Relapse and its mitigation: Toward behavioral inoculation

Kimball, Ryan T.; Greer, Brian; Fuhrman, Ashley M.; Lambert, Joseph M.

doi:10.1002/jaba.971

Cited by 19 publications

(11 citation statements)

References 182 publications

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“…In Phase 3, there is usually some sort of manipulation involving a change in contextual stimuli or alternative reinforcement conditions. Although the literature reports on several types of relapse (e.g., Wathen & Podlesnik, 2018), resurgence and renewal have received the most attention of late, particularly in applied settings (e.g., Kimball et al, 2023).…”

Section: Resurgencementioning

confidence: 99%

“…Although the pharmacological literature offers technical guidance for operationalizing the effects of individual and combined stimulus changes on behavior and the experimental preparations needed to empirically evaluate said effects, the full extent to which these evaluations have been extended to resurgence preparations is unknown. This represents an important area of study, as a greater understanding of the behavioral processes underlying additive and superadditive resurgence positions clinicians in the proactive role of ensuring clients' readiness for the dynamically changing environmental conditions anticipated following successful treatment (Kimball et al, 2023). Below, we briefly review previous research on resurgence and renewal to provide a foundation on which enhanced resurgence paradigms can be more clearly understood.…”

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confidence: 99%

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A systematic review of enhanced resurgence paradigms

King,

Martone,

Laureano

et al. 2024

J Exper Analysis Behavior

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Following successful treatment in which problem behavior is reduced, it may reemerge as a function of changes in contextual stimuli or the worsening of reinforcement conditions for an alternative response. Although understudied, preliminary research suggests that simultaneous changes in contextual stimuli and reinforcement conditions may represent particularly exigent treatment challenges that create the condition for additive or superadditive relapse. The purpose of the present review was to systematically examine the relapse literature involving simultaneous changes in contextual stimuli and reinforcement conditions in relapse tests and experimental preparations arranged to evaluate their effect on response recovery. We identified 16 empirical articles spanning 27 experiments. Although all experiments included at least one condition that experienced a change in contextual stimuli and worsening of alternative reinforcement conditions, only two experiments included the comparison conditions needed to precisely evaluate additive and superadditive relapse. Our findings establish the preclinical generality of relapse effects associated with simultaneous changes to reinforcement conditions and contextual stimuli across a range of subjects, schedule arrangements, response topographies, reinforcers, and types of contextual changes. We make several recommendations for future research based on our findings from this nascent and clinically relevant subdomain of the relapse literature.

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Section: Resurgencementioning

confidence: 99%

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confidence: 99%

A systematic review of enhanced resurgence paradigms

King,

Martone,

Laureano

et al. 2024

J Exper Analysis Behavior

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“…Treatment errors that occur during extinction bursts may pose even greater challenges to the long‐term maintenance of treatment effects because the target response may be intermittently reinforced (Lerman et al, 1996) or other problematic response topographies in the same response class may be reinforced (Lieving et al, 2004; Richman et al, 1999). Thus, a better understanding of the prevalence of extinction bursts and, importantly, the factors that mitigate the likelihood of these bursts is important to promoting the continued effectiveness of treatments (Fisher et al, 2023; Kimball et al, 2023).…”

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confidence: 99%

Descriptive characteristics of extinction bursts: A record review

Muething,

Cariveau,

Bottini

et al. 2024

J of App Behav Analysis

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Procedural extinction is sometimes associated with a temporary increase in responding known as an extinction burst. Extinction bursts present unique challenges in the context of treating behavior targeted for reduction. The present study updates the prevalence of extinction bursts using a clinical sample (N = 108) receiving treatment for targeted behavior. The prevalence of extinction bursts in our sample (24%) was consistent with that in prior literature. The extinction‐burst magnitude decreased across sessions after extinction was contacted during treatment, but this sample did not demonstrate decreased persistence or magnitude of extinction bursts across successive transitions from baseline to treatment. We also examined the prevalence and magnitude of extinction bursts based on the function and topography of targeted behavior and treatment components and found no consistent relation among these variables. These findings should lead clinicians to prepare for transient extinction bursts when implementing extinction‐based treatment for challenging behavior.

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“…Unfortunately, recent research suggests that relapse of problem behavior commonly occurs during or following behavioral treatments with DRA procedures (Briggs et al, 2018;Mitteer et al, 2022;Muething et al, 2020). Researchers generally define relapse as the recurrence of a previously eliminated response (e.g., problem behavior) following successful treatment (Kimball et al, 2023;Pritchard et al, 2014). One form of treatment relapse is renewal, which occurs due to a change in context (i.e., setting or intervention agent) in the absence of a change in contingencies (Podlesnik et al, 2017).…”

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confidence: 99%

Operant ABA renewal during dense and lean schedules of differential reinforcement

Kimball

Salvetti

Day

et al. 2023

J Exper Analysis Behavior

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Renewal is a type of relapse that occurs due to a change in context. Previous research has demonstrated that renewal of target responding may occur despite the availability of differential reinforcement for an alternative response (DRA). Nevertheless, the current literature on renewal presents mixed findings regarding the effects of dense and lean schedules of DRA on the magnitude of renewal. We used a translational approach with undergraduate college students and a task on a touchscreen tablet device to study the effects of dense and lean schedules of DRA during repeated renewal tests. All participants experienced two, three-phase ABA renewal arrangements. In the dense and lean renewal arrangements, we differentially reinforced alternative behavior in Context B and the renewal test in Context A on a VI 3-s or a VI 12-s schedule, respectively. Overall, we observed renewal in 31/36 (86%) renewal tests regardless of the density of reinforcement for the alternative response. Furthermore, the results showed that although renewal occurred in both arrangements, we found slightly higher magnitudes of renewal during DRA with lean schedules of reinforcement relative to dense schedules. We discuss the implications of these findings as they relate to the treatment of problem behavior.

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Relapse and its mitigation: Toward behavioral inoculation

Cited by 19 publications

References 182 publications

A systematic review of enhanced resurgence paradigms

A systematic review of enhanced resurgence paradigms

Descriptive characteristics of extinction bursts: A record review

Operant ABA renewal during dense and lean schedules of differential reinforcement

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