Behavior therapy is placed as one of the most important psychologic therapies in psychosomatic field at present Behavior therapy, catching hold of maladaptive behavior as an erroneously learned or a conversional behavior due to insufficiently learned adaptive behavior, is to extinct the erroneously learned maladaptive behavior and make the patient learn correct adaptive behavior. The following have been known to be the therapeutic technics: implosive therapy, extinction therapy, inhibition of ideas, aversive therapy, conditional inhibition therapy and assertion training as technics. of behavioral abnormalities, in addition to classical conditioning therapies, operant conditioning therapies, systematic desensitization. and furthermore, biofeedback technic has also been employed. In this article, the author will describe historical changes in the behavior therapies used in psychosomatic field in Japan, along with the outlook of the therapies. The reported target diseases of the behavior therapies in psychosomatic field in Japan comprise hypertension and Raynaud's disease as cardiovascular psychosomatic diseases, anorexia nervosa as a gastrointestinal psychosomatic disease, writer's spasm. spasmodic wryneck, muscle contraction headache, migraine and labial involuntary movement as neuromuscular psychosomatic diseases, obesity as an endocrine and metabolic psychosomatic disease, and bronchial asthma as a respiratory psychosomatic disease in internal medicine; infantile bronchial asthma, refusal of attending school and tic in pediatrics; enuresis and ejaculation insufficiency in urology; aphasia and psychogenic dysphonia in otorhinology; habit of pulling out of the hair in dermatology; psychogenic visual disturbances and hysteric blindness in ophthalmology, and also pain and phobias. The technics favored for the treatment of such diseases are operant conditioning therapies, systematic desensitization, aversive therapy, token economy, assertive reaction, squeeze technic, modeling therapy, feedback therapy (GSR, respiration, blood pressure, electromyogram, skin temperature). Systematic classification of the cases heretofore treated with the behavior therapies in Japan indicates that the behavior therapies for psychosomatic diseases began in 1975. In other words, the history of the therapies is still relatively short, and it may be anticipated that the therapies will further develop in the future. In the current social situations with a presumably increasing incidence of psychosomatic diseases, the behavior therapies willl further develop, and prove more effective when used in combination with other psychologic therapies. In the clinical treatment of such diseases, however, it is an essential treatment ground to establish desirable human relations between the therapist and the patient by a verbal means, and based on it, it is desirable to develop therapies incorporating the role of modifying an emotionless tendency liable to associate psychosomatic diseases.

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The purpose of the present study was to examine the availability of the vicarious experience as the preperformance information of the direct experience, by means of comparison between the HR changes during each of the experiences. As the vicarious experience, subjects observed the videotape describing the same aversive situation of the direct experience. Main findings were as follows. (1) The high HR subject in the vicarious experience showed higher HR level during the direct experience. (2) The subjects who had showed the increasing HR pattern during the vicarious experience depressed the HR increment during the direct experience. The subjects with irregular HR pattern, however, showed higher HR level. (3) The subjects who had showed similar HR patterns during the vicarious and the direct experiences depressed the HR increment during the direct experience. On the other hand, the subjects with dissimilar HR patterns showed high HR level during the direct experience. These findings indicate that, as a whole, anxiety during the direct experence is deperessed when the preperformance information is available.

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Biofeedback (BF) has been employed as the therapy for headaches. At this time, a long term study was conducted in order to examine the relationship between the efficacy of BF and three factors : age at time of BF training, sex, and psychological states such as anxiety and depression. Subjects and methods : The study population consisted of 38 patients whose chief complaints were headaches. The patients were devided into migraine and muscle contraction headache (MCH) groups. This distinction was made according to the classification of the Ad Hoc Committee. The 38 patients included 26 migraine patients (3 males, 23 females) and 12 MCH patients (6 males, 6 females). The mean age was 44. 3 years in migraine patients and was 51. 2 years in MCH patients. They were trained in skin temperature BF for migraines, and electromyographic BF for MCH. In order to evaluate anxiety, Taylor's Manifest Anxiety Scale (MAS) was used. To evaluate depressive state, the Self-Rating Questionnaire for Depression (SRQ-D) was used. At the first meeting, each subject was given the MAS and the SRQ-D, which were returned later at the first BF training session. One year later at completion of training, a retrospective study was conducted. The questionnaire was used to examine the relationship between the efficacy rates of BF and such factors as age and sex. Results and discussion : After one year, the success rate of BF was 58. 3% in MCH and 53. 8% in migraines. Comparing patients by age and sex, there was no significant difference between an effective case and an ineffective case of BF for both MCH and migraine headacaches. Comparing patients by MAS score and SRQ-D score, there was no significant difference between an effective case and an ineffective case of BF for both MCH and migraine headaches. It can be suggested that age, sex, and psychological states such as anxiety and depression do not significantly influence the continuation of the success of BF.

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This study investigated the clinical effectiveness of two DRA procedures with different reinforcement contingencies in transforming generalized and localized self-stimulatory behaviors (GSSB and LSSB) in four autistic and four mentally retarded children of equivalent mental age into appropriate toy play. The first procedure, artificial DRA, presented the sensori stimulation demonstrated as artificial reinforcer contingent on appropriate toy play. The results showed that both GSSB and LSSB were transformed to appropriate toy play in the mentally retarded children but not in the autistic children. d The second procedure, natural DRA, provided opportunities for playing appropriately with the toy producing the sensory reinforcer identified for each SSB. The results showed that both GSSB and LSSB were transformed to appropriate toy play in the autistic children, and these improvements were performed and maintained outside of treatment settings without special: intervention. The findings suggest that natural DRA could play an essential role in treating autistic children.

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This study, consisting of two parts, was undertaken for the purpose of clarifying the assertiveness in stutterers. Part I The purpose of Part I was to examine the inter-group differences between stutterers and nonstutterers in assertiveness. A 36 item assertion scale was administered to 201 stutterers (mean age, 31.8) and 348 nonstutterers (mean age, 20.0). A factor analysis was carried out and four factors were extracted. These factors were interpreted as "expression of fair or foul" (factor I ), "loss of orientation in expression" (factor ), "expression of right or wrong" (factor III ), and "communication of intention" (facor N ). After factor scores of each subject on four factors were calculated respectively, the mean factor scores of each group were calculated, the result of which showed that stuttering group was higher in factor I and 1I than nonstuttering group, but lower in factor and N. Part II The purpose of Part II was to examine the intra-group differences among stutterers in asseriveness. According to their assertion scores, a high assertive group (N=48) and a low assertive group (N=50) were extracted from 201 stutterers in Part I and were compared with regard to their asseriveness. A factor analysis was carried out and three factors were extracted. These factors were labeled as "expression of fair or foul" (factor I ), "expression of right or wrong" (factor 11 ), and "loss of orientation in expression" (factor N ). The mean factor scores of each group on three factors were calculated, and its result indicated that a high assertive group was higher than a low assertive group in all three factors. Several tiems on how stutterers grasp their own stuttering were added to the 36 assertion items in stutterers. Thus the way that two groups grasp their respective stuttering was also compared with each other. In result, it was clarified that the low asserive group considered his stuttering symptoms more severe ones and was more distressed at his own stuttering problems than the high assertive group. Conclusions (1) The differences in assertiveness among stutterers are much greater than those observed between stutterers and nonstutterers. (2) We found a close relationship between assertiveness in stutterers and how stutterers grasp their own stuttering. This suggests that stuttering problems will be alleviated by having stutterers attain a more assertive way of life, and also that this alleviation of stuttering ploblems will make stutterers more assertive.

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A mentally retarded subject was taught use of grammatically correct sentences, all of which included subjects, predicates, and objects. The particular sentence form 'which was used in training consisted of combining labels that had already been present in his repertorie. A systematic sequence of prompt and probe trials was used to teach a particular sentence form. During prompt trials the experimenter presented a picture and modeled the particular sentence form for the subiect to imitate, on probe trials the experimenter did not model. Correct responses to prompts were reinforced on the FR6 schedule and correct responses to probes were reinforced on a continuous reinforcement (CRF) schedule by chiming followed by a green 0 signal. Incorrect responses were punished by buzzing followed by a red X signal. A follow-up study was conducted for 3-18 weeks after the training ended. During Baseline 1, the subject could hardly use the correct sentence form. At Baseline 2 which came after the training ended, the subiect demonstrated a significant increase in percent correct during use of the sentence form. The increased percentage was maintained throughout the follow-up period and the response generalized to untrained and novel stimuli. The results of this study demonstrated that a complex verbal response could be trained in a mentally retarded child. The acquisition and retention of the use of grammatically correct sentences demonstrated that the training procedures, imitative prompting, and differential reinforcement were the crucial factors in the development of the response.

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The purpose of this study is to make clear the relationship between fluctuation in perceived selfefficacy, which is successively self-evaluated during every treatment session, and behavioral changes accompanied by the elimination of fear responses to eye-to-eye confrontation, and to examine how the perceived self-efficacy functions as the antecedent determinant of behavioral change. A fourteen-year-old youngster, who exhibits severe fear responses to eye-to-eye confrontation mainly "in the school, was treated with systematic desensitization. The therapeutic intervention enduring about ten months resulted in notable improvement with regard to subjiective and cognitive (Subjective Unit of Disturbance and perceived self-efficacy), psychophysiological (Heart Rate), and behaVioral measures (performance without fear responses in everyday life and behavioral self-evaluation). As a result of the detailed and successive analyses on the relationship between perceived self -efficacy, which was self-evaluated forecasting the next week after every treatment session, and the behavioral change, which was observed in the following week and measured as a self-evaluation of daily life performance in a week after a preceeding treatment session, it was revealed that the fluctuation of perceived self-efficacy had intense relation to the elimination of fear responses. In other words, it was observed that the stronger the client had judged the perceived self -efficay, the less he felt fear responses at the time of eye-to-eye confrontation and the more certainly he could be confronted with the interpersonal situations in a follOWing week, and vice versa. It was suggested that the perceived selfefficacy, functions as the antecedent 'determinant of behavioral change. The results of this study were discussed from the self-efficacy point of view in the social learning theory.

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Two chronic and 2 acute cases of obsessive-compulsive disorder have maintained their improvement after exposure and response prevention in this University Hospital. Concrete methods of therapy in each case are described, and issues during the learning process and techniques in practical sessions are speculated on. In acute cases, the fear-evoking stimulus and the evoked avoidance response (obsessive action) were loosely connected. After a few sessions of exposure, the evoked response soon subsided. In chronic cases, the evoking stimulus/evoked response junction was close, and the evoked response was even ritualized. Their improvement was after many sessions of therapy. The effective factors of this therapy were considered as follows : exposure to the fear-evoking stimulus until the evoked response subsided was relatively simplified in procedure, because the stimulus used was fixed in each case ; and the therapist could carry out response prevention so sufficiently to get them accustomed to the stimulus, because the main symptoms of the patients were obsessive actions. In cases having intense fear, reciprocal inhibition to fear was associated in therapy, which produced effectiveness in sessions. Patients who fell into a severe obsessive state were attempted to join recreations and occupations in hospital. It seemed important as well to motivate patients to be treated, by making cognitive changes of their obsessive state.

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