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，破坏性行为的治疗基于 在功能分析方面，如功能沟通培训(FCT)，通常通过以下方式减少破坏性行为 90%或更多，并且比其他治疗方法有效得多。然而，这些治疗涉及到 灭绝，这会产生由灭绝引起的不良副作用。最常见的副作用是 消退包括在治疗开始时靶向反应的频率或强度的增加， 这种疾病被称为“生物灭绝爆发”，可能会使患者和其他人面临极大的伤害风险。先前的理论关于 灭绝爆发未能解释这些现象的动态性质，以及基本的行为 控制猝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)符合 我们的试点数据相当好，(B)解决了先前关于猝发的基础研究和临床研究之间的差异，以及(C) 确定防止物种灭绝爆发的新的临床程序。该项目的长期目标是 在典型的临床条件下测试我们的消退爆发的量化模型，以展示其潜在的 在更广泛的高度受控条件下改进破坏性行为和实验室中的处理 为理论的预测提供正式的定量评估，评估其边界条件， 并确定未来可能的临床改进。具体的目标是证明大的、可辨别的 速率下降(规范目标1)、震级(规格目标2)和质量(规范目标3)在以下情况下加强 灭绝或FCT的引入增加了灭绝爆发的发生率和程度，并且 防止增援的速度、幅度和质量出现这种下降，将防止或减轻灭绝。 应用研究参与者和基础研究参与者(即，涉及破坏性行为的人和大鼠， )。具体目标4将检查速率、幅度和强度变量之间的潜在交互作用 TWML预测了加固的质量，以测试当前情况并通知未来的临床改进。这个 增强率、强度和质量的影响将使用受试者内部的 以人类临床参与者为研究对象，以实验室大鼠为研究对象，采用随机化组设计， 破坏性行为(人类)和杠杆挤压(老鼠)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.