BEHAVIOR THERAPY 35,605 619,2004 Verbal Self-Regulation of Impulsive Behavior of Persons With Frontal Lobe Brain Injury LucIus ARCO LYNNE COHEN KEREN GEDDES Edith Cowan University A multiple-baseline across participants design was used to examine effects of a ver- bal self-regulatory procedure on direct measures of impulsivity associated with fron- tal lobe brain damage. Four young men participated in socially interactive group sessions with a therapist who (a) assisted the participants in selecting individualized instructions on how to behave, (b) provided participants with feedback on their cor- respondence between instructions and nonverbal behavior, and (c) gradually reduced assistance while participants maintained self-monitoring. Resuks show that the verbal self-regulation was efficacious in reducing impulsive behavior to clinically signifi- cant levels during the group sessions, although effects with 1 participant were variable. Many people with frontal lobe brain injury present with a syndrome of problems including emotional lability (e.g., uncontrollable anger, or mood), inattentiveness or distractibility, inappropriate social behavior (e.g., verbal abuse, sexually explicit acts), memory problems, and impaired executive function- ing (e.g., deficient goal setting, self-monitoring, and self-evaluation). These problems have proved difficult to treat as a syndrome, and present an enor- mous challenge to researchers and practitioners in neurobehavioral rehabili- tation (see Hart & Jacobs, 1993; Mattson & Levin, 1990). A pivotal characteristic of frontal lobe syndrome appears to be impulsivity, or impaired self-regulatory behavior. Problems such as emotional lability, inattentiveness, and poor executive functioning all show components of impul- sivity, which may be defined as a predisposing response to stimuli that pro- duce immediate but small consequences, and not to stimuli associated with This study was supported by collaborative grant 3612026 from Edith Cowan University and Brightwater Care Group (Inc.), Western Australia, and was presented at the 38th Annual Con- ference of the Australian Psychological Society, Perth, October, 2003. Many thanks to Dr. Penny Flett and Ms. Jan Bishop for their encouragement and support. Address correspondence to L. Arco, Ph.D., School of Psychology, Edith Cowan University, Joondalup, WA 6027, Australia; e-mail: 1.arco@ecu.edu.au. 605 005-7894/04/0605~)61951.00/0 Copyright 2004 by Association for Advancement of Behavior Therapy All rights for reproductionin any form reserved.