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Habit Reversal Training
Habit reversal training (HRT) is a "multicomponent behavioral treatment package originally developed to address a wide variety of repetitive behavior disorders". Behavioral disorders treated with HRT include tics, trichotillomania, nail biting, thumb sucking, skin picking, temporomandibular disorder (TMJ), lip-cheek biting and stuttering. It consists of five components: awareness training, competing response training, contingency management, relaxation training, and generalization training. Research on the efficacy of HRT for behavioral disorders have produced consistent, large effect sizes (approximately 0.80 across the disorders). It has met the standard of a well-established treatment for stuttering, thumb sucking, nail biting, and TMJ disorders. According to a meta-analysis from 2012, decoupling, a self-help variant of HRT, also shows efficacy. History Habit reversal training was developed by psychologists Nathan H. Azrin and Ronald G. Nunn, who first published a p ...
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Trichotillomania
Trichotillomania (TTM), also known as hair-pulling disorder or compulsive hair pulling, is a mental disorder characterized by a long-term urge that results in the pulling out of one's own hair. A brief positive feeling may occur as hair is removed. Efforts to stop pulling hair typically fail. Hair removal may occur anywhere; however, the head and around the eyes are most common. The hair pulling is to such a degree that it results in distress and hair loss can be seen. As of 2023, the specific cause or causes of trichotillomania are unclear. Trichotillomania is probably due to a combination of genetic and environmental factors. The disorder may run in families. It occurs more commonly in those with obsessive compulsive disorder (OCD). Episodes of pulling may be triggered by anxiety. People usually acknowledge that they pull their hair, and broken hairs may be seen on examination. Other conditions that may present similarly include body dysmorphic disorder; however, in that co ...
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Decoupling For Body-focused Repetitive Behaviors
Body-focused repetitive behavior (BFRB) is an umbrella name for impulse-control behaviors involving compulsively damaging one's physical appearance or causing physical injury. BFRB disorders are currently estimated to be under the obsessive–compulsive spectrum. They are also associated with attention deficit hyperactivity disorder (ADHD) and anxiety. Causes The cause of BFRBs is unknown. Emotional variables may have a differential impact on the expression of BFRBs. Research has suggested that the urge to repetitive self-injury is similar to a body-focused repetitive behavior but others have argued that for some the condition is more akin to a substance abuse disorder. Researchers are investigating a possible genetic component. Onset BFRBs most often begin in late childhood or in the early teens. Diagnosis Types The main BFRB disorders are: * Skin ** Dermatillomania (excoriation disorder), skin picking ** Dermatophagia, skin nibbling * Mouth ** Morsicatio buccarum, chee ...
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Behaviour Therapy
Behaviour therapy or behavioural psychotherapy is a broad term referring to clinical psychotherapy that uses techniques derived from behaviourism and/or cognitive psychology. It looks at specific, learned behaviours and how the environment, or other people's mental states, influences those behaviours, and consists of techniques based on behaviorism's theory of learning: respondent or operant conditioning. Behaviourists who practice these techniques are either behaviour analysts or cognitive-behavioural therapists. They tend to look for treatment outcomes that are objectively measurable. Behaviour therapy does not involve one specific method, but it has a wide range of techniques that can be used to treat a person's psychological problems.Antony, M.M., & Roemer, E. (2003). Behaviour therapy. In A.S. Gurman & S.B. Messer (Eds.), Essential psychotherapies (2nd ed., pp. 182-223). New York: Guilford. Behavioural psychotherapy is sometimes juxtaposed with cognitive psychotherapy. W ...
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Operant Conditioning
Operant conditioning, also called instrumental conditioning, is a learning process in which voluntary behaviors are modified by association with the addition (or removal) of reward or aversive stimuli. The frequency or duration of the behavior may increase through reinforcement or decrease through punishment or Extinction (psychology), extinction. Origins Operant conditioning originated with Edward Thorndike, whose law of effect theorised that behaviors arise as a result of consequences as satisfying or discomforting. In the 20th century, operant conditioning was studied by Behaviorism, behavioral psychologists, who believed that much of mind and behaviour is explained through environmental conditioning. Reinforcements are environmental stimuli that increase behaviors, whereas punishments are stimuli that decrease behaviors. Both kinds of stimuli can be further categorised into positive and negative stimuli, which respectively involve the addition or removal of environmental stim ...
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Cognitive Behavioral Therapy
Cognitive behavioral therapy (CBT) is a form of psychotherapy that aims to reduce symptoms of various mental health conditions, primarily depression, PTSD, and anxiety disorders. Cognitive behavioral therapy focuses on challenging and changing cognitive distortions (thoughts, beliefs, and attitudes) and their associated behaviors in order to improve emotional regulation and help the individual develop coping strategies to address problems. Though originally designed as an approach to treat depression, CBT is often prescribed for the evidence-informed treatment of many mental health and other conditions, including anxiety, substance use disorders, marital problems, ADHD, and eating disorders. CBT includes a number of cognitive or behavioral psychotherapies that treat defined psychopathologies using evidence-based techniques and strategies. CBT is a common form of talk therapy based on the combination of the basic principles from behavioral and cognitive psychology. I ...
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Tic Disorder
Tic disorders are defined in the ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM) based on type (motor or phonic) and duration of tics (sudden, rapid, nonrhythmic movements). Tic disorders are defined similarly by the World Health Organization (ICD-10 codes). Classification DSM-5 The fifth revision of the ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM-5), published in May 2013, classifies Tourette syndrome and tic disorders as motor disorders listed in the neurodevelopmental disorder category. Tic disorders, in ascending order of severity, are: * 307.20 Other specified tic disorder (specify reason) * 307.20 Unspecified tic disorder * 307.21 Provisional tic disorder * 307.22 Persistent (chronic) motor or vocal tic disorder (specify motor or vocal) * 307.23 Tourette's disorder Developmental coordination disorder and stereotypic movement disorder are also classified as motor disorders. ICD-10 ICD10 diagnosis codes are: * F95.0 Transient tic disord ...
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Tourette Syndrome
Tourette syndrome (TS), or simply Tourette's, is a common neurodevelopmental disorder that begins in childhood or adolescence. It is characterized by multiple movement (motor) tics and at least one vocal (phonic) tic. Common tics are blinking, coughing, throat clearing, sniffing, and facial movements. These are typically preceded by an unwanted urge or sensation in the affected muscles known as a premonitory urge, can sometimes be suppressed temporarily, and characteristically change in location, strength, and frequency. Tourette's is at the more severe end of a spectrum disorder, spectrum of tic disorders. The tics often go unnoticed by casual observers. Tourette's was once regarded as a rare and bizarre syndrome and has popularly been associated with coprolalia (the utterance of obscene words or socially inappropriate and derogatory remarks). It is no longer considered rare; about 1% of school-age children and adolescents are Tourette syndrome#Epidemiology, estimated to hav ...
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Nathan Azrin
Nathan H. Azrin (November 26, 1930  – March 29, 2013) was a behavioral modification researcher, psychologist, and university professor. He taught at Southern Illinois University and was the research director of Anna State Hospital between 1958 and 1980. In 1980 he became a professor at Nova Southeastern University, and entered emeritus status at the university in 2010. Azrin was the founder of several research methodologies, including Token Economics, the Community Reinforcement Approach (CRA) on which the CRAFT model was based, Family Behavior Therapy, and habit reversal training. According to fellow psychologist Brian Iwata: “Few people have made research contributions equaling Nate’s in either basic or applied behaviour analysis, and none have matched his contributions to both endeavors.” Early life Nathan Azrin was born on November 26, 1930, in Boston, Massachusetts, to parents Harold and Esther. His parents owned and operated a small local grocery store, w ...
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Effect Size
In statistics, an effect size is a value measuring the strength of the relationship between two variables in a population, or a sample-based estimate of that quantity. It can refer to the value of a statistic calculated from a sample of data, the value of one parameter for a hypothetical population, or to the equation that operationalizes how statistics or parameters lead to the effect size value. Examples of effect sizes include the correlation between two variables, the regression coefficient in a regression, the mean difference, or the risk of a particular event (such as a heart attack) happening. Effect sizes are a complement tool for statistical hypothesis testing, and play an important role in power analyses to assess the sample size required for new experiments. Effect size are fundamental in meta-analyses which aim to provide the combined effect size based on data from multiple studies. The cluster of data-analysis methods concerning effect sizes is referred to as estima ...
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Nail Biting
Nail biting, also known as onychophagy or onychophagia, is an oral compulsive habit of biting one's fingernails. It is sometimes described as a parafunctional activity, the use of the mouth for an activity other than speaking, eating, or drinking. Nail biting is very common, especially amongst children, of whom 25–35 percent bite nails. More pathological forms of nails biting are considered an impulse control disorder in the DSM-IV-R and are classified under obsessive-compulsive and related disorders in the DSM-5. The ICD-10 classifies the practice as "other specified behavioral and emotional disorders with onset usually occurring in childhood and adolescence". However, not all nail biting is pathological, and the difference between harmful obsession and normal behavior is not always clear. The earliest reference to nail biting as a symptom of anxiety was in the late sixteenth century in France. Signs and symptoms Nail biting may lead to harmful effects to the fingers, li ...
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Efficacy
Efficacy is the ability to perform a task to a satisfactory or expected degree. The word comes from the same roots as '' effectiveness'', and it has often been used synonymously, although in pharmacology a distinction is now often made between efficacy and effectiveness. The word ''efficacy'' is used in pharmacology and medicine to refer both to the maximum response achievable from a pharmaceutical drug in research settings, and to the capacity for sufficient therapeutic effect or beneficial change in clinical settings. Pharmacology In pharmacology, efficacy () is the maximum response achievable from an applied or dosed agent, for instance, a small molecule drug. Intrinsic activity is a relative term for a drug's efficacy relative to a drug with the highest observed efficacy. It is a purely descriptive term that has little or no mechanistic interpretation. In order for a drug to have an effect, it needs to bind to its target, and then to affect the function of this tar ...
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Stuttering
Stuttering, also known as stammering, is a speech disorder characterized externally by involuntary repetitions and prolongations of sounds, syllables, words, or phrases as well as involuntary silent pauses called blocks in which the person who stutters is unable to produce sounds. Almost 80 million people worldwide stutter, about 1% of the world's population, with a prevalence among males at least twice that of females. Persistent stuttering into adulthood often leads to outcomes detrimental to overall mental health, such as social isolation and suicidal thoughts. Stuttering is not connected to the physical ability to produce phonemes (i.e. it is unrelated to the structure or function of the vocal cords). It is also unconnected to the structuring of thoughts into coherent sentences inside sufferers' brains, meaning that people with a stutter know precisely what they are trying to say (in contrast with alternative disorders like aphasia). Stuttering is purely a neurological disc ...
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