Long-term maintenance of a behavioral alternative to surgery for severe vomiting and weight loss

A 34-year-old woman with severe mental retardation suffered from gastroesophageal reflux, projectile vomiting, weight loss, and a prepyloric ulcer. Despite the implementation of non-intrusive behavior treatment procedures involving simple correction and differential reinforcement (Treatment A), fund...

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Bibliographic Details
Published in:Journal of behavior therapy and experimental psychiatry 1997-06, Vol.28 (2), p.105-112
Main Authors: Lockwood, Kirk, Maenpaa, Maija, Williams, Don E.
Format: Article
Language:English
Subjects:
Adult
Alternatives
Behavior Therapy
Behavior therapy. Cognitive therapy
Behaviour therapy
Biological and medical sciences
Eating - psychology
Escape Reaction
Female
Humans
Intellectual Disability - complications
Learning disabled women
Long term treatment
Medical sciences
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Surgery
Treatments
USA
Vomiting
Vomiting - psychology
Vomiting - therapy
Weight Loss
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Summary:A 34-year-old woman with severe mental retardation suffered from gastroesophageal reflux, projectile vomiting, weight loss, and a prepyloric ulcer. Despite the implementation of non-intrusive behavior treatment procedures involving simple correction and differential reinforcement (Treatment A), fundoplication surgery with implantation of a gastrostomy feeding tube had been recommended. A descriptive functional analysis suggested that the woman's vomiting was maintained by escape. Revised treatment was implemented throughout her waking hours. Treatment B consisted of the addition of escape extinction and antecedent control procedures. Treatment C added to these procedures food choice and additional differential reinforcement procedures. Results showed the respective mean frequency of vomiting and mean weight were: Treatment A—1.4 episodes/day and 118 lbs; Treatment B—1.1 episodes/day and 105 lbs; Treatment C—0.2 incidents/day and 133 lbs. The woman's progress has been maintained for nearly 2 years.
ISSN:0005-7916
1873-7943
DOI:10.1016/S0005-7916(97)00009-8