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“卫生间游戏”:一种消除大便失禁行为的系统方案。

The "bathroom game": a systematic program for the elimination of encopretic behavior.

作者信息

Bornstein P H, Balleweg B J, McLellarn R W, Wilson G L, Sturm C A, Andre J C, van den Pol R A

出版信息

J Behav Ther Exp Psychiatry. 1983 Mar;14(1):67-71. doi: 10.1016/0005-7916(83)90015-0.

Abstract

The present investigation utilized a unique, variable ratio schedule of reinforcement (the "bathroom game") to treat a 10-year-old encopretic male. Dependent measures included confirmed incidents of (a) soiling and (b) appropriate bowel movements monitored across an ABAB design (Baseline 1, "Bathroom Game 1", Baseline 2, "Bathroom Game 2") with one-year follow-up. During "bathroom game" conditions, contingent monetary rewards were provided for non-instances of soiling and appropriate bowel movements. Such rewards were progressively and systematically leaned-out over the course of treatment on a pre-determined variable ratio schedule. Results indicated a clear demonstration of functional control and clinically significant treatment effects during both experimental periods. These findings are discussed with regard to the positive features of the "bathroom game" procedure and recommendations are made for future investigations in the area.

摘要

本研究采用了一种独特的可变比率强化程序(“卫生间游戏”)来治疗一名10岁的大便失禁男性。相关测量指标包括在ABAB设计(基线1、“卫生间游戏1”、基线2、“卫生间游戏2”)中监测到的(a)弄脏情况和(b)正常排便的确切事件,并进行了为期一年的随访。在“卫生间游戏”阶段,对于没有弄脏情况和正常排便的情况给予相应的金钱奖励。在治疗过程中,按照预先确定的可变比率程序,这些奖励逐步且系统地减少。结果表明,在两个实验阶段都明确显示出了功能控制和具有临床意义的治疗效果。本文讨论了“卫生间游戏”程序的积极特点,并对该领域未来的研究提出了建议。

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