RESPONDING MAINTAINED BY INTERMITTENT REINFORCEMENT: IMPLICATIONS FOR THE USE OF EXTINCTION WITH PROBLEM BEHAVIOR IN CLINICAL SETTINGS

Results of basic research have demonstrated that behavior maintained on an intermittent schedule of reinforcement (INT) will be extinguished more slowly than behavior maintained on a continuous schedule (CRF). Although these findings suggest that problem behaviors may be difficult to treat with extinction if they have been maintained on INT rather than on CRF schedules, few applied studies have examined this phenomenon with human behavior in clinical settings. The purpose of this study was to determine whether problem behavior maintained on CRF schedules would be extinguished more rapidly than behavior maintained on INT schedules. Three individuals diagnosed with profound mental retardation participated after results of pretreatment functional analyses had identified the sources of reinforcement that were maintaining their self-injury, aggression, or disruption. Subjects were exposed to extinction following baseline conditions with CRF or INT schedules alternated within reversal or multielement designs. Results suggested that problem behaviors may not be more difficult to treat with extinction if they have been maintained on INT rather than CRF schedules. However, switching from an INT to a CRF schedule prior to extinction may lower the baseline response rate as well as the total number of responses exhibited during extinction.     

APPLIED IMPLICATIONS OF REINFORCEMENT HISTORY EFFECTS

Although the influence of reinforcement history is a theoretical focus of behavior analysis, the specific behavioral effects of reinforcement history have received relatively little attention in applied research and practice. We examined the potential effects of reinforcement history by reviewing nonhuman, human operant, and applied research and interpreted the findings in relation to possible applied significance. The focus is on reinforcement history effects in the context of reinforcement schedules commonly used either to strengthen behavior (e.g., interval schedules) or commonly used to decrease behavior (e.g., extinction).     

Side effects of extinction: prevalence of bursting and aggression during the treatment of self-injurious behavior

Findings from basic and applied research suggest that treatment with operant extinction may produce adverse side effects; two of these commonly noted are an increase in the frequency of the target response (extinction burst) and an increase in aggression (extinction-induced aggression). Although extinction is often used to treat problem behavior in clinical settings, few applied studies have examined the prevalence of these side effects or their possible attenuation with other operant procedures. An analysis of 41 data sets for individuals who received treatment for self-injurious behavior indicated that extinction bursts or increases in aggression occurred in nearly one half of the cases. The prevalence of bursting and aggression was substantially lower when extinction was implemented as part of a treatment package rather than as the sole intervention.     

A TRANSLATIONAL EVALUATION OF THE INTERPOLATED REINFORCEMENT PROCEDURE WITH YOUNG CHILDREN

The interpolated reinforcement procedure (IRP) involves the deliberate continuous reinforcement of a previously intermittently reinforced behavior prior to implementing extinction. Basic research on the IRP has produced equivocal findings, and applied research has suffered from methodological limitations. The present study was an evaluation of the IRP with typically developing young children and a nonclinical target behavior. The IRP was demonstrated in only two of five participants. The results are discussed in the context of the IRP's clinical utility given the unreliability of the finding. Copyright © 2012 John Wiley & Sons, Ltd.     

Is an epigenetic switch the key to persistent extinction?

Many studies of learning have demonstrated that conditioned behavior can be eliminated when previously established relations between stimuli are severed. This extinction process has been extremely important for the development of learning theories and, more recently, for delineating the neurobiological mechanisms that underlie memory. A key finding from behavioral studies of extinction is that extinction eliminates behavior without eliminating the original memory; extinguished behavior often returns with time or with a return to the context in which the original learning occurred. This persistence of the original memory after extinction creates a challenge for clinical applications that use extinction as part of a treatment intervention. Consequently, a goal of recent neurobiological research on extinction is to identify potential pharmacological targets that may result in persistent extinction. Drugs that promote epigenetic changes are particularly promising because they can result in a long-term molecular signal that, combined with the appropriate behavioral treatment, can cause persistent changes in behavior induced by extinction. We will review evidence demonstrating extinction enhancements by drugs that target epigenetic mechanisms and will describe some of the challenges that epigenetic approaches face in promoting persistent suppression of memories.     

On the status of knowledge for using punishment implications for treating behavior disorders

In this paper, we review basic and applied findings on punishment and discuss the importance of conducting further research in this area. The characteristics of responding during punishment and numerous factors that interact with basic processes are delineated in conjunction with implications for the treatment of behavior disorders in clinical populations. We conclude that further understanding of punishment processes is needed to develop a highly systematic, effective technology of behavior change, including strategies for improving the efficacy of less intrusive procedures and for successfully fading treatment.     

Baseline reinforcement rate and resurgence of destructive behavior

Concepts from behavioral momentum theory, along with some empirical findings, suggest that the rate of baseline reinforcement may contribute to the relapse of severe destructive behavior. With seven children who engaged in destructive behavior, we tested this hypothesis in the context of functional communication training by comparing the effects of different baseline reinforcement rates on resurgence during a treatment challenge (i.e., extinction). We observed convincing resurgence of destructive behavior in four of seven participants, and we observed more resurgence in the condition associated with high‐rate baseline reinforcement (i.e., variable‐interval 2 s in Experiment 1 or fixed‐ratio 1 in Experiment 2) compared to a low‐rate baseline reinforcement condition. We discuss the implications of these results relative to schedules of reinforcement in the treatment of destructive behavior and strategies to mitigate resurgence in clinical settings.     

Learning to fear outgroups: An associative learning explanation for the development and reduction of intergroup anxiety

Pavlovian conditioning is a form of associative learning shown to contribute to the development and reduction of clinical anxiety and fear, and more recently, intergroup anxiety and fear. The current review provides a synthesis of the literature on associative learning of fear toward outgroups. Findings are reviewed that outline how fear toward the outgroup, relative to the ingroup, can be preferentially learnt and is resistant to extinction‐based techniques. Novel future research directions for intergroup anxiety are then identified based upon previous research on clinical anxiety. It is proposed that processes known to enhance the extinction of specific phobia should be investigated with social stimuli. Specifically, it is argued that exploring cognitive factors during extinction and conducting extinction in multiple contexts may provide new avenues to pursue intergroup harmony through reduced intergroup anxiety. The review concludes by suggesting innovative research designs are needed to validate an associative learning account of fear toward outgroups outside of experimental settings.     

Descriptive characteristics of extinction bursts: A record review

Procedural extinction is sometimes associated with a temporary increase in responding known as an extinction burst. Extinction bursts present unique challenges in the context of treating behavior targeted for reduction. The present study updates the prevalence of extinction bursts using a clinical sample (N = 108) receiving treatment for targeted behavior. The prevalence of extinction bursts in our sample (24%) was consistent with that in prior literature. The extinction-burst magnitude decreased across sessions after extinction was contacted during treatment, but this sample did not demonstrate decreased persistence or magnitude of extinction bursts across successive transitions from baseline to treatment. We also examined the prevalence and magnitude of extinction bursts based on the function and topography of targeted behavior and treatment components and found no consistent relation among these variables. These findings should lead clinicians to prepare for transient extinction bursts when implementing extinction-based treatment for challenging behavior.     

Renewed behavior produced by context change and its implications for treatment maintenance: A review

Behavioral treatment gains established in one setting do not always maintain in other settings. The present review examines the relevance of basic and translational research to understanding failures to maintain treatment gains across settings. Specifically, studies of the renewal effect examine how transitioning away from a treatment setting could evoke a return of undesirable behavior, rather than newly trained appropriate behavior. Studies of renewal typically arrange three phases, with a response trained and reinforced under a particular set of contextual stimuli in the first phase. Next, that response is extinguished, often under a different set of contextual stimuli. Finally, that response returns despite extinction remaining in effect upon returning to the original training context or transitioning to a novel context. Thus, removing the extinction context is sufficient to produce a recurrence of the response. The findings suggest treatment effects can become specific to the context in which the treatment was delivered. This literature offers promising methods for systematically assessing the factors contributing to treatment maintenance and improving generalization of treatment gains across contexts. Therefore, the present review suggests basic and translational research on renewal provides an empirical literature to bring greater conceptual systematization to understanding generalization and maintenance of behavioral treatment.     

Assessing the role of alternative response rates and reinforcer rates in resistance to extinction of target responding when combining stimuli

Studies of behavioral momentum reveal that reinforcing an alternative response in the presence of a target response reduces the rate of target responding but increases its persistence, relative to training the target response on its own. Because of the parallels between these studies and differential‐reinforcement techniques to reduce problem behavior in clinical settings, alternative techniques to reduce problem behavior without enhancing its persistence are being explored. One potential solution is to train an alternative response in a separate stimulus context from problem behavior before combining the alternative stimulus with the target stimulus. The present study assessed how differences in reinforcement contingencies and rate for alternative responding influenced resistance to extinction of target responding when combining alternative and target stimuli in pigeons. Across three experiments, alternative stimuli signaling a response–reinforcer dependency and greater reinforcer rates more effectively decreased the persistence of target responding when combining alternative and target stimuli within the same extinction tests, but not when compared across separate extinction tests. Overall, these findings reveal that differences in competition between alternative and target responding produced by contingencies of alternative reinforcement could influence the effectiveness of treating problem behavior through combining stimulus contexts.     

Further evaluation of differential exposure to establishing operations during functional communication training

Recent research findings (DeRosa, Fisher, & Steege, 2015 ) suggest that minimizing exposure to the establishing operation (EO) for destructive behavior when differential reinforcement interventions like functional communication training (FCT) are introduced may produce more immediate reductions in destructive behavior and prevent or mitigate extinction bursts. We directly tested this hypothesis by introducing FCT with extinction in two conditions, one with limited exposure to the EO (limited EO) and one with more extended exposure to the EO (extended EO) using a combined reversal and multielement design. Results showed that the limited‐EO condition rapidly reduced destructive behavior to low levels during every application, whereas the extended‐EO condition produced an extinction burst in five of six applications. We discuss these findings in relation to the effects of EO exposure on the beneficial and untoward effects of differential reinforcement interventions.     

A preliminary evaluation of treatment duration on the resurgence of destructive behavior

Quantitative models of resurgence (e.g., Behavioral Momentum Theory, Resurgence as Choice) suggest that resurgence is partly a function of the duration of extinction exposure, with longer histories of extinction producing less resurgence. This prediction is supported by some laboratory research and has been partially supported by clinical translations that did not isolate the effects of extinction exposure prior to testing for resurgence. The degree to which different histories of extinction impact the likelihood of treatment relapse in therapeutic applications of differential reinforcement is of great interest to the clinical community, including insurance carriers and other financial providers. In the present study, we isolated the effects of extinction history for severe destructive behavior across 6 participants referred for treatment services and examined resurgence of destructive behavior when alternative reinforcement terminated. Our within-subject evaluation showed no difference in the level of resurgence or persistence of destructive behavior following short and long exposures to differential reinforcement with extinction. We discuss our failure to replicate in relation to experimental-design considerations for investigating this and other relapse phenomena in future research with clinical populations.     

EXPERIMENTAL ANALYSIS AND EXTINCTION OF SELF-INJURIOUS ESCAPE BEHAVIOR

Three studies are presented in which environmental correlates of self-injurious behavior were systematically examined and later used as the basis for treatment. In Study 1, 7 developmentally disabled subjects were exposed to a series of conditions designed to identify factors that maintain self-injurious behavior: attention contingent on self-injurious behavior (positive reinforcement), escape from or avoidance of demands contingent on self-injurious behavior (negative reinforcement), alone (automatic reinforcement), and play (control). Results of a multielement design showed that each subject's self-injurious behavior occurred more frequently in the demand condition, suggesting that the behavior served an avoidance or escape function. Six of the 7 subjects participated in Study 2. During educational sessions, “escape extinction” was applied as treatment for their self-injurious behavior in a multiple baseline across subjects design. Results showed noticeable reduction or elimination of self-injurious behavior for each subject and an increase in compliance with instructions in all subjects for whom compliance data were taken. The 7th subject, whose self-injurious behavior during Study 1 occurred in response to medical demands (i.e., physical examinations), participated in Study 3. Treatment was comprised of extinction, as in Study 2, plus reinforcement for tolerance of the examination procedure, and was evaluated in a multiple baseline across settings design. Results showed that the treatment was successful in eliminating self-injurious behavior and that its effects transferred across eight new therapists and three physicians. General implications for the design, interpretation, and uses of assessment studies are discussed.     

Translational behavior analysis: from laboratory science in stimulus control to intervention with persons with neurodevelopmental disabilities

Throughout its history, laboratory research in the experimental analysis of behavior has been successful in elucidating and clarifying basic learning principles and processes in both humans and nonhumans. In parallel, applied behavior analysis has shown how fundamental behavior-analytic principles and procedures can be employed to promote desirable forms of behavior and to prevent or ameliorate undesirable forms in clinical, educational, and other settings. Less obviously, there has also emerged a small but identifiable bridging field that can potentially connect and inform both basic and applied behavior analysis. Although such translational behavior analysis uses laboratory methodologies, research targets are selected largely for their value in ultimate application to improve the human condition. I will discuss the distinction of translational behavior analysis from basic and applied behavior analysis and consider the potential contribution that translational research can make in the development of the science of behavior.     

基于“相关线索-自动化用药行为”联结的成瘾记忆消退

成瘾记忆消退致力于消除成瘾者相关线索与药物奖赏效应的联结,以达到消除心理渴求、戒断成瘾行为的目的,但其效果还十分有限。最近,大量的动物和人类实验研究发现:在相关线索下,成瘾者的激活脑区不仅包括中脑边缘皮层-背内侧纹状体,还延伸到感觉运动脑区-背外侧纹状体。这意味着成瘾记忆中存在相关线索与自动化(习惯性)用药行为的联结。所以,与成瘾相关的记忆可能包含两种不同的成分:一是与药物奖赏效应相关的情绪记忆,另一种是与用药动作、技能有关的动作记忆(程序记忆)。由于在成瘾阶段,药物奖赏效应对药物使用和复发的作用已经相对减少,因此,针对成瘾记忆的消退训练,以相关线索与自动化用药行为的联结为标靶,可能可以取得更好的效果,值得做进一步的深入探索。     

Further evaluation of a nonsequential approach to studying operant renewal

Basic‐laboratory assessments of renewal may inform clinical efforts to maintain reduction of severe destructive behavior when clients transition between contexts. The contextual changes arranged during standard renewal procedures, however, do not necessarily align with those that clients experience during outpatient therapy. More specifically, clients transition between clinical (associated with extinction for target behavior) and home/community (associated with reinforcement for target behavior) contexts during outpatient treatment. Standard renewal assessments do not incorporate these contextual alternations during treatment. The present experiment aimed to directly compare renewal of rats' lever pressing following a standard (“sequential”) ABA renewal procedure (i.e., baseline in Context A, extinction in Context B, renewal test in Context A) and a “nonsequential” renewal assessment wherein treatment consisted of daily alternation between Context A (associated with reinforcement for lever pressing) and Context B (associated with extinction). Lever pressing renewed to a greater extent for rats in the Nonsequential group than for rats in the Sequential group, suggesting the contextual changes that clients experience during outpatient treatment for severe destructive behavior may be a variable that is important to consider in translational research on renewal. Potential implications of these findings for basic and clinical research on renewal are discussed.     

WHAT MAKES EXTINCTION WORK: AN ANALYSIS OF PROCEDURAL FORM AND FUNCTION

We examined methods for determining how extinction should be applied to different functions of self-injurious behavior (SIB). Assessment data indicated that the head banging of 3 children with developmental disabilities was maintained by different reinforcement contingencies: One subject's SIB was positively reinforced by attention from adults, the 2nd subject's SIB was negatively reinforced by escape from educational tasks, and the 3rd subject's SIB appeared to be automatically reinforced or “self-stimulatory” in nature. Three functional variations of extinction—EXT (attention), EXT (escape), and EXT (sensory)—were evaluated, and each subject was exposed to at least two of these variations in reversal or multiple baseline designs. Reductions in SIB were observed only when implementation of “extinction” involved the discontinuation of reinforcement previously shown to be responsible for maintaining the behavior. These results highlight important differences among treatment techniques based on the same behavioral principle (extinction) when applied to topographically similar but functionally dissimilar responses, and further illustrate the practical implications of a functional analysis of behavior disorders for designing, selecting, and classifying therapeutic interventions.     

Differential reinforcement of alternative behavior increases resistance to extinction: clinical demonstration, animal modeling, and clinical test of one solution

Basic research with pigeons on behavioral momentum suggests that differential reinforcement of alternative behavior (DRA) can increase the resistance of target behavior to change. This finding suggests that clinical applications of DRA may inadvertently increase the persistence of target behavior even as it decreases its frequency. We conducted three coordinated experiments to test whether DRA has persistence-strengthening effects on clinically significant target behavior and then tested the effectiveness of a possible solution to this problem in both a nonhuman and clinical study. Experiment 1 compared resistance to extinction following baseline rates of reinforcement versus higher DRA rates of reinforcement in a clinical study. Resistance to extinction was substantially greater following DRA. Experiment 2 tested a rat model of a possible solution to this problem. Training an alternative response in a context without reinforcement of the target response circumvented the persistence-strengthening effects of DRA. Experiment 3 translated the rat model into a novel clinical application of DRA. Training an alternative response with DRA in a separate context resulted in lower resistance to extinction than employing DRA in the context correlated with reinforcement of target behavior. The value of coordinated bidirectional translational research is discussed.