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Xerox University Microfilms 300 North Zesb Road Ann Arbor, Michigan 46106 MASTERS THESIS M-7129 TOLBERT, Herman, Or. EXAMINATION OF TWO CUMULATIVE REWARD DELAY SCHEDULES IN A CLOSED TOKEN ECONOMY. The American University, M.A., 1975 Psychology, clinical

Xerox University Microfilms, Ann Arbor. Michigan 4sio6 EXAMINATION OF TWO CUMULATIVE REWARD

DELAY SCHEDULES IN A CLOSED TOKEN ECONOMY

by

Herman Tolbert, Jr.

Submitted to the

Faculty of the College of Arts and Sciences

of The American University

in Partial Fulfillment of

the Requirements for the Degree

of

Master of Arts

Psychology

Signatures of Committee

Chairman ;

Dean of the ColleiCollege

Date ;____ '/ ■ 7 V Date; / / / / . ^ W

1974

The American University Washington, D. C,

t h e AMERICAN UNIVERSITY LIBRAEY ACKNOWLEDGEMENTS

I would like to thank my thesis committee members. Dr,

James Gray and Dr. Roger Bufford for their support and guidance during the course of this study. I would also like to thank the chief administrative staff of Walter Reed Array

Hospital for permitting me to do the research at the Hospital and the staff on ward 110 for their aid in data collection.

11 TABLE OF CONTENTS

Page

Abstract ...... i

Acknowledgements ...... ii

Table of C o n t e n t s ...... iii

Introduction ...... 1

Animal S t u d i e s ...... 7

Method

Experiment I

Subjects ...... 14

Assessment Measures .... 15

Reinforcers ...... 15

S e t t i n g ...... 17

Description of the W a r d ...... 18

P r o c e d u r e ...... 21

R e s u l t s ...... 23

Discussion...... 36

Method

Experiment II

Sub je c t s ...... 40

P r o c e d u r e ...... 40

R e s u l t s ...... 41

Discussion...... 49

General Discussion

Schedules of Reinforcement and Treatment C o n d i t i o n s ...... 52

111 The Compsy Patient Behavior Observation ChecklistMeasure ..... 54

Problems Encountered in the Study ...... 55

ConcludingRemarks ...... 57

F o o t n o t e s ...... 60

References ...... 60

Tables

Table 1 ...... 24

Table 2 ...... 26

Table 3 ...... 29

Table 4 ...... 41

Table 5 ...... 43

Table 6 ...... 45

F igures

Figure 1 ...... 30

Figure 2 ...... 33

Figure 3 ...... 46

Appendices

Appendix A ...... 64

Appendix B ...... 68

Appendix C ...... 69

Appendix D ...... 70

Appendix E ...... 82

Appendix F ...... 91

Appendix G ...... 92

Appendix H ...... 93

IV INTRODUCTION

Rewarding a person for desirable behavior is a well established technique practiced in every day life. People have been practicing this technique in various forms for centuries. Recently, however, the planned and systematic use of the reinforcement paradigm has been implemented in a number of rehabilitative and educational settings. One form of reinforcement that has been administered in this planned and systematic manner is token reinforcement.

Since its advent, the token economy has become widely ac­ cepted as a tool for shaping and/or re-establishing adaptive behaviors.

The pioneering work in token economy implementation was carried out by Ayllon and Michael (1959) and Ayllon and Azrin (1965; 1968). Since the publication of their initial research, there has been a proliferation of programs employing variants of the token economy approach. A number of studies implementing such procedures in an effort to ameliorate deviant behaviors have reported successful re­ sults (Hunt and Zimmerman, 1969; Lloyd and Garlington, 1968;

Phillips, 19 69; Lloyd and Abel, 197 0; Boren and Coleman,

1970; Cohen, Filipczak and Bis, 1970). In these studies, as in most token programs, an immediate continuous rein­ forcement schedule was used. Although successful results were reported, the acquisition of adaptive behaviors was only temporary. This is not an uncommon finding in re­ ported token economy research (Kazdin and Bootzin, 1972).

In most cases where immediate continuous reinforcement is operative, the acquisition and maintenance of adaptive behaviors are confined to the treatment setting. Conse­ quently, token economy researchers have begun to search for other means of dispensing token reinforcement that will strengthen the acquisition and maintenance of adaptive be­ havior in and out of the treatment setting.

Use of intermittent reinforcement is one of those

"other means" for dispensing token reinforcement. Under this rubric falls delayed reinforcement. Delay of rein­ forcement is one technique that is promising in sustaining stabilization of acquired adaptive behaviors. Yet, only minimal research has been done in this area. In fact, very few studies involving humans as subjects have employed a delay schedule of reinforcement to improve deviant be­ haviors .

In a recent article, Kazdin and Bootzin (1972) pre­ sented a comprehensive review of token economies utilized in a wide range of settings. Only a small portion of the review, reflective of the research in the area, alluded to delayed reinforcement. However, in their discussion on delay of reinforcement, they mentioned the resemblance of delayed reinforcement to numerous rewards in the natural setting, such as grades and money, that are also delayed.

Since such a practice controls the majority of our popu­ lation to which the rehabilitated person is to return, it seems only fitting that delayed reinforcement in a treatment setting would serve as a bridge to the non­ treatment setting. Despite such an assumption this area is still opened to novel investigation.

One study that used delayed reinforcement in the re­ habilitative setting was carried out by Atthowe and

Krasner (1968). They used delayed reinforcement involving the total ward token economy program, set up to cover all phases of the patient's life. The delayed reinforcement was based on a weekly-pay-day schedule where the total ward was on the delay-schedule. The ward program was set up to place responsibility on the patients. Consequently, the more independent and responsible patient had to learn to punch a time card and receive his "pay" (points) at a specified future date. The patient then had to "budget" his tokens so they would cover his wants for the next seven days.

In addition, a small group of about twelve patients was in a position of receiving what might be considered the ultimate in reinforcement. They were allowed to become independent of the token system. These patients carried a "Carte Blanche" which entitled them to all the privileges within the token economy plus a few added privileges and a greater status. For this special status, the patients had to work twenty-five hours per week in special vocational assignments. In order to become a member of the "elite" group, members had to accumulate 12 0 tokens which entailed a considerable delay in gratification.

The aim of this study was to support more effective behavior and to weaken ineffective behavior by withdrawal of approval and attention and, if necessary, by penalties.

Penalties were comprised of "fines" of specified numbers of tokens levied for especially undesirable behavior or for not paying the tokens required by the system.

The experimental procedures were based on the rationale that the attainment of goals which bring about greater in­ dependence should also result in strong sustaining rein­ forcement in and of itself. The results indicated that a "systematic" procedure of applying contingent reinforcement via a token economy appears effective in modifying specific behaviors. Reference was made to the effect that they, the researchers, utilized a number of different delay periods for various behaviors. However, nothing relating to this was cited in the published information. Another study implementing delayed reinforcement involving token reinforcement was employed in the educa­ tional system (O'Leary and Becker, 1967). This study has significance in verifying to some degree the general­ ization effect of delayed reinforcement. There were seven­ teen nine year old emotionally disturbed children used in the study. Because of their undesirable classroom be­ haviors, such as temper tantrums, crying, fighting, etc., they were placed in an adjustment class. Although the token reinforcement system was in effect for the whole class, the study referred to here focused on the eight most disruptive children.

The token procedure included a baseline period with observers before the reinforcement period was instituted.

The tokens were ratings placed in small booklets on each child's desk. The children were told that they would re­

ceive ratings from 1 to 10 and that the ratings would re­

flect the extent to which they followed the instructions.

The points or ratings could be exchanged for a variety of

backup reinforcers.

The delayed procedure was as follows : The number of

ratings made each day was gradually decreased from five to

three, and the number of points required to obtain a prize

gradually increased. For the first three days tokens were

exchanged at the end of the token program. For the next four days, points were accumulated for two days and ex­ changed at the end of the token period on the second day.

Then for the next 15 days three day delays were used be­ tween tokens and reinforcers. For the remaining 24 days four day delays were employed between tokens and reinforcers.

Results showed that the token system was successful.

Two interesting implications of the study were the effects of the delay of reinforcement and generalization of acquired behaviors. Results showed that the daily mean of deviant behavior dropped drastically from the baseline period to the token period. A follow-up showed the"average percentage of deviant behavior deviant behavior at the end of the year was still very low. Due to such good results, a reversal to baseline condition was not implemented during the experiment. Consequently, it can only be assumed that the reinforcement delay system was the cause for change in the students' behaviors.

Recently in a study within an educational setting,

Schwarz and Hawkins (1970) applied delayed reinforcement techniques. They used a multiple baseline experimental design involving token reinforcement to modify three areas of behavior (face-touching, posture and voice loudness) in a mildly maladjusted sixth grade child. The experiment was divided into three phases, a baseline, control and three sections of an experimental phase. During each phase, video-tape recordings were made of the subject's behavior during mathematics and spelling periods each day. Tapes from the spelling period were used to check for generali­ zation of the modified behaviors. There was a time lapse of about five hours between the taping and after school viewing, at which time poker chips (exchangeable for items of value) were administered as token reinforcement. Oc­ casionally the time lapse was shorter, but never less than one hour.

Results showed that the techniques employed in the study were not only effective, but their effect was rapid, generalized beyond the portion of the day used for training, and appeared to be lasting. This was not a systematic in­ vestigation and it only involved one subject. Nevertheless, it does have some significance in relation to the generali­ zation effect of delayed reinforcement employing token reinforcers .

Animal Studies

There are several animal studies in the literature which employed delayed reinforcement. However, very few, if any, of the animal studies using delayed reinforcement relate directly to the present research. There are virtually no published animal or human studies that may be considered 8 parallel to the present study. However, in the animal literature one study of particular importance is the experi­ ment by Pubols (1962). Pubols investigated constant (fixed) versus variable delay of reinforcement. In two experiments,

Pubols found variable delay more effective than constant or fixed delay.

In the first experiment 18 male albino rats were used with 9 rats each on either a constant or variable delay of reinforcement schedule. The two groups of rats differed only in terms of the value of delay assigned to them. For one group, group 5, the constant delay was fixed at 5 sec on one side with a variable delay of 10 sec or 0 sec on the other side. For the second group, group 15, the constant delay on one side was 15 sec and a variable delay of 30 sec or 0 sec on the other side. In both cases the constant delay was the average of the variable delay. A 1-unit alley Y maze consisting of a start box, runway and choice point, two delay chambers, and two goal boxes were used as equipment for the experiment,

The main part of the experiment lasted for 15 days with all subjects receiving eight trials per day in the apparatus. There were ten preliminary trials implemented prior to the main part of the experiment. The procedure followed the same format of a previous experiment involving variable versus constant amount of reward carried out by Leventhal, Morrell, Morgan and Perkins (1959). Every subject received d-sec delay in the delay chamber for responses to one side of the maze and either 2d-sec or

0 sec delay, equally often, for responses to the other side. After a subject had run to one side four times in one day, the entrance to that arm was blocked, forcing response to the opposite side for the remainder of that day's trials, equating responses and the number of rein­ forcements and habit strength to the two sides.

The delays on the variable side followed a six random sequence of short (s) and Long (L) delays with the sequence repeating every six days. Half the subjects in each of the two groups were run with the variable side preferred and half the variable side non-preferred. Furthermore, for half the subjects a white door hung over the goal box entrance on the variable side and a black door hung over the goal box entrance on the constant delay side. For the other half, this relationship was reversed.

Based on the first prediction that there would be a preference for the variable delay side, the results con­ firmed the prediction. The measure of the response strength

each day was the number of responses to the variable delay

side (designated as the "correct" side) on the first four

trials of that day, all trials being free-choice. Both

groups developed a preference for the variable delay side 10 with neither group showing an appreciable difference in the rates at which this preference was developed. However, the second prediction that this preference should develop sooner the greater the average delay of reinforcement was not verified.

In Experiment II, 36 male albino rats were used. The rats were randomly divided into four groups, nine subjects each. All conditions were the same as in Experiment I with the following exceptions: (1) the experiment lasted for 16 days; (2) because it was obvious from the results of Experiment I that subjects would develop a preference for the variable-delay side, if any, and to make the groups more homogeneous, all subjects were run with the variable- delay side as the nonpreferred side.

Special note should be given to the four groups. In the first group. Group 2, all responses were reinforced on a variable delay of 0 sec or 4 sec and a constant delay of

2 sec. In the second group. Group 20, all responses were

reinforced on a variable 0 sec or 40 sec delay and a constant

delay of 2 0 sec. The third group. Group 2P- was on the same delay chamber schedule as that of Group 2, but food reward was given on 0 sec delay trials only. The other delay

chamber detention times were followed by an additional 10

sec detention in the empty box. The last group. Group 2OP, 11 followed the same delay chamber schedule as that of Group

20. The goal box reward schedule was the same as that of

Group 2P.

With the response strength measure the same as in

Experiment I, the prediction was that all four groups should develop a preference for the variable-delay side at the same rate. The prediction was not confirmed. All subjects eventually developed a preference for the variable- delay side, but they developed a preference at different rates. It appeared that the longer the delay period the longer it took the rats to adapt to the variable delay side,

There are other animal studies that have used various techniques of delay of reinforcement. Because of the nature of these experiments, they are not appropriate for this literature review. Some of these studies have used such techniques as choice and delay, and changes in delay and have found similar results -- an increase in delay re­ sulted in a decrease in freuqency of responding (McHose and Tauber, 1972; Pierce, Hanford and Zimmerman, 1972;

Chung and Herrnstein, 1967; Wilkie, 1971),

From the studies referred to in detail, they all support the concept of delayed reinforcement. The human studies referred to add some support for the generalization effect 12 of delayed reinforcement employing token reinforcers

(O'Leary and Becker, 1967; Schwartz and Hawkins, 1970).

Both of these studies were done in an educational setting.

It should be noted, however, that in a replication study of O'Leary and Becker's (1967) first study there was no effective generalizing of adaptive behaviors from the training period to other periods (O'Leary, Becker, Evans, and Saudargas, 1969). In Atthowe and Krasner's study

(1968), no information was mentioned as to whether the behaviors acquired had any generalizing effect or not. The study only indicated that delayed reinforcement could be instituted in a total ward program.

The animal experiments alluded to are supportive of variable delayed reinforcement (Pubols, 1962; Experiments

I & II). The study only referred to the variable delay reinforcement schedule as being the preferred schedule in both experiments. As mentioned earlier, in most animal studies the typical finding in delay of reinforcement has been that the response rate is a negatively accelerated decreasing function of the delay duration (cf. review by

Renner, 1964; Pierce ot a^. , 1972; McHose and Tauber,

197 2). However, in some studies, none of which are recent,

Watson (1917), Ferster (1953), and Logan (1960) found little or no effect on performance of a delay duration which, in other studies was sufficient to markedly reduce responding. 13

It would, be incorrect to say that literature on delayed reinforcement is lacking, but it is correct to say that literature relating to the present study is lacking. Renner (1964) presented a comprehensive review of delayed reinforcement literature. Practically none of the studies cited, animal or human, are related to the present research. The human studies involved primarily delayed feedback of knowledge of results and were only roughly comparable to the animal studies up to that time.

Animal studies up to that time relating to variable delay, particularly Logan (1960) and Kimble (1961), considered variable delay reinforcement interchangeable with partial reinforcement. Consequently, such studies should be con­

sidered under a reviev: of partial reinforcement.

Liberman (1967) and Kazdin and Bootzin (1972) both presented comprehensive reviews of Behavior Modification programs involving human studies, Liberman's review covered projects in California and Kazdin and Bootzin's article

covered the entire spectrum of token economy programs.

Very little attention was given to delayed reinforcement

in either evaluation. Therefore, the fact still remains that there is a lack of conclusive evidence regarding the

effectiveness of delay schedules of reinforcement on acqui­

sition and maintenance of adaptive behaviors. 14

In the present study two experiments were conducted.

In Experiment I a variable-delay-cumulâtive-reward schedule was compared with immediate continuous reinforcement. An

ABAB design was employed.

Experiment II was instituted because of certain com­ plications with Experiment I on the token economy ward.

Experiment II was designed to be more congruent with the ongoing ward program. A delay-cumulât ive-reward-schedule was used, based on a semi-weekly reinforcement schedule.

The major hypothesis for both studies was that schedules involving delayed reinforcement would facilitate maximum growth and maintenance of adaptive behaviors,

METHOD

Experiment I

Subj ects The subject group consisted of eleven soldiers drawn from a population of delinquent soldiers entering the token economy program at Walter Reed Army Hospital (Ward

110). All subjects were diagnosed as acute schizophrenics.

There were four "groups" consisting of 2 to 4 subjects each.

Each "group" of subjects was on a different schedule of reinforcement. Subjects in each "group" were on either an immediate continuous reinforcement schedule (CRF), or a variable delay cumulative reinforcement schedule (DCR) or both. The designated length of time for each subject was 15 approximately eight weeks. However, the length of time each subject remained in the study was dependent on his being transferred to another ward for which the token program was inoperative or on his eligibility for dis­ charge .

Assessment Measures Two assessment measures were used. The first measure was the Compsy Patient Behavioral

Observation Checklist (CPBO), (See Appendix A). The

CPBO was used to provide information on the subjects' be­ havior on a day-to-day basis. (See Appendix B for earning sheet).

The Compsy Patient Behavioral Observation Checklist

(Morgan, Crawford, Frenkel and Hedlund, 1971) is a 47 item patient behavioral observation checklist developed at Walter Reed Army Hospital. The CPBO was devised using the Patient Behavioral Index (PBI), developed at the

Institute of Living, as a major model (Glueck, 1968;

Rosenberg and Glueck, 1967; 1969; Rosenberg, Glueck and

Bennett, 1967; Rosenberg, Glueck and Stroebel, 1967;

Rosenberg, Glueck, Stroebel, Reznikoff and Ericson, 1969;

Stroebel and Glueck, 1970).

Some of the 112 items from the PBI having optimal relevance to the military psychiatric patients were selected to be used in devising the CPBO. Most of the 47 items 15

listed in the Compsy Patient Behavioral Observation

checklist were selected primarily from a list of 103

items by behavioral ratings having to do with specific

patient activities, privileges and treatment, directly

applicable to the Walter Reed Army Hospital treatment milieu.

All of the items listed in the CPBO have a key word

and an explicit behaviorally-oriented definition, (i_*e^-»

Pacing: walked back and forth, back and forth). Next to each behavioral item the rater has five alternative response categories: unable to rate the behavior; patient

did not display this behavior; behavior minimally observed;

behavior definitely observed and; behavior observed in a

severe degree. The items on the CPBO measure four main

categories in the range of clinically significant patient

behavior. The four categories are 1) acting out; 2) de­ press ion/withdrawal ; 3) degree of disturbance and 4)

adaptation to the ward.

The tabulation of points earned was recorded on master

sheets. The total points earned related directly to each

individual subject's participation in the various acti­ vities, scheduled and unscheduled, provided on the operant ward at the hospital.

Re inforcers The secondary reinforcers were points recorded in a pointbook, a small green "cash book," by 17 stamping the number of points with a price stamper which equalled the number of points earned up to the particular reinforcement period. Point records were maintained for each individual subject.

The secondary reinforcers (points earned) accumulated by the subjects were traded in for primary reinforcers de­ pending on the particular phase they were in. Points were traded in for tangible objects, primarily food, at a small store on the ward. Points were also traded in for watching television, checking out and using the Ping Pong set, cards and games, listening to the radio and records. In addition, subjects were allowed to obtain week-end, holiday, and evening passes. It should be noted though, that the time these passes were allowed were specifically fixed.

The subjects were also allowed to bank points for interest and participate in a stock market session for additional points.

Setting The research took place at the Walter Reed

Army Hospital Annex in Forest Glen, Maryland. The section of the hospital where the study was conducted included

Wards 110 and 115. Ward 110 is presently an operant ward where a token economy has been in operation for some time.

Ward 115 is an added ward used primarily for housing soldiers who advance to Phase III and the Graduate Phase 18 of the program (Phases will be explained below). Ward

110 is an operant ward where delinquent soldiers are sent after encountering psychological problems in the Army. The soldiers are sent to the hospital for rehabilitation pur­ poses in order to return to civilian life or continue their tour of duty in the Army. The program that the research was involved in is Project GROW (Group Rehabilitation

Operant Ward). The ward functions as a regular military unit which is considered a part of the Medical Holding

Company.

Description of the Ward On Wards 110 and 115 the token economy program is divided into four Phases (1,11,111,

Graduate). Phases I, II, and III, are the most important.

These phases are related directly to the rehabilitation of the delinquent soldier. After advancing through these

Phases, he is able to reach the Graduate phase and eventually leave the hospital. A soldier acquires Phase I status by his admission to Project GROW. To advance from Phase I to

Phase II, and Phase II to Phase III, the individual soldier must participate in most aspects of the token program.

Phase I: The Phase I soldier has to wear the conval­ escent blue uniform at all times. The blue uniform is the official uniform color distinction for Phase I. The soldier has little or no privileges. He has to be escorted to all 19 off-unit activities, such as meals, recreational activi­ ties and official appointments. He has to bank 1500 points before he is able to achieve Phase II status.

Phase II: Once the soldier has banked 1500 points, he can apply for Phase II. The Phase II participant has to wear a green uniform to distinguish him from the Phase

I or Phase III soldier. In Phase II, the soldier has more privileges and opportunity to engage in more pleasurable activities (refer to section on secondary reinforcers).

All privileges have to be paid for by points earned in various activities on the ward.

In order to move to Phase III, the Phase II soldier must bank 4000 points. Before a soldier can move to Phase

III, he must also write a formal application letter to the

Project GROW staff and to the other Phase III members in­ dicating why he should be admitted to higher status.

(Soldier also needs a sponsor to move to Phase III),

Phase III: After being accepted into Phase III, the soldier must acquire and maintain a Phase III contract. He must acquire this within seven days of his new status in order to remain in the Phase. The Phase III soldier is allowed to wear civilian clothes with two exceptions; 1) he must wear fatigue uniform for early morning inspection and 2) he must wear complete fatigue uniform during work 20 project activities. The Phase III soldier experiences the highest earning potential and the widest choice of passes and other spending possibilities.

The last Phase is the Graduate Phase. The Graduate

Phase is a waiting period for official processing so that the soldier may leave the hospital. The Graduate is com­ pletely off of the point system except for a fixed salary of 250 points per week, to purchase items from the food store. All other activities are free.

Operating on the ward as described above, is a three component concurrent multiple schedule according to Ferster and Skinner (1957) . The schedule as outlined is a 1)

Multiple-Fixed time, continuous reinforcement variable magnitude, variable inter-trial intervals; 2) Variable time, continuous reinforcement, variable magnitude, variable inter-trial intervals; and 3) Response cost on variable time magnitude of punishment. Operating in the research study, with fixed and variable time activities, was a vari- able-delay-cumulative-reward schedule with variable magnitude, variable inter-trial intervals. The Response cost on variable time, with variable magnitude of punishment was also operative.

The ward activities, both fixed and variable time activities, remained the same as did the Phase sequence.

(The periods of reinforcement as outlined by the research 21 are mentioned below). Reinforcement procedures were carried out by ward technicians and the researcher himself.

Procedure (The Token System) There were four

"groups" that comprised the subject sample, with 2 to 4 subjects in each "group." The subjects upon entering the hospital and Project GROW, were assigned randomly to one of the four "groups." The study consisted primarily of a manipulation period (divided into 4 trial periods of

2 weeks each) in which the four groups were on different schedules of reinforcement. The study ran for approximately three months. However, for any individual subject's par­ ticipation, the maximum was approximately eight weeks.

During the Manipulatory period, the subjects in the various groups received reinforcement according to the delay-cumulative reinforcement schedule for which they were randomly assigned. This period was the basis of the clinically oriented experimental study. Reinforcement was administered on a variable delay schedule based on a 24 hour mean delay. The reinforcement periods fell at 12 and

36 hours respectively, arranged randomly within a weekly limit. During this period, ratings were also taken on the

CPBO.

Group I, the control group, received immediate con­ tinuous reinforcement (no-delay) throughout the entire experiment. Subjects in this group were on the schedule 22

for which the entire ward operated before the introduction of the experimental study.

Group II served as one of the experimental groups on the 24 hour mean delay cumulative reward schedule. Of the eight week period, the first two weeks the subjects were on a no delay (CRF) schedule. After the first two weeks in the manipulatory phase, the subjects were changed over to the 24 hour mean delay schedule for two weeks. The sub­ jects received reinforcement based on a respective 12 and

36 hour random schedule with reinforcement periods falling at 8:30 in the morning and 8:30 in the evening. Reinforce­ ment periods were delayed a maximum of two days with rein­ forcement being administered on the evening of the second day. After this schedule was implemented for two weeks, the subjects were put back on the no-delay (CRF) schedule for 2 weeks and then reversed back to the 24 hour mean delay schedule for the remaining two weeks of the experi­ mental period.

Group III subjects were also on the 24 hour mean delay-cumulâtive-reward-schedule. The subjects in this group followed the same schedule as Group II only in the reversed order. The difference was that when Group II was on CRF, Group III was on the 24 hour mean delay cumulative reward schedule. In other words, Group III was on the exact reversed delay schedule of reinforcement as that of

Group II. 23

Finally, Group IV subjects were on a continuous 24 hour mean variable delay cumulative reward schedule for the entire experimental period. This group was just the opposite of Group I in that they were on a stabilized delay schedule throughout the experiment, receiving rein­ forcement on a continuous delay schedule of 12 and 36 hours respectively arranged randomly. (See Table 1)

Insert Table 1 about here

RESULTS

Experiment I

Group performance in Experiment I shows that the con­ trol group (I), which was on an immediate continuous rein­ forcement schedule throughout the entire experiment, earned

241 points as a mean daily average from trial I through trial IV. The first experimental group (II), which was on a schedule of immediate continuous reinforcement during trials I and III, and variable delayed cumulative reinforce­ ment during trials II and IV, earned a mean daily average of

174 points. The third group (III), the second experimental group which was on a variable delay cumulative reinforcement schedule during trials I and III and immediate continuous reinforcement during trials II and IV, earned a mean daily 24

‘able 1

Schedule of 'Ircups' Cumulative Reward Delay - VI 24 Hr.

Time

Group Subj ects 2 V e e ;< s 2 weeks 2 weeks 2 weeks

I 4 - 0 0 0^ Control

-b II 2 - 24 X 0 24 X

III 2 2- 0 24 X 0

IV 3 2- 24 X 24 X 24 X

N = 11

Note Time of reinfcrcezer.": presentation:

8:30 morning

8:30 evening

^Immediate Continuous reinforcement

^Variable delay cumulative reinforcement based on a 12 and 36 hour

randomly arranged schedule 25 average of 243 points. Subjects in Group IV, the third experimental group, earned a mean daily average of 252 points on a variable delay cumulative reinforcement schedule operating throughout the entire experiment. Means and

Standard deviations for all four groups are presented in

Table II. For information regarding individual subjects

Insert Table 2 about here

point earnings, see Appendix C and Appendix D.

During the first trial. Group I (control) earned a daily average of 254 points. Groups II, III and IV, all experi­ mental groups, earned 99, 168, and 175 points a day re­ spectively in trial I. Statistical analysis (t^=3.44) shows that there was a significant difference between Group

I and Group II initially at the .025 level of significance.

Both groups were on immediate reinforcement in the first trial. It seems that the subjects in Group II had a very hard time adjusting to the initial orientation period.

In the second trial period, all groups showed an increase in the number of daily average points earned except the control group. All the experimental groups showed increases whereas the control group showed a decrease in the number of points earned. The control group earned 243 points per day in the second trial which was an 11 point decrease in 26 Table 2

Summary of Overall Group Performance

Experiment 1

Group # of Subjects X Standard Deviation

Control 4 241 47

Experimental 1 2 174 75.5

Experimental 2 2 243 60

Experimental 3 3 252 21 27 daily average points earned from the first to second trial period. Group II showed a 75 point increase in points earned from the first to second trial with average earnings of 174 points daily in the second trial. Sub­ jects in Group III showed the greatest increase in daily average points earned from trial I to trial II with earn­ ings of 249 points daily, which represented a 101 point increase in daily average point earnings. Group IV sub­ jects showed an increase of 58 points in daily average points earned from the first to second trial period with a collective daily average of 233 points.

Performance by Group I subjects during the third trial period improved. The control group earned the same daily average during the third trial (254) period as was earned in the first trial, showing an 11 point gain in the number of average points earned daily. Group II showed an in­ creased daily average of 94 points during trial III with average earnings of 268 points daily. This group showed the greatest gain in daily average point earnings from the second to third trial. Group III earned 325 points aS a daily average in the third trial which represented a 56 point gain in daily average point earnings. Group IV showed a 90 point increase in daily average point earnings from the second to third trial period with earnings of 323 points a day in trial III. Both Groups III and IV were on 28 a variable delay cumulative reinforcement schedule during this trial period and Groups I and II were on immediate continuous reinforcement.

Results show that from trial I to trial III, all ex­ perimental groups continued to improve on their performance levels whereas the performance level for the control group remained relatively constant. Analysis of variance for changes in performance over trials yielded a value of

F = 7.61 with 2 and 5 degrees of freedom, significant at the .05 level. Therefore, it may be concluded that there were significant differences among the trial means.

Only a few subjects entered the fourth trial. There

is not sufficient data to warrant statistical analysis.

However, of the six subjects entering the fourth trial period, subjects in Groups I and III showed decreases in daily average point earnings and subjects in Groups II and

IV showed continued increases in daily averages. Results of each group's performance are presented in Table III and

Insert Table 3 about here

Figure I.

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I i I I 9 I Control ow < a OS u I Experimental 1 s i g S«X)| i I g i Experimental 2 i i I i o Experimental 3

TR ALS FIGURE 1. Daily Average Point Earnings for Each Group During Trial Periods. 31

In Experiment I, subjects (N=6) in treatment condition

A (immediate reinforcement), and treatment condition B

(Variable delayed reinforcement; N=5), showed virtually no difference in performance during trial I. Subjects in treatment A earned a daily average of 176 points and subjects in treatment B earned a daily average of 5 points less than those in treatment A (171 points).

Subjects in both treatment conditions showed increases in daily averages during trial II. Subjects in treatment

A had an average of 256 points and subjects in treatment B had an average of 203 points. This represented a 53-point difference between average point earnings in both condi­ tions which proved to be in significant at the .05 level

(tg=1.26). However, there was an increase of 80 points in daily average point earnings for subjects in treatment A and only a 32 point increase for those in treatment B.

The performance level of the subjects in treatment B increased considerably from the second to third trial.

Treatment B subjects showed an increase of 121 points in daily average earnings and subjects in treatment A showed on 5 point gain during the same period. Treatment A subjects earned an average of 261 points daily and treatment B sub­ jects earned an average of 324 points daily. This resulted in a 63 point difference between the subjects point earnings 32 in trial III. Again the difference proved insignificant

(t.^ = l.l*+; p 7 .15) .

Too few subjects entered the fourth trial period for statistical analysis. However, subjects in treatment B showed a continued gain in daily averages and those in treatment A showed a decrease in their daily average earn­ ings. Figure II is a presentation of the trial performance

Insert Figure 2 about here

levels achieved by the subjects in the two treatment con­ ditions .

In addition to the tabulation of the number of points earned, a behavioral scale was used to check for four major clinical categories of behavior. These four major cate­ gories, Acting Out, Depression withdrawal. Degree of Dis­ turbance and Adaptation to Ward, were each correlated with the number of points earned for each subject on which the

CPBO was taken. The CFBOs were taken on a total of eight subjects in Experiment I. The number of days the CPBOs were taken varied for each subject ranging from 9 to 12 days. For individual presentation of the subjects CPBO daily averages (based on the average of the four factors measured by CPBO) see Appendix E. 400 1 Z OS 2 m g 300 ■ 2 U

Immediate 200 Reinforce* ment

mi

Variable De i layed Rein* 0 forcement U 100

H Z U 1 t e H 1 2 TRIALS FIGURE 2. Daily Average Point Earnings for Each Treatment Condition During Trial Periods. 34

The Product Moment correlation coefficient or

Pearson's (r) was used to correlate the four factors in­

dividually with the number of points earned. Results show

that for subjects in Experiment I, the correlations between

acting out and the number of points earned were insignifi­

cant. This indicates that acting out behavior had little

or no effect on the number of points earned. The correla­

tions ranged from -0.540 to -0.068.

Depression withdrawal also had little effect on the

number of points earned. Overall, the correlations ranged

from -0.643 to +0.005. However, one subject from Group

III did show a significant negative correlation (-0.643)

between the two variables.

The Degree of Disturbance correlated with the number

of points earned yielded correlations ranging from -0.752

to +0.38. Two subjects, one from the control group (-0.752) and the other from Group III (-0.716), correlations re­

sulted in a significant negative relationship between de­

gree of disturbance and the number of points earned.

The major correlation for which the study was most

concerned was the adaptation to ward factor correlated with the number of points earned. Only one subject showed

a significant negative relationship between adaptation to ward and points earned (^ from Group II). The correlations

for this factor ranged from -0.692 to -0.014. 35

DISCUSSION

Results show that the mean daily averages were approxi­ mately the same for all groups except Group II. Although the differences between the mean daily averages proved insignificant for all comparisons, the implication is that a schedule of reinforcement that moves back and forth from immediate continuous reinforcement to variable delayed cumulative reinforcement is not the most effective schedule of reinforcement. However, there is some indication that a schedule of continuous variable delayed cumulative rein­ forcement is a more productive schedule in terms of facili­ tating maximum point earning potential.

Group performance on a trial-by-trial basis showed that the trial means for Group I and Group II differed signifi­ cantly in the initial trial period. This was not true for comparisons with other groups' trial means for the first trial. This finding suggests that Group II subjects were possibly from a different population than subjects in Group I unless there were other factors which impeded their progress in trial I, which were not evident in the analysis, or the difference could be due to non-random selection.

The rate of performance exhibited by the control group in trial I remained relatively constant throughtout the study. The experimental groups that were on different 36 schedules showed continued increases in point earnings from trial to trial. Statistical analysis showed that the continued increases in performance over trials were significant for the experimental groups. This finding suggests a positive interaction between treatment and performance. It also indicates a trend in that the experi­ mental groups were making significant gains in the number of points earned from trial to trial.

The greatest increases in trial performance were for the two groups that were on varying schedules of both immediate continuous reinforcement and variable delayed cumulative reinforcement. These increases only reflected performance on a trial by trial basis and not overall per­ formance. The two instances where the greatest increases in performance levels occurred were during the first three trials. In both instances the groups changed from variable delayed cumulative reinforcement to immediate continuous reinforcement. These groups showed continued gains from trial to trial, but the point increase from trial to trial fluctuated. It should be noted, however, that the group of subjects on the continuous delayed cumu­ lative reinforcement schedule showed continued gains from trial to trial in which the point increase continued to increase higher rather than fluctuate. 37

Analysis of the two treatment conditions administered during each trial (2 groups on the same schedule) resulted in no significant difference in treatment effect. Although there were considerable differences in points earned in the second and third trials, the differences were not large enough to achieve significance. However, subjects in treatment B (variable delay) showed a considerable increase in points earned from the second to third trial period.

Again the results suggest that a variable delay cumulative reinforcement schedule is a more productive schedule in facilitating continued acquisition of adaptive behaviors.

From an overall standpoint, correlations performed on the CPBO yielded mostly insignificant results. Most of the correlations indicated that the various clinically related behaviors had little or no effect on the number of points earned. It was expected that high CPBO scores on the first three clinical categorized behaviors, acting, out, depression withdrawal and degree of disturbance, would result in low point earnings for each subject. Such a trend was not evident.

The clinical category that was of major concern was the individual subject's adaptation to the ward routine.

In this instance, subjects with high scores on the CPBO

(1-10; extremely poor to excellent) were expected to gen­ erate high point earnings. To the contrary, the subjects 38

point earnings seem to have been affected very little by their adaptation or non-adaptation to the ward routine.

Because of the low number of CPBOs taken, it is impossible to comment on the effect of the various schedules used in relation to the results on the CPBO. 39

METHOD

Experiment II

Subj ects Subjects were drawn from the same popula­ tion of delinquent soldiers as in Experiment I. Twenty- four soldiers diagnosed as acute schizophrenics served as subjects. There were two groups, 12 subjects each. The various phases the subjects moved through were those es­ tablished by the Ward 110 program. (Phases I, II, III, and Graduate). The individual subject moved through these

Phases at his own pace. No specific time was designated for the experimental period. Again the length of time a subject remained in the program was dependent on the same factors as in Experiment I.

The Assessment measures. Setting, and Reinforcers were the same as in Experiment I.

Procedure (The token system) The subjects, upon entering the hospital and Project GROW (Ward 110), were assigned randomly to one of two groups. The subjects ad­ vanced through the program on an individual basis, depen­ dent on their adaptation to the ward program and their ability to earn and maintain the required number of points to move to and remain in the various phases.

One group was on an immediate continuous reinforcement schedule and the other was an immediate continuous rein­ forcement schedule and a delay cumulative reward schedule. 40

Group I served as the control group in which subjects were on an immediate continuous reinforcement schedule from

Phase I to Phase III. The subjects received points earned immediately after each activity they participated in.

Group II, the experimental group, was on an immediate continuous reinforcement schedule initially (Phase I), but was put on a delay cumulative reward schedule in Phase II and Phase III. In Phase II and Phase III, Group II sub­ jects were reinforced twice weekly. They received their points earned only during banking hours on Monday and

Thursday of each week at 11:30 in the morning. The banking hours were periods when the subjects could put portions or all of their earnings in savings in an effort to save enough points for Phase status advancement. All reinforce­ ment was administered by ward technicians.

RESULTS

In Experiment II, the control group (I) earned a daily average of 206 points. Group performance by subjects in

Group II, the experimental group, resulted in a daily average of 229 points^. Means and standard deviations for

Groups I and II are presented in Table 4. Group I was on

Insert Table 4 about here 41

Table 4

Summary of Overall Group Performance: Experiment 2

Group # of Subjects X Standard Deviation

Control 12 206 56

Experimental 12 229 38 . 5 42 an immediate continuous reinforcement schedule throughout phases I - III and Group II was on an immediate continuous reinforcement schedule in Phase 1/ but was reinforced twice weekly in Phases II and III. Statistical analysis indicated insignificant differences between the control and experi­ mental groups (t22=l*32; £=.10).

Table 5 presents the results of each group’s initial

Insert Table 5 about here

performance in Phases I and II. The results of the control and experimental groups' initial performance showed a

significant difference in the number of days spent in the phase but not in the number of points earned. The control group spent an average of 13 days in Phase I as compared

to 8 days for the experimental control group ,

£ > .05). The daily average for the control group was 2 07 points and the daily average for the experimental group was

236 points (tgg^l-25; £ > .20).

In Phase II there were no differences in the number of days spent in the phase initially or the point earnings.

The control group spent an average of 27 days in Phase I and the experimental spent an average of 21 days i^22~

1.20; £ > .15). The daily average resulted in 213 points

for the control as compared to 240 points for the experi­ mental (t2j^=0.84; £ < .20). 43

Table 5

Summary of Initial Group Performance During

Phases I and II: Experiment 2

Group Phase # of # of days Daily Point Average

Control 1 12 155 207

Experimental 1 12 95 236

Control 2 11 300 213

Experimental 2 12 259 240 44

In comparing both groups’ (control and experimental) total performance in Phase I, there was also a considerable difference in performance between the two groups. The total performance includes the groups * initial performance and their achievements made when moving back and forth 2 from one phase to the other . Table 6 and Figure 3 present

Insert Table 6 about here

Insert Figure 3 about here

the results of each group's total performance level during each phase. In Phase I, the experimental group spent an

"overall" average of 10 days as compared to 19 days for the control group. The difference proved significant

(tg2 = l.8 ; £ >.05).

The "overall" daily average point earnings for the experimental group were much higher than the "overall" daily average for the control group. The control subjects earned a daily average of 182 points and the experimental subjects earned 229 points daily in Phase I. This showed a 47 point difference between the two groups which proved to be significant ( ^ = 2 . 0 3; £>.05). 45

Table 6

Summary of Group Performance During Phases: Experiment 2

Group Phase # of Ss # of days Daily Point Average

Control 1 12 234 182

Experimental 1 12 123 229

Control 2 11 319 227

Experimental 2 12 321 225

Control 3 1 9 477

Experimental 3 3 84 280 4 0 0

Z 3 0 0

O 200

Control

% Experimental

FIGURE 3. Daily Average Point Earnings for Control and Experimental Groups During Phases. 47

Based on the overall performance of the two groups, subjects in the experimental group were doing far better than subjects in the control group.

In Phase II there was virtually no difference in the overall performance of the two groups, The control group spent an average of 29 days in Phase II and the experimental group spent an average of 27 days. The daily averages in point earnings resulted in 227 points a day for the control group and 225 points for the experimental group. (For individual data see Appendix F and Appendix G).

In Experiment II only five subjects were administered the CPBO. Four of these subjects were in the control group and only one subject was in the experimental group. The

CPBOs were taken as in Experiment I. The number of days the CPBOs were taken ranged from 8 to 17 days excluding weekends. For individual presentation of the subjects

CPBO daily averages (based on average of four factors measured by CPBO) see Appendix H.

Too few subjects managed to reach Phase III before being either discharged or transferred off of the token economy ward. Only three subjects from the experimental group and one subject from the control group reached Phase

III status. The difference between the number of subjects in the two groups reaching Phase III status proved insig­ nificant (X^ = 2.2; df»1 ; £^.10)., The data do not permit further statistical analysis. 48

Correlational analysis using Pearson’s (r) show that all the correlations for the four clinical categories correlated with the number of points earned were insignif­ icant. However, there was a highly significant difference between the number of negative and positive correlations

(^^ = 6.6; df = 1; £=.01). The number of points earned cor­ related with the four clinical categories individually, resulted in the following: 1) Acting out--correlations ranged from -0.516 to +0.323; 2) Depression withdrawal-- correlat ions ranged from -0 . 582 to +0.146; 3) Degree of disturbance--correlations ranged from -0.453 to +0.281; and 4) Adaptation to ward--correlations ranged from

-0.524 to -0.255. It seems apparent that the behavior of the subjects had little effect on their point earnings.

DISCUSSION

The results of Experiment II are of special importance in that it was designed to accomodate the existing ward structure due to uncontrollable complications during Ex­ periment I. The results suggest that there is very little difference between immediate continuous reinforcement and delayed cumulative reinforcement. However, the results showed that the experimental group (delayed reinforcement) achieved a higher point daily average than the control group. 49

Although the experimental group achieved a higher daily average in point earnings the difference between the two groups (control and experimental) point earnings was insignificant.

A phase-by-phase analysis resulted in significant dif­ ferences between the experimental and control groups both in their initial performance level and their overall per­ formance levels in Phase I, A significant difference was found in the number of days spent in the phase initially, but not in the point earnings. However, an analysis of the overall performance level between the two groups showed that the experimental group spent significantly fewer days in the phase and attained a much higher daily average in point earnings. Ordinarily, no significant findings were expected in the first phase initially or in the overall performance, since both groups were on immediate continuous reinforcement. Such findings indicate that the subjects in the two groups were not from the same populations or subjects were involved or the differences could be due to non-random selection. Consequently, the groups are not comparable but possible differences in treatment conditions are measurable.

Evidence of changes related to treatment conditions was noticeable in Phase II. The change in treatment from

immediate reinforcement to delayed reinforcement seemed to 50

have had adverse effects. The results suggest that such a change appeared to be deleterious to the performance level of the subjects undergoing the change. The change in performance, especially in relation to the number of days spent in the phase, may not have been the result of the schedule(s) of reinforcement. There is strong evidence which suggests that the number of days spent in the phase was due more to the subject's complacency in the phase than the schedule itself. Phase II was a much better phase than Phase I. Most subjects tried very hard to get out of Phase I in order to reap the benefits and take ad­ vantage of the opportunities available in Phase II. While the subjects were continuously earning more points, the opportunity to spend those points was much greater in

Phase II than in Phase I. This made it quite difficult for the subjects to bank the required number of points to enter Phase III.

Since there was very little difference between Phases

II and III, most subjects were very content to reamin in

Phase II. This was quite evident due to the fact that only four subjects out of 24 managed to make it to Phase III.

In addition, it was not a requirement to reach Phase III status and eventually Graduate status to leave the hospital,

This added factor suggests that there was very little in­ centive or enticement (benefits and advantages) to advance beyond Phase II. As the results show, most subjects re­ mained in Phse II until they were either discharged or 51 transferred off of the token economy ward.

Another very important factor was that the subjects had to maintain a designated number of points to move to and remain in Phase II (1500) and Phase III (4000). After some of the subjects had reached Phase II status they over­ spent their earnings which meant they were unable to main­ tain the 1500 points in the bank to stay in Phase II. As a result they had to move back to Phase I until they had earned enough points to be promoted back to Phase II. More subjects in the control group had to move back into Phase

I than subjects in the experimental group. This accounted for the significant differences between the groups overall performance in Phase I. Consequently the experimental group spent fewer days on the ward than the control group.

The few CPBOs that were taken in Experiment II are not a clear representation of the subject population. No generalizations can be made except that the results are similar to the results in Experiment I. None of the clinical measured behaviors affected point earnings significantly in the expected directions.

GENERAL DISCUSSION

Schedules of Reinforcement and Treatment Conditions

It was expected that the delay schedules would facilitate maximum growth and maintenance of acquired adaptive behaviors.

Of the several schedules of reinforcement used in the study. 52 the results do not indicate that any one schedule was sig­ nificantly different from the other. Performance levels by the subjects under the various schedules of reinforcement were approximately the same. Although no significant dif­ ferences were found between the two treatment conditions used in the various schedules, evidence from Experiment I suggests that schedules of reinforcement in which delayed cumulative reinforcement is employed generate continued progress in performance over time.

Liberman (1967) reported, based on assessment of studies employing schedules, that immediate reinforcement seems to facilitate introduction to the rules of an economy (the contingencies), but does not seem to be more effective than delayed reinforcement after the initial orientation period.

This assumption was based on informal observations by staffs involved in these programs at different hospitals.

From systematic measured observations in the present study,

Liberman's assumption held true in both experiments. There were no dramatic differences in the overall performance levels of subjects in any group in both Experiments I and

II.

In Experiment I there were no significant differences between subjects on immediate reinforcement and those on delayed reinforcement during the initial orientation period.

One of the groups on immediate reinforcement achieved the 53

lowest point earnings of all the groups involved. Ironically

the subjects on a schedule of continuous delayed cumulative

reinforcement did quite well during the initial trial period

and attained a higher mean point earning record than those

on a schedule of immediate continuous reinforcement or a

mixture of the two. There was no clear evidence which would

indicate that using delayed reinforcement initially is very much different from using immediate reinforcement. This

suggests that beginning subjects on delayed reinforcement

is not as threatening as it may seem.

The Compsy Patient Behavioral Observation Checklist Measure

Not very much information was gathered from the CPBO

measure. One of the main problems with the administration

of the CPBO was getting enough daily measures on the indi­

vidual subjects. Of the 35 subjects in both experiments,

only 13 subjects' CPBO measurements were taken sufficiently

to warrant statistical analysis. A cut off score of seven

days was used as a criterion for correlational analysis.

This time limit provided an equivalent measure of at least

one week of behavior measured by the CPBO.

The CPBO data is suspect for several reasons. First

of all, there was a lack of consistency in administering

the CPBO by the staff on the token economy ward. Secondly,

inter-rater reliability is less than ideal. During the 54 initial development of the checklist, the reported inter- rater reliability ranged from .48 to .92. Thirdly, on some of the CPBOs the number of items marked 'unable to rate' were quite high. This factor leads one to ask whether the scores on the CPBO measurement represented the subjects behavior broadly enough. Due to the extremely low correlations between the number of points earned and scores on the four clinical behavioral categories, the results are questionable. It is impossible to make any generalizations about the subject population based on what was ascertained from the CPBO,

Problems Encountered During the Study

Several problems were encountered during the experiment.

When the study was first designed a ten week period was required for each subject to complete the study. However, this was reduced to eight weeks. It was assumed (based on administrative staff reports) that it would take a soldier at least 12 weeks to get through the token economy program.

Therefore, Experiment I was designed for this time period.

After the study was undertaken, due to administrative changes, soldiers began to leave the hospital much earlier than 12 weeks. Of the 11 subjects included in Experiment I, only three subjects finished the eight week manipulatory period.

All three subjects were from different groups.

Other problems were centered around the schedules of reinforcement. The variable delayed reinforcement schedule 55 was not an easy one to follow, especially with both morning and evening reinforcement periods. Although the informa­ tion needed for efficient implementation of reinforcement was given, the staff still encountered problems with the reinforcement schedules. The problems involved reinforcing the subjects at the proper time and making sure the subjects were changed over to their proper schedule as outlined in the experiment. Since the two week trial periods (phases) did not coincide with the ongoing ward phase changes, sometimes the change over periods became a source of con­ fusion .

These problems were due to, perhaps, two major factors.

One of the factors involved a different staff for morning and evening. Some staff members were on the day shift and others were on the evening shift with various changes in shifts at periodical intervals. Only one staff member during each shift assumed the responsibility of reinforcing the soldiers, especially those in the study. If this particular staff member was assigned to another shift or was absent

(or even busy at the time of the reinforcement delivery) reinforcement was delayed beyond the period specified.

The second factor involved the overall planning of the experiment. The experimenter was not allowed to explain the details of the reinforcement schedules to the staff that worked on the ward. Host of the staff members were somewhat interested; however, they did not receive adequate briefing 56 on the experimental study by the chief staff member in charge of the ward. These factors impeded greatly the efficient operation of Experiment I. It became quite clear that although the experimental design was technical­ ly sound, it was not applicable in this setting.

Experiment II was devised because of the problems with the first experiment. Experiment II was designed to ac­ commodate the ongoing ward program. It was felt that if the research design approximated the ward program in time and schedule changes (in congruence with the phase changes), more reliable data could be gathered. This was accomplished.

The major problem encountered in Experiment II was that most of the subjects (the entire soldier population on the ward) were put through the program on a shorter time period than what was originally called for. As a result, very few subjects completed the program or the study.

Concluding Remarks

It is assumed that delayed reinforcement will facilitate generalization of acquired adaptive behaviors. This is based on the assumption that when extrinsic reinforcement is delayed, behaviors will come under the control of naturally occurring reinforcers, such as praise and attention. Kazdin and Bootzin (1972) reported that evidence supporting these assumptions is not available. No support for these assump­ tions was found in this study. 57

While the results show that the study was not carried out under the most favorable conditions, the evidence sug­ gests that delayed reinforcement is just as effective as immediate reinforcement in facilitating productive perfor­ mance levels. In order to determine which treatment method is more effective, further research has to be done in this area. However, it is suggested that the research be carried out under much better conditions. If a study of this nature is ever undertaken in a similar setting, it would be imperative that the experimenter have a great deal of influence, control, time and familiarity with the setting and staff. 58

Footnotes

^The daily averages referred to are actually the means of the two groups.

2 Subjects had to maintain 1500 points to remain in Phase II and 4000 points to remain in Phase III. If for some reason subjects did not maintain the number of points needed to remain in a phase, they had to move back into the previous phase. In most cases the subjects moved back and forth between Phases I and II. As a result the initial performance level refers to their stay in Phase I from their admission to Ward 110 to their ad­ vancement to Phase II. The overall performance level refers to their movement back and forth between the two phases, total days spent in each and total number of points earned while in each phase. REFERENCES

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Appendix A; THE COMPSY PATIENT BEHAVIORAL OBSERVATION

CHECKLIST.*

* Next Page NAME DATE

SEX: ' F SHIFT DAY: EVENING:

::fcr ■:6 : W . 4 ' S' t; ;-L: ft : # : •t ;4:: ■ 3'; - t . : ::D : PREFIX A : ' ■ a . ::T. ::k: : : : S H . A . 3 :.l : *:S;: .5 .4:: ;.l. L it • -;J:. :LO.i D ::» : : 0:: : ::ft : ■ 4 : 5 . 2 ■:J- ■ Û . ». 0 . .'ft: P :.S: ■ :;t:. i:0 :; A :;S : ;:ft: : : :*3 ■ 17 :4 3 • . t ::l ■ 0 :iR ‘ : : T.. ::ft T -4c’ .;5 ;. ::2 ' :: ir : A ::S:i ;:B-- ::a : T , 4'. 3/ 7 % 1% : k. : 8. : T: ;C:* ■ ft E :4:- ■ ;3: : : ; t r :: 1" t N :;9- : : e -.ft H : 4 ? :z 1 o . : ■« ' ■ 7: . 0 ft: T :4 : : ■ 'ft. - -;ï ; ;; L ::0.. N :;k: : :-a-: : & ' ; 4 . 3 : : Z ;;J-: •Û • : » : ■ *» ■ ::T= : a : : ft: N r4;i :’JT' ::I l:::J; l U M U ::9l: :: ; : .ft. :;A 5 . •,r. : 1 ;D : : ». : . D : : 7.. ■e.: Lift ;4:: ft :t: . :i:; ::0-; B M E D :i9: :■ :. ft ■. ::S ‘ . 4 . S ?.: ,:i- Cl .9 ' .7. ft •4 : : ft ■ : t : J:: . 0 .' R a E R :: 9: :: : : ft ’ ■. ft : 4 , 3. * ; 2 ■ J ft • 9.: 1 T : ;:6.. - ft .4;- ,3r. : t : :.0 i.

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: ; 9 . r:fl :: : ::fl- : ft ■ .4 S .'2 : 1 ft . 9 ■. B .7 . : Û . : ft D 4 ' .. i . . .t. l:j:; .Tft-.' A

: : u ; : O ' : 2 ;.ft_ 31 Sl o w took i.of •Sfi* THAN MOST » -B : : ’ t: • : ft Y. :4, ' ..S;- l: It: ::0: PATIENTS TO DO THINGS CxPECttO : : A : r: r :.ft. M 4:: . .3 . ::2 : .'•it: : ’0 ' 0 :t u : -.ro: :.r.: t 32 AhNOyCt) ANNCTFD OK PESfEKfD . » *. P • : 6:; ‘ -ft - '4 :; . ft ■ ■:t :: 1;: "D : STAFF ~ ’ ft :. 7.1 'ft : -ft Y trt.. :5 . : it: : t:i;: :iD.: H 33 5U£CIPAV.„miili'I'i- - 9 : : fl ::7 ! • * 6 • . '.'ft . *4:: •'5 l: ::Jr: -Or; ÈxPRtSSLD ‘.u Tc’iI' al thoughts ::tL: . O . T * : ■£ : ; : i : AG 00ISJC£UUS, WAS LOUO (NTtftftUf'T CO OTHClis C0\s-LHSATIÛNS MUCH NOISY 34 nr.SCflT FUl ACTED AS IF OR STATED HOHSCPLAV AND JOKING HÉ DOCS NOT H K t ftOUtlflT. 47 MOODY : set MFO TEUPERAMLHl AL . HAD FREOUÎNT CHAhGCS IN r-u. ::q : 35 OHOWSY- SCEMEÜ SLCtPY Tr«rO OR Di snosn ION. WORN OUT. HATE THE FOLLOWING ITEMS AS '

0 - DOES NOT a p p l y 56 KCPTTJllOy^ KLI'LATCD SAME 1 - DOCS APPLY THOUGH f 5, W-.flOt OH PHRASrS OVER ANÜ CVHI 4 a t o : -.1 PIITSILAL COMPLAINTS {SPECIFY IN NARRATIVL) .:a: :■ ft :2 : 37 Pf.RAKURnC7*4..SnCALl Y 4 9 . . O ' ::t : CCT STAGED PEOPLE Y/fHC UNFAIR, MEAN OH OUT TO DO HIM HARM. 50. :.0 : : I ' PSYCHODRAMA

::o-: : 1:. 30 ÇJsSdl.^,iJ*St'L WAS c le a n , HEAT 51. ::0 : "1 : GROUP THCRAPY ANtTAPPftO^PfllATELV DRESSED 52. r-O.L :-i : NON*ROUT)NE LAB WORK DONE (SPECIFY IN NARMATIVE ) 39 lODKCO AND STATED HE WAS 53 ; to : : J ; CONSULT DOME [SPECIFY IN NARRATIVE) UNHAPPY, UEJLCTED OR DOWN- 54. :rO : :;J INDIVIDUAL THERAPY WITH PHYSICIAN

::0 : :: ]: <0 ARGLLMCirTATivC HAD A CHIP ON ?HOUU)EH**TtHOCD TO 01 NEGATIVE UR TO S1AA1 A?#GUM£».TS PATIENT STATUS

Ü ■ : : 0 : ;.3 • :■ £ - t;:3 41 SETKED a t t e n t io n 55 . 0;: :: i.: CLOSED W0NOPDLl7fD T IVC OF OTHERS flY SEEKING REASSURANCE OR PHAISE. 56. .0 : :*Jt MESS MALL PASS

V ' ;: o : ; : iT : z : : :3 : 42 ^RiPtp^ COMPLAINED MOf(E THAN 57 O : : r : WORK PASS «Û S I PATlCST'; ABOUT BEING IN THE HO&rMIAL 56. l O . L.t:: EVENING PASS

U: ; : 0 : -LLf • :: 5 : 43 gjjiEjr_ SPOKE VERY l it t l e And 59 ::3.: WEEK END PASS IN SOFT VOICE O’U NUT INTRUDE DM OTHERS 60 . o : OPEN WARD

U: z:^■ " 2 .: : : 5-. 44. INSOMNIA CQMPLAjNEO OF NOT 61. ■ 0 . :.J:; SUICIDE WATCH ÜCINC AULE 10 SLEEP AT NIGHT 6 2 . ; 0 . :;J:: ESCAPE PHCCAUT

V- ::a. . f : I ’.t : . ; 3 : 45. OVERACTIVE' WAS HYPERACTIVE 63 .O ::i:: FULL PASSES

NARRATIVE

SIGNATURE:. lUMWUW 66

Appendix A Continued*

*Next Page NA MF RATCH. DATC__

UNABLE TO RATE PATiLNT THIS SHIFT SMirr PAY EVENING (SPECIFY REASON IN N A M fïAlivLï

: 9 : : : Ji;* : T‘ : ■ B: ft . 3 t . ; Û ■ 0 ft 7x ft; a 4’ rft ! Z : :X;: :D^: sv PRfFIX A :s:r : 7.: -xa.: . a : . 4 a : .1. : 0 . . a , ft XT. .ax : A:’ : ft . :£> H z ; :.t:: 0 :-7 x x fl:; ; a : X4-. a : t. .Or 1 . B : - 7x ■ . ; . P x4 : ft: t :0 . A 7 ’ :x:: ft R 3 I 0 a 1» : 7 : :ft :S;: T .4 : ; ft : 7. :D: l ; 3 : r f t " . f : :: .r9:z r t • ..0. r ax ft Y. ‘ftr: :ax L' ;4x : ft ’ ■z :0: c U : 3 X :ra: ' 7 : : 6 ' . 1 1 ■ 0 • a ■ ft 7 : ’ft ■ft r T :4 : : ft ; 2 :0 : H S '

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: ex . 7 . c ; ; : 3 ■ a x .7 1 . ■ 0 . . ft : ft T e : ft X X4" : ft Z: xOx

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0 - P A T lL M DIO NOT CX.PlAY T.ric; f--■: H A L d P 9 r ■ft XT’: ft • 5 • ■ Y , .4 • : ft Z : 0 - R 1-0CHAVIUf( VlfilMALLV CU: t K \ E H , .9 ; ft XT.- xft; X.4 ■ : ft X -z. xOx 2-QEHAVIJK DEFINITELY

3 -BEHAVIOR 035tRVCD 'N A SC VC RE OEGRllE

Î WRITE ANY ADDITIONAL CCWWlHTS OR (1 DS C IÎ V A U Of. S IN SPACE MAR KCD "N A R R A T I V E

:U * ::0 : . 1 .:Z- ..ft . 1 n. A t s t l n m , . U-: * 0 . . t ; ; .ft: : tb. COÙ tXHigiTTD rTRAMOC MANMtq.SW? f 1 : .;l1 t ! ILL t\ L A'.L CK n tH A v ;O R YnllCH WOULD MAKE HIM STAND our IN A CNCWD

:u.. XOX : I X2 : XftX i HA: urftSATLft S ^ A ! : 0 hi 17 r-CM ASXNA WAS iM PATiLNT', COULO RDT WISHES.TùL î H ATC* OCL ATS Oil [ILN IA L Of HIS

: g; ix x?x 3 LSDPC*IAI»V‘. fCi LOWCD HOUMnE ; 0.: : o • .1; 18 l'AATirif»AJf n; TOOK f'AHT IN A N(* c'CNT H i i l u / t o ’ t o CROUP A C T IV IT E S

x y . XQ: x r 4 MOo:rTONpi;^s V-UÇJ VOICI m:> n o t ::U; r.O 19 ÇüNr,UiÇO;_WAS PT.RPLtXEO AS TO LHAtiiiL Ifi TOf.L, W-Aj. CULL AND T M t, PLACE DR PtHSON, HAU LC L 'f C TÛ n

::u;; x.a: x 1 x ft f oC’rT n r y P N t . N tC O iD h e l p on XLr ; X O . x t . : :;3. 20 ANSk Y CXPFtCSSfO HOSTILITY OB Î'H lC L H û ü v 'M L M IN HAThSNS, An' sÊ h BY WORDS OB ACTIONS. DMESSH.C ON keeping SEl.f CLEAN

XU : .:tj; xi.' .3.. b iMOOint WAS mtTnuBTEOVS, X U.. X o * XÎX. x ftx 21 TÇAMP ÜL CniEO on SEEMED ON THE b tS H C iP tc rP U L Oi! kJ'JL TO OtMEHS. V E ACE OF CRYING.

xtf' ::n: xj 7 VlAS IVî'A^lLNti ACTED : U : x O x 22. SECLUSIVi; STAYED DV HIMSELF WHEN witn Jut”T»-'î,->;NC lU L \\ Ork'NS FÔVstÜLE, iNTtRACTCD ONLY WHEN TtiC CONaCOUtNCES 0 ' m.', '0 4 . APPROACHED.

x y .* x o ■ .ftX S FATlSO WHEN m NP Vf S5 HALL. xEx xS.r 2ft S L tP T- TB'LD TO SLEEP IN BEO OB AU *Lf>S THAN n o r m a l CHAIM DURING DAY OH EARLY EVENING.

XiF- :: o: ;.i: . f t ’. 9 Irritable was C.\s:lt ANnotED, H.\0 S V j P IC I^ S QUESTIONED ACTIONS U » it 'Ük L V1.1 rLN T . fLt* Of r OR MOTIVES OF OTItCBSi EXPMLSSED HANUlL oh MiMtO LACK OF TRUST,

.ft.: 10 (NA.IC^UATÇ tXPHCftlCO iNSfCUHlTr OB 2ft AfAlHETlC^ WAS INDIFFEflENTj SNOWED INAQ-L’ l V TO CJPC w:rn PHCLH.fMS l it t l e ” FEEL »N0 Off RESPONSE TO 0 THEBS

X u : X o 3 . II PAC INC W A LK E D BACK AND fO R T H , ::k. * 0.. ::lx ;;B:: : 26 RAMBl ED- TALKED ON AND ON BACK AND FDHTH W iThOUT MAKIftO HIS POINT, CHANGED TOPICS FRLQiJLNTLYi WAS DIFFICULT to UNDERSIANO.

: U: xo: x . :ftx 12 EVEN Dis p o s itio n was CA l m . not ::Dx xJx xtx 27 B^EXAXrO WAS PHYSICALLY A t EASE * EASILY ÛPS t f SEEMED COMFOHTADLC.

::u: :: 0 . : 2 : x s : 13 F[.AB U[k LOUhCD FNIOHTENFD OR .Ox ::Jx XÎ:: X>x 28 fOAGET^UL m ad to be REMINDED COMPLAir.tO fir BC'NG A fK A 'O OF WHAT 10 ÜU WITH AftSlGNEO DUTIES, SOME THING WARD ROUTINES AND APHOlNTHiPirS m ::u: xo* x r. * 3 - M SAHÇA&I »_C’ COUMtNlS ABOUT WARD :x k : “ 0,: xlx XÎX THREATENING WAS THREATENING HOufiNG, STA^F cm patients WERE TOWARD o ther PATIENTS OR STAFF. SNIPPY, BtTUR OR CAUSTlC

. . . I * SPEECH SLOWED. HAIC OF SPEECH VULQAJI LANOUAOE SwORC Oft CURSED WAS Slow' and " HCSlfANT MORT fÏÏÏN M0Sf“PA7lCNTS, Appendix B: Recording sheet for points earned for participation in scheduled and unscheduled activities

EARNINGS DATE CODE ACTIVITY 1 Rounds 2 or 3 Bkfst Lunch Supper 4 Appts 5 Escort 6 Form 7 Area 8 Room 9 UM 10 Cl 11 GT(or C2) 12 VR 13 WPM IL WP 15 PT 16 WR 17 ADM 18 SM 19 CQ 20 Sponsor 21 Interest 22 Details 23 Games 24 Contracts

Total

68 69

Appendix C; Individual Subjects' Point Earnings during trials

Experiment 1

Group______Subjects' #______Ü- o f days______Daily point average

Control (I) 1 40 193

4 25 247

8 32 315

11 14 211

Experimental 1 (II ) 7 33 228

10 25 121

Experimental 2 (III) 5 40 286

9 25 201

Experimental 3 (IV) 2 16 256

3 35 230

6 40 271 70

Appendix I: Individual Subjects Cumulative Daily Point Earr.ir.gs: Experiment I. CUMULATIVE DAILY POINT EARNINGS

en CUMULATIVE DAILY POINT EARNINGS

I

4^ CUMULATIVE DAILY POINT EARNINGS

I CUMULATIVE DAILY POINT EARNINGS Ol o s §

I Ml

wl ol

ol cn CUMULATIVE DAILY POINT EARNINGS

% en CUMULATIVE DAILY POINT EARNINGS 01 Os m

Ml I CUMULATIVE DAILY POINT EARNINGS

I

I CUMULATIVE DAILY POINT EARNINGS I S

Ml I

Wl ol

*1 ol .y» CUMULATIVE DAILY POINT EARNINGS

I

éP CUMULATIVE DAILY POINT EARNINGS

O

%

e n m 82

Appendix E: Individual Subjects CPBO Daily Averages: Experiment I. CPBO DAILY AVERAGES ISA 4^ 0» OO S . tM-S-

m l

o

§ J

(/> CPBO DAILY AVERAGES

r o

c n îCÿ" ' ' CPBO DAILY AVERAGES ts>

en

II.

en CPBO DAILY AVERAGES IS> ^ o> OO S

(n ai CPBO DAILY AVERAGES K» O) OO S

en

I

cn (A CPBO DAILY AVERAGES ls> oo

(/) oo CPBO DAILY AVERAGES ts> 4k o> ee S

(A e CPBO DAILY AVERAGES

(/) 91

Appendix F: Individual Subjects Point Earnings during Phases

Experiment II (Control)

Subj ect # of days Daily Point Average

1 65 192

2 37 188

3 50 316

4 53 275

5 90 155

6 30 190

7 55 240

8 26 186

9 40 246

10 33 121

11 50 225

12 33 145 92

Appendix G; Individual Subjects Point Earnings during Phases

Experiment II (Experimental)

Subject # of days Daily Point Average

1 98 187

2 76 219

3 76 274

4 65 246

5 45 228

6 42 203

7 39 163

8 22 209

9 23 261

10 22 237

11 26 302

12 21 220 93

Appendix H: Individual Subjects CPBO Daily Averages; Experiment II. CPBO DAILY AVERAGES iSd ^ CD OO K

Oil

cnl tf) isa CP BO DAILY AVERAGES IS» ^ o> OO K

JP CPBO DAILY AVERAGES N» .fh 0» OO K

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u i

O §

wil (A C PBO DAILY AVERAGES IS» ^ o> OO S

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