Basic and applied research on extinction bursts when treating problem behavior

项目摘要 流行病学研究和荟萃分析的结果表明，对破坏性行为的治疗， 功能性分析，如功能性沟通训练（FCT），通常通过以下方式减少破坏性行为 90%或更多，比其他治疗方法更有效。然而，这些治疗包括 灭绝，这可能会产生预防引起的不良副作用。最常见的副作用 消退涉及在治疗开始时靶反应的频率或强度的增加， 这被称为“灭绝爆发”，它可能会使患者和其他人面临严重的伤害风险。先前的理论 灭绝爆发未能解释这些现象的动态性质，以及基本的行为特征。 控制爆发的过程仍然知之甚少。我们的临床和动物试验数据强烈表明， 我们对广义匹配律的新改进，称为时间加权匹配律 （TWML），它将加固时间和加固历史纳入定量模型，（a）拟合 我们的试验数据相当好，（B）解决了基础和临床研究之间的差异，（c） 确定新的临床程序，以防止灭绝爆发。该项目的长期目标是 在典型的临床条件下测试我们的灭绝爆发的定量模型，以证明其潜在的 改善破坏性行为的治疗，并在实验室中在更广泛的高度控制的条件下， 提供理论预测的正式定量评估，评估其边界条件， 并确定未来潜在的临床改进。具体的目的是证明，大的，可辨别的 在以下情况下，强化的速度（规格目标1）、强度（规格目标2）和质量（规格目标3）下降 灭绝或FCT的引入增加了灭绝爆发的流行和规模， 防止增援部队的速度、规模和质量下降，将防止或减轻灭绝 应用和基础研究参与者的突发（即，人类和老鼠的破坏性行为， 分别）。具体目标4将检查速率、幅度和 TWML预测的强化质量，以测试当前并为未来的临床改进提供信息。的 强化率、强度和质量的影响将使用受试者内 设计与人类临床参与者和使用随机分组设计与实验室大鼠，和率 破坏性行为（人类）和压杆（大鼠）将是主要的因变量。

Project Summary Results of epidemiological studies and meta-analyses indicate that treatments for destructive behavior based on functional analyses, like functional communication training (FCT), typically reduce destructive behavior by 90% or more and are much more effective than other treatments. However, these treatments involve extinction, which can produce extinction-induced adverse side effects. The most common side effect of extinction involves an increase in the frequency or intensity of the target response at the start of treatment, called an "extinction burst," which can place the patient and others at significant risk of harm. Prior theories on extinction bursts fail to account for the dynamic nature of these phenomena, and the basic behavioral processes that control bursts remain poorly understood. Our clinical and animal pilot data strongly suggest that our novel refinement of the generalized matching law, called the temporally weighted matching law (TWML), which incorporates reinforcement time and reinforcement history into the quantitative model, (a) fits our pilot data quite well, (b) resolves prior discrepancies between basic and clinical studies on bursts, and (c) identifies novel clinical procedures for preventing extinction bursts. The long-term goals of the project are to test our quantitative model of extinction bursts under typical clinical conditions to demonstrate its potential for improving treatment of destructive behavior and in the lab under a wider range of highly controlled conditions to provide a formal quantitative assessment of the predictions of the theory, evaluate its boundary conditions, and identify potential future clinical refinements. The specific aims are to demonstrate that large, discriminable drops in the rate (Spec. Aim 1), magnitude (Spec. Aim 2), and quality (Spec. Aim 3) of reinforcement when extinction or FCT are introduced increase the prevalence and magnitude of extinction bursts and that preventing such drops in the rate, magnitude, and quality of reinforcement will prevent or mitigate extinction bursts for both applied and basic research participants (i.e., humans referred for destructive behavior and rats, respectively). Specific Aim 4 will examine potential interactions between the variables of rate, magnitude, and quality of reinforcement predicted by the TWML to test current and inform future clinical refinements. The effects of reinforcement rate, magnitude, and quality will be manipulated and evaluated using a within-subjects design with the human clinical participants and using a randomized group design with lab rats, and the rate of destructive behavior (humans) and lever pressing (rats) will be the primary dependent variables.