Behavioral Persistence: Basic, Translational, and Clinical Studies

行为持久性：基础、转化和临床研究

• 批准号: 8040235
• 负责人: JOHN ANTHONY NEVIN
• 金额: $ 24.31万
• 依托单位: UNIVERSITY OF NEW HAMPSHIRE
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-04-10 至 2016-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8040235
• 关键词: Adaptive Behaviors; Address; Adverse effects; Aftercare; Aggressive behavior; Animal Model; Animals; Attention; Basic Science; Behavior; Behavior Therapy; Behavioral; Child; Clinical; Clinical Research; Columbidae; Communication; Controlled Study; Development; Developmental Disabilities; Effectiveness; Elements; Ensure; Extinction (Psychology); Floor; Frequencies; Human; Individual; Intellectual functioning disability; Intervention; Mental Retardation; Methods; Modeling; Myristica fragrans; National Institute of Child Health and Human Development; Outcome; Participant; Persons; Population; Problem behavior; Procedures; Psychological reinforcement; Public Health; Publishing; Relapse; Relative (related person); Reporting; Research; Research Project Grants; Resistance; Self-Injurious Behavior; Sensory; Series; Stimulus; Testing; Training; Translational Research; Work; alternative treatment; analog; animal data; base; behavior change; behavior prediction; clinical application; clinically significant; effective therapy; interest; prevent; reinforcer; response; skills; theories; translational study; treatment strategy

DESCRIPTION (provided by applicant): Clinical applications of reinforcement-based treatments for problem behavior in persons with intellectual and developmental disabilities reduce the frequency of problem behavior by reinforcing an explicit desirable alternative (DRA), making reinforcers contingent on the absence of problem behavior (DRO), or providing reinforcers independently of responding (NCR). Although these methods can be highly effective in reducing the frequency of problem behavior to low levels within the treatment context, they can also have the perverse effect of increasing the persistence of problem behavior if some aspect of the context is altered or if lapses in treatment integrity occur. This clinically problematic outcome is predicted by behavioral momentum theory, which proposes that the frequency and persistence of behavior are separately determined by response-reinforcer contingencies such as DRA, DRO, or NCR, and by the overall rate of reinforcers obtained in the setting (which is increased by presenting alternative reinforcers according to any contingency). This project will evaluate the extent to which different contingencies for presenting alternative reinforcers (Specific Aim 1) and the rate of alternative reinforcers (Specific Aim 2) contribute to the persistence of problem behavior. In addition, it will develop methods that may reduce the persistence of problem behavior by arranging that desirable alternative behavior is reinforced in a separate setting, elements of which may then be brought into the treatment setting to reduce the frequency of problem behavior (Specific Aim 3), or by making access to that separate setting contingent on the absence of problem behavior (Specific Aim 4). Studies addressing each of these aims will be conducted with animal subjects in controlled experimental conditions modeled on those in which basic research on behavioral momentum originated. These studies will be repeated with children with intellectual and developmental disabilities in translational settings employing arbitrary responses analogous to problem and alternative behavior to ensure applicability of the animal data to the clinical population. Clinical interventions addressing significant problem behavior in children with intellectual and developmental disabilities will apply the most effective methods identified in basic and translational studies. Coordination of these studies within a single research project and the integration of their findings across the full range from basic research to clinical application will contribute importantly to effective treatment. PUBLIC HEALTH RELEVANCE: The proposed research is highly relevant to the public health interests of NICHD and its Mental Retardation Developmental Disabilities Branch. A significant proportion of individuals with intellectual and developmental disabilities receive reinforcer-based behavioral interventions to reduce the frequency of problem behaviors. The proposed project will (a) determine conditions under which such interventions also have the unintended side effect of increasing the persistence of those problem behaviors, and (b) contribute to the development of alternative treatment strategies that circumvent this side effect.

描述（由申请人提供）：对智力和发育障碍患者的问题行为进行基于认知的治疗的临床应用，通过加强明确的理想选择（ODR），使认知者视问题行为的存在而定（DRO），或提供独立于响应的认知者（NCR），降低了问题行为的频率。虽然这些方法可以非常有效地将问题行为的频率降低到治疗环境中的低水平，但如果环境的某些方面被改变，或者如果治疗完整性发生失误，它们也可能会增加问题行为的持续性。这种临床上有问题的结果是由行为动量理论预测的，该理论提出，行为的频率和持续性分别由反应-行为者偶然事件（如DRO，DRO或NCR）和在环境中获得的总体行为率（通过根据任何偶然事件提供替代行为来增加）决定。本项目将评估在何种程度上不同的意外情况提出替代性障碍（具体目标1）和替代性障碍的比率（具体目标2）有助于问题行为的持续性。此外，它将开发可以减少问题行为持续性的方法，通过安排在单独的环境中加强理想的替代行为，然后将其元素引入治疗环境以减少问题行为的频率（具体目标3），或者通过使访问该单独的环境视问题行为的存在而定（具体目标4）。针对这些目标中的每一个的研究将在受控实验条件下对动物受试者进行，这些受控实验条件以行为动量的基础研究起源的条件为模型。这些研究将在翻译环境中对智力和发育障碍儿童进行重复，采用类似于问题和替代行为的任意反应，以确保动物数据适用于临床人群。解决智力和发育障碍儿童的重大问题行为的临床干预措施将采用基础和转化研究中确定的最有效的方法。在一个单一的研究项目中协调这些研究，并在从基础研究到临床应用的整个范围内整合其研究结果，将对有效治疗做出重要贡献。 公共卫生关系：拟议的研究与NICHD及其精神发育迟滞发育障碍分支的公共卫生利益高度相关。很大一部分有智力和发育障碍的人接受了基于康复者的行为干预，以减少问题行为的发生频率。拟议的项目将（a）确定在何种条件下，这种干预措施也会产生增加这些问题行为持续性的意外副作用，（B）有助于开发规避这种副作用的替代治疗策略。