Treatment relapse and behavioral momentum theory

Abstract

The relapse of problem behavior after apparently successful treatment is an enduring problem for the field of applied behavior analysis. Several theoretical accounts of treatment relapse have emerged over the years. However, one account that has received considerable recent attention is based on behavioral momentum theory (BMT). BMT has shown that behavior is more persistent in contexts that are correlated with higher rates of reinforcers after disruption of the response-reinforcer relation. Accordingly, relapse after successful treatment can be viewed as the persistence of behavior when treatment is compromised in some manner. We review basic BMT research, alternative accounts of treatment relapse, and translational research studies derived from BMT research. The implications for applied behavior analysis in practice are discussed along with potential solutions to the problem of treatment relapse.

Basing assessment and treatment of problem behavior on behavioral momentum theory: Analyses of behavioral persistence

“…In Table 1, we provide a listing of articles in the applied behavior analysis literature that have evaluated behavioral persistence or compliance based on BMT. Please also see DeLeon, Podlesnik, and Miller (2015), Nevin and Shahan (2011), Podlesnik and DeLeon (2015), Pritchard, Hoerger, and Mace (2014), Pritchard, Hoerger, Mace, Penney, and Harris, (2014), and Shahan and Sweeney (2011) for a more comprehensive discussion of the application of BMT to clinical situations or applied behavior analysis.…”

A preliminary investigation on improving functional communication training by mitigating resurgence of destructive behavior

“…For example, decreases in reinforcement rate relative to baseline (DeRosa, Fisher, & Steege, 2015) and shifts from dense to lean schedules of reinforcement during FCT (Volkert, Lerman, Call, & Trosclair-Lasserre, 2009) have been shown to produce reemergence, or resurgence, of destructive behavior. Resurgence is generally defined as the recurrence of a previously reinforced response (e.g., destructive behavior) when alternative reinforcement is challenged (e.g., extinction or schedule thinning; Leitenberg, Rawson, & Bath, 1970; Lieving, Hagopian, Long, & O'Connor, 2004; Lieving & Lattal, 2003; Pritchard, Hoerger, & Mace, 2014; Volkert et al, 2009; Winterbauer & Bouton, 2010). Resurgence is a potentially important topic to study in applied research because of the likelihood of lapses in treatment integrity in naturalistic environments.…”

“…For example, Nevin and Shahan (2011) refined Shahan and Sweeney's (2011) behavioral momentum theory framework for predicting response persistence and resurgence of destructive behavior following alternative reinforcement (e.g., DRA, noncontingent reinforcement). This framework has been used as a model for understanding variables that may contribute to treatment relapse in the form of resurgence of destructive behavior (Podlesnik & Shahan, 2009; Pritchard et al, 2014). Nevin and Shahan proposed the following equation to predict the degree of resurgence that should occur when alternative reinforcement is discontinued (i.e., during an extinction challenge) after treatment of destructive behavior with alternative reinforcement (e.g., following FCT): $$\frac{B_t}{B_o}={10}^{\left(\frac{-t(c+dr+p{R}_a)}{{(r+R_a)}^{0.5}}\right)}.$$ In Equation 1, response rates during extinction ( B t ) are expressed as a proportion of the baseline response rate ( B o ) and are dependent on the time in or sessions with extinction ( t ), the baseline reinforcement rate ( r ), and the rate of alternative reinforcement ( R a ).…”

Training reinforcement rates, resistance to extinction, and the role of context in reinstatement

“…The same was true in separate experiments assessing different types of relapse preparations (i.e., resurgence, context renewal). Thus, their results suggest that both persistence and relapse are a function of baseline stimulusreinforcer relations (see Podlesnik & DeLeon, 2015;Podlesnik & Shahan, 2010;Pritchard, Hoerger, & Mace, 2014, for reviews).…”