Dixon M J, Helsel W J, Rojahn J, Cipollone R, Lubetsky M J
Behav Modif. 1989 Jan;13(1):91-107. doi: 10.1177/01454455890131006.
This study investigated the usefulness of aversive conditioning of a mild punishment procedure that had ceased to suppress target behaviors to clinically acceptable levels. A 6.8-year-old severely retarded boy with high levels of aggressive, destructive, and loud screeching behaviors was readmitted to a psychiatric facility to adjust behavioral programs and rule out seizure disorder. A design combining withdrawal and multiple baselines across behaviors tested for effects of aversive conditioning of visual screening with ammonia and the impact of anticonvulsant medication (carbamazepine, phenytoin). Data indicated that aversively conditioned visual screening temporarily lowered rates of responding. It is tentatively concluded that aversive conditioning might be a useful mechanism to strengthen suppressive effects of mild punishment procedures and a promising approach for alleviating placement problems due to maladaptive behaviors in mentally retarded persons. Maintenance of treatment effects, community placement, and the mandate to choose the least restrictive aversive treatment alternative are discussed. Anticonvulsant medication showed no beneficial effect for the target behaviors investigated.
本研究调查了一种轻度惩罚程序的厌恶条件作用的效用,该程序已不再能将目标行为抑制到临床可接受的水平。一名6.8岁的重度智障男孩,具有高度攻击性、破坏性和大声尖叫行为,被重新收治到一家精神病机构,以调整行为方案并排除癫痫障碍。采用了一种结合行为消退和多基线的设计,测试了用氨水进行视觉筛查的厌恶条件作用的效果以及抗惊厥药物(卡马西平、苯妥英)的影响。数据表明,厌恶条件作用的视觉筛查暂时降低了反应率。初步得出结论,厌恶条件作用可能是一种加强轻度惩罚程序抑制效果的有用机制,也是缓解智障人士因适应不良行为导致的安置问题的一种有前景的方法。文中还讨论了治疗效果的维持、社区安置以及选择限制最小的厌恶治疗替代方案的要求。抗惊厥药物对所研究的目标行为没有显示出有益效果。