Resurgence of destructive behavior following decreases in alternative reinforcement: A prospective analysis.

Basic and retrospective translational research has shown that the magnitude of resurgence is determined by the size of the decrease in alternative reinforcement, with larger decreases producing more resurgence. However, this finding has not been evaluated prospectively with a clinical population. In Experiment 1, five participants experienced a fixed progression of reinforcement schedule-thinning steps during treatment of their destructive behavior. Resurgence occurred infrequently across steps and participants, and when resurgence did occur, its clinical meaningfulness was often minimal. In Experiment 2, five new participants experienced these same schedule-thinning steps but in a counterbalanced order. Resurgence occurred most often and was generally largest with larger decreases in alternative reinforcement programmed earlier in the evaluation. Large decreases in alternative reinforcement may be more problematic clinically when they occur earlier in treatment. Whether larger transitions can be recommended in the clinic following the success of smaller ones will require additional research.

Longitudinal examination of alcohol demand and alcohol-related reinforcement as predictors of heavy drinking and adverse alcohol consequences in emerging adults.

BACKGROUND AND AIMS: Behavioral economic theory predicts that high alcohol demand and high proportionate alcohol-related reinforcement are important determinants of risky alcohol use in emerging adults, but the majority of research to date has been cross-sectional in nature. The present study investigated prospective and dynamic relationships between alcohol demand and proportionate alcohol-related reinforcement in relation to heavy drinking days and alcohol problems. DESIGN: Longitudinal cohort with assessments every 4 months for 20 months. SETTING: Ontario, Canada. PARTICIPANTS: Emerging adults reporting regular heavy episodic drinking (n = 636, Mage = 21.44; 55.8% female). MEASUREMENTS: Heavy drinking days (HDD; Daily Drinking Questionnaire), alcohol problems (Brief Young Adult Alcohol Consequences Questionnaire), alcohol demand (Alcohol Purchase Task) and proportionate alcohol-related reinforcement (Activity Level Questionnaire). FINDINGS: Linear mixed effects models revealed that behavioral economic indicators and alcohol-related outcomes significantly decreased over the study, consistent with 'aging out' of risky alcohol use. Random intercept cross-lagged panel models revealed significant between-person relationships, such that higher alcohol demand and alcohol-related reinforcement were positively associated with HDD and alcohol problems (random intercepts = 0.187-0.534, Ps < 0.01). Moreover, alcohol demand indicators (particularly the rate of change in elasticity of the demand curve, as measured by α, and the maximum expenditure, Omax) and proportionate alcohol-related reinforcement significantly forecasted changes in HDD at all time points (|ßs| = 0.063-0.103, Ps < 0.05) in cross-lagged relationships, with bidirectional associations noted for the rate of change in elasticity (ßs = -0.085 to -0.104, Ps < 0.01). Proportionate alcohol-related reinforcement also significantly forecasted changes in alcohol problems at all time points (ßs = 0.072-0.112, Ps < 0.01). CONCLUSIONS: Multiple behavioral economic indicators (demand elasticity, maximum expenditure and reinforcement ratio) forecast changes in heavy episodic drinking and alcohol problems over the course of emerging adulthood. These results further implicate alcohol demand and proportionate alcohol-related reinforcement as etiologically and developmentally important mechanisms in alcohol use trajectories.

Translational evaluation of on/off alternative reinforcement cycling.

Cycling between the availability and unavailability of reinforcement for alternative responding has successfully reduced resurgence in basic laboratory evaluations, but this approach represents a marked departure from current standards of care when treating problem behavior, warranting careful translation before its use clinically. Therefore, with extinction arranged for target responding across groups in Phase 2, we evaluated the effects of cycling between the availability and unavailability of differential reinforcement of alternative behavior (DRA) using a computer-based task with adult humans recruited through Amazon MTurk. Two control groups experienced constant DRA in Phase 2, with one group experiencing a dense DRA schedule and another group experiencing a lean DRA schedule. The cycling DRA group tended to show greater reductions in target responding and improved discrimination in Phase 2 and less target responding across Phases 2 and 3 than the lean DRA and dense DRA groups. These preliminary findings suggest that on/off DRA cycling procedures may produce more desirable treatment outcomes than constant DRA without producing negative side effects; however, further research is needed to confirm these possibilities.

Examining resurgence in rats following expanded-operant treatments.

Resurgence of previously reinforced behavior represents a challenge to otherwise successful interventions based on differential reinforcement of alternative behavior (DRA). Expanded-operant treatments seek to increase the number of functional alternative behaviors through DRA, thereby potentially mitigating resurgence. However, the few studies that have directly examined these methods as a tool for resurgence mitigation have provided limited and unclear results. Thus, the present experiments were designed to investigate the effect of expanded-operant DRA methods on resurgence of previously reinforced behavior using rat subjects. In two experiments, following a baseline phase in which a target response was trained, groups of rats experienced concurrent (i.e., five simultaneous alternative responses), serial (i.e., five sequentially available alternative responses), or single DRA interventions arranging similar rates of alternative reinforcement in order to examine potential differences in resurgence. Both experiments showed that neither serial nor concurrent DRA expanded-operant treatments reduced resurgence compared with single DRA regardless of whether stimuli associated with previously reinforced alternative responses were removed (Experiment 1) or remained present (Experiment 2) for the serial-DRA group. Further, a primacy effect in resurgence was obtained for the serial-DRA group in both experiments. Overall, these results suggest that expanded-operant treatments may not help to reduce resurgence.

Nondrug reinforcers contingent on alternative behavior or abstinence increase resistance to extinction and reinstatement of ethanol-maintained behavior.

The effects of delivering nondrug alternative reinforcement on resistance to extinction and reinstatement of rats' ethanol-maintained lever pressing were evaluated in two experiments. In both, rats self-administered ethanol by lever pressing in a two-component multiple schedule during baseline. In the Rich component, alternative food reinforcement was made available for performing an alternative response (Experiment 1) or according to a differential-reinforcement-of-other-behavior schedule for lever pressing (Experiment 2). In the Lean component, only ethanol was available. Moreover, the frequency of alternative reinforcement was manipulated across conditions in Experiment 1. Following baseline, lever pressing was extinguished in both components by suspending ethanol reinforcement, and alternative food reinforcers were discontinued. Finally, to test for reinstatement, ethanol reinforcers were delivered independently of lever pressing in both components. In both experiments, proportion-of-baseline response rates were higher during extinction and reinstatement testing in the Rich component than in the Lean component (although differentiation was not observed at the lowest frequency of alternative reinforcement in Experiment 1). Thus, alternative nondrug reinforcers increased resistance to extinction and reinstatement of rats' ethanol-maintained lever pressing, even when those reinforcers were delivered contingently on an alternative response or on abstinence from lever pressing.

Resurgence and repeated within-session progressive-interval thinning of alternative reinforcement.

Resurgence of a previously suppressed target behavior is common when reinforcement for a more recently reinforced alternative behavior is thinned. To better characterize such resurgence, these experiments examined repeated within-session alternative reinforcement thinning using a progressive-interval (PI) schedule with rats. In Experiment 1, a transition from a high rate of alternative reinforcement to a within-session PI schedule generated robust resurgence, but subsequent complete removal of alternative reinforcement produced no additional resurgence. Experiment 2 replicated these findings and showed similar effects with a fixed-interval (FI) schedule arranging similarly reduced session-wide rates of alternative reinforcement. Thus, the lack of additional resurgence following repeated exposure to the PI schedule was likely due to the low overall obtained rate of alternative reinforcement provided by the PI schedule, rather than to exposure to within-session reinforcement thinning per se. In both experiments, target responding increased at some point in the session during schedule thinning and continued across the rest of the session. Rats exposed to a PI schedule showed resurgence later in the session and after more cumulative alternative reinforcers than those exposed to an FI schedule. The results suggest the potential importance of further exploring how timing and change-detection mechanisms might be involved in resurgence.

Measurement of substance-free reinforcement in addiction: A systematic review.

A robust body of theoretical and experimental work highlights the influence of alternative, substance-free rewards on decisions to use alcohol and other drugs. However, translational applications have been limited in part by the lack of consensus on how to measure substance-free reinforcement in applied and clinical settings. The current study summarizes extant research utilizing self-report reinforcement or reward methodologies, and critically reviews the psychometric properties of the available measures. These studies (N = 50) fell into three categories: measures of recent substance-related and substance-free activity participation and enjoyment (n = 32), measures of time or monetary resource allocation (n = 15), and rating scale measures of reward availability and experience (n = 8). The available research suggests that, consistent with experimental laboratory research and with behavioral economic predictions, there is an inverse relation between substance-free reinforcement and substance use. These studies also support the clinical utility of these measures in predicting substance use severity and course. Reinforcement measures could be improved by enhancing content validity, multimethod convergent validity, and generalizability.

Delivering alternative reinforcement in a distinct context reduces its counter-therapeutic effects on relapse.

Delivery of alternative reinforcers in the presence of stimuli previously associated with reinforcement for target behavior increases the susceptibility of target behavior to relapse. To explore contingencies that might mitigate this counter-therapeutic effect, we trained pigeons on a procedure that entailed extinction of previously reinforced target-key pecking, access to a distinct stimulus context contingently on refraining from target behavior (differential-reinforcement-of-other-behavior; DRO), and reinforcement of alternative-key pecks (differential-reinforcement of alternative behavior; DRA) in that context. This DRO-DRA treatment was compared with standard DRA in successive conditions, counterbalanced across pigeons. Target behavior extinguished more rapidly in the Standard-DRA condition. When alternative reinforcement was discontinued, however, there was less resurgence after DRO-DRA than after Standard DRA. In a third condition, the DRO contingency was suspended so that the former DRA stimuli were not presented (DRO-NAC), and resurgence was greater than in the Standard-DRA and DRO-DRA conditions. Reinstatement produced by response-independent reinforcers was small and similar across conditions. Subsequent reacquisition of target-key pecking under baseline reinforcement conditions was faster following DRO-NAC than Standard-DRA or DRO-DRA. These findings suggest that DRO-DRA might serve as a useful method in clinical settings for reducing problem behavior while minimizing the threat of posttreatment relapse.

Effects of differential rates of alternative reinforcement on resurgence of human behavior.

Despite the success of exposure-based psychotherapies in anxiety treatment, relapse remains problematic. Resurgence, the return of previously eliminated behavior following the elimination of an alternative source of reinforcement, is a promising model of operant relapse. Nonhuman resurgence research has shown that higher rates of alternative reinforcement result in faster, more comprehensive suppression of target behavior, but also in greater resurgence when alternative reinforcement is eliminated. This study investigated rich and lean rates of alternative reinforcement on response suppression and resurgence in typically developing humans. In Phase 1, three groups (Rich, n = 18; Lean, n = 18; Control, n = 10) acquired the target response. In Phase 2, target responding was extinguished and alternative reinforcement delivered on RI 1 s, RI 3 s, and extinction schedules, respectively. Resurgence was assessed during Phase 3 under extinction conditions for all groups. Target responding was suppressed most thoroughly in Rich and partially in Lean. Target responding resurged in the Rich and Lean groups, but not in the Control group. Between groups, resurgence was more pronounced in the Rich group than the Lean and Control groups. Clinical implications of these findings, including care on the part of clinicians when identifying alternative sources of reinforcement, are discussed.

Effects of signaled and unsignaled alternative reinforcement on persistence and relapse in children and pigeons.

Three experiments explored the impact of different reinforcer rates for alternative behavior (DRA) on the suppression and post-DRA relapse of target behavior, and the persistence of alternative behavior. All experiments arranged baseline, intervention with extinction of target behavior concurrently with DRA, and post-treatment tests of resurgence or reinstatement, in two- or three-component multiple schedules. Experiment 1, with pigeons, arranged high or low baseline reinforcer rates; both rich and lean DRA schedules reduced target behavior to low levels. When DRA was discontinued, the magnitude of relapse depended on both baseline reinforcer rate and the rate of DRA. Experiment 2, with children exhibiting problem behaviors, arranged an intermediate baseline reinforcer rate and rich or lean signaled DRA. During treatment, both rich and lean DRA rapidly reduced problem behavior to low levels, but post-treatment relapse was generally greater in the DRA-rich than the DRA-lean component. Experiment 3, with pigeons, repeated the low-baseline condition of Experiment 1 with signaled DRA as in Experiment 2. Target behavior decreased to intermediate levels in both DRA-rich and DRA-lean components. Relapse, when it occurred, was directly related to DRA reinforcer rate as in Experiment 2. The post-treatment persistence of alternative behavior was greater in the DRA-rich component in Experiment 1, whereas it was the same or greater in the signaled-DRA-lean component in Experiments 2 and 3. Thus, infrequent signaled DRA may be optimal for effective clinical treatment.

Higher rate alternative non-drug reinforcement produces faster suppression of cocaine seeking but more resurgence when removed.

Relapse following removal of an alternative source of reinforcement introduced during extinction of a target behavior is called resurgence. This form of relapse may be related to relapse of drug taking following loss of alternative non-drug reinforcement in human populations. Laboratory investigations of factors mediating resurgence with food-maintained behavior suggest higher rates of alternative reinforcement produce faster suppression of target behavior but paradoxically generate more relapse when alternative reinforcement is discontinued. At present, it is unknown if a similar effect occurs when target behavior is maintained by drug reinforcement and the alternative is a non-drug reinforcer. In the present experiment three groups of rats were trained to lever press for infusions of cocaine during baseline. Next, during treatment, cocaine reinforcement was suspended and an alternative response was reinforced with either high-rate, low-rate, or no alternative food reinforcement. Finally, all reinforcement was suspended to test for relapse of cocaine seeking. Higher rate alternative reinforcement produced faster elimination of cocaine seeking than lower rates or extinction alone, but when treatment was suspended resurgence of cocaine seeking occurred following only high-rate alternative reinforcement. Thus, although higher rate alternative reinforcement appears to more effectively suppress drug seeking, should it become unavailable, it can have the unfortunate effect of increasing relapse.

Treatment of Escape-Maintained Challenging Behavior Using Chained Schedules: An Evaluation of the Effects of Thinning Positive plus Negative Reinforcement During Functional Communication Training.

OBJECTIVE: Previous research has supported functional communication training (FCT) as an effective intervention for reducing challenging behavior. Clinicians often program schedule-thinning procedures to increase the portability of the treatment (i.e., reinforcement is provided less frequently). For individuals with escape-maintained problem behavior, chained schedules have proven effective in increasing task completion and supplemental procedures may ameliorate reemergence of challenging behavior as access to reinforcement is decreased. The present study compared the use of a chained schedule-thinning procedure with and without alternative reinforcement (e.g., toys and activities) embedded in an intervention in which escape from the task is provided contingent on a request for a break. METHOD: Two individuals with escape-maintained challenging behavior participated. We compared two treatment conditions, escape-only and escape-to-tangibles, using a single-subject, alternating treatments design with each treatment implemented in a distinct academic context. RESULTS: With the escape-to-tangibles treatment, we reached the final schedule in both contexts with both participants (4 successes out of 4 applications). We did not reach the final schedule with either participant with the escape-only intervention (0 successes out of 2 applications). CONCLUSION: The current results provided preliminary confirmation that providing positive plus negative reinforcement would decrease destructive behavior, increase compliance, and facilitate reinforcer-schedule thinning.

Resurgence of sucrose and cocaine seeking in free-feeding rats.

Resurgence is relapse of an extinguished operant response following the removal of alternative reinforcement. In animal models of resurgence to date, rats have been food deprived and food is used as the source of alternative reinforcement. Thus, when the alternative reinforcer is removed, the only remaining source of food during experimental sessions is no longer available. Acute food deprivation is known to produce reinstatement of drug seeking, thus such deprivation has been suggested a potential mechanism of resurgence. The present experiments examined whether resurgence of sucrose and cocaine seeking could be obtained with rats that were not food deprived. Free-feeding rats were trained to press a lever for either sucrose (Experiment 1) or cocaine infusions (Experiment 2). Next, lever pressing was extinguished and an alternative response (nose poking) was reinforced with sucrose. When nose poking was also placed on extinction, resurgence of both sucrose and cocaine seeking was observed. Thus, resurgence of both sucrose and cocaine seeking can be obtained in rats that are not food restricted and it appears unlikely that an acute hunger state is responsible for resurgence. In addition, the present procedures for studying resurgence in the absence of interpretive complexities introduced by the use of food-deprivation may prove useful for further investigations of the neurobiological mechanisms of resurgence.

Effects of high, low, and thinning rates of alternative reinforcement on response elimination and resurgence.

A common treatment for operant problem behavior is alternative reinforcement. When alternative reinforcement is removed or reduced, however, resurgence of the target behavior can occur. Shahan and Sweeney (2011) developed a quantitative model of resurgence based on behavioral momentum theory that suggests higher rates of alternative reinforcement result in faster response elimination and greater resurgence when removed, whereas lower rates of alternative reinforcement result in slower response elimination but are followed by less resurgence. Thus, the present study was designed to examine whether faster target response elimination and less resurgence could be achieved by beginning with a high rate of alternative reinforcement and gradually thinning it such that a low rate is ultimately removed during a simulated treatment lapse. Results showed that high rates of alternative reinforcement were more effective than low or thinning rates at target response suppression but resulted in resurgence when discontinued. Low and thinning rates, on the other hand, were less effective at response suppression but target responding did not increase when alternative reinforcement was discontinued. The quantitative model cannot currently account for the finding that lower-rate alternative reinforcement may not effectively disrupt behavior relative to an extinction only control. Relative advantages of high, low, thinning, or no alternative reinforcement are discussed with respect to suppression of target response rate during treatment, resurgence when alternative reinforcement is removed, and alternative response persistence, while taking into account differences between this animal model and modern applied behavior analytic treatments.

A model of resurgence based on behavioral momentum theory.

Resurgence is the reappearance of an extinguished behavior when an alternative behavior reinforced during extinction is subsequently placed on extinction. Resurgence is of particular interest because it may be a source of relapse to problem behavior following treatments involving alternative reinforcement. In this article we develop a quantitative model of resurgence based on the augmented model of extinction provided by behavioral momentum theory. The model suggests that alternative reinforcement during extinction of a target response acts as both an additional source of disruption during extinction and as a source of reinforcement in the context that increases the future strength of the target response. The model does a good job accounting for existing data in the resurgence literature and makes novel and testable predictions. Thus, the model appears to provide a framework for understanding resurgence and serves to integrate the phenomenon into the existing theoretical account of persistence provided by behavioral momentum theory. In addition, we discuss some potential implications of the model for further development of behavioral momentum theory.

Behavioral momentum theory: equations and applications.

Behavioral momentum theory provides a quantitative account of how reinforcers experienced within a discriminative stimulus context govern the persistence of behavior that occurs in that context. The theory suggests that all reinforcers obtained in the presence of a discriminative stimulus increase resistance to change, regardless of whether those reinforcers are contingent on the target behavior, are noncontingent, or are even contingent on an alternative behavior. In this paper, we describe the equations that constitute the theory and address their application to issues of particular importance in applied settings. The theory provides a framework within which to consider the effects of interventions such as extinction, noncontingent reinforcement, differential reinforcement of alternative behavior, and other phenomena (e.g., resurgence). Finally, the theory predicts some counterintuitive and potentially counterproductive effects of alternative reinforcement, and can serve as an integrative guide for intervention when its terms are identified with the relevant conditions of applied settings.

Differential reinforcement of alternative behavior increases resistance to extinction: clinical demonstration, animal modeling, and clinical test of one solution.

Basic research with pigeons on behavioral momentum suggests that differential reinforcement of alternative behavior (DRA) can increase the resistance of target behavior to change. This finding suggests that clinical applications of DRA may inadvertently increase the persistence of target behavior even as it decreases its frequency. We conducted three coordinated experiments to test whether DRA has persistence-strengthening effects on clinically significant target behavior and then tested the effectiveness of a possible solution to this problem in both a nonhuman and clinical study. Experiment 1 compared resistance to extinction following baseline rates of reinforcement versus higher DRA rates of reinforcement in a clinical study. Resistance to extinction was substantially greater following DRA. Experiment 2 tested a rat model of a possible solution to this problem. Training an alternative response in a context without reinforcement of the target response circumvented the persistence-strengthening effects of DRA. Experiment 3 translated the rat model into a novel clinical application of DRA. Training an alternative response with DRA in a separate context resulted in lower resistance to extinction than employing DRA in the context correlated with reinforcement of target behavior. The value of coordinated bidirectional translational research is discussed.