Podcast
Questions and Answers
What is a characteristic of motor tics?
What is a characteristic of motor tics?
Which disorder is classified as a combination of motor and vocal tics?
Which disorder is classified as a combination of motor and vocal tics?
What percentage of the population is estimated to experience motor tics?
What percentage of the population is estimated to experience motor tics?
What role does the neurotransmitter dopamine play in tic disorders?
What role does the neurotransmitter dopamine play in tic disorders?
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What psychological issue may occur simultaneously with tic disorders, particularly Tourette's syndrome?
What psychological issue may occur simultaneously with tic disorders, particularly Tourette's syndrome?
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What is a common behavioral perspective on the maintenance of tics?
What is a common behavioral perspective on the maintenance of tics?
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What is the prevalence rate of Tourette's syndrome in the general population?
What is the prevalence rate of Tourette's syndrome in the general population?
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What is NOT a common consequence of tic disorders?
What is NOT a common consequence of tic disorders?
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What is a common consequence of chronic hair pulling in individuals with trichotillomania?
What is a common consequence of chronic hair pulling in individuals with trichotillomania?
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How does behavioral theory explain the maintenance of nail biting?
How does behavioral theory explain the maintenance of nail biting?
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What percentage of children under the age of 4 engage in thumb sucking?
What percentage of children under the age of 4 engage in thumb sucking?
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Which of the following statements is true regarding the prevalence of trichotillomania?
Which of the following statements is true regarding the prevalence of trichotillomania?
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What physical damage is associated with chronic thumb sucking?
What physical damage is associated with chronic thumb sucking?
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What is a possible explanation for the etiology of trichotillomania?
What is a possible explanation for the etiology of trichotillomania?
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What is a potential risk of chronic nail biting?
What is a potential risk of chronic nail biting?
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Which demographic is more likely to engage in thumb sucking?
Which demographic is more likely to engage in thumb sucking?
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Which method is considered the most reliable for assessing longer duration habit behaviors?
Which method is considered the most reliable for assessing longer duration habit behaviors?
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What is a main criticism of self-report and parental report procedures in measuring habit behaviors?
What is a main criticism of self-report and parental report procedures in measuring habit behaviors?
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Which of the following medications is NOT commonly used to treat tic disorders?
Which of the following medications is NOT commonly used to treat tic disorders?
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What does a functional assessment of habit disorders aim to identify?
What does a functional assessment of habit disorders aim to identify?
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What is a potential side effect of medications used to treat tic disorders?
What is a potential side effect of medications used to treat tic disorders?
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Which procedure is primarily designed to modify the treatment of habit disorders?
Which procedure is primarily designed to modify the treatment of habit disorders?
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What type of practice involves intentionally engaging in the target behavior for a specific duration to reduce it?
What type of practice involves intentionally engaging in the target behavior for a specific duration to reduce it?
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Which of these forms of assessment is least likely to provide an accurate measure of habitual behaviors?
Which of these forms of assessment is least likely to provide an accurate measure of habitual behaviors?
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What is a primary objective of awareness training in addressing habit behaviors?
What is a primary objective of awareness training in addressing habit behaviors?
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Which of the following best describes competing response (CR) training?
Which of the following best describes competing response (CR) training?
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What treatment is most well-evaluated and effective for habit disorders when presented in a group format?
What treatment is most well-evaluated and effective for habit disorders when presented in a group format?
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Which technique is NOT associated with motivation training?
Which technique is NOT associated with motivation training?
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What is one of the popular treatments for chronic thumb sucking?
What is one of the popular treatments for chronic thumb sucking?
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Which of the following medications has been attempted for treating nail biting?
Which of the following medications has been attempted for treating nail biting?
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Which behavioral treatment has shown effective results in various studies for nail biting?
Which behavioral treatment has shown effective results in various studies for nail biting?
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Which of the following best summarizes the approach used to understand habit disorders?
Which of the following best summarizes the approach used to understand habit disorders?
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Study Notes
Habit Disorders
- Habit behaviors are repetitive or stereotypical responses that serve no apparent social function but are maintained by operant contingencies.
- Examples include physical damage and poor social acceptability.
- Habit disorders can be maintained by automatic reinforcement in the form of self-stimulation or arousal reduction.
- The four most frequent habit disorders are: tic disorders, trichotillomania, thumb sucking, and nail biting.
Tic Disorders
- Tic disorders are rapid, repetitive, and often jerking muscle movements (motor tics) or sudden, rapid, recurrent, nonrhythmic vocalizations (vocal tics).
- Prevalence rates for motor tics are approximately 1% of the population, vocal tics are unclear but 6.5% of college students engage in throat clearing at least 5 times per day, and for Tourette's syndrome is approximately .04-.05%.
- Individuals with tic disorders sometimes have concurrent problems such as obsessive-compulsive behaviors, attention deficit/hyperactivity disorder, aggression management problems, and sleep problems.
- Tics may also cause physical damage such as cuts, burns, and bruises.
Development and Current Etiological Theories of Habit Disorders
- Genetic research shows a 77% concordance rate for tic disorders among monozygotic twins.
- The biological perspective suggests that an excess of the neurotransmitter dopamine may be responsible for tics.
- The behavioral perspective suggests that individuals experience heightened tension in specific muscle groups and tics may be maintained by tension reduction in those muscles; the tension may also be reduced by the presence of an anxiety-provoking person.
Trichotillomania
- Individuals with trichotillomania experience chronic hair pulling which results in noticeable hair loss.
- They often experience a feeling of tension or anxiety that is relieved after pulling their hair.
- Prevalence is approximately 1-4% of the population with adult females being 3 times more likely to receive the diagnosis than males.
- Consequences of trichotillomania include chronic hair follicles damage or severe gastrointestinal difficulties if the hair is ingested.
Development and Current Etiological Theories of Habit Disorders
- Biological theories have not established a causal link between neurological activity and trichotillomania.
- Some studies suggest that trichotillomania may be related to a serotonin deficiency.
- Hair pulling may be maintained through social consequences.
- The behavioral theory suggests that hair pulling produces automatic reinforcing consequences such as tactile stimulation and tension or anxiety reduction.
Thumb Sucking
- Thumb sucking occurs in up to 46% of children under the age of 4 and continues in 19% of children over the age of 5.
- Thumb or finger mouthing occurs in approximately 2.8% of college-age adults.
- Females are more likely to engage in thumb sucking than males.
- Consequences of chronic thumb sucking include dental malocclusion, atypical root resorption, and increased risk of accidental poisoning.
- The behavioral theory suggests that the behavior is learned early in infancy to modulate arousal.
Nail Biting
- Nail biting includes placing any digit into the mouth and biting either the nails or the skin around the nails.
- Chronic nail biting can result in damage or inflammation of the tissue around the nail, possible infection, and shortening of the roots of the teeth.
Development and Current Etiological Theories of Habit Disorders
- Nail biting may be maintained by biological processes affected by clomipramine.
- Nail biting is thought to be maintained by tension/anxiety or increased arousal in under-stimulating situations.
Assessment of Habit Behaviors
- It may be best to use a duration measure when assessing longer duration behaviors (such as thumb sucking, nail biting, and hair pulling).
- Physical trace measures might not always correspond highly with the occurrence of the behavior (e.g., a small amount of the behavior might produce a substantial amount of damage).
Measuring Habit Behaviors
- Direct observation (live or videotaped) is preferable for the measurement of any habit behavior.
- Nail biting may be measured using physical trace procedures, most often by measuring the length of the fingernails.
- Self-report, self-monitoring, and parental report procedures have been criticized for methodological problems such as proneness to bias and distortion, lack of specificity, and relatively poor correspondence with more objective assessment strategies.
Assessing the Social Validity of Habit Disorder Treatments and Outcome
- The assessment of treatment acceptability using standardized measures has only been conducted extensively in evaluating the habit reversal procedure.
A Functional Approach to the Assessment of Habit Disorders
- Functional assessment may provide two key pieces of information:
- Data needed to modify etiological theories of the various habit disorders.
- Information to alter treatment plans to maximize their effectiveness.
- Functional analysis attempts to identify the function(s) that maintain the behavior through antecedent and consequence manipulations.
Treatment of Habit Disorders
Tic Disorders
Medical Treatments
- The three most common medications used to treat tic disorders are haloperidol, clonidine, and pimozide.
- Drugs used to treat tics have side effects such as dry mouth, constipation, sedation, and possible risk of developing permanent movement disorders such as tardive dyskinesia.
Behavioral Treatments
- Massed (negative) practice (MP): The participant intentionally engages in the target behavior rapidly and with great effort for a specified frequency or length of time.
- Habit reversal (HR): A multi-component procedure originally developed to treat nervous habit and motor tics.
-
Awareness training: Utilizes four techniques to increase awareness of the habit behavior:
- Response description
- Response detection
- Early warning
- Situation awareness training
- Competing response (CR) training: The client engages in a behavior incompatible with the target habit behavior.
-
Motivation training: Increases motivation through three techniques:
- Habit inconvenience review
- Public display
- Social support procedure
- Symbolic rehearsal
- Relaxation training: Effective as a sole treatment for tics, as it functions as a dissimilar CR.
Trichotillomania
Medical Treatments
- Medications used to treat trichotillomania include fluoxetine, clomipramine, imipramine, haloperidol, and lithium.
Behavioral Treatments
- Habit reversal is the most extensively evaluated and is effective in 60% of the cases when presented in a group format.
- Simplified HR package: Consists of awareness training and CR training with parental social support.
- Self-monitoring has also produced effective results.
-
Other treatments:
- Aversive conditioning
- The elimination of covarying habit behaviors (e.g., thumb sucking).
- Various reinforcement and punishment procedures.
Thumb Sucking
Medical Treatments
- No medications have been used to treat chronic thumb sucking.
Behavioral Treatments
- Bitter substance application is one of the most popular and effective treatments.
- Habit reversal is another popular and effective treatment.
Nail Biting
Medical Treatments
- Clomiprimine is the only medical intervention attempted with nail biting.
Behavioral Treatments
- Self-monitoring has been demonstrated to be effective.
- Habit reversal has also been evaluated in several studies.
-
Other treatments:
- Electric shock
- A portable self-administered shock device
- Bitter substances
- Contingency contracting
- Covert sensitization
Conclusions
- Habit disorders are a complex set of behaviors that need to be approached from a functional assessment standpoint.
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Description
Explore the nature of habit disorders, including tic disorders, trichotillomania, and other repetitive behaviors. This quiz delves into the prevalence and characteristics of these conditions, highlighting the role of operant contingencies and automatic reinforcement. Understand the impact of such disorders on social functioning and personal health.
