ABSTRACT
Binge-eating disorders (BED) are a common problem affecting up to 5 percent of the American population in any given 6-month period. Currently, the most widely accepted treatment is some variation of Cognitive Behavior Therapy, although the abstinence rates following this type of treatment are only around 50%. A recent study by Bosch et al. explored the effects of extinction with four women who engaged in binge-eating behavior associated with BED and bulimia nervosa (BN). The treatment was successful, with three of the four participants obtaining abstinence. To date, this has been the only study examining this procedure. The purpose of the current study was to further evaluate extinction of binge eating with four young women who met diagnostic criteria for BN. The results showed that the treatment decreased binge eating to zero for all four women, although one dropped out of the study shortly after beginning the intervention.
Subject(s)
Bulimia Nervosa/therapy , Bulimia/therapy , Cognitive Behavioral Therapy , Bulimia/complications , Bulimia/diagnosis , Bulimia Nervosa/complications , Bulimia Nervosa/diagnosis , Extinction, Psychological , Female , Humans , Interviews as Topic , Psychiatric Status Rating Scales , Surveys and Questionnaires , Treatment Outcome , Young AdultABSTRACT
The aim of this study was to assess the antecedents and consequences of binge eating in ten obese binge eaters. The subjects completed retrospective measures and monitored themselves at the time binge eating occurred. The results show that the common temporally remote antecedents to binge eating included being very busy throughout the day, feeling unusually tired/fatigued, having consumed too much food during the day, and feeling down or irritable. A number of affective variables (e.g., anxiety, anger, frustration, sadness, guilt, agitation) temporarily decreased during a binge eating episode, yet increased again following binge eating. Furthermore, the antecedents and consequences surrounding binge eating episodes were moderately to highly variable both between and within subjects, thus supporting the need for individualised functional assessments of the antecedents and consequences of binge eating. The implications for treatment and future research are discussed.
Subject(s)
Bulimia Nervosa/diagnosis , Bulimia Nervosa/psychology , Medical Records , Obesity/complications , Surveys and Questionnaires , Adult , Bulimia Nervosa/complications , Feeding Behavior , Female , Humans , Middle Aged , PsychometricsABSTRACT
An evaluation of the awareness enhancement device (AED) described by Rapp, Miltenberger, and Long (1998) was conducted with 2 children who engaged in thumb sucking past the age at which it was developmentally appropriate. The AED effectively suppressed thumb sucking for both children. Future research evaluating the AED is discussed.
Subject(s)
Awareness , Child Behavior Disorders/prevention & control , Equipment and Supplies/standards , Fingersucking/psychology , Adolescent , Child , Extinction, Psychological , Humans , MaleABSTRACT
Functional analysis methods have become standard practice for determining the maintaining variables of problem behavior. The analysis of within-session response patterns has been proposed as a useful adjunct to the functional analysis. Many within-session analyses have been conducted on data obtained from interval scoring methods. However, interval methods only provide an estimate of within-session data. The authors briefly describe a real-time recording method and provide a rationale for its use. The authors then provide descriptions of several research studies from their lab in which real-time data were crucial in determining behavioral function from experimental analyses.
Subject(s)
Behavior Therapy/statistics & numerical data , Data Collection/statistics & numerical data , Videotape Recording/instrumentation , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Psychometrics , Reinforcement Schedule , Restraint, Physical , Self-Injurious Behavior/therapyABSTRACT
A young child participated in a functional analysis and treatment of hair twirling, a frequently occurring precursor to hair pulling. The functional analysis showed that hair twirling occurred mostly when the child was alone at bedtime. Noncontingent application of mittens decreased hair twirling to near-zero levels in two settings (home and day care).
Subject(s)
Behavior Therapy/methods , Habits , Hair , Child, Preschool , Extinction, Psychological , Female , Gloves, Protective , HumansABSTRACT
We analyzed and treated the finger sucking of 2 developmentally typical children aged 7 and 10 years. The functional analysis revealed that the finger sucking of both children was exhibited primarily during alone conditions, suggesting that the behavior was maintained by automatic reinforcement. An extended analysis provided support for this hypothesis and demonstrated that attenuation of stimulation produced by the finger sucking resulted in behavior reductions for both children. Treatment consisted of having each child wear a glove on the relevant hand during periods when he or she was alone. Use of the glove produced zero levels of finger sucking for 1 participant, whereas only moderate reductions were obtained for the other. Subsequently, an awareness enhancement device was used that produced an immediate reduction in finger sucking.
Subject(s)
Behavior Therapy , Fingersucking/psychology , Motivation , Awareness , Child , Female , Humans , Male , Reinforcement, SocialABSTRACT
We experimentally assessed the functions of hair pulling and hair manipulation of a 19-year-old woman (Kris) with moderate mental retardation and cerebral palsy. In Phase 1 a functional analysis revealed that Kris pulled and manipulated hair for the greatest amount of time in the alone condition, suggesting that the behaviors were maintained by some form of automatic reinforcement (Vaughan & Michael, 1982). In Phase 2 we assessed the nature of the sensory stimulation that maintained hair pulling by providing continuous access to previously pulled or cut hair and, thereafter, by having Kris wear a rubber glove. The results suggested that hair pulling was maintained by digital-tactile stimulation (automatic positive reinforcement). These findings are discussed, and recommendations for further analyses of automatically reinforced habit behaviors are provided.
Subject(s)
Trichotillomania/prevention & control , Adult , Female , Humans , Reinforcement, Psychology , Task Performance and Analysis , Trichotillomania/diagnosis , Trichotillomania/psychologyABSTRACT
We investigated whether a simplified habit reversal treatment eliminates fingernail biting and related oral-digital habits exhibited by individuals with mild to moderate mental retardation. Although simplified habit reversal did little to decrease the target behaviors for 3 of 4 participants, simplified habit reversal plus additional treatment procedures decreased the behavior to near-zero levels for all participants. These procedures included remote prompting, remote contingencies involving differential reinforcement plus response cost, and differential reinforcement of nail growth. Limitations of habit reversal for individuals with mental retardation along with directions for future research involving therapist-mediated treatment procedures, particularly those involving remote prompting and remote contingencies, are discussed.
Subject(s)
Habits , Intellectual Disability/psychology , Nail Biting/psychology , Adult , Female , Humans , Male , Patient Compliance , Reinforcement, Psychology , Treatment Outcome , Video RecordingABSTRACT
Previous research has shown that behavioral skills training to teach sexual abuse prevention skills to women with mental retardation results in skill acquisition but poor generalization. In this investigation we evaluated procedures for enhancing generalization following training. Five women with mental retardation received 10 behavioral skills training sessions followed by in situ training when the skills did not fully generalize. Behavioral skills training resulted in skill acquisition and in situ training produced generalized responding during naturalistic assessments.
Subject(s)
Generalization, Psychological , Intellectual Disability/psychology , Sex Offenses/prevention & control , Teaching , Adult , Behavior Therapy/methods , Female , Humans , Middle Aged , Severity of Illness IndexABSTRACT
OBJECTIVE: This study examined the usefulness of the Function of Binge Eating Scale and monitoring forms for a sample of subclinical binge eaters. METHOD: Participants included 23 college students who reported engaging in binge eating an average of two or more times per week. Participants completed the Function of Binge Eating Scale at the initial session, at 2 weeks, and at 4 weeks. Participants also monitored binge eating behavior and completed an Antecedent Checklist each time they engaged in binge eating. RESULTS: Participants responded similarly to direct and indirect measures of antecedents of binge eating although they tended to rate items on the indirect measures as more intense than on the direct measures. Boredom and dissatisfaction with body weight and shape were rated as the most intense proximate antecedents while anxiety and anger at others were reported as least intense. Irritability and depressed mood were the most frequently reported temporally remote antecedents. DISCUSSION: Implications and suggestions for future research are discussed.
Subject(s)
Feeding and Eating Disorders/diagnosis , Feeding and Eating Disorders/psychology , Adult , Body Mass Index , Depression/psychology , Female , Humans , Male , Severity of Illness Index , Somatoform Disorders/diagnosis , Somatoform Disorders/psychology , Stress, Psychological/psychology , Surveys and QuestionnairesABSTRACT
This study was designed to examine temporally proximal and remote antecedents as well as immediate and delayed consequences of binge eating behavior. Participants included 16 undergraduate females who reported engaging in binge eating at least two times per week and experiencing a sense of lack of control during binge eating episodes on the Questionnaire of Eating and Weight Patterns. Results indicated that the most frequent proximal antecedents to binge eating were negative emotions such as feeling depressed, angry, empty, hopeless, worried, or dissatisfied. The most frequent consequences of binge eating included relief from negative feelings and thoughts and decrease in hunger or craving. The results of this study suggest that the function of binge eating can be identified through assessment of antecedents and consequences with real time recording and retrospective reports. Treatment implications are discussed.
Subject(s)
Bulimia/psychology , Hyperphagia/psychology , Adult , Affective Symptoms/diagnosis , Affective Symptoms/psychology , Body Mass Index , Bulimia/diagnosis , Female , Humans , Hyperphagia/diagnosis , Internal-External Control , Motivation , Personality Inventory , PsychometricsABSTRACT
This article provides a review and analysis of habit reversal, a multicomponent procedure developed by Azrin and Nunn (1973, 1974) for the treatment of nervous habits, tics, and stuttering. The article starts with a discussion of the behaviors treated with habit reversal, behavioral covariation among habits, and functional analysis and assessment of habits. Research on habit reversal and simplified versions of the procedure is then described. Next the article discusses the limitations of habit reversal and the evidence for its generality. The article concludes with an analysis of the behavioral processes involved in habit reversal and suggestions for future research.
Subject(s)
Behavior Therapy/methods , Stereotypic Movement Disorder/rehabilitation , Awareness , Child , Female , Habits , Humans , Male , Reversal Learning , Self-Injurious Behavior/psychology , Self-Injurious Behavior/rehabilitation , Stereotypic Movement Disorder/psychology , Stuttering/psychology , Stuttering/rehabilitation , Tic Disorders/psychology , Tic Disorders/rehabilitationABSTRACT
This paper reviews the prevalence and behavioral and pharmacological treatment-outcome studies for habit disorders exhibited by individuals with mental retardation. The treatment-outcome studies target the habit disorders identified previously by researchers including nervous habits (nail biting, bruxism, and trichotillomania), motor and vocal tics, and Tourette's disorder. The paucity of behavioral treatments and the lack of controlled pharmacological research warrants further experimental evaluation of treatments for habit disorders affecting individuals with mental retardation. Conclusions and recommendations for future research are made.
Subject(s)
Behavior Therapy/methods , Compulsive Behavior/therapy , Disruptive, Impulse Control, and Conduct Disorders/therapy , Habits , Intellectual Disability/complications , Behavior Therapy/standards , Bruxism/therapy , Humans , Nail Biting/therapy , Psychotropic Drugs/therapeutic use , Self-Injurious Behavior/therapy , Tic Disorders/therapy , Treatment Outcome , Trichotillomania/therapyABSTRACT
Three developmentally normal adolescents with chronic hair pulling were treated with a simplified habit reversal procedure consisting of awareness training, competing response training, and social support. Treatment resulted in an immediate reduction to near-zero levels of hair pulling, with one to three booster sessions required to maintain these levels. The results were maintained from 18 to 27 weeks posttreatment, although 1 participant reported difficulty at follow-up. The effectiveness of simplified habit reversal and suggestions for future research are discussed.
Subject(s)
Behavior Therapy/methods , Trichotillomania/therapy , Awareness , Child , Female , Habits , Humans , Male , Reinforcement, SocialABSTRACT
Programs to teach sexual abuse prevention skills to persons with mental retardation have rarely been evaluated empirically, and typical evaluations are limited to assessment of the participants' knowledge rather than their performance of specific skills. In the present study, 6 adult women with mental retardation were trained in sexual abuse prevention, and performance was assessed using four separate measures: pretests and posttests of knowledge, verbal report, role play, and naturalistic probes. All women learned the skills but failed to exhibit them to criterion during the probes. We discuss the implications for further training and assessment of sexual abuse prevention skills.
Subject(s)
Education of Intellectually Disabled , Rape/prevention & control , Sex Education , Adult , Female , Group Homes , Health Knowledge, Attitudes, Practice , Humans , Rape/psychology , Role PlayingABSTRACT
We evaluated a brief therapy protocol involving the simplified regulated breathing method as a treatment for stuttering in children. The simplified treatment included awareness training, competing response training, and social support. Treatment was implemented in a multiple baseline across subjects design for 5 boys between the ages of 5 and 11. Each child received a 1 h treatment session, and 1/2 h booster sessions as needed. Four of the 5 children reduced their stuttering to less than 3% stuttered words (the criterion for successful treatment) after one 1 h treatment session. These results were maintained for 3 of the subjects from 6 to 9 months posttreatment. Social validity measures revealed significant differences between ratings on baseline and posttreatment speech samples. Treatment acceptability and credibility measures indicated that the subjects' guardians found the simplified regulated breathing method a reasonable treatment for stuttering in children.
Subject(s)
Behavior Therapy/methods , Respiration , Stuttering/therapy , Child , Child, Preschool , Clinical Protocols , Evaluation Studies as Topic , Habits , Humans , Male , Relaxation Therapy , Severity of Illness Index , Speech , Stuttering/diagnosis , Treatment OutcomeABSTRACT
The chronic hair pulling of a 36-year-old woman with moderate mental retardation was initially treated with a simplified habit-reversal (SHR) procedure that consisted of awareness training, competing response training, and social support. When SHR did not produce large and sustained reductions in hair pulling, an awareness enhancement device was added, and it reduced hair pulling to near-zero levels in two settings. The results are discussed, and directions for future research with this device are provided.
Subject(s)
Aversive Therapy/methods , Awareness , Habits , Trichotillomania/therapy , Adult , Extinction, Psychological , Female , Humans , Time FactorsABSTRACT
This article briefly discusses the process of conducting a functional assessment of a problem behavior. Current research on the assessment of antecedents and consequences of binge eating behavior is then reviewed. The article concludes with suggestions for future research in the functional assessment and classification of binge eating.
Subject(s)
Bulimia/classification , Bulimia/etiology , Psychometrics/methods , Forecasting , Humans , ResearchABSTRACT
The problem of sexual abuse among persons with mental retardation, skills for preventing sexual abuse, and methods for assessing prevention skills were discussed. Because very little research on teaching sexual abuse prevention skills exists, research on abduction prevention programs for persons with mental retardation as well as on sexual abuse prevention programs for children, was reviewed. Suggestions for future research in the area of sexual abuse prevention for persons with mental retardation were discussed.
Subject(s)
Child Abuse, Sexual/prevention & control , Education of Intellectually Disabled/methods , Intellectual Disability/psychology , Adolescent , Adult , Child , Female , Humans , Male , ResearchABSTRACT
In this study the frequency of chewing behavior in a 6-year-old male diagnosed with pica was reduced using a simplified habit reversal procedure. Data were collected on the frequency of chewing behavior, treatment acceptability, parent satisfaction, and social validity of the behavior change. This study represents the first known application of the habit reversal procedure to treat pica-related chewing in a normally intelligent child.
