Aversion Therapy Research Articles

Persistence: The role of partial reinforcement in psychotherapy.

Persistence, which refers to the ability of a learned behavior to survive protracted nonreinforcement (extinction), has been an overlooked dimension of clinical intervention. While persistence of newly acquired coping behavior is desired (and possibly assumed) by all psychotherapeutic procedures, few treatment programs possess features that operate to sustain responding in the face of a nonsupportive, nonreinforcing environment. The present article presents a treatment strategy designed to foster persistence based on the laboratory findings that partial reinforcement schedules produce greater resistance to extinction than continuous reinforcement schedules--a phenomenon referred to as the partial reinforcement extinction effect. The two major theories of persistence (Amsel's general theory of persistence and Capaldi's sequential theory) are discussed, and the basic principles of these models are extended to a number of therapeutic modalities including depression therapies, systemic desensitization, assertiveness training, and aversion therapy. In addition, procedural considerations including generalized and discriminated persistence are discussed.

Treatment of pedophilia using multistage aversion therapy and social skills training

A successful case study of behavior therapy with a pedophile is described, in which pedophilia is viewed as a multifaceted pattern of aberrant sexual arousal with accompanying excesses and deficits in other significant social and sexual areas. Aversive deconditioning procedures and graded social skills training were employed. The implications of this study are discussed with regard to therapy strategies and generalization effects.

Paradoxical aversive conditioning with ethanol

In three experiments with hooded rats, paired injections of ethanol and lithium chloride produced an aversion to the taste of ethanol, yet reduced ethanol's potency as an unconditioned stimulus during subsequent taste aversion conditioning with saccharin (i.e., saccharin→ethanol). Two of the experiments were designed to test an associative “blocking” account of the latter finding. In each of these experiments, an attempt was made to extinguish the aversion conditioned to a potential blocking stimulus after ethanol-lithium pairings, but before saccharain-ethanol conditioning. Nonreinforced exposure to intraperitoneally mediated ethanol taste cues did not eliminate the detrimental effect of ethanol-lithium pairings on subsequent saccharin-ethanol conditioning (Experiment 2), whereas nonreinforced exposure to handling-injection cues did (Experiment 3), thus providing support for the associative blocking interpretation. Implications of these findings for chemical aversion therapy are discussed.

A reconsideration of the relevance of recent animal studies for development of treatment procedures for alcoholics

Amit and Sutherland's conclusions concerning the use of conditioned taste aversions for alcoholism treatment are critically evaluated. Their conclusion that painful electric shock is contraindicated as a basis for alcohol taste aversions is consistent with the animal and human literature which depicts nausea as a more biologically appropriate US for taste aversion formation. However, Amit and Sutherland also conclude that alcoholics will not develop illness-induced alcohol aversions because animal studies show that aversion acquisition is disrupted by preconditioning familiarity with the conditioned stimulus (CS) — flavor — or unconditioned stimulus (US) — illness. This conclusion is untenable because Amit and Sutherland only considered animal conditioning methods that differed markedly from aversion therapy practices. Other animal studies modeled after aversion therapy procedures clearly show CS and US preexposure effects to be transitory phenomena. Moreover, experimental and clinical data show humans to be quite susceptible to taste aversion formation, and that many alcoholics do form strong alcohol aversions under appropriate conditioning parameters. Additional implications of the animal literature for effective aversion therapy are explored, and the paper concludes with a discussion of covert sensitization, a promising verbal aversion therapy which has resulted in the development of strong alcohol aversions in many volunteer subjects at the Augusta Veterans Administration Medical Center.

The Treatment of Compulsive Gambling

The techniques used for treating compulsive gamblers are reviewed. They include psychoanalytic psychotherapy, aversion therapy, marital therapy, and self-help groups (Gamblers Anonymous). The problems especially important in treating compulsive gamblers include lack of motivation for change and the role of the significant others in maintaining the gambler as the scapegoat of the family. Although therapists report good success in treating gamblers, the sporadic nature of gambling probably inflates "success' rates.

Drugs employed in the treatment of alcoholism: Rat data suggest they are unnecessarily severe

A tacit assumption, which has often been made by practitioners of both chemical aversion therapy (CAT) and deterrent therapy of alcoholism, is that efficacy of a drug depends mainly on how noxious it is. We conducted two experiments which challenge this assumption. These experiments compared five noxious drugs employed in the treatment of alcoholism, with lithium, in regard to their ability to reduce rats' drinking of a familiar, readily consumed, ethanol (10% v/v) solution. In both experiments, the dose of lithium was equivalent, in terms of body weight, to the largest daily recommended human dose: the dose of each of the five, noxious drugs was twice this equivalent. In the first experiment, the CAT drugs emetine, ipecac and succinylcholine were compared with lithium: in the second, the deterrent therapy drugs citrated calcium carbimide and disulfiram were compared. Despite the use of comparatively smaller doses of lithium, none of the noxious drugs administered in either experiment produced stronger ethanol aversions than lithium. This supports the use of lithium in CAT, and suggests that unnecessarily noxious drugs are being used in the treatment of alcoholism.

Maintenance of nonsmoking behavior through self-administered wrist-band aversion therapy

Participants in the aversion treatment were instructed to focus vividly on the triggering thoughts leading to smoking each time the urge to smoke occurred. Subjects then were to self-administer a painful snap immediately using the rubber band they were wearing around their wrist and to engage in alternate behaviors such as chewing gum. Participants in a placebo treatment were instructed to wear the wrist band as a “reminder” and to engage in alternate behaviors such as chewing gum, etc. About a third of the participants never wore the wrist band either as an aversive stimulus dispenser or as a “reminder”. These people were assigned to a nonuser group in the statistical analysis. At a 1-year follow-up, a treatment effect was shown for males but not for females. One year after treatment five of the seven males in the aversion group were still abstinent, as compared to one out of seven abstinent in the placebo group and none in the nonuser group.

DELINQUENT BEHAVIOUR MODIFICATION IN THE NATURAL ENVIRONMENT

Behaviour modification techniques are based on the assumption that the likelihood of occurrence of a behaviour depends on its consequences. If a behaviour is followed by a reward, it becomes more likely to occur in future, while if it is followed by a punishment it becomes less likely. This assumption is neither profound nor original. It has formed the basis, implicitly or explicitly, of many training methods used in the past by parents, teachers, institutional stalf, and others with the power to shape people's behaviour. What is new in behaviour modification research is the systematic and explicit use of rewards and/or punishments to modify behaviour, and the emphasis on a research design which will permit an evaluation of the effectiveness of any treatment. Behaviour modification should be distinguished from behaviour therapy. While there is undoubtedly some overlapping, it is generally true that behaviour therapy is based on the principles of classical conditioning, while behaviour modification is based on the principles of operant conditioning. Classical conditioning is concerned with the acquisition of reflex-like responses. For example, Rachman (1966) showed subjects (male psycho logists) slides of black knee-length women's boots, followed immediately by slides of attractive naked girls. Initially, only the naked girls produced sexual arousal (as measured by penis volume), but, after a number of pairings of the boots and the girls, the boots alone began to produce a sexual response. It seemed that simple pairing had made the boots a conditioned stimulus for the sexual response. Operant conditioning, on the other hand, is concerned with strengthening or weakening behaviour by rewarding or punishing consequences. One of the methods used by behaviour therapists is aversion therapy (see Rachman and Teasdale, 1969). For example, MacCulloch, Williams and Birtles (1971) treated a 12 year-old boy who liked exhibiting himself to older women by showing him slides of older women followed by electric shocks. According to the boy's own reports, this treatment shifted his sexual interests to girls of his own age. Aversion therapy has been used more with alcoholics and sex offenders than with the more usual delinquency offences of dishonesty, aggression and vandalism. As exceptions to this general statement, Kellam ( 1969) treated a female shoplifter by showing her a film of shoplifting and giving her electric shocks, and Keutzer (1972) treated a female shoplifter by asking her to hold her breath until it became mildly painful, whenever she got the impulse to steal. Cautela (1967) recommended treating juvenile delinquents by covert sensitization , asking them to

Evidence of an ethnomedical form of aversion therapy on the United States-Mexico border

Ethnographic data are presented on the use of a seed, haba de San Ignacio (Hura polyandra L. and Hura crepitans L.) to promote an aversion to the consumption of alcohol by problem drinkers in Mexican American and Mexican national populations on the United States-Mexico border.

TREATMENT OF SELF‐INJURIOUS BEHAVIOUR WITH A GABA (GAMMA‐AMINOBUTYRIC ACID) ANALOGUE

Self-injurious behaviour (SIB) is not uncommon in the severely subnormal. Corbett (1975) found the incidence in several reported series to vary between 3.5 per cent and almost 40 per cent, and Van Velzen (1973), in a survey of ten institutions in the Netherlands, found it present in 584 patients out of almost 2,000 (30.3 per cent). Treatment is notoriously difficult and many kinds have been tried including physical restraint, drug regimes, and electric shock aversion therapy. An account is given here of a drug trial using baclofen, a gamma-aminobutyric acid (GABA) analogue that crosses the blood brain barrier. GABA, in addition to being a muscle relaxant, is also a major inhibitor in many areas of the brain, including the cortex and basal ganglia (Callingham, 1972) andit was presumed by the author that some severely subnormal defectives have damage in these areas and hence might be deficient in this inhibitor. The trial commenced with a preliminary period during which the reactions of patients to the drug at different dose levels were observed. This was followed by a double-blind cross-over trial in patients who had already shown improvement.

Aversion Therapy: Technical, Ethical, and Safety Issues

The factors which should be considered when deciding on the appropriateness of a version therapy are discussed in terms of the type of stimulation to be used, the safety of electrical stimulation, and the ethical problems inherent in using aversive procedures. It is argued that aversion therapy is appropriate in limited circumstances provided that strict control is maintained over the decision making process.

Taste aversion therapy with alcoholics: Techniques and evidence of a conditioned response

Summary Aversion therapy for alcoholism is based on the notion that aversion conditioning produces a conditioned response (CR) to alcohol that is antagonistic to subsequent alcohol ingestion. This study reports the first experimental evidence that aversion conditioning produces a CR to the taste and smell of alcohol. Two patients were given taste aversion therapy for alcoholism. While medically conservative, the taste-aversion procedures produced profound malaise and reliable emesis shortly after patients began drinking alcoholic beverages. Behavioral. attitudinal and psychophysiological indices all reflected the acquisition of an alcohol aversion as a function of conditioning.

Case of Transvestism Treated with Faradic Aversion Therapy

Case of Transvestism Treated with Faradic Aversion Therapy

Chemical aversion therapy: Rat data suggest it may be countertherapeutic to pair an addictive drug state with sickness

Summary The injection of a low dose of alcohol after a rat drinks saccharin solution usually produces a mild saccharin aversion. One would expect that if alcohol sedation had previously been paired with a very toxic injection of lithium, the capacity of alcohol to produce saccharin aversions would increase, since the alcohol would then elicit conditioned lithium sickness. Contrary to expectation, however, alcohol-lithium pairings were found to eliminate the capacity of a small dose of alcohol to produce saccharin aversions. Similar results are obtained with other recreational drugs. If this finding is applicable to humans, a technique which might be expected to produce an aversion to a drug state would have exactly the opposite effect.

Blood nicotine and carboxyhemoglobin levels after rapid-smoking aversion therapy.

Blood nicotine and carboxyhemoglobin levels after rapid-smoking aversion therapy.

Aversive conditioning treatment of overweight

College women volunteers for a weight reduction program were assigned to one of three treatment conditions. Twelve subjects received olfactory aversion therapy, while another group of 12 received attention-placebo treatment. A third group of 14 served as waiting-list controls. Weight losses over time were statistically significant, but there were no differences among groups. The losses were clinically trivial, and both aversion therapy and placebo treatments were considered to be ineffective in the treatment of obesity. The aversion therapy and attention-placebo groups both downrated the palatability of favorite (target) foods, found the experiment to be helpful and sensible, and claimed reduced food intake. These subjective reports were discussed in terms of demand characteristics and suggestion effects.

Procedures for taste aversion therapy for alcoholism

Procedures for taste aversion therapy for alcoholism

Avoidance latencies reliably reflect sexual attitude change during aversion therapy for homosexuality

Work on the analysis and significance of avoidance latencies gathered during anticipatory avoidance (A.A.) aversion therapy for homosexual behavior is reviewed. An analysis of automatically collected data showed two types of sessional avoidance latency behavior. These two types of latency behavior are shown to be related to differing degrees of clinical efficacy during treatment sessions in terms of reduced homoerotic interest measured on a psychometric test. One type of avoidance behavior is shown to be very closely associated with the incubation of decreasing homoerotic attitude between treatment sessions, the other with the absence of attitude change. A quantitative relationship between changes in avoidance latency behavior and changes in homoerotic interest has been derived. The relationship was then used to predict the overall attitude change in a number of patients by using the avoidance latency data alone. These predictions were in accordance with eventual clinical outcomes and were superior indicators of clinical success compared with psychometric assessment. It is suggested that the avoidance response itself may serve a positive therapeutic role as it can predict outcome. It also appears that A.A. aversion therapy produces or enhances response increment outside of therapy .

Incubation of sexual attitude change between sessions of instrumental aversion therapy: Two case studies

Anticipatory avoidance aversion therapy (AA) was conceived in an attempt to gain efficient control of unwanted approach behavior; this aim has been achieved in the hands of only relatively few workers. paradoxically other, seemingly more simple, techniques have produced comparable results. This paper presents in detail psychometric attitudinal data on changes in sexual orientation measured immediately before and after sessions of AA aversion therapy in two cases of homosexual behavior. The findings suggest that the crucial reduction in sexual interest in men occurred in the between-treatment time. It was also found that male scores tended to increase during the later treatment sessions. Three points emeerge: first, these data appear to demonstrate incubation. Second, this experimental design could be applied to other dependent variables with the prediction that they will show response increment in the absence of the experimentally presented CS. Finally, if the theoretical argument presented here approximates to the truth then the effectiveness of apparently dissimilar techniques can be explained.

Effects of Researcher Status and University Status on the Evaluation of Scientific Articles

The present study examined the influence of the status of the researcher and the status of the university on the evaluation of research articles. Twenty-seven graduate students in clinical psychology, each of whom had had at least two graduate courses in statistics and experimental design, were asked to evaluate a fictitious research article (Commoner, 1972) dealing with the efficacy of aversion therapy vs an analytic approach to weight reduction. The research article included only the introduction, the methodology, and the raw data which were marginally significant (p = .lo), favoring aversion therapy. Nine subjects evaluated the article, purportedly written by a H~gh status researcher from a High status university (Leonard Krasner,' State University of New Yotk). Nine other subjects rated the article, purportedly written by a Low stams researcher from a High scatus university (M. Lynch, State University of New York); the remaining nine subjects rated the article, purportedly written by a Low status researcher from a Low status school (M. Lynch, Rockford College). The items on which the article was rated were five Likert-type scales (Commoner, 1972) dealing with the adequaq of methodology, recommendations concerning publication, confidence in evaluating the article, and eight evaluative scales of the semantic differential (Osgood, Suci, & Tannenbaum, 1957). After evaluating the article, the subjects rank-ordered 17 psychologists and three fictitious names, including Krasner and Lynch respectively, according to their contributions to psychological research and practice. The six dependent measures were analyzed in separate one-way analyses of variance. The three groups differed significantly on only one scale assessing statistical significance of the article (F = 4.61, df = 2/24, p = .02), which may have been simply the most difficult item the subjects were asked to judge. Also the interpretation of the P ratio is virtually impossible because the Low-Low condition was rated more positively than the High-High condition which was rated more positively than the Low-High condition. When the 17 psychologists and 3 fictitious names were rank-ordered, with one being equal to the greatest contribution, the mean number attributed to Krasner was 4 (SD = 3.71) and to Lynch was 14 (SD = 5.431, indicating that the subjects at least recognized Krasnet's name. A question often arises concerning whether the statuses of given researchers affect how their scientific articles are reviewed. Specifically do the statuses of the researchers and their universities influence how their articles are evaluated? In the present study in which graduate students were reviewers, the find~ngs suggest that these students did not differentially rate the articles as a function of the starus of the researcher and university.