less likely to endorse response options hypothesized to be consistent with more severe forms of depression. Also, given that previous editions of the BDI have shown inconsistent associations with social undesirability (e.g., Tanaka-Matsumi & Kameoka, 1986), an opportunity was missed to evaluate the extent to which the BDI-II measures something different than this response set. Despite these relative weaknesses in the development and presentation of the BDI-II, existent evidence suggests that the BDI-II is just as sound if not more so than its earlier versions. REVIEWER’S REFERENCES Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561-571. Beck, A. T., & Beamesderfer, A. (1974). Assessment of depression: The Depression Inventory. In P. Pichot & R. Oliver-Martin (Eds.), Psychological measurements in psychopharmacology: Modern problems in pharmacopsychiatry (vol. 7, pp. 151-169). Basel: Karger. Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford. Berndt, D. J., Schwartz, S., & Kaiser, C. F. (1983). Readability of self-report depression inventories. Journal of Consulting and Clinical Psychology, 51, 627-628. Hatzenbuehler, L. C., Parpal, M., & Matthews, L. (1983). Classifying college students as depressed or nondepressed using the Beck Depression Inventory: An empirical analysis. Journal of Consulting and Clinical Psychology, 51, 360-366. Steer, R. A., Beck, A. T., & Garrison, B. (1986). Applications of the Beck Depression Inventory. In N. Sartorius & T. A. Ban (Eds.), Assessment of depression (pp. 123-142). New York: Springer-Verlag. Tanaka-Matsumi, J., & Kameoka, V. A. (1986). Reliabilities and concurrent validities of popular self-report measures of depression, anxiety, and social desirability. Journal of Consulting and Clinical Psychology, 54, 328-333. Beck, A. T., & Steer, R. A. (1987). Beck Depression Inventory manual. San Antonio, TX: The Psychological Corporation. Kendall, P. C., Hollon, S. D., Beck, A. T., Hammen, C. L., & Ingram, R. E. (1987). Issues and recommendations regarding the use of the Beck Depression Inventory. Cognitive Therapy and Research, 11, 289-299. Beck, A. T., Steer, R. A., & Garbin, M. G. (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8, 77-100. Kendall, P. C., & Watson, D. (Eds.). (1989). Anxiety and depression: Distinctive and overlapping features. San Diego, CA: Academic Press. Beck, A. T., & Steer, R. A. (1993). Beck Depression Inventory manual. San Antonio, TX: Psychological Corporation. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author. Santor, D. A., Ramsay, J. O., & Zuroff, D. C. (1994). Nonparametric item analyses of the Beck Depression Inventory: Evaluating gender item bias and response option weights. Psychological Assessment, 6, 255-270. Steer, R. A., Ball, R., Ranieri, W. F., & Beck, A. T. (1997). Further evidence for the construct validity of the Beck Depression Inventory-II with psychiatric outpatients. Psychological Reports, 80, 443-446. Steer, R. A., & Clark, D. A. (1997). Psychometric characteristics of the Beck Depression Inventory-II with college students. Measurement and Evaluation in Counseling and Development, 30, 128-136. Dozois, D. J. A., Dobson, K. S., & Ahnberg, J. L. (1998). A psychometric evaluation of the Beck Depression Inventory-II. Psychological Assessment, 10, 83-89. Steer, R. A., Kumar, G., Ranieri, W. F., & Beck, A. T. (1998). Use of the Beck Depression Inventory-II with adolescent psychiatric outpatients. Journal of Psychopathology and Behavioral Assessment, 20, 127-137. Waller, N. G. (1998). [Review of the Beck Depression Inventory-1993 Revised]. In J. C. Impara & B. S. Plake (Eds.), The thirteenth mental measurements yearbook (pp. 120-121). Lincoln, NE: The Buros Institute of Mental Measurements.
Copyright Copyright © 2011. The Board of Regents of the University of Nebraska and the Buros Center for Testing. All rights reserved. Any unauthorized use is strictly prohibited. Buros Center for Testing, Buros Institute, Mental Measurements Yearbook, and Tests in Print are all trademarks of the Board of Regents of the University of Nebraska and may not be used without express written consent.
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Applied Behavioral Analysis 2

Resource: How to Make a Graph Using Microsoft Excel

The Unit 6 Assignment requires you to apply the theories, concepts, and research that you have covered so far this term to a hypothetical case study. Your answers to the questions and completed graph should consist of information from the text and supplemental readings.You also may use sources from the Kaplan library or other credible Internet sources, but your primary sources should be the readings assigned for the course.

Read each Case Study and answer the questions below. You will need to write 2–3 typed pages for each case in order to address all required parts of the project.Answers to the questions should be typed in an APA formatted Word document, double-spaced in 12-point font and submitted to the Dropbox.

Your final paper must be your original work; plagiarism will not be tolerated. Be sure to review the Syllabus in terms of what constitutes plagiarism.Please make sure to provide proper credit for those sources used in your case study analysis in proper APA format. Please see the APA Quick Reference for any questions related to APA citations. You must credit authors when you:

  1. Summarize a concept, theory or research
  2. Use direct quotes from the text or articles

Read Case Study 1: Martin

Martin, a behavior analyst, is working with Sara, a 14-year-old girl with severe developmental delays who exhibits self-injurious behavior (SIB). Sara’s target behavior is defined as pulling her hair, biting her arm and banging her head against the wall. After conducting a functional analysis, Martin decided to employ an intervention program consisting of differential reinforcement of other (DRO) desired behavior. Martin collected data on Sara’s SIB before and during the intervention. Below is a depiction of the data that Martin collected:

Sara’s Frequency of SIB

BASELINE Occurrences DRO Occurrences
22 5
25 5
27 3
26 2

 

Address the following questions, and complete the following requirements:

  1. Create a basic line graph using Microsoft Excel, to be included in your Word document. The graph should depict the data provided in this case study. You should only need to create one graph, with SIB depicted, both in baseline and in intervention.
  2. What type of research design did Martin employ when working with Sara? What is an advantage and a disadvantage of using this research design?
  3. According to the data in the graph, was the intervention that Martin selected effective in modifying Sara’s self-injurious behavior?
  4. Martin had considered using an ABAB reversal design when working with Sara. What are some ethical implications of selecting a reversal design when working with the type of behavior problems that Sara was exhibiting?
  5. Martin’s supervisor requested a graph of the data he collected when working with Sara. Why are graphs useful in evaluating behavior change?
  6. Discuss how a graph demonstrates a functional relationship. Identify whether the graph that you created using the data provided in this section depicts a functional relationship.

Chapter 3

3 Graphing Behavior and Measuring Change

· ▪ What are the six essential components of a behavior modification graph?

· ▪ How do you graph behavioral data?

· ▪ What different dimensions of behavior can be shown on a graph?

· ▪ What is a functional relationship, and how do you demonstrate a functional relationship in behavior modification?

· ▪ What different research designs can be used in behavior modification research?

As we saw in  Chapter 2 , people who use behavior modification define their target behavior carefully, and directly observe and record the behavior. In this way, they can document whether the behavior has indeed changed when a behavior modification procedure is implemented. The primary tool used to document behavior change is the graph.

A  graph  is a visual representation of the occurrence of a behavior over time. After instances of the target behavior are recorded (on a data sheet or otherwise), the information is transferred to a graph. A graph is an efficient way to view the occurrence of the behavior because it shows the results of recording during many observation periods.

Behavior analysts use graphs to identify the level of behavior before treatment and after treatment begins. In this way, they can document changes in the behavior during treatment and make decisions about the continued use of the treatment. The graph makes it easier to compare the levels of the behavior before, during, and after treatment because the levels are presented visually for comparison. In  Figure 3-1 , for example, it is easy to see that the frequency of the behavior is much lower during treatment (competing response) than before treatment (baseline). This particular graph is from a student’s self-management project. The student’s target behavior involved biting the insides of her mouth when she studied. She recorded the behavior on a data sheet each time it occurred. After 10 days of recording the behavior without any treatment (baseline), she implemented a behavior modification plan in which she used a competing response (a behavior that is incompatible with mouth-biting and interrupts each occurrence of mouth-biting) to help her control the mouthbiting behavior. After implementing this competing response procedure, she continued to record the behavior for 20 more days. She then recorded the behavior four more times, after 1, 5, 10, and 20 weeks. The long period after treatment has been implemented is called the follow-up period. From this graph, we can conclude that the mouth-biting behavior (as recorded by the student) decreased substantially while the student implemented the treatment. We can also see that the behavior continued to occur at a low level up to 20 weeks after treatment was implemented.

Components of a Graph

In the typical behavior modification graph, time and behavior are the two variables illustrated. Each data point on a graph gives you two pieces of information: It tells you when the behavior was recorded (time) and the level of the behavior at that time. Time is indicated on the horizontal axis (also called the x-axis, or the  abscissa ), and the level of the behavior is indicated on the vertical axis (also called the y-axis, or the  ordinate ). In  Figure 3-1 , the frequency of mouth-biting is indicated on the vertical axis, and days and weeks are indicated on the horizontal axis. By looking at this graph, you can determine the frequency of mouth-biting on any particular day, before or after treatment was implemented. Because follow-up is reported, you can also see the frequency of the behavior at intervals of up to 20 weeks.

Six components are necessary for a graph to be complete.

▪The y-axis and the x-axis. The vertical axis (y-axis) and the horizontal axis (x-axis) meet at the bottom left of the page. On most graphs, the x-axis is longer than the y-axis; it is usually one to two times as long ( Figure 3-2 ).

The labels for the y-axis and the x-axis. The y-axis label usually tells you the behavior and the dimension of the behavior that is recorded. The x-axis label usually tells you the unit of time during which the behavior is recorded. In  Figure 3-3 , the y-axis label is “Hours of Studying” and the x-axis label is “Days.”

Thus, you know that the hours of studying will be recorded each day for this particular person.

The numbers on the y-axis and the x-axis. On the y-axis, the numbers indicate the units of measurement of the behavior; on the x-axis, the numbers indicate the units of measurement of time. There should be a hash mark on the y-axis and the x-axis to correspond to each of the numbers. In  Figure 3-4 , the numbers on the y-axis indicate the number of hours the studying behavior occurred, and the numbers on the x-axis indicate the days on which studying was measured.

Data points. The data points must be plotted correctly to indicate the level of the behavior that occurred at each particular time period. The information on the level of the behavior and the time periods is taken from the data sheet or other behavior-recording instrument. Each data point is connected to the adjacent data points by a line ( Figure 3-5 ).

Phase lines. A phase line is a vertical line on a graph that indicates a change in treatment. The change can be from a no-treatment phase to a treatment phase, from a treatment phase to a no-treatment phase, or from one treatment phase to another treatment phase. A phase is a period in which the same treatment (or no treatment) is in effect. In  Figure 3-6 , the phase line separates baseline (no treatment) and treatment phases. Data points are not connected across phase lines. This allows you to see differences in the level of the behavior in different phases more easily.

Phase labels. Each phase in a graph must be labeled. The phase label appears at the top of the graph above the particular phase ( Figure 3-7 ). Most behavior modification graphs have at least two phases that are labeled: the notreatment phase and the treatment phase. “ Baseline ” is the label most often given to the no-treatment phase. The label for the treatment phase should identify the particular treatment being used. In  Figure 3-7 , the two phase labels are “Baseline” and “Behavioral Contract.” The behavioral contract is the particular treatment the student is using to increase studying. Some graphs have more than one treatment phase or more than one baseline phase.

Graphing Behavioral Data

As discussed in  Chapter 2 , behavioral data are collected through direct observation and recording of the behavior on a data sheet or other instrument. Once the behavior has been recorded on the data sheet, it can be transferred to a graph. For example,  Figure 3-8 a is a frequency data sheet that shows 2 weeks of behavior recording, and  Figure 3-8 b is a graph of the behavioral data from the data sheet. Notice that days 1–14 on

contract in which the client agreed to smoke one fewer cigarette per day every second day. Behavioral contracts are described in  Chapter 23 .

Also notice that the frequency of the behavior listed on the data sheet for each day corresponds to the frequency recorded on the graph for that day. As you look at the graph, you can immediately determine that the frequency of the behavior is much lower during treatment than during baseline. You have to look more closely at the data sheet to be able to detect the difference between baseline and treatment. Finally, notice that all six essential components of a graph are included in this graph.

Consider a second example. A completed duration data sheet is shown in  Figure 3-9 a, and  Figure 3-9 b is a table that summarizes the daily duration of the behavior recorded on the data sheet. Notice that the duration of the behavior listed in the summary table for each of the 20 days corresponds to the duration that was recorded each day on the data sheet.

To complete  Figure 3-9 c, you must add four components. First, you should add the data points for days 8–20 and connect them. Second, include the phase line between days 7 and 8. Data points on days 7 and 8 should not be connected across the phase line. Third, add the phase label “Behavioral Contract,” to the right of the phase line. Fourth, add the label “Days” to the x-axis. When these four components are added, the graph includes all six essential components ( Figure 3-10 ).

FOR FURTHER READING Graphing in Excel

Although it is easy to construct a graph with a piece of graph paper, a ruler, and a pencil, there are graphing programs that allow you to construct a graph on your computer. Graphs can be constructed in two different Microsoft Office programs; PowerPoint and Excel ( Vaneslow & Bourret, 2012 ). Carr and  Burkholder (1998)  and Dixon et al. (2007) published articles in the Journal of Applied Behavior Analysis providing step-by-step instructions on how to use Microsoft Excel for constructing the types of graphs used in applied behavior analysis or behavior modification.  Vaneslow and Bourret (2012)  described how to use an online tutorial about constructing graphs using Microsoft excel. Students interested in learning how to construct graphs in Excel are encouraged to read these articles.

Graphing Data from Different Recording Procedures

Figures 3-8 and 3-10 illustrate graphs of frequency data and duration data, respectively. Because other types of data can be recorded, other types of graphs are possible. Regardless of the dimension of behavior or type of data that is being graphed, however, the same six components of a graph must be present. What will change with different recording procedures are the y-axis label and the numbering on the y-axis. For example, if you are recording the percentage of math problems a student completes correctly during each math class, you would label the y-axis “Percentage of Correct Math Problems” and number the y-axis from 0% to 100%. As you can see, the y-axis label identifies the behavior (correct math problems) and the type of data (percentage) that is recorded.

Consider another example. A researcher is studying Tourette’s syndrome, a neurological disorder in which certain muscles in the body twitch or jerk involuntarily (these are called motor tics). The researcher uses an interval recording system and records whether a motor tic occurs during each consecutive 10-second interval in 30-minute observation periods. At the end of each observation period, the researcher calculates the percentage of intervals in which a tic occurred. The researcher labels the y-axis of the graph “Percentage of Intervals of Tics” and numbers the y-axis from 0% to 100%. Whenever an interval recording system is used, the y-axis is labeled “Percentage of Intervals of (Behavior).” The x-axis label indicates the time periods in which the behavior was recorded (e.g., “Sessions” or “Days”). The x-axis is then numbered accordingly. A session is a period in which a target behavior is observed and recorded. Once treatment is started, it is also implemented during the session.

Other aspects of a behavior may be recorded and graphed, such as intensity or product data. In each case, the y-axis label should clearly reflect the behavior and the dimension or aspect of the behavior that is recorded. For example, as a measure of how intense or serious a child’s tantrums are, you might use the label “Tantrum Intensity Rating” and put the numbers of the rating scale on the y-axis. For a measure of loudness of speech, the y-axis label might be “Decibels of Speech,” with decibel levels numbered on the y-axis. To graph product recording data, you would label the y-axis to indicate the unit of measurement and the behavior. For example, “Number of Brakes Assembled” is a y-axis label that indicates the work output of a person who puts together bicycle brakes.

Research Designs

When people conduct research in behavior modification, they use research designs that include more complex types of graphs. The purpose of a  research design  is to determine whether the treatment (independent variable) was responsible for the observed change in the target behavior (dependent variable) and to rule out the possibility that extraneous variables caused the behavior to change. In research, an  independent variable  is what the researcher manipulates to produce a change in the target behavior. The target behavior is called the  dependent variable . An extraneous variable, also called a confounding variable, is any event that the researcher did not plan that may have affected the behavior. For a person with a problem, it may be enough to know that the behavior changed for the better after using behavior modification procedures. However, a researcher also wants to demonstrate that the behavior modification procedure is what caused the behavior to change.

When a researcher shows that a behavior modification procedure causes a target behavior to change, the researcher is demonstrating a  functional relationship  between the procedure and the target behavior. That is, the researcher demonstrates that the behavior changes as a function of the procedure.

A functional relationship is established if:

· (a) a target behavior changes when an independent variable is manipulated (a procedure is implemented), while all other variables are held constant, and

· (b) the process is replicated or repeated one or more times and the behavior changes each time.

A behavior modification researcher uses a research design to demonstrate a functional relationship. A research design involves both treatment implementation and replication. If the behavior changes each time the procedure is implemented and only when the procedure is implemented, a functional relationship is demonstrated.

In this case, we would say that the researcher has demonstrated experimental control over the target behavior. It is unlikely that an extraneous variable caused the behavior change if it changed only when the treatment was implemented. This section reviews research designs used in behavior modification (for further information on behavior modification research designs, see  Bailey, 1977 ;  Barlow & Hersen, 1984 ;  Gast, 2009 ;  Hayes, Barlow, & Nelson-Gray, 1999 ;  Kazdin, 2010 ;  Poling & Grossett, 1986 ).

A-B Design

The simplest type of design used in behavior modification has just two phases: baseline and treatment. This is called an  A-B design , where A = baseline and B = treatment. A-B designs are illustrated in Figures 3-1, 3-7, 3-8b, and 3-10. By means of an A-B design, we can compare baseline and treatment to determine whether the behavior changed in the expected way after treatment. However, the A-B design does not demonstrate a functional relationship because treatment is not replicated (implemented a second time). Therefore, the A-B design is not a true research design; it does not rule out the possibility that an extraneous variable was responsible for the behavior change. For example, although mouth-biting decreased when the competing response treatment was implemented in  Figure 3-1 , it is possible that some other event (extraneous variable) occurred at the same time as treatment was implemented. In that case, the decrease in mouth-biting may have resulted from the other event or a combination of treatment and the other event. For example, the person may have seen a TV show about controlling nervous habits and learned from that how to control her mouth-biting.

The A-B design is not a true research design. Because the A-B design does not include a replication and thus does not demonstrate a functional relationship, it is rarely used by behavior modification researchers. It is most often used in applied, nonresearch situations, in which people are more interested in demonstrating that behavior change has occurred than in proving that the behavior modification procedure caused the behavior change. You probably would use an A-B graph in a self-management project to show whether your behavior changed after you implemented a behavior modification procedure.

A-B-A-B Reversal Design

The  A-B-A-B reversal design  is an extension of the simple A-B design (where A = baseline and B = treatment). In the A-B-A-B design, baseline and treatment phases are implemented twice. It is called a reversal design because after the first treatment phase, the researcher removes the treatment and reverses back to baseline. This second baseline is followed by replication of the treatment.  Figure 3-11  illustrates an A-B-A-B design.

The A-B-A-B graph in  Figure 3-11  shows the effect of a teacher’s demands on the aggressive behavior of an adolescent with intellectual disability named Bob. Carr and his colleagues ( Carr, Newsom, & Binkoff, 1980 ) studied the influence of demands on Bob’s aggressive behavior by alternating phases in which teachers made frequent demands with phases in which teachers made no demands. In  Figure 3-11 , you can see that the behavior changed three times. In the baseline phase (“Demands”), the aggressive behavior occurred frequently. When the treatment phase (“No Demands”) was first implemented, the behavior decreased. When the second “Demands” phase occurred, the behavior returned to its level during the first “Demands” phase. Finally, when the “No Demands” phase was implemented a second time, the behavior decreased again. The fact that the behavior changed three times, and only when the phase changed, is evidence that the change in demands (rather than some extraneous variable) caused the behavior change. When the independent variable was manipulated (demands were turned on and off each time), the behavior changed accordingly. It is highly unlikely that an extraneous variable was turned on and off at exactly the same time as the demands, so it is highly unlikely that any other variable except the independent variable (change in demands) caused the behavior change.

 

Variations of the A-B-A-B reversal design may be used in which more than one treatment is evaluated. Suppose for example, you implemented one treatment (B) and it did not work, so you implemented a second treatment (C) and it did work. To replicate this treatment and show experimental control, you might use an A-B-C-A-C design. If the second treatment (C) resulted in a change in the target behavior each time it was implemented, you are demonstrating a functional relationship between this treatment and the behavior.

A number of considerations must be taken into account in deciding whether to use the A-B-A-B research design. First, it may not be ethical to remove the treatment in the second baseline if the behavior is dangerous (e.g., self-injurious behavior). Second, you must be fairly certain that the level of the behavior will reverse when treatment is withdrawn. If the behavior fails to change when the treatment is withdrawn, a functional relationship is not demonstrated. Another consideration is whether you can actually remove the treatment after it is implemented. For example, if the treatment is a teaching procedure and the subject learns a new behavior, you cannot take away the learning that took place. (For a more detailed discussion of considerations in the use of the A-B-A-B design, see  Bailey [1977] ,  Bailey and Burch [2002] ,  Barlow and Hersen [1984] ,  Gast [2009] , and  Kazdin [2010] .)

Multiple-Baseline Design

There are three types of multiple-baseline designs.

▪In a  multiple-baseline-across-subjects design , there is a baseline and a treatment phase for the same target behavior of two or more subjects.

▪In a  multiple-baseline-across-behaviors design , there is a baseline and treatment phase for two or more behaviors of the same subject.

▪In a  multiple-baseline-across-settings design , there is a baseline and treatment phase for two or more settings in which the same behavior of the same subject is measured.

Remember that the A-B-A-B design can also have two baseline phases and two treatment phases, but both baseline and treatment phases occur for the same behavior of the same subject in the same setting. With the multiple-baseline design, the different baseline and treatment phases occur for different subjects, or for different behaviors, or in different settings.

A multiple-baseline design may be used:

· (a) when you are interested in the same target behavior exhibited by multiple subjects,

· (b) when you have targeted more than one behavior of the same subject, or

· (c) when you are measuring a subject’s behavior across two or more settings.

A multiple-baseline design is useful when you cannot use an A-B-A-B design for the reasons listed earlier. The multiple-baseline design and the appropriate time to use it are described in more detail by  Bailey (1977) ,  Bailey and Burch (2002) ,  Barlow and Hersen (1984) ,  Gast (2009) , and  Kazdin (2010) .

 Figure 3-12  illustrates the multiple-baseline-across-subjects design. This graph, from a study by  DeVries, Burnette, and Redmon (1991) , shows the effect of an intervention involving feedback on the percentage of time that emergency department nurses wore rubber gloves when they had contact with patients. Notice that there is a baseline and treatment phase for four different subjects (nurses).  Figure 3-12  also illustrates a critical feature of the multiple-baseline design: The baselines for each subject are of different lengths. Treatment is implemented for subject 1, while subjects 2, 3, and 4 are still in baseline. Then, treatment is implemented for subject 2, while subjects 3 and 4 are still in base line. Next, treatment is implemented for subject 3 and, finally, for subject 4. When treatment is implemented at different times, we say that treatment is staggered over time. Notice that the behavior increased for each subject only after the treatment phase was started for that subject. When treatment was implemented for subject 1, the behavior increased, but the behavior did not increase at that time for subjects 2, 3, and 4, who were still in baseline and had not yet received treatment. The fact that the behavior changed for each subject only after treatment started is evidence that the treatment, rather than an extraneous variable, caused the behavior change. It is highly unlikely that an extraneous variable would happen to occur at exactly the same time that treatment started for each of the four subjects.

multiple-baseline-across-behaviors design is illustrated in  Figure 3-13 . This graph, from a study by  Franco, Christoff, Crimmins, and Kelly (1983) , shows the effect of treatment (social skills training) on four different social behaviors of a shy adolescent: asking questions, acknowledging other people’s comments, making eye contact, and showing affect (e.g., smiling). Notice in this graph that treatment is staggered across the four behaviors, and that each of the behaviors changes only after treatment is implemented for that particular behavior. Because each of the four behaviors changed only after treatment was implemented for that behavior, the researchers demonstrated that treatment, rather than some extraneous variable, was responsible for the behavior change.

A graph used in a multiple-baseline-across-settings design would look like those in Figures 3-12 and 3-13. The difference is that in a multiple-baseline-acrosssettings graph, the same behavior of the same subject is being recorded in baseline and treatment phases in two or more different settings, and treatment is staggered across the settings.

 Draw a graph of a multiple-baseline-across-settings design with hypothetical data. Be sure to include all six components of a complete graph. Assume that you have recorded the disruptive behavior of a student in two different class rooms using an interval recording system. Include baseline and treatment across two settings in the graph.

The graph in  Figure 3-14 , from a study by  Dunlap, Kern-Dunlap, Clarke, and Robbins (1991) , shows the percentage of intervals of disruptive behavior by a student during baseline and treatment (revised curriculum) in two settings, the morning and afternoon classrooms. It also shows follow-up, in which the researchers collected data once a week for 10 weeks. Notice that treatment is staggered across settings; it was implemented first in one setting and then in the other, and the student’s disruptive behavior changed only after treatment was implemented in each setting. Your graph of a multiple-baseline-across-settings design would look like  Figure 3-14 .

FOR FURTHER READING Nonconcurrent Multiple-Baseline-Across-Subjects Design

In a multiple-baseline-across-subjects design, data collection starts in each of the baselines (for each of the subjects) at around the same time and the treatment phase is then staggered across time. However, in a nonconcurrent multiple baseline (MBL) across subjects design ( Carr, 2005 ;  Watson & Workman, 1981 ) the subjects do not participate in the study concurrently. In a nonconcurrent MBL design, the baselines for two or more subjects may begin at different points in time. The nonconcurrent MBL is equivalent to a number of different A-B designs with each participant having a different baseline length. Treatment is then staggered across baselines of different lengths rather than across time. As long as each of the subjects has a different number of baseline data points before treatment is implemented, the research design is considered a nonconcurrent MBL. The advantage of a nonconcurrent MBL is that participants may be evaluated at different points in time; they may be brought into the study consecutively rather than concurrently, which is often more practical for researchers to carry out ( Carr, 2005 ).

Alternating-Treatments Design

The  alternating-treatments design (ATD) , also called a multi-element design, differs from the research designs just reviewed in that baseline and treatment conditions (or two treatment conditions) are conducted in rapid succession and compared with each other. For example, treatment is implemented on one day, baseline the next day, treatment the next day, baseline the next day, and so on. In the A-B, A-B-A-B, or multiple-baseline designs, a treatment phase occurs after a baseline phase has been implemented for a period of time; that is, baseline and treatment occur sequentially. In these designs, a baseline or treatment phase is conducted until a number of data points are collected (usually at least three) and there is no trend in the data. A trend means the data are increasing or decreasing across a phase. In the ATD, two conditions (baseline and treatment or two different treatments) occur during alternating days or sessions. Therefore, the two conditions can be compared within the same time period. This is valuable because any extraneous variables would have a similar effect on both conditions, and thus an extraneous variable could not be the cause of any differences between conditions.

Consider the following example of an ATD. A teacher wants to determine whether violent cartoons lead to aggressive behavior in preschool children. The teacher uses an ATD to demonstrate a functional relationship between violent cartoons and aggressive behavior. On one day, the preschoolers do not watch any cartoons (baseline) and the teacher records the students’ aggressive behavior. The next day, the students watch a violent cartoon and the teacher again records their aggressive behavior. The teacher continues to alternate a day with no cartoons and a day with cartoons. After a few weeks, the teacher can determine whether a functional relationship exists. If there is consistently more aggressive behavior on cartoon days and less aggressive behavior on no-cartoon days, the teacher has demonstrated a functional relationship between violent cartoons and aggressive behavior in the preschoolers. An example of a graph from this hypothetical ATD is shown in  Figure 3-15 .

Changing-Criterion Design

A  changing-criterion design  typically includes a baseline and a treatment phase. What makes a changing-criterion design different from an A-B design is that, within the treatment phase, sequential performance criteria are specified; that is, successive goal levels for the target behavior specify how much the target behavior should change during treatment. The effectiveness of treatment is determined by whether the subject’s behavior changes to meet the changing performance criteria. That is, does the subject’s behavior change each time the goal level changes? A graph used in a changing-criterion design indicates each criterion level so that when the behavior is plotted on the graph, we can determine whether the level of the behavior matches the criterion level.

Consider the graph in  Figure 3-16 , from a study by  Foxx and Rubinoff (1979) . These researchers helped people reduce their excessive caffeine consumption through a positive reinforcement and response cost procedure. (These procedures are discussed in  Chapters 15  and  17 .) As you can see in the graph, they set four different criterion levels for caffeine consumption, each lower than the previous level. When subjects consumed less caffeine than the criterion level, they earned money. If they drank more, they lost money. This graph shows that treatment was successful: This subject’s caffeine consumption level was always below each of the criterion levels. Because the subject’s behavior changed each time the performance criterion changed, the researchers demonstrated a functional relationship—it is unlikely that an extraneous variable was responsible for the change in behavior.  DeLuca and Holborn (1992)  used a changingcriterion design in a study constructed to help obese boys exercise more. The boys rode exercise bikes and received points for the amount of pedaling that they did on the bikes. They later exchanged the points for toys and other rewards. In this study, each time the exercise performance criterion was raised (the boys had to pedal more to earn points), the boys’ exercise level increased accordingly, thus demonstrating a functional relationship between treatment and the amount of pedaling.

CHAPTER SUMMARY

· 1. The six essential features of a complete behavior modification graph are the y-axis and x-axis, labels for the y-axis and x-axis, units for the y-axis and x-axis, data points, phase lines, and phase labels.

· 2. To graph behavioral data, you plot the data points on the graph to reflect the level of the behavior on the vertical axis (y-axis) and the unit of time on the horizontal axis (x-axis).

· 3. The different dimensions of behavior you can show on a graph include the frequency, duration, intensity, and latency of the behavior. A graph may also show the percentage of intervals of the behavior derived from interval recording or time sample recording or the percentage of opportunities in which the behavior occurred (e.g., percentage correct).

· 4. A functional relationship between the treatment (independent variable) and the target behavior (dependent variable) exists when the treatment causes the behavior to change. A functional relationship or experimental control is demonstrated when a target behavior changes after the implementation of treatment and the treatment procedure is repeated or replicated one or more times and the behavior changes each time.

· 5. The different research designs you can use in behavior modification research include the following:

· ▪ The A-B design shows baseline and treatment for the behavior of one subject. It is not a true research design.

· ▪ The A-B-A-B design shows two baseline and treatment phases repeated for the behavior of one subject.

· ▪ A multiple-baseline design presents baseline and treatment phases for one of the following options: multiple behaviors of one subject, one behavior of multiple subjects, or one behavior of one subject across multiple settings. In each type of multiple-baseline design, treatment is staggered across behaviors, subjects, or settings.

· ▪ The alternating-treatments design presents data from two (or more) experimental conditions that are rapidly alternated (baseline and treatment or two treatments).

· ▪ Finally, in the changing-criterion design, a baseline phase is followed by a treatment phase in which sequential performance criteria are specified.

All research designs, except the A-B design, control for the influence of extraneous variables, so that the effectiveness of a treatment can be evaluated.

 

6 Punishment

· ▪ What is the principle of punishment?

· ▪ What is a common misconception about the definition of punishment in behavior modification?

· ▪ How does positive punishment differ from negative punishment?

· ▪ How are unconditioned punishers different from conditioned punishers?

· ▪ What factors influence the effectiveness of punishment?

· ▪ What are the problems with punishment?

In  Chapters 4  and  5 , we discussed the basic principles of reinforcement and extinction. Positive and negative reinforcement are processes that strengthen operant behavior, and extinction is a process that weakens operant behavior. In this chapter, we focus on punishment, another process that weakens operant behavior ( Lerman & Vorndran, 2002 ). Consider the following examples.

Kathy, a college senior, moved into a new apartment near campus. On her way to class, she passed a fenced-in yard with a big, friendly looking dog. One day, when the dog was near the fence, Kathy reached over to pet the dog.

At once, the dog growled, bared its teeth, and bit her hand. After this, she never again tried to pet the dog.

On Mother’s Day, Otis decided to get up early and make breakfast for his mom. He put the cast-iron skillet on the stove and turned the burner on high. Then he mixed a couple of eggs in a bowl with some milk to make scrambled eggs. After about 5 minutes, he poured the eggs from the bowl into the skillet. Immediately, the eggs started to burn and smoke rose from the skillet. Otis grabbed the handle of the skillet to move it off of the burner. As soon as he touched the handle, pain shot through his hand; he screamed and dropped the skillet. After that episode, Otis never again grabbed the handle of a hot cast-iron skillet. He always used a hot pad to avoid burning himself.

Defining Punishment

The preceding two examples illustrate the behavioral principle of punishment. In each example, a person engaged in a behavior and there was an immediate consequence that made it less likely that the person would repeat the behavior in similar situations in the future. Kathy reached over the fence to pet the dog, and the dog immediately bit her. As a result, Kathy is less likely to reach over the fence to pet that dog or other unfamiliar dogs. Otis grabbed the hot handle of a cast-iron skillet, which resulted immediately in painful stimulation as he burned his hand. As a result, Otis is much less likely to grab the handle of a cast-iron skillet on a hot stove again (at least not without a hot pad).

 

As demonstrated in these examples, there are three parts to the definition of  punishment .

· 1. A particular behavior occurs.

· 2. A consequence immediately follows the behavior.

· 3. As a result, the behavior is less likely to occur again in the future. (The behavior is weakened.)

A  punisher  (also called an aversive stimulus) is a consequence that makes a particular behavior less likely to occur in the future. For Kathy, the dog bite was a punisher for her behavior of reaching over the fence. For Otis, the painful stimulus (burning his hand) was the punisher for grabbing the handle of the cast-iron skillet. A punisher is defined by its effect on the behavior it follows. A stimulus or event is a punisher when it decreases the frequency of the behavior it follows.

Consider the case of 5-year-old Juan who teases and hits his sisters until they cry. His mother scolds him and spanks him each time he teases or hits his sisters. Although Juan stops teasing and hitting his sisters at the moment that his mother scolds him and spanks him, he continues to engage in these aggressive and disruptive behaviors with his sisters day after day.

No, the scolding and spanking do not function as punishers. They have not resulted in a decrease in Juan’s problem behavior over time. This example actually illustrates positive reinforcement. Juan’s behavior (teasing and hitting) results in the presentation of a consequence (scolding and spanking by his mother and crying by his sisters), and the outcome is that Juan continues to engage in the behavior day after day. These are the three parts of the definition of positive reinforcement.

This raises an important point about the definition of punishment. You cannot define punishment by whether the consequence appears unfavorable, unpleasant, or aversive. You can conclude that a particular consequence is punishing only if the behavior decreases in the future. In Juan’s case, scolding and spanking appear to be unfavorable consequences, but he continues to hit and tease his sisters. If the scolding and spanking functioned as a punisher, Juan would stop hitting and teasing his sisters over time. When we define punishment (or reinforcement) according to whether the behavior decreases (or increases) in the future as a result of the consequences, we are adopting a functional definition. See  Table 6-1  for examples of punishment.

One other point to consider is whether a behavior decreases or stops only at the time the consequence is administered, or whether the behavior decreases in the future. Juan stopped hitting his sisters at the time that he received a spanking from his mother, but he did not stop hitting his sisters in the future. Some parents continue to scold or spank their children because it puts an immediate stop to the problem behavior, even though their scolding and spanking do not make the child’s problem behavior less likely to occur in the future. The parents believe they are using punishment. However, if the behavior continues to occur in the future, the scolding and spanking do not function as punishers and may actually function as reinforcers.

TABLE 6-1 Examples for Self-Assessment (Punishment)

· 1. Ed was riding his bike down the street and looking down at the ground as he pedaled. All of a sudden he ran into the back of a parked car, flew off the bike, and hit the roof of the car with his face. In the process, he knocked his front teeth loose. In the future, Ed was much less likely to look down at the ground when he rode his bike.

· 2. When Alma was in the day care program, she sometimes hit the other kids if they played with her toys. Alma’s teacher made her quit playing and sit in a chair in another room for 2 minutes each time she hit someone. As a result, Alma stopped hitting the other children.

· 3. Carlton made money in the summer by mowing his neighbor’s lawn each week. One week, Canton ran over the garden hose with the lawn mower and ruined the hose. His neighbor made Carlton pay for the hose. Since then, whenever Carlton mows the lawn, he never runs over a hose or any other objects lying in the grass.

· 4. Sarah was driving down the interstate on her way to see a friend who lived a few hours away. Feeling a little bored, she picked up the newspaper on the seat next to her and began to read it. As she was reading, her car gradually veered to the right without her noticing. Suddenly, the car was sliding on gravel and sideswiped a speed limit sign. As a result, Sarah no longer reads when she drives on the highway.

· 5. Helen goes to school in a special class for children with behavior disorders. Her teachers use poker chips as conditioned reinforcers for her academic performance. The teachers place a poker chip in a container to reinforce her correct answers. However, each time Helen gets out of her seat without permission, the teachers take one chip away from her. As a result, Helen stopped getting out of her seat without permission.

· 6. At parties, Kevin used to make jokes about his wife’s cooking and got a lot of laughs from his friends. At first, his wife smiled at his jokes, but eventually she got upset; whenever Kevin made a joke about her cooking, she gave him an icy stare. As a result, Kevin stopped joking about his wife’s cooking.

© Cengage Learning®

 What reinforces the parents’ behavior of scolding and spanking the child?

Because the child temporarily stops the problem behavior after the scolding or spanking, the parents’ behavior of scolding or spanking is negatively reinforced, so the parents continue to scold or spank the child in the future when he or she misbehaves.

A Common Misconception about Punishment

In behavior modification, punishment is a technical term with a specific meaning. Whenever behavior analysts speak of punishment, they are referring to a process in which the consequence of a behavior results in a future decrease in the occurrence of that behavior. This is quite different from what most people think of as punishment. In general usage, punishment can mean many different things, most of them unpleasant.

Many people define punishment as something meted out to a person who has committed a crime or other inappropriate behavior. In this context, punishment involves not only the hope that the behavior will cease, but also elements of retribution or retaliation; part of the intent is to hurt the person who has committed the crime. Seen as something that a wrongdoer deserves, punishment has moral or ethical connotations. Authority figures such as governments, police, churches, or parents impose punishment to inhibit inappropriate behavior—that is, to keep people from breaking laws or rules. Punishment may involve prison time, a death sentence, fines, the threat of going to hell, spanking, or scolding. However, the everyday meaning of punishment is quite different from the technical definition of punishment used in behavior modification.

People who are unfamiliar with the technical definition of punishment may believe that the use of punishment in behavior modification is wrong or dangerous. It is unfortunate that Skinner adopted the term punishment, a term that has an existing meaning and many negative connotations. As a student, it is important for you to understand the technical definition of punishment in behavior modification and to realize that it is very different from the common view of punishment in society.

On Terms: Punish Behavior, not People

· ▪ It is correct to say that you punish a behavior (or a response). You are weakening a behavior by punishing it. To say “The teacher punished Sarah’s disruptive behavior with time out” is correct.

· ▪ It is incorrect to say that you punish a person. You don’t weaken a person, you weaken a person’s behavior. To say, “The teacher punished Sarah for disruptive behavior” is not correct.

Positive and Negative Punishment

The two basic procedural variations of punishment are positive punishment and negative punishment. The difference between positive and negative punishment is determined by the consequence of the behavior.

 Positive punishment  is defined as follows.

· 1. The occurrence of a behavior

· 2. is followed by the presentation of an aversive stimulus,

· 3. and as a result, the behavior is less likely to occur in the future.

 Negative punishment  is defined as follows.

· 1. The occurrence of a behavior

· 2. is followed by the removal of a reinforcing stimulus,

· 3. and as a result, the behavior is less likely to occur in the future.

Notice that these definitions parallel the definitions of positive and negative reinforcement (see  Chapter 4 ). The critical difference is that reinforcement strengthens a behavior or makes it more likely to occur in the future, whereas punishment weakens a behavior or makes it less likely to occur in the future.

Many researchers have examined the effects of punishment on the behavior of laboratory animals.  Azrin and Holz (1966)  discussed the early animal research on punishment, much of which they had conducted themselves. Since then, researchers have investigated the effects of positive and negative punishment on human behavior ( Axelrod & Apsche, 1983 ). For example, Corte, Wolf, and Locke (1971) helped institutionalized adolescents with intellectual disabilities decrease self-injurious behavior by using punishment. One subject slapped herself in the face. Each time she did so, the researchers immediately applied a brief electric shock with a handheld shock device. (Although the shock was painful, it did not harm the girl.) As a result of this procedure, the number of times she slapped herself in the face each hour decreased immediately from 300 400 to almost zero. (Note that this study is from 1971. Electric shock is rarely, if ever, used as a punisher today because of ethical concerns. This study is cited to illustrate the basic principle of positive punishment, not to support the use of electric shock as a punisher.)

 Why is this an example of positive punishment?

This is an example of positive punishment because the painful stimulus was presented each time the girl slapped her face, and the behavior decreased as a result.  Sajwaj, Libet, and Agras (1974)  also used positive punishment to decrease life-threatening rumination behavior in a 6-month-old infant. Rumination in infants involves repeatedly regurgitating food into the mouth and swallowing it again. It can result in dehydration, malnutrition, and even death. In this study, each time the infant engaged in rumination, the researchers squirted a small amount of lemon juice into her mouth. As a result, the rumination behavior immediately decreased, and the infant began to gain weight.

One other form of positive punishment is based on the Premack principle, which states that when a person is made to engage in a low-probability behavior contingent on a high-probability behavior, the high-probability behavior will decrease in frequency (Miltenberger & Fuqua, 1981). That is, if, after engaging in a problem behavior, a person has to do something he or she doesn’t want to do, the person will be less likely to engage in the problem behavior in the future.  Luce, Delquadri, and Hall (1980)  used this principle to help a 6-year-old boy with developmental disability stop engaging in aggressive behavior. Each time the boy hit someone in the classroom, he was required to stand up and sit down on the floor ten times in a row. As shown in  Figure 6-1 , this punishment procedure, called contingent exercise, resulted in an immediate decrease in the hitting behavior.

One thing you should notice in  Figure 6-1  is that punishment results in an immediate decrease in the target behavior. Although extinction also decreases a behavior, it usually takes longer for the behavior to decrease, and an extinction burst often occurs where the behavior increases briefly before it decreases. With punishment, the decrease in behavior typically is immediate and there is no extinction burst. However, other side effects are associated with the use of punishment; these are described later in this chapter.

Negative punishment has also been the subject of extensive research. Two common examples of negative punishment are  time-out from positive reinforcement  and  response cost  (see  Chapter 17  for a more detailed discussion). Both involve the loss of a reinforcing stimulus or activity after the occurrence of a problem behavior. Some students may confuse negative punishment and extinction. They both weaken behavior. Extinction involves withholding the reinforcer that was maintaining the behavior. Negative punishment, by contrast, involves removing or withdrawing a positive reinforcer after the behavior; the reinforcer that is removed in negative punishment is one the individual had already acquired and is not necessarily the same reinforcer that was maintaining the behavior. For example, Johnny interrupts his parents and the behavior is reinforced by his parents’ attention. (They scold him each time he interrupts.) In this case, extinction would involve withholding the parents’ attention each time Johnny interrupts. Negative punishment would involve the loss of some other reinforcer—such as allowance money or the opportunity to watch TV—each time he interrupted. Both procedures would result in a decrease in the frequency of interrupting.

 Clark, Rowbury, Baer, and Baer (1973)  used time-out to decrease aggressive and disruptive behavior in an 8-year-old girl with Down syndrome. In time-out, the person is removed from a reinforcing situation for a brief period after the problem behavior occurs. Each time the girl engaged in the problem behavior in the classroom, she had to sit by herself in a small time-out room for 3 minutes. As a result of time-out, her problem behaviors decreased immediately ( Figure 6-2 ). Through the use of time-out, the problem behavior was followed by the loss of access to attention (social reinforcement) from the teacher and other reinforcers in the classroom ( Figure 6-3 ).

In a study by  Phillips, Phillips, Fixsen, and Wolf (1971) , “predelinquent” youths with serious behavior problems in a residential treatment program earned points for engaging in appropriate behavior and traded in their points for backup reinforcers such as snacks, money, and privileges. The points were conditioned reinforcers. The researchers then used a negative punishment procedure called response cost to decrease late arrivals for supper. When the youths arrived late, they lost some of the points they had earned. As a result, late arrivals decreased until the youths always showed up on time.

In all of these examples, the process resulted in a decrease in the future occurrence of the behavior. Therefore, in each example, the presentation or removal of a stimulus as a consequence of the behavior functioned as punishment.

On Terms: Distinguishing between Positive and Negative Punishment

Some students have confusion distinguishing between positive and negative punishment. They are both types of punishment, therefore, they both weaken behavior. The only difference is whether a stimulus is added (positive punishment) or removed (negative punishment) following the behavior. Think of positive as a plus or addition (+) sign and negative as a minus or subtraction (−) sign. In + punishment, you add a stimulus (an aversive stimulus) after the behavior. In − punishment, you subtract or take away a stimulus (a reinforcer) after the behavior. If you think of positive and negative in terms of adding or subtracting a stimulus after the behavior, the distinction should be clearer.

Unconditioned and Conditioned Punishers

Like reinforcement, punishment is a natural process that affects human behavior. Some events or stimuli are naturally punishing because avoiding or minimizing contact with these stimuli has survival value ( Cooper et al., 1987 ). Painful stimuli or extreme levels of stimulation are often dangerous. Behaviors that produce painful or extreme stimulation are naturally weakened, and behaviors that result in escape or avoidance of such stimulation are naturally strengthened. For this reason, painful stimuli or extreme levels of stimulation have biological importance. Such stimuli are called  unconditioned punishers . No prior conditioning is needed for an unconditioned punisher to function as a punisher. Through the process of evolution, humans have developed the capacity for their behavior to be punished by these naturally aversive events without any prior training or experience. For example, extreme heat or cold, extreme levels of auditory or visual stimulation, or any painful stimulus (e.g., from electric shock, a sharp object, or a forceful blow) naturally weakens the behavior that produces it. If these were not unconditioned punishers, we would be more likely to engage in dangerous behaviors that could result in injury or death. We quickly learn not to put our hands into a fire, look directly into the sun, touch sharp objects, or go barefoot in the snow or on hot asphalt because each of these behaviors results in a naturally punishing consequence.

A second type of punishing stimulus is called a  conditioned punisher . Conditioned punishers are stimuli or events that function as punishers only after being paired with unconditioned punishers or other existing conditioned punishers. Any stimulus or event may become a conditioned punisher if it is paired with an established punisher.

The word no is a common conditioned punisher. Because it is often paired with many other punishing stimuli, it eventually becomes a punisher itself. For example, if a child reaches for an electrical outlet and the parent says “no,” the child may be less likely to reach for the outlet in the future. When the child spells a word incorrectly in the classroom and the teacher says “no,” the child will be less likely to spell that word incorrectly in the future. The word no is considered a  generalized conditioned punisher  because it has been paired with a variety of other unconditioned and conditioned punishers over the course of a person’s life. Van Houten and his colleagues ( Van Houten, Nau, MacKenzie-Keating, Sameoto, & Colavecchia, 1982 ) found that if firm reprimands were delivered to students in the classroom when they engaged in disruptive behavior, their disruptive behavior decreased. In this study, reprimands were conditioned punishers for the students’ disruptive behavior. Threats of harm often are conditioned punishers. Because threats have often been associated with painful stimulation in the past, threats may become conditioned punishers.

Stimuli that are associated with the loss of reinforcers may become conditioned punishers. A parking ticket or a speeding ticket is associated with the loss of money (paying a fine), so the ticket is a conditioned punisher for many people. In reality, whether speeding tickets or parking tickets function as conditioned punishers depends on a number of factors, including the schedule of punishment (how likely is it that you will get caught speeding?) and the magnitude of the punishing stimulus (how big is the fine?). These and other factors that influence the effectiveness of punishment are discussed later in this chapter.

A warning from a parent may become a conditioned punisher if it has been paired with the loss of reinforcers such as allowance money, privileges, or preferred activities. As a result, when a child misbehaves and the parent gives the child a warning, the child may be less likely to engage in the same misbehavior in the future. A facial expression or look of disapproval may be a conditioned punisher when it is associated with the loss of attention or approval from an important person (such as a parent or teacher). A facial expression may also be associated with an aversive event such as a scolding or a spanking, and thus may function as a conditioned punisher ( Doleys, Wells, Hobbs, Roberts, & Cartelli, 1976 ;  Jones & Miller, 1974 ).

Once again, it is important to remember that a conditioned punisher is defined functionally. It is defined as a punisher only if it weakens the behavior that it follows. If a person exceeds the speed limit and receives a speeding ticket and the outcome is that the person is less likely to speed in the future, the ticket functioned as a punisher. However, if the person continues to speed after receiving a ticket, the ticket was not a punisher. Consider the following example.

 

The look is not a conditioned punisher because the child’s behavior of belching at the table was not weakened; the child did not stop engaging in the behavior. The mother’s look may have functioned as a positive reinforcer, or perhaps other family members laughed when the child belched, and thus reinforced the belching behavior. Alternatively, belching may be naturally reinforcing because it relieves an unpleasant sensation in the stomach.

Contrasting Reinforcement and Punishment

Important similarities and differences exist between positive and negative reinforcement on one hand and positive and negative punishment on the other. The defining features of each principle are that a behavior is followed by a consequence, and the consequence influences the future occurrence of the behavior.

The similarities and differences between the two types of reinforcement and punishment can be summarized as follows:

 

· ▪ When a stimulus is presented after a behavior (left column), the process may be positive reinforcement or positive punishment, depending on whether the behavior is strengthened (reinforcement) or weakened (punishment) in the future.

· ▪ When a stimulus is removed after the behavior (right column), the process may be negative reinforcement or negative punishment. It is negative reinforcement if the behavior is strengthened and negative punishment if the behavior is weakened.

· ▪ When a behavior is strengthened, the process is reinforcement (positive or negative).

· ▪ When a behavior is weakened, the process is punishment (positive or negative).

One particular stimulus may be involved in reinforcement and punishment of different behaviors in the same situation, depending on whether the stimulus is presented or removed after the behavior. Consider the example of Kathy and the dog. When Kathy reached over the fence, this behavior was followed immediately by the presentation of an aversive stimulus (the dog bit her). The dog’s bite served as a punisher: Kathy was less likely to reach over the fence in the future. However, when Kathy pulled her hand back quickly, she terminated the dog bite. Because pulling her hand back removed the pain of being bitten, this behavior was strengthened. This is an example of negative reinforcement. As you can see, when the dog bite was presented after one behavior, the behavior was weakened; when the dog bite was removed after another behavior, that behavior was strengthened.

 

In the example of Otis and the hot skillet, the immediate consequence of grabbing the skillet handle was a painful stimulus. The outcome was that Otis was less likely to grab a hot skillet in the future. This is positive punishment.

 How is negative reinforcement involved in this example?

When Otis used a hot pad, he avoided the painful stimulus. As a result, he is more likely to use a hot pad when grabbing a hot skillet in the future (negative reinforcement). Touching the hot skillet is punished by the presentation of a painful stimulus; using the hot pad is reinforced by avoidance of the painful stimulus.

Now consider how the same stimulus may be involved in negative punishment of one behavior and positive reinforcement of another behavior. If a reinforcing stimulus is removed after a behavior, the behavior will decrease in the future (negative punishment), but if a reinforcing stimulus is presented after a behavior, the behavior will increase in the future (positive reinforcement). You know that a stimulus is functioning as a positive reinforcer when its presentation after a behavior increases that behavior and its removal after a behavior decreases that behavior. For example, Fred’s parents take his bicycle away for a week whenever they catch him riding after dark. This makes Fred less likely to ride his bike after dark (negative punishment). However, after a few days, Fred pleads with his parents to let him ride his bike again and promises never to ride after dark. They give in and give him his bike back. As a result, he is more likely to plead with his parents in the future when his bike is taken away (positive reinforcement).

Factors That Influence the Effectiveness of Punishment

The factors that influence the effectiveness of punishment are similar to those that influence reinforcement. They include immediacy, contingency, motivating operations, individual differences, and magnitude.

Immediacy

When a punishing stimulus immediately follows a behavior, or when the loss of a reinforcer occurs immediately after the behavior, the behavior is more likely to be weakened. That is, for punishment to be most effective, the consequence must follow the behavior immediately. As the delay between the behavior and the consequence increases, the effectiveness of the consequence as a punisher decreases. To illustrate this point, consider what would happen if a punishing stimulus occurred sometime after the behavior occurred. A student makes a sarcastic comment in class and the teacher immediately gives her an angry look. As a result, the student is less likely to make a sarcastic comment in class. If the teacher had given the student an angry look 30 minutes after the student made the sarcastic comment, the look would not function as a punisher for the behavior of making sarcastic comments. Instead, the teacher’s angry look probably would have functioned as a punisher for whatever behavior the student had engaged in immediately before the look.

Contingency

For punishment to be most effective, the punishing stimulus should occur every time the behavior occurs. We would say that the punishing consequence is contingent on the behavior when the punisher follows the behavior each time the behavior occurs and the punisher does not occur when the behavior does not occur. A punisher is most likely to weaken a behavior when it is contingent on the behavior. This means that punishment is less effective when it is applied inconsistently—that is, when the punisher follows only some occurrences of the behavior or when the punisher is presented in the absence of the behavior. If a reinforcement schedule continues to be in effect for the behavior, and punishment is applied inconsistently, some occurrences of the behavior may be followed by a punisher and some occurrences of the behavior may be followed by a reinforcer. In this case, the behavior is being influenced by an intermittent schedule of reinforcement at the same time that it is resulting in an intermittent punishment schedule. When a concurrent schedule of reinforcement is competing with punishment, the effects of punishment are likely to be diminished.

If a hungry rat presses a bar in an experimental chamber and receives food pellets, the rat will continue to press the bar. However, if punishment is implemented and the rat receives an electric shock each time it presses the bar, the bar-pressing behavior will stop. Now suppose that the rat continues to receive food for pressing the bar and receives a shock only occasionally when it presses the bar. In this case, the punishing stimulus would not be effective because it is applied inconsistently or intermittently. The effect of the punishing stimulus in this case depends on the magnitude of the stimulus (how strong the shock is), how often it follows the behavior, and the magnitude of the establishing operation for food (how hungry the rat is).

Motivating Operations

Just as establishing operations (EOs) and abolishing operations (AOs) may influence the effectiveness of reinforcers, they also influence the effectiveness of punishers. An establishing operation is an event or a condition that makes a consequence more effective as a punisher (or a reinforcer). An abolishing operation is an event or a condition that makes a consequence less effective as a punisher (or a reinforcer).

In the case of negative punishment, deprivation is an EO that makes the loss of reinforcers more effective as a punisher and satiation is an AO that makes the loss of reinforcers less effective as a punisher. For example, telling a child who misbehaves at the dinner table that dessert will be taken away will: (a) be a more effective punisher if the child has not eaten any dessert yet and is still hungry (EO), (b) be a less effective punisher if the child has had two or three helpings of the dessert already and is no longer hungry (AO). Losing allowance money for misbehavior will: (a) be a more effective punisher if the child has no other money and plans to buy a toy with the allowance money (EO), (b) be a less effective punisher if the child has recently received money from other sources (AO).

In the case of positive punishment, any event or condition that enhances the aversiveness of a stimulus event makes that event a more effective punisher (EO), whereas events that minimize the aversiveness of a stimulus event make it less effective as a punisher (AO). For example, some drugs (e.g., morphine) minimize the effectiveness of a painful stimulus as a punisher. Other drugs (e.g., alcohol) may reduce the effectiveness of social stimuli (e.g., peer disapproval) as punishers.

 Are these examples of AOs or EOs?

These are examples of AOs because in each case the drugs made punishers less effective. Instructions or rules may enhance the effectiveness of certain stimuli as punishers. For example, a carpenter tells his apprentice that when the electric saw starts to vibrate, it may damage the saw or break the blade. As a result of this instruction, vibration from the electric saw is established as a punisher. The behavior that produces the vibration (e.g., sawing at an angle, pushing too hard on the saw) is weakened.

 Is this an example of an EO or an AO?

This is an example of an EO because the instruction made the presence of vibration more aversive or more effective as a punisher for using the saw incorrectly. In addition, using the saw correctly avoids the vibration and this behavior is strengthened through negative reinforcement.

Effects of Motivation Operations on Reinforcement and Punishment

An establishing operation (EO): An abolishing operation (AO):
Makes a reinforcer more potent so it increases:

· ▪ the effectiveness of positive reinforcement

· ▪ the effectiveness of negative punishment

Makes a reinforcer less potent so it decreases:

· ▪ the effectiveness of positive reinforcement

· ▪ the effectiveness of negative punishment

Makes an aversive stimulus more potent so it increases:

· ▪ the effectiveness of negative reinforcement

· ▪ the effectiveness of positive punishment

Makes an aversive stimulus less potent so it decreases:

· ▪ the effectiveness of negative reinforcement

· ▪ the effectiveness of positive punishment

Factors That Influence the Effectiveness of Punishment

Immediacy A stimulus is more effective as a punisher when presented immediately after the behavior.
Contingency A stimulus is more effective as a punisher when presented contingent on the behavior.
Motivating operations Some antecedent events make a stimulus more effective as a punisher at a particular time (EO). Some events make a stimulus a less effective punisher at a particular time (AO).
Individual differences and magnitude Punishers vary from person to person. In general, a more intense aversive stimulus is a more effective punisher.

Individual Differences and Magnitude of the Punisher

Another factor that influences the effectiveness of punishment is the nature of the punishing consequence. The events that function as punishers vary from person to person ( Fisher et al., 1994 ). Some events may be established as conditioned punishers for some people and not for others because people have different experiences or conditioning histories. Likewise, whether a stimulus functions as a punisher depends on its magnitude or intensity. In general, a more intense aversive stimulus is more likely to function as a punisher. This also varies from person to person. For example, a mosquito bite is a mildly aversive stimulus for most people; thus, the behavior of wearing shorts in the woods may be punished by mosquito bites on the legs, and wearing long pants may be negatively reinforced by the avoidance of mosquito bites. However, some people refuse to go outside at all when the mosquitoes are biting, whereas others go outside and do not seem to be bothered by mosquito bites. This suggests that mosquito bites may be a punishing stimulus for some people but not others. The more intense pain of a bee sting, by contrast, probably is a punisher for most people. People will stop engaging in the behavior that resulted in a bee sting and will engage in other behaviors to avoid a bee sting. Because the bee sting is more intense than a mosquito bite, it is more likely to be an effective punisher.

FOR FURTHER READING Influence Punishment

The behavior modification principle of punishment has been studied by researchers for years. One important recommendation when using punishment is to use a reinforcement procedure in conjunction with punishment. For example,  Thompson, Iwata, Conners, and Roscoe (1999)  showed that punishment for self-injurious behavior was more effective when a differential reinforcement procedure was used with punishment (they reinforced a desirable behavior at the same time they used punishment for self-injurious behavior). Similarly,  Hanley, Piazza, Fisher, and Maglieri (2005)  showed that when punishment was added to a differential reinforcement procedure, the reinforcement procedure was more effective. Interestingly, the children in this study preferred the procedure involving reinforcement and punishment over reinforcement alone. These two studies demonstrate the importance of combining reinforcement and punishment. In an investigation of different intensities of punishment, Vorndran and Lerman (2006) showed that a less intense punishment procedure was not effective until it was paired with a more intense punishment procedure. Finally,  Lerman, Iwata, Shore, and DeLeon (1997)  showed that intermittent punishment is less effective than continuous punishment, although for some participants, intermittent punishment was effective when it followed the use of continuous punishment. Together, these two studies suggest that the punishment contingency and intensity are important factors in the effectiveness of punishment.

Problems with Punishment

A number of problems or issues must be considered with the use of punishment, especially positive punishment involving the use of painful or other aversive stimuli.

· ▪ Punishment may produce elicited aggression or other emotional side effects.

· ▪ The use of punishment may result in escape or avoidance behaviors by the person whose behavior is being punished.

· ▪ The use of punishment may be negatively reinforcing for the person using punishment, and thus may result in the misuse or overuse of punishment.

· ▪ When punishment is used, its use is modeled, and observers or people whose behavior is punished may be more likely to use punishment themselves in the future.

· ▪ Finally, punishment is associated with a number of ethical issues and issues of acceptability. These issues are addressed in detail in  Chapter 18 .

Emotional Reactions to Punishment

Behavioral research with nonhuman subjects has demonstrated that aggressive behavior and other emotional responses may occur when painful stimuli are presented as punishers. For example,  Azrin, Hutchinson, and Hake (1963)  showed that presenting a painful stimulus (shock) results in aggressive behavior in laboratory animals. In this study, when one monkey received a shock, it immediately attacked another monkey that was present when the shock was delivered. When such aggressive behaviors or other emotional responses result in the termination of the painful or aversive stimulus, they are negatively reinforced. Thus, the tendency to engage in aggressive behavior (especially when it is directed at the source of the aversive stimulus) may have survival value.

Escape and Avoidance

Whenever an aversive stimulus is used in a punishment procedure, an opportunity for escape and avoidance behavior is created. Any behavior that functions to avoid or escape from the presentation of an aversive stimulus is strengthened through negative reinforcement. Therefore, although an aversive stimulus may be presented after a target behavior to decrease the target behavior, any behavior the person engages in to terminate or avoid that aversive stimulus is reinforced ( Azrin, Hake, Holz, & Hutchinson, 1965 ). For example, a child might run away or hide from a parent who is about to spank the child. Sometimes people learn to lie to avoid punishment, or learn to avoid the person who delivers the punishing stimulus. When implementing a punishment procedure, you have to be careful that inappropriate escape and avoidance behaviors do not develop.

Negative Reinforcement for the Use of Punishment

Some authors argue that punishment may be too easily misused or overused because its use is negatively reinforcing to the person implementing it ( Sulzer-Azaroff & Mayer, 1991 ).

 Describe how the use of punishment may be negatively reinforcing.

When punishment is used, it results in an immediate decrease in the problem behavior. If the behavior decreased by punishment is aversive to the person using punishment, the use of punishment is negatively reinforced by the termination of the aversive behavior. As a result, the person is more likely to use punishment in the future in similar circumstances. For example, Dr. Hopkins hated it when her students talked in class while she was teaching. Whenever someone talked in class, Dr. Hopkins stopped teaching and stared at the student with her meanest look. When she did this, the student immediately stopped talking in class. As a result, Dr. Hopkins’s behavior of staring at students was reinforced by the termination of the students’ talking in class. Dr. Hopkins used the stare frequently, and she was known all over the university for it.

Punishment and Modeling

People who observe someone making frequent use of punishment may themselves be more likely to use punishment when they are in similar situations. This is especially true with children, for whom observational learning plays a major role in the development of appropriate and inappropriate behaviors ( Figure 6-4 ). For example, children who experience frequent spanking or observe aggressive behavior may be more likely to engage in aggressive behavior themselves ( Bandura, 1969 ;  Bandura, Ross, & Ross, 1963 ).

Ethical Issues

Some debate exists among professionals about whether it is ethical to use punishment, especially painful or aversive stimuli, to change the behavior of others ( Repp & Singh, 1990 ). Some argue that the use of punishment cannot be justified ( Meyer & Evans, 1989 ). Others argue that the use of punishment may be justified if the behavior is harmful or serious enough and, therefore, the potential benefits to the individual are great ( Linscheid, Iwata, Ricketts, Williams, & Griffin, 1990 ). Clearly, ethical issues must be considered before punishment is used as a behavior modification procedure. The ethical guidelines that Board Certified Behavior Analysts must follow state that (a) reinforcement should be used before punishment is considered and (b) if punishment is necessary it should be used in conjunction with reinforcement for alternative behavior (see  chapter 15 ) ( Bailey & Burch, 2011 ). Surveys show that procedures involving punishment are much less acceptable in the profession than are behavior modification procedures that use reinforcement or other principles ( Kazdin, 1980; Miltenberger, Lennox, & Erfanian, 1989 ). Professionals must consider a number of issues before they decide to use behavior modification procedures based on punishment. In addition, punishment procedures are always used in conjunction with functional assessment and functional interventions emphasizing extinction, strategies to prevent problem behaviors, and positive reinforcement procedures to strengthen the desirable behavior. (See  Chapters 13 – 18  for further discussion of these issues.)

CHAPTER SUMMARY

· 1. Punishment is a basic principle of behavior. Its definition has three basic components: The occurrence of a behavior is followed by an immediate consequence, and the behavior is less likely to occur in the future.

· 2. A common misconception about punishment is that it means doing harm to another person or exacting retribution on another person for that person’s misbehavior. Instead, punishment is a label for a behavioral principle devoid of the legal or moral connotations usually associated with the word.

· 3. There are two procedural variations of punishment: positive and negative punishment. In positive punishment, an aversive stimulus is presented after the behavior. In negative punishment, a reinforcing stimulus is removed after the behavior. In both cases, the behavior is less likely to occur in the future.

· 4. The two types of punishing stimuli are unconditioned punishers and conditioned punishers. An unconditioned punisher is naturally punishing. A conditioned punisher is developed by pairing a neutral stimulus with an unconditioned punisher or another conditioned punisher.

· 5. Factors that influence the effectiveness of punishment include immediacy, contingency, motivating operations, individual differences, and magnitude.

· 6. Potential problems associated with the use of punishment include emotional reactions to punishment, the development of escape and avoidance behaviors, negative reinforcement for the use of punishment, modeling of the use of punishment, and ethical issues.