Application of Reinforcement Contingencies with a 23-Year-Old Anorexic Patient

Stumphauzer, Jerome S.

doi:10.2466/pr0.1969.24.1.109

Cited by 17 publications

(3 citation statements)

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“…Notably, Bhanji and Thompson (1974) and Bhanji (1975) report about the same 11 cases and are therefore only counted once for the total number of patients. All of the included case reports and case series outline a positive short-term effect of contingency management for weight gain (Abel et al, 1987;Agras, Barlow, Chapin, Abel, & Leitenberg, 1974;Azerrad & Stafford, 1969;Bachrach, Erwin, & Mohr, 1965;Bhanji, 1975;Bhanji & Thompson, 1974;Blue, 1979;Boey, 1985;Bruch, 1974;Cinciripini, Kornblith, Turner, & Hersen, 1983;Geller, Kelly, Traxler, & Marone Jr, 1978;Hauserman & Lavin, 1977;Martin & Mclaughlin, 1975;Matthews & Peterson, 2016;Monti, Mccrady, & Barlow, 1977;Munford, 1980;Munford, Tarlow, & Gerner, 1984;Perkin & Surtees, 1976;Stumphauzer, 1969).…”

Section: Case Reports and Case Seriesmentioning

confidence: 99%

The effectiveness of contingency management in the treatment of patients with anorexia nervosa: A systematic review

Ziser¹,

Resmark²,

Giel³

et al. 2018

Euro Eating Disorders Rev

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Contingency management in stipulating weight gain is routinely used in the treatment of anorexia nervosa, however, empirical investigations concerning its effectiveness have been scarce. This systematic review was conducted according to the PRISMA statement. Of N = 973 hits, 42 full-texts were included in the qualitative synthesis (11 theoretical texts, 19 case reports, 12 descriptive, cohort, and controlled trials). A central topic in the included publications concerns the enhancement of patients' autonomy through participation in the contingency management process. This heightened autonomy is achieved by using contingency contracts. Positive short-term effects on weight gain were shown, whereas follow-up results were heterogeneous. Although contingency contracts are widely used in clinical practice, our systematic review shows that empirical evidence on underlying mechanisms and efficacy is still scarce. Using an explicit treatment contract can enhance patients' motivation, compliance, and autonomy. Clinical practice should see further development including innovative motivation enhancing and conflict dissolving techniques in addressing the pronounced ambivalence often shown by patients with anorexia nervosa.

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Section: Case Reports and Case Seriesmentioning

confidence: 99%

The effectiveness of contingency management in the treatment of patients with anorexia nervosa: A systematic review

Ziser¹,

Resmark²,

Giel³

et al. 2018

Euro Eating Disorders Rev

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“…Recently, behavior modification techniques including systematic desensitization (Hallsten, 1965;Lang, 1965) and operant conditioning (Bachrach, Erwin, 8r Mohr, 1965;Blinder, Freeman, & Stunkard, 1970;Leitenberg, Agras, & Thornson, 1968;Stumphauzer, 1969) have been used successfully with anorexic patients. With the exception of the Leitenberg, et al (1968) report, few experimental studies appear in the archival literature.…”

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confidence: 98%

Modification of Caloric Intake in Anorexia Nervosa: An Experimental Analysis

et al. 1973

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The effects of feedback, reinforcement, and increased food presentation on caloric intake were sequentially examined in an experimental single-case design with an anorexia nervosa patient. Although feedback on weight and a point-reinforcement system for weight gains led to increased consumption, augmenting the amount of food presented in combination with feedback and reinforcement resulted in the most dramatic change in caloric intake.

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“…The treatments of Werry and Bull (1975), Geller (1975), Neumann and Gaoni (1975), Schnurer et al (1973), Bianco (1972), Blinder et al (l910), Azerrad and Stafford (1969), and Stumphauzer (1969), to name just a few, are based upon operant principles of conditioning. Hallsten (1965), for example, treated a 12-year-old 57 lb female called 'Fatty' prior to her weight loss, who had dieted until she was 25 lb underweight at the time of hospitalization.…”

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confidence: 99%

Anorexia nervosa: a Case Study

Steele¹

1976

Psychother Psychosom

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D.R., a single 19-year-old female experiencing anorexia nervosa, was admitted to a mental health center inpatient unit weighing 64 lb, approximately 54 lb underweight, with liver, kidney, and pancreas damage. D.R. was hospitalized for 59 days. Treatment consisted of utilizing a hierarchy of reinforcements in the form of privileges mutually agreed upon between patient and therapist, psychodynamic and supportive psychotherapy, and involvement in the ward milieu therapeutic program. All privileges had to be earned. Access to food was controlled by the staff. For pounds gained privileges were granted, for pounds lost privileges were curtailed. Dynamically, D.R.’s eating behavior was viewed as an unconscious spite and revenge reaction toward her parents as well as an attempt to elicit attention. At the time of discharge D.R. weighed 104.5 lb. Prior to discharge D.R. agreed that if her weight dropped below 100 lb she would return for readmission. Five months later D.R/s weight stabilized between 102 and 104 lb. Two years later, D.R.’s weight remains at that level. The study cautions against using solely a behavior modification approach in the treatment of anorexia nervosa.

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Application of Reinforcement Contingencies with a 23-Year-Old Anorexic Patient

Abstract: This paper reports the use of learning principles in the crisis intervention of a hospitalized, anorexic patient. An uncle's attention was made contingent on improved eating behavior. A reversal of weight trend with improved cooperation was achieved.

Cited by 17 publications

References 0 publications

The effectiveness of contingency management in the treatment of patients with anorexia nervosa: A systematic review

The effectiveness of contingency management in the treatment of patients with anorexia nervosa: A systematic review

Modification of Caloric Intake in Anorexia Nervosa: An Experimental Analysis

Anorexia nervosa: a Case Study

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