Discussion 4

Toward a Better Basic Understanding of Operant-Respondent Interactions: Translational Research on Phobias

Adam Brewer Florida Institute of Technology

Anita Li Western Michigan University

Yanerys Leon Florida Institute of Technology

Joshua Pritchard Southern Illinois University

Laura Turner University of Saint Joseph

David Richman Texas Tech University

A promising area of study that emerged from the early days of the experimental analysis of behavior (EAB) was the study of aversive control. However, research on this topic has declined and has largely been neglected in contemporary experimental psychopathology. To address the challenge of promoting growth in this area, this paper proposes a revival of basic research by incorporating the examination of complex human problems such as anxiety disorders (e.g., phobias) to increase our understanding of basic behavioral processes and improve the efficacy of our applied treatments by first considering fundamental operant-respondent interactions underlying phobias. Past and future work involving operant-respondent interactions are discussed as well as oppor- tunities for cross-pollination with other disciplines.

Keywords: anxiety, approach-avoidance, experimental analysis of behavior, operant- respondent interactions, phobia

One of the earliest basic behavioral research studies reported on the quantitative properties of anxiety (Estes & Skinner, 1941). Although impor- tant basic research has been conducted on the topic of anxiety-related disorders (e.g., phobias), this area remains largely at a standstill, perhaps due to the factors related to the decline in research

on aversive control (Baron, 1991; Critchfield & Rasmussen, 2007) and primary focus on operant contingencies rather than interactions with respon- dent learning processes. Hineline (1984) proposed continued examination of aversive control and negative reinforcement in order to develop an adequate account of such processes. A way to reinvigorate interest in this topic, as well as basic research overall, may entail collaboration between basic and applied researchers as well as practitio- ners to gain a better basic understanding of oper- ant-respondent interactions that underlie phobias with an eye toward variables that are germane to practice. Such translational efforts (Mace & Critchfield, 2010) may result in cross-pollination with other disciplines such as experimental and clinical psychopathology. Therefore, the goal of this paper is to provide a brief overview of past contributions and highlight areas for future re- search to stimulate growth in basic research on the topic of operant-respondent interactions specific to anxiety-related disorders.

This article was published Online First June 18, 2018. Adam Brewer, School of Behavior Analysis, Florida In-

stitute of Technology; Anita Li, Department of Psychology, Western Michigan University; Yanerys Leon, School of Behavior Analysis, Florida Institute of Technology; Joshua Pritchard, Rehabilitation Institute, Southern Illinois Univer- sity; Laura Turner, Counseling and Applied Behavioral Studies Institute for Autism and Behavioral Studies, Uni- versity of Saint Joseph; David Richman, Department of Educational Psychology and Leadership, Texas Tech Uni- versity.

Correspondence should be addressed to Adam Brewer, School of Behavior Analysis, Florida Institute of Technol- ogy, 150 West University Boulevard, Melbourne, FL 32901. E-mail: [email protected]

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Behavior Analysis: Research and Practice © 2018 American Psychological Association 2018, Vol. 18, No. 4, 328–332 2372-9414/18/$12.00 http://dx.doi.org/10.1037/bar0000112

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A major advantage of this experimental ap- proach was that it conceptualized anxiety- re- lated disorders within an inductive behavioral framework rather than resorting to a hypo- de- ductive approach that appealed to mentalistic constructs or inner dispositions (e.g., Larsen & Augustine, 2008). From a behavioral perspec- tive, anxiety-related disorders such as clinical phobias may best be understood via interactions between operant-respondent learning processes that can be studied experimentally. one way to study these operant-respondent interactions is to arrange competition between appetitive and aversive contingencies.

In the nonhuman animal laboratory, the Vo- gel Conflict test is used to study operant- re- spondent interactions related to anxiety disor- ders. In this task, water-deprived rats are provided with a water bottle in which licks result in access to water; periodically licking is followed by electric shock (Vogel, Beer, & Clody, 1971). As shock magnitude increases, an approach- avoidance (AA) transition point is obtained, defined as the point at which rats no longer approach the water bottle and avoid lick- ing altogether. This AA transition point pro- vides a quantitative measure of the shift in con- trol from appetitive to aversive control. Similar disruptive operant-respondent interactions may occur following exposure to cues previously correlated with an aversive event such as shock (i.e., conditioned aversive stimuli). For exam- ple, Estes and Skinner (1941) exposed food- deprived pigeons to a distinct keylight that was paired with electric shock. Following respon- dent fear conditioning, the presentation of the cue (a conditioned aversive stimulus) was su- perimposed onto a baseline of a steady rate of responding generated by a variable-interval (VI) schedule of positive reinforcement. The presentation of the cue elicited emotional be- havior (e.g., freezing and defecation) that dis- rupted operant performance resulting in a loss of edible reinforcers for the food-deprived sub- jects. Conditioned emotional responding was measured by decreases in response rate on the VI schedule relative to baseline. Indices of “anxiety” were inferred from elicited emotional behavior such as freezing or defection prior to shock. Conflict tests between appetitive and aversive contingencies that evoke approach and avoidance have effectively been used as a base- line to study the behavioral and neural mecha-

nism action of anxiolytic drugs in the nonhu- man laboratory (for a review see, Flaherty, 1999). These results highlight the importance of understanding how operant-respondent interac- tions can elicit anxiety-like behavior that can disrupt operant responding and can inform clin- ical practice.

An important challenge for basic researchers is to extend the nonhuman literature on operant- respondent interactions by examining the con- tribution of uniquely human characteristics such as verbal stimuli. For example, Schlund et al. (2017) developed a human operant version of the AA conflict test to examine the effects of instructed threat on AA transition points and verbal ratings of anxiety. Healthy adults (i.e., college students) were given accurate, inaccu- rate, or no instructions regarding an escalating threat meter (i.e., conditioned aversive stimu- lus) that was associated with different probabil- ities of money loss on a computer. For example, the threat meter ranged from 0 to 100 and in- creased in step sizes of 4. Participants were instructed that the threat level was associated with the probability of money loss. However, unknown to the participants, only threat level 98 was associated with a 100% probability of money loss; all other threat levels had a 0% chance of money loss. Participants were given the choice to either approach money on a fixed- ratio schedule (press button #1) or to observe the threat meter (press button #2). Choosing to observe the threat meter, simultaneously dis- played the threat level (e.g., 48) and the oppor- tunity to choose to return to approaching money or to avoid money loss by lowering the threat level (e.g., pressing #3 reduced the threat from 48 to 44). In a free-operant fashion, participants could engage in multiple choice responses by either transitioning from approach to avoidance or avoidance to approach with no changeover delay. Results of Schlund et al. showed that participants tended to approach when threats were associated with low probabilities of money loss and avoided at higher threats. Par- ticipants earned more money when the instruc- tions about the threat were accurate (i.e., matched the programmed loss contingency) or unavailable. However, earnings decreased when the instructions were inaccurate or did not match the direct contingencies. Thus, this hu- man AA conflict test provides a valuable frame- work for basic research into studying how

329OPERANT-RESPONDENT INTERACTIONS

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uniquely human characteristics (i.e., verbal stimuli) impact operant-respondent interactions and may serve as a critical “bridge” between nonhuman research and applied research and practice. Extending this framework into con- texts with clinical populations may also prove to be fruitful.

Operant-respondent interactions may under- lie the assessment and treatment of phobias in applied contexts. Tyner et al. (2016) effectively treated a dog phobia in children with autism using contact desensitization plus reinforcement without escape extinction. This treatment pack- age combined features of exposure-based inter- ventions with positive reinforcement of approach responses to gradually increase approach toward the phobic stimulus. The synthesis of these treat- ment components can be effective by targeting operant-respondent interactions underlying phobias. Contact desensitization may reduce anxiety through gradual respondent extinction via stimulus exposure, which disrupts the con- tingency between the phobic stimulus and an aversive elicited physiological event. Approach toward the phobic stimulus is shaped via posi- tive reinforcement thereby increasing contact which creates a new appetitive stimulus func- tion of the phobic stimulus—resulting in a de- crease in avoidance. Results of Tyner et al. showed that contact desensitization plus rein- forcement can be an effective treatment to de- crease operant avoidance of a phobic stimulus for children with limited verbal repertoires. However, it is noteworthy that although the participants in Tyner et al. approached and in- teracted with the dog following treatment, it is unclear if the treatment package resulted in any changes of autonomic responses (e.g., increased cortisol, galvanic skin response, heart rate) elic- ited by the phobic stimulus or if approach re- sponses persisted despite continued autonomic arousal.

Although basic research on operant-respondent interactions suggest that operant contingencies may influence respondent behavior, little applied research in the area of anxiety- related disorders has directly measured these potential changes (despite the strong autonomic responses associ- ated with this class of behavior). One notable exception is a study conducted by Chok, De- manche, Kennedy, and Studer (2010). Chok et al. evaluated the effects of a similar treatment package (i.e., reinforced practice plus social

praise) for dog phobias in a child with autism. However, in addition to measuring operant avoidance responses, Chok et al. incorporated physiological measures (i.e., heart rate) into their evaluation. Results of Chok et al. showed that the treatment package facilitated not only operant approach toward the dogs but also pro- duced a concomitant decrease in respondent- regulated heart rate. These results may interest basic researchers in that reinforcement contin- gencies can compete with and override respon- dent- regulated behavior. Interestingly, for indi- viduals without autism, graduated exposure (i.e., contact desensitization) alone, in the ab- sence of a social positive reinforcer contingent on approach responses is considered an empir- ically supported treatment for phobias (e.g., Wolitzky-Taylor, Horowitz, Powers, & Telch, 2008). This technique is based primarily on respondent extinction in that individuals are gradually put into contact with a feared stimulus until they no longer experience a fear response (i.e., habituation). Rather than individuals re- sponding to current operant contingencies (e.g., positive reinforcement), their behavior may be governed by a therapist rule to stay and tolerate the aversive stimulus. These processes could be studied with humans utilizing both operant be- havior and physiological responses.

Many opportunities exist for future areas of growth on the topic of operant-respondent in- teractions related to phobias within our own discipline and abroad. If basic researchers chose to apply a translational strategy to this topic, they may wish to investigate variables that feed both their intellectual curiosity about under- standing operant-respondent in its own right with an eye toward selecting variables that are germane to treatment. Of great applied interest are variables that are hypothesized to render the phobic stimulus less aversive in order to both facilitate approach while also decreasing elicit- ing stress and emotional reactivity. For exam- ple, a potential treatment that can be “reverse- translated” back into the human operant laboratory is advance notice. In practice, advance notice, typically in the form of a 2-min verbal warning, is used to signal an aversive event, such as a transition between activities. Advance no- tice may be functionally similar to a warning stimulus in the basic literature (e.g., cf. Mace, Shapiro, & Mace, 1998; Sidman, 1955). Despite the wide use of warning stimuli in practice, it is

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unclear under what environmental conditions advance notice is likely to be effective (for a review see, Brewer, Strickland-Cohen, Dotson, & Williams, 2014). Warnings are hypothesized to reduce anxiety related to uncertainty and tend to be effective when some aspect of the transi- tion is (e.g., the timing and/or nature of upcom- ing activities). There is some evidence in the applied literature that emotional behavior (e.g., yelling “no,” physical aggression occurs at the time the warning is delivered rather during the transition (e.g., Wilder, Nicholson, & Allison, 2010). Thus, an important question that may appeal to basic researchers is whether advance notice (i.e., a warning stimulus) that signals an aversive event can acquire conditioned aversive properties. If so, it is possible that including advance notice as a treatment option for transi- tion-related problem behavior may elicit emo- tional behavior that disrupts the operant rein- forcement contingency.

Collectively, these results suggest that re- searchers should consider including biobehav- ioral measures in the analysis of human AA conflict research. Methods designed to directly assess elicited emotional behavior, rather than focusing exclusively on operant- maintained be- havior, may provide a more thorough under- standing of the basic mechanisms that give rise to and maintain anxiety-like behavior in these contexts. Including such information may assist applied researchers in their treatment decision- making model (e.g., choosing the least stressful effective treatment for client). Additionally, biobehavioral measures along with verbal- self reports of anxiety may allow for cross-pollination to disciplines such as experimental and clinical psychopathology. Collaboration with other disci- plines may also advance our environmental-based account of anxiety rather focusing on mentalistic constructs or inner dispositions as causal mecha- nisms.

Summary

A translational approach to our science will ensure that basic research will allow for a better understanding of operant-respondent interac- tions during AA conflict while considering is- sues of societal importance. The human AA conflict test may be useful to generate both pure basic knowledge and to “bridge” research and practice on disruptive operant-respondent inter-

actions. To impact areas of neurophysiological research related to anxiety-related disorders will require collecting biobehavioral measures such as operant escape/avoidance, self-reports, and elicited emotional behaviors using the human AA conflict test. This task can be modified to conduct research using stimuli matched to an individual’s phobic stimulus in clinically rele- vant populations (e.g., stimuli associated with routine dental visits for children with autism). By adopting a translational approach, basic re- searchers are able to focus on examination of the effects of uniquely human characteristics (e.g., verbal stimuli) while providing value to practitioners tasked with treating these behav- ioral disorders. Translational research directed at the discovery of the treatment strategies that render stimuli less aversive may produce greater social acceptance of our field’s applied treat- ments and provide an outlet for basic research to thrive.

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Received August 1, 2017 Revision received November 16, 2017

Accepted November 20, 2017 �

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