Citation
A comparison of several different imagery instruction procedures for the treatment of test anxiety

Material Information

Title:
A comparison of several different imagery instruction procedures for the treatment of test anxiety
Creator:
Harris, Gina M. ( Gina Melanie ), 1953- ( Dissertant )
Johnson, Suzanne Bennett ( Thesis advisor )
Davis, Hugh ( Reviewer )
Hall, Everette ( Reviewer )
Larsen, Janet ( Reviewer )
Barger, Benjamin ( Reviewer )
Place of Publication:
Gainesville, Fla.
Publisher:
University of Florida
Publication Date:
Copyright Date:
1980
Language:
English
Physical Description:
vii, 156 leaves ; 28 cm

Subjects

Subjects / Keywords:
Academic achievement ( jstor )
Academic testing ( jstor )
Anxiety ( jstor )
Cognitive psychology ( jstor )
Individualization ( jstor )
Inurement ( jstor )
Psychology ( jstor )
Study skills ( jstor )
Teachers ( jstor )
Test anxiety ( jstor )
Dissertations, Academic -- Clinical Psychology -- UF
Imagery (Psychology)
Test anxiety
Genre:
bibliography ( marcgt )
non-fiction ( marcgt )

Notes

Abstract:
The primary purpose of the present study was to assess the effectiveness of different imagery instruction procedures for the treatment of test anxiety. In this study, a comparison of the efficacy of instructing subjects in individualized coping imagery treatment based on nonacademic experiences of competence and success and individualized coping imagery treatment based on academic experiences of competence and success was carried out. Another purpose of the study was to assess how effective instruction in relaxation is in increasing overall treatment effectiveness of individualized coping imagery treatment. This study also sought to assess whether the elaborateness and content of imagery were related to overall treatment effectiveness. It was evident from the results of this study that all variations of individualized coping imagery treatment brought about significant decreases in test anxiety. In terms of academic performance, two groups, individualized coping imagery without relaxation and academic individualized coping imagery with relaxation, were significantly different from the control.group at posttest. Individualized coping imagery treatment alone and individualized coping imagery treatment combined with relaxation brought about significant changes from pretreatment to post-treatment on grade point average. Academic individualized coping imagery alone did not change significantly on this measure of academic performance. The waiting list control group decreased on grade point average. In addition, the findings of this study suggest that changing the content of emotional imagery may be an important factor in bringing about a successful treatment outcome. It appears that decreases in negative coping imagery and increases in positive coping imagery figured strongly in treatment success.
Thesis:
Thesis (Ph.D.)--University of Florida, 1980.
Bibliography:
Includes bibliographical references (leaves 145-155).
General Note:
Vita.
General Note:
Typescript.

Record Information

Source Institution:
University of Florida
Holding Location:
University of Florida
Rights Management:
All applicable rights reserved by the source institution and holding location.
Resource Identifier:
07240468 ( oclc )
AAL5426 ( ltuf )
0023432818 ( ALEPH )

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A COMPARISON OF SEVERAL DIFFERENT IMAGERY INSTRUCTION
PROCEDURES FOR THE TREATMENT OF TEST ANXIETY













BY


GINA M. HARRIS


A DISSERTATION PRESENTED TO THE GRADUATE COUNCIL
OF THE UNIVERSITY OF FLORIDA IN
PARTIAL FULFILLMENT OF THE REQUIREMENTS
FOR THE DEGREE OF DOCTOR OF PHILOSOPHY



UNIVERSITY OF FLORIDA


1980


L























This dissertation is dedicated to my parents,

Caroline and Harold Harris, the sustaining force of

my life.



Gina M. Harris

October 10, 1980















ACKNOWLEDGMENTS


I would like to thank my dissertation advisor and

dissertation committee chairperson, Dr. Suzanne Bennett

Johnson, for the guidance, continued support and incisive

criticism she offered during all phases of this disserta-

tion project. I greatly appreciate the assistance offered

by members of the dissertation committee: Dr. Hugh C.

Davis, Dr. Everette Hall, Dr. Janet Larsen and Dr. Benjamin

Barger for their thoughtful reading of my manuscript. I

am greatful to Mr. Michael DeGennaro for assistance with

the data analysis, and appreciation is also expressed to

Dr. Randy Carter for statistical advice.

I wish to thank Leslie Dubin, Elizabeth Haughney,

Andrew Kerr, Mark Miller, Linda Nissenoff, Dan Rosenthal

and Kevin Stempel who served as raters in this study.


iii

















TABLE OF CONTENTS

PAGE

ACKNOWLEDGMENTS. . . . . iii

ABSTRACT . . . . . vi

INTRODUCTION . . . . . 1

The Current Use of Imagery in Behavior Therapy. 5
Should the Image Be Studied?. . ... 15
How Should the Image Be Studied?. . 18

METHOD . . . . . 30

Design. . . . . .. 30
Subjects. . . . . 31
Measures. . . .. . 31
Treatment . .... .. . 38
General Procedures. . . .. . 39
Treatment Manipulations . .. . 41

RESULTS . . . ... . 45

Analysis of Treatment Effects . .. 45
Expectations for Improved Academic Performance. 54
Treatment Efficiency: Speed of Hierarchy
Completion . . . .55
Imagery Analyses. . . . .. 55

DISCUSSION . . . . .. 66

Treatment Outcome . . .. .66
Imagery . . . . . 72

APPENDICES

A PROPOSITIONAL UNITS OF THE EMOTIONAL IMAGE. 78

B INSTRUCTIONS TO THE EXPERIMENTER:
INDIVIDUALIZED COPING IMAGERY TREATMENT. 80

C INSTRUCTIONS TO THE EXPERIMENTER:
INDIVIDUALIZED COPING IMAGERY TREATMENT
COMBINED WITH RELAXATION . . .. 91









D INSTRUCTIONS TO THE EXPERIMENTER:
ACADEMIC COPING IMAGERY TREATMENT . 95

E INSTRUCTIONS TO THE EXPERIMENTER:
ACADEMIC COPING IMAGERY TREATMENT
COMBINED WITH RELAXATION. .. . 100

F GENERAL INSTRUCTIONS FOR THE ADMINISTRATION
OF INDIVIDUALIZED COPING IMAGERY TREATMENT. 101

G GENERAL INSTRUCTIONS FOR THE ADMINISTRATION
OF ACADEMIC INDIVIDUALIZED COPING
IMAGERY TREATMENT. . . .. 103

H STUDY SKILLS THERAPIST MANUAL. . . 105

REFERENCES. . . . . .. 145

BIOGRAPHICAL SKETCH . . . .. 156










































v


1















Abstract of Dissertation Presented to the Graduate
Council of the University of Florida in Partial
Fulfillment of the Requirements for the
Degree of Doctor of Philosophy

A COMPARISON OF SEVERAL DIFFERENT IMAGERY INSTRUCTION
PROCEDURES FOR THE TREATMENT OF TEST ANXIETY

By

Gina M. Harris

December 1980

Chairman: Suzanne B. Johnson
Major Department: Clinical Psychology

The primary purpose of the present study was to assess

the effectiveness of different imagery instruction procedures

for the treatment of test anxiety. In this study, a com-

parison of the efficacy of instructing subjects in indi-

vidualized coping imagery treatment based on nonacademic

experiences of competence and success and individualized

coping imagery treatment based on academic experiences of

competence and success was carried out. Another purpose of

the study was to assess how effective instruction in relaxa-

tion is in increasing overall treatment effectiveness of

individualized coping imagery treatment. This study also

sought to assess whether the elaborateness and content of

imagery were related to overall treatment effectiveness.

It was evident from the results of this study that all

variations of individualized coping imagery treatment









brought about significant decreases in test anxiety. In

terms of academic performance, two groups, individualized

coping imagery without relaxation and academic individual-

ized coping imagery with relaxation, were significantly

different from the control.group at posttest. Individual-

ized coping imagery treatment alone and individualized cop-

ing imagery treatment combined with relaxation brought

about significant changes from pretreatment to posttreatment

on grade point average. Academic individualized coping

imagery alone did not change significantly on this measure

of academic performance. The waiting list control group

decreased on grade point average.

In addition, the findings of this study suggest that

changing the content of emotional imagery may be an impor-

tant factor in bringing about a successful treatment out-

come. It appears that decreases in negative coping imagery

and increases in positive coping imagery figured strongly

in treatment success.


vii


1















INTRODUCTION


Psychological historians could construct a story of the

development of psychology and its critical methodological

problems based on attempts to investigate the image. Scru-

tiny of the image was one of the first areas to be explored

by psychologists and, some have argued, one of the greatest

impediments to its development as a science (Holt, 1964).

Man's fantasy and the images of his mind dominated the

philosophy and poetry of the 20th century. The stream of

consciousness, the internal monologue, was the major charac-

teristic of the important literature of the day. James

Joyce in his book Ulysses (1922) made the stream of con-

sciousness the most discussed and influential literary

technique of our era. Amy Lowell and her followers (Sanders,

Nelson, & Rosenthal, 1972) known as the imagists,composed in

vers libre and expressed ideas and emotions exclusively

through a succession of precise and clear images. The de-

velopment of Freudian psychology was also dominated by the

stream of consciousness (Robinson, 1976).

Psychology from the perspective of its early leaders,

Wundt, Kulpe, Titchener, etc., was concerned with more than

external stimuli; it embraced images, dreams, feelings,

memories--the stuff that consciousness is made of (Marx &

Hillix, 1973). Thus the basic task of the psychologist

1









was to understand the structure and content of the human

mind by means of systematic introspection. The technique

involved a carefully worked out procedure in which highly

trained subjects were to report the immediate content of ex-

perience rather than to describe events that led to produce

the experience. Writing in 1898 Titchener stated:


The primary aim of the experimental psycholo-
gist has been to analyze the structure of the
mind, to ravel out the elemental processes from
the tangle of consciousness, or (if we may
change the metaphor) to isolate the constitu-
ents of a given conscious formation .
The aim of the psychologist is three fold.
He seeks (1) to analyze concrete (actual) men-
tal experience into its simplest components,
(2) to discover how these elements combine,
what are the laws which govern their combina-
tion, and (3) to bring them into connection
with their physiological (bodily) conditions.
(Marx & Hillix, 1973, p. 15)


Although Wundt, Titchener and Kulpe were greatly in-

trigued by the study of the stream of thought and man's

mental imagery, the introspectionists made little progress

in advancing the knowledge of psychology. "It died of

narrow dogmatism, a disease which no school of psychology

can long survive. Structuralism lacked the support of

practical application and connections to other areas of

psychology; its demise was mourned by few" (Marx & Hillix,

1973, p. 135).

The early objective behaviorists under the leadership

of John Watson not only stymied the efforts of Titchener

and his associates but offered an alternative. In contrast

to Wundt and Titchener,Watson focused exclusively on


1








objective, observable and quantifiable behavior. He saw

mental processes, images and thoughts as not scientifically

legitimate precisely because they were not objective, ob-

servable and quantifiable (Craighead, Kazdin, & Mahoney,

1976). Writing in 1924, Watson stated that consciousness

was "neither a definite nor usable concept" (p. 2). Captur-

ing the attitude of the objective behaviorists towards the

study of the elements of consciousness, Boring in 1937 wrote:


Having understood, tough-minded rigorous
thinkers will, I think, want to drop the term
consciousness altogether. A scientific psy-
chology is scarcely yet ready to give im-
portance to so ill defined a physiological
event as an awareness of an awareness. This
concept might never have come to the fore had
not people tried to interpret others in terms
of their own "private" minds--that egocentric
Copernican distortion which properly leads to
desolate solipsism. (Marx & Hillix, 1973,
p. 135)


Thus, behavioral psychologists such as Watson felt that

"mental images are ghosts with no functional significance"

(Watson, 1913, p. 158). Experimentalists of the behavior-

ist school saw only the sensation-related aspects of imagery

as suitable subjects for experimental study because they

were closest to objective stimuli.

While American psychologists were abandoning their

efforts to study covert phenomena, it was Freud and the

European psychologists who continued to explore the meaning

of our private world, our dreams, daydreams, aspirations,

images of violence and love. Psychoanalysis was essentially

Freud's attempt to scientifically and systematically study









the inner world (Holt, 1964). However, Freud's attempt to

formalize the psychoanalytic method as a means to scienti-

fically study the private world did not meet with great

success. Its dependence on the role of the therapist, his

judgment and experience, inevitably led to the growth of

many splinter groups who believed that what they experienced

in their patients was both different and more accurate than

what was experienced by their Freudian counterparts. The

development of multiple schools of therapy--the Jungians,

Adlerians, Horneyans, Humanists, etc., pointed up the basic

problems in attempting to explain components of man's inner

life using traditional clinical methods. In addition, Freud

did not create any viable way to test his theory, leaving it

open to a wide range of interpretation (Marx & Goodson,

1976).

After the study of imagery by Titchener's students

waned in the first decade of the twentieth century, few

scientific efforts were made in this area for close to 50

years. As late as 1965, prominent researchers in the area

of verbal learning were underplaying or avoiding considering

the function of images in mediating associations between

words (Paivio, 1969).

However, a review of the clinical literature of the

past 20 years reveals that imagery is very much present and

alive. This resurgence of interest in imagery, fantasy and

hallucination appears due to the efforts of, interestingly

enough, not of the Freudian psychologists, but of the





5


behavioral psychologists who previously had cast out imagery

as a topic for serious study. Thus, while behaviorally

oriented psychologists have been uncovering important

principles about reinforcement contingencies in the en-

vironment, they have also begun to explore the capacity

for imagery production in man and the uses to which this

image-making capacity can be put to alleviate emotional

suffering.


The Current Use of Imagery in Behavior Therapy


This resurgence in the use of imagery by behaviorists

is best exemplified by reviewing some of the behavioral

techniques that appear to be dependent on imagery.

Although much of behavioral treatment utilizes the

production of overt responses such as the operant condition-

ing methods derived from Skinner's investigations or

Bandura's modeling techniques, an ever increasing number

of behavioral procedures are based on the clients' use of

imagery. Indeed, the most frequently employed of all be-

havioral modification methods is the systematic desensi-

tization procedure of Wolpe (1958) in which it is claimed

that the production and use of imagery is a critical com-

ponent (Wilkins, 1971). As part of this treatment, the

patient is asked to produce a hierarchy of imaginal fear

provoking events (Wolpe, 1958). These situations are

intended to approximate real-life stimuli or performances

which currently evoke a high level of anxiety (e.g., making









a speech). A list or hierarchy of these situations is then

built in which the imaginal scenes are ordered according to

their capacity to produce anxiety. The patient then under-

goes an extensive period of training in relaxation which

promotes an increase in the potential to produce imagery

under conditions of reduced arousal (Singer, 1974).

The efficacy of systematic desensitization as a behav-

ioral procedure has received much research scrutiny. A

multitude of reports, monographs, and controlled investiga-

tions corroborate its effectiveness (Bandura, 1969; Paul,

1969; Wilson & Davison, 1971; Davison & Wilson, 1973).

However, large questions still remain concerning why it is

effective and what are the major ingredients contributing

to its success. It is generally agreed that Wolpe's counter-

conditioning explanation for desensitization's efficacy is

insufficient. Investigations have revealed relaxation to

be a useful but not critical component for treatment suc-

cess (Wilkins, 1971). In fact, a number of behavioral

psychologists (Mahoney, 1974; Paul, 1966) have claimed that

the production of imagery appears to be the crucial component

of desensitization. Mahoney (1974), for example, states

that although in vivo hierarchies have been utilized, the

predominant stimulus modality is covert.

Behavioral psychologists such as Gordon Paul (1966)

have underscored the necessity for the client to visualize

himself in the anxiety-evoking situation, not as if he were

seeing himself in a movie, but as if he were fully









participating in all the action. In his desensitization

instructions, Paul emphasized the importance of the client

producing stimuli-laden images, drawn from all the sense

modalities in an attempt to make the imaginal scene as close

to the actually experienced anxiety evoking situation as

possible. Yet Paul did not attempt to evaluate the neces-

sity for multisensory images empirically.

For all its presumed importance in the systematic de-

sensitization technique, behaviorally oriented psychologists

have devoted little empirical attention to exploring the

importance of imagery in desensitization. Like the Freudian

psychologists before them, behavioral psychologists have

used imagery as a therapeutic tool but have ignored many of

the critical questions about the nature of the imagery pro-

duced. Indeed, while other components of desensitization,

such as progressive relaxation, have undergone exhaustive

scrutiny and refinement, the scientific energy devoted to

examining the importance of imagery has commenced only

recently (Lang, 1977).

This same phenomenon has occurred with other thera-

peutic approaches presumably derived from classical condi-

tioning and reinforcement models. While systematic de-

sensitization is the behavioral technique that has been

applied most frequently and with substantial success for a

variety of fears and phobias, a number of therapeutic

approaches utilizing imagery have emerged. Emotive imagery,

covert sensitization, covert reinforcement, implosive









therapy, covert modeling have been in wide use. It is

generally assumed that imagery is an important component of

these techniques; however, little scientific energy has

been expended to explore whether imagery is crucial.

Emotive imagery, growing out of the counterconditioning

idea, was employed by A.A. Lazarus and his associates

(Lazarus & Abramovitz, 1962; Lazarus, Davison & Polefka,

1965) for the treatment of children's anxieties because of

the difficulties they experienced in teaching children pro-

gressive relaxation. In this technique, the children were

instructed to imagine "stronger and stronger phobic stimuli

woven into progressively more enjoyable fantasies" (Lazarus,

1971, p. 211). The assumption of this procedure was that

the positive feelings evoked by the fantasy would compete

successfully with the anxiety-arousing stimuli until these

stimuli would become conditioned to feelings incompatible

with fear. An example is provided by Lazarus (1971) who

treated an eight-year-old boy experiencing fears when

visiting the dentist:


The sequence consisted of having the child
picture himself accompanying Batman and
Robin on various adventures and then imag-
ining them receiving dental attention.
He was asked to picture this scene at least
five times daily for a week. Next, he was
to imagine himself in the dentist's chair
while Batman and Robin stood by and observed.
He also practiced this image several times
a day for one week. He visited the dentist
the following week, and according to his
mother, he sat through four fillings without
flinching. (p. 211)








However, in emotive imagery treatment, as in desensitiza-

tion, the importance of imagery in bringing about behavior

change has not been subjected to empirical scrutiny.

Covert sensitization, an imaginally based variant of

aversive counterconditioning, is another of those behavioral

interventions which assumes imagery to be a crucial compo-

nent. Covert sensitization has been used to modify behavior

such as sexual deviance, smoking, alcoholism and overeating

(Jones, 1969; Rachman & Teasdale, 1969). In covert sensi-

tization, images which evoke extreme disgust, unpleasantness

are employed (Cautela, 1967; Davison, 1968; Lazarus, 1958).

After having undergone progressive relaxation, the client

is instructed to imagine himself about to engage in the

reinforcing deviant behavior, e.g., smoking, drinking,

pedophilia, etc., and then to imagine that he feels both

nausea and disgust in response to previously reinforced

activities.

Cautela (1970) has employed a covert reinforcement

technique for the alleviating of fears and phobias. Al-

though purportedly having its origins in the reinforcement

model, it bears a marked similarity to the emotive imagery

techniques of Lazarus. As part of his procedure, a number

of reinforcing images such as activities the client fre-

quently enjoys doing are first elicited by the therapist.

In the next step in this treatment, the client is instructed

to imagine "a difficult but desired response sequence"

such as asking a girl for a date and then to imagine himself


1






10


in one of the reinforcing images. Covert reinforcement has

been used to modify evaluative anxieties (Cautela, 1970;

Wisocki, 1973; Kosta & Galassi, 1974; Chang-Liang & Denny,

1976), snake phobia (Marshall, 1975) and to improve the self-

concept of emotionally disturbed children and psychiatric

patients (Krop, Calhoun, &Verrier, 1971; Krop, Perez &

Beaudoin, 1973). Cautela has proposed that covert re-

inforcement enables the client to more easily imagine the

target behavior; ultimately this result is transferred to

dealing with the target situation in real life. In covert

reinforcement techniques, as in desensitization, little

attention has been devoted to determine whether imagery is

indeed a crucial component of the procedure.

Another of the behavioral techniques which relies

heavily on the use of imagery is implosive therapy. In this

technique, presumably based on the principles of extinction,

the client receives repeated exposure to intense anxiety

evoking stimuli, imagining the worst possible outcome of a

particular fear or obsession. It is assumed that anxiety

will first greatly increase and precipitously decrease as

the person is exposed to increasingly elaborate versions of

fear provoking stimuli. However, the evidence for the ef-

fectiveness of implosive therapy is only equivocal

(Morganstern, 1973), and there is little knowledge of the

possible mechanisms of behavior change. Various investiga-

tions have suggested "extinction, adaptation level, fatigue,

modeling, habituation, cognitive rehearsal and








discrimination," as possible mechanisms (Smith, Dickson, &

Sheppard, 1973, p. 358), but the imagery component has

never been empirically studied.

As a rule, investigations have not sought to discover

if the imagery component of these treatments reliably adds

something in addition to the other techniques employed as

part of the treatment. Further, these imagery based be-

havioral treatments such as covert reinforcement, emotive

imagery, covert sensitization, implosive therapy, etc.,

have usually been employed in combination with other treat-

ment procedures, e.g., study skills (Wisocki, 1970, 1973;

Cautela, 1970; Kendrick & McCullough, 1972; Lazarus, 1971;

Prochaska, 1971). Moreover, most studies exploring the

efficacy of behavioral imagery treatments have frequently

employed self-report inventories as the sole indices of

improvement, often when more reliable behavioral measures

were available. Thus, for the most part, the empirical

evaluation of these techniques has been limited. A tech-

nique that has received greater empirical evaluation is

covert modeling.

Covert modeling is a behavioral imagery based procedure

in which the client is "directed in the symbolic rehearsal

of appropriate behavior" for a difficult performance task or

a feared situation (Mahoney, 1974, p. 112). Here too, im-

agery is assumed to play a critical role in treatment. The

results of studies suggest that covert modeling is effective

in alleviating avoidance behavior (Kazdin, 1973a; Cautela,


L









Walsh, & Wish, 1971; Flannery, 1972b). In some of these

studies there was a definite effort on the part of the ex-

perimenter to instruct the subjects in the sort of imagery

that should be used (Kazdin, 1974; Cautela, Flannery, &

Hanley, 1974). In fact, studies of covert modeling are

among the few that have attempted to manipulate the content

of the imagery produced (Cautela, Flannery, & Hanley, 1974).

However, most studies have been of a laboratory analogue

nature. Therefore, we do not know how effective they are

with actual patient populations. Moreover, the active

therapeutic components are still unclear.

Covert phenomena and imagery based treatment has been

a subject of so much interest that an entirely new arena of

inquiry and controversy, cognitive behavior therapy, has

been opened (Meichenbaum, 1977). Nevertheless, while im-

agery based therapies have been used widely, carefully con-

trolled assessments and refinements of these therapies "have

lagged embarrassingly behind clinical applications"

(Mahoney, 1974, p. 117). One reason for the paucity of

controlled assessments of the importance of imagery in

these therapies may be the presence of substantial methodo-

logical difficulties and procedural inadequacies in studying

covert phenomena. The first and most obvious methodological

difficulty in studying imagery in the therapeutic process

is that images are private events, available only to human

introspection. Lang in 1977, sounding very much like Watson

in 1924, states, "As their observation cannot be shared nor









their dimensions measured by any instrument, they cannot be

data in a scientific analysis" (Lang, 1977, p. 862). The

image cannot be observed, tasted or touched.

Because it is so difficult to study the image, many

areas deserving of research scrutiny have consequently been

neglected. Singer (1974) points out that in scientific in-

vestigation of therapies incorporating imagery, investiga-

tors have not been attuned to "the fluid character of fan-

tasy, the rapidity of shifts away from the assigned image

or the various covert antagonisms that may occur in the

course of presumably attempting to produce imagery on de-

mand" (p. 235). Weitzman (1967) observes that within de-

sensitization treatment, the image is not a static entity

but is so fluid that it is often quite different from the

image called for by the specific item in the hierarchy.

Different images may impinge on the desired images. Persons

and events, frightening or not, unconnected with the present

scene to be imagined, may impose themselves on the scene

the patient is trying to imagine. Further, therapists and

investigators have tended to ignore crucial differences

between individuals' imaginative ability which could have

a significant effect on determining which patients could

benefit from imagery based treatments. Such knowledge of

differences could also signal the therapist that some

patients require added instruction and skill in producing

imagery. The possible use of pretreatment practice in

imagery, with the exception of the work of a few recent









investigations (Lang, 1977), has been too little explored.

Indeed, there has been little attempt to employ even paper-

and-pencil imagery assessment techniques to aid in the

assessment of patients.

While depending greatly upon the client's producing

images in the imagery based treatments, experimenters have

paid little attention to the characteristics the imagery

produces or whether it is being produced at all. In all

these treatments, whether systematic desensitization, im-

plosive therapy, covert sensitization, etc., the therapist

assumes that the client is actually imagining the desired

image and not just saying he is. During such treatment,

the patient can choose whether or not to cooperate with the

procedures employed. Wolpe and Lazarus (1966) cite cases

in which patients fail to cooperate with desensitization

treatments by introducing negative thoughts or unpleasant

images into the imaginal sequence. Therefore, an underlying

methodological problem appears to be the experimenter's lack

of control over the client's production of imagery.

Because of difficulties in studying the phenomena,

there has been a lack of research attention paid to the

importance of the vividness and affective intensity of the

imagery produced. These data,which could be obtained

through physiological and self-report measures, could

impart extremely vital information bearing on imagery

processing during therapy.









Should the Image Be Studied?


Given these substantial methodological difficulties,

does it make sense to study the elusive image, to system-

atically explore covert phenomena? Researchers, theorists

and social critics as diverse as Mahoney (1974, 1977),

Lang (1977, 1979) and Mumford (1967) propose that it does

indeed make sense to study imagery as a very significant

component of human thought.


To dismiss the most central fact of man's
being because it is inner and subjective is
to make the hugest subjective falsification
possible--one that leaves out the really
critical half of man's nature. For without
that underlying subjective flux, as experi-
enced in floating imagery, dreams, bodily
impulses, formative ideas, projections and
symbols, the world that is open to human
experience can be neither described nor
rationally understood. When our age learns
that lesson, it will have made the first
move toward redeeming for human use the
mechanized and electrified wasteland that
is now being bulldozed at man's expense and
to his permanent loss, for the benefit of
megamachine. (Lewis Mumford, 1967, pp. 75-76)


Despite the current interest in exploring the image as

a subject for scientific study and as a therapeutic tool,

there are a number of critics, e.g., Rachlin (1977a), who

question whether scientific energies are well spent explor-

ing covert phenomena.

This controversy concerning whether it makes sense to

study mental imagery was brought into sharp focus by a de-

bate between Rachlin and Mahoney in 1977. While Rachlin









argued that "it is not necessary to refer to thoughts or cog-

nitions at all" (Rachlin, 1977c, p. 661), seeing observable

behavior as sufficient, Mahoney took the position that the

"dichotomy between observed and inferred events is an arti-

ficial one. It implies that there are some stimuli which

register directly with our sense and these somehow are more

real, legitimate or scientific" (1976, p. 674). Mahoney sug-

gests that all stimuli, overt or covert, are mediated. He

proposes that no stimulus impinges on the sensorium without

undergoing the transforming and constructive process that is

human perception. He further suggests that the "Doctrine of

Immaculate Perception," which implies that some stimuli are

apprehended without undergoing the mediating influences of

constructive perceptual processes is "wholly untenable and

it has long since been abandoned by its staunchest philo-

sophical defenders" (p. 674). "No one has ever directly

seen a pure, unedited stimulus; human perception is a con-

structive process" (Mahoney, 1976, p. 674).

In contrast, Rachlin (1977b) argues that while per-

ception may be constructive, while thoughts and images may

occur, "the tactic of inferring events inside the organism

has not led to coherent prediction or control of behavior

or in useful therapeutic techniques" (1977a, p. 680). The

data provided by observable phenomena have the virtues of

"parsimony, simplicity and theoretical consistency," (1977b,

p. 373) will suffice. Writing in response to Mahoney,

Rachlin stated:









I would abandon my non-mediational position
when it proved inadequate to predict and
control behavior and when a mediational
position was shown to be:
(A) at least as coherent
(B) at least as applicable in the laboratory
(C) at least as applicable in every day life
(D) at least as applicable in therapy.
(1977a, p. 681)

Mahoney continues to contend that the study of covert

phenomena, images, thoughts, etc., do improve our predic-

tion, understanding and control of behavior and hence

should continue to be studied.

There are a growing number of psychologists who share

this attitude. Most investigators do acknowledge that the

image is very difficult to study. They all seem to be in

agreement that it forms "that part of human behavior which

is so private and close to the self as to belie effective

scientific scrutiny in an age of operationism" (Singer,

1973, p. 385). However, spurred on by great progress in

the fields of neurophysiology, sensory deprivation (Hebb,

1949) and dream research (Aserinsky & Kleitman, 1953) and

by the "new look at man as an information processing or-

ganism brought on by computer theory" (Singer, 1973, p. 385),

investigators from both cognitive and clinical psychology

have recently begun to direct their efforts towards a re-

evaluation of imagery as a cognitive phenomena and as a

therapeutic tool.









How Should the Image Be Studied?


Assuming we are going to study the image, can we define

it? The problem of defining the image has been made particu-

larly difficult because "we know nothing about any form or

structure that the image might possess or reside in" Bugelski,

Kidd, & Segman, 1968). Investigators have used expressions

as diverse as "pictures in the mind," "impressions made

upon a plastic substance" (Tichener, 1912) or "the petri-

fied product of perceptual functions" (Kluver, 1932) in an

attempt to describe and define what is essentially a hypo-

thetical, implicit and nonobservable cognitive product.

Psychologists have offered a number of definitions of imag-

ery. Some investigators studying the image have defined it

from a sensory perceptual (Singer, 1974) or a constructional

perspective (Pylyshyn, 1973; Lang, 1977), while still other

investigators appear to be studying the image without offer-

ing any explicit definitions (e.g., Paivio, 1971).

Working from the sensory-perceptual perspective, psy-

chologists such as Singer (1973, 1974) propose that "the

image represents man's capacity to duplicate environmental

information in the absence of the persistence of external

signals" (1973, p. 385). In contrast to the percept, in

which the individual makes a "response to an object or stimu-

lus that continues to be within the physical scanning capaci-

ty of the sense organs for at least one second," one can

posit the existence of an image if the "original source of









stimulation is further removed in time from the observer but

is described as present or experienced in some form as part

of the subject's consciousness" (Singer, 1973, p. 385).

Cognitive psychologists working from this sensory-

perceptual perspective have focused considerable research

attention on eidetic imagery, an intriguing phenomenon found

in a small segment of the population. To be considered

eidetic, an imager after studying a scene for 30 or 40 sec-

oncs should be able to retain his perception of it for sev-

eral minutes afterward and "view" the eidetic image in as

much detail as if the picture were still there (Jaensch,

1930; Haber & Haber, 1964). Some eidetic images seem indis-

tinguishable from actual perceptions to the imagers even when

employing objective criteria. In an experiment conducted

by Leask, Haber,& Haber (1968) eidetic subjects were shown

two schematic drawings of ocean scenes. If these scenes

were juxtaposed in the imagination, the picture that would

result would be that of a bearded man. Leask, Haber, &

Haber (1968) reported that some of their eidetic subjects

reported the presence of a face after imaginally juxtaposing

these scenes. For these subjects, it appears that the image

almost functioned like a sensory impression.

Also adopting the sensory-perceptual perspective,

Sheehan (1966), Segal (1971), and Shepard (1978) have been

responsible for bringing about important methodological

refinements in the study of imagery, which in turn have

contributed to the effort to predict and control behavior.








Sheehan (1966) has developed a new procedure to obtain in-

formation on vividness and other characteristics of visual

imagery. In Sheehan's procedure, the individual, having

studied a picture of an object such as a red apple, projects

it mentally onto a screen. The subject then manipulates a

projector light for color, intensity and shape in order to

bring this objective measurable index as close as possible

to his actual image. Through this method, Sheehan was able

to determine how well memory images served in creating some-

thing similar to the original stimulus, how well memory

images capture the qualities--the shape, color, etc., of

the original stimulus.

Segal (1971) has been studying various aspects of the

Perky phenomena. In the initial experiment, Perky's sub-

jects were asked to imagine common objects while looking at

a fixation point in the middle of a window. In the back of

the window a machine projected forms that were very close

to the items to be imagined in all their characteristics

(e.g., shape, color). After the subject was told what ob-

ject to imagine, the projected form was gradually brightened

to about threshold brightness and was removed before the

subject began to describe what he had imagined. Perky found

that all subjects confused the projected forms with their

own images. All these observers were unable to discern that

an actual objective stimulus was present, believing that the

stimulus they described was totally a project of their

imaginative processes. Segal (1971) was able to successfully









replicate the Perky effect, which could be defined as an

inability to differentiate "a real from a mentally projected

image." The way that subjects decide whether a stimulus

is real or not was subjected to exhaustive empirical scru-

tiny; the expectations induced by the experimenter seemed

to be critical. If subjects were told to expect to see

some real stimuli, they were successful in discerning these.

Conversely, if the subjects did not expect to see any "real

stimuli," they did not see them (Segal, 1971).

In an attempt to dispense with what he perceives as

fruitless arguments about internal processes underlying

imagery, Shepard (1978) proposes that we can study such

images "as defined solely in relation to their correspond-

ing external objects" (1978, p. 125). In his studies,

Shepard found that "to the extent that mental images can

substitute for perceptual images, subjects are able to

answer questions about objects as well when those objects

are merely imagined as when they are directly perceived"

(Baylor, 1971; Kosslyn, 1975). Shepard has concluded that

subjects make the same judgments about objects in their

absence as in their presence: Subjects who imagine a

particular object are very quick and accurate in making a

response to related external stimuli. In addition, he found

that when called upon to spatially transform stimuli in the

imagination, subjects are accurate in carrying out these

transformations. These results are derived from many

experiments employing a wide range of objects, including









two dimensional shapes (Shepard & Chipman, 1970), spectral

colors (Shepard & Cooper, 1975), one digit numbers in such

forms as Arabic numerals, printed English names and patterns

of dots (Shepard, Kilpatrick &Cunningham, 1975), familiar

faces, and musical sounds (Shepard, 1975). In all cf these

experiments, there was no statistical difference between how

well subjects performed in the experimental condition in

which the object was directly perceived or when the object

was imagined.

Defining the image from a constructional perspective,

investigators, notably Neisser (1967) and Pylyshyn (1973),

propose that the experience of an image itself arises out

of constructive processes. These psychologists suggest that

"the units abstracted and interpreted during perception are

stored in long-term memory in an abstract propositional

format and must be acted on by processes that serve to

generate or to produce an experience of an image" (Kosslyn,

1975, p. 342). Thus, the aforementioned investigators sug-

gest that we view the image not as a picture in the head,

which the phenomenological description implies, but that we

define the image as a propositional structure, which is

more like an elaborated description of the information con-

tained in the image. Rather than being "a raw harvest of

sensory observation" (Lang, 1977, p. 864) that is implied by the

picture metaphor, the image gives us information about

objects or events, not pictures or representations of them.

Working within this perspective, P.J. Lang and others are









studying imagery and its component processes through the use

of physiological techniques. From the results of his stud-

ies, Lang (1977) has suggested that careful training and

experimenter-monitoring and reinforcement of appropriate

responses can enable subjects to increase their psycho-

physiological response to imagined situations and hence

the potential effectiveness of the use of imagery during

therapy. It appears that the way instructions to the client

are organized can be shown to control somatovisceral re-

sponses during imagery. It is Lang's contention that

psychophysiology provides "a window through which the image

can be observed and a means through which it can be al-

tered" (1977, p. 882).

Lang is not alone among experimental psychologists in

having investigated the power of imagery to produce physio-

logical changes. Simpson & Pavio (1966) observed changes

in pupillary size during imagery. May & Johnson (1973)

perceived an increase in heart rate when arousing images

were presented. Studies such as those of Barber & Hahn

(1964) and Grossberg & Wilson (1968) suggest that imagining

a painful or frightening event results in a strong physio-

logical response that can be gauged through physiological

measures such as GSR. Increases in electromyograms (EMGs)

have also been noted by several researchers (Craig, 1969;

Jacobsen, 1929, 1930; McGuigan & Schoonover, 1973).

While psychologists such as Paivio (1969), Bower (1971),

Bugelski (1968), studying imagery and its relationship









to learning and memory, have made certain assumptions about

the image, they have not offered an explicit statement of

definition of imagery with respect to memory and learning.

There has been "with memory images, as with memory in gen-

eral, an almost irresistible tendency to rely on metaphors"

(Crowder, 1976). Paivio (1971) cites three basic operations

that have been employed by cognitive psychologists to describe

and manipulate imagery: "stimulus attributes, experimental

manipulations and individual differences" (p. 253). Viewed

within the perspective of Paivio (1971) and Kosslyn &

Pomerantz (1977), it may not be necessary to assume a defini-

tion of the image. Kosslyn & Pomerantz (1977) state that the

"image is not the only construct in cognitive psychology that

lacks a unique operational definition it is legitimate

for a scientific enterprise in its formative period to be

engaged in research on a construct whose definition has not

been precisely formulated" (p. 64). Therefore, one could

study the image in relation to its individual differences,

stimulus attributes and experimental manipulations without

resorting to a definition. For example, eidetic imagery has

been studied in relation to individual differences in the

subjects' eidetic abilities (Leask, Haber, & Haber, 1968).

The image has been described and studied through its stimu-

lus attributes, described "in terms of the image-arousing

value or concreteness of the stimulus material. This can

be viewed as a dimension ranging from objects or their pic-

tures on the high imagery end, through concrete words to









abstract words on the low end of the scale" (Paivio, 1971,

p. 253). Studies of learning and memory (Paivio & Madigan,

1970; Paivio, 1971) have shown that imagery can greatly en-

hance both these processes. Described in terms of its

stimulus attributes, the use of concrete noun images re-

sulted in significantly better paired associate recall than

the use of abstract nouns in the studies conducted by Paivio

and associates. Imagery has been found to have a facili-

tating effect not only in paired-associate learning but in

free recall, serial learning, verbal discrimination learn-

ing and the Brown-Peterson short-term (STM) memory task

(Paivio, 1969; Paivio & Rowe, 1970, Paivio & Smythe, 1971).

It has been proposed by Crowder (1976) that mediation of

retention through imagery techniques is among the most

powerful experimental effects found in the psychology of

memory (Crowder, 1976).

Within cognitive psychology, training subjects in

the use of imagery through different instructions appears

to be the most frequently used method of experimentally

manipulating imagery (Bower, 1971; Bugelski, Kidd, &

Segman, 1968). In his studies, P.J. Lang found that the

way instructions to the client are organized has been

shown to exert substantial control over the client's somato-

visceral responses during imagery.

Among the clinical treatment studies employing imagery,

only a handful of investigations conducted using covert









modeling have sought to determine whether manipulating the

type of imagery instruction employed results in differen-

tial treatment effectiveness. Covert modeling, as previously

mentioned, is the behavioral imagery based procedure in

which the client is "directed in the symbolic rehearsal of

appropriate behavior" for a difficult performance task or

feared situation (Mahoney, 1974, p. 112). These covert model-

ing studies have suggested that one can enhance the efficacy

of treatment by instructing subjects in the sort of imagery

that should be used (Kazdin, 1974; Cautela, Flannery, & Hanley,

1974). For example, Kazdin (1974) found that subjects who

were instructed to imagine a model of the same sex and age

were significantly more effective in reducing avoidance be-

havior (fear of harmless snakes) than those who were in-

structed to imagine models that were dissimilar in these

characteristics. Recent research on model characteristics

has also focused on the superiority of coping vs. mastery

models in the alleviation of avoidance behavior (Kazdin,

1973a, 1974; Meichenbaum, 1972). Both Meichenbaum and Kazdin

concluded as a result of their studies that subjects who were

instructed to imagine coping models who demonstrated initial

fearful behavior, then coping behavior and finally mastery

behavior were significantly more effective in enhancing

behavioral change than were subjects who were instructed

to imagine mastery models who demonstrated no fear, but

competence throughout. These studies suggest that manipu-

lating the content of imagery through instructions may









substantially augment the power of the imagery technique

in bringing about desired changes in behavior. Support for

this contention is found in the results of a recent study

by Harris & Johnson (1980) who compared the efficacy of

instructing subjects in individualized coping imagery based

on experiences of success and competence to self-control

desensitization for the treatment of test anxiety. The

images of competence and success used as part of this coping

technique were drawn from the individual's own repertoire

of success experiences achieved in situations other than

test taking. In this study, the type of imagery instruc-

tion employed seemed to be important. Individualized coping

imagery treatment was significantly more effective in in-

creasing grade point average and decreasing self-report of

anxiety than was self-control desensitization. A replica-

tion of individualized coping imagery treatment produced

similar results.

Building upon the results of the previous studies

(Kazdin, 1974; Lang, 1977; Harris & Johnson, 1980) which

found support for the use of instructions aimed at manipu-

lating the content of the imagery produced, the primary

purpose of the present study was to assess the effectiveness

of different imagery instruction procedures for the treatment

of test anxiety. In this study a comparison of the efficacy

of instructing subjects in individualized coping imagery

treatment based on nonacademic experiences of competence and

success and individualized coping imagery treatment based on









academic experiences of competence and success was carried

out. The images of competence and success used as part of

the initial treatment study conducted by Harris & Johnson

(1980) were essentially nonacademic in nature, using suc-

cess experiences drawn from fields as diverse as athletics

and gourmet cooking. Because the target anxiety of this

study was test anxiety, it was felt that it might prove

useful to instruct subjects in the use of individualized

coping images based upon previously realized academic suc-

cess (e.g., making an academic presentation, doing well on

a previous exam) within the desensitization framework for

the treatment of test anxiety. The use of academic images

of competence derived from subjects' academic achievements

may further promote generalization through the employment

of imagery highly relevant to test taking and other academic

stressors. For subjects in both these treatments, images

of competence were drawn from the individual's own rep-

ertoire of success experiences and the individual was a

party to the formulation of his own treatment. As in the

previous study, the subject was able to become an active

agent in a very individualized regimen, perhaps making the

approach more efficient.

Another purpose of this current study was to assess

how effective instruction in relaxation is in increasing

both imagery vividness and overall treatment effectiveness

of the individualized coping imagery techniques. Several

investigators, among them Singer (1973, 1974), Van Egeren,






29


Feather & Hein (1971), have cited the role that relaxation

instruction plays in increasing both the vividness and

overall treatment effectiveness of imagery based techniques.

However, their conclusions emerge mainly from case reports,

therapist observations, etc., and have not been subjected

to controlled assessment.















METHOD


In order to compare the efficacy of individualized

coping imagery based upon academic and nonacademic images

of competence and to assess the value of relaxation train-

ing, students seeking treatment for their test anxiety were

randomly assigned to one of four treatment conditions in a

2x2 factorial design. Subjects in the first treatment group

were given training in the use of nonacademic coping images

to reduce test anxiety. The second group received both

training in progressive relaxation and the use of non-

academic coping images. Subjects in group three were

trained in the use of individualized coping imagery based

on academic success experiences. The fourth treatment group

received both individualized coping imagery based on aca-

demic experiences of competence and relaxation training.

Because no amount of anxiety relief can compensate for in-

adequate study skills, a study skills package was adminis-

tered to all treatment groups (Mitchell & Ng, 1972). In

addition, in order to assess whether any of the treatments

produced an effect, a waiting list control group was

established.









Subjects


Sixty-three subjects were selected from a group of

individuals meeting the following criteria: (A) volunteered

in response to announcements of a study for the treatment

of test anxiety made in several core university premedical

courses (e.g., organic chemistry, chemistry, biology), in

which multiple examinations are given; (B) scored above 30

on the debilitating anxiety scale of the Achievement Anxiety

Test (Alpert & Haber, 1960); (C) had a cumulative grade

point average (GPA) under 3.5; (D) were willing to partici-

pate in all of the 8 treatment sessions and 2 assessment

sessions; (E) granted permission for the investigator to

obtain grade records from the Registrar's office. Students

who had the highest degree of subjectively measured anxiety

and the lowest cumulative grade point average were con-

sidered first for treatment.


Measures


Treatment outcome. Two different sets of measures

were used to assess the efficacy of the different treatments

for test anxiety: five self-report measures of test and

evaluative anxiety and academic performance as reflected

in change in grade point average.

The self-report anxiety assessment battery, adminis-

tered at pretest and posttest, consisted of:








(A) The Suinn Test Anxiety Behavior Scale (STABS)--

this is a 50 item inventory describing situations related

to test taking (Suinn, 1969).

(B) The Alpert-Haber Achievement Anxiety Test (AAAT)--

this instrument is designed to measure both Debilitating

Anxiety (DA) and Facilitating Anxiety (FA) in test situa-

tions (Alpert & Haber, 1960).

(C) The Test Anxiety Scale (TAS)--the TAS is a 37 item

true/false inventory which attempts to assess the subjective

emotional reactions experienced by students in test situa-

tions (Sarason, 1972).

(D) The Social Avoidance and Distress Scale (SADS)--

this scale consists of 28 items which appear in a true/false

format and relate to how much subjects deliberately avoid

social situations (Watson & Friend, 1969).

(E) The Fear of Negative Evaluation Scale (FNES)--is

comprised of 30 items which appear in a true/false format;

this inventory measures how fearful subjects are of negative

evaluation (Watson & Friend, 1969).

Grade point averages were collected for the quarter

prior to treatment, the quarter during which the study was

conducted and the quarter following treatment.

Expectations for improvement. In the postassessment

session, subjects in all five groups were asked to estimate

what their expected grade point average for that treatment

quarter would be, given their academic performance up to

that point in the quarter. This expected grade point








average was designed to assess whether there were different

expectations for improvement across treatment groups.

Treatment efficiency: Speed of hierarchy completion. In

order to assess one aspect of treatment efficiency, the num-

ber of trials it took for subjects to complete the hierarchy

was tabulated.

Imagery measures. Subjects who met the initial criteria

for inclusion in the study underwent an additional assess-

ment procedure designed to assess the images the subjects

produced. This assessment was conducted both before and af-

ter treatment. Scenes were selected by dividing the de-

sensitization hierarchy employed by Harris & Johnson

(1980) in their test anxiety treatment study into three

portions reflecting low, medium and highly anxiety evoking

items. One item was randomly chosen from each anxiety

level of the hierarchy. Thus, one scene was chosen from

the least anxiety evoking section of the hierarchy (items

1-9), a second scene was randomly chosen from items (10-18),

and a third scene was chosen from the most anxiety evoking

third of the hierarchy (items 19-27). These same target

scenes were employed for subjects in all five groups.

All imagery assessments were conducted individually in

a dimly illuminated carpeted room in which distracting

sounds were minimized. Subjects were presented verbally

with four situations to imagine and describe. Before imag-

ining and describing the three actual test taking target








scenes, the subject was given a pretest practice scene

which was to imagine that s(he) is taking a walk on a sunny

spring day.

For this practice scene, as in the subsequent three

scenes to be imagined, the subject was asked to imagine this

scene as clearly as s(he) could, and when s(he) imagined

the scene as clearly as s(he) could, to raise a finger of

the right hand. At that point, the subject was asked to

describe what was imagined in detail. In these preliminary

instructions to the subjects, it was emphasized that the

purpose of this procedure was to help the therapists in

preparing for treatment.

After the subject described the practice scene, s(he)

was told that "I have a few situations related to tests and

test taking here--just a few that I'd like you to imagine

and describe to me in detail." The same procedure was fol-

lowed for the imagined test-related scenes as was followed

for the practice scene. Thus, after imagining the scene,

the subject was asked to describe the scene in detail. A

tape recorder was used to record both the experimenter's

instructions and the subjects' descriptions of the imagined

hierarchy items.

To control for order effects, all six combinations of

scene presentation were employed. Thus, one-sixth of the

subjects were asked to imagine the least anxiety evoking

scene first, the second most anxiety evoking scene second

and the most anxiety evoking scene last. A second sixth of









the subjects in all treatment conditions were asked to im-

agine the most anxiety evoking scene first, the second most

anxiety evoking scene second and the least anxiety evoking

scene last, etc. Thus, within each treatment group of

twelve subjects, two participants followed the same order

of scene presentation.

This same procedure employing the same practice scene

and three different scenes chosen from the same test

anxiety hierarchy was repeated at posttreatment assessment.

Although different test anxiety scenes were employed, each

subject was asked to imagine one scene from the low, medium

and high anxiety levels of the hierarchy.

From these pre- and posttest scene descriptions, four

imagery measures were taken:

(A) Elaborateness--a behavioral measure of scene

elaborateness was defined as the number of words employed

by the subject to describe each of the target scenes s(he)

was asked to imagine. Numerical tabulations of the number

of words in each scene were compiled by the author and

checked by a volunteer university student.

(B) Latency--this measure was defined as the length of

time it took for a subject to signal by raising a finger

that s(he) was ready to begin his (her) description of a

target scene, after having received instructions from the

experimenter to imagine and describe these scenes. This

time was measured with a stop watch to allow for an

accurate reading.









(C) Content: Stimulus/Response--stimulus content of

a scene is that aspect of the imagined situation which re-

fers to the physical details of the object or situation

described. The response content of the imagined scene re-

fers to the somatovisceral or emotional responses that the

subject described him/herself making in the imagined target

situations.

In order to provide for reliability, seven raters, un-

associated with the study, coded the imagery descriptions

given by subjects in response to the target scenes. Each

sentence was classified by a rater according to whether it

primarily reflected stimulus attributes or response at-

tributes.

In advance of the actual coding procedure, all identi-

fication was removed from subjects' imagery descriptions.

Packets of equal numbers of imagery descriptions were then

randomly selected. Neither the experimenter nor the raters

knew from which treatment group these descriptions were

drawn.

Raters received pretest training in order to afford

them sufficient practice in coding the sentences of the

scenes, according to the criteria employed. Thus, as part

of the pretest training the principles governing the differ-

entiation of predominantly stimulus and response sentences

were first discussed and examined. After raters clearly

understood stimulus vs. response characteristics, they then

received both examples and sample scenes to code along these









dimensions. Difficulties experienced in coding these scenes

were explored and any questions were answered by the experi-

menter.

Raters were checked for reliability every five scenes.

One of the scenes in each packet which had been randomly

chosen from all imagery descriptions was the scene on which

each rater was evaluated for reliability. Reliability was

calculated for each test scene employing the following

formula:

agreements
agreements + disagreements

If a rater's reliability fell below 80% on any test scene,

this rater received retraining on additional scenes to en-

able him/her to better understand and employ the criteria.

The rater then was required to rerate the packet on which

s(he) fell below the reliability standard. The experimenter

served as the reliability standard for all raters.

(D) Content: Coping--in addition to coding the imagery

descriptions according to whether they reflected predomi-

nantly stimulus and response characteristics, raters were

asked to evaluate and classify the same imagery descrip-

tions as to whether each sentence of each description given

in response to the target scene reflected predominantly

positive or negative coping. For those statements which

raters saw as neither positive nor negative coping in

character, they were asked to code as neutral.









As part of this procedure, the seven raters were

assessed for reliability throughout their coding of the

data, with the experimenter serving as reliability standard.

All procedures to assess reliability for these variables

were identical to those employed in the coding of stimulus-

response data. Thus, if reliability fell below 80%, raters

received additional training in the coding principles and

procedures and were instructed to code that set of descrip-

tions and were checked again.


Treatment


After measures of general and test anxiety were admin-

istered and imagery assessments conducted, subjects were

randomly assigned by sex to one of five groups: individual-

ized coping imagery treatment based on nonacademic experi-

ences of competence and success (N=12), individualized cop-

ing imagery treatment based on nonacademic experiences of

competence and success combined with relaxation training

(N=12), individualized coping imagery treatment based on

academic images of competence and success (N=12), individual-

ized coping imagery treatment based on academic images of

competence and success combined with relaxation training

(N=12), and a waiting list control group (N=15).

Therapists. The author and one female, advanced gradu-

ate student in clinical psychology served as therapists for

this study. Each of the therapists conducted two of the

four types of treatment so that each therapist had contact

with the same number of subjects.









Treatment setting. All group treatment took place in

a dimly illuminated carpeted room in which distracting

sounds were minimized.


General Procedures


All treatments were conducted in groups for the eight

weekly, 60 minute sessions and were given the same rationale,

anxiety hierarchy, study skills training and homework assign-

ments.

Rationale. Individuals taking part in these groups

were given a rationale that emphasized that they had re-

sponses already in their repertoire, success experiences

that could be used to cope with anxiety (see Appendix B).

Test anxiety hierarchy. In session two of treatment,

the construction of a group hierarchy was carried out by

employing the results of the preassessment measures in con-

junction with subject suggestions to create a hierarchy

specific to test taking situations. In order to control for

the divergent elements of the treatment procedures, the same

hierarchy was employed for all four treatment groups. For

all treatment groups, each item on the hierarchy was pre-

sented for a minimum of two times. The length of item pre-

sentation was either 60 seconds or the amount of time for

all individuals in the group to imagine the hierarchy scene

for a 20 second anxiety free period. However, if a subject

signaled anxiety after the second exposure, the item was

repeated until no subject signaled anxiety when imagining

this scene.









Study skills. Subjects in all four treatment groups

received training in study skills employing a variety of

study skills techniques. Throughout all sessions, as part

of the study skills portion of the treatment, the basic

focus was on helping subjects to examine their present be-

havior and to try new and more productive methods for meet-

ing the demands of their current academic environment. In

these sessions it was emphasized that more efficient prepara-

tion would in turn result in fewer feelings of anxiety prior

to and during examinations. In session one, discussion

centered on how students arrange their study time, examin-

ing for high and low efficiency areas. In addition, an

attempt was made to elicit subject suggestions concerning

specific behavioral steps which might reduce study interrup-

tions and more adequately meet course related demands on

their time.

In the second session, study skills training focused

on different methods of increasing study behavior such as

systematically studying in the same place and time, re-

ducing study interruptions and more adequately meeting

course related demands on their time. The student was

helped to construct and modify proposed time scheduled

during the following weeks.



1These study skills techniques were the same ones used
by Harris & Johnson (1980) and were based on a study
skills package developed by Allen (1971).









In session three the SQ3R method of study (Robinson,

1961) was taught to subjects. This method was used to help

students select what they are expected to know, comprehend

these ideas more rapidly, fix these ideas in memory, and

review efficiently for examinations.

Session four of the study skills portion of the treat-

ment was concerned with techniques of good note taking,

with an emphasis on organization. In addition, the SQ3R

method was reviewed. Sessions five and six focused on

preparation for examinations--reviewing, outlining, repeti-

tion and additional memorization techniques. Session seven

centered on the use of response management techniques to

increase study behavior. The final session served to re-

view the principles covered during the entire study skills

part of treatment. Study skills training took approximately

20 minutes of each treatment session.

Homework. Subjects received a homework assignment

based on the study skills techniques examined during each

treatment session.


Treatment Manipulations


In a 2(academic vs. nonacademic coping images) x

2(relaxation vs. no relaxation) design, each treatment

group differed in the type of imagery and relaxation in-

structions employed.

Individualized coping imagery treatment based upon

nonacademic images of competence. For two treatment groups,









highly personalized, previously established images of com-

petence and proficiency achieved by the subjects in stress-

ful environments other than test taking were paired with

visualization of anxiety eliciting scenes that comprised the

test anxiety hierarchy. Individuals taking part in this

treatment were given a rationale that emphasized responses

already in their repertoire as current resources that could

be used to cope with test anxiety. The first session

focused on a group discussion of possible success experiences

of the subjects that could be transformed into images of

competence for use in this covert imagery procedure. In

sessions three through eight, the actual treatment proce-

dure was carried out. Using these previously established

images of competence (e.g., running a radio broadcast,

tending a busy bar, playing in a recital), subjects were

presented with the test anxiety hierarchy items. In ad-

vance of the presentation of each item, subjects were

instructed (1) to imagine themselves performing well in

their personalized coping image and (2) then to transpose

the same confident and competent person of the personalized

coping image to the imaginal anxiety-provoking situation

presented in the hierarchy. Thus, the subject was instructed

to imagine this same competent person of his individualized

coping image now contending with test situations as

they appeared in the hierarchy.

Individualized coping imagery treatment based upon

academic images of competence. Subjects in the two other









treatment groups were instructed to employ individualized

coping imagery based upon academic images of competence.

Highly personalized, previously established images of com-

petence and proficiency achieved by the subjects in aca-

demic activities (e.g., making presentations, performing

difficult problems in class, successful test taking experi-

ences in the past) were paired with the visualization of

anxiety scenes from the test anxiety hierarchy. Individuals

taking part in this treatment were given a rationale that

emphasized responses already in their repertoire and cur-

rent resources that could be used to cope with test anxiety

and that these current resources could be derived from their

own experiences of competence and success in academic ac-

tivities. It was assumed that even test anxious college

students would have some history of academic achievement

and success (albeit an intermittent one) in order to have

gained college admission. The first session focused on a

group discussion of possible success experiences of the

subjects that could be transformed into academic images of

competence for use in this covert imagery procedure. In

sessions three through eight, the actual treatment procedure

was carried out. Using these previously established aca-

demic images of competence, subjects were presented with the

test anxiety items. In advance of the presentation of each

item, subjects were instructed (1) to imagine themselves

performing well in their personalized coping image and

(2) then to transpose the same confident and competent









person of the personalized academic coping image to the

imaginal anxiety-evoking situation presented in the hier-

archy. In this treatment, too, the subject was instructed

to imagine this same, competent, confident person of his

individualized coping image now contending with test situa-

tions as they appear in the hierarchy.

Progressive relaxation instructions. Subjects in two

of the treatment groups received training in progressive

relaxation following the format developed by Dorothy

Susskind (1970). The relaxation procedure consisted of

the alternate tensing and relaxing of various muscle groups.

Subjects were told that the relaxation training facilitated

the lowering of their tension level, making it easier for

them to cope with test taking situations both as they

imagined them in the session as well as when they were

confronting them outside. Subjects were instructed to

practice their relaxation at home between sessions. The

other two treatment groups received no specific instructions

in progressive relaxation.

Waiting list control group. Fifteen subjects made up

a fifth experimental group of waiting list controls. After

the posttreatment assessment, individuals of the waiting

list control group were offered the opportunity to partici-

pate in the test anxiety treatment proven to be most ef-

fective.















RESULTS


Analysis of Treatment Effects


All subjects, eighteen males and fifteen females, in

the four treatment groups who completed the eight one-hour

treatment sessions and two assessment sessions were in-

cluded in the data analysis. Three subjects dropped out

of each of the two relaxation treatment groups, leaving

nine subjects in each. For the group involved in individu-

alized coping imagery treatment without relaxation, four

subjects withdrew in the course of treatment. Five sub-

jects withdrew from the academic coping imagery treatment

without relaxation. Of the control subjects, thirteen out

of fifteen completed the postassessment measures. A multi-

variate analysis of variance was conducted on the pretreat-

ment assessment measures completed by the dropouts to de-

termine if they differed significantly from nondropouts.

This analysis revealed no significant differences. Conse-

quently, data from dropouts were discarded from all

subsequent analyses. The intercorrelation matrix for the

scores on the seven dependent measures used to assess the

efficacy of test anxiety treatment is presented in Table 1.

As expected, the correlations between self-report measures









Table 1

Intercorrelation Matrix of Scores on the Seven Dependent
Measures at Pretreatment



Measure 1 2 3 4 5 6 7


1. GPA -.19 -.02 .024 -.20 -.02 -.06

2. AAT-DA -.63 .488* .449* .12 .075

3. AAT-FA -.29 -.19 -.04 .19

4. STABS .38* .22 .30

5. TAS .12 .21

6. SADS .25

7. FNES


Note: GPA = Grade Point Average; AAT-DA = Debilitating
Anxiety subscale of the Alpert-Haber Achievement Anxiety
Test; AAT-FA = Facilitating Anxiety subscale of this same
instrument; STABS = Suinn Test Anxiety Behavior Scale;
TAS = Test Anxiety Scale; SADS = Social Avoidance and
Distress Scale; and FNES = Fear of Negative Evaluation
Scale.

p < .05.



were low to moderate. There was no significant correlation

between any self-report measure and grade point average.

Since multivariate analysis of variance of pretreat-

ment scores revealed significant pretreatment differences

for one variable, FNES, this variable was subjected to a

separate analysis of covariance. A multivariate analysis

of the pretreatment scores for the remaining six self-

report and performance measures was nonsignificant,









F(24,102) = .83, p< .6913, indicating initial equivalence of

the four treatment and control groups on these measures.

To assess the relative efficacy of the four treatment

and one control conditions, a multivariate analysis of

variance was run on the six repeated measures (Service,

1979). Since the groups were significantly different at

the multivariate level F(24,90) = 2.25, p < .0032, further

analyses were performed. Separate repeated measures analy-

ses of variance were conducted for each of the dependent

measures. When appropriate, Duncan's Multiple Range Test

for pairwise comparisons was used to assess posttreatment

differences between groups. Pairwise T-tests were employed

for assessing pre- to posttreatment changes.1

Self-report measures of test anxiety. Repeated meas-

ures analysis of variance performed on the pretest and

posttest Debilitating Anxiety subscale scores of the

Alpert-Haber Achievement Anxiety Test revealed a highly

significant Group x Time interaction F(4,40) = 4.71, p <

.0047, indicating differential improvement among the groups

on this measure.



1Anadditional 2(Relax) x 2(Image) x 2(Time) Manova was
conducted to assess the possible main effects of relaxation
and imagery used on the treatment outcome measures. No
main effects nor interactions were found. A multivariate
analysis of variance was run to determine if treatment was
differentially effective for men and women taking part in
the study. The multivariate analysis was nonsignificant
indicating that there was no interaction between sex and
treatment for any of the dependent measures.









The mean Debilitating Anxiety and Facilitating Anxiety

scores for each of the four treatment and one control con-

ditions are shown in Table 2.

While all treatment groups decreased on this measure

of test anxiety, Table 2 reveals that the magnitude of

change from pretest to posttest appears to be greatest for

individualized coping imagery treatment alone, followed by

individualized coping imagery treatment combined with re-

laxation and academic coping imagery combined with relaxa-

tion. The Duncan's Multiple Range Test for pairwise com-

parisons employing Kramer's (1956) adjustment for unequal

sample sizes conducted on posttest scores indicated that all

four treatment groups scored significantly lower than the

waiting list control group, p < .05, but were not signifi-

cantly different from each other. Results of pairwise

T-tests indicated that all four treatment groups showed

significant change from pre- to posttreatment, p < .04.

No substantive change occurred for the waiting list control

group.

Repeated measures analysis of variance on the Facili-

tating Anxiety subscale at the AAT did not yield a signifi-

cant Group x Time interaction. The main effects for group,

F(4,40) = 12.88, p < .0001, and time, F(1,40) = 9.49,

p < .0045, were significant. Duncan's test showed that

each treatment group reported more facilitating anxiety

than the control group, p < .05. There was an overall in-

crease in pre- to posttreatment scores (see Table 2),

p < .05.















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Repeated measures analysis of variance performed on

the Suinn Test Anxiety Behavior Scale (Stabs test) re-

vealed a highly significant Group x Time interaction

F(4,40) = 6.63,p < .0006 (see Table 3).



Table 3

Suinn Test Anxiety Behavior Scale Means


Pretest


Individualized coping imagery
with relaxation (N=9)

Academic coping imagery with
relaxation (N= 9)

Individualized coping imagery
--no relaxation (N= 9)

Academic coping imagery--no
relaxation (N= 7)

Wait list control (N= 13)


140


133.22


161.125


134.71

143.53


Posttest


106.55


100


118


100.142

169


Individualized coping imagery treatment without

relaxation showed the largest decrease in test anxiety,

followed by individualized coping imagery treatment

combined with relaxation, academic coping imagery alone,

and academic coping imagery combined with relaxation.

The waiting list control group increased on this

measure of test and evaluative anxiety. At posttest,

all four treatment groups were significantly lower









on this measure than was the waiting list control group,

p < .05. All other group comparisons were nonsignificant.

In addition, at posttest, pairwise T-tests revealed that

all four treatment groups were significantly lower on this

measure than at pretest, while the waiting list control

group showed a significant increase, p <..04.

Results of the Test Anxiety Scale, presented in Table 4,

show that all treatment groups decreased more than the con-

trol group on this measure.



Table 4

Sarason Test Anxiety Scale Means


Pretest Posttest

Individualized coping imagery
with relaxation (N= 9) 23.77 14.66

Academic coping imagery with
relaxation (N= 9) 23.88 14.33

Individualized coping imagery
--no relaxation (N= 8) 26.25 14.50

Academic coping imagery--
no relaxation (N= 7) 24.0 16.71

Wait list control (N= 13) 22.53 23.23




The magnitude of change from pretest to posttest appears

to be largest for individualized coping imagery treatment

alone followed by academic coping imagery combined with









relaxation, individualized coping imagery combined with

relaxation and academic coping imagery alone.

Repeated measures analysis of variance performed on

this measure revealed a highly significant Group x Time

interaction, F(4,40) = 3.47, p < .0196. At posttest all

four treatment groups scored significantly lower than the

waiting list control group, p < .05, but were not signifi-

cantly different from each other. Pre- to posttreatment

changes as measured by pairwise T-tests were significant

for the individualized coping imagery group combined with

relaxation, the academic coping imagery group combined with

relaxation and the individualized coping imagery treatment

without relaxation, p < .005. Pre- to posttreatment changes

on this variable for the academic coping imagery group

approached significance, p < .0680. The waiting list con-

trol group showed a slight, nonsignificant increase on this

measure.

Self-report measures of evaluative and social anxiety.

Repeated measures analyses of variance of the scores ob-

tained at pretest and at posttest on the Social Avoidance

Distress Scale (Watson & Friend, 1969) indicated no signifi-

cant Group x Time interaction on this measure. The analysis

did reveal significant group F(4,40) = 16.16, p < .0001 and

time F(1,40) = 16.90, p < .0002, main effects. However,

subsequent tests using Duncan's revealed no significant

differences between groups, although all subjects scored

significantly lower on this measure at posttest that at

pretest.









Because of initial pretreatment differences on the

FNES (Fear of Negative Evaluation Scale), an analysis of

covariance was conducted. This analysis revealed no dif-

ference between groups.

Academic performance. Mean grade point averages ob-

tained from the University of Florida Registrar's Office for

both the pretreatment and posttreatment quarters are pre-

sented in Table 5.



Table 5

Grade Point Average


Means

Pretreatment Posttreatment

Individualized coping
imagery combined with
relaxation (N= 9) 2.0 2.62

Academic coping imagery
combined with relaxa-
tion (N= 9) 2.32 2.96

Individualized coping
imagery without
relaxation (N= 8) 2.38 3.00

Academic coping imagery
without relaxation
(N= 7) 2.32 2.54

Waiting list control
group (N= 13) 2.66 2.08




Repeated measures analysis of variance performed on

the pretreatment and posttreatment grade point averages









revealed a highly significant Group x Time interaction

F(4,40 = 3.57, p < .0173, indicating differential improve-

ment among the groups on this measure of academic perform-

ance. Duncan's test revealed that at posttest none of the

four treatment groups were significantly different from

each other. Only the academic coping imagery group combined

with relaxation and the individualized coping imagery group

alone were significantly different from the control group.

From pre- to posttreatment, both individualized coping imag-

ery treatment combined with relaxation and the individual-

ized coping imagery group without relaxation showed a

significant increase in grade point average, p < .05. Pre-

to posttreatment changes in grade point average for the

academic coping imagery group combined with relaxation

approached significance, p < .089. Academic coping imagery

without relaxation made a small nonsignificant increase in

academic performance from the pretest to posttest. The

waiting list control group significantly decreased on this

measure of academic performance, p < .0437.


Expectations for Improved Academic Performance


In the postassessment session, which occurred before

summer term examination week, subjects in all four treatment

groups were asked to estimate what their grade point aver-

age for that quarter would be, given their academic per-

formance up to that point in the quarter. No significant

differences in group expectations emerged from these

analyses.









Treatment Efficiency: Speed of Hierarchy Completion


An analysis of variance performed on this measure re-

vealed a highly significant difference between groups

F(3,76) = 4.80, p < .0042. Further analyses in the form of

Duncan's Multiple Range Test showed that individualized

coping imagery combined with relaxation, academic coping

imagery combined with relaxation, and individualized coping

imagery alone were significantly more efficient treatments

in terms of the number of trials taken for subjects to com-

plete each item of the hierarchy than the academic coping

imagery--no relaxation treatment.


Imagery Analyses


The same individuals who completed the treatment out-

come measures completed the imagery assessment procedure at

pretreatment and posttreatment. However, one of the male

subjects, who completed the individualized coping imagery

treatment combined with relaxation and all treatment out-

come measures, failed to complete the posttreatment imagery

assessment.

For each of the imagery measures (i.e., elaborateness

or words, latency, stimulus-response, and coping) separate

analyses of variance were conducted on the pretreatment

scores on these variables to assess whether the dropouts

differed significantly from nondropouts. As these analyses

revealed no significant differences, data from dropouts were

discarded from all subsequent imagery analyses.









Scene elaborateness. A behavioral measure of scene

elaborateness was defined as the number of words employed

by the subject to describe each of the target scenes s(he)

was asked to imagine. In order to assess whether the four

treatment and one control group were different on this

behavioral measures of scene elaboratensss, a 5(Groups) x

2(Time) x 4(Scene) anova was conducted. This analysis

revealed no significant interactions but did yield main

effects for Time F(1,37) = 4.43, p < .04 and Scene

F(3,123) = 12.21, p < .0001. Further analysis in the form

of Pairwise T-tests indicated that at posttreatment, sub-

jects used more words to describe these target scenes than

at pretest. Duncan's revealed that all subjects used more

words to describe the three anxiety evoking scenes than

the practice scene, p < .05.

A further 2(Relax) x 2(Imagery) x 2(Time) x 4(Scene)

anova was performed in order to assess whether the addition

of relaxation or the type of imagery used differentially

contributed to scene elaborateness. This analysis also re-

vealed no significant interactions or main effects between

relaxation and imagery on this scene elaborateness measure.

Latency. This measure was defined as the length of

time it took for a subject to signal by raising a finger

that s(he) was ready to begin his(her) description of a

target scene (e.g., practice scene, anxiety evoking scenes)

after having received instructions from the experimenter to

imagine and describe these scenes. A 5(Groups) x 2(Time) x









4(Scene) analysis of variance was conducted to assess

whether the four treatment and one control groups were

different on this measure. This analysis revealed no

interactions or main effects.

To determine the effects of relaxation and image type

on latency, a 2(Relax) x 2(Imagery) x 2(Time) x 4(Scenes)

anova was also performed. All interactions and main effects

proved to be nonsignificant.

Scene content: Stimulus and response. Stimulus

content of a scene is that aspect of the imagined situation

which refers to the physical details of the object or situa-

tion described. The response content of the imagined scene

refers to the somatovisceral or emotional responses that

the subject described him/herself making in the imagined

target situations.

As described previously, seven individuals unassociated

with the study served as raters. Each rater received an

equal number of imagery descriptions to code. Each sentence

was classified by the raters according to whether it pri-

marily reflected stimulus attributes or response attributes.

The experimenter served as reliability standard for

all raters. If a rater's reliability fell below 80% on any

test scene, this rater received retraining on additional

scenes to enable him/her to better understand and employ the

criteria. The rater was then required to rerate the packet

on which s(he) fell below the reliability standard. Only

one of the seven raters required additional training on









the criteria. Reliability was calculated for each test

scene employing the following formula:


agreements
agreements + disagreements

Reliability between the raters and the experimenter (re-

liability standard) ranged between 80-100% and averaged

85% for all test scenes.

In order to control for differing scene length and to

normalize the data, all stimulus and response data were

subjected to Arcsin Transformations. Analysis of either

stimulus or response statements through a 5(Groups) x

2(Time) x 4(Scene) repeated measures analysis of variance

on the transformed scores was essentially equivalent,

yielding a highly significant Scene x Time interaction

F(3,102) = 4.3, p < .006 for both of these variables.

Duncan's revealed that at pretest subjects used signifi-

cantly more stimulus elements (statements) in the practice

scene than they did in any of the three anxiety scenes,

p < .05. Subjects also used more stimulus elements in

their descriptions of medium anxiety scene than they used

in the most anxiety scene, p < .05. The number of stimulus

statements evoked by the low and medium anxiety scenes

were not significantly different from each other. At

posttest, this pattern was again apparent, with the number

of stimulus elements used in the practice scene exceeding

those used in the anxiety scenes, p < .05. In addition,

the low anxiety scene exceeded the medium and high anxiety









scene in the number of stimulus elements used, p < .05.

The medium and high anxiety scenes were not statistically

different from each other.

Follow-up Duncans on the response variable revealed

that at pretest, significantly more response statements

were used to describe the three anxiety scenes than were

used in the description of the practice scene, p < .05.

More response statements were used to describe the high

anxiety scene than were used to describe the medium anxiety

scene, p < .05.

At posttest, descriptions of anxiety scenes again

contained significantly more response elements than made

up the descriptions of the practice scene, p < .05. There

was no difference in the number of response statements

elicited by the medium and high anxiety scenes. The number

of response elements evoked by the low anxiety scene was

lower than these two scenes, p < .05.

Table 6 shows both the percentages of each of the

anxiety scenes and practice scenes that were made up of

stimulus and response statements as well as the trans-

formed scores.

To determine the effects of relaxation and image type

used as part of treatment on both the stimulus and response

content of the scenes, 2(Relax) x 2(Imagery) x 2(Time) x

4(Scene), analysis of variance were performed on both the

stimulus and response variables. These analyses were











































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essentially equivalent and yielded no significant inter-

actions or main effects for either of these variables.

Pairwise T-tests were conducted to ascertain if each

scene elicited more stimulus or response oriented content.

As can be seen in Table 6, a pattern of greater response

orientation compared to stimulus orientation was true for

all anxiety scenes, p < .001, at both pretest and

posttest. In contrast, for the practice scene, there was

no difference between stimulus and response orientation at

pretest. At posttest, the practice scene elicited signifi-

cantly more stimulus content, p < .03.

Scene content: Coping. Positive coping content of a

scene refers to those statements made by the subjects in

response to the target scenes which would indicate that

they were functioning effectively, adopting a problem-

solving orientation or attitude that would lead to a satis-

factory outcome. Negative or "bad coping" was the converse

of the above.

The same procedures for calculating reliability were

employed for coping/negative coping scene content as were

employed for stimulus and response content. Only one of

the seven raters required additional retraining on the

criteria in order to increase his level of reliability.

Reliability for coping/negative coping ranged from 80 to

100% and averaged 86%.

In order to control for differing scene length and to

normalize the data, all coping and negative coping data









were subjected to Arcsin Transformations. A 5(Groups) x

2(Time) x 2(Type of Coping) x 4(Scene) repeated measures

analyses of variance was run on the transformed scores to

determine if different treatments made subjects more likely

to describe themselves coping successfully or unsuccessfully

with the situations presented to them in these target

scenes. These analyses revealed a significant Scene x

Type of Coping x Time interaction F(3,136) = 5.53, p < .002.

Further Duncan's indicated that at pretest there were more

positive coping elements used for the three anxiety scenes

than for the pretest practice scene, p < .05 (see Table 7).

At posttreatment more positive coping statements were made

by subjects to describe the three anxiety scenes than were

used to describe the practice scene, p < .05.

Because of the pre-post increase in the percentage of

positive coping elements used for both the medium and high

anxiety scene, additional follow-up pairwise T-tests were

conducted. This analysis revealed a highly significant

change for the medium anxiety scene from pre- to post-

treatment, p < .0001.

Additional pairwise T-tests were employed to determine

if there might be differences between the treatment groups

in the number of positive coping statements used to describe

the medium anxiety scenes. Every treatment group showed

significant increases in the number of coping statements

employed from pre- to posttreatment. This did not occur

for the control group.















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Similar analyses were conducted on the negative coping

statements. Duncan's revealed at pretest that all anxiety

scenes elicited more negative coping statements than did the

practice scene, p < .05. The high and medium anxiety scenes,

though not significantly different from each other, elicited

more negative coping than the low anxiety scene, p < .05.

At posttest, all anxiety scenes again evoked more nega-

tive coping statements than the practice scene, and the high

anxiety scene evoked more negative coping than both the

medium and low anxiety scenes. These two were not signifi-

cantly different from each other.

Because of the pre-post decrease in the percent of

negative coping elements used in the low, medium and high

anxiety scenes, additional follow-up pairwise T-tests were

conducted. This analysis revealed a highly significant

decrease for the medium and high anxiety scenes from pre-

to posttest, p < .01. The pre- to posttest change for the

low anxiety scene approached significance, p < .07.

Additional pairwise T-tests employed to determine if

there might be differences between the treatment groups in

the number of negative coping statements used to describe

the three anxiety scenes showed significant decreases on

the medium anxiety scene for both the individualized cop-

ing imagery group with relaxation and the academic coping

imagery group with relaxation, p < .05, and a decrease ap-

proaching significance for the individualized coping imagery

group without relaxation, p < .09. A significant decrease

occurred for the individualized coping imagery group combined









with relaxation on the high anxiety scene, p < .02). No

significant pre- to posttest decrease was made for the

academic coping imagery group without relaxation or the

control group on any of the scenes.

Pairwise T-tests were also conducted to ascertain

whether different scenes elicited more positive coping or

negative coping content. At pretest, more positive coping

statements compared to negative coping statements were pro-

duced by subjects responding to both the low and medium

anxiety scenes, p < .06. A similar pattern emerged at post-

test with positive coping orientation dominating in the

practice scene and the low and medium anxiety scenes,

p < .03.

A 2(Relax) x 2(Type of Imagery) x 2(Time) x 4(Scene)

analysis of variance was conducted to assess whether the

addition of relaxation or the type of imagery used differ-

entially contributed to the number of positive coping and

negative coping elements used. This analysis revealed a

significant Relax x Time interaction, p < .04. However,

follow-up analyses in the form of Duncan's and pairwise

T-tests revealed no significant differences between groups

or changes from pre- to posttest on this variable.















DISCUSSION


Treatment Outcome


It was evident from the results of this study that all

variations of individualized coping imagery treatment

brought about significant decreases in test anxiety as

measured by self-report anxiety questionnaires. In terms

of academic performance, two groups, individualized coping

imagery without relaxation and academic coping imagery com-

bined with relaxation, were significantly different from

the control group at posttest. The individualized coping

imagery treatment combined with relaxation and individualized

coping imagery treatment without relaxation brought about

significant changes from pretreatment to posttreatment

assessment on grade point average. Subjects receiving

academic coping imagery treatment alone manifested substan-

tial improvement on some measures of evaluative anxiety,

but subjects in this treatment were not able to achieve

significant increases from pretest to posttest on academic

performance and were not significantly better than waiting

list controls. While preventing subjects from deteriorat-

ing in academic performance, it appears that academic cop-

ing imagery treatment alone was not enough to bring about









consistently significant pretest to posttest increases in

grade point average.

Academic coping imagery treatment alone was clearly

the least efficient of all of the four treatments. At the

outset of the academic coping imagery treatment, subjects

experienced much difficulty employing their academic images

of competence to counter the anxiety evoking situations of

the hierarchy. They required significantly more hierarchy

scene exposures than subjects taking part in the other

three treatment groups. Initially, subjects reported they

had trouble producing and imagining these academic images

of competence clearly. Thus, while the decreases in test

anxiety were similar to those of other treatment groups,

it did not appear to be as efficient to institute and carry

out. It was also noteworthy that this group had the high-

est dropout rate of all four treatment groups.

When all variables are considered, individualized

coping imagery with or without relaxation appears to be an

effective treatment across the domains of anxiety self-

report measures, academic performance and treatment effi-

ciency. Similar consistent positive results were obtained

with academic images only when they were paired with

relaxation training.

The waiting list control group showed an increase in

self-report anxiety on two of the primary self-report

measures of evaluative anxiety and a significant decrease

in grade point average from pretreatment to posttreatment









assessment which is consistent with the findings of several

previous investigators (Harris & Johnson, 1980; Holroyd,

1976; Paul & Shannon, 1966). It appears that subjects who

are part of a waiting list control group run the risk of

further deterioration in academic performance and increases

in anxiety.

It is noteworthy that differences that were obtained

in both treatment efficiency and academic performance were

not reflected in differential expectations for improvement

at posttest; apparently, all treatments were viewed by

participants as equally credible and convincing.

The fact that there was no Group x Time interaction on

both the Social Avoidance and Distress Scale (Watson &

Friend, 1969) and the Fear of Negative Evaluation Scale

(Watson & Friend, 1969) is consistent with the findings of

Harris & Johnson (1980) and Spielberger, Anton, & Bedell

(1975), who found that while test anxiety treatment may

produce reduction in anxiety measures that were specific to

testing situations, such treatment may not result in gen-

eralized significant decreases on self-report indices of

social and evaluative fear.

The low correlations achieved between grade point

average and self-report anxiety measures in this study

points to the need for multiple measures in treatment

outcome studies of this type.

Consistent with previous findings, there were no dif-

ferences in the efficacy of treatment for men and women









taking part in this study. Although previous investigations

have found that women admit to more anxiety than men (Hersen,

1973), in this particular group of subjects who sought treat-

ment, there were no differences.

A significant finding to emerge from the results of

this study was that manipulating the type of imagery in-

struction employed does appear to result in differential

treatment effectiveness at least on some measures. This is

consistent with the findings of Kazdin (1973a, 1974) and

Lang (1977, 1979) that the content of imagery is very sensi-

tive to instruction. The hypothesis that the use of aca-

demic images of competence alone, derived from subjects'

academic achievements, would further promote generalization

through the employment of imagery highly relevant to test

taking and other academic stresses was not supported by

the results of the study. The magnitude of change for

individualized coping imagery based on nonacademic experi-

ences of competence and success was greater than that made

by academic coping imagery alone on grade point average.

While academic coping imagery treatment alone led to small

nonsignificant gains from pretest to posttest, in grade

point average, nonacademic individualized coping imagery

treatment produced a significant increase in academic per-

formance. It had been hypothesized that because academic

images of competence were highly relevant to test-taking,

it might therefore be a more efficient treatment. The

reverse appears to be the case.









An explanation for this finding may lie in the nature

of the coping imagery instruction itself. Critical to the

individualized coping imagery treatment is the direct

harnessing of highly individualized past performance ac-

complishments as coping skills and using them within the

context of the desensitization procedure to reinforce the

belief that highly test anxious individuals can cope ef-

fectively in stressful situations such as test taking.

Their past performance accomplishments are used to provide

evidence of this. By their nonacademic nature and their

lack of association with the stressor, nonacademic experi-

ences of competence and success evoke feelings of competence

and success, not fear and avoidance. In contrast, academic

experiences of competence and success are part of a class

of situations (academic or test taking) that for these

subjects have a potential to evoke fear and avoidance.

Thus, subjects may have more difficulty producing and

maintaining academic images of competence as part of the

desensitization procedure; as such, images are too closely

associated with the experience of test taking and its

concomitant anxiety. It is not surprising, given these

factors, that both treatment efficacy and efficiency should

be impaired.

As reported in the study conducted by Harris &

Johnson (1980), test anxious subjects have often indicated

in the course of their treatment program that their negative

thoughts are, for them, more vivid and perseverant than









their images of competence and proficiency. These negative

cognitions appear to have been overlearned and may be more

directly and parsimoniously countered by the overlearning

of highly individualized positive self-thoughts, images of

competence and proficiency that comprise the coping tech-

nique employed in the nonacademic individualized coping

imagery treatment. Thus, because of the close association

with the stressor, academic coping imagery may not be in-

herently as able to alter anxiety to the same degree as

treatments employing nonacademic coping images.

However, it appeared that the addition of relaxation

to the academic coping imagery treatment augmented both its

treatment efficacy in terms of grade point average and

treatment efficiency. Subjects required no more scene

presentations to complete the desensitization hierarchy

than participants in the two nonacademic coping imagery

treatment groups.

Previous investigators, among them Singer (1973, 1974);

Van Egeren, Feather & Hein (1971), have proposed that

relaxation plays an important role in increasing both the

vividness and overall treatment effectiveness of imagery

based techniques. Their conclusions emerged mainly from

case reports and therapist observations and had not been

subject to controlled assessment. It may be that because

relaxation training reduces distracting physical sensation

and thought (Lang, 1979); it may, in turn, enhance the

ability of subjects to approach stressful situations,









including imaging even potentially stressful coping re-

sponses. Thus, as a result, subjects may be able to ef-

fectively use this response in the subsequent anxiety evok-

ing hierarchy scenes, unencumbered by fear or avoidance.

In contrast, the addition of relaxation did not substan-

tially add to the power of nonacademic individualized cop-

ing imagery treatment.

As a result of this study, the basic hypothesis that

different imagery instructions could differentially affect

test anxiety and performance was confirmed. Indeed, changes

in the instructional content of the images employed showed

these treatments to be differentially effective in increas-

ing academic performance and treatment efficiency. Such

instructions appeared to be sensitive to experimental manipu-

lation with variations in these instructions (e.g., the

differences in instructions for individualized coping

imagery vs. academic coping imagery) producing changes in

overall treatment efficacy as measured by academic per-

formance and efficiency.


Imagery


Results of the imagery analysis suggest the absence of

any significant relationship between the use of relaxation

as part of treatment and the production of highly elaborate

hierarchy scenes as measured by the number of words used by

subjects to describe the target scenes. In addition, data

analysis did not uncover differences in this elaborateness










measure for any of the five treatment groups. It is to be

noted, also, that relaxation training did not increase

subjects' use of stimulus, response, positive coping or

negative coping elements as part of their scene descriptions.

While treatment did not appear to influence the elabor-

ateness of imagery produced, it appears that the target

scenes the subjects were asked to imagine and describe were

discriminative stimuli, evoking different patterns of im-

aginal responding. Subjects not only used more words in

describing the anxiety evoking scenes than they used in

describing the practice scene but used significantly more

response elements as well. Similarly, more positive and

negative coping statements were used to describe the

anxiety evoking scenes than the practice scene. These

findings are consistent with the results of desensitization

studies (Lang, Melamed, & Hart, 1970) which demonstrated

that subjects respond to anxiety scenes with increased

physiological arousal as measured by GSR, heartrate in-

creases, etc. Anxiety scenes may not only produce dif-

ferences in physiological responding but may lead to dif-

ferences in the subject's imagery content as well.

While the use of different imagery treatment instruc-

tions appeared to have given subjects increased control

over their anxiety and academic performance, it was found

that imagery based treatment alone did not differentially

change the number of stimulus or response elements subjects

used in their scene descriptions. It was found on all








variables that there was no significant difference for the

four treatment and one control groups in the elaborateness or

stimulus-response content of the images subjects produced.

On the other hand, there were significant differences

in content for both the number of positive coping statements

and negative coping statements subjects used to describe

these anxiety scenes. From pretreatment to posttreatment,

subjects significantly increased their use of positive cop-

ing statements for the medium anxiety scene. Further statis-

tical analysis revealed that this change could be accounted

for by significant increases in positive coping statements

employed by all four treatment groups. This increase in

positive coping elements was absent for the control group.

Similar analyses made for negative coping statements

revealed highly significant decreases in negative coping for

both the medium and high anxiety evoking scenes from pre-

to posttreatment. The decrease for the low anxiety evoking

scene approached significance. Further analysis demon-

strated significant decreases in negative coping on the

medium anxiety scene for individualized coping imagery and

academic coping imagery combined with relaxation and de-

creases approaching significance for the individualized

coping imagery treatment without relaxation. A highly sig-

nificant decrease in negative coping statements was made on

the high anxiety scene by the individualized coping imagery

group. There were no significant changes for either aca-

demic coping imagery treatment alone or the waiting list

control group.









An examination of the content of the images at pre-

treatment revealed more positive coping statements compared

to negative coping statements were produced by subjects

responding to both the low and medium anxiety evoking scenes.

At posttreatment, a similar pattern emerged with positive

coping orientation predominating for the practice and the

low and medium anxiety scenes.

Because positive coping imagery significantly increased

and negative coping imagery significantly decreased, this

finding suggests that it may be that changes in image con-

tent may also figure in the successful outcome of treatment.

Unlike the report of Lang and his associates (Lang,

1977, 1978) which suggests that increasing the response

orientation (increasing the number of response sentences)

of the individual is critical to imagery based treatment,

the results of this study suggest that changing the content

of the image to incorporate successful coping strategies

may be a more significant feature. More importantly, the

finding that significant decreases in negative coping

elements on the medium anxiety scene for the treatment

groups who attained the largest increase in grade point

average suggest that decreasing negative coping imagery may

even be more crucial to the successful outcome of imagery

based treatment than increasing positive coping imagery.

These findings are in line with the theoretical model

proposed by Wine (1971) and Ellis (1962) that negative

cognitions such as self-statements lead to performance









decrements. In Wine's view, it is the modification of

negative self-statements and the substitution of positive

ones that serves to decrease anxiety and enhance perform-

ance.

Examining imagery data is only one way of attempting

to assess behavioral and attitudinal change as a result of

treatment. One cannot be completely sure that images pro-

duced in an assessment situation are adequate reflections

of the emotional content of subjects' imagery in the natural

environment (such assessments are subject to the demand

characteristics of the situation). Yet this type of assess-

ment may offer some insight into the process of changing

the emotional content of imagery and its possible relation-

ship to effective behavior change.

Bandura, Adams, & Beyer (1977) and Averill (1973) have

proposed that in dealing with potentially aversive events,

it is the perceived inefficacy and incompetence in coping

with them that makes them so fearsome. This study has used

the vehicle of changing the content of the emotional image

to impart a significant sense of personal control.

This study has addressed a number of critical questions

about the nature of imagery produced and how man's image

making capacity can be put to the use of alleviating emo-

tional suffering. Enlarging on the work of other investi-

gators into covert phenomena, the individualized coping

imagery technique employed in this study not only afforded

significant relief from anxiety but also demonstrated that






77


concrete behavior change for the individuals involved in

this study could be achieved. While the use of imagery has

become an established therapeutic tool, the careful study

of the image may permit us a better understanding of the

process by which a cognitive treatment yields behavioral

or emotional change.


















APPENDIX A
PROPOSITIONAL UNITS OF THE EMOTIONAL IMAGE


A. Stimulus propositions (auditory, visual, tactile,
cutaneous, olfactory, vestibular, kinesthetic)
1) physical details of the object or situation
2) changes in object configuration
3) object movement (approach or withdrawal)
4) physical place or general location
5) presence or absence of others as observers or
participants
6) comments made by others
7) pain--location on the body; sharp, dull, etc.

B. Response propositions
I. Verbal responses
1) overt vocalization--out loud comments or
expressive cries
2) covert verbalizations
a) emotional labeling
b) self-evaluative statements, e.g., feelings
of inferiority
c) attribution of attitudes to others

II. Somato-motor events
1) muscle tension
2) uncontrolled gross motor behavior
3) organized motor acts--freezing, approach,
avoidance

III. Visceral events
1) heart rate and pulse
2) body or palmar sweat
3) vascular changes--blanching or flushing
4) pilomotor response
5) salivary response--mouth dry
6) respiratory change
7) intestinal upset
a) vomiting
b) incontinence
8) urinary dysfunction

IV. Processor characteristics
1) perception unclear or unusually vivid,
or distorted










2) loss of control over thoughts, cannot think
clearly
3) disoriented in time or space

V. Sense organ adjustments
1) general postural changes
2) eye and head movements







































Note: All hierarchy scenes described by the subjects
were coded for extensiveness and elaborateness of verbal
description, employing the image taxonomy presented above
and developed by Lang (1977).















APPENDIX B
INSTRUCTIONS TO THE EXPERIMENTER:
INDIVIDUALIZED COPING IMAGERY TREATMENT


This is the manual for the treatment of test anxiety

through the use of individualized coping imagery combined

with study skills training. This treatment is designed to

build an individualized structure which employs the individ-

ual's perception of self-competence as the primary coping

technique. In this treatment images of perceived self-

competence are incorporated into a covert modeling procedure

for the treatment of test anxiety. Six steps are involved

in the use of this technique.

1) Exploration of degree and extent of test anxiety of

subject

2) Presentation of rationale for treatment

3) Group discussion of possible success experiences of the

subject that can be transformed into images of competence

for use in this covert imagery procedure. This step also

includes discussion of treatment goals and problems

4) Construction of test anxiety hierarchy

5) Employment of covert imagery treatment

6) Study skills training









Treatment Schedule


Session One

1) Group introduction and exploration of degree and extent

of test anxiety for each subject (10 minutes)

2) Rationale described and treatment explained (10 minutes)

3) Beginning group discussion of possible success experi-

ences that could be transformed into images of competence

to be used as part of this covert imagery procedure (15

minutes)

4) Beginning construction of test anxiety hierarchy (10

minutes)

5) Study Skills step I--see Study Skills Manual (15

minutes)

Session Two

1) Brief review of treatment goals and questions--homework

assignment discussed (10 minutes)

2) Open discussion of problems, e.g., difficulty in coming

up with success experiences (15 minutes)

3) Completion of hierarchy of relevant anxiety evoking

situations, also training in visual imagery (20 minutes)

4) Study Skills Package step II (15 minutes)

Sessions Three through Eight

1) Brief review of homework assignment and any problems--

additions to the hierarchy should be incorporated (10

minutes)

2) Instructions in the use of individualized coping imagery

(25 minutes)









3) Homework assignment made (5 minutes)

4) Group discussion (5 minutes)

5) Study Skills training (15 minutes)


Procedures to be Followed


Exploration of degree and extent of test anxiety.

This beginning exploration should serve to establish a

warm relationship between therapist and subject and also

allow subjects to become acquainted with one another.

This procedure should help the therapist learn the duration,

extent and the severity of the subject's test anxiety. In

addition to using the material contained in the self-report

anxiety questionnaires, the therapist should seek to deter-

mine whether there are other interpersonal or evaluative

situations that make the subject anxious.

Rationale

It is essential that all individuals involved in this

treatment program comprehend and accept what treatment will

involve. In an attempt to clarify both the principles and

procedures behind the treatment interventions used, a brief

overview should be provided. The following format should

be used. The experimenter should say the following to the

subject:

I'd like to give you a picture of
the rationale for this treatment to ex-
plain the concept of anxiety and how anx-
iety relates to the test taking situation
specifically. Then I will describe all
the facets of the treatment program. We
are working under the basic premise that









the present anxiety you feel taking tests--
and in any sort of evaluative situation--
probably is linked (has a lot to do with) to
your past experiences in these situations.
You have probably have had bad experiences
in taking tests and these unpleasant ex-
periences and memories may have been rein-
forced by hearing other people describe
their unpleasant experiences with tests.
Along with these negative test taking
experiences you may have come to believe
that tests and doing well on them is very
important. Getting into Med School or
Grad School may be uppermost in your mind
and makes tests very important. In fact,
your bad experiences with test taking
might only have served to support this
notion.
Thus your emotions and feelings sur-
rounding test taking and evaluative situa-
tions often result in feelings of anxiety
that are probably out of line with the
situation and interfere with your func-
tioning on tests. Since your perceptions
of these anxiety arousing situations take
place within you--inside your head--we
can work with these reactions and percep-
tions during these sessions.
Many times in the course of your life
you are called on to do things that make
you tense and anxious. Someone says to
you--'here, try my new moped' and you've
never been on one before. You do have
an idea how it works, but mostly you know
that you're a darn good bike rider and you
call on the skills you have as a bike rider
to help drive the moped. (Tell other
example) You come into a chemistry class
and you see the beakers and all the chemi-
cals and you're scared, thinking how am I
going to mix the right amounts and come up
with the right results, but then you re-
member that you did a very good job of
mixing paints and colors (for an art class)
so you called on these skills and you did
measure all the chemicals out, and you did
complete the experiment without blowing
up the laboratory. Everyday you call on
competencies that you have established in
other areas and use them in new ways in
areas that might originally be anxiety pro-
voking. What we are going to do in these
sessions to help you alleviate test anxiety
is something like that. We're going to









develop your ability to use your previously
established competencies to handle the problem
of test anxiety. We'll examine your test
anxiety--when it occurs, how often, what
makes it worse, what makes it better. We'll
make a special kind of list of all the test
taking situations that make you react with
anxiety--it's called a hierarchy. You'll
learn to cope with these test taking situa-
tions--each one of you will develop several
individualized coping images and you will
be taught how to use these coping images
in contending with these test taking situa-
tions. This will be accomplished by using
your imagination. We know that the nervous-
ness, the anxiety, the tension involved in
taking tests is the same as the tension you
have mastered in the other skills in which
you are competent. In this treatment, we
want to show you that test taking and the
handling of the anxiety associated with it
is just a series of skills like anything
else. As you see yourself coping and
succeeding with trying difficult situations,
you'll imagine a series of graded situa-
tions that have to do with taking tests and
the anxiety related to test taking. This
technique has been shown to be successful
in helping people--students, like yourselves--
who are test anxious. Do you have any
questions?
In addition to working with this pro-
cedure we will spend some time in each
session talking and working out ways to im-
prove study skills. While you all study--
most of you would probably like to study
more efficiently--get more out of the time
you put in. Of course, more efficient
preparation for these courses will probably
result in fewer feelings of tension and
apprehension prior to and during exams.
During the next eight weeks, as part
of the study skills training we will follow
this approach.
During our first session, we will dis-
cuss exactly what study is and present a
method found useful in helping you estimate
the time you need for accomplishing the
objectives set forth in your courses, and
several other techniques useful in deter-
mining whether you are using your time
efficiently.
Week two will be spent detailing a
method of shaping study behavior and









techniques useful in increasing motiva-
tion to study. Week three will be devoted
to presenting the SQ3R method (Scan, Ques-
tion, Read, Recite, Review Method) of how
to read a book. Week four will cover the
efficient taking down and use of lecture
notes. Week five will be spent discussing
specific techniques useful in studying for
an exam, as well as procedures helpful in
avoiding the emotional turmoil sometimes
felt as you enter the examination situation.
Week six will be devoted to getting more
study in less time by the application of
stimulus control and response management
techniques. Weeks seven and eight will
serve to review the entire study counseling
program.
For each session, we will spend a brief
period discussing any problems or successes
you had applying the principles and tech-
niques discussed and learned the previous
week, including the process you make,
your use of the study principles, etc.
During this time, feel free to discuss any
material which was unclear to you or prob-
lems with any of the above topics.

Open Discussion Period

An allotment of time should be made at both the begin-

ning and end of each session for discussion about any prob-

lems concerning treatment. In the course of treatment, if

any questions about the hierarchy arise, they can be answered

during the discussion session. A homework assignment should

be given at each session which in the first two sessions

would consist of the subjects' recording their success ex-

periences for use in the covert imagery procedure. Assign-

ments in the last six sessions will center on the practice

in coping imagery and gaining proficiency in study skills.

Development of Anxiety Hierarchy

The development of the anxiety hierarchy is one of

the most essential parts of this treatment. Anxiety evoking









situations related to taking tests should be organized to

extend from those evoking very small, manageable amounts

of anxiety to those that arouse the most. These items

making up the hierarchy should be drawn from the subject's

responses to self-report inventories and from subject sug-

gestions during the sessions.

Sample test anxiety hierarchy. The following is a

possible sample of a temporal spatial hierarchy that could

be employed for these test anxious subjects:

1) Studying material for a final exam two weeks before the

exam

2) Discussing approaching test with friends a week before

it is to be given

3) Listening to the professor describe what is going to

be on the exam a week before it is to be given

4) Remembering how you felt about a test you took in the

past

5) Studying for the test in your room the night before

6) Reviewing study materials the morning before the test

7) Eating, getting dressed, etc. just before leaving to

take the test

8) Walking over to the classroom on the morning of the test

9) Entering the room the day of the exam

10) Waiting for the test to be handed out--you hear other

students talking about how hard the test will probably be

11) Reading the first question on the test

12) Seeing that the test is longer than expected









13) Seeing a question that you can't answer

14) Seeing test questions on material that you didn't study

Any hierarchy that is developed should incorporate

all anxiety provoking elements relating to tests and test

taking that the group shares. This hierarchy should not

be excessively long with a maximum of 25 items contained

within in.

Training in Visual Imagery

Before work in using the individualized coping imagery

begins at the start of the third session, some preliminary

training in visual imagery should be conducted probably at

the end of the second session. A sample stimulus item to

imagine vividly could be offered such as:

Visualize yourself shopping in Publix or
Winn Dixie. Tell me what you see. Is
your image clear--is it black and white
or is it in color. Where are you in the
store--on the frozen food aisle, or near
the soda or cheese.

It might be useful to have subjects think of their images

as if they were watching a movie in which he/she is the

principle actor. It should be emphasized that they should

not see themselves as in a mirror image, rather as if they

are there--as active participants in all the action.

While some subjects may have no difficulty in imagin-

ing these stimulus scenes clearly, others may experience

difficulty. The therapist should emphasize that this

imagining is a skill, like relaxation, and improves with

practice. Before proceeding with the actual use of the

individualized coping imagery, the therapist should










present a few more nonanxiety evoking scenes to imagine,

e.g., eating an ice cream cone or lying on a beach.

Upon embarking upon the actual use of the individu-

alized coping imagery in the third session, subjects

should again be informed of what will occur during this

process in order to clear up any uncertainties the subjects

may have.

Individualized Coping Imagery Treatment

This group should receive the same study skills

training as the other groups. In this treatment group,

an attempt should be made to build an individualized

structure which employs the subject's perception of self-

competence as the primary coping technique. For this

treatment group, highly personalized previously estab-

lished images of competence and proficiency achieved by

the subjects in stressful environments other than test

taking should be paired with the visualization of anxiety

eliciting scenes that comprise the test anxiety hierarchy.

The first two sessions should be focused on a group

discussion of possible success experiences of the subjects

that can be transformed into images of competence for use

in this covert imagery procedure. There should be no

training in progressive relaxation as part of this treat-

ment. In sessions one and two, hierarchy construction

should be carried out in this group as it was in the other

three groups. In sessions three to eight the actual










treatment procedure should be carried out. Using these

previously established images of competence, subjects

should be presented with the test anxiety hierarchy items.

With each item subjects should be instructed to: 1) imag-

ine themselves coping with their tension by seeing them-

selves performing well in their personalized coping image

and 2) then to transpose the same competent and confi-

dent person of the personalized coping image to the im-

aginal anxiety provoking situation presented in the

hierarchy.

The subject should be instructed to imagine this

same competent person of his individualized coping image

now contending with test situations as they appear in the

hierarchy.

In the individualized coping imagery treatment,

each item on the hierarchy should be presented for a

minimum of two times. The length of item presentation

would either be 60 seconds or the amount of time for all

individuals in the group to imagine the item for a 20

second anxiety free period. However, if a subject signals

anxiety after the second exposure, the items should be

repeated until no subject signalled anxiety when imagin-

ing this item. In order to control for the divergent

elements of the two treatment procedures, the same

hierarchy of anxiety evoking scenes should be






90


employed in all variations of individualized coping imagery

treatment.















APPENDIX C
INSTRUCTIONS TO THE EXPERIMENTER:
INDIVIDUALIZED COPING IMAGERY TREATMENT
COMBINED WITH RELAXATION


This is the manual for the treatment of test anxiety

through the use of individualized coping imagery combined

with relaxation and study skills. This treatment is de-

signed to build an individualized structure which employs

the individual's perception of self-competence as the pri-

mary coping technique. In addition, relaxation training is

employed to determine if it enhances treatment effects.

Seven steps are involved in the use of this technique:

1) Exploration of degree and extent of test anxiety of

subject

2) Presentation of rationale for treatment

3) Group discussion of possible success experiences of

subject that can be transformed into images of competence

for use in this covert imagery procedure. This step also

includes discussion of treatment goals and problems.

4) Construction of test anxiety hierarchy

5) Progressive relaxation training

6) Employment of covert imagery treatment

7) Study skills training

With the exception of the use of progressive relaxation

training, all aspects of this treatment are identical to









that of individualized coping imagery treatment without

relaxation (see Appendix B). The progressive relaxation

instructions which follow were adapted from Susskind (1970)

to be used in combination with individualized coping imagery

treatment.

Instructions in relaxation. The room in which instruc-

tion in progressive relaxation takes place should be at a

pleasant even temperature. Before relaxation begins, the

lights should be dimmed, subjects should be seated in com-

fortable chairs. Subjects should then be asked to close

their eyes. The Muscle-Relaxant Method is as follows:

Please lean back in your chairs. Place
both feet on the floor. Close your eyes.

Now, stretch your legs as far as they
can go. Turn your toes under and tighten
the muscles, very, very tight. Hold it. And
now also tighten the muscle in your calves
and those in your thighs. Make your entire
leg tight as a drum, and hold it, hold it,
hold it. And now, let your legs sink down
and relax all the muscles in your calves,
all the muscles in your thighs. Let your
legs go completely limp. And now, feel
that wonderful relaxation coming up from your
toes, up your calves, and your thighs. Feel-
ing wonderfully relaxed, beautifully relaxed,
very calm, very relaxed. Feeling beautiful,
just beautiful, wonderfully relaxed.

Now I want you to stretch out your hands.
Make a fist, Feel the tightness, and now
make it tighter, tighter, tighter. Hold it.
And now also tighten the muscles in your
wrist, in your forearm, in your upper arm.
Hold it. Hold it. And now, let go, just let
go, let your arms sink down and get that
wonderful feeling of relaxation, right through
your fingers, your hands, now through your
forearm, and upper arm. Let your arms go
completely limp. Feeling wonderfully relaxed,
beautifully relaxed, very calm, very relaxed
and beautiful, just beautiful. Now, I want
you to arch your back backwards, raise your









chest, and tighten your stomach muscles,
and those in your neck. Make them as tight
as you can, tighter, tighter, tighter.
Hold it, hold it, hold it. And now, let
go, just let go, and you get that wonderful
feeling of relaxation. Just feel the muscles
relax from your back, from your neck, from
your chest, from your stomach, all over your
back, all your muscles are feeling wonder-
fully relaxed.

And now, I want you to tighten the mus-
cles in your face, around your mouth, the
muscles in your chin, around your eyes and
your forehead. Make them tighter, tighter,
tighter, hold it, hold it, hold it. And
now, let go, just let go, let go and get that
wonderful feeling of relaxation, from all
the muscles in your forehead, the muscles
around your eyes, the muscles of your cheek,
the muscles of your chin and the muscles
around your mouth, feeling wonderfully relaxed,
beautifully relaxed, very calm, very relaxed,
wonderfully relaxed.

Now, I want you to take a very deep breath
and hold it, hold it, hold it. Now, slowly,
let it out, and you're letting out all your
tensions, your frustrations, your anxieties,
feeling wonderfully well, wonderfully well,
wonderfully well.

Once again, take a deep breath, a very deep
breath, hold it, hold it, hold it. Now, slowly,
slowly, let it out, relax your tensions, your
frustrations, your anxieties, feeling wonder-
fully well, wonderfully well, wonderfully well.

Now as I count down from 10 to 1, think
of the scene that makes you feel calm, that
makes you relaxed, and that gives you a feel-
ing of well-being.
(pause 10 seconds)
Now, with your eyes closed, see that scene, in
all its details, and as I'm counting down from
10 to 1, you are going to find yourself deeper
and deeper relaxed and you will have a feeling
of well-being. Calm and relaxed, and wonder-
fully well, just relax.

I'm going to count, 10...., 9...., very deep,
8...., 7...., deeply relaxed, 6...., 5...., very,
very, deep, deeply relaxed, 4...., 3...., very




Full Text

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I A COMPARISON OF SEVERAL DIFFERENT IMAGERY INSTRUCTION PROCEDURES FOR THE TREATMENT OF TEST A N XIETY BY GINA M. HARRIS A DISSERTATION PRESENTED TO THE GRADUATE COUNCIL OF THE UNIVERSITY OF FLORIDA IN PARTIAL FULFILLMENT OF THE REQUIRE M ENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY UNIVERSITY OF FLORIDA 1980

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This dissertation is dedicated to my parents, Caroline and Harold Harris, the sustaining force of my life. Gina M. Harris October 10, 1980

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0 0 z ACKNOWLEDGMENTS I would like to thank my dissertation advisor and dissertation committee chairperson, Dr. Suzanne Bennett Johnson, for the guidance, continued support and incisive criticism she offered during all phases of this disserta tion project. I greatly appreciate the assistance offered by members of the dissertation committee: Dr. Hugh C. Davis, Dr. Everette Hall, Dr. Janet Larsen and Dr. Benjamin Barger for their thoughtful reading of my manuscript. I am greatful to Mr. Michael DeGennaro for assistance with the data analysis, and appreciation is also expressed to Dr. Randy Carter for statistical advice. I wish to thank Leslie Dubin, Elizabeth Haughney, Andrew Kerr, Mark Miller, Linda Nissenoff, Dan Rosenthal and Kevin Stempel who served as raters in this study. iii

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ACKNOWLEDGMENTS .. ABSTRACT . INTRODUCTION TABLE OF CONTENTS PAGE iii vi 1 The Current Use of Imagery in Behavior Therapy. 5 Should the Image Be Studied?. . . . . 15 How Should the Image Be Studied?. . . . 18 METHOD Design. Subjects. Measures. Treatment .... General Procedures. Treatment Manipulations RESULTS ..... Analysis of Treatment Effects. ..... Expectations for Improved Academic Performance. Treatment Efficiency: Speed of Hierarchy Completion. . .... Imagery Analyses ..... DISCUSSION Treatment Outcome Imagery ..... APPENDICES A B C PROPOSITIONAL UNITS OF THE EMOTIONAL IMAGE ... INSTRUCTIONS TO THE EXPERIMENTER: INDIVIDUALIZED COPING IMAGERY TREATMENT. INSTRUCTIONS TO THE EXPERIMENTER: INDIVIDUALIZED COPING IMAGERY TREATMENT COMBINED WITH RELAXATION ....... iv 30 30 31 31 38 39 41 45 45 54 55 55 66 66 72 78 80 91

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D E INSTRUCTIONS TO THE E X PERIMENTER: ACADEMIC COPING IMAGERY TREATMENT INSTRUCTIONS TO THE E X PERIMENTER: ACADE M IC COPING IMAGERY TREATMENT COMBINED WITH RELAXATION ..... F GENERAL INSTRUCTIONS FOR THE ADMINISTRATION 95 100 OF INDIVIDUALIZED COPING IMAGERY TREATMENT. 101 G H GENERAL INSTRUCTIONS FOR THE ADMINISTRATION OF ACADEMIC INDIVIDUALIZED COPING IMAGERY TREATMENT ........ STUDY SKILLS THERAPIST MANUAL. REFERENCES ... BIOGRAPHICAL SKETCH. V 103 105 145 156

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Abstract of Dissertation Presented to the Graduate Council of the University of Florida in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy A COMPARISON OF SEVERAL DIFFERENT IMAGERY INSTRUCTION PROCEDURES FOR THE TREATMENT OF TEST ANXIETY By Gina M. Harris December 1980 Chairman: Suzanne B. Johnson Major Department: Clinical Psychology The primary purpose of the present study was to assess the effectiveness of different imagery instruction procedures for the treatment of test anxiety. In this study, a com parison of the efficacy of instructing subjects in indi vidualized coping imagery treatment based on nonacademic experiences of competence and success and individualized coping imagery treatment based on academic experiences of competence and success was carried out. Another purpose of the study was to assess how effective instruction in relaxa tion is in increasing overall treatment effectiveness of individualized coping imagery treatment. This study also sought to assess whether the elaborateness and content of imagery were related to overall treatment effectiveness. It was evident from the results of this study that all variations of individualized coping imagery treatment vi

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brought about significant decreases in test anxiety. In terms of academic performance, two groups, individualized coping imagery without relaxation and academic individual ized coping imagery with relaxation, were significantly different from the control group at posttest. Individual ized coping imagery treatment alone and individualized cop ing imagery treatment combined with relaxation brought about significant changes from pretreatment to posttreatment on grade point average. Academic individualized coping imagery alone did not change significantly on this measure of academic performance. The waiting list control group decreased on grade point average. In addition, the findings of this study suggest that changing the content of emotional imagery may be an impor tant factor in bringing about a successful treatment out come. It appears that decreases in negative coping imagery and increases in positive coping imagery figured strongly in treatment success. vii

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INTRODUCTION Psychological historians could construct a story of the development of psychology and its critical methodological problems based on attempts to investigate the image. Scrutiny of the image was one of the first areas to be explored by psychologists and, some have argued, one of the greatest impediments to its development as a science (Holt, 1964). Man's fantasy and the images of his mind dominated the philosophy and poetry of the 20th century. The stream of consciousness, the internal monologue, was the major charac teristic of the important literature of the day. James Joyce in his book Ulysses (1922) made the stream of con sciousness the most discussed and influential literary technique of our era. Amy Lowell and her followers (Sanders, Nelson, & Rosenthal, 1972) known as the imagists, composed in vers libre and expressed ideas and emotions exclusively through a succession of precise and clear images. The de velopment of Freudian psychology was also dominated by the stream of consciousness (Robinson, 1976). Psychology from the perspective of its early leaders, Wundt, Kulpe, Titchener, etc., was concerned with more than external stimuli; it embraced images, dreams, feelings, memories--the stuff that consciousness is made of (Marx & Hillix, 1973). Thus the basic task of the psychologist 1

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2 was to understand the structure and content of the human mind by means of systematic introspection. The technique involved a carefully worked out procedure in which highly trained subjects were to report the immediate content of ex perience rather than to describe events that led to produce the experience. Writing in 1898 Titchener stated: The primary aim of the experimental psycholo gist has been to analyze the structure of the mind, to ravel out the elemental processes from the tangle of consciousness, or (if we may change the metaphor) to isolate the constitu ents of a given conscious formation .. The aim of the psychologist is three fold. He seeks (1) to analyze concrete (actual) men tal experience into its simplest components, (2) to discover how these elements combine, what are the laws which govern their combina tion, and (3) to bring them into connection with their physiological (bodily) conditions. (Marx & Hillix, 1973, p. 15) Although Wundt, Titchener and Kulpe were greatly in trigued by the study of the stream of thought and man's mental imagery, the introspectionists made little progress in advancing the knowledge of psychology. "It died of narrow dogmatism, a disease which no school of psychology can long survive. Structuralism lacked the support of practical application and connections to other areas of psychology; its demise was mourned by few" (Marx & Hillix, 1973, p. 135). The early objective behaviorists under the leadership of John Watson not only stymied the efforts of Titchener and his associates but offered an alternative. In contrast to Wundt and Titchener, Watson focused exclusively on

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3 objective, observable and quantifiable behavior. He saw mental processes, images and thoughts as not scientifically legitimate precisely because they were not objective, ob servable and quantifiable (Craighead, Kazdin, & Mahoney, 1976). Writing in 1924, Watson stated that consciousness was "neither a definite nor usable concept" (p. 2). Captur ing the attitude of the objective behaviorists towards the study of the elements of consciousness, Boring in 1937 wrote: Having understood, tough-minded rigorous thinkers will, I think, want to drop the term consciousness altogether. A scientific psy chology is scarcely yet ready to give im portance to so ill defined a physiological event as an awareness of an awareness. This concept might never have come to the fore had not people tried to interpret others in terms of their own "private" minds--that egocentric Copernican distortion which properly leads to desolate solipsism. (Marx & Hillix, 1973, p. 135) Thus, behavioral psychologists such as Watson felt that "mental images are ghosts with no functional significance" (Watson, 1913, p. 158). Experimentalists of the behavior ist school saw only the sensation-related aspects of imagery as suitable subjects for experimental study because they were closest to objective stimuli. While American psychologists were abandoning their efforts to study covert phenomena, it was Freud and the European psychologists who continued to explore the meaning of our private world, our dreams, daydreams, aspirations, images of violence and love. Psychoanalysis was essentially Freud's attempt to scientifically and systematically study

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4 the inner world (Holt, 1964). However, Freud's attempt to formalize the psychoanalytic method as a means to scienti fically study the private world did not meet with great success. Its dependence on the role of the therapist, his judgment and experience, inevitably led to the growth of many splinter groups who believed that what they experienced in their patients was both different and more accurate than what was experienced by their Freudi~n counterparts. The development of multiple schools of therapy--the Jungians, Adlerians, Horneyans, Humanists, etc., pointed up the basic problems in attempting to explain components of man's inner life using traditional clinical methods. In addition, Freud did not create any viable way to test his theory, leaving it open to a wide range of interpretation (Marx & Goodson, 1976). After the study of imagery by Titchener's students waned in the first decade of the twentieth century, few scientific efforts were made in this area for close to 50 years. As late as 1965, prominent researchers in the area of verbal learning were underplaying or avoiding considering the function of images in mediating associations between words (Paivio, 1969). However, a review of the clinical literature of the past 20 years reveals that imagery is very much present and alive. This resurgence of interest in imagery, fantasy and hallucination appears due to the efforts of, interestingly enough, not of the Freudian psychologists, but of the

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5 behavioral psychologists who previously had cast out imagery as a topic for serious study. Thus, while behaviorally oriented psychologists have been uncovering important principles about reinforcement contingencies in the en vironment, they have also begun to explore the capacity for imagery production in man and the uses to which this image-making capacity can be put to alleviate emotional suffering. The Current Use of Imagery in Behavior Therapy This resurgence in the use of imagery by behaviorists is best exemplified by reviewing some of the behavioral techniques that appear to be dependent on imagery. Although much of behavioral treatment utilizes the production of overt responses such as the operant condition ing methods derived from Skinner's investigations or Bandura's modeling techniques, an ever increasing number of behavioral procedures are based on the clients' use of imagery. Indeed, the most frequently employed of all be havioral modification methods is the systematic desensi tization procedure of Wolpe (1958) in which it is claimed that the production and use of imagery is a critical com ponent (Wilkins, 1971). As part of this treatment, the patient is asked to produce a hierarchy of imaginal fear provoking events (Wolpe, 1958). These situations are intended to approximate real-life stimuli or performances which currently evoke a high level of anxiety (e.g., making

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6 a speech). A list or hierarchy of these situations is then built in which the imaginal scenes are ordered according to their capacity to produce anxiety. The patient then under goes an extensive period of training in relaxation which promotes an increase in the potential to produce imagery under conditions of reduced arousal (Singer, 1974). The efficacy of systematic desensitization as a behav ioral procedure has received much research scrutiny. A multitude of reports, monographs, and controlled investiga tions corroborate its effectiveness (Bandura, 1969; Paul, 1969; Wilson & Davison, 1971; Davison & Wilson, 1973). However, large questions still remain concerning why it is effective and what are the major ingredients contributing to its success. It is generally agreed that Wolpe's counterconditioning explanation for desensitization's efficacy is insufficient. Investigations have revealed relaxation to be a useful but not critical component for treatment suc cess (Wilkins, 1971). In fact, a number of behavioral psychologists (Mahoney, 1974; Paul, 1966) have claimed that the production of imagery appears to be the crucial component of desensitization. Mahoney (1974), for example, states that although in vivo hierarchies have been utilized, the predominant stimulus modality is covert. Behavioral psychologists such as Gordon Paul (1966) have underscored the necessity for the client to visualize himself in the anxiety-evoking situation, not as if he were seeing himself in a movie, but as if he were fully

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7 participating in all the action. In his desensitization instructions, Paul emphasized the importance of the client producing stimuli-laden images, drawn from all the sense modalities in an attempt to make the irnaginal scene as close to the actually experienced anxiety evoking situation as possible. Yet Paul did not attempt to evaluate the neces sity for multisensory images empirically. For all its presumed importance in the systematic de sensitization technique, behaviorally oriented psychologists have devoted little empirical attention to exploring the importance of imagery in desensitization. Like the Freudian psychologists before them, behavioral psychologists have used imagery as a therapeutic tool but have ignored many of the critical questions about the nature of the imagery pro duced. Indeed, while other components of desensitization, such as progressive relaxation, have undergone exhaustive scrutiny and refinement, the scientific energy devoted to examining the importance of imagery has commenced only recently (Lang, 1977). This same phenomenon has occurred with other thera peutic approaches presumably derived from classical condi tioning and reinforcement models. While systematic de sensitization is the behavioral technique that has been applied most frequently and with substantial success for a variety of fears and phobias, a number of therapeutic approaches utilizing imagery have emerged. Emotive imagery, covert sensitization, covert reinforcement, implosive

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---------8 therapy, covert modeling have been in wide use. It is generally assumed that imagery is an important component of these techniques; however, little scientific energy has been expended to explore whether imagery is crucial. Emotive imagery, growing out of the counterconditioning idea, was employed by A.A. Lazarus and his associates (Lazarus & Abramovitz, 1962; Lazarus, Davison & Polefka, 1965) for the treatment of children's anxieties because of the difficulties they experienced in teaching children progressive relaxation. In this technique, the children were instructed to imagine "stronger and stronger phobic stimuli woven into progressively more enjoyable fantasies" (Lazarus, 1971, p. 211). The assumption of this procedure was that the positive feelings evoked by the fantasy would compete successfully with the anxiety-arousing stimuli until these stimuli would become conditioned to feelings incompatible with fear. An example is provided by Lazarus (1971) who treated an eight-year-old boy experiencing fears when visiting the dentist: The sequence consisted of having the child picture himself accompanying Batman and Robin on various adventures and then imag ining them receiving dental attention. He was asked to picture this scene at least five times daily for a week. Next, he was to imagine himself in the dentist's chair while Batman and Robin stood by and observed. He also practiced this image several times a day for one week. He visited the dentist the following week, and according to his mother, he sat through four fillings without flinching. (p. 211)

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9 However, in emotive imagery treatment, as in desensitiza tion, the importance of imagery in bringing about behavior change has not been subjected to empirical scrutiny. Covert sensitization, an imaginally based variant of aversive counterconditioning, is another of those behavioral interventions which assumes imagery to be a crucial compo nent. Covert sensitization has been used to modify behavior such as sexual deviance, smoking, alcoholism and overeating (Jones, 1969; Rachrnan & Teasdale, 1969). In covert sensitization, images which evoke extreme disgust, unpleasantness are employed (Cautela, 1967; Davison, 1968; Lazarus, 1958). After having undergone progressive relaxation, the client is instructed to imagine himself about to engage in the reinforcing deviant behavior, e.g., smoking, drinking, pedophilia, etc., and then to imagine that he feels both nausea and disgust in response to previously reinforced activities. Cautela (1970) has employed a covert reinforcement technique for the alleviating of fears and phobias. Al though purportedly having its origins in the reinforcement model, it bears a marked similarity to the emotive imagery techniques of Lazarus. As part of his procedure, a number of reinforcing images such as activities the client fre quently enjoys doing are first elicited by the therapist. In the next step in this treatment, the client is instructed to imagine "a difficult but desired response sequence" such as asking a girl for a date and then to imagine himself

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10 in one of the reinforcing images. Covert reinforcement has been used to modify evaluative anxieties (Cautela, 1970; Wisocki, 1973; Kosta & Galassi, 1974; Chang-Liang & Denny, 1976), snake phobia (Marshall, 1975) and to improve the self concept of emotionally disturbed children and psychiatric patients (Krop, Calhoun, &Verrier, 1971; Krop, Perez & Beaudoin, 1973). Cautela has proposed that covert re inforcement enables the client to more easily imagine the target behavior; ultimately this result is transferred to dealing with the target situation in real life. In covert reinforcement techniques, as in desensitization, little attention has been devoted to determine whether imagery is indeed a crucial component of the procedure. Another of the behavioral techniques which relies heavily on the use of imagery is implosive therapy. In this technique, presumably based on the principles of extinction, the client receives repeated exposure to intense anxiety evoking stimuli, imagining the worst possible outcome of a particular fear or obsession. It is assumed that anxiety will first greatly increase and precipitously decrease as the person is exposed to increasingly elaborate versions of fear provoking stimuli. However, the evidence for the ef fectiveness of implosive therapy is only equivocal (Morganstern, 1973), and there is little knowledge of the possible mechanisms of behavior change. Various investiga tions have suggested "extinction, adaptation level, fatigue, modeling, habituation, cognitive rehearsal and

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11 discrimination," as possible mechanisms (Smith, Dickson, & Sheppard, 1973, p. 358), but the imagery component has never been empirically studied. As a rule, investigations have not sought to discover if the imagery component of these treatments reliably adds something in addition to the other techniques employed as part of the treatment. Further, these imagery based be havioral treatments such as covert reinforcement, emotive imagery, covert sensitization, implosive therapy, etc., have usually been employed in combination with other treat ment procedures, e.g., study skills (Wisocki, 1970, 1973; Cautela, 1970; Kendrick & McCullough, 1972; Lazarus, 1971; Prochaska, 1971). Moreover, most studies exploring the efficacy of behavioral imagery treatments have frequently employed self-report inventories as the sole indices of improvement, often when more reliable behavioral measures were available. Thus, for the most part, the empirical evaluation of these techniques has been limited. A tech nique that has received greater empirical evaluation is covert modeling. Covert modeling is a behavioral imagery based procedure in which the client is "directed in the symbolic rehearsal of appropriate behavior" for a difficult performance task or a feared situation (Mahoney, 1974, p. 112). Here too, im agery is assumed to play a critical role in treatment. The results of studies suggest that covert modeling is effective in alleviating avoidance behavior (Kazdin, 1973a; Cautela,

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12 Walsh, & Wish, 1971; Flannery, 1972b). In some of these studies there was a definite effort on the part of the ex perimenter to instruct the subjects in the sort of imagery that should be used (Kazdin, 1974; Cautela, Flannery, & Hanley, 1974). In fact, studies of covert modeling are among the few that have attempted to manipulate the content of the imagery produced (Cautela, Flannery, & Hanley, 1974). However, most studies have been of a laboratory analogue nature. Therefore, we do not know how effective they are with actual patient populations. Moreover, the active therapeutic components are still unclear. Covert phenomena and imagery based treatment has been a subject of so much interest that an entirely new arena of inquiry and controversy, cognitive behavior therapy, has been opened (Meichenbaum, 1977). Nevertheless, while im agery based therapies have been used widely, carefully con trolled assessments and refinements of these therapies "have lagged embarrassingly behind clinical applications" (Mahoney, 1974, p. 117). One reason for the paucity of controlled assessments of the importance of imagery in these therapies may be the presence of substantial methodo logical difficulties and procedural inadequacies in studying covert phenomena. The first and most obvious methodological difficulty in studying imager y in the therapeutic process is that images are private events, available only to human introspection. Lang in 1977, sounding ver y much like Watson in 1924, states, "As their observation cannot be shared nor

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13 their dimensions measured by any instrument, they cannot be data in a scientific analysis" (Lang, 1977, p. 862). The image cannot be observed, tasted or touched. Because it is so difficult to study the image, many areas deserving of research scrutiny have consequently been neglected. Singer (1974) points out that in scientific in vestigation of therapies incorporating imagery, investiga tors have not been attuned to "the fluid character of fan tasy, the rapidity of shifts away from the assigned image or the various covert antagonisms that may occur in the course of presumably attempting to produce imagery on de mand'' (p. 235). Weitzman (1967) observes that within de sensitization treatment, the image is not a static entity but is so fluid that it is often quite different from the image called for by the specific item in the hierarchy. Different images may impinge on the desired images. Persons and events, frightening or not, unconnected with the present scene to be imagined, may impose themselves on the scene the patient is trying to imagine. Further, therapists and investigators have tended to ignore crucial differences between individuals' imaginative ability which could ha v e a significant effect on determining which patients could benefit from imagery based treatments. Such knowledge of differences could also signal the therapist that some patients require added instruction and skill in producing imagery. The possible use of pretreatment practice in imagery, with the exception of the work of a few recent

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14 investigations (Lang, 1977), has been too little explored. Indeed, there has been little attempt to employ even paper and-pencil imagery assessment techniques to aid in the assessment of patients. While depending greatly upon the client's producing images in the imagery based treatments, experimenters have paid little attention to the characteristics the imagery produces or whether it is being produced at all. In all these treatments, whether systematic desensitization, im plosive therapy, covert sensitization, etc., the therapist assumes that the client is actually imagining the desired image and not just saying he is. During such treatment, the patient can choose whether or not to cooperate with the procedures employed. Wolpe and Lazarus (1966) cite cases in which patients fail to cooperate with desensitization treatments by introducing negative thoughts or unpleasant images into the imaginal sequence. Therefore, an underlying methodological problem appears to be the experimenter's lack of control over the client's production of imagery. Because of difficulties in studying the phenomena, there has been a lack of research attention paid to the importance of the vividness and affective intensity of the imagery produced. These data,which could be obtained through physiological and self-report measures, could impart extremely vital information bearing on imagery processing during therapy.

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15 Should the Image Be Studied? Given these substantial methodological difficulties, does it make sense to study the elusive image, to system atically explore covert phenomena? Researchers, theorists and social critics as diverse as Mahoney (1974, 1977), Lang (1977, 1979) and Mumford (1967) propose that it does indeed make sense to study imagery as a very significant component of human thought. To dismiss the most central fact of man's being because it is inner and subjective is to make the hugest subjective falsification possible--one that leaves out the really critical half of man's nature. For without that underlying subjective flux, as experi enced in floating imagery, dreams, bodily impulses, formative ideas, projections and symbols, the world that is open to human experience can be neither described nor rationally understood. When our age learns that lesson, it will have made the first move toward redeeming for human use the mechanized and electrified wasteland that is now being bulldozed at man's expense and to his permanent loss, for the benefit of megamachine. (Lewis Mumford, 1967, pp. 75-76) Despite the current interest in exploring the image as a subject for scientific study and as a therapeutic tool, there are a number of critics, e.g., Rachlin (1977a), who question whether scientific energies are well spent ~xplor ing covert phenomena. This controversy concerning whether it makes sense to study mental imagery was brought into sharp focus by a de bate between Rachlin and Mahoney in 1977. While Rachlin

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16 argued that "it is not necessary to refer to thoughts or cog nitions at all" (Rachlin, 1977c, p. 661), seeing observable behavior as sufficient, Mahoney took the position that the "dichotomy between observed and inferred events is an arti ficial one. It implies that there are some stimuli which register directly with our sense and these somehow are more real, legitimate or scientific" (1976, p. 674). Mahoney sug gests that all stimuli, overt or covert, are mediated. He proposes that no stimulus impinges on the sensorium without undergoing the transforming and constructive process that is human perception. He further suggests that the "Doctrine of Immaculate Perception," which implies that some stimuli are apprehended without undergoing the mediating influences of constructive perceptual processes is "wholly untenable and it has long since been abandoned by its staunchest philosophical defenders" (p. 674). "No one has ever directly seen a pure, unedited stimulus; human perception is a con structive process" (Mahoney, 1976, p. 674). In contrast, Rachlin (1977b) argues that while per ception may be constructive, while thoughts and images may occur, "the tactic of inferring events inside the organism has not led to coherent prediction or control of behavior or in useful therapeutic techniques" (1977a, p. 680). The data provided by observable phenomena have the virtues of "parsimony, simplicity and theoretical consistency," ( 1977b, p. 373) will suffice. Writing in response to Mahoney, Rachlin stated:

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17 I would abandon my non-mediational position when it proved inadequate to predict and control behavior and when a mediational position was shown to be: {A) at least as coherent {B) at least as applicable in the laboratory (C) at least as applicable in every day life (D) at least as applicable in therapy. (1977a, p. 681) Mahoney continues to contend that the study of covert phenomena, images, thoughts, etc., do improve our predic tion, understanding and control of behavior and hence should continue to be studied. There are a growing number of psychologists who share this attitude. Most investigators do acknowledge that the image is very difficult to study. They all seem to be in agreement that it forms "that part of human behavior which is so private and close to the self as to belie effective scientific scrutiny in an age of operationism" (Singer, 1973, p. 385). However, spurred on by great progress in the fields of neurophysiology, sensory deprivation (Hebb, 1949) and dream research (Aserinsky & Kleitrnan, 1953) and by the "new look at man as an information processing or ganism brought on by computer theory" (Singer, 1973, p. 385), investigators from both cognitive and clinical psychology have recently begun to direct their efforts towards a re evaluation of imagery as a cognitive phenomena and as a therapeutic tool.

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18 How Should the Image Be Studied? Assuming we are going to study the image, can we define it? The problem of defining the image has been made particu larly difficult because ''we know nothing about any form or structure that the image might possess or reside in" Bugelski, Kidd, & Segman, 1968). Investigators have used expressions as diverse as "pictures in the mind," "impressions made upon a plastic substance" (Tichener, 1912) or "the petri fied product of perceptual functions" (Kluver, 1932) in an attempt to describe and define what is essentially a hypo thetical, implicit and nonobservable cognitive product. Psychologists have offered a number of definitions of imag ery. Some investigators studying the image have defined it from a sensory perceptual (Singer, 1974) or a constructional perspective (Pylyshyn, 1973; Lang, 1977), while still other investigators appear to be studying the image without offer ing any explicit definitions (e.g., Paivio, 1971). Working from the sensory-perceptual perspective, psy chologists such as Singer (1973, 1974) propose that "the image represents man's capacity to duplicate environmental information in the absence of the persistence of external signals" (1973, p. 385). In contrast to the percept, in which the individual makes a "response to an object or stimu lus that continues to be within the physical scanning capaci ty of the sense organs for at least one second," one can posit the existence of an image if the "original source of

PAGE 26

19 stimulation is further removed in time from the observer but is described as present or experienced in some form as part of the subject's consciousness" (Singer, 1973, p. 385). Cognitive psychologists working from this sensory perceptual perspective have focused considerable research attention on eidetic imagery, an intriguing phenomenon found in a small segment of the population. To be considered eidetic, an imager after studying a scene for 30 or 40 sec ones should be able to retain his perception of it for sev eral minutes afterward and "view" the eidetic image in as much detail as if the picture were still there {Jaensch, 1930; Haber & Haber, 1964). Some eidetic images seem indis tinguishable from actual perceptions to the imagers even when employing objective criteria. In an experiment conducted by Leask, Haber, & Haber (1968) eidetic subjects were shown two schematic drawings of ocean scenes. If these scenes were juxtaposed in the imagination, the picture that would result would be that of a bearded man. Leask, Haber, & Haber (1968) reported that some of their eidetic subjects reported the presence of a face after imaginally juxtaposing these scenes. For these subjects, it appears that the image almost functioned like a sensory impression. Also adopting the sensory-perceptual perspective, Sheehan (1966), Segal (1971), and Shepard (1978) have been responsible for bringing about important methodological refinements in the study of imagery, which in turn have contributed to the effort to predict and control behavior.

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20 Sheehan (1966) has developed a new procedure to obtain in formation on vividness and other characteristics of visual imagery. In Sheehan's procedure, the individual, having studied a picture of an object such as a red apple, projects it mentally onto a screen. The subject then manipulates a projector light for color, intensity and shape in order to bring this objective measurable index as close as possible to his actual image. Through this method, Sheehan was able to determine how well memory images served in creating some thing similar to the original stimulus, how well memory images capture the qualities--the shape, color, etc., of the original stimulus. Segal (1971) has been studying various aspects of the Perky phenomena. In the initial experiment, Perky's sub jects were asked to imagine common objects while looking at a fixation point in the middle of a window. In the back of the window a machine projected forms that were very close to the items to be imagined in all their characteristics (e.g., shape, color). After the subject was told what ob ject to imagine, the projected form was gradually brightened to about threshold brightness and was removed before the subject began to describe what he had imagined. Perky found that all subjects confused the projected forms with their own images. All these observers were unable to discern that an actual objective stimulus was present, believing that the stimulus they described was totally a project of their imaginative processes. Segal (1971) was able to successfully

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21 replicate the Perky effect, which could be defined as an inability to differentiate "a real from a mentally projected image." The way that subjects decide whether a stimulus is real or not was subjected to exhaustive empirical scru tiny; the expectations induced by the experimenter seemed to be critical. If subjects were told to expect to see some real stimuli, they were successful in discerning these. Conversely, if the subjects did not expect to see any "real stimuli," they did not see them (Segal, 1971). In an attempt to dispense with what he perceives as fruitless arguments about internal processes underlying imagery, Shepard (1978) proposes that we can study such images "as defined solely in relation to their corresponding external objects" (1978, p. 125). In his studies, Shepard found that "to the extent that mental images can substitute for perceptual images, subjects are able to answer questions about objects as well when those objects are merely imagined as when they are directly perceived" (Baylor, 1971; Kosslyn, 1975). Shepard has concluded that subjects make the same judgments about objects in their absence as in their presence: Subjects who imagine a particular object are very quick and accurate in making a response to related external stimuli. In addition, he found that when called upon to spatially transform stimuli in the imagination, subjects are accurate in carrying out these transformations. These results are derived from many experiments employing a wide range of objects, including

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22 two dimensional shapes (Shepard & Chipman, 1970), spectral colors (Shepard & Cooper, 1975), one digit numbers in such forms as Arabic numerals, printed English names and patterns of dots (Shepard, Kilpatrick & Cunningham, 1975), familiar faces, and musical sounds (Shepard, 1975). In all cf these experiments, there was no statistical difference between how well subjects performed in the experimental condition in which the object was directly perceived or when the object was imagined. Defining the image from a constructional perspective, investigators, notably Neisser (1967) and Pylyshyn (1973), propose that the experience of an image itself arises out of constructive processes. These psychologists suggest that "the units abstracted and interpreted during perception are stored in long-term memory in an abstract propositional format and must be acted on by processes that serve to generate or to produce an experience of an image" (Kosslyn, 1975, p. 342). Thus, the aforementioned investigators sug gest that we view the image not as a picture in the head, which the phenomenological description implies, but that we define the image as a propositional structure, which is more like an elaborated description of the information con tained in the image. Rather than being "a raw harvest of sensory observation" (Lang, 1977, p. 864) that is implied by the picture metaphor, the image gives us information about objects or events, not pictures or representations of them. Working within this perspective, P.J. Lang and others are

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23 studying imagery and its component processes through the use of physiological techniques. From the results of his stud ies, Lang (1977) has suggested that careful training and experimenter-monitoring and reinforcement of appropriate responses can enable subjects to increase their psycho physiological response to imagined situations and hence the potential effectiveness of the use of imagery during therapy. It appears that the way instructions to the client are organized can be shown to control somatovisceral re sponses during imagery. It is Lang's contention that psychophysiology provides "a window through which the image can be observed and a means through which it can be al tered" (1977, p. 882). Lang is not alone among experimental psychologists in having investigated the power of imagery to produce physio logical changes. Simpson & Pavio (1966) observed changes in pupillary size during imagery. May & Johnson (1973) perceived an increase in heart rate when arousing images were presented. Studies such as those of Barber & Hahn (1964) and Grossberg & Wilson (1968) suggest that imagining a painful or frightening event results in a strong physio logical response that can be gauged through physiological measures such as GSR. Increases in electromyograms (EMGs) have also been noted by several researchers (Craig, 1969; Jacobsen, 1929, 1930; McGuigan & Schoonover, 1973). While psychologits such as Paivio (1969), Bower (1971), Bugelski (1968), studying imagery and its relationship

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24 to learning and memory, have made certain assumptions about the image, they have not offered an explicit statement of definition of imagery with respect to memory and learning. There has been "with memory images, as with memory in gen eral, an almost i:!:"resistible tendency to rely on metaphors" (Crowder, 1976). Paivio (1971) cites three basic operations that have been employed by cognitive psychologists to describe and manipulate imagery: "stimulus attributes, experimental manipulations and individual differences" (p. 253). Viewed within the perspective of Paivio (1971) and Kosslyn & Pomerantz (1977), it may not be necessary to assume a defini tion of the image. Kosslyn & Pomerantz (1977) state that the "image is not the only construct in cognitive psychology that lacks a unique operational definition ... it is legitimate for a scientific enterprise in its formative period to be engaged in research on a construct whose definition has not been precisely formulated" (p. 64) Therefore, one could study the image in relation to its individual differences, stimulus attributes and experimental manipulations without resorting to a definition. For example, eidetic imagery has been studied in relation to individual differences in the subjects' eidetic abilities (Leask, Haber, & Haber, 1968). The image has been described and studied through its stimu lus attributes, described "in terms of the image-arousing value or concreteness of the stimulus material. This can be viewed as a dimension ranging from objects or their pic tures on the high imagery end, through concrete words to

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25 abstract words on the low end of the scale" (Paivio, 1971, p. 253). Studies of learning and memory (Paivio & Madigan, 1970; Paivio, 1971) have shown that imagery can greatly en hance both these processes. Described in terms of its stimulus attributes, the use of concrete noun images re sulted in significantly better paired associate recall than the use of abstract nouns in the studies conducted by Paivio and associates. Imagery has been found to have a facili tating effect not only in paired-associate learning but in free recall, serial learning, verbal discrimination learn ing and the Brown-Peterson short-term (STM) memory task (Paivio, 1969; Paivio & Rowe, 1970, Paivio & Smythe, 1971). It has been proposed by Crowder (1976) that mediation of retention through imagery techniques is among the most powerful experimental effects found in the psychology of memory (Crowder, 1976). Within cognitive psychology, training subjects in the use of imagery through different instructions appears to be the most frequently used method of experimentally manipulating imagery (Bower, 1971; Bugelski, Kidd, & Segrnan, 1968). In his studies, P.J. Lang found that the way instructions to the client are organized has been shown to exert substantial control over the client's somato visceral responses during imagery. Among the clinical treatment studies employing imagery, only a handful of investigations conducted using covert

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26 modeling have sought to determine whether manipulating the type of imagery instruction employed results in differential treatment effectiveness. Covert modeling, as previously mentioned, is the behavioral imagery based procedure in which the client is "directed in the symbolic rehearsal of appropriate behavior" for a difficult performance task or feared situation (Mahoney, 1974, p. 112). These covert model ing studies have suggested that one can enhance the efficacy of treatment by instructing subjects in the sort of imagery that should be used (Kazdin, 1974; Cautela, Flannery, &Hanley, 1974). For example, Kazdin (1974) found that subjects who were instructed to imagine a model of the same sex and age were significantly more effective in reducing avoidance be havior (fear of harmless snakes) than those who were in structed to imagine models that were dissimilar in these characteristics. Recent research on model characteristics has also focused on the superiority of coping vs. mastery models in the alleviation of avoidance behavior (Kazdin, 1973a, 1974; Meichenbaurn, 1972). Both Meichenbaurn and Kazdin concluded as a result of their studies that subjects who were instructed to imagine coping models who demonstrated initial fearful behavior, then coping behavior and finally mastery behavior were significantly more effective in enhancing behavioral change than were subjects who were instructed to imagine mastery models who demonstrated no fear, but competence throughout. These studies suggest that manipu lating the content of imagery through instructions may

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-27 substantially augment the power of the imagery technique in bringing about desired changes in behavior. Support for this contention is found in the results of a recent study by Harris & Johnson (1980) who compared the efficacy of instructing subjects in individualized coping imagery based on experiences of success and competence to self-control desensitization for the treatment of test anxiety. The images of competence and success used as part of this coping technique were drawn from the individual's own repertoire of success experiences achieved in situations other than test taking. In this study, the type of imagery instruction employed seemed to be important. Individualized coping imagery treatment was significantly more effective in in creasing grade point average and decreasing self-report of anxiety than was self-control desensitization. A replica tion of individualized coping imagery treatment produced similar results. Building upon the results of the previous studies (Kazdin, 1974; Lang, 1977; Harris & Johnson, 1980) which found support for the use of instructions aimed at manipu lating the content of the imagery produced, the primary purpose of the present study was to assess the effectiveness of different imagery instruction procedures for the treatment of test anxiety. In this study a comparison of the efficacy of instructing subjects in individualized coping imagery treatment based on nonacademic experiences of competence and success and individualized coping imagery treatment based on

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-------28 academic experiences of competence and success was carried out. The images of competence and success used as part of the initial treatment study conducted by Harris & Johnson (1980) were essentially nonacademic in nature, using suc cess experiences drawn from fields as diverse as athletics and gourmet cooking. Because the target anxiety of this study was test anxiety, it was felt that it might prove useful to instruct subjects in the use of individualized coping images based upon previously realized academic suc cess (e.g., making an academic presentation, doing well on a previous exam) within the desensitization framework for the treatment of test anxiety. The use of academic images of competence derived from subjects' academic achievements may further promote generalization through the employment of imagery highly relevant to test taking and other academic stressors. For subjects in both these treatments, images of competence were drawn from the individual's own rep ertoire of success experiences and the individual was a party to the formulation of his own treatment. As in the previous study, the subject was able to become an active agent in a very individualized regimen, perhaps making the approach more efficient. Another purpose of this current study was to assess how effective instruction in relaxation is in increasing both imagery vividness and overall treatment effectiveness of the individualized coping imagery techniques. Several investigators, among them Singer (1973, 1974), Van Egeren,

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29 Feather & Hein (1971), have cited the role that relaxation instruction plays in increasing both the vividness and overall treatment effectiveness of imagery based techniques. However, their conclusions emerge mainly from case reports, therapist observations, etc., and h~ve not been subjected to controlled assessment.

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METHOD Design In order to compare the efficacy of individualized coping imagery based upon academic and nonacademic images of competence and to assess the value of relaxation train ing, students seeking treatment for their test anxiety were randomly assigned to one of four treatment conditions in a 2x2 factorial design. Subjects in the first treatment group were given training in the use of nonacademic coping images to reduce test anxiety. The second group received both training in progressive relaxation and the use of non academic coping images. Subjects in group three were trained in the use of individualized coping imagery based on academic success experiences. The fourth treatment group received both individualized coping imagery based on aca demic experiences of competence and relaxation training. Because no amount of anxiety relief can compensate for in adequate study skills, a study skills package was adminis tered to all treatment groups (Mitchell & Ng, 1972). In addition, in order to assess whether any of the treatments produced an effect, a waiting list control group was established. 30

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31 Subjects Sixty-three subjects were selected from a group of individuals meeting the following criteria: (A) volunteered in response to announcements of a study for the treatment of test anxiety made in several core university premedical courses (e.g., organic chemistry, chemistry, biology), in which multiple examinations are given; (B) scored above 30 on the debilitating anxiety scale of the Achievement Anxiety Test (Alpert & Haber, 1960); (C) had a cumulative grade point average (GPA) under 3.5; (D) were willing to partici pate in all of the 8 treatment sessions and 2 assessment sessions; (E) granted permission for the investigator to obtain grade records from the Registrar's office. Students who had the highest degree of subjectively measured anxiety and the lowest cumulative grade point average were con sidered first for treatment. Measures Treatment outcome. Two different sets of measures were used to assess the efficacy of the different treatments for test anxiety: five self-report measures of test and evaluative anxiety and academic performance as reflected in change in grade point average. The self-report anxiety assessment battery, adminis tered at pretest and posttest, consisted of:

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32 (A) The Suinn Test Anxiety Behavior Scale (STABS)this is a 50 item inventory describing situations related to test taking (Suinn, 1969). (B) The Alpert-Haber Achievement Anxiety Test (AAAT)this instrument is designed to measure both Debilitating Anxiety (DA) and Facilitating Anxiety (FA) in test situa tions (Alpert & Haber, 1960). (C) The Test Anxiety Scale (TAS)--the TAS is a 37 item true/false inventory which attempts to assess the subjective emotional reactions experienced by students in test situa tions (Sarason, 1972). (D) The Social Avoidance and Distress Scale (SADS)this scale consists of 28 items which appear in a true/false format and relate to how much subjects deliberately avoid social situations (Watson & Friend, 1969). {E) The Fear of Negative Evaluation Scale (FNES)--is comprised of 30 items which appear in a true/false format; this inventory measures how fearful subjects are of negative evaluation (Watson & Friend, 1969). Grade point averages were collected for the quarter prior to treatment, the quarter during which the study was conducted and the quarter following treatment. Expectations for improvement. In the postassessment session, subjects in all five groups were asked to estimate what their expected grade point average for that treatment quarter would be, given their academic performance up to that point in the quarter. This expected grade point

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33 average was designed to assess whether there were different expectations for improvement across treatment groups. Treatment efficiency: Speed of hierarchy completion. In order to assess one aspect of treatment efficiency, the num ber of trials it took fo:i::subjects to complete the hierarchy was tabulated. Imagery measures. Subjects who met the initial criteria for inclusion in the study underwent an additional assess ment procedure designed to assess the images the subjects produced. This assessment was conducted both before and after treatment. Scenes were selected by dividing the desensitization hierarchy employed by Harris & Johnson (1980) in their test anxiety treatment study into three portions reflecting low, medium and highly anxiety evoking items. One item was randomly chosen from each anxiety level of the hierarchy. Thus, one scene was chosen from the least anxiety evoking section of the hierarchy (items 1-9), a second scene was randomly chosen from items (10-18), and a third scene was chosen from the most anxiety evoking third of the hierarchy (items 19-27). These same target scenes were employed for subjects in all five groups. All imagery assessments were conducted individually in a dimly illuminated carpeted room in which distracting sounds were minimized. Subjects were presented verbally with four situations to imagine and describe. Before imag ining and describing the three actual test taking target

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34 scenes, the subject was given a pretest practice scene which was to imagine that s(he) is taking a walk on a sunny spring day. For this practice scene, as in the subsequent three scenes to be imagined, the subject was asked to imagine this scene as clearly as s(he) could, and when s(he) imagined the scene as clearly as s(he) could, to raise a finger of the right hand. At that point, the subject was asked to describe what was imagined in detail. In these preliminary instructions to the subjects, it was emphasized that the purpose of this procedure was to help the therapists in preparing for treatment. After the subject described the practice scene, s(he) was told that ttI have a few situations related to tests and test taking here--just a few that I'd like you to imagine and describe to me in detail." The same procedure was fol lowed for the imagined test-related scenes as was followed for the practice scene. Thus, after imagining the scene, the subject was asked to describe the scene in detail. A tape recorder was used to record both the experimenter's instructions and the subjects' descriptions of the imagined hierarchy items. To control for order effects, all six combinations of scene presentation were employed. Thus, one-sixth of the subjects were asked to imagine the least anxiety evoking scene first, the second most anxiety evoking scene second and the most anxiety evoking scene last. A second sixth of

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35 the subjects in all treatment conditions were asked to im agine the most anxiety evoking scene first, the second most anxiety evoking scene second and the least anxiety evoking scene last, etc. Thus, within each treatment group of twelve subjects, two participants followed the same order of scene presentation. This same procedure employing the same practice scene and three different scenes chosen from the same test anxiety hierarchy was repeated at posttreatment assessment. Although different test anxiety scenes were employed, each subject was asked to imagine one scene from the low, medium and high anxiety levels of the hierarchy. From these preand posttest scene descriptions, four imagery measures were taken: (A) Elaborateness--a behavioral measure of scene elaborateness was defined as the number of words employed by the subject to describe each of the target scenes s(he) was asked to imagine. Numerical tabulations of the number of words in each scene were compiled by the author and checked by a volunteer university student. (B) Latency--this measure was defined as the length of time it took for a subject to signal by raising a finger that s(he) was ready to begin his (her) description of a target scene, after having received instructions from the experimenter to imagine and describe these scenes. This time was measured with a stop watch to allow for an accurate reading.

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36 (C) Content: Stimulus/Response--stimulus content of a scene is that aspect of the imagined situation which re fers to the physical details of the object or situation described. The response content of the imagined scene re fers to the somatovisceral or emotional responses that the subject described him/herself making in the imagined target situations. In order to provide for reliability, seven raters, un associated with the study, coded the imagery descriptions given by subjects in response to the target scenes. Each sentence was classified by a rater according to whether it primarily reflected stimulus attributes or response at tributes. In advance of the actual coding procedure, all identi fication was removed from subjects' imagery descriptions. Packets of equal numbers of imagery descriptions were then randomly selected. Neither the e x perimenter nor the raters knew from which treatment group these descriptions were drawn. Raters received pretest training in order to afford them sufficient practice in coding the sentences of the scenes, according to the criteria employed. Thus, as part of the pretest training the principles governing the differ entiation of predominantly stimulus and response sentences were first discussed and e x amined. After raters clearl y understood stimulus vs. response characteristics, they then received both e x amples and sample scenes to code along these

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37 dimensions. Difficulties experienced in coding these scenes were explored and any questions were answered by the experi menter. Raters were checked for reliability every five scenes. One of the scenes in each packet which had been ranao~ly chosen from all imagery descriptions was the scene on which each rater was evaluated for reliability. Reliability was calculated for each test scene employing the following formula: agreements agreements+ disagreements If a rater's reliability fell below 80 % on any test scene, this rater received retraining on additional scenes to en able him/her to better understand and employ the criteria. The rater then was required to rerate the packet on which s(he) fell below the reliability standard. The experimenter served as the reliability standard for all raters. (D) Content: Coping--in addition to coding the imagery descriptions according to whether they reflected predomi nantly stimulus and response characteristics, raters were asked to evaluate and classify the same imagery descrip tions as to whether each sentence of each description given in response to the target scene reflected predominantly positive or negative coping. For those statements which raters saw as neither positive nor negative coping in character, they were asked to code as neutral.

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38 As part of this procedure, the seven raters were assessed for reliability throughout their coding of the data, with the experimenter serving as reliability standard. All procedures to assess reliability for these variables were identical to those employed in the coding of stimulus response data. Thus, if reliability fell below 80 % raters received additional training in the coding principles and procedures and were instructed to code that set of descrip tions and were checked again. Treatment After measures of general and test anxiety were admin istered and imagery assessments conducted, subjects were randomly assigned by sex to one of five groups: individual ized coping imagery treatment based on nonacademic experi ences of competence and success (N=l2), individualized cop ing imagery treatment based on nonacademic experiences of competence and success combined with relaxation training (N=l2), individualized coping imagery treatment based on academic images of competence and success (N=l2), individual ized coping imagery treatment based on academic images of competence and success combined with relaxation training (N=l2), and a waiting list control group (N=lS). Therapists. The author and one female, advanced gradu ate student in clinical psychology served as therapists for this study. Each of the therapists conducted two of the four types of treatment so that each therapist had contact with the same number of subjects.

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39 Treatment setting. All group treatment took place in a dimly illuminated carpeted room in which distracting sounds were minimized. General Procedures All treatments were conducted in groups for the eight weekly, 60 minute sessions and were given the same rationale, anxiety hierarchy, study skills training and homework assign ments. Rationale. Individuals taking part in these groups were given a rationale that emphasized that they had re sponses already in their repertoire, success experiences that could be used to cope with anxiety (see Appendix B). Test anxiety hierarchy. In session two of treatment, the construction of a group hierarchy was carried out by employing the results of the preassessment measures in con junction with subject suggestions to create a hierarchy specific to test taking situations. In order to control for the divergent elements of the treatment procedures, the same hierarchy was employed for all four treatment groups. For all treatment groups, each item on the hierarchy was pre sented for a minimum of two times. The length of item pre sentation was either 60 seconds or the amount of time for all individuals in the group to imagine the hierarchy scene for a 20 second anxiety free period. However, if a subject signaled anxiety after the second exposure, the item was repeated until no subject signaled anxiety when imagining this scene.

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40 Study skills. Subjects in all four treatment groups received training in study skills employing a variety of study skills techniques. 1 Throughout all sessions, as part of the study skills portion of the treatment, the basic focus was on helping subjects to examine their present be havior and to try new and more productive methods for meet ing the demands of their current academic environment. In these sessions it was emphasized that more efficient prepara tion would in turn result in fewer feelings of anxiety prior to and during examinations. In session one, discussion centered on how students arrange their study time, examining for high and low efficiency areas. In addition, an attempt was made to elicit subject suggestions concerning specific behavioral steps which might reduce study interrup tions and more adequately meet course related demands on their time. In the second session, study skills training focused on different methods of increasing study behavior such as systematically studying in the same place and time, re ducing study interruptions and more adequately meeting course related demands on their time. The student was helped to construct and modify proposed time scheduled during the following weeks. 1 These study skills techniques were the same ones used by Harris & Johnson (1980) and were based on a study skills package developed by Allen (1971).

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41 In session three the SQ3R method of study (Robinson, 1961) was taught to subjects. This method was used to help students select what they are expected to know, comprehend these ideas more rapidly, fix these ideas in memory, and review efficiently for examinations. Session four of the study skills portion of the treat ment was concerned with techniques of good note taking, with an emphasis on organization. In addition, the SQ3R method was reviewed. Sessions five and six focused on preparation for examinations--reviewing, outlining, repeti tion and additional memorization techniques. Session seven centered on the use of response management techniques to increase study behavior. The final session served to re view the principles covered during the entire study skills part of treatment. Study skills training took approximately 20 minutes of each treatment session. Homework. Subjects received a homework assignment based on the study skills techniques examined during each treatment session. Treatment Manipulations In a 2(academic vs. nonacademic coping images) x 2(relaxation vs. no relaxation) design, each treatment group differed in the type of imagery and relaxation in structions employed. Individualized coping imagery treatment based upon nonacademic images of competence. For two treatment groups, --------------------

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42 highly personalized, previously established images of com petence and proficiency achieved by the subjects in stress ful environments other than test taking were paired with visualization of anxiety eliciting scenes that comprised the test anxiety hierarchy. Individuals taking part in this treatment were given a rationale that emphasized responses already in their repertoire as current resources that could be used to cope with test anxiety. The first session focused on a group discussion of possible success experiences of the subjects that could be transformed into images of competence for use in this covert imagery procedure. In sessions three through eight, the actual treatment procedure was carried out. Using these previously established images of competence (e.g., running a radio broadcast, tending a busy bar, playing in a recital), subjects were presented with the test anxiety hierarchy items. In ad vance of the presentation of each item, subjects were instructed (1) to imagine themselves performing well in their personalized coping image and (2) then to transpose the same confident and competent person of the personalized coping image to the imaginal anxiety-provoking situation presented in the hierarchy. Thus, the subject was instructed to imagine this same competent person of his individualized coping image now contending with test situations as they appeared in the hierarchy. Individualized coping imagery treatment based upon academic images of competence. Subjects in the two other

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43 treatment groups were instructed to employ individualized coping imagery based upon academic images of competence. Highly personalized, previously established images of com petence and proficiency achieved by the subjects in aca demic activities (e.g., making presentations, performing difficult problems in class, successful test taking experi ences in the past) were paired with the visualization of anxiety scenes from the test anxiety hierarchy. Individuals taking part in this treatment were given a rationale that emphasized responses already in their repertoire and cur rent resources that could be used to cope with test anxiety and that these current resources could be derived from their own experiences of competence and success in academic ac tivities. It was assumed that even test anxious college students would have some history of academic achievement and success (albeit an intermittent one) in order to have gained college admission. The first session focused on a group discussion of possible success experiences of the subjects that could be transformed into academic images of competence for use in this covert imagery procedure. In sessions three through eight, the actual treatment procedure was carried out. Using these previously established academic images of competence, subjects were presented with the test anxiety items. In advance of the presentation of each item, subjects were instructed (1) to imagine themselves performing well in their personalized coping image and (2) then to transpose the same confident and competent

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44 person of the personalized academic coping image to the imaginal anxiety-evoking situation presented in the hier archy. In this treatment, too, the subject was instructed to imagine this same, competent, confident person of his individualized coping image now contending with test situa tions as they appear in the hierarchy. Progressive relaxation instructions. Subjects in two of the treatment groups received training in progressive relaxation following the format developed by Dorothy Susskind (1970). The relaxation procedure consisted of the alternate tensing and relaxing of various muscle groups. Subjects were told that the relaxation training facilitated the lowering of their tension level, making it easier for them to cope with test taking situations both as they imagined them in the session as well as when they were confronting them outside. Subjects were instructed to practice their relaxation at home between sessions. The other two treatment groups received no specific instructions in progressive relaxation. Waiting list control group. Fifteen subjects made up a fifth experimental group of waiting list controls. After the posttreatment assessment, individuals of the waiting list control group were offered the opportunity to partici pate in the test anxiety treatment proven to be most ef fective.

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RESULTS Analysis of Treatment Effects All subjects, eighteen males and fifteen females, in the four treatment groups who completed the eight one-hour treatment sessions and two assessment sessions were in cluded in the data analysis. Three subjects dropped out of each of the two relaxation treatment groups, leaving nine subjects in each. For the group involved in individu alized coping imagery treatment without relaxation, four subjects withdrew in the course of treatment. Five sub jects withdrew from the academic coping imagery treatment without relaxation. Of the control subjects, thirteen out of fifteen completed the postassessment measures. A multi variate analysis of variance was conducted on the pretreat ment assessment measures completed by the dropouts to de termine if they differed significantly from nondropouts. This analysis revealed no significant differences. Conse quently, data from dropouts were discarded from all subsequent analyses. The intercorrelation matrix for the scores on the seven dependent measures used to assess the efficacy of test anxiety treatment is presented in Table 1. As expected, the correlations between self-report measures 45

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46 Table 1 Intercorrelation Matrix of Scores on the Seven Dependent Measures at Pretreatment Measure 1 2 3 4 5 6 7 1. GPA -.19 -.02 .024 -.20 -.02 -.06 2. AAT-DA -.63 .488* .449* .12 .075 3. AAT-FA -.29 -.19 -.04 .19 4. STABS .38* .22 .30 5. TAS .12 .21 6. SADS .25 7. FNES Note: GPA= Grade Point Average; AAT-DA = Debilitating Anxiety subscale of the Alpert-Haber Achievement Anxiety Test; AAT-FA = Facilitating Anxiety subscale of this same instrument; STABS= Suinn Test Anxiety Behavior Scale; TAS = Test Anxiety Scale; SADS = Social Avoidance and Distress Scale; and FNES = Fear of Negative Evaluation Scale. p < 05. were low to moderate. There was no significant correlation between any self-report measure and grade point average. Since multivariate analysis of variance of pretreat ment scores revealed significant pretreatment differences for one variable, FNES, this variable was subjected to a separate anal y sis of covariance. A multivariate analysis of the pretreatment scores for the remaining six self report and performance measures was nonsignificant,

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47 F(24,102) = .83, p < .6913, indicating initial equivalence of the four treatment and control groups on these measures. To assess the relative efficacy of the four treatment and one control conditions, a multivariate analysis of variance was run on the six repeated measures (Service, 1979). Since the groups were significantly different at the multivariate level F(24,90) = 2.25, p < .0032, further analyses were performed. Separate repeated measures analyses of variance were conducted for each of the dependent measures. When appropriate, Duncan's M ultiple Range Test for pairwise comparisons was used to assess posttreatment differences between groups. Pairwise T-tests were employed 1 for assessing preto posttreatment changes. Self-report measures of test anxiety. Repeated measures analysis of variance performed on the pretest and posttest Debilitating An x iety subscale scores of the Alpert-Haber Achievement Anxiety Test revealed a highly significant Group x Time interaction F(4,40) = 4.71, p < .0047, indicating differential improvement among the groups on this measure. 1 Anadditional2(Rela x ) x 2(Image) x 2(Time) Manova was conducted to assess the possible main effects of relaxation and imagery used on the treatment outcome measures. No main effects nor interactions were found. A multivariate analysis of variance was run to determine i f treatment was differentiall y effective for men and women taking part in the study. The multivariate anal y sis was nonsignificant indicating that there was no interaction between se x and treatment for an y of the dependent measures.

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48 The mean Debilitating Anxiety and Facilitating Anxiety scores for each of the four treatment and one control con ditions are shown in Table 2. While all treatment groups decreased on this measure of test anxiety, Table 2 reveals that the magnitude of change from pretest to posttest appears to be greatest for individualized coping imagery treatment alone, followed by individualized coping imagery treatment combined with re laxation and academic coping imagery combined with relaxa tion. The Duncan's Multiple Range Test for pairwise com parisons employing Kramer's (1956) adjustment for unequal sample sizes conducted on posttest scores indicated that all four treatment groups scored significantly lower than the waiting list control group, p < .05, but were not signifi cantly different from each other. Results of pairwise T-tests indicated that all four treatment groups showed significant change from preto posttreatment, p < .04. No substantive change occurred for the waiting list control group. Repeated measures analysis of variance on the Facili tating Anxiety subscale at the AAT did not yield a signifi cant Group x Time interaction. The main effects for group, F(4,40) = 12.88, p < .0001, and time, F(l,40) = 9.49, p < .0045, were significant. Duncan's test showed that each treatment group reported more facilitating anxiety than the control group, p < .05. There was an overall in crease in preto posttreatment scores (see Table 2), p < 05.

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Table 2 Alpert Haber Achievement Anxiety Test Individualized coping imagery treatment with relaxation (N = 9) Academic coping imagery treatment with relaxa tion (N = 9) Individualized coping imagery--no relaxation (N = 8) Academic coping imagery --no relaxation (N = 7) Waiting list control group (N = 13) Means Debilitating Anxiety Pretest Posttest 37.22 26.33 34.88 28.55 35.62 24.5 33.71 27.71 36.38 36.61 Facilitating Anxiety Pretest Posttest 21. 22 24.55 23.66 25 21 23 22.28 24.14 19.15 20.61 ,i:,. I.D

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50 Repeated measures analysis of variance performed on the Suinn Test Anxiety Behavior Scale ( Stabs test) re vealed a highly significant Group x Time interaction F(4,40) = 6.63, p < .0006 (see Table 3). Table 3 Suinn Test Anxiety Behavior Scale Means Pretest Posttest Individualized coping imagery with relaxation (N = 9) 140 106.55 Academic coping imagery with relaxation (N = 9) 133.22 100 Individualized coping imagery --no relaxation (N = 9) 161.125 118 Academic coping imagery--no relaxation (N = 7) 134.71 100.142 Wait list control (N = 13) 143.53 169 Individualized coping imagery treatment without relaxation showed the largest decrease in test anxiety, followed by individualized coping imagery treatment combined with relaxation, academic coping imagery alone, and academic coping imagery combined with relaxation. The waiting list control group increased on this measure of test and evaluative anxiety. At posttest, all four treatment groups were significantly lower

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51 on this measure than was the waiting list control group, p < .05. All other group comparisons were nonsignificant. In addition, at posttest, pairwise T-tests revealed that all four treatment groups were significantly lower on this measure than at pretest, while the waiting list control group showed a significant increase, p < 04. Results of the Test An x iety Scale, presented in Table 4, show that all treatment groups decreased more than the con trol group on this measure. Table 4 Sarason Test Anxiety Scale Means Individualized coping imagery with relaxation (N = 9) Academic coping imagery with relaxation (N = 9) Individualized coping imagery --no relaxation (N = 8) Academic coping imagery-no relaxation (N = 7) Wait list control (N=l3) Pretest 23.77 23.88 26.25 24.0 22.53 Posttest 14.66 14.33 14.50 16.71 23.23 The magnitude of change from pretest to posttest appears to be largest for individualized coping imagery treatment alone followed by academic coping imagery combined with

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--------------------------------52 relaxation, individualized coping imagery combined with relaxation and academic coping imager y alone. Repeated measures analysis of variance performed on this measure revealed a highly significant Group x Time interaction, F(4,40) = 3.47, p < .0196. At posttest all four treatment groups scored significantly lower than the waiting list control group, p < .05, but were not signifi cantly different from each other. Preto posttreatment changes as measured by pairwise T-tests were significant for the individualized coping imagery group combined with relaxation, the academic coping imagery group combined with relaxation and the individualized coping imagery treatment without relaxation, p < .005. Preto posttreatment changes on this variable for the academic coping imagery group approached significance, p < .0680. The waiting list con trol group showed a slight, nonsignificant increase on this measure. Self-report measures of evaluative and social an x iety. Repeated measures analyses of variance of the scores ob tained at pretest and at posttest on the Social Avoidance Distress Scale (Watson & Friend, 1969) indicated no signifi cant Group x Time interaction on this measure. The anal y sis did reveal significant group F(4,40) = 16.16, p < .0001 and time F(l,40) = 16.90, p < .0002, main effects. However, subsequent tests using Duncan's revealed no significant differences between groups, although all subjects scored significantly lower on this measure at posttest that at pretest.

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53 Because of initial pretreatment differences on the FNES (Fear of Negative Evaluation Scale), an analysis of covariance was conducted. This analysis revealed no dif ference between groups. Academic performance. Mean grade point averages obtained from the University of Florida Registrar's Office for both the pretreatment and posttreatment quarters are pre sented in Table 5. Table 5 Grade Point Average Individualized coping imagery combined with relaxation (N = 9) Academic coping imagery combined with relaxa tion (N = 9) Individualized coping imagery without relaxation (N = 8) Academic coping imagery without relaxation (N = 7) Waiting list control group (N = 13) Means Pretreatment 2.0 2.32 2.38 2.32 2.66 Post treatment 2.62 2.96 3.00 2.54 2.08 Repeated measures analysis of variance performed on the pretreatment and posttreatment grade point averages

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54 revealed a highly significant Group x Time interaction F(4,40 = 3.57, p < .0173, indicating differential improve ment among the groups on this measure of academic perform ance. Duncan's test revealed that at posttest none of the four treatment groups were significantly different from each other. Only the academic coping imagery group combined with relaxation and the individualized coping imagery group alone were significantly different from the control group. From preto posttreatment, both individualized coping imag ery treatment combined with relaxation and the individual ized coping imagery group without relaxation showed a significant increase in grade point average, p < .05. Pre to posttreatment changes in grade point average for the academic coping imagery group combined with relaxation approached significance, p < .089. Academic coping imagery without relaxation made a small nonsignificant increase in academic performance from the pretest to posttest. The waiting list control group significantly decreased on this measure of academic performance, p < .0437. Expectations for Improved Academic Performance In the postassessment session, which occurred before summer term examination week, subjects in all four treatment groups were asked to estimate what their grade point aver age for that quarter would be, given their academic per formance up to that point in the quarter. No significant differences in group expectations emerged from these analyses.

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55 Treatment Efficiency: Speed of Hierarchy Completion An analysis of variance performed on this measure re vealed a highly significant difference between groups F(3,76) = 4.80, p < .0042. Further analyses in the form of Duncan's Multiple Range Test showed that individualized coping imagery combined with relaxation, academic coping imagery combined with relaxation, and individualized coping imagery alone were significantly more efficient treatments in terms of the number of trials taken for subjects to com plete each item of the hierarchy than the academic coping imagery--no relaxation treatment. Imagery Analyses The same individuals who completed the treatment out come measures completed the imagery assessment procedure at pretreatment and posttreatment. However, one of the male subjects, who completed the individualized coping imagery treatment combined with relaxation and all treatment out come measures, failed to complete the posttreatment imagery assessment. For each of the imagery measures (i.e., elaborateness or words, latency, stimulus-response, and coping) separate analyses of variance were conducted on the pretreatment scores on these variables to assess whether the dropouts differed significantly from nondropouts. As these analyses revealed no significant differences, data from dropouts were discarded from all subsequent imagery analyses.

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56 Scene elaborateness. A behavioral measure of scene elaborateness was defined as the number of words employed by the subject to describe each of the target scenes s(he) was asked to imagine. In order to assess whether the four treatment and one control group were different on this behavioral measures of scene elaboratensss, a 5(Groups) x 2(Time) x 4(Scene) anova was conducted. This analysis revealed no significant interactions but did yield main effects for Time F(l,37) = 4.43, p < .04 and Scene F(3,123) = 12.21, p < .0001. Further analysis in the form of Pairwise T-tests indicated that at posttreatment, sub jects used more words to describe these target scenes than at pretest. Duncan's revealed that all subjects used more words to describe the three anxiety evoking scenes than the practice scene, p < .05. A further 2(Relax) x 2(Imagery) x 2(Time) x 4(Scene) anova was performed in order to assess whether the addition of relaxation or the type of imagery used differentially contributed to scene elaborateness. This analysis also re vealed no significant interactions or main effects between relaxation and imagery on this scene elaborateness measure. Latency. This measure was defined as the length of time it took for a subject to signal by raising a finger that s(he) was ready to begin his(her) description of a target scene (e.g., practice scene, anxiety evoking scenes) after having received instructions from the experimenter to imagine and describe these scenes. A 5(Groups) x 2(Time) x

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57 4(Scene) analysis of variance was conducted to assess whether the four treatment and one control groups were different on this measure. This analysis revealed no interactions or main effects. To determine the effects of relaxation and image type on latency, a 2(Relax) x 2(Imagery) x 2(Time) x 4(Scenes) anova was also performed. All interactions and main effects proved to be nonsignificant. Scene content: Stimulus and response. Stimulus content of a scene is that aspect of the imagined situation which refers to the physical details of the object or situa tion described. The response content of the imagined scene refers to the somatovisceral or emotional responses that the subject described him/herself making in the imagined target situations. As described previously, seven individuals unassociated with the study served as raters. Each rater received an equal number of imagery descriptions to code. Each sentence was classified by the raters according to whether it pri marily reflected stimulus attributes or response attributes. The experimenter served as reliability standard for all raters. If a rater's reliability fell below 80 % on any test scene, this rater received retraining on additional scenes to enable him/her to better understand and employ the criteria. The rater was then required to rerate the packet on which s(he) fell below the reliability standard. Only one of the seven raters required additional training on

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58 the criteria. Reliability was calculated for each test scene employing the following formula: agreements agreements+ disagreements Reliability between the raters and the experimenter (re liability standard) ranged between 80-100 % and averaged 85% for all test scenes. In order to control for differing scene length and to normalize the data, all stimulus and response data were subjected to Arcsin Transformations. Analysis of either stimulus or response statements through a S(Groups) x 2(Time) x 4(Scene) repeated measures analysis of variance on the transformed scores was essentially equivalent, yielding a highly significant Scene x Time interaction F(3,102) = 4.3, p < .006 for both of these variables. Duncan's revealed that at pretest subjects used signifi cantly more stimulus elements (statements) in the practice scene than they did in any of the three anxiety scenes, p < .05. Subjects also used more stimulus elements in their descriptions of medium anxiety scene than they used in the most anxiety scene, p < .OS. The number of stimulus statements evoked by the low and medium anxiety scenes were not significantly different from each other. At posttest, this pattern was again apparent, with the number of stimulus elements used in the practice scene exceeding those used in the anxiety scenes, p < .05. In addition, the low anxiety scene exceeded the medium and high anxiety

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-----~ 59 scene in the number of stimulus elements used, p < .05. The medium and high anxiety scenes were not statistically different from each other. Follow-up Duncans on the response variable revealed that at pretest, significantly more response statements were used to describe the three anxiety scenes than were used in the description of the practice scene, p < .05. More response statements were used to describe the high anxiety scene than were used to describe the medium anxiety scene, p < .05. At posttest, descriptions of anxiety scenes again contained significantly more response elements than made up the descriptions of the practice scene, p < .05. There was no difference in the number of response statements elicited by the medium and high anxiety scenes. The number of response elements evoked by the low anxiety scene was lower than these two scenes, p < .05. Table 6 shows both the percentages of each of the anxiety scenes and practice scenes that were made up of stimulus and response statements as well as the trans formed scores. To determine the effects of relaxation and image type used as part of treatment on both the stimulus and response content of the scenes, 2(Relax) x 2(Imagery) x 2(Time) x 4(Scene), analysis of variance were performed on both the stimulus and response variables. These analyses were

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Table 6 Stimulus and Response Percentages and Transformed Scores Pretreatment Post treatment Scene Transformed Transformed Transformed Transformed % % Stimulus Response % % Stimulus Response Stimulus Response Score Sc ore Stimulus Response Score Score Practice 57 43 .872 .698 62 38 946 .6 24 Low 10 90 .191 1. 379 30 70 .4 98 1.07 Anxi e ty CJ) 0 Medium 18 82 311 Anxiety 1. 25 13 87 220 1. 35 Hi gh 5 9 5 .0 9 7 Anxiety 1.47 4 96 .070 1.5

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61 essentially equivalent and yielded no significant inter actions or main effects for either of these variables. Pairwise T-tests were conducted to ascertain if each scene elicited more stimulus or response oriented content. As can be seen in Table 6, a pattern of greater response orientation compared to stimulus orientation was true for all anxiety scenes, p < 001, at both pretest and posttest. In contrast, for the practice scene, there was no difference between stimulus and response orientation at pretest. At posttest, the practice scene elicited signifi cantly more stimulus content, p < .03. Scene content: Coping. Positive coping content of a scene refers to those statements made by the subjects in response to the target scenes which would indicate that they were functioning effectively, adopting a problem solving orientation or attitude that would lead to a satis factory outcome. Negative or "bad coping" was the converse of the above. The same procedures for calculating reliability were employed for coping/negative coping scene content as were employed for stimulus and response content. Only one of the seven raters required additional retraining on the criteria in order to increase his level of reliability. Reliability for coping / negative coping ranged from 80 to 100 % and averaged 86 % In order to control for differing scene length and to normalize the data, all coping and negative coping data

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62 were subjected to Arcsin Transformations. A 5(Groups) x 2(Time) x 2(Type of Coping) x 4(Scene) repeated measures analyses of variance was run on the transformed scores to determine if different treatments made subjects more likely to descriu8 themselves coping successfully or unsuccessfully with the situations presented to them in these target scenes. These analyses revealed a significant Scene x Type of Coping x Time interaction F(3,136) = 5.53, p < .002. Further Duncan's indicated that at pretest there were more positive coping elements used for the three anxiety scenes than for the pretest practice scene, p < .05 (see Table 7). At posttreatment more positive coping statements were made by subjects to describe the three anxiety scenes than were used to describe the practice scene, p < .05. Because of the pre-post increase in the percentage of positive coping elements used for both the medium and high anxiety scene, additional follow-up pairwise T-tests were conducted. This analysis revealed a highly significant change for the medium anxiety scene from preto post treatment, p < .0001. Additional pairwise T-tests were employed to determine if there might be differences between the treatment groups in the number of positive coping statements used to describe the medium anxiety scenes. Every treatment group showed significant increases in the number of coping statements employed from preto posttreatment. This did not occur for the control group.

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Table 7 Coping and Negative Coping Percentages and Transformed Scores Pretreatment Posttreatment Scene % % Transfonned Transfonned % % Transformed Transformed Positive Negative Positive Negative Positive Negative Positive Negative Coping Coping Coping Score Coping Score Coping Coping Coping Score Coping Score Practice 6 1 .105 .020 8 0 .147 0 w Low 51 23 797 Anxiety .386 50 1 2 774 216 Medium 24 41 .3 92 Anxiety .641 61 13 938 224 High 41 46 .652 Anxiety .71 6 50 26 .758 .431

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64 Similar anal y ses were conducted on the negative coping statements. Duncan's revealed at pretest that all anxiety scenes elicited more negative coping statements than did the practice scene, p < .05. The high and medium anxiety scenes, though not significantly different from each other, elicited more negative coping than the low anxiety scene, p < .05. At posttest, all anxiety scenes again evoked more nega tive coping statements than the practice scene, and the high anxiety scene evoked more negative coping than both the medium and low anxiety scenes. These two were not signifi cantly different from each other. Because of the pre-post decrease in the percent of negative coping elements used in the low, medium and high anxiety scenes, additional follow-up pairwise T-tests were conducted. This analysis revealed a highly significant decrease for the medium and high anxiety scenes from pre to posttest, p < .01. The preto posttest change for the low anxiety scene approached significance, p < .07. Additional pairwise T-tests employed to determine if there might be differences between the treatment groups in the number of negative coping statements used to describe the three anxiety scenes showed significant decreases on the medium anxiety scene for both the individualized coping imagery group with relaxation and the academic coping imagery group with relaxation, p < .05, and a decrease ap proaching significance for the individualized coping imagery group without relaxation, p < .09. A significant decrease occurred for the individualized coping imagery group combined

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65 with relaxation on the high anxiety scene, p < .02). No significant preto posttest decrease was made for the academic coping imagery group without relaxation or the control group on any of the scenes. Pairwise T-tests were also conducted to ascertain whether different scenes elicited more positive coping or negative coping content. At pretest, more positive coping statements compared to negative coping statements were pro duced by subjects responding to both the low and medium anxiety scenes, p < .06. A similar pattern emerged at post test with positive coping orientation dominating in the practice scene and the low and medium anxiety scenes, p < .03. A 2(Relax) x 2(Type of Imagery) x 2(Time) x 4(Scene) analysis of variance was conducted to assess whether the addition of relaxation or the type of imagery used differ entially contributed to the number of positive coping and negative coping elements used. This analysis revealed a significant Relax x Time interaction, p < .04. However, follow-up analyses in the form of Duncan's and pairwise T-tests revealed no significant differences between groups or changes from preto posttest on this variable.

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DISCUSSION Treatment Outcome It was evident from the results of this study that all variations of individualized coping imagery treatment brought about significant decreases in test anxiety as measured by self-report anxiety questionnaires. In terms of academic performance, two groups, individualized coping imagery without relaxation and academic coping imagery com bined with relaxation, were significantly different from the control group at posttest. The individualized coping imagery treatment combined with relaxation and individualized coping imagery treatment without relaxation brought about significant changes from pretreatment to posttreatment assessment on grade point average. Subjects receiving academic coping imagery treatment alone manifested substan tial improvement on some measures of evaluative anxiety, but subjects in this treatment were not able to achieve significant increases from pretest to posttest on academic performance and were not significantly better than waiting list controls. While preventing subjects from deteriorat ing in academic performance, it appears that academic cop ing imagery treatment alone was not enough to bring about 66

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67 consistently significant pretest to posttest increases in grade point average. Academic coping imagery treatment alone was clearly the least efficient of all of the four treatments. At the outset of the academic coping imagery treatment, subjects experienced much difficulty employing their academic images of competence to counter the anxiety evoking situations of the hierarchy. They required significantly more hierarchy scene exposures than subjects taking part in the other three treatment groups. Initially, subjects reported they had trouble producing and imagining these academic images of competence clearly. Thus, while the decreases in test anxiety were similar to those of other treatment groups, it did not appear to be as efficient to institute and carry out. It was also noteworthy that this group had the high est dropout rate of all four treatment groups. When all variables are considered, individualized coping imagery with or without relaxation appears to be an effective treatment across the domains of anxiety self report measures, academic performance and treatment efficiency. Similar consistent positive results were obtained with academic images only when they were paired with relaxation training. The waiting list control group showed an increase in self-report anxiety on two of the primary self-report measures of evaluative anxiety and a significant decrease in grade point average from pretreatment to posttreatment

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68 assessment which is consistent with the findings of several previous investigators (Harris & Johnson, 1980; Holroyd, 1976; Paul & Shannon, 1966). It appears that subjects who are part of a waiting list control group run the risk of further deterioration in academic performance and increases in anxiety. It is noteworthy that differences that were obtained in both treatment efficiency and academic performance were not reflected in differential expectations for improvement at posttest; apparently, all treatments were viewed by participants as equally credible and convincing. The fact that there was no Group x Time interaction on both the Social Avoidance and Distress Scale (Watson & Friend, 1969) and the Fear of Negative Evaluation Scale (Watson & Friend, 1969) is consistent with the findings of Harris & Johnson (1980) and Spielberger, Anton, & Bedell (1975), who found that while test anxiety treatment may produce reduction in anxiety measures that were specific to testing situations, such treatment may not result in gen eralized significant decreases on self-report indices of social and evaluative fear. The low correlations achieved between grade point average and self-report anxiety measures in this study points to the need for multiple measures in treatment outcome studies of this type. Consistent with previous findings, there were no dif ferences in the efficacy of treatment for men and women

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69 taking part in this study. Although previous investigations have found that women admit to more anxiety than men (Hersen, 1973), in this particular group of subjects who sought treat ment, there were no differences. A significant finding to emerge from the results of this study was that manipulating the type of imagery in struction employed does appear to result in differential treatment effectiveness at least on some measures. This is consistent with the findings of Kazdin (1973a, 1974) and Lang (1977, 1979) that the content of imagery is very sensi tive to instruction. The hypothesis that the use of aca demic images of competence alone, derived from subjects' academic achievements, would further promote generalization through the employment of imagery highly relevant to test taking and other academic stresses was not supported by the results of the study. The magnitude of change for individualized coping imagery based on nonacademic experi ences of competence and success was greater than that made by academic coping imagery alone on grade point average. While academic coping imagery treatment alone led to small nonsignificant gains from pretest to posttest, in grade point average, nonacademic individualized coping imagery treatment produced a significant increase in academic per formance. It had been hypothesized that because academic images of competence were highly relevant to test-taking, it might therefore be a more efficient treatment. The reverse appears to be the case.

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70 An explanation for this finding may lie in the nature of the coping imagery instruction itself. Critical to the individualized coping imagery treatment is the direct harnessing of highly individualized past performance ac complishments as coping skills and using them within the context of the desensitization procedure to reinforce the belief that highly test anxious individuals can cope ef fectively in stressful situations such as test taking. Their past performance accomplishments are used to provide evidence of this. By their nonacademic nature and their lack of association with the stressor, nonacademic experi ences of competence and success evoke feelings of competence and success, not fear and avoidance. In contrast, academic experiences of competence and success are part of a class of situations (academic or test taking) that for these subjects have a potential to evoke fear and avoidance. Thus, subjects may have more difficulty producing and maintaining academic images of competence as part of the desensitization procedure; as such, images are too closely associated with the experience of test taking and its concomitant anxiety. It is not surprising, given these factors, that both treatment efficacy and efficiency should be impaired. As reported in the study conducted by Harris & Johnson (1980), test anxious subjects have often indicated in the course of their treatment program that their negative thoughts are, for them, more vivid and perseverant than

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71 their images of competence and proficiency. These negative cognitions appear to have been overlearned and may be more directly and parsimoniously countered by the overlearning of highly individualized positive self-thoughts, images of competence and proficiency that comprise the coping tech nique employed in the nonacademic individualized coping imagery treatment. Thus, because of the close association with the stressor, academic coping imagery may not be in herently as able to alter anxiety to the same degree as treatments employing nonacademic coping images. However, it appeared that the addition of relaxation to the academic coping imagery treatment augmented both its treatment efficacy in terms of grade point average and treatment efficiency. Subjects required no more scene presentations to complete the desensitization hierarchy than participants in the two nonacademic coping imagery treatment groups. Previous investigators, among them Singer (1973, 1974); Van Egeren, Feather & Hein (1971), have proposed that relaxation plays an important role in increasing both the vividness and overall treatment effectiveness of imagery based techniques. Their conclusions emerged mainly from case reports and therapist observations and had not been subject to controlled assessment. It may be that because relaxation training reduces distracting physical sensation and thought (Lang, 1979); it may, in turn, enhance the ability of subjects to approach stressful situations,

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72 including imaging even potentially stressful coping re sponses. Thus, as a result, subjects may be able to ef fectively use this response in the subsequent anxiety evok ing hierarchy scenes, unencumbered by fear or avoidance. In contrast, the addition of relaxation did not substan tially add to the power of nonacademic individualized cop ing imagery treatment. As a result of this study, the basic hypothesis that different imagery instructions could differentially affect test anxiety and performance was confirmed. Indeed, changes in the instructional content of the images employed showed these treatments to be differentially effective in increas ing academic performance and treatment efficiency. Such instructions appeared to be sensitive to experimental manipu lation with variations in these instructions (e.g., the differences in instructions for individualized coping imagery vs. academic coping imagery) producing changes in overall treatment efficacy as measured by academic per formance and efficiency. Imagery Results of the imagery analysis suggest the absence of any significant relationship between the use of relaxation as part of treatment and the production of highly elaborate hierarchy scenes as measured by the number of words used by subjects to describe the target scenes. In addition, data analysis did not uncover differences in this elaborateness

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73 measure for any of the five treatment groups. It is to be noted, also, that relaxation training did not increase subjects' use of stimulus, response, positive coping or negative coping elements as part of their scene descriptions. While treatment did not appear to influence the elabor ateness of imagery produced, it appears that the target scenes the subjects were asked to imagine and describe were discriminative stimuli, evoking different patterns of im aginal responding. Subjects not only used more words in describing the anxiety evoking scenes than they used in describing the practice scene but used significantly more response elements as well. Similarly, more positive and negative coping statements were used to describe the anxiety evoking scenes than the practice scene. These findings are consistent with the results of desensitization studies (Lang, Melamed, & Hart, 1970) which demonstrated that subjects respond to anxiety scenes with increased physiological arousal as measured by GSR, heartrate in creases, etc. Anxiety scenes may not only produce dif ferences in physiological responding but may lead to dif ferences in the subject's imagery content as well. While the use of different imagery treatment instruc tions appeared to have given subjects increased control over their anxiety and academic performance, it was found that imagery based treatment alone did not differentially change the number of stimulus or response elements subjects used in their scene descriptions. It was found on all

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74 variables that there was no significant difference for the four treatment and one control groups in the elaborateness or stimulus-response content of the images subjects produced. On the other hand, there were significant differences in content for both the number of positive coping statements and negative coping statements subjects used to describe these anxiety scenes. From pretreatment to posttreatment, subjects significantly increased their use of positive cop ing statements for the medium anxiety scene. Further statis tical analysis revealed that this change could be accounted for by significant increases in positive coping statements employed by all four treatment groups. This increase in positive coping elements was absent for the control group. Similar analyses made for negative coping statements revealed highly significant decreases in negative coping for both the medium and high anxiety evoking scenes from preto posttreatment. The decrease for the low anxiety evoking scene approached significance. Further analysis demon strated significant decreases in negative coping on the medium anxiety scene for individualized coping imagery and academic coping imagery combined with relaxation and de creases approaching significance for the individualized coping imagery treatment without relaxation. A highly sig nificant decrease in negative coping statements was made on the high anxiety scene by the individualized coping imagery group. There were no significant changes for either aca demic coping imagery treatment alone or the waiting list control group.

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75 An examination of the content of the images at pre treatment revealed more positive coping statements compared to negative coping statements were produced by subjects responding to both the low and medium anxiety evoking scenes. At posttreatment, a similar pattern emerged with positive coping orientation predominating for the practice and the low and medium an x iety scenes. Because positive coping imagery significantly increased and negative coping imagery significantly decreased, this finding suggests that it may be that changes in image con tent may also figure in the successful outcome of treatment. Unlike the report of Lang and his associates (Lang, 1977, 1978) which suggests that increasing the response orientation (increasing the number of response sentences) of the individual is critical to imagery based treatment, the results of this study suggest that changing the content of the image to incorporate successful coping strategies may be a more significant feature. M ore importantly, the finding that significant decreases in negative coping elements on the medium anxiety scene for the treatment groups who attained the largest increase in grade point average suggest that decreasing negative coping imagery may even be more crucial to the successful outcome of imagery based treatment than increasing positive coping imagery. These findings are in line with the theoretical model proposed by Wine (1971) and Ellis (1962) that negative cognitions such as self-statements lead to performance

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76 decrements. In Wine's view, it is the modification of negative self-statements and the substitution of positive ones that serves to decrease anxiety and enhance perform ance. Examining imagery data is only one way of attempting to assess behavioral and attitudinal change as a result of treatment. One cannot be completely sure that images pro duced in an assessment situation are adequate reflections of the emotional content of subjects' imagery in the natural environment (such assessments are subject to the demand characteristics of the situation). Yet this type of assess ment may offer some insight into the process of changing the emotional content of imagery and its possible relation ship to effective behavior change. Bandura, Adams, & Beyer (1977) and Averill (1973) have proposed that in dealing with potentially aversive events, it is the perceived inefficacy and incompetence in coping with them that makes them so fearsome. This study has used the vehicle of changing the content of the emotional image to impart a significant sense of personal control. This study has addressed a number of critical questions about the nature of imagery produced and how man's image making capacity can be put to the use of alleviating emo tional suffering. Enlarging on the work of other investi gators into covert phenomena, the individualized coping imagery technique employed in this study not only afforded significant relief from anxiety but also demonstrated that

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77 concrete beha v ior change for the individuals involved in this study could be achieved. While the use of imagery has become an established therapeutic tool, the careful study of the image may permit us a better understanding of the process by which a cognitive treatment yields behavioral or emotional change.

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APPENDIX A PROPOSITIONAL UNITS OF THE EMOTIONAL IMAGE A. Stimulus propositions (auditory, visual, tactile, cutaneous, olfactory, vestibular, kinesthetic) 1) physical details of the object or situation 2) changes in object configuration 3) object movement (approach or withdrawal) 4) physical place or general location 5) presence or absence of others as observers or participants 6) comments made by others 7) pain--location on the body; sharp, dull, etc. B. Response propositions I. Verbal responses 1) overt vocalization--out loud comments or expressive cries 2) covert verbalizations a) emotional labeling b) self-evaluative statements, e.g., feelings of inferiority c) attribution of attitudes to others II. Somato-motor events 1) muscle tension 2) uncontrolled gross motor behavior 3) organized motor acts--freezing, approach, avoidance III. Visceral events 1) heart rate and pulse 2) body or palmar sweat 3) vascular changes--blanching or flushing 4) pilomotor response 5) salivary response--mouth dry 6) respiratory change 7) intestinal upset a) vomiting b) incontinence 8) urinary dysfunction IV. Processor characteristics 1) perception unclear or unusually vivid, or distorted 78

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79 2) loss of control over thoughts, cannot think clearly 3) disoriented in time or space V. Sense organ adjustments 1) general postural changes 2) eye and head movements Note: All hierarchy scenes described by the subjects were coded for extensiveness and elaborateness of verbal description, employing the image taxonomy presented above and developed by Lang (1977).

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APPENDIX B INSTRUCTIONS TO THE EXPERIMENTER: INDIVIDUALIZED COPING IMAGERY TREATMENT This is the manual for the treatment of test anxiety through the use of individualized coping imagery combined with study skills training. This treatment is designed to build an individualized structure which employs the individ ual's perception of self-competence as the primary coping technique. In this treatment images of perceived self competence are incorporated into a covert modeling procedure for the treatment of test anxiety. Six steps are involved in the use of this technique. 1) Exploration of degree and extent of test anxiety of subject 2) Presentation of rationale for treatment 3) Group discussion of possible success experiences of the subject that can be transformed into images of competence for use in this covert imagery procedure. This step also includes discussion of treatment goals and problems 4) Construction of test anxiety hierarchy 5) Employment of covert imagery treatment 6) Study skills training 80

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81 Treatment Schedule Session One 1) Group introduction and exploration of degree and extent of test anxiety for each subject (10 minutes) 2) Rationale described and treatment explained (10 minutes) 3) Beginning group discussion of possible success experi ences that could be transformed into images of competence to be used as part of this covert imagery procedure (15 minutes) 4) Beginning construction of test anxiety hierarchy (10 minutes) 5) Study Skills step I--see Study Skills Manual (15 minutes) Session Two 1) Brief review of treatment goals and questions--homework assignment discussed (10 minutes) 2) Open discussion of problems, e.g., difficulty in coming up with success experiences (15 minutes) 3) Completion of hierarchy of relevant anxiety evoking situations, also training in visual imagery (20 minutes) 4) Study Skills Package step II (15 minutes) Sessions Three through Eight 1) Brief review of homework assignment and any problemsadditions to the hierarchy should be incorporated (10 minutes) 2) Instructions in the use of individualized coping imagery (25 minutes)

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82 3) Homework assignment made (5 minutes) 4) Group discussion (5 minutes) 5) Study Skills training (15 minutes) Procedures to be Followed Exploration of degree and extent of test anxiety. This beginning exploration should serve to establish a warm relationship between therapist and subject and also allow subjects to become acquainted with one another. This procedure should help the therapist learn the duration, extent and the severity of the subject's test anxiety. In addition to using the material contained in the self-report anxiety questionnaires, the therapist should seek to deter mine whether there are other interpersonal or evaluative situations that make the subject anxious. Rationale It is essential that all individuals involved in this treatment program comprehend and accept what treatment will involve. In an attempt to clarify both the principles and procedures behind the treatment interventions used, a brief overview should be provided. The following format should be used. The experimenter should say the following to the subject: I'd like to give you a picture of the rationale for this treatment to ex plain the concept of anxiety and how anx iety relates to the test taking situation specifically. Then I will describe all the facets of the treatment program. We are working under the basic premise that

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83 the present anxiety you feel taking testsand in any sort of evaluative situationprobably is linked (has a lot to do with) to your past experiences in these situations. You have probably have had bad experiences in taking tests and these unpleasant ex periences and memories may have been rein forced by hearing other people describe their unpleasant experiences with tests. Along with these negative test taking experiences you may have come to believe that tests and doing well on them is very important. Getting into Med School or Grad School may be uppermost in your mind and makes tests very important. In fact, your bad experiences with test taking might only have served to support this notion. Thus your emotions and feelings sur rounding test taking and evaluative situa tions often result in feelings of anxiety that are probably out of line with the situation and interfere with your func tioning on tests. Since your perceptions of these anxiety arousing situations take place within you--inside your head--we can work with these reactions and percep tions during these sessions. Many times in the course of your life you are called on to do things that make you tense and anxious. Someone says to you--' here, try my new moped' and you've never been on one before. You do have an idea how it works, but mostly you know that you're a darn good bike rider and you call on the skills you have as a bike rider to help drive the moped. (Tell other example) You come into a chemistry class and you see the beakers and all the chemi cals and you're scared, thinking how am I going to mix the right amounts and come up with the right results, but then you re member that you did a very good job of mixing paints and colors (for an art class) so you called on these skills and you did measure all the chemicals out, and you did complete the experiment without blowing up the laboratory. Everyday you call on competencies that you have established in other areas and use them in new ways in areas that might originally be anxiety pro voking. What we are going to do in these sessions to help you alleviate test anxiety is something like that. We're going to

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84 develop your ability to use your previously established competencies to handle the problem of test anxiety. We'll examine your test anxiety--when it occurs, how often, what makes it worse, what makes it better. We'll make a special kind of list of all the test taking situations that make you react with anxiety--it's called a hierarchy. You'll learn to cope with these test taking situa tions--each one of you will develop several individualized coping images and you will be taught how to use these coping images in contending with these test taking situa tions. This will be accomplished by using your imagination. We know that the nervous ness, the anxiety, the tension involved in taking tests is the same as the tension you have mastered in the other skills in which you are competent. In this treatment, we want to show you that test taking and the handling of the anxiety associated with it is just a series of skills like anything else. As you see yourself coping and succeeding with trying difficult situations, you'll imagine a series of graded situa tions that have to do with taking tests and the anxiety related to test taking. This technique has been shown to be successful in helping people--students, like yourselveswho are test anxious. Do you have any questions? In addition to working with this pro cedure we will spend some time in each session talking and working out ways to im prove study skills. While you all studymost of you would probably like to study more efficiently--get more out of the time you put in. Of course, more efficient preparation for these courses will probably result in fewer feelings of tension and apprehension prior to and during exams. During the next eight weeks, as part of the study skills training we will follow this approach. During our first session, we will dis cuss exactly what study is and present a method found useful in helping you estimate the time you need for accomplishing the objectives set forth in your courses, and several other techniques useful in deter mining whether you are using your time efficiently. Week two will be spent detailing a method of shaping study behavior and

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85 techniques useful in increasing motiva tion to study. Week three will be devoted to presenting the SQ3R method (Scan, Ques tion, Read, Recite, Review Method) of how to read a book. Week four will cover the efficient taking down and use of lecture notes. Week five will be spent discussing specific techniques useful in studying for an exam, as well as procedures helpful in avoiding the emotional turmoil sometimes felt as you enter the examination situation. Week six will be devoted to getting more study in less time by the application of stimulus control and response management techniques. Weeks seven and eight will serve to review the entire study counseling program. For each session, we will spend a brief period discussing any problems or successes you had applying the principles and tech niques discussed and learned the previous week, including the progess you make, your use of the study principles, etc. During this time, feel free to discuss any material which was unclear to you or prob lems with any of the above topics. Open Discussion Period An allotment of time should be made at both the begin ning and end of each session for discussion about any problems concerning treatment. In the course of treatment, if any questions about the hierarchy arise, they can be answered during the discussion session. A homework assignment should be given at each session which in the first two sessions would consist of the subjects' recording their success ex periences for use in the covert imagery procedure. Assign ments in the last six sessions will center on the practice in coping imagery and gaining proficiency in study skills. Development of Anxiety Hierarchy The development of the anxiety hierarchy is one of the most essential parts of this treatment. Anxiety evoking

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86 situations related to taking tests should be organized to extend from those evoking very small, manageable amounts of anxiety to those that arouse the most. These items making up the hierarchy should be drawn from the subject's responses to self-report inventories and from subject sug gestions during the sessions. Sample test anxiety hierarchy. The following is a possible sample of a temporal spatial hierarchy that could be employed for these test anxious subjects: 1) Studying material for a final exam two weeks before the exam 2) Discussing approaching test with friends a week before it is to be given 3) Listening to the professor describe what is going to be on the exam a week before it is to be given 4) Remembering how you felt about a test you took in the past 5) Studying for the test in your room the night before 6) Reviewing study materials the morning before the test 7) Eating, getting dressed, etc. just before leaving to take the test 8) Walking over to the classroom on the morning of the test 9) Entering the room the day of the exam 10) Waiting for the test to be handed out--you hear other students talking about how hard the test will probably be 11) Reading the first question on the test 12) Seeing that the test is longer than expected

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87 13) Seeing a question that you can't answer 14) Seeing test questions on material that you didn't study Any hierarchy that is developed should incorporate all anxiety provoking elements relating to tests and test taking that the group shares. This hierarchy should not be excessively long with a maximum of 25 items contained within in. Training in Visual Imagery Before work in using the individualized coping imagery begins at the start of the third session, some preliminary training in visual imagery should be conducted probably at the end of the second session. A sample stimulus item to imagine vividly could be offered such as: Visualize yourself shopping in Publix or Winn Dixie. Tell me what you see. Is your image clear--is it black and white or is it in color. Where are you in the store--on the frozen food aisle, or near the soda or cheese. It might be useful to have subjects think of their images as if they were watching a movie in which he/she is the principle actor. It should be emphasized that they should not see themselves as in a mirror image, rather as if they are there--as active participants in all the action. While some subjects may have no difficulty in imagin ing these stimulus scenes clearly, others may experience difficulty. The therapist should emphasize that this imagining is a skill, like relaxation, and improves with practice. Before proceeding with the actual use of the individualized coping imagery, the therapist should

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88 present a few more nonanxiety evoking scenes to imagine, e.g., eating an ice cream cone or lying on a beach. Upon embarking upon the actual use of the individu alized coping imagery in the third session, subjects should again be informed of what will occur during this process in order to clear up any uncertainties the subjects may have. Individualized Coping Imagery Treatment This group should receive the same study skills training as the other groups. In this treatment group, an attempt should be made to build an individualized structure which employs the subject's perception of self competence as the primary coping technique. For this treatment group, highly personalized previously estab lished images of competence and proficiency achieved by the subjects in stressful environments other than test taking should be paired with the visualization of anxiety eliciting scenes that comprise the test anxiety hierarchy. The first two sessions should be focused on a group discussion of possible success experiences of the subjects that can be transformed into images of competence for use in this covert imagery procedure. There should be no training in progressive relaxation as part of this treat ment. In sessions one and two, hierarchy construction should be carried out in this group as it was in the other three groups. In sessions three to eight the actual

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89 treatment procedure should be carried out. Using these previously established images of competence, subjects should be presented with the test anxiety hierarchy items. With each item subjects should be instructed to: 1) imag ine themselves coping with their tension by seeing them selves performing well in their personalized coping image and 2) then to transpose the same competent and confi dent person of the personalized coping image to the im aginal anxiety provoking situation presented in the hierarchy. The subject should be instructed to imagine this same competent person of his individualized coping image now contending with test situations as they appear in the hierarchy. In the individualized coping imagery treatment, each item on the hierarchy should be presented for a minimum of two times. The length of item presentation would either be 60 seconds or the amount of time for all individuals in the group to imagine the item for a 20 second anxiety free period. However, if a subject signals anxiety after the second exposure, the items should be repeated until no subject signalled anxiety when imagining this item. In order to control for the divergent elements of the two treatment procedures, the same hierarchy of anxiety evoking scenes should be

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90 employed in all variations of individualized coping imagery treatment.

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APPENDIX C INSTRUCTIONS TO THE EXPERIMENTER: INDIVIDUALIZED COI'ING IMAGERY TREATMENT COMBINED WITH RELAXATION This is the manual for the treatment of test anxiety through the use of individualized coping imagery combined with relaxation and study skills. This treatment is de signed to build an individualized structure which employs the individual's perception of self-competence as the pri mary coping technique. In addition, relaxation training is employed to determine if it enhances treatment effects. Seven steps are involved in the use of this technique: 1) Exploration of degree and extent of test anxiety of subject 2) Presentation of rationale for treatment 3) Group discussion of possible success experiences of subject that can be transformed into images of competence for use in this covert imagery procedure. This step also includes discussion of treatment goals and problems. 4) Construction of test anxiety hierarchy 5) Progressive relaxation training 6) Employment of covert imagery treatment 7) Study skills training With the exception of the use of progressive relaxation training, all aspects of this treatment are identical to 91

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92 that of individualized coping imagery treatment without relaxation (see Appendix B). The progressive relaxation instructions which follow were adapted from Susskind (1970) to be used in combination with individualized coping imagery treatment. Instructions in relaxation. The room in which instruction in progressive relaxation takes place should be at a pleasant even temperature. Before relaxation begins, the lights should be dimmed, subjects should be seated in com fortable chairs. Subjects should then be asked to close their eyes. The Muscle-Relaxant Method is as follows: Please lean back in your chairs. Place both feet on the floor. Close your eyes. Now, stretch your legs as far as they can go. Turn your toes under and tighten the muscles, very, very tight. Hold it. And now also tighten the muscle in your calves and those in your thighs. Make your entire leg tight as a drum, and hold it, hold it, hold it. And now, let your legs sink down and relax all the muscles in your calves, all the muscles in your thighs. Let your legs go completely limp. And now, feel that wonderful relaxation corning up from your toes, up your calves, and your thighs. Feel ing wonderfully relaxed, beautifully relaxed, very calm, very relaxed. Feeling beautiful, just beautiful, wonderfully relaxed. Now I want you to stretch out your hands. Make a fist, Feel the tightness, and now make it tighter, tighter, tighter. Hold it. And now also tighten the muscles in your wrist, in your forearm, in your upper arm. Hold it. Hold it. And now, let go, just let go, let your arms sink down and get that wonderful feeling of relaxation, right through your fingers, your hands, now through your forearm, and upper arm. Let your arms go completely limp. Feeling wonderfully relaxed, beautifully relaxed, very calm, very relaxed and beautiful, just beautiful. Now, I want you to arch your back backwards, raise your I I I I I I I I I I I

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93 chest, and tighten your stomach muscles, and those in your neck. Make them as tight as you can, tighter, tighter, tighter. Hold it, hold it, hold it. And now, let go, just let go, and you get that wonderful feeling of relaxation. Just feel the muscles relax from your back, from your neck, from your chest, from your stomach, all over your back, all your muscles are feeling wonder fully relaxed. And now, I want you to tighten the mus cles in your face, around your mouth, the muscles in your chin, around your eyes and your forehead. Make them tighter, tighter, tighter, hold it, hold it, hold it. And now, let go, just let go, let go and get that wonderful feeling of relaxation, from all the muscles in your forehead, the muscles around your eyes, the muscles of your cheek, the muscles of your chin and the muscles around your mouth, feeling wonderfully relaxed, beautifully relaxed, very calm, very relaxed, wonderfully relaxed. Now, I want you to take a very deep breath and hold it, hold it, hold it. Now, slowly, let it out, and you're letting out all your tensions, your frustrations, your anxieties, feeling wonderfully well, wonderfully well, wonderfully well. Once again, take a deep breath, a very deep breath, hold it, hold it, hold it. Now, slowly, slowly, let it out, relax your tensions, your frustrations, your anxieties, feeling wonder fully well, wonderfully well, wonderfully well. Now as I count down from 10 to 1, think of the scene that makes you feel calm, that makes you relaxed, and that gives you a feel ing of well-being. (pause 10 seconds) Now, with your eyes closed, see that scene, in all its details, and as I'm counting down from 10 to 1, you are going to find yourself deeper and deeper relaxed and you will have a feeling of well-being. Calm and relaxed, and wonder fully well, just relax. I'm going to count, 10 .... 9 .... very deep, 8 .... 7 .... deeply relaxed, 6 .... 5 .... very, very, deep, deeply relaxed, 4 .... 3 .... very

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94 deeply, 2 .... 1 .... very calm, very relaxed, very calm, deeply relaxed. Think of nothing now but relaxation, feeling wonderfully well, just relaxed, calm, relaxed, feeling wonder fully well. When I count to 5, you will open your eyes and you'll feel calm, you'll feel relaxed, you'll feel wonderfully well, 1 .... 2 .... coming up slowly, 3 .... 4 .... coming up, feeling relaxed, feeling calm, but alert, 5 .... open your eyes, feel relaxed, feel calm, feel wonderfully well .....

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APPENDIX D INSTRUCTIONS TO THE EXPERIMENTER: ACADE: ac COPING IMAGERY TREATMENT The goal of academic coping imagery treatment is to build an individualized structure which employs the indi vidual's perception of self-competence as the primary coping technique. This treatment attempts to incorporate per ceived self-competence in academic situations into a covert modeling procedure for the treatment of test anxiety. As in nonacademic individualized coping imagery treatment, six steps are involved in the use of this technique. 1) Exploration of degree and extent of test anxiety of subject 2) Presentation of rationale for treatment 3) Group discussion of possible academic success experi ences of the subject that can be transformed into images of competence for use in this covert imagery procedure. This step also includes discussion of treatment goals and problems. 4) Construction of test anxiety hierarchy 5) Employment of covert imagery treatment 6) Study skills training Because this treatment employed perceived self competence in academic situations rather than nonacademic 95

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96 situations as in the coping technique, a different rationale was given to individuals taking part in this treatment pro gram. This rationale reflected the academic nature of the coping images used as part of this covert modeling pro cedure. Rationale It is essential that all individuals involved in this treatment program comprehend and accept what treatment will involve. In an attempt to clarify both the principles and procedures behind the treatment interventions used, a brief overview should be provided. The following format should be used, the experimenter saying to the subject: I'd like to give you a picture of the rationale for this treatment to explain the concept of anxiety and how anxiety is related to the test taking situation specifically. Then I will describe all the facets of the treatment program. We are working under the basic premise that the present anxiety you feel taking tests--and in any sort of evaluative situation--probably is linked (has a lot to do with) to your past experiences in these situations. You have probably have had bad experiences in taking tests and these unpleasant experiences and memories may have been reinforced by hearing other people de scribe their unpleasant experiences with tests. Along with these negative test taking experiences you may have come to believe that tests and doing well on them is very impor tant. Getting into Med School or Grad School may be uppermost in your mind and makes tests very important. In fact, your bad experiences with test taking might only have served to support this notion. Thus your emotions and feelings surround ing test taking and evaluative situations often result in feelings of anxiety that are probably out of line with the situation and interfere with your functioning on tests.

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97 Since your perceptions of these anxiety arousing situations take place within youinside your head--we can work with these re actions and perceptions during these sessions. Many times in the course of your life you are called on to do things that make you tense and anxious. Someone says to you'here, try my new Moped' and you've never been on one before. You do have an idea how it works. But mostly you know that you're a darn good bike rider and you call on the skills you have as a bike rider to help drive the Moped. (Tell other example) You come into a chemistry class and you see the beakers and all the chemicals necessary for your experiment and you're scared, thinking, how am I going to mix the right amounts and come up with the right results, but then your remember that you did a very good job of mixing paints and colors (for an art class) so you called on these skills and you did measure all the chemicals out, and you did complete the experiment without blowing up the laboratory. In the same way, you have academic competencies that you have developed all through your school career--some of you are very good in setting up experiments (in chemistry, biology, psychology) etc., some of you are very good in working problems in class, making a good oral report on a book you have read or doing darn well on a quiz. While some courses have given you trouble, in other courses you may have done excellently. Every day you call on competencies that you have established in other areas and use them in new ways, in areas that might originally be anxiety provoking. What we are going to do in these sessions to help you alleviate test anxiety is something like that. We're going to develop your ability to use your pre viously established competencies to handle the problem of test anxiety. We'll examine your test anxiety--when it occurs, how often, what makes it worse, what makes it better. We'll make a special kind of list of all the test taking situations that make you react with anxiet y --it's called a hierarchy. You'll learn to cope with these test taking situations. Each one of you will develop several indi vidualized coping images and you will be taught how to use these coping images in contending with these test taking situations.

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98 This will be accomplished by using your im agination. We know that the nervousness, the anxiety, the tension involved in taking tests is the same as the tension you have mastered in the other skills or academic situations in which you are competent. In this treatment, we want to show you that test taking and the handling of anxiety associated with it is just a series of skills like anything else. As you see yourself cop ing and succeeding with trying, difficult academic situations, you'll imagine a series of graded situations that have to do with taking tests and the anxiety related to test taking. This technique has been shown to be successful in helping people--students, like yourselves--who are test anxious. Do you have any questions? In addition to working with this proce dure we will spend some time in each session talking and working out ways to improve your study skills. While you all study--most of you would probably like to study more effi ciently--get more out of the time you put in. Of course, more efficient preparation for these courses will probably result in fewer feelings of tension and apprehension prior to and during exams. During the next eight weeks, as part of the study skills training we will follow this approach: During our first session, we will discuss exactly what study is, and present a method found useful in helping you estimate the time you need for accomplishing the objectives set forth in your courses, and several other techniques useful in determining whether you are using your time efficiently. Week two will be spent detailing a method of shaping study behavior and techniques useful in increasing motivation to study. Week three will be devoted to presenting the SQ3R method (Scan, Question, Read, Recite, Review Method) of how to read a book. Week four will cover the efficient taking down and use of lecture notes. Week five will be spent discussing specific techniques useful in studying for an exam, as well as procedures helpful in avoiding the emotional turmoil sometimes felt

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99 as you enter the examination situation. Week six will be devoted to getti p g more study done in less time by the application of stimulus control and response management techniques. Weeks seven and eight will serve to review the entire study counseling program. For each session, we will spend a brief period discussing any problems or success you had applying the principles and techniques discussed and learned the previous week, in cluding the progress you make, your use of the study principles, etc. During this time, feel free to discuss any material which was unclear to you or problems with any of the above topics.

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APPENDIX E INSTRUCTIONS TO THE EXPERIMENTER: ACADEMIC COPING IMAGERY TREATMENT COMBINED WITH RELAXATION In this technique academic coping imagery is used in combination with relaxation and study skills training for the treatment of test anxiety. With the exception of the addition of relaxation training, all elements of this treatment are identical to the treatment based on academic coping imagery without relaxation (see description in Appendix D). The relaxation instructions employed are identical to those used in combination with nonacademic individualized coping imagery treatment. Seven steps are followed as part of this treatment program. 1) Exploration of degree and extent of test anxiety of subject 2) Presentation of rationale for treatment 3) Group discussion of possible success experiences of subject that can be transformed into images of competence for use in this covert imagery procedure. This step also includes discussion of treatment goals and problems. 4) Construction of test anxiety hierarchy 5) Progressive relaxation training 6) Employment of covert imagery treatment 7) Study skills training 100

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APPENDIX F GENERAL INSTRUCTIONS FOR THE ADMINISTRATION OF INDIVIDUALIZED COPING IMAGERY TREATMENT Students should be told to make themselves comfortable, to loosen any tight clothing or shoes. Have them lean back in their chairs and close their eyes. After students appear comfortable, then say: "I'd like you to imagine yourself engaging in one of your individualized coping images. I'd like you to imagine yourself performing well and com petently and confidently at an activity or task in which you are particularly proficient, such as sailing in a compe tition, waiting tables in a busy restaurant, modeling be fore a large audience, showing horses in a competition," etc. (whatever the students have mentioned as nonacademic areas or tasks in which they are competent would be ap propriate to include). Note: After completing the first hierarchy item of the day, whether it is item 3, 8, 17, etc., it is not necessary to give the students examples of relevant nonacademic images. Instead, you can say, "I'd like you to imagine yourself performing well and competently and confidently at an activity or task in which you are particularly proficient or competent whatever it may be .... Then say, "I'd like you to imagine this scene as clearly as you can. 101

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102 When you have imagined this scene as clearly as you can, raise a finger of your right hand.'' (Wait 20-25 seconds to allow the students ample time to visualize their indi vidualized coping image.) If not all students signal that their scene is clear after the 25 second interval has elapsed, repeat the statement: "When you have imagined the scene as clearly as you can, raise a finger of your right hand." After the students have signaled that their image is clear, say: "Now, I'd like you to imagine that this same competent, confident person who is performing so well, who is doing such a good job in this activity .... (at this point, read the relevant item from the test anxiety hierarchy to the subjects). After reading this item, pause about 20 seconds to allow enough visualization time. Then say, "If you feel a sense of incompetence or lack of confidence when imagining this scene, raise a finger of your left hand." For this treatment, each hierarchy item should be re peated twice. If your students signal that they still feel a sense of incompetence or lack of confidence when imagining the hierarchy scene for the second time, repeat the process until no student signals that s(he) feels incompetent or lacks confidence when imagining the scene.

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APPENDIX G GENERAL INSTRUCTIONS FOR THE ADMINISTRATION OF ACADEMIC INDIVIDUALIZED COPING IMAGERY TREATMENT Students should be told to make themselves comfortable, to loosen any tight clothing or shoes. Have them lean back in their chairs and close their eyes. After students appear comfortable, then say: "I'd like you to imagine yourself engaging in one of your individualized coping images. I'd like you to imagine yourself performing well and competently and confidently at an activity or task in which you are particularly proficient, such as making a presentation to your biology class, working chemistry labs successfully or taking a quiz," etc. (whatever the students have mentioned as academic areas or tasks in which they are competent would be appropriate to include). Note: after completing the first hierarchy item of the day, whether it is item 3, 8, 17, etc., it is not necessary to give the students examples of relevant nonacademic images. Instead, you can say, "I'd like you to imagine yourself performing well and competently and confidently at an academically related activity or task in which you are particularly proficient or competent, whatever it may be .... Then say, "I'd like you to imagine this scene as clearly as you can. When you have imagined this scene 103

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104 as clearly as you can, raise a finger of your right hand." (Wait 20-25 seconds to allow the students ample time to visualize their individualized coping image). If not all students signal that their scene is clear after the 25 second interval has elapsed, repeat the statement, "When you have imagined the scene as clearly as you can, raise a finger of your right hand." After the students have signaled that their image is clear, say, "Now, I'd like you to imagine that this same competent, confident person who is performing so well, who is doing such a good job in this activity .... (at this point, read the relevant item from the test anxiety hierarchy to the subjects). After reading this item pause about 20 seconds to allow enough visualization time. Then say, "If you feel a sense of incompetence or lack of confidence when imagining this scene, raise a finger of your left hand." For this treatment, each hierarchy item should be repeated twice. If your students signal that they still feel a sense of incompetence or lack of confidence when imagining the hierarchy scene for the second time, repeat the process until no student signals that s(he) feels incompetent or lacks confidence when imagining the scene. -----------------------

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APPENDIX H STUDY SKILLS THERAPIST MANUAL This manual contains a series of important steps to be covered during each session. Since there is more material to cover in this treatment, the time limits must be closely ob served. The major steps of this treatment are outlined, and examples and applications are specified. As in other treat ments, the therapist is encouraged to present the material in the manner which makes him feel most comfortable. The sub jects should perceive the treatment as both helpful a~d en joyable, and the therapists are encouraged to use any method which will increase the likelihood of accomplishing these goals. However, the therapists should follow the specified outline as closely as possible at all times to insure true comparability of administration across therapists. Session One In the first session there should be an introduction, an explanation of the rationale of study counseling. The performance of the therapist during this session is ex tremely crucial as a determinant of the subjects' expec tations of the program. The procedures are, therefore, spelled out in detail. Note: In the current study, the study skills time schedule was modified as indicated in the Methods section. 105

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106 Introduction of Therapist and Subjects (10 minutes) The therapist should initiate the introductions, by identifying himself to the subjects, presenting such information as name, educational background, professional experience and future plans. The therapist should model warmth and frankness. Each subject should be invited to present similar information about himself. The therapist may ask questions if these will help the subjects to relax. The therapist should also explicate the rules which will guide the group interactions. These rules are the same as those in other treatments. 1. The meeting should be both useful and enjoyable. 2. All information transmitted within the session is confidential. 3. All sessions will be tape recorded. Rationale It is essential that all individuals involved in this treatment program comprehend and accept what treatment will involve. In an attempt to clarify both the principles and procedures behind the treatment interventions used, a brief overview should be provided. The following format could be used. "I'd like to give you a picture of the rationale for this treatment to explain the concept of anxiety and how anxiety relates to the test taking situation specifically. Then I will describe all the facets of the treatment program. We are working under the basic premise that the present anxiety you feel taking tests--and in any sort of

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107 evaluative situation probably is linked (has a lot to do with) your past experiences in these situations. You probably have had bad experiences in taking tests and these unpleasant experiences and memories may have been reinforced by hearing other people describe their unpleasant experiences with tests. Along with these negative test taking experiences you may have come to believe that tests and doing well on them is very important. Getting into Med School or Grad School may be uppermost in your mind and plans and makes tests very important. In fact, your bad experiences with test taking might only have served to support this notion. Thus your emotions and feelings sur rounding test taking and evaluative situa tions often result in feelings of anxiety that are probably out of line with the situation and interfere with your function ing on tests. In these sessions we will spend a great deal of time talking and working out ways to improve your study skills. While you all study--most of y ou would probably like to study more effi ciently--get more out of the time you put in. Of course, more efficient preparation for these courses will probably result in fewer feelings of tension and apprehension prior to and during exams. During the next seven weeks, we will cover the following topics. Today, we will discuss exactly what study is and present a method found useful in helping you estimate the time you need for accom plishing the objectives set forth in your courses and several techniques useful in determining whether you are using your time efficiently. Week two will be spent detailing a method of shaping study behavior and tech niques useful in increasing motivation to study will be covered. Week three will be devoted to pre senting the SQ3R method (Scan, Question, Read, Recite, Review Method) of how to read a book. Week four will cover the efficient taking down and use of lecture notes. Week five will be spent discussing specific techniques useful in studying for an exam, as well as procedures helpful in

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108 avoiding the emotional turmoil sometimes felt as you enter the examination situation. Week six will be devoted to getting more study done in less time, by the application of stimulus control and response management techniques. Week seven will be a review of the entire study counseling program. Each of the six succeeding sessions should follow a definite format and the therapist should present this to the subjects, saying something along the following line. For each subsequent session, we will spend a brief period discussing any problems or successes you had applying the principles and techniques discussed and learned the previous week, including the progress you make, your use of the study principles, etc. During this time, feel free to discuss any material which was unclear to you or prob lems with any of the above topics. Following this, we will discuss new techniques you will find useful in increasing your study efficiency. Study Counseling (50 minutes) During this phase of the session, the therapist is free to use either a lecture or discussion approach. It is important that the subjects understand the following concepts, as well as possible applications. Questions and discussion by the subjects should be encouraged. The following con cepts should be covered. 1. Study is a vague nonspecific term and cannot be de fined without reference to the objectives of each particular course. The therapist may wish to elaborate this point by mentioning that course objectives are reflected in the material covered, type of exams given and remarks made by the instructor.

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109 2. Time spent in 'study' is not related to academic per formance. A graduate student at Illinois has found that no relationship between self-reported time spent in study and exam performance existed for a sample of 154 under graduates. Some recent data indicate good students may actually spend less time in study, but use their time more efficiently. Seniors also tend to use their study time more efficiently than freshmen or sophomores. 3. The first step in beginning to study efficiently is to plan your study time from a general to an increasingly specific scheduling: a. The first step is to work out a weekly schedule, labelling classes, activities, free time, job com mitments, etc. This schedule should vary from week to week and reflect the differences in time demands for each course. b. Estimate the average amount of time you would need to study each subject in order to obtain a B or better grade. c. Schedule, if at all possible, blocks of free time between classes and assign these 'blocks' for study of one particular subject, all the time. d. When you do study during the week, note carefully and write down what you do while you 'study' (your behaviors and their consequences). For example, do you take frequent 'breaks,' (perhaps more often when confronted with a difficult problem or assignment)

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110 get 'headache' when it is time to study. How long does it take you to begin the assignment? The therapist should provide the subjects with the Weekly Schedule Form and a Model Functional Analysis of study behavior and spend the remainder of the time pointing out the value of recording actual behavior as a means of pro viding information about each subject's inefficiencies. In order to help the subjects perform a Functional Analysis, the therapist should provide each subject with the Func tional Analysis Form and the guideline for using the form. Any questions the subjects may have concerning the construction of a Functional Analysis should be answered and the subjects should be provided with guidelines for these analyses. The therapist should suggest that the subjects begin to record their own study behavior. This type of recording is a skill and,like the other skills pre viously discussed, will improve with practice. Such records also can provide a valuable source of data, pointing up areas of strength and weakness. Ask the subjects to bring in their functional analyses next session and mention some time will be spent discussing any problems they had in setting the analyses up and effectively using them. Session Two This session and all subsequent sessions should follow a format involving a short review of significant events during the previous week and carry out study counseling.

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111 Therapist praise and approval should be the primary tools used to shape the subjects into performing the necessary behaviors. Whenever possible encourage the subjects to interact with each other in order to solve the problems they have encountered. This may be accomplished by re directing specific questions to other group members, asking for their solutions. Study Counseling (50 minutes) This discussion deals with shaping study behavior. The assumption is being made that, if the subjects have been recording their behavior during the week, they will have begun to notice differences in the efficiency of various procedures. The subjects must be able to make such a dis crimination if they are to successfully work to shape up their most efficient behaviors. The following points should be made clear to the subjects and they should be encouraged to discuss the implications and applications of the princi ples and work out individual applications. 1. The concepts discussed during this session are tied to 'motivation' for studying. The average student views study as a burdensome chore which must be accomplished but he rarely defines any specific times or places study should be carried out in. 2. Thus, for many students 'study' never really begins or ends. One bad side effect of this lack of spatial and temporal limits is that the student is continually nagged or worried about doing his assignments. Such

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112 students usually find it difficult to begin studying, since he feels it is 'too little too late.' Similarly, such students report difficulties in being able to enjoy themselves after they have studied since they are concerned about having studied enough. 3. Some correlates of 'good students.' Allen (1971) gave 25 students enrolled in an introductory psychology class at his university a questionnaire designed to measure their study habits and used their responses to predict their grades in the course. He found that students ob taining higher grades reported the following about them selves: a. While they did not assign themselves a specific time to study each individual subject, they did set aside a specific time every day for study. b. They usually studied during the day (often between classes) and made enjoyable activities contingent upon completing a definite assignment. c. They studied alone. d. They studied one subject continuously for at least one hour, rather than skipping from subject to subject. e. They began working on long range assignments long before they were due. f. They obtained at least 5 hours of exercise each week.

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113 g. They actually spent less time studying the material specific to the psychology course than those who received lower grades. The therapist may wish to summarize these points as indicat ing that these students were more efficient in using their allotted time than those who received lower grades. 4. The techniques presented below assume that study be havior is a function of the person and the environment. Any student may arrange his environment so as to pro mote more efficient study behavior. Efficient study behaviors may be shaped by reinforcement of successive approximation. The therapist should make sure that all subjects are able to verbalize the meaning of these terms, as these princi ples form the basis of increasing 'motivation' and study efficiency. Several case studies are presented below and the therapist should attempt to insure that the subjects understand how the various principles were applied in the case studies. 5. One major method of shaping yourself into using efficient study behavior is to put our behavior under the control of specific, repetitive environmental events (stimuli). Stimulus control refers to the influence that environmental events exert upon behavior. Two simple examples are: a) going out to eat lunch at noon, whether you are hungry or not and 2) stopping for a red light even when no other traffic is nearby. We perform these

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114 behaviors because we have done them in the past and their performance has reinforcing consequences. The associa tions mentioned above are between specific environmental events and specific behaviors are quite strong. (For an absurd example, we don't normally get up in response to a red light or stop our car in response to an alarm clock). Other associations, especially in regard to study behavior, are not so strong. The problem for each individual is to apply specific events consistently so as to increase study behavior. Several case studies are presented as examples of how this may be accomplished. a) A college girl reported she felt sleepy and unable to study in her room especially at her desk. Analysis of her behavior revealed she used her desk to engage in many enjoyable activities not related to study. It was agreed she would replace a dim bulb in her desk lamp with a brighter one, and would engage in only study behaviors at her desk. If she wished to write letters, read magazines, talk with friends, etc., she would leave her desk. After one week, she reported spending only 10 minutes at her desk engaged in study. However, by the end of the semester, she was studying 3 hours a day, 4 days a week at her desk. Her desk thus became a 'signal' marking the time and occasion for study behavior. b) In a previous study, two students with above average GPA's and three with below average GPA's were

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115 recruited and promised they could accomplish all study necessary to raise their GPA's during the day, leaving evenings and weekends free. The first step was to increase stimulus control over study behavior. For example, one student was in structed to go to the library (a specific room and table was agreed upon) for an hour immediately after his most difficult class (physics). He was to enter this specific room and study only physics. If he experienced discomfort, began to daydream or found himself distracted from his study, he left the library immediately, after finishing one more page of his text or solving an additional problem. Each day the student increased the amount of work to be completed after deciding to leave (usually by one page or problem). These procedures had the effect of establishing stimulus control over his study behavior. The next series of procedures lead to the development of more efficient study behavior by substituting performance for time criteria. After the student was studying for almost the full hour, the material was broken into sections. After the student finished one section, he made a decision as to whether he would leave the library or stay and finish the next section. Once he started a section, he was required to finish it, but could leave after completing that section if he wished to.

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116 Over a one semester period, this pattern was ex tended to all of the student's courses, working from the most difficult to the easiest. Each course was assigned a different time and place of study every day. It was reported that the smallest improve ment was 1.0 GPA point and the largest was 4.0 points (from an F to a B average) for the subjects involved in this program. If time permits, the therapist should assess the subjects' reactions to the ideas contained in the study counseling section, correct any misconceptions concerning shaping and reinforcement techniques and quiz the subjects concerning how they could apply the principles in their own specific situation. Encourage subjects to verbalize how the prin ciples could be employed and indicate they probably would find it worthwhile to use them. Session Three Review of Significant Events (15 minutes) The therapist should review the important events which occurred during the week. Again, as in previous weeks, he/she should encourage the subjects to interact to solve one another's problems. Data concerning the usefulness of the techniques discussed should also be collected from the subjects. This period of time may also be profitably used by the therapist to determine whether the subjects have

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117 any misconceptions about the principles or applications, or, more generally, about any phase of the program. Study Counseling (45 minutes) The discussion to be covered during this session deals with efficient reading. It is assumed that the subjects are continuing to record their study behavior and have begun to implement some of the principles discussed the previous week. The discussion should begin with a short review of the principles discussed during the previous two weeks. A short review of these is presented below and should be covered in 5 minutes. The following points should be summarized: 1. Efficient study may be developed only by performing a continual functioning analysis, as this is the only method which allows the student to a) determine what techniques are most efficient for him, and b) assess the effects of constant practice of these techniques in terms of spending less time in study. 2. A functional analysis of study behavior requires, at the very least, recording the time you begin study, time you end study and environmental conditions which affect your concentration. 3. Study breaks should be programmed into your study time. The number of breaks depends upon the length of the assignment and the 'block' of time you can study efficiently.

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118 4. Study efficiency can be shaped by tying breaks or other payoffs initially to time limits and later to high qual ity performance within blocks of time. In this session, a specialized set of techniques should be presented, which deals with efficiently reading a book. The technique is based on the SQ3R method proposed by Robinson (1961). (Robinson is a professor at Ohio State who has spent 15 years working out these procedures.) After going through the procedures presented by Robinson, several examples of how these may be tied with the suggestions regarding shaping should be given. Accord ing to Robinson, efficient reading involves a transfer of material from the written page to memory and involves 5 steps--Scan, Question, Read, Recite, Review. These steps are presented below: 1. Scan--Look over the entire chapter, attempting to gain a general understanding of what the author is saying. Look especially at the major headings and the relationships between them. If the chapter has a summary, read this first as it provides a general overview of what the author believes is most important. This procedure should take only 2 to 4 minutes, and the student should have picked out 5 to 7 major points as important. (Note: A content analysis of college texts by Robinson has indicated authors typically cover 6 major points in every chapter.)

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119 2. Question--What you are about to read. Turn major and minor headings into questions. Often it is helpful to write these questions down in a notebook. Such ques tions serve the functions of a) allowing the student to quickly review efficiently by using a problem solving frame of reference, and b) allowing the student to quickly assess areas of strength and weakness when re viewing for an exam. Questions the student cannot answer indicate a need of reviewing that particular area, while an ability to answer questions in one particular area indicates that no further review is needed. Three types of questions are especially important: a) Definitions. Many test questions, especially in basic courses are of this type. Some examples are: b) "What is psychology?" "What is a mathematical integral?" Similarities and Differences. This type of question is useful in determining whether the student can state the essential components of a concept, and components which distinguish two or more related concepts. Some examples are: "How are Pavlovian and Operant Conditioning similar and different?" "What are two similarities and three differences between prose and poetry?" c) Examples. Questions of this type deal with apply ing a learned definition or concept to a new situation. "Which of these three examples is most like operant conditioning?"

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120 3. Read and Mark--The student should now read the text carefully in order to find answers to the questions he has written down. The student should not waste time underlining, rather, two efficient options are open to the student: a) The student may work out a personal notational sys tem for use in the margin. The purpose of such a system is to allow the student to quickly find relevant material during a review. An example of such a system is given below: I=important VI=very important S=summary l=answer to question 1 2=answer to question 2 ??=unclear b) The student may write the answer to each question in a notebook immediately after the question. This method has the advantages of consolidating all rele vant material for review purposes. The answers need not be lengthy. It is more important to pick out key phrases which will later 'key off' or 'trigger' recitation of the entire concept. The therapist should note the concept of discrimination stimulus fading is being used here, and may wish to present the following example of how this principle can be put into operation: "Four score and seven years ago, our forefathers ... "Four score and seven years ago ...

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4. 121 "Four score and ... Stimulus-Recite the Gettysburg Address Since all textbooks are the end product of the author's outline, it is convenient to search for the most impor tant material in four places in the text. a) The first sentence of a paragraph. Often, the rest of the paragraph serves to elaborate the main idea presented in the first sentence. b) Graphs, tables and charts are placed in texts in order to alert students to important material. They also serve to summarize key concepts whose explana tion may cover many pages of written material. c) Following key phrases such as "Four kinds ... "Two causes ... "First" "Second ... "Finally ... "In summary ... "Generally ... d) In chapter summaries. Recite the answers to your questions after having read the entire chapter. Recitation of the material is the most important step in the entire process, as it rep resents the method of transferring material from the text to the student's memories. Reciting the material, from memory, out loud results in more rapid learning because the student receives information through both verbal and auditory channels. Initially, a student may use prompts in the form of key words which serve to 'trigger' the correct response, but these should be faded out over time. If a student has successfully

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5. 122 memorized all main points, and can verbalize these without a prompt, he will do well on an exam covering this material, since prompts (in the form of test ques tions) will be provided. Consistently spaced recita tion of material is the most efficient method of 'over learning' that material. Research has indicated students who overlearn material are able to recall more important detail in less time when placed in a stressful examina tion situation, than students who have not overlearned the material. Review the material covered immediately after finishing all the questions in the chapter. The student should take no more than 5 minutes and reanswer all questions in the chapter. The student should then take no more than 5 minutes and reanswer all questions from memory. Questions which can be answered easily should be skipped over and the student should search for answers to the questions he is unable to answer at this time. tions requiring further review should be marked. Ques The general rule the student should follow during review is: If you cannot verbalize the answer, you don't know it. If any questions arise concerning the spacing of review, the therapist should explain this topic will be covered in a later session. Any questions the subjects have should be answered and, if time permits, the subjects should be encouraged to verbalize how they might effec tively use the procedures outlined above.

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123 Session Four Review of Significant Events (15 minutes) The subjects should be quizzed concerning important events, both positive and negative, which occurred during the week. The therapist's goal is to collect specific be havioral information which can be recorded and analyzed. Study Counseling (45 minutes) This week's material deals with the efficient recording of lecture notes. Since there is not as much material to be presented now as there was during the previous sessions, additional time may be available for discussion. The dis cussion may center on any phase of the program, but the therapist should always endeavor to maintain a 'problem solving' orientation. The following points should be pre sented to the subjects and elaborated, if necessary. 1. Most one hour lectures contain about 6 main points. 2. Most lecturers take pride in their work and attempt to present organized and informative lectures to the stu dents. While lecturing, these instructors will usually: a) Present a broad, general overview of the problem of material they plan to cover b) Briefly outline how he plans to cover the material c) State the main points as they are covered in the lecture, and label them as "important," "the main idea," etc. d) Label examples as such

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124 e) Label off topic comments as "excursions," "side issues," and so on 3. If a student has an instructor whom he considers a poor lecturer, it is the job of that student to be 'intellectually aggressive.' This means that the student must ask questions. Questions such as "What is the main point?" "Where are you going?" and so on are usually flattering to instructors, since these are viewed as indicative of 'student interest.' 4. During a lecture, instructors often drop information about their own personal interests. Most students do not bother to record this information and thus miss potentially useful cues. The fundamental point to be made here is that instructors are hwnan and their be havior follows the same series of operant laws that the student's behavior does. This means that spontaneous verbalizations of interest by the instructor may be high probability verbal behaviors and may be emitted by him when making up the exam. This point will probably need considerable elaboration but it is extremely important. Another way of stating the same thing is to point out that students which obtain the highest grades are usually able to 'play the role of the instructor' better than most students. This simply means that such students are able to determine what the instructor is look ing for and give it to him. These students are able to use a majority of the cues the instructor provides, even

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125 though these cues may not all pertain to the material presented in the lecture itself. 5. Some cues which the student should look for or actively seek out include: a) Philosophy of Testing 1) Terms like 'understanding,' 'integrating the material' usually indicate a preference for essay type examinations. 2) 'Being able to apply what you learn' usually indicates a preference for problems and analogy questions. The student should, therefore, carefully look at examples and extensions of the major concepts. 3) 'Knowing the basics' implies an emphasis on short answer questions involving similarities and differences. b) Philosophy of Education The cues mentioned above may also be useful here. If the instructor is unable to verbalize his 'philosophy of education' the student may wish to assume that he must feed back to the instructor what the instructor has originally fed him. c) Research Interests and Competencies Instructors at most institutions are rewarded for doing original research. Most work in a particular area because they enjoy it and are competent in it and they are likely to bring these areas into their

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126 teaching. Be aware of where their interests are. For example, if an instructor teaching an abnormal psychology course did research on fear behavior in hospitalized schizophrenics, the student might expect some questions touching on this area. In an essay question, citation of relevant literature on topics of research interest are very likely to be rewarded. d) Outside Interests and Activities These areas reflect the instructor's interests and competencies. Many instructors will use their per sonal experiences as examples to make a point. Citation of these experiences where appropriate on an essay exam may lead to extra points. 6. The lecture itself also provides useful cues concerning what may appear on the exam. Two important sources of information are: a) Handout sheets often contain information which was either not or insufficiently explained during the lecture. b) If the instructor writes something on the board, it is probably important enough to copy down. 7. Taking notes during the lecture is the single most im portant source of information. Good organization of notes assures that the student will understand their contents when studying for an exam. Some tips for taking organized notes are presented below:

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127 a) A system of headings, subheadings and minor points should be used. Each of these headings should be indented to set it off from the others. The use of numbers and letters to identify each point also helps increase organization. b) A personal notational system will also increase organization. Many students have found the follow ing notations useful: Ex=example S =summary ??=unclear ) =excursion from main point I =important c) By using wide margins, the student can write in additional clarifying information. d) It is also helpful to leave approximately one half page blank between lectures. This procedure has two uses which are explained below. 8. After the lecture has been completed the student should; a) Take 5 minutes to skim over his lecture notes and complete his organization, marking ambiguous points b) Write two or three sentences summarizing the main points of the lecture c) Write a note to himself to remind him to ask for a clarification of any ambiguous points at the begin ning of the next lecture 9. The student often discovers that the instructor can offer a concise summary of any ambiguous points if asked to do so by the student. These summaries are important

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128 for two reasons and should be copied down in the blank space at the end of the previous lecture notes. The reasons why such summaries are important include: a) Time pressure forces the instructor to present only the material he feels is essential. For ex ample, he may explain a concept in three minutes while the original took 15, by omitting all non essential points. b) The instructor will often clarify questions by reciting material from memory and not by recourse to his previous lecture notes. Taken together, these two facts may be used by the stu dent effectively to take the role of the instructor while taking an exam. Remember, the fact that the instructor could answer the question from memory indi cates a high probability that other cues could set off a similar response. In terms of common sense, if the instructor is grading a short essay test covering infor mation he lectured on four weeks previously, and he reads a summary one student wrote which was taken down by the student after asking for a clarification, the instructor's response would probably be "This sounds good," "very well written." He would probably not think that this "student just repeated what I said." If time permits, answer any questions the subjects may have and have the subjects discuss how they might use the principles they have just covered.

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129 Session Five Review of Significant Events (15 minutes) The format presented in previous sessions should again be continued. It is important for the therapist to deter mine how effectively the students have been applying the principles they have learned. Study Counseling (45 minutes) The topic covered during this session is "How to Prepare for an Examination." The therapist should discuss the fol lowing topics, as outlined below: 1) The importance of review; 2) Distribution of review time; 3) Two major review methods; and 4) Relaxing in the examination situation. The therapist should present the material with the goal of demonstrating to the subjects that there is "no easy way out" of study. One cannot get something for nothing. However, the systematic application of the principles presented during all the sessions usually leads to in creased study efficiency. 1. The importance of review is that it is the only method by which the facts and knowledge can be transmitted from a book or lecture notes and fixed into memory of the student. The first review should occur as part of the original study process. Several methods presented in the previous two weeks (e.g., scanning your notes after lectures, reciting material, answering questions about what you have read) are basically review methods. The greatest value of systematic review is that it allows

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130 the student to focus most readily on areas which he does not know well and skipover those he does. If the student recites the material out loud, he is using up to 3 sense modalities (sight, hearing and speech) and thus may increase his learning speed and retention. 2. The distribution of review time is critical since all students have a certain limited time to complete a re view and prepare for an exam. The following rules serve as useful guides in conducting a more efficient review: a) Space the reviews out over time. Research has in dicated the superiority of spaced over massed practice in terms of lengthening retention time. Several methods of spacing reviews are presented below. They may be used singly or in combination. i) Carry out the first review immediately after class, in the manner suggested last week. ii) Perform a cumulative review each week for every subject (stress the notion of cumula tive). A cumulative review may seem unneces sarily repetitive, but constant repetition makes the material easier to verbalize especially under stressful exam conditions. This type of review need take no more time than 15 minutes per subject and the student most likely should find he does not need to spend as much time on previous material after several repetitions.

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131 iii) Begin a concentrated review several days before the exam. b) Use study questions to guide the direction of the review. By using such guides or cues the student is able to quickly pinpoint his strengths and weak nesses as well as keep the review task content rather than time oriented. c) Conduct your reviews in the same places you study. This rule is especially important where the student has successfully established stimulus control over his study behavior. 3. Most students who are able to effectively utilize their study time use one of two review methods, or some com bination of both types. The therapist might point out that both methods involve chaining responses in the presence of discriminative stimuli (either questions or cue words) and gradually fading the discriminative stimuli. The subjects might better grasp these con cepts if any discussion was put off until both methods have been presented. All questions should be answered by the therapist at that time. The first method is recommended for students who have become comfortable using the SQ3R method of reading outlined in session three. This method involves the use of previously prepared study questions as cues to 'trigger off' correct answers, and consists of the following steps:

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132 a) Page through the chapters, one at a time, noting the headings and subheadings, and reciting aloud all that you can remember about what is contained in that part of the chapter. b) At the end of each division, read and answer aloud all the study questions concerning that particular material. c) Look up any answers you cannot provide from memory and recite these until they can be answered without using any cues. It is also worthwhile to note these questions so you can return to them at the end of the review period. d) Ask yourself variations of the previously prepared questions, and write down for future reference. By using additional questions, you will increase the scope of the material you have covered and be able to determine whether you can apply what you have learned to new situations. e) Before ending your review, go back and test your ability to answer all questions you previously missed. If you are able to do this, you are likely to do well on the exam. The second method deals with outlining material rather than answering questions and is recommended for students gathering material which may be useful in later courses. The therapist should mention the value of saving old outlines and readings, especially in the courses a

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133 student is majoring in. The therapist might wish to point out that several graduate students in psychology can write extensive term papers without looking up a single reference in the library. This can be accom plished because these students take notes of relevant material (books, journals, articles, etc.) when they read them. Their outlines always include the reference of that article in the approved style of the American Psychological Association. The basic concept to trans mit to the subject is that education is a cumulative (sometimes redundant) process, and they would find cumulative information gathering a time saving process in the long run. The method involving outlining consists of the following steps: a) Going through each chapter and outlining the main points. A system of indentations and numbers and letters will be useful in helping separate major and minor points. b) The outline should include such things as defini tions similarities and differences, names, dates and relevant examples. Direct quotes should be avoided unless the author is able to make his point more succinctly than you could by paraphrasing him. The amount of material to be contained in an outline is always a problem. Too little material leads to lack of information; too much defeats the purpose

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134 of outlining. Usually, an adequate outline of 15 to 20 pages of text can be made on one page of narrow lined paper. c) Several days before the exam, skim over the outline and form a condensed outline (an outline of the outline). d) Use this outline as a study guide and attempt to recite all you can remember about a concept, using only the cues present in the condensed outline. e) One or two days before the exam, make an even more condensed outline consisting of single key words, and repeat the recitation process. In general, you 'know' the material when you are able to verbalize a number of related concepts from memory using only the single key words as cues. This method has several advantages, such as helping the student systematically condense the material, allowing him to carry the short outline around with him and using it frequently during the day and so on. f) In addition to using the condensed outlines, the student should scan the original outline several times a day, in order to strengthen the associa tions between the cue words and the outlined material. An excellent time to scan the first outline would be immediately before going to bed at night, as going to sleep after conducting the short review would prevent or lessen any retroactive in hibition which might otherwise occur.

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135 4. Relaxing in the testing situation is extremely helpful, as these situations generally appear to provoke a great deal of emotional behavior from students (e.g., anxiety, hostility, etc.). The series of procedures we have been using should help you relax in the exam situation, es specially since we are working to remove both the con ditioned and reactive components of test anxiety. Sev eral procedures can be used in the immediate examination situation which will help you relax. a) Arrive early at the testing place. Latecomers often become agitated trying to 'catch up' to the students who have already started working and their per formance suffers. b) Bring the proper materials so you can settle down to work immediately. c) Avoid discussions with other students about possible questions and answers. d) Do not panic if you suddenly cannot remember any of the material you have learned. Remember you have used cues to learn the material and the test questions will serve as cues to set off the proper response. 5. Good students are able to use different strategies for answering different types of exams. Listed below are the most useful strategies for answering essay and short answer (the so-called 'objective') exams. When answering essay exams:

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136 a) Make a brief (30 second to 1 minute) survey of the entire exam, reading every question, noting the value of each and estimating the difficulty of each for you. This brief survey will allow you to divide your time so as to maximize your possible point total. b) Plan to answer the least difficult questions first and the most difficult last. This procedure allows you to write down concepts useful for answering the most difficult question as these concepts occur to you as you work on the other questions. c) After selecting the first question you wish to work on, read it carefully. Do not confuse ques tions dealing with cause and effect. If you are asked to discuss the causes of an event, do not spend time writing about the event itself or the consequences of that event. The following words often have special meanings and you should look out for these: List (you may use outline form in answering) Compare (emphasize similarities) Contrast (emphasize differences) Outline d) If you are not sure you understand the question, write a short note on your answer sheet, stating explicitly how you interpret the question and men tioning you will answer the question according to your interpretation.

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137 e) Organize an outline of what you wish to say. List the important cue concepts you wish to use in your answer. By writing these words down you will 'trigger' your memory for finer details and other cue concepts. f) Focus your answer around some central point. Do not ramble or throw in extraneous facts simply to show you know them. Sum up your argument at the end of the essay. If you have written a good essay, the grader or any other reader should be able to outline the contents in a systematic fashion. g) Do not spend more than the allotted amount of time on any one essay. If you have only 10 minutes to write the answer, write a short one. Remember, everyone else is limited by time. When answering objective questions: a) Find out whether any correction is to be used for guessing. Usually these corrections are in the form of right minus some percentage of wrong an swers. If you can eliminate a number of alterna tives as obviously wrong, then guessing will help your score. b) In true false questions watch out for trick words which either over or understate the degree of rela tionship between two concepts. Questions containing the words always, every, none, all, never, etc. usually are false unless they involve a definition.

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138 As an example, consider the definition 'Psychology is the science of human behavior.' If the question were worded 'According to the definition of psy chology given, the psychologist is always concerned with human behavior,' then, this statement is true. c) If a true-false question contains two independent clauses, connected by the words 'and' 'or' 'but' etc., then if one clause is false the entire sentence is false. d) When working with multiple choice questions, at tempt to eliminate any obviously wrong alternatives. A good clue to use is to automatically eliminate any alternatives which seem to represent the same con cept. As an example, consider the question: Which correlation has the best predictive value? A. +.60 B. -.80 C. -.60 D. =.01 Even if you do not know the answer you should be able to eliminate the choices 'A' and 'C' due to the redundancy of the number given. e) If you are unable to remember the exact answer for a fill in blank question, return to it later. If you are still unable to remember write down the closest approximation you can think of. You might get some partial credit for answers of this type. f) Research has indicated your first response is not necessarily correct. Do not hesitate to change any answers, if, after further consideration, you feel another response would be more appropriate.

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139 If time permits the therapist should answer any ques tions the subjects have and work to insure that they could effectively utilize the suggestions which have been presented to them. Session Six Study Counseling (45 minutes) Today's topic deals with response management of study behavior and is slightly shorter than previous discussions. It has been assumed that the subjects have established some stimulus control over their study behavior by sys tematically applying the material they have learned. The information presented today deals with using the Premack principle (combined with previously discussed techniques) to extend study behavior to situations not usually con nected with study. The following points should be pre sented and discussed. 1. Response management techniques refer to the use of specific environmental events (reinforcers or be haviors) to control the rate of response and the situations in which a response is to occur. 2. The Premack principle is one major method of response management. This principle states: If behavior Bis of higher probability (greater frequency of occurrence) than behavior A, then behavior A can be made more probable by making behavior B contingent upon it. The therapist should provide enough examples of this

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140 principle to provide the subjects with the knowledge of how it could be applied. Several examples are presented below. These deal with shaping study be havior and should be presented after the other examples. Several examples of how this technique can be applied to study behavior are: a) If you smoke a pack of cigarettes a day, smoking is probably of a higher probability than studying. To increase study behavior, you need to follow the steps outlined below. i) Carry around condensed outlines or questions on 3 x 5 cards. ii) Set up the following rule. Before I light my cigarettes, I will read out and answer the questions on one card. iii) Do not light your cigarette until you have carried out the requirements you have set for yourself. b) Many students eat while they study. Eating often serves as a diversion from concentrated memorization, and may be associated with inefficient study. Food may be used to increase study efficiency by using the Premack principle; by setting up a rule such as: "I will study for X minutes and then eat for X minutes." The value of this procedure is that it can be used in many places (waiting for the campus bus, while in line in a cafeteria, etc.).

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141 Consistent use of the rules you impose on yourself allows you to conduct many surveys of the material you must memorize and thus, serves as a fairly painless method of strengthening the associations you will need to do well on exams. The rules you set up should not require a large amount of work or time. Constant repetition of reciting the material will lead to longer lasting associations. Use of this principle, however, ought to be tied to the methods of study discussed in previous sessions for maximum efficiency. 3. A second method of response management involves arrang ing 'payoffs' for yourself at the end of longer periods of study. Examples of such 'payoffs' may range from going out for a beer after studying for several hours or clothes after receiving an A or Bon an exam. The important idea here is that you reward yourself for studying to some present criterion and not reward your self because you are feeling down in the dumps, de pressed, or any reason tied to your performance. 4. Both these techniques have the added benefit of allowing you to forget about studying after you have reached the criteria you have set for yourself. If your criteria were reasonable, and if you did not cheat yourself by not following them, then you can reward yourself with out any nagging doubts about your preparedness for an upcoming exam. Discuss these principles with the

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142 subjects in any remaining time. The therapist should attempt to get the subjects to verbalize how they might use both principles, what kinds of reasonable rules they could impose on themselves, and what rewards they might use. While it is important that th8 subjects can verbalize the importance of these procedures, they should not interpret these as an easy substitute for the procedures discussed in previous sessions. They should be viewed as being most useful when the stu dents have combined them with other techniques previ ously discussed. Session Seven The format of this final session varies somewhat from that of previous sessions. Time limits for each procedure used are not rigidly set in session seven. The extra time could be used for discussion. Review of Significant Events (15-20 minutes) The format used previously should be continued. All pertinent data should be recorded. In addition to the standard procedures, the therapist should question the subjects regarding the stability of any positive changes which have occurred. Information concerning the environmental events maintaining any positive changes should be recorded, and discussed during the session, if necessary. It is extremely important that the subjects leave the final session confident in their ability to maintain and

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143 strengthen any desirable behaviors which were developed during the sessions. The therapist can best determine this by playing the 'devil's advocate' and proposing problems to the subjects and asking how they might solve these. Review Discussion of Study Techniques (X minutes) Rather than present any new techniques, the counseling is devoted to a review of all the techniques previously presented as well as the purpose of each. The therapist should present a short swnmary of each technique, all of which are listed below, and allow the subjects to discuss problems and successes in their application. Discussion of using these techniques in the future should also be carried on with the therapist praising correct and novel applica tions and correcting any misinformation presented by the subjects. The major techniques and rationales are presented below in outline form. 1. Session one was spent defining study behavior in terms of what you as students actually do with your time. The necessity of analyzing study in terms of a func tional analysis is to help spot areas of high and low efficiency, and become increasingly better able to verbalize the relationship between your behavior and their consequences. After presenting this summary, the therapist should allow the subjects to discuss the techniques and rationale, until time has run out, or the subjects are able to verbalize both.

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144 2. Week two was spent providing examples of how study behavior may be gradually increased by systematically studying in the same place at the same time. The methods suggested, if faithfully followed, should have led to a relatively 'painless' increase in study behavior. 3. During the third session the SQ3R method of reading was explained. This method is the best one so far developed to increase reading speed and comprehension. 4. The fourth week was devoted to taking neat, organized lecture notes. The use of such notes aids review and can help shorten review time, as well as provide back ground information in a student's major and minor area. 5. Specific review techniques and methods of outlining were presented in the fifth session. The value of repetition in memorizing material was stressed. 6. Last week, we dealt with methods to allow repetition in learning material by using several response manage ment techniques. These methods provide another rela tively efficient and 'painless' method of overlearning relevant material. This study skills treatment manual was adapted from the unpublished Desensitization Study Counseling Manual authored by G. Allen.

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REFERENCES Allen, G.J. Effectiveness of study counseling and de sensitization in alleviating test anxiety in college students. Journal of Abnormal Psychology, 1971, 72, 282-289. Alpert, R., & Haber, R.N. Anxiety in academic achievement situations. Journal of Abnormal and Social Psychology, 1960, 61, 207-215. Antrobus, J.S. thought. 423-430. Information theory and stimulus-independent British Journal of Psychology, 1968, ~' Antrobus, J.S., Antrobus, Judith S., & Singer, J.L. Eye movements accompanying daydreaming, visual imagery, and thought suppression. Journal of Abnormal and Social Psychology, 1964, ~' 244-252. Antrobus, J.S., Coleman, R., & Singer, J.L. Signal detec tion performance by subjects differing in predisposi tion to daydreaming. Journal of Consulting Psychology, 1967, 31, 487-491. Aserinsky, E., & Kleitman, N. Regularly occurring periods of eye motility and concomitant phenomena during sleep. Science, 1953, 118, 273-274. Ashem, B., & Donner, L. Covert sensitization with alcohol ics. A controlled replication. Behavior Research and Therapy, 1968 6, 7-12. Averill, J.R. Personal control over aversive stimuli and its relationship to stress. Psychological Bulletin, 1973, ~' 286-303. Bacheland, G. On poetic imagination and reverie. New York: Bobbs-Merrill, 1971. Bandura, A. Principles of behavior modification. New York: Holt, Rinehart & Winston, 1969. 145

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---------------146 Bandura, A. Adams, N., & Beyer, J. Cognitive processes mediating behavior change. Journal of Personality and Social Psychology, 1977, ~' 125-139. Bandura, A., & Jeffrey, R. The role of symbolic coding, cognitive organization and rehearsal processes in observational learning. Journal of Personality and Social Psychology, 1973, ~' 122~130. Barber, T.X., & Hahn, K.W., Jr. Experimental studies in "hypnotic" behavior: Physiological and subjective effects of imagined pain. Journal of Nervous and Mental Disease, 1964, 139, 416-425. Barlow, D. H. Lei tenberg, H. & Agras, W. S. Experimental control of sexual deviation through manipulation of the noxious scene in covert sensitization. Journal of Abnormal Psychology, 1969, 74, 596-600. Baylor, G.W. "A Treatise on the mind's eye." Ph.D. thesis, Carnegie-Mellon University, 1971. Bower, G.H. Mental imagery and associative learning. In Lee Gregg, (Ed.), Cognition in learning and memory. New York: Wiley, 1971. Bower, G.H., & Winzenz, D. learning strategies. 119-120. Comparison of associative Psychonomic Science, 1970, ~, Breger, L., & McGaugh, J.L. Critique and reformulation of learning theory approaches to psychotherapy and neurosis. Psychological Bulletin, 1965, .l_, 338-358. Bugelski, B., Kidd, E., & Segman, J. The image as a mediator in one trial paired associate learning. Journal of Experimental Psychology, 1968, J!i, 69-73. Calhoun, J. manual. Desensitization study counseling therapist Unpublished manuscript. New York, 1972. Cautela, J.R. Covert sensitization. Psychological Reports, 1967, ~, 459-468. Cautela, J.R. Covert reinforcement. Behavior Therapy, 1970, l:., 22-50. Cautela, J.R. Covert conditioning. Unpublished manuscript, 1974. Cautela, J., Flannery, R., & Hanley, E. Covert modeling: An experimental test. Behavior Therapy, 1974, ~, 494502.

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147 Cautela, J.R., Walsh, K., & Wish, P. The use of covert reinforcement in the modification of attitudes toward the mentally retarded. The Journal of Psychology, 1971, 7..2, 257-260. Cautela, J.R., & Wisocki, P.A. Covert sensitization for the treatment of sexual deviations. Psychological Record, 1971, l:_, 37-48. Chang-Liang, R., & Denny, D.R. Applied relaxation as training in self-control. Journal of Counseling Psychology, 1976, ~' 183-189. Craig, K.D. Physiological arousal as a function of imagined, vicarious, and direct stress experiences. Journal of Abnormal Psychology, 1969, 73, 513-520. Craighead, W .E., Kazdin, A., & Mahoney, M. Behavior modifica tion, principles, issues and applications. Boston: Houghton Mifflin Co., 1976. Crowder, R.G. Principles of learning and memory. Hillsdale, N.J.: Lawrence Erlbaum Associates, 1976. Davison, G.C. Elimination of a sadistic fantasy by a client-controlled counterconditioning technique: A case study. Journal of Abnormal Psychology, 1968, 22., 84-89. Davison, G.C., & Wilson, G.T. Critique of "Desensitiza tion: Social and cognitive factors underlying the effectiveness of Wolpe's procedure." Psychological Bulletin, 1973, 78, 28-31. Desoille, R. Geneva: Theorie et pratique du reve eveille dirige. Mont-Blanc, 1961. Ellis, A. Reason and emotion in psychotherapy. New York: Lyle Stuart, 1962. Fazio, A.F. Treatment components in implosive therapy. Journal of Abnormal Psychology, 1970, J.i, 211-291. Flannery, R.B. A laboratory analogue of two covert re inforcement procedures. Journal of Behavior Therapy and Experimental Psychiatry, 1972a,i, 171-177. Flannery, R.B. Use of covert conditioning in the treatment of a drug-dependent college dropout. Journal of Counseling Psychology, 1972b,19, 547-550. Freud, S. Freud's psychoanalytic procedure. In J. Strachey, (Ed. ) The standard edition. Vol. 1. London: Hogarth, 1962.

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148 Gendlin, E.T. Focusing. Psychotherapy, 1969, ~' 4-15. Goldfried, M. Systematic desensitization as training in self-control. Journal of Consulting and Clinical Psychology, 1971, 37, 228-234. Grossberg, J.M. & Wilson, H. Physiological changes ac companying the visualization of fearful and neutral situations. Journal of Personality and Social Psychology, 1968, 10, 124-133. Haber, R.N. & Haber, R.B. Eidetic imagery: I. Frequency. Perceptual and Motor Skills, 1964, ~' 131-138. Harris, G., & Johnson, S. Comparison of individualized covert modeling, self-control desensitization, and study skills training for alleviation of test anxiety. Journal of Consulting and Clinical Psychology, 1980, ~' 186-194. Hebb, D.O. Organization of behavior. New York: Wiley, 1949. Hebb, D.O. Concerning imagery. Psychological Review, 1968, 75, 466-477. Hersen, M. Self-assessment of fear. Behavior Therapy, 1973, 4, 241-257. Holroyd, K.A. Cognition and desensitization in the group treatment of test anxiety. Journal of Consulting and Clinical Psychology, 1976, i.i_, 991-1001. Holt, R. Imagery: The return of the ostracized. American Psychologist, 1964, 19, 254-264. Holt, R. On the nature and generality of mental imagery. In P. Sheehan, (Ed.), The function and nature of imag ery. New York: Academic Press, 1972. Horowitz, M.J. Image formation and cognition. New York: Appleton, 1970. Jacobsen, E. Electrical measurements of neuromuscular states during mental activities: I. Imagination of movement involving skeletal muscle. American Journal of Physiology, 1929, 2...!_, 567-608. Jacobsen, E. Electrical measurement of neuromuscular states during mental activities: III. Visual imagination and recollection. American Journal of Physiology, 1930, 22_, 694-702.

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.--------------------------~ ~ ~ 149 Jaensch, E.R. Eidetic imagery. London: Kegan, Paul, Trench, Trubner and Company, Ltd., 1930. Jones, M.R. (Ed.) Aversive stimulation. Coral Gables: Univer. of M iami Press, 1969. Joyce, J. Ulysses. Paris: Shakespeare and Co., 1922. Kazdin, A.E. Covert modeling and the reduction of avoidance behavior. Journal of A bnormal Psychology, 1973a, 81, 87-95. Kazdin, A.E. Effects of covert modeling and reinforcement on assertive behavior. Proceedings of the 81st Annual Convention of the American Psychological Association, 1973b, ~' 537-538. Kazdin, A.E. relevant Therapy, The effect of model identity and fear similarity on covert modeling. Behavior 1974, ~' 624-635. Kazdin, A.E. Covert modeling, model similarity, and reduction of avoidance behavior. Behavior Therapy, 1975, !l, 716-724. Kendrick, S.R., & McCullough, J.P. Sequential phases of covert reinforcement and covert sensitization in the treatment of homosexuality. Journal of Behavior Therapy and E x perimental Psychiatry, 1972, 3, 229-231. Kleitman, N. Sleep and wakefulness. Chicago: Urriversity of Chicago Press, 1963. Kluver, H. Eidetic phenomena. Psychological Bulletin, 1932, ~, 181-203. Kosslyn, S.M. "Constructing visual images." Ph.D. disser tation, Stanford University, 1974. Kosslyn, S. M Information Representation in visual images. Cogniti v e Psycholog y 1975, 2, 341-370. Kosslyn, S.M. & Pomerantz, J.R. Imagery, propositions, and the form of internal representations. Cognitive Psychology, 1977, 9, 52-77. Kosta, M .P. & Galassi, J. Group systematic desensitiza tion versus covert positive reinforcement in the reduction of test an x iet y Journal of Counseling Psychology, 1974, Q, 464-468. Kramer, C. Extension of multiple range tests to group means with unequal number of replications. Biometrics, 1956, 12, 307-310.

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150 Krop, H., Calhoun, B., & Verrier, R. Modification of the "self-concept" of emotionally disturbed children by covert self-reinforcement. Behavior Therapy, 1971, ~' 201-204. Krop, H., Perez, F., & Beaudoin, C. Modification of "self concept" of psychiatric patients by covert reinforce ment. In R.D. Rubin, J.P. Brady, & J.D. Henderson (Eds.), Advances in behavior therapy, Vol. 4. New York: Academic Press, 1973, pp. 139-144. Lang, P. Imagery in therapy: An information processing analysis of fear. Behavior Therapy, 1977, ~' 862-886. Lang, P. A Bio-Informational Theory of Emotional Imagery. Presidential Address, Society for Psychophysiological Research, Sept. 1978. Lang, P. A bio-informational theory of emotional imagery. Psychophysiology, 1979, in press. Lang, P., Kozak, M.J., Miller, G.A., Levin, D.N., &McLean, A. Emotional imagery: Conceptual structure and pattern of somato-visceral response. Psychophysiology, 1979, in press. Lang, P. Melamed, B. & Hart, J. A psychophysiological analysis of fear modification using an automated desensitization procedure. Journal of Abnormal Psychology, 1970, '}_j__, 220-234. Lazarus, A.A. New methods in psychotherapy: A case study. South African Medical Journal, 1958, 32, 660-663. Lazarus, A.A. Group therapy of phobic disorders by sys tematic desensitization. Journal of Abnormal and Social Psychology, 1961, ~' 505-510. Lazarus, A.A. Behavior therapy and beyond. New York: McGraw-Hill, 1971. Lazarus, A.A., & Abramovitz, A. The use of "emotive imager y in the treatment of children's phobias. Journal of Mental Science, 1962, 108, 191-195. Lazarus, A.A., Davison, G.C., & Polefka, D.A. Classical and operant factors in the treatment of a school phobia. Journal of Abnormal Psychology, 1965, J..!2, 225-229. Leask, J., Haber, R.N., & Haber, R.B. Eidetic imagery in children. II. Longitudinal and experimental results. Unpublished manuscript, University of Rochester, 1968.

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151 Mahoney, M.J. Cognition and behavior modification. Cambridge, Mass.: Ballinger, 1974. Mahoney, M.J. Scientist as subject. Cambridge, Mass.: Ballinger, 1976. Mahoney, M.J. therapy. On the continuing resistance to thoughtful Behavior Therapy, 1977, 8, 673-677. Marshall, W.L. The modification of phobic behavior by covert reinforcement. Behavior Therapy, 1975, in press. Marx, M., & Goodson, F. Theories in contemporary psychology. New York: Macmillan Publishing Co., 1976. Marx, M., & Hillix, W. Systems and theories in psychology. New York: McGraw-Hill Co., 1973. May, J. & Johnson, H. Physiological activity to internally elicited arousal and inhibitory throughts. Journal of Abnormal Psychology, 1973, ~' 239-245. McGuigan, F.J., & Schoonover, R.A. (Eds.) The psycho physiology of thinking. New York: Academic Press, 1973. Meichenbaurn, D. Cognitive modification of test anxious college students. Journal of Consulting and Clinical Psychology, 1972, i2_, 370-380. Meichenbaum, D. Cognitive behavior modification: An integrative approach. New York: Plenum Press, 1977. Mitchell, K.R., & Ng, K.T. Effects of group counseling and behavior therapy upon the academic achievement of test anxious students. Journal of Counseling Psychology, 1972, 19, 491-497. Morganstern, L. Implosive therapy and flooding procedures: A critical review. Psychological Bulletin, 1973, 7..2_, 318-334. Mumford, L. The myth of the machine. London: Secker & Warburg, 1967. Neisser, U. Cognitive Psychology. New York: Appleton Century-Crofts, 1967. Neisser, U. Visual imagery as process and as experience. In J. Antrobus, (Ed.) Cognition and Affect. Boston: Little Brown & Company, 1970.

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152 Neisser, U. Changing conceptions of imagery. In P. Sheehan, (Ed.), The function and nature of imagery. New York: Academic Press, 1972. Paivio, A. Mental imagery in associative learning and memory. Psychological Review, 1969, ~, 241-263. Paivio, A. Imagery and verbal prophecy. New York: Holt, Rinehart & Winston, 1971. Paivio, A. The role of imagery in learning and memory. In P. Sheehan, (Ed.), The function and nature of imagery. New York: Academic Press, 1972. Paivio, A., & Madigan, s. Noun imagery and frequency in paired associate and free recall learning. Canadian Journal of Psychology, 1970, 24, 353-361. Paivio, A., & Rowe, E.J. Noun imagery, frequency, and meaningfulness in verbal discrimination. Journal of Experimental Psychology, 1970, 85, 264-269. Paivio, A., & Smythe, P.C. Word imagery, frequency and meaningfulness in short term memory. Psychonomic Science, 1971, ~, 333-335. Paul, G. L. Insight vs. desensitization in psychotherapy. Stanford, California: Stanford Univ. Press, 1966. Paul, G.L. Two year follow-up of systematic desensitiza tion in therapy groups. Journal of Abnormal Psychology, 1969, 73, 119-130. Paul, G., & Shannon, D. Treatment of anxiety through systematic desensitization in therapy groups. Journal of Abnormal Psychology, 1966, 71, 124-135. Prochaska, J.O. Symptoms and dynamic cues in the implosive treatment of test anxiety. Journal of Abnormal Psychology, 1971, 72, 133-142. Pylyshyn, Z.W. What the mind's eye tells the mind's brain: A critique of mental imagery. Psychological Bulletin, 1973, ~, 1-24. Rachlin, H. Reinforcing and punishing thoughts: A re joined to Ellis and Mahoney. Behavior Therapy, 1977a, _, 678-681. Rachlin, H. A review of M.J. Mahoney's cognition and behavior modification. Journal of Applied Behavior Analysis, 1977b, l.Q_, 369-374. Rachlin, H. Reinforcing and punishing thoughts. Behavior Therapy, 1977c, 8, 659-665.

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153 Rachman, S., & Teasdale, J. Aversion therapy and behavior disorders: An analysis. Coral Gables, Fla.: Universit y of M iami, 1969. Robinson, D.N. New York: An intellectual history of psychology. Macmillan Publishing Co., Inc., 1976. Robinson, F.P. Effective study. New York: Harper and Row, 1961. Sanders, G., Nelson, J., & Rosenthal, M. of Britain and America. London: 1972. Chief modern poets The MacMillan Co., Sarason, I.G. Experimental approaches to test anxiety: Attention and the uses of information. In C.D. Spielberger (Ed.), Anxiety: Current trends in theory and research (Vol. 2). New York: Academic Press, 1972. Segal, S.J. Processing of the stimulus in imagery and perception. In Imagery: Current cognitive approaches. New York: Academic Press, 1971. Service, J. Users guide to statistical analysis system. Raleigh: North Carolina State University Press, 1979. Sheehan, P.1v. Accuracy and vividness of visual images. Perceptual and Motor Skills, 1966, ~, 391-398. Shepard, R.N. Form, formation, and transformation of in ternal representations. In R. Solso (Ed.), Information processing and cognition: The Loyola Symposium. Hillsdale, N.J.: Erlbaurn, 1975. Shepard, R.N. The mental image. American Psychologist, 1978, ll, 125-137. Shepard, R.N. & Chipman, S. Second-order somorphism of internal representations: Shapes of states. Cognitive Psychology, 1970, 1-17. Shepard, R. N & Cooper, L.A. Representation of colors in normal, blind and color-blind subjects. Paper pre sented at the annual meeting of the American Psycho logical Association, Chicago, September 2, 1975. Shepard, R. N ., Kilpatrick, D.W., & Cunningham, J.P. The internal representation of numbers. Cognitive Psy chology, 1975, 2, 82-138.

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154 Simpson, H.M., & Paivio, A. Changes in pupil size during an imagery task without motor involvement. Psychonomic Science, 1966, ~' 405-406. Singer, J.L., Imagery and daydreaming. In B. Wolman, Handbook of General Psychology. New York: Prentice Hall, Inc., 1973, pp. 385-394. Singer, J.L. Imagery and daydream methods in psychotherapy and behavior modification. New York: Academic Press, 1974. Singer, J.L., & Antrobus, J.S. Eye movements during fantasies, A.M.A. Archives of General Psychiatry, 1965, g, 71-76. Smith, E.D., Dickson, A.L., & Sheppard, L. Review of flooding procedures (implosion) in animals and man. Perceptual and Motor Skills, 1973, 37, 351-374. Spielberger, C.D., Anton, W.D., & Bedell, J. The nature and treatment of test anxiety. In M. Zuckerman and C.D. Spielberge~ (Eds.), Emotions and anxiety: New concepts, methods and applications. New York: LEA Wiley, 1975. Spurgeon, C. Shakespeare's imagery and what it tells us. Cambridge: Cambridge Univ. Press, 1935. Suinn, R. The STABS, a measure to test anxiety for behavior therapy: Normative data. Behavior Research and Therapy, 1969, 2, 335-339. Susskind, D. The idealized self-image (ISI): A new technique in confidence training. Behavior Therapy, 1970, !, 538-541. Titchener, E.B. The scheme of introspection. American Journal of Psychology, 1912, Q, 427-488. Van Egeren, L.F., Feather, B.W., & Hein, P.L. Desensitiza tion of phobias: Some psychophysiological proposi tions. Psychophysiology, 1971, ~' 213-228. Watson, D., & Friend, R. Measurement of social-evaluative anxiety. Journal of Consulting and Clinical Psychology, 1969, 33, 448-457. Watson, J.B. Psychology as the behaviorist views it. Psychological Review, 1913, ~, 158-177. Watson, J.B. Behaviorism. Chicago: University of Chicago Press, 1924.

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155 Weitzman, B. Behavior therapy and psychotherapy. Psychological Review, 1967, 74, 300-317. Wilkins, W. Desensitization: Social and cognitive fac tors underlying the effectiveness of Wolpe's proce dure. Psychological Bulletin, 1971, 7..i_, 311-317. Wilson, C.T., & Davison, C.C. Processes of fear-refuuction in systematic desensitization: Animal studies. Psychological Bulletin, 1971, 7..i_, 1-15. Wine, J. Test anxiety and direction of attention. Psychological Bulletin, 1971, 7..i_, 92-104. Wisocki, P.A. Treatment of obsessive-compulsive behavior by covert sensitization and covert reinforcement: A case report. Journal of Behavior Therapy and Experi mental Psychiatry, 1970, !, 233-239. Wisocki, P.A. A covert reinforcement program for the treatment of test anxiety. Behavior Therapy, 1973, !, 264-266. Wolpe, J. Psychotherapy by reciprocal inhibition. Stanford, California: Stanford Univ. Press, 1958. Wolpe, J. The systematic desensitization treatment of neuroses. Journal of Nervous and Mental Disease, 1961, 132, 189-203. Wolpe, J. The practice of behavior therapy. New York: Pergamon, 1969. Wolpe, J., & Lazarus, A.A. Behavior therapy techniques. New York: Pergamon, 1966.

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BIOGRAPHICAL SKETCH I, Gina M. Harris, was born on April 30, 1953, in New York, New York. From 1971 to 1975 I attended Princeton University from which I was graduated with honors in psychology in 1975. I obtained my master's degree from the University of Florida in 1978. My master's thesis was the recipient of the 1979 Graduate Student Outstanding Research Award of the Florida Psychological Association and was subsequently published in the Journal of Consulting and Clinical Psychology in 1980. Throughout my graduate train ing and clinical internship, I have retained an abiding interest in the use of mental imagery, its function in the cognitive process and its possibility as a therapeutic tool to alleviate emotional suffering. 156

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I certify that I have read this study and that in my opinion it conforms to acceptable standards of scholarly presentation and is fully adequate, in scope and quality, as a dissertation for the degree of Doctor of Philosophy. 31~ /I) M 3'2Ml ~~V\~""-Suzanne Bennett John~hairman Assistant Professor of Psychiatry and Clinical Psychology I certify that I have read this study and that in my opinion it conforms to acceptable standards of scholarly presentation and is fully adequate, in scope and quality, as a dissertation for the degree of Doctor of Philosophy. Hugh D is Professor of Clinical Psychology I certif y that I have read this study and that in my opinion it conforms to acceptable standards of scholarly presentation and is fully adequate, in scope and quality, as a dissertation for the degree of Doctor of Philosophy. Everette Hall Associate Professor of Psycholog y

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---------------I certify that I have read this study and that in my opinion it conforms to acceptable standards of scholarly presentation and is fully adequate, in scope and quality, as a dissertation for the degree of Doctor of Philosophy. I certify that I have read this study and that in my opinion it conforms to acceptable standards of scholarly presentation and is fully adequate, in scope and quality, as a dissertation for the degree of Doctor of Philosophy. Benjamin Barger Professor of Clinical Psychology This dissertation was submitted to the Graduate Faculty of the College of Health Related Professions and to the Gradu ate Council, and was accepted as partial fulfillment of the requirements for the degree of Doctor of Philosophy. December 1980 Dean, College of Health Related Professions Dean, Graduate School

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