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Aversion therapy is a form of psychological treatment in which the patient is exposed to a stimulus while simultaneously being subjected to some form of discomfort. This conditioning is intended to cause the patient to associate the stimulus with unpleasant sensations with the intention of quelling the targeted (sometimes compulsive) behavior.

Aversion therapy
ICD-9-CM 94.33
MeSH D001348

Aversion therapies can take many forms, for example: placing unpleasant-tasting substances on the fingernails to discourage nail-chewing; pairing the use of an emetic with the experience of alcohol; or pairing behavior with electric shocks of mild to higher intensities.

Contents

In addictionsEdit

The major use of aversion therapy is for the treatment of addiction to alcohol and other drugs. This form of treatment has been applied since 1932. The treatment is discussed in the Principles of Addiction Medicine, Chapter 8, published by the American Society of Addiction Medicine in 2003.

Alcohol addictionEdit

Disulfiram is used to treat alcohol dependence; it causes negative effects when a person drinks alcohol while the drug is in their system. It has been described as an aversion therapy, but it appears that it has more of a deterrent effect, since people who take it generally don't drink and therefore don't experience the negative effects.[1][2]

Cigarette addictionEdit

Specifically, electrical aversion techniques have been demonstrated to significantly improve success rates among cigarette smokers.[3] Additional longitudinal studies have repeated this effect, and showed cessation periods lasting at least 15 months post-trial. The examined trial involved 5 days of aversion therapy using an electric stimulus.[4]

Cocaine dependencyEdit

Emetic therapy and faradic aversion therapy is used to induce aversion for cocaine dependency.[5]

In compulsive habitsEdit

Many individuals struggle with subconscious or compulsive habits, such as chronic nailbiting, hair-pulling (Trichotillomania), or skin-picking (commonly associated with forms of Obsessive Compulsive Disorder as well as Trichotillomania). The effects of these habits are compounded by a lack of awareness, as the individual often does not make the conscious decision to engage in the particular behavior, in contrast to disorders of drug or alcohol addiction.

Nail bitingEdit

A relevant study of chronic nail-biters examined effects of electric stimulus, bitter substance (as applied to the nails), and placebo in biting reduction. Associating nail-biting with an electric stimulus or bitter substance showed similar levels of habit reduction as a result of aversion therapy, with over 80% of subjects exhibiting significant cessation rates up to 3 months post-trial.[6] A similar study on the UCLA campus, examining electric stimulus conditioning on nail-biting alone, shared similar rapid and lasting results, with almost half of subjects ceasing entirely on the first day of treatment, and the majority having quit within 5 days.[7]

TrichotillomaniaEdit

More research is needed in cases of Trichotillomania (obsessive hair-pulling), but preliminary case-based data have demonstrated promising results for aversion therapy, specifically that of electric aversion.[8][9][10]

Obsessive compulsive disorderEdit

As well, in cases specific to the rituals of obsessive compulsive disorder, using an electric stimulus to pair an unpleasant association with the undesired behavior has been successful in individual studies.[11][12][13]

In popular cultureEdit

See alsoEdit

ReferencesEdit

  1. ^ Brewer, C; Streel, E; Skinner, M (9 March 2017). "Supervised Disulfiram's Superior Effectiveness in Alcoholism Treatment: Ethical, Methodological, and Psychological Aspects". Alcohol and alcoholism (Oxford, Oxfordshire). 52 (2): 213–219. doi:10.1093/alcalc/agw093. PMID 28064151.   
  2. ^ Fralwey, P. Joseph; Howard, Matthew O. (2009). "Aversion Therapies". In Ries, Richard K.; Fiellin, David A.; Miller, Shannon C.; Saitz, Richard. Principles of Addiction Medicine (4th ed.). Philadelphia: Lippincott, Williams and Wilkins. pp. 843–844. ISBN 978-0-7817-7477-2. 
  3. ^ Russell, M. A. Hamilton (January 1970). "Effect Of Electric Aversion On Cigarette Smoking". British Medical Journal. 1 (5688): 82–86. JSTOR 20379143. PMC 1699162 . PMID 5411450. 
  4. ^ Smith, J. Journal of Substance Abuse Treatment, Vol. 5. pp. 33-36, 1988.)
  5. ^ Jerome J. Platt (2000). Cocaine Addiction: Theory, Research, and Treatment. Harvard University Press. pp. 241–. ISBN 978-0-674-00178-7. 
  6. ^ Vargas, John M., and Vincent J. Adesso. ‘A Comparison Of Aversion Therapies For Nailbiting Behavior’. Behavior Therapy 7.3. 322-329. (1976)
  7. ^ Bucher, Bradley D. ‘A Pocket-Portable Shock Device With Application To Nailbiting’. Behaviour Research and Therapy 6.3 (1968)
  8. ^ BAR, LOUIS H. J., and BEN R. M. KUYPERS. ‘Behaviour Therapy In Dermatological Practice’.Br J Dermatol 88.6 (1973): 591-598.
  9. ^ Aversion Therapy in the Treatment of Trichotillomania: A Case Study__Crawford, David A. ‘Aversion Therapy In The Treatment Of Trichotillomania: A Case Study’. Behav. Psychother. 16.01 (1988)
  10. ^ Rapp, J T, R G Miltenberger, and E S Long. ‘Augmenting Simplified Habit Reversal With An Awareness Enhancement Device: Preliminary Findings.’. Journal of Applied Behavior Analysis 31.4 (1998): 665-668.
  11. ^ ‘The Elimination Of Chronic Cough By Response Suppression Shaping’. Journal of Behavior Therapy and Experimental Psychiatry 4.1 (1973)
  12. ^ Le Boeuf, Alan. ‘An Automated Aversion Device In The Treatment Of A Compulsive Handwashing Ritual’. Journal of Behavior Therapy and Experimental Psychiatry 5.3-4 (1974): 267-270.
  13. ^ Kenny, F.T., L. Solyom, and C. Solyom. ‘Faradic Disruption Of Obsessive Ideation In The Treatment Of Obsessive Neurosis’. Behavior Therapy 4.3 (1973): 448-457.

SourcesEdit

  • Lancaster, T., Stead, L., Silagy, C., & Sowden, A. (2000). Effectiveness of interventions to help people stop smoking: findings from the Cochrane Library. BMJ : British Medical Journal, 321(7257), 355–358.