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Unprogrammed reinforcement of patients' behavior in a mental hospital
Authors:D M Gelfand  S Gelfand  W R Dobson
Affiliation:1. Gynaecology Unit, The Royal Marsden NHS Foundation Trust, 203 Fulham Road, London SW3 6JJ, United Kingdom;2. Breast Unit, Royal Marsden NHS Foundation Trust, Downs Road, Sutton SM2 5PT, United Kingdom;3. Department of Ageing and Health, 9th Floor North Wing, St Thomas’ Hospital, Guys & St Thomas’ NHS Foundation Trust, Westminster Bridge Road, London SE1 7EH, United Kingdom;4. Division of Health and Social Care Research, King’s College London, Capital House, 42 Weston Street, London SE1 3QD, United Kingdom;1. Division of Endocrinology, Section of Gynecology, The Hospital for Sick Children; and Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada;2. Division of General and Thoracic Surgery, The Hospital for Sick Children; and Department of Surgery, University of Toronto, Toronto, Ontario, Canada;1. Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Mass;2. Department of Biostatistics, Boston University, School of Public Health, Boston, Mass;3. Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisc;2. Institute of Anesthesiology and Pain Medicine, Kantonsspital Winterthur, Winterthur, Switzerland;3. Department of Anesthesiology, Hofstra Northshore-LIJ School of Medicine, New Hyde Park, NY;4. Section of Epidemiology, Vetsuisse Faculty, University of Zurich, Switzerland;5. Clinic for Cardiac Surgery, Triemli City Hospital, Zurich, Switzerland
Abstract:This study investigated the social reinforcement contingencies which psychotic patients experience in mental hospitals. The patients' behavior was observed and rated for appropriateness and the consequent environmental responses recorded. The results indicate that the patients' prosocial and psychotic behavior were inconsistently reinforced. The patients themselves were the best behavioral engineers, followed by nurses and nursing assistants in that order. A positive correlation was found between the severity of a patient's psychotic behavior and the inappropriateness with which he is reinforced. Implications of these results for the training of hospital staff-members are discussed.
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