Behavioral Therapy Development and Psychological Science: Part II

United States

Lisa Simon Onken, Ph.D.

The workshop, "Behavioral Therapy Development and Psychological Science: Part II," was held on September 18 and 19. The purpose of the workshop was to enrich NIDA's behavioral therapy development efforts by strengthening the connection between behavioral therapy development and more basic behavioral science. Six behavioral scientists were asked to present their research. Each presentation was followed by a discussion of how the research might be applicable to behavioral therapy. These discussions were led by behavioral therapy researchers. The following research was presented and discussed:

• Ian Gotlib presented his work on information-processing approaches to the study of depression, and on the implications of this work for understanding vulnerability and relapse. He discussed the body of evidence suggesting that depressed individuals have an information-processing style that tends to favor emotionally negative information, particularly with regard to memory. That is, depressed individuals appear to have a bias to remember negative information. In addition, Dr. Gotlib presented data suggesting that previously dysphoric individuals, compared to never dysphoric people, also share this bias of a facilitated memory of negative stimuli. He suggested that the information processing style of depressed, dysphoric, and previously dysphoric individuals may play a role in their future vulnerability to depression. Neil Jacobson led a discussion of Dr. Gotlib's work.
• Jill Hooley gave the second presentation. Her talk focused on family factors in the course of major mental illness. Specifically, Dr. Hooley focused on the relationship of "expressed emotion" in the family to the long-term functioning of individuals with major mental disorders. The construct of expressed emotion involves high levels of criticism, hostility, and emotional over involvement. Dr. Hooley pointed out that psychiatric patients who return from the hospital to families high in expressed emotion are significantly more likely to relapse than those who return to families low in expressed emotion. Dr. Sam Turner led the discussion on the implications of the research on expressed emotion to behavioral therapy development.
• Peter Lang's talk focused on emotion, the startle response, and pathological anxiety. He discussed research showing that, among anxiety disordered individuals, the greater the level of psychopathology (e.g., PTSD and panic disorder with agoraphobia), the larger the basal startle response. Those individuals with less severe anxiety disorders (e.g., simple phobia or social phobia) showed more cue-specific startle potentiation. Edna Foa discussed how Peter Lang's research has been incorporated into her own research on the development of behavioral therapies for obsessive compulsive disorder and PTSD. She also commented upon how Dr. Lang's more recent finding may impact upon the development of behavioral therapies.
• Elizabeth Loftus presented her research on memory and imagination. She discussed the processes by which individuals may be led to remember events that never occurred, and she also discussed research suggesting that the process of imagination may increase people's tendency to believe events actually happened. Tim Strauman led the discussion on her presentation, and placed some of her findings within the context of the social psychology literature. The group discussed the possibilities of her research for the development of novel behavioral therapies.
• Michael Dougher discussed stimulus classes, categories, and the untrained transformation of functions. He delineated the processes by which stimulus relations are formed. That is, the ways in which they are acquired and in which generalizations to other stimuli are formed. William Follette discussed Dr. Dougher's data, and the clinical relevance of the conclusion that it is easy to acquire connections, but difficult to lose them. The group explored the possibilities for Dr. Dougher's research to impact upon the development or refinement of behavioral interventions.
• Warren Bickel presented research on the behavioral economics of drug dependence. He showed that drug taking behavior is a function of both cost and available alternatives. Alan Marlatt discussed the obvious relevance of Dr. Bickel's work to behavioral therapy development, and indeed, many existing behavioral economic principles have already been incorporated into existing behavioral therapies for drug addicts. Further relevance to behavioral therapy research was explored.
• Ken Howard led the general discussion. The issue of barriers to the collaboration of basic behavioral scientists with behavioral therapy researchers was raised. Support was voiced for NIDA's existing Behavioral Therapies Development Program. NIDA was encouraged to continue the funding of Stage 1 research, with an emphasis on linkage to basic psychological science.

Action Plan:

1. Edit the papers presented at this meeting for publication in the journal Behavior Therapy. The papers from the prior workshop were published in Psychological Science, in an attempt to reach many basic behavioral scientists and to encourage their collaboration with behavioral therapy researchers. Publication in Behavior Therapy will help to reach clinicians and clinical scientists with a similar message- encouraging the collaboration of behavior therapy researchers with basic behavioral scientists when developing new therapies.
2. Encourage new Stage 1 proposals to link therapy development with basic behavioral science. Because of the barriers inherent in integrating basic behavioral research findings into behavioral therapy development research, consider releasing an RFA to stimulate innovative therapy development efforts, as encouraged by the Treatment Initiative Council Subcommittee.
3. Begin planning the third of three meetings linking behavioral therapy development and basic behavioral science. This will help to reinforce the message that the linkage of behavioral therapy development to basic behavioral science is of continuing interest to NIDA.