Abstract
Antipsychotic medications are commonly used to address destructive behaviors in people with developmental disabilities. Contingent skin shock is less commonly employed. Here, the risks and the benefits of antipsychotic medications and contingent skin shock are enumerated and compared. First, the major untoward effects of antipsychotic medications and contingent skin shock are summarized. Second, an efficacy analysis was conducted consisting of the following components: a brief description of the conclusions of a 1991 review of antipsychotic medications; a complete analysis of the effect of first generation and second generation antipsychotics on the irritability subscale of the Aberrant Behavior Checklist; a complete analysis of first generation and second generation antipsychotics on the Clinical Global Impression – Improvement Scale; a complete analysis of the effect of first generation antipsychotics, second generation antipsychotics, and contingent skin shock on destructive behavior frequency. The results of the analysis suggest that contingent skin shock is by far the most effective procedure and has the most favorable side effect profile.
Highlights
Clinical teams comprised of psychiatrists, behavior analysts, and other professionals strive to provide the least restrictive most effective treatment to those people with developmental disabilities who exhibit destructive behaviors
After reviewing a series of studies related to chlorpromazine, they stated the following: In summary, the literature concerning the therapeutic effects of chlorpromazine on the problem behaviors of people with mental retardation suggests that, in some cases some therapeutic benefit has been observed, in most cases it was either (1) not observed, (2) observed, but at the expense of adverse side effects, (3) observed, but perhaps not to a clinically-relevant degree, (4) observed, but inferior to behavioral treatments, or (5) observed, but inferior to other drug treatments
The analysis presented here suggests that the behaviors treated with contingent skin shock (CSS) in the literature are certainly more frequent than those treated with first generation antipsychotic medications (FGAs) or second generation antipsychotic medications (SGAs)
Summary
Clinical teams comprised of psychiatrists, behavior analysts, and other professionals strive to provide the least restrictive most effective treatment to those people with developmental disabilities who exhibit destructive behaviors. Frequency Data: Thirty-two studies, describing the individual effect of CSS on destructive behaviors of 114 individuals are summarized in Table 12 (Supplementary File) [3, 95, 97,98,99,100, 102, 132,133,134,135,136,137,138,139,140,141,142,143,144,145,146,147,148,149,150,151,152,153,154,155].
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