Hierarchical resurgence

Different criteria affect prevalence of relapse of behavior targeted for treatment

Several studies have examined the prevalence of behavioral relapse among individuals with intellectual and developmental disabilities following common treatment challenges (context changes, schedule thinning). Most applied studies compare behavior during the treatment challenges with the maximum level of behavior from five preceding treatment sessions. This max-of-5 criterion could inadvertently capture behavior in transition during the preceding treatment phase, thereby underestimating the prevalence of relapse. In the current study, we reanalyzed existing clinical data with the max-of-5 criterion and an alternative criterion less likely to capture target behavior in transition-the mean of the last two sessions (mean-of-2 criterion) of the treatment phase. As hypothesized, the max-of-5 criterion produced lower prevalence estimates relative to the mean-of-2 criterion. We encourage researchers conducting these analyses to weigh different approaches to reporting prevalence data and discuss considerations for future areas of research and practice related to measurement of relapse.

Understanding resurgence and other emergent activity with the laws of allocation, induction, and covariance

Resurgence is defined as an increase in a previously extinguished target response (B1) resulting from the worsening of conditions for a more recently reinforced alternative response (B2). Worsening includes extinction or reductions in rate, amount, and immediacy of delivery of food or some other phylogenetically important event (PIE). In the first part of the article, we apply the laws of allocation, induction, and covariance to understand not only resurgence of operant activity previously covarying with the PIE (B1) but also a constellation of ontogenetic and phylogenetic activities both related to the PIE (B0) and unrelated to the PIE (BN). In the second part, we discuss how induction might be incorporated into and provide alternative processes within an existing matching-based framework, resurgence as choice (RaC). We begin to identify how this range of activities could depend on changes in the relative competitive weight (V) of all available activities (B1, B2, B0, BN) in addition to only those receiving explicit training (B1, B2). Future empirical and theoretical research is needed within this framework to provide a more complete understanding of resurgence and behavior more generally.

Examining resurgence in rats following expanded-operant treatments

Resurgence of previously reinforced behavior represents a challenge to otherwise successful interventions based on differential reinforcement of alternative behavior (DRA). Expanded-operant treatments seek to increase the number of functional alternative behaviors through DRA, thereby potentially mitigating resurgence. However, the few studies that have directly examined these methods as a tool for resurgence mitigation have provided limited and unclear results. Thus, the present experiments were designed to investigate the effect of expanded-operant DRA methods on resurgence of previously reinforced behavior using rat subjects. In two experiments, following a baseline phase in which a target response was trained, groups of rats experienced concurrent (i.e., five simultaneous alternative responses), serial (i.e., five sequentially available alternative responses), or single DRA interventions arranging similar rates of alternative reinforcement in order to examine potential differences in resurgence. Both experiments showed that neither serial nor concurrent DRA expanded-operant treatments reduced resurgence compared with single DRA regardless of whether stimuli associated with previously reinforced alternative responses were removed (Experiment 1) or remained present (Experiment 2) for the serial-DRA group. Further, a primacy effect in resurgence was obtained for the serial-DRA group in both experiments. Overall, these results suggest that expanded-operant treatments may not help to reduce resurgence.

Relapse and its mitigation: Toward behavioral inoculation

Relapse following the successful treatment of problem behavior can increase the likelihood of injury and the need for more intensive care. Current research offers some predictions of how treatment procedures may contribute to relapse, and conversely, how the risk of relapse can be mitigated. This review describes relapse-mitigation procedures with varying levels of support, the quantitative models that have influenced the research on relapse mitigation, different experimental methods for measuring relapse mitigation, and directions for future research. We propose that by viewing the implementation of relapse-mitigation procedures as a means of producing behavioral inoculation, clinicians are placed in the proactive and intentional role of exposing their client's behavior to an array of reinforcement and stimulus conditions during treatment with the goal of decreasing the detrimental impact of future treatment challenges.

A Comprehensive Systematic Review of Procedures and Analyses Used in Basic and Preclinical Studies of Resurgence, 1970-2020

Resurgence is the return of a previously reinforced response as conditions worsen for an alternative response, such as the introduction of extinction, reductions in reinforcement, or punishment. As a procedure, resurgence has been used to model behavioral treatments and understand behavioral processes contributing both to relapse of problem behavior and flexibility during problem-solving. Identifying existing procedural and analytic methods arranged in basic/preclinical research could be used by basic and preclinical researchers to develop novel approaches to study resurgence, whereas translational and clinical researchers could identify potential approaches to combating relapse during behavioral interventions. Despite the study of resurgence for over half a century, there have been no systematic reviews of the basic/preclinical research on resurgence. To characterize the procedural and analytic methods used in basic/preclinical research on resurgence, we performed a systematic review consistent with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). We identified 120 articles consisting of 200 experiments that presented novel empirical research, examined operant behavior, and included standard elements of a resurgence procedure. We reported prevalence and trends in over 60 categories, including participant characteristics (e.g., species, sample size, disability), designs (e.g., single subject, group), procedural characteristics (e.g., responses, reinforcer types, control conditions), criteria defining resurgence (e.g., single test, multiple tests, relative to control), and analytic strategies (e.g., inferential statistics, quantitative analysis, visual inspection). We make some recommendations for future basic, preclinical, and clinical research based on our findings of this expanding literature.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40614-022-00361-y.

Primacy and recency effects in hierarchical renewal in rats

Previous studies on hierarchical resurgence produced mixed results regarding the order and magnitude of recurrence of responses trained initially (primacy effect) or more recently (recency effect). Although changes in contextual stimuli could explain such differences, in resurgence procedures contextual stimuli are not commonly presented, thus their effects on multiple operants trained sequentially remain unclear. Renewal procedures, in contrast, have been useful to determine the effects of exteroceptive contextual stimuli on response recurrence. Thus, primacy and recency effects were studied using a renewal procedure in which three contexts were presented sequentially. Lever presses by rats were reinforced on a different lever under each training context and were then exposed to extinction in a different context. Presses on a fourth lever were never reinforced. During renewal testing, the three training contexts were presented in the same or inverse order relative to training. A strong primacy effect was found in rats exposed to the original training order. Both primacy and recency effects were found when the rats were exposed to contexts in inverse order. These results suggest that the magnitude of renewal of hierarchically trained responses is affected by training order and order of presentation of contextual stimuli during testing.

Increased number of responses may account for reduced resurgence following serial training

Abrupt discontinuation of functional communication training can cause resurgence of challenging behavior. Teaching multiple alternative responses in sequence (serial training) may reduce resurgence, relative to teaching a single alternative. However, previous evaluations of serial training included a different number of response options across comparison conditions. In Experiment 1, we varied both training type (single and serial) and number of response options, and replicated previous findings showing that more resurgence occurred following single training relative to serial training. In Experiment 2, we varied the training type while holding the number of alternative responses constant and obtained no consistent differences in resurgence. In Experiment 3, we varied the number of alternative responses while holding training type constant (i.e., single). More resurgence occurred in the condition with fewer response options, suggesting that the number of available alternative responses, and not explicit serial training of alternatives, was critical to outcomes.

The control response in assessing resurgence: Useful or compromised tool?

Resurgence experiments sometimes include an operandum on which a history of reinforcement has not been experimentally established. The purpose of this control operandum is to rule out a generalized increase in responding when the alternative response is extinguished as being the cause of the resurgent target response. A review of the results of experiments conducted with both nonhumans and humans in which a control operandum was included shows that control- operandum responding is more common in the latter and almost nonexistent in the former. Both the presence and absence of responding on the control operandum, however, are subject to multiple interpretations thereby rendering it a compromised tool. Alternatives to using a control operandum to rule out extinction induction as the basis for resurgence include a preresurgence test control procedure and a differential resurgence procedure.