Academic literature on the topic 'Multiple-baseline design'

The purpose of this study was to address gaps in the trauma treatment literature related to the expense and inaccessibility of evidence-based interventions for children with disabilities who have experienced trauma. Another aim of this study was to provide additional support for a newly piloted intervention for children with disabilities who have experienced trauma. This intervention is known as Smart Start: Parenting Tools for Children with Developmental Delay, Social-Emotional Concerns, and Trauma. A non-concurrent multiple baseline method was used to determine whether there was a functional relationship between the intervention and children’s challenging behaviors for five caregiver-child dyads. In addition, three of five caregiver-child dyads were assessed for improvements in child PTSD symptomatology, positive parenting practices, parenting stress, and treatment acceptability. Results from visual analysis, masked visual analysis, and hierarchical linear modeling were mixed, but generally supported a statistically and clinically significant relationship between participation in Smart Start and improved caregiver ratings of children’s challenging behaviors. Wilcoxon Signed-Rank test did not show statistically significant changes in interventionists’ ratings of challenging behavior, but descriptively, four of five children were rated as improved. Reliable change index scores revealed statistically significant changes in trauma symptoms and parenting stress for two participants. Positive parenting practices improved significantly for all participants according to the reliable change index. The intervention was implemented with good fidelity. All caregivers found Smart Start highly acceptable. Future research with larger samples is warranted based on the extremely promising results of the present study.

Irritable Bowel Syndrome (IBS) is a disorder characterized by abdominal pain and altered bowel habits (diarrhea and/or constipation) occurring in the absence of abnormalities on both physical and laboratory investigations. This study examined the effects of respiration biofeedback to decrease abdominal pain, anxiety levels, and medication intake in participants with IBS, using a multiple-baseline design across 10 participants. The STAI-Trait Anxiety Inventory, and the Nijmegen Questionnaire for Hyperventilation were administered at baseline and follow-up to determine decreases in anxiety and hyperventilation. It was hypothesized that respiration biofeedback training would produce significant decreases in pain, anxiety, and medication intake during treatment, as well as decreases in the State-Trait and Nijmegen Questionnaire scores at follow-up. Decreases in pain levels were obtained in 70% of the participants, and 30% of the participants showed decreases in anxiety levels. Four of the 5 participants (80%) who recorded medication intake showed decreases in medication. Findings are interpreted and future research is suggested.

This thesis addresses understanding the underlying change that occurs in mindfulness practice. The first paper reviews the literature regarding the processes of change implicated in mindfulness. The paper reviews the literature regarding definition and conceptualisation of mindfulness and the literature regarding therapeutic interventions and applications of mindfulness. The paper then considers in detail literature regarding the proposed processes operating in mindfulness, looking in particular at: cognitive change, exposure, acceptance, attentional control and non-attachment. The review concludes by drawing together the research and discussing the difficulties faced by this developing literature base. The second paper reports the findings of a study looking at the impact of mindfulness practice on cognitive and affective change for individuals with distressing psychosis. A multiple-baseline design assessing changes to twice weekly ratings of: distress, believability, metacognitive belief, personal control, voices control, acceptance of self, and acceptance of voices during baseline and completion of a mindfulness intervention. Visual analyses indicated no clear discernable changes across participants but individual benefits and patterns of cognitive and affective change indicated for each participant are reported. The mediating effect of practice is also highlighted and consideration is given to limitations, future research, and implications for clinical practice.

Teaching is considered to be one of the most highly demanding professions, and one that is associated with high levels of stress and sometimes deleterious outcomes. Although research demonstrates that burnout and attrition are often associated with specific characteristics of the occupation (e.g., challenging workload, standardized testing, merit-based salary) minimal research focuses on how to better support teachers’ well-being. The field of positive psychology affords a new perspective in how to obtain quality mental health without solely focusing on psychopathology within a deficits-based approach. This includes the implementation of interventions (i.e., positive psychology interventions [PPI]) that target constructs of well-being (e.g., character strengths, hope, optimism, gratitude, etc.) and are associated with positive changes in authentic happiness. This study examined how a strength-based, PPI entitled Utilizing Signature Strengths in a New Way (Seligman, Steen, Park, & Peterson, 2005) impacts dimensions of teacher well-being, as well as other relevant outcomes (i.e., flourishing, burnout) within the school context. Previous research has shown that strengths-based intervention to be the PPI with the most substantial impact and the longest lasting outcomes (Seligman et al., 2005). Utilizing a concurrent multiple baseline single-case design with eight teachers, the study evaluated the effects of the strengths-based PPI on teacher’s overall happiness (i.e., subjective well-being) as indicated by self-report measures of life satisfaction and positive and negative affect. The teachers exhibited significant gains in life satisfaction and reductions in negative affect from pre- to post-intervention that were also evident one month following the intervention. Although positive affect did not significantly change from pre- to post-intervention, a significant gain was apparent at one-month follow-up. Single-case analytic strategies (i.e., visual analysis, masked visual analysis, and hierarchical linear modeling) found that the intervention positively impacted teachers’ overall subjective well-being (composite of standardized life satisfaction, positive affect, and negative affect scores). Results for single indicators of subjective well-being found variability in basic effects among different individuals (i.e., some teachers benefited more than others) further supporting the theory of person-activity fit. Regarding the intervention’s effects on secondary outcomes that were examined only at pre, post, and one-month follow-up time points, findings indicated the teachers experienced a significant increase in work satisfaction immediately following the intervention, as well as a significant increase in feelings of flourishing at follow-up. Significant decreases in negative dimensions of teachers’ mental health including stress and burnout (i.e., emotional exhaustion) were also demonstrated. Findings from the current study provide initial support for the efficacy of a teacher-focused, strengths-based intervention and its ability to improve multiple components of teacher well-being within an elementary school. Implications for school psychologists and policy, contributions to the literature, and future directions are discussed.

A number of randomization statistical procedures have been developed to analyze the results from single-case multiple-baseline intervention investigations. In a previous simulation study, comparisons of the various procedures revealed distinct differences among them in their ability to detect immediate abrupt intervention effects of moderate size, with some procedures (typically those with randomized intervention start points) exhibiting power that was both respectable and superior to other procedures (typically those with single fixed intervention start points). In Investigation 1 of the present follow-up simulation study, we found that when the same randomization-test procedures were applied to either delayed abrupt or immediate gradual intervention effects: (1) the powers of all of the procedures were severely diminished; and (2) in contrast to the previous study's results, the single fixed intervention start-point procedures generally outperformed those with randomized intervention start points. In Investigation 2 we additionally demonstrated that if researchers are able to successfully anticipate the specific alternative effect types, it is possible for them to formulate adjusted versions of the original randomization-test procedures that can recapture substantial proportions of the lost powers.

The dissertation describes the first reported application of a small-N experimental design, the randomized baseline experimental design across subjects and behaviours. It is applied to a small scale clinical psychological experiment on the cognitive modification of delusional ideation in four people with a diagnosis of schizophrenia. The data were analysed by a form of randomization test which does not depend on the classical parametric assumptions. The randomization test based on random data permutation gave statistically significant results for the effect of the independent variable (cognitive modification of delusions) on two dependent variables (strength of conviction, and preoccupation) but not on a third dependent variable, amount of distress. Estimates of effect size are provided based on Cohen's d and on the Common Language Effect Size. It presents data on the statistical power of the procedure derived from Monte Carlo power analysis. It provides reviews of the concept of statistical power in applied psychological research, of the concept of effect size, of the use of cognitive modification of delusional ideation and of randomization tests. The results support the feasibility of small-N clinical experiments using the randomized baseline experimental design, analysing the data graphically and by use of randomization tests and designing experiments with the aid of Monte Carlo power analysis.

The purpose of this study was to examine the effectiveness of PCIT as an alternative to medication in managing symptoms and behavior problems of preschool-aged children with ADHD. Using a multiple baseline single-case design, the study measured the impact of PCIT on four preschool-aged children's problem behaviors and ADHD symptoms, parenting practices, and mothers' attitudes towards therapy. Outcome measures included the Child Behavior Checklist, Eyberg Child Behavior Inventory, Behavior Assessment System for Children, ADHD Symptom Observation form, Dyadic Parent-Child Interaction Coding System, Parenting Practices Interview, and Therapy Attitude Inventory. Results from visual analyses, a visual permutation test, and hierarchical linear modeling showed partial treatment effects for mothers' use of labeled praises (b = 10.67, p < 0.0001), commands (b = -26.84, p = 0.000), behavior management skills (b = 91.21, p < 0.0001), children's behavior problems (b = -20.29, p = 0.000), and parent-reported ADHD symptoms (b = -25.76, p = 0.000). Mothers expressed high satisfaction with PCIT and reported their relationships with their children and their children's compliance and behavior problems had improved post-intervention. The consistency with which other caretaking partners (e.g., fathers) practiced the same discipline procedures as the mothers in the study played a significant role in the changes observed in mothers' use of effective discipline practices and children's behavior problems. Findings of this study indicate PCIT may partially be an effective intervention in improving children's behavior problems and ADHD symptoms.