A Comparison of Escalating Versus Fixed Reinforcement Schedules on Undergraduate Quiz Taking

Drug abstinence studies indicate that escalating reinforcement schedules maintain abstinence for longer periods than fixed reinforcement schedules. The current study evaluated whether escalating reinforcement schedules would maintain more quiz taking than fixed reinforcement schedules. During baseline and for the control group, bonus points were distributed on random days for attending class. Following baseline, students in the fixed reinforcement section received 5 bonus points for each quiz completed while students in the escalating reinforcement received 3 bonus points for the first quiz with an increase of 0 or 1 point for each consecutive quiz completed. Results indicated that the escalating reinforcement schedule maintained quiz taking significantly longer than the fixed reinforcement schedule. The control group took the fewest number of quizzes. Students with good attendance took significantly more quizzes under the escalating reinforcement schedule than students with good attendance exposed to the fixed reinforcement schedule or control condition. This study demonstrates a potential novel application for escalating reinforcement schedules. Results indicate that escalating reinforcement schedules may be successfully applied to academic settings, but more research is needed.     

VOUCHER‐BASED CONTINGENT REINFORCEMENT OF SMOKING ABSTINENCE AMONG METHADONE‐MAINTAINED PATIENTS: A PILOT STUDY

This study evaluated the efficacy of a contingency management (CM) intervention to promote smoking cessation in methadone‐maintained patients. Twenty participants, randomized into contingent (n = 10) or noncontingent (n = 10) experimental conditions, completed the 14‐day study. Abstinence was determined using breath carbon monoxide and urine cotinine levels. Contingent participants received voucher‐based incentives for biochemical evidence of smoking abstinence. Noncontingent participants earned vouchers independent of smoking status. Contingent participants achieved significantly more smoking abstinence and longer durations of continuous smoking abstinence than did noncontingent participants. These results support the potential efficacy of using voucher‐based CM to promote smoking cessation among methadone‐maintained patients.     

CONTINGENT PAYMENT PROCEDURES FOR SMOKING REDUCTION AND CESSATION

We assessed the ability of a combined contingent reinforcement and intensive monitoring procedure to promote and sustain temporary smoking cessation among 34 hired research volunteers, and the ability of a smoking reduction test to predict the subsequent initiation of abstinence. During the 5-day cutdown test, subjects were paid from $0 to $6 per day depending on the extent of reduction from baseline CO levels. During the abstinence test, breath samples were obtained three times daily and subjects were paid $4 for each CO reading ≤11 ppm. Sixty-eight percent of subjects initiated abstinence. Of the breath samples collected during the abstinence test (91% of scheduled samples), 96.5% were ≤11 ppm and 80.5% were ≤8 ppm. Subjects who earned more money during the cutdown test were more likely to abstain (r = ?0.51, p < .001). Contingent reinforcement and intensive monitoring procedures appear to have usefulness for analog studies of smoking reduction and cessation.     

CONTINGENT REINFORCEMENT FOR CARBON MONOXIDE REDUCTION: WITHIN-SUBJECT EFFECTS OF PAY AMOUNT

The relationship between reinforcer amount and daytime smoking reduction in smokers offered money for reduced afternoon breath carbon monoxide (CO) levels was examined. Twenty-three hired regular smokers with average baseline CO levels of about 30 ppm were exposed in random order to five sliding scale payment schedules that changed daily or weekly. Money was available for afternoon CO readings between 0 and 21 ppm with pay amount inversely related to the absolute CO reading obtained. Maximum pay amount for readings below 7 ppm varied among $0, $1.50, $3, $6, and $12 per day. Contingent reinforcement promoted CO and daytime cigarette reduction within individuals with the amount of behavior change related to the amount of payment available. Average CO levels decreased from 30 to 15 ppm as a function of pay amount whereas self-reported daytime cigarettes decreased from 12 to 5 per day. Average minutes of cigarette abstinence prior to the afternoon study contact increased from 62 to 319 minutes as a function of pay amount, whereas the percentage of available money earned increased from 22% to 48%. Nontargeted evening cigarette use also decreased during periods of daytime smoking reduction. The orderly effects of this contingent reinforcement intervention on daytime smoking of regular smoker volunteers suggest that this is a sensitive model for continued evaluation of factors that influence smoking reduction and cessation.     

Effects of internet-based voucher reinforcement and a transdermal nicotine patch on cigarette smoking

Nicotine replacement products are commonly used to promote smoking cessation, but alternative and complementary methods may increase cessation rates. The current experiment compared the short-term effects of a transdermal nicotine patch to voucher-based reinforcement of smoking abstinence on cigarette smoking. Fourteen heavy smokers (7 men and 7 women) completed the four 5-day phases of the study: baseline, patch treatment, voucher treatment, and return to baseline. The order of the two treatment phases was counterbalanced across participants. In the patch treatment condition, participants wore a 14-mg transdermal nicotine patch every day. In the voucher treatment condition, participants received vouchers contingent on abstinence from smoking, defined as producing carbon monoxide (CO) readings of < or =4 parts per million. Participants e-mailed two video clips per day showing them breathing into a CO monitor and the resulting CO reading to clinic staff. In the voucher treatment, 24% of samples were negative, and 5% of samples were negative in the patch treatment. Results suggest that contingent vouchers were more effective than transdermal nicotine patches in promoting abstinence.     

Internet‐based self‐tailored deposit contracts to promote smoking reduction and abstinence

Deposit contracting may reduce costs and increase efficacy in contingency management interventions. We evaluated two Internet‐based deposit contract arrangements for smoking. In Experiment 1, nine participants deposited self‐selected amounts that could be earned back for meeting goals. During treatment, participants were reimbursed for breath samples with less than or equal to 6 parts per million carbon monoxide and met the criterion for 47% of samples compared to 1% during baseline. In Experiment 2, 10 participants’ deposits were matched up to $50. No samples met the criterion during baseline but 41.5% met it during treatment. The average deposit was $82 in Experiment 1 and $49 in Experiment 2. Participants rated the intervention favorably and sample submission rates were high. These experiments suggest that Internet‐based self‐tailored deposits are acceptable, feasible, and can promote brief reduction and abstinence in some smokers. Future research should investigate individual and intervention factors that affect long‐term cessation and uptake of deposit contracts.     

Escalating schedules of incentives increase physical activity with no differences between deposit and no-deposit groups: A systematic replication

Physical inactivity has increasingly affected public health in the United States during the COVID-19 pandemic as it is associated with chronic diseases such as arthritis, cancer, and heart disease. Contingency management has been shown to increase physical activity. Therefore, the present study sought to evaluate the effects of an escalating schedule of monetary reinforcement with a reset contingency on physical activity, as compared between 2 counterbalanced groups in which a monetary deposit of $25 was either required (deposit group) or not (no-deposit group). Twenty-five adults wore Fitbit accelerometers to monitor step counts. An ABA reversal design was used; in the 2 baseline phases, no programmed contingencies were in place for step counts. During intervention, step goals were set using a modified 70^th percentile schedule with a 7-day window: Reaching the first goal would result in $0.25, and incentives increased by $0.25 for each subsequent day in which the goal was met. Failure to reach a goal resulted in a reset of the monetary incentive value to $0.25. Ten out of 12 participants from the deposit group were determined to be responders to intervention, whereas 8 out of 13 participants from the no-deposit group were determined to be responders to intervention. Overall, there were no significant differences between the groups' step counts. However, the deposit group's intervention was cheaper to implement, which suggests that deposit contracts are a viable modification for physical activity interventions.     

When Sharing Is Not Caring: Does (un)Certainty About Bill Payment Method Lead Diners to Consume More and Spend More Money?

Previous work has demonstrated that unacquainted participants in an experimental, restaurant‐like setting consume more when they know in advance that the bill will be split evenly rather than paid according to individual consumption. Real life, however, often differs from these experimental settings in two important ways. First, unlike random groups of participants, diners who eat together are frequently friends or colleagues. Second, payment method (even vs. individual payment) is usually unknown (i.e. uncertain) at the time people place their orders, and is determined when the check arrives. The current research tests the ecological validity of the association between consumption amount and payment method. Study 1 was conducted in a natural setting with organic groups of diners. Some were asked to state their desired payment method before ordering (Certain condition); others did so only after asking for the check (Uncertain condition). In both conditions, even payment (as opposed to individual payment) was associated with greater consumption amount. However, overall, consumption amount was lower among diners in the Uncertain condition than among those in the Certain condition. Study 2 presents a controlled follow‐up experiment showing that eliminating diners' prior expectations regarding the payment method—by informing them that the payment method will be randomly determined after the consumption decision—eliminates the relationship between payment method and consumption amount. This study further indicates that when diners are uncertain what the payment method will be, even bill‐splitting has negative implications for their subsequent social interactions, expressed in retribution tendencies. Copyright © 2016 John Wiley & Sons, Ltd.     

A randomized trial of employment-based reinforcement of cocaine abstinence in injection drug users

High-magnitude and long-duration abstinence reinforcement can promote drug abstinence but can be difficult to finance. Employment may be a vehicle for arranging high-magnitude and long-duration abstinence reinforcement. This study determined if employment-based abstinence reinforcement could increase cocaine abstinence in adults who inject drugs and use cocaine during methadone treatment. Participants could work 4 hr every weekday in a workplace where they could earn about $10.00 per hour in vouchers; they were required to provide routine urine samples. Participants who attended the workplace and provided cocaine-positive urine samples during the initial 4 weeks were invited to work 26 weeks and were randomly assigned to an abstinence-and-work (n = 28) or work-only (n = 28) group. Abstinence-and-work participants had to provide urine samples showing cocaine abstinence to work and maintain maximum pay. Work-only participants could work independent of their urinalysis results. Abstinence-and-work participants provided more (p = .004; OR = 5.80, 95% CI = 2.03-16.56) cocaine-negative urine samples (29%) than did work-only participants (10%). Employment-based abstinence reinforcement can increase cocaine abstinence.     

OPIOID ABSTINENCE REINFORCEMENT DELAYS HEROIN LAPSE DURING BUPRENORPHINE DOSE TAPERING

A positive reinforcement contingency increased opioid abstinence during outpatient dose tapering (4, 2, then 0 mg/day during Weeks 1 through 3) in non‐treatment‐seeking heroin‐dependent volunteers who had been maintained on buprenorphine (8 mg/day) during an inpatient research protocol. The control group (n = 12) received $4.00 for completing assessments at each thrice‐weekly visit during dose tapering; 10 of 12 lapsed to heroin use 1 day after discharge. The abstinence reinforcement group (n = 10) received $30.00 for each consecutive opioid‐free urine sample; this significantly delayed heroin lapse (median, 15 days).     

mMotiv8: A smartphone‐based contingency management intervention to promote smoking cessation

Cigarette smoking is the leading preventable cause of death and illness in the United States. We tested the usability, acceptability, and efficacy of a smartphone‐based contingency management treatment to promote cessation. We used a nonconcurrent multiple‐baseline design. Participants (N = 14) provided breath carbon monoxide (CO) samples by using a CO meter that was connected to the user's smartphone. An app (mMotiv8) housed on participants' smartphones automatically captured pictures of the CO sampling procedure to validate the end user's identity, and it prompted submissions via a push message delivered to participants' smartphones. Participants earned a $10 incentive for daily abstinence, which was added to a reloadable debit card. Overall, 4% of the CO samples were negative during baseline, and 89% were negative during treatment. Self‐reported usability and acceptability were high, and 85% of the prompted samples were submitted. A smartphone intervention could be scalable and reduce the health consequences and costs associated with cigarette smoking, particularly in rural and low‐income populations.     

CONTINGENCY MANAGEMENT PROMOTES SMOKING REDUCTIONS IN RESIDENTIAL SUBSTANCE ABUSE PATIENTS

Rates and consequences of cigarette smoking are more severe in substance abusers. In this 12‐week pilot study, residential substance abuse treatment patients received standard care for smoking cessation (n = 12) or prize contingency management (n = 12) for expired carbon monoxide (CO) tests ≤ 8 ppm and salivary cotinine < 10 ng/ml, which are indicative of smoking abstinence. Percentage of negative CO tests and the highest number of consecutive negative CO tests were greater in contingency management compared to standard care.     

The Relative Contribution of Economic Valence to Contingency Management Efficacy: A Pilot Study

We investigated the extent to which a contingency management (CM) procedure that deducted money from a grand total available at the end of the study compared to a procedure in which money accumulated with continued abstinence from cigarette smoking. Results suggested that the procedure in which money increased contingent on abstinence resulted in a significantly greater likelihood of obtaining a clinically relevant (i.e., 48-hr) period of abstinence. In terms of attendance, participants in the condition in which monetary reinforcement accrued with consecutive instances of abstinence were significantly less likely to miss consecutive appointments than those in which money was deducted for failure to abstain.     

Technology‐based contingency management and e‐cigarettes during the initial weeks of a smoking quit attempt

Contingency management (CM) interventions are among the most effective behavioral interventions for smoking. This study assessed the effects of CM and electronic cigarettes (ECs) on smoking reductions and abstinence for durations of 30‐36 days. Twelve participants were exposed to Baseline, EC alone, and EC + CM conditions. An internet‐based platform was used to monitor smoking via breath carbon monoxide (CO) and deliver CM for smoking abstinence (CO ≤4 ppm). A Bluetooth‐enabled EC monitored daily EC puffs. Abstinence rates were equivalent between EC (34.4%) and EC + CM (30.4%) conditions. Both conditions promoted smoking reductions. We observed an inverse correlation between smoking and EC puffs (r = ‐.62, p < .05). Results suggest the use of electronic cigarettes can promote smoking reductions and abstinence, and CM did not improve these outcomes. Larger magnitude consequences or tailoring EC characteristics (e.g., flavor) may have improved outcomes. Technology‐based methods to collect intensive, longitudinal measures of smoking and electronic cigarette use may be useful to characterize their environmental determinants.     

Mood Management Mail Intervention Increases Abstinence Rates for Spanish-Speaking Latino Smokers

A self-administered mood management intervention program for smoking cessation provided through the mail to Spanish-speaking Latinos resulted in a 23% abstinence rate at 3 months compared to an 11% abstinence rate for a smoking cessation guide alone. Participants (N = 136) were randomly assigned to receive either the cessation guide (the Guía), or the Guía plus a mood management intervention (Tomando Control de su Vida) presented in writing and in audiotape format. At 3 months after random assignment, 16 out of 71 of those assigned to the Guía-plus-mood management condition reported being abstinent (not smoking for at least 7 days) compared to 7 out of 65 in the Guía-only condition (z = 1.8; p = .04, one-tailed). Moreover, those with a history of major depressive episodes, but not currently depressed, reported an even higher abstinence rate in the Guía-plus-mood management condition, compared to the Guía-only condition (31 vs. 11%, z = 1.8, p = .04, one-tailed). We conclude that the mood management mail intervention substantially increases abstinence rates, especially for those with a history of major depressive episodes.     

A Deposit Contract Method to Deliver Abstinence Reinforcement for Cigarette Smoking

Eight smokers were randomly assigned to a deposit contract ($50.00) or to a no-deposit group. Using a reversal design, participants could recoup their deposit (deposit group) or earn vouchers (no-deposit group) for smoking reductions and abstinence (breath carbon monoxide [CO] ≤ 4 parts per million) during treatment phases. Treatment was delivered via a novel Internet-based method to monitor smoking status. Although equivalent decreases in breath CO and abstinence were observed during treatment in both groups, $178.50 in vouchers were distributed to participants in the no-deposit group, whereas a small surplus remained in the deposit group. A deposit contract method may represent a cost-effective model to deliver abstinence reinforcement for cigarette smoking.     

Effects of incentives in web-based prevention for adolescents: Results of an exploratory field study

This study examines if the willingness of adolescents to participate in a web-based prevention program can be increased by providing an incentive for participation. Eighth graders (n = 166) were instructed to work on an online stress-prevention program via the internet from home. A subgroup of n = 80 subjects from three school classes were told that they would take part in a raffle if they completed the program. The remaining n = 86 participants (again three classes) served as a control group. The school classes were randomly allocated to the training conditions. During the 8-week intervention period, compliance rates were recorded by means of an online tracking system. In addition, self-reported compliance and training acceptance were assessed. The application of an incentive had considerable effects on retention rates, on training acceptance and self-assessed effectiveness of the intervention. Adolescents in the ‘incentive condition’ completed three times as many program lessons as control subjects did, and–as their self-reports suggest–they worked as attentively. Validity of self-reported compliance was higher among participants of the incentive group and they reported significantly higher program acceptance. As a consequence, the application of incentive systems is recommended for future implementation of web-based prevention programs targeting adolescents.     

AN EXPERIMENTAL COMPARISON OF THREE DIFFERENT SCHEDULES OF REINFORCEMENT OF DRUG ABSTINENCE USING CIGARETTE SMOKING AS AN EXEMPLAR

The efficacy of three different schedules of reinforcement for promoting and sustaining drug abstinence was compared in this study. Cigarette smoking was studied as an exemplar of stimulant drug self-administration. Sixty cigarette smokers were assigned to one of three groups (progressive rate of reinforcement, fixed rate of reinforcement, and yoked control). Participants in all three groups were asked to refrain from smoking for 1 week. Participants in the progressive and fixed groups achieved greater mean levels of abstinence than those in the control group. Participants in the progressive group were significantly less likely to resume smoking when they became abstinent than participants in the other groups.     

Development of a Behavioral Activation–Based Intervention for Cigarette-Smoking Young Adults

Quitting smoking during young adulthood can substantially reduce tobacco-related morbidity and mortality later in life. Depressive symptomatology is prevalent among smokers and increases risk for poor smoking cessation outcomes. However, few integrated behavioral interventions simultaneously target smoking and depressive symptoms and rarely have young smokers been included in the development of these interventions. In this paper we describe an 8-session behavioral activation–based treatment for smoking (BATS; MacPherson et al., 2010) adapted for youth. We conducted a series of focus groups with young adult smokers with depressive symptoms in order to modify treatment manuals to be developmentally appropriate. Subsequently, we completed a small pilot group (n = 5) of the intervention to provide preliminary data on feasibility, acceptability, and outcomes. We provide a case series of the participants in order to provide clinical illustrations of how the modified BATS treatment was implemented among young adults. Most pilot study participants exhibited smoking abstinence and smoking reductions at the end of treatment, as well as improvement in depressive symptoms and maintenance of levels of activation and environmental reward. Participants provided positive qualitative constructive feedback regarding the intervention.     

Human latent inhibition and the density of predictive relationships in the context in which the target stimulus occurs

In two experiments, participants were exposed to a listing of actions performed by a fictitious Mr. X, over three days of his life. For most of his actions an outcome was described, but some were not followed by any outcome. On Day 3, Mr. X performed an action (the target action) that was followed by a novel outcome. For participants in the control condition, the target action that preceded the appearance of this outcome was also novel; for participants in the latent inhibition (LI) condition, Mr. X had performed the target action on repeated occasions during Days 2 and 3, without it producing any outcome. All the participants were tested on their ability to retrieve the action performed by Mr. X prior to the target outcome. In Experiment 1, retrieval of the target action (indicating a less effective target action–outcome association) was poorer in the LI than in the control condition. In Experiment 2, reducing the proportion (the density) of nontarget actions that brought outcomes during initial training was found to reduce the size of the LI effect. These results are predicted by the account of LI put forward previously [Hall, G., & Rodríguez, G. (2010). Associative and nonassociative processes in latent inhibition: An elaboration of the Pearce-Hall model. In R. E. Lubow & I. Weiner (Eds.), Latent inhibition: Data, theories, and applications to schizophrenia (pp. 114–136). Cambridge, England: Cambridge University Press]. A high density of predictive relationships ensures strong activation of the expectancy that some outcome will occur when the target action is first presented; this facilitates the formation of a target action–no-event association during training in the LI condition, thus enhancing the LI effect.