Therapeutic failure in a case of aversion therapy

A problem of paramount importance in the application of behaviour therapy concerns the relationship between personality parameters and the therapeutic outcome of such therapy, particularly in the case of aversion therapy. This report is concerned with a comparison between two patients with similar psychometric scores and similar complaints, one of whom responded well to aversion therapy while the other withdrew from treatment. It is argued that this differential response to treatment was due not to the amount of anxiety present but rather to a specific fear in the case of the latter patient that the treatment itself would precipitate cancer. Precautionary enquiries along these lines should, in future, be carried out prior to embarking on an aversion therapy programme.     

Electrical aversion therapy with alcoholics: An analogue study

Chronic alcoholic patients matched on age, education and length of problem drinking were assigned to one of three treatment conditions, with 10 subjects in each group: (1) Electrical Aversion Conditioning (high shock paired with alcohol sips); (2) Control Conditioning (very low shock paired with alcohol sips); and (3) Group Therapy (confrontation psychotherapy). Groups 2 and 3 were included to control for possible ‘attention-placebo’ and expectancy factors involved in the conditioning procedures. Subjects in each group were given instructions designed to produce high expectancy for therapeutic success. Pre-post measures of alcohol consumption and attitudes toward alcohol were obtained using an analogue ‘taste test’ assessment procedure. No statistically significant differences in reduced alcohol consumption or attitudes toward alcohol were found among the groups. Trends in the data support the contention that effects of electrical aversion may be more related to such factors as therapeutic instructions, expectancy, specificity of the procedure or experimental demand characteristics than to conditioning factors.     

Temporal contiguity in electric aversion therapy for cigarette smoking

Seventy dependent heavy smokers (32 cigarettes per day) were randomly assigned to one of five treatment and control procedures: (1) electric aversion therapy, involving ten 20-trial sessions of shocks contiguous with the smoking act. (2) simulated electric aversion. with non-contiguous shocks, (3) non-shock smoking sessions, to control for stimulus satiation and negative practice effects. (4) simple support and attention from therapist, (5) no-treatment. Before treatment, simple ‘self-monitoring’ and ‘self-control’ reduced cigarette consumption by an average of 12% (p < 0.001) and 26% (p < 0.001) respectively. Thirty-four of the 56 treated subjects (61%) were able to stop smoking compared with two out of fourteen (14%) of the no-treatment controls (p < 0.005). Treatment was highly effective at reducing and stopping smoking during the 4-week course and for 2 weeks afterwards (p < 0.005). Its effect was rapid, but not immediate. Outcome was virtually decided after 1 week (five sessions); subjects who had not stopped or almost stopped at this stage were most unlikely to respond later on (p < 0.001). All four treatments were equally effective, regular attendance for 15 min of simple support being as effective as the treatments involving additional 45-min sessions with a second therapist. The effects of contiguous vs non-contiguous shocks did not differ. A motor response was conditioned in 19 of the 28 subjects who received shocks but this was therapeutically irrelevant. The clinical outcome depended on the kind of subject rather than the kind of treatment. Those who were depressed, with poor psychiatric adjustment and a high Eysenck-Scale P score tended to do badly, while those who initially expressed high confidence in the outcome were more likely to succeed (p < 0.001). It is concluded that traditional conditioning processes do not contribute significantly to the clinical response of human subjects to electric aversion therapy for cigarette smoking.     

Tension headache: Theoretical problems

The traditional view of tension (muscular contraction) headache is delineated in a set of seven assumptions. A review of recent psychophysiological studies gives little support for these assumptions. However the findings provide a basis for a preliminary hypothesis about tension cases, and some predictions concerning how they can be treated. A three-systems analysis of tension headache is recommended.     

Cardiac response as an index of the effect of aversion therapy

Recent research shows that aversion conditioning produces conditioned aversions to target stimuli. Conditioned aversions are manifest in the following posttreatment changes in Ss' responses to target stimuli: increased negative evaluations, decreased contact or consumption, and increased phasic heart-rate responses (HRRs). Research on aversion therapy for additive disorders reveals that HRR is a particularly important index of therapeutic change as it is predictive of latency to relapse to drug use. We speculate that aversion conditioning increases Ss' fear and repugnance of target stimuli, that HRRs accurately reflect such defensive responses and that magnitude of defensive response is positively related to latency to relapse. In addition to defensive responding, we believe that HRRs may reflect coping-response or active-avoidance information processing.     

Loss aversion and perceptual risk aversion

We prove that, in cumulative prospect theory, the weak loss aversion for S-shaped value functions is equivalent to a notion of risk aversion that we define from the perceptual point of view. No additional assumption or condition on the probability distortion is needed. It is demonstrated that a power S-shaped value function does not satisfy weak loss aversion, i.e., a decision maker is risk seeking with respect to some mixed sign lotteries.