Some Factors Modulating the Strength of Resurgence After Extinction of an Instrumental Behavior

Punishment-induced resurgence

The phenomenon of extinction-induced resurgence is well established, but there is comparatively little experimental evidence for punishment-induced resurgence. Punishment-induced resurgence can by tested by contingent shocks following the alternative response. The purpose of Experiment 1 was to test whether low-intensity shocks, that do not decrease rate of reinforcement, result in resurgence. Four rats served as subjects. Rats were exposed to three sequential conditions: (a) variable-interval (VI) 30-s food delivery for a lever press (target response); (b) VI 30-s food delivery for a nose poke (alternative response) and extinction of the lever press; (c) VI 30-s reinforcement for a nose poke with superimposed VI 60-s shock delivery. In the final condition, shocks increased gradually from 0.1 to 0.5 mA. Experiment 2 evaluated whether an abrupt introduction of a high-intensity shock would result in resurgence. Three rats served as subjects and were exposed to three sequential conditions: (a) VI 30-s food delivery for a lever press; (b) VI 30-s food delivery for a nose poke and extinction of the lever press; (c) continued VI 30-s reinforcement for a nose poke with superimposed VI 60-s 0.6 mA shock delivery. Resurgence was observed in all subjects, including in situations in which rate of responding, but not rate of reinforcement, decreased. The present study provides additional evidence for punishment-induced resurgence, but future studies are warranted to determine the extent to which punishment can produce resurgence with or without decreases in rates of reinforcement.

Examination of clinical variables affecting resurgence: A reanalysis of 46 applications

Despite the efficacy of behavioral interventions, resurgence of challenging behavior (e.g., aggression, self-injury) following successful treatment can still occur. Applied work has focused on identifying treatment-related variables thought to affect the occurrence and magnitude of resurgence. The current study describes the relation between several variables (i.e., phase duration, response rates in baseline and treatment, obtained rates of reinforcement, downshift in reinforcement step size) and resurgence in a retrospective consecutive controlled case series of 46 treatment applications for challenging behavior conducted in an inpatient setting. Only the downshift in reinforcement (e.g., schedule-thinning) step size was correlated with the magnitude of resurgence. These results are consistent with recent findings suggesting that treatment duration and other factors have inconsistent effects on resurgence of challenging behavior.

Abstinence as Choice: Exploring Voluntary Abstinence from Alcohol Self-Administration Using the Resurgence-as-Choice Framework

Resurgence is an increase in the rate of a previously suppressed behavior that occurs when an alternative source of reinforcement is made worse in some way. The Resurgence as Choice model offers a quantitative approach to understanding resurgence that may provide important insights into the variables that affect this form of relapse in the natural environment. Bringing this model to bear on relapse following reinforcement-based interventions for alcohol and other substance use disorders, however, may not be straightforward. Laboratory work on which the Resurgence as Choice model is based has almost exclusively focused on resurgence following extinction of target behavior, but abstinence from alcohol during intervention is often voluntary: Patients may drink alcohol and forfeit therapeutic reinforcers at any time. In this article, we first will review recent data from our group that demonstrate a method for studying resurgence following voluntary abstinence from alcohol seeking in rats. In a previous experiment, we reduced rats' alcohol-maintained lever pressing to low levels without placing it on extinction by arranging nondrug differential reinforcement of other behavior. Further, when we suspended nondrug reinforcement, resurgence of lever pressing occurred. Next, we will explore methods for modeling these outcomes using the Resurgence-as-Choice framework. We conclude that the data under consideration may not be sufficient to discriminate between candidate models of resurgence following voluntary abstinence and point to areas for future empirical and theoretical development. This work may provide a stronger bridge between preclinical and conceptual work on resurgence and clinical treatments for alcohol use disorder.

Resurgence Following Higher or Lower Quality Alternative Reinforcement

Resurgence is a temporary increase in a previously suppressed target behavior following a worsening in reinforcement conditions. Previous studies have examined how higher rates or magnitudes of alternative reinforcement affect suppression of the target behavior and subsequent resurgence. However, there has been no investigation of the effects of higher versus lower qualities of alternative reinforcement on resurgence. Using a three-phase resurgence preparation with rats, the present experiments examined the effects of an alternative reinforcer that was of higher (Experiment 1) or lower (Experiment 2) quality than the reinforcer that had previously maintained the target behavior. The results of both experiments showed greater reductions in target behavior with a higher quality alternative reinforcer and larger increases in target responding when a higher quality alternative reinforcer was removed. Along with prior findings with higher rates and magnitudes of alternative reinforcement, these findings suggest that variations in reinforcer dimensions that increase the efficacy of alternative reinforcement also tend to increase resurgence when alternative reinforcement is removed. The results are discussed in terms of the resurgence as choice in context model and in terms of potential clinical implications.

The impact of prolonging extinction on the ABC "super renewal" of instrumental responses in rats

Two free operant conditioning experiments with rats examined the impact of conducting a large amount of extinction training on situations that enhance the ABC renewal effect (ABC super renewal). In Experiment 1, ABC renewal was strengthened by conducting acquisition in multiple contexts. All rats were trained to press a lever for food. One group was trained in one context, while the other two groups were trained in three contexts. Then, all rats received extinction in context B. For two groups this phase lasted 4 sessions, whereas it lasted 36 sessions for the other group. In Experiment 2, ABC renewal was strengthened by using a large number of acquisition sessions. Rats were trained to perform an operant response to obtain food in context A. One group received a moderate amount of training, while the rest of the rats received a larger number of acquisition sessions. Responses underwent extinction in context B. Two groups received 4 sessions, while 36 extinction sessions were used for the remaining group. In both experiments, rats were tested in context B (extinction context) and C (renewal context). Greater ABC renewal occurred both when acquisition training was conducted in multiple contexts (Experiment 1) and by increasing the amount of acquisition training (Experiment 2). Nevertheless, we found that conducting a large number of extinction sessions reduced ABC super renewal in Experiment 1 only.

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.

Response effort and resurgence

This study provides an initial translational examination of response effort and resurgence. Eleven typically developing adults and five adolescents with autism served as participants across two experiments. Participants received points for touching moving stimuli on a computer screen. The resurgence evaluation consisted of three phases: establishment wherein R1 was reinforced, elimination wherein R1 was placed on extinction while R2 was reinforced, and extinction wherein R1 and R2 no longer resulted in reinforcement. Rate of R1 during extinction was compared across three conditions: intermediate, easy, and difficult. Disparity in effort was created by manipulations of the size and speed of objects that moved about on a computer screen. In Experiment 2, control stimuli were added to the experimental arrangement. Across the two experiments, the magnitude of resurgence was greater when R1 was easy. In Experiment 2, both R1 and control responding were greater in the extinction phase than in the elimination phase in all conditions with all participants. The present study supports the hypothesis that response effort affects resurgence and that less effortful responses are likely to recur with greater magnitude under conditions that produce resurgence than are their more effortful counterparts.

Further evaluation of treatment duration on the resurgence of destructive behavior

Translation of promising procedures for mitigating treatment relapse has received considerable attention recently from researchers across the basic-applied continuum. One procedure that has demonstrated mixed support involves increasing the duration of treatment as a strategy for blunting resurgence. In a recent translational study, Greer et al. (2020) failed to detect a mitigation effect of increased treatment duration on the resurgence of destructive behavior. However, design limitations may have been responsible. The present study corrected these limitations by (a) employing a sequential design to decrease the possibility of multiple-treatment interference, (b) evaluating more treatment durations, (c) arranging treatments of fixed durations, and (d) conducting treatments of more extreme duration in a different clinical sample. Despite these improvements in experimental rigor and the testing of more extreme boundary conditions, the present study also failed to detect a mitigation effect of increased treatment duration. Likely explanations are discussed.

Translating Quantitative Theories of Behavior into Improved Clinical Treatments for Problem Behavior

The most important advancement in the treatment of destructive behavior has been the development of the functional analysis, which is used to prescribe effective treatments like functional communication training. Although this approach can be highly effective, extinction bursts and forms of treatment relapse commonly occur when function-based treatments are implemented by caregivers in natural community settings. In recent years, researchers have increasingly applied quantitative theories of behavior like behavioral momentum theory (BMT) and the temporally weighted matching law (TWML) to understand, prevent, or mitigate extinction bursts and treatment relapse. In this paper, we describe BMT and TWML and selectively review the basic, translational, and applied research supporting and opposing each theory. Then, we describe how function-based treatments may be refined based on these theories to improve the effectiveness, generality, and durability of function-based treatments for individuals with autism spectrum and related disorders who display problem behavior.

Phase duration and resurgence

Resurgence, the recurrence of responding due to a worsening of reinforcement conditions for current behavior, is a prevalent form of treatment relapse. Resurgence as Choice in Context predicts that increasing the duration of exposure to reinforcement for target responding during Phase 1 will increase resurgence magnitude, whereas increasing the duration of exposure to reinforcement for alternative responding and extinction for target responding during Phase 2 will decrease resurgence magnitude. We conducted an experiment evaluating these predictions with human participants recruited through Amazon's Mechanical Turk platform. We varied Phase 1 and Phase 2 durations across 4 experimental groups. Resurgence as Choice in Context successfully predicted the differences in resurgence magnitude across these groups, and fitting the quantitative model to the obtained data yielded an exceptional coefficient of determination. We discuss the implications of these results for using Resurgence as Choice in Context to inform experiments with human participants and the feasibility of using human-operant preparations to evaluate resurgence.

Evaluating effects of context changes on resurgence in humans

Laboratory models of relapse provide methods for evaluating challenges to behavioral treatments with differential reinforcement of an alternative response (DRA). Resurgence occurs with the worsening of conditions of reinforcement for appropriate behavior and renewal occurs when transitioning out of a treatment context. Across five experiments, participants recruited via online crowdsourcing pressed onscreen buttons to earn points exchangeable for money and contexts sometimes changed through changes in the background image. Returning to the training context (ABA, Experiment 1) and transitioning to a novel context (ABC, Experiment 2) produced greater resurgence when removing alternative reinforcement in comparison with remaining in the treatment context (ABB). In contrast, we observed little difference in resurgence among AAA, ABB, and AAC context manipulations (Experiment 3) and ABA, ABC, and AAC context manipulations (Experiment 4). In Experiment 5, we evaluated relative contributions of the presence versus absence of context changes (ABA vs. ABB) in combination with or without the removal of alternative reinforcement. Both changing context and removing alternative reinforcement increased responding in isolation and the combination produced greater-than-additive effects. Overall, the present findings demonstrate a consistent effect of removing alternative reinforcement on relapse that, under certain conditions, can be enhanced by context change.

Examining effects of training duration on humans' resurgence and variability using a novel touchscreen procedure

Resurgence occurs when a previously reinforced and then extinguished target response increases due to reducing/eliminating an alternative source of reinforcement or punishing an alternative response. We evaluated whether duration of reinforcement history for a target response (1) affects the degree to which resurgence is observed in humans and (2) produces different gradients of response generalization around target responding during extinction testing. We arranged a novel touchscreen interface in which university students could swipe a 3D soccer ball to spin any direction. In Phase 1, the first direction swiped became the target and produced points exchangeable for money for 3 or 1 min across 2 groups. The first swipe was recorded but had no programmed consequence in a third group. In Phase 2, swipes 180-degrees from the target resulted in points for 3 min in all groups. Point deliveries ceased for 2 min to test for resurgence in Phase 3. Target responses resurged during testing to a relatively greater extent with longer Phase-1 training but gradients of response generalization did not differ among groups. These findings extend prior research on the role of training duration on resurgence. We discuss methodological and conceptual issues surrounding the assessment of response generalization in resurgence.

Evaluating Extinction, Renewal, and Resurgence of Operant Behavior in Humans with Amazon Mechanical Turk

Amazon Mechanical Turk (MTurk) is a crowdsourcing marketplace providing researchers with the opportunity to collect behavioral data from remote participants at a low cost. Recent research demonstrated reliable extinction effects, as well as renewal and resurgence of button pressing with MTurk participants. To further examine the generality of these findings, we replicated and extended these methods across six experiments arranging reinforcement and extinction of a target button press. In contrast to previous findings, we did not observe as reliable of decreases in button pressing during extinction (1) after training with VR or VI schedules of reinforcement, (2) in the presence or absence of context changes, or (3) with an added response cost for button pressing. However, we found that that a 1-point response cost for all button presses facilitated extinction to a greater extent than the absence of response cost. Nevertheless, we observed ABA renewal of button pressing when changing background contexts across phases and resurgence when extinguishing presses on an alternative button. Our findings suggest that MTurk could be a viable platform from which to ask and address questions about extinction and relapse processes, but further procedural refinements will be necessary to improve the replicability of control by experimental contingencies.

Resurgence Following Traditional and Interdependent Differential Reinforcement of Alternative Behavior

Clinicians frequently prescribe functional communication training (FCT) as a treatment for severe destructive behavior. Recent research has shown that FCT treatments are susceptible to treatment relapse in the form of resurgence of destructive behavior when individuals contact periods in which reinforcers are unavailable. Results of preliminary studies suggest that teaching multiple response alternatives can mitigate the resurgence of target behavior. The current evaluation serves as a preliminary study in which we used a laboratory arrangement to evaluate the effects of a novel approach to training multiple alternative responses on the resurgence of target behavior. Findings showed that multiple-response training did not decrease resurgence of target responding consistently; however, it increased the total amount of target and alternative responding observed during the resurgence phase and decreased the overall probability of the target response.

Changes in the elimination and resurgence of alcohol-maintained behavior in rats and the effects of naltrexone

Resurgence may be a mechanism of relapse in alcohol use disorder patients upon discharge from treatment as part of an abuse-treatment-relapse cycle. Adjunctive pharmacotherapies may be a means to facilitate behavioral treatments and block resurgence. Experiments were conducted using a model of alcohol self-administration to assess the repeatability of the elimination and resurgence of alcohol-maintained behavior and the effects of naltrexone. Experiments had three phases. In Phase 1, behavior was maintained by oral alcohol under a fixed-ratio schedule. In Phase 2, behavior was extinguished via condensed milk delivery under a differential-reinforcement-of-other-behavior (DRO) schedule. In Phase 3, the DRO schedule was eliminated. In Experiment 1, this 3-phase cycle was replicated 4 times. Across replications, response rates and dose of alcohol consumed did not differ in Phase 1, alcohol-maintained behavior was eliminated more rapidly in Phase 2, and the resurgence effect was generally stable in Phase 3. In Experiment 2, naltrexone was administered in Phase 2, Phase 3, or both Phases 2 and 3, to separate groups of rats. Naltrexone facilitated the elimination of alcohol-maintained behavior in Phase 2 and, the resurgence of alcohol-maintained behavior was reduced only for those rats that received naltrexone in both phases. Together, these experiments demonstrate that the resurgence of alcohol-maintained behavior is replicable within-subjects and, further, resurgence of alcohol-maintained behavior may be a useful model to evaluate pharmacological interventions to facilitate behavioral treatments and reduce the likelihood of relapse. Results with naltrexone support the use of medication-assisted therapy approaches to reduce relapse risk in patients. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Cues Associated with Alternative Reinforcement During Extinction Can Attenuate Resurgence of an Extinguished Instrumental Response

In resurgence, a target behavior (R1) is acquired in an initial phase and extinguished in a second phase while an R2 behavior is reinforced. When R2 is extinguished, R1 behavior can return or resurge. Two experiments tested the effectiveness of a potential retrieval cue associated with extinction in attenuating resurgence. Experiment 1 established that a 2-s cue paired with outcome delivery in Phase 2 can attenuate resurgence when presented during testing. This effect depended on the cue being associated with the outcome, and it occurred if the cue was delivered contingently or noncontingently on responding during testing. Pairing the cue with reinforcement might be necessary to maintain attention to it during Phase 2. Experiment 2 demonstrated that the cue must be experienced in sessions that also include R1 extinction and that it does not reduce resurgence through a conditioned reinforcement mechanism. The results suggest that previously neutral stimuli can attenuate resurgence if they are first paired with alternative reinforcement and presented in sessions in which R1 is extinguished. They build on existing literature that suggests enhancing generalization between extinction and testing reduces resurgence. The results may have implications for reducing relapse following interventions in humans such as contingency management (CM), in which participants can earn vouchers contingent upon drug abstinence. A cue associated with CM might help reduce this relapse.

A preliminary evaluation of treatment duration on the resurgence of destructive behavior

Quantitative models of resurgence (e.g., Behavioral Momentum Theory, Resurgence as Choice) suggest that resurgence is partly a function of the duration of extinction exposure, with longer histories of extinction producing less resurgence. This prediction is supported by some laboratory research and has been partially supported by clinical translations that did not isolate the effects of extinction exposure prior to testing for resurgence. The degree to which different histories of extinction impact the likelihood of treatment relapse in therapeutic applications of differential reinforcement is of great interest to the clinical community, including insurance carriers and other financial providers. In the present study, we isolated the effects of extinction history for severe destructive behavior across 6 participants referred for treatment services and examined resurgence of destructive behavior when alternative reinforcement terminated. Our within-subject evaluation showed no difference in the level of resurgence or persistence of destructive behavior following short and long exposures to differential reinforcement with extinction. We discuss our failure to replicate in relation to experimental-design considerations for investigating this and other relapse phenomena in future research with clinical populations.

Resurgence as Choice in Context: Treatment duration and on/off alternative reinforcement

Resurgence as Choice (RaC) is a quantitative theory suggesting that an increase in an extinguished target behavior with subsequent extinction of an alternative behavior (i.e., resurgence) is governed by the same processes as choice more generally. We present data from an experiment with rats examining a range of treatment durations with alternative reinforcement plus extinction and demonstrate that increases in treatment duration produce small but reliable decreases in resurgence. Although RaC predicted the relation between target responding and treatment duration, the model failed in other respects. First, contrary to predictions, the present experiment also replicated previous findings that exposure to cycling on/off alternative reinforcement reduces resurgence. Second, RaC did a poor job simultaneously accounting for target and alternative behaviors across conditions. We present a revised model incorporating a role for more local signaling effects of reinforcer deliveries or their absence on response allocation. Such signaling effects are suggested to impact response allocation above and beyond the values of the target and alternative behaviors as longer-term repositories of experience. The new model provides an excellent account of the data and can be viewed as an integration of RaC and a quantitative approximation of some aspects of Context Theory.

An evaluation of resurgence following functional communication training conducted in alternative antecedent contexts via telehealth

Treatments based on differential reinforcement may inadvertently increase the recurrence of problem behavior in the face of challenges because reinforcers for appropriate behavior occur in the same context as problem behavior. The current study evaluated one potential approach to mitigating these problems with differential reinforcement treatments based on behavioral momentum theory. Specifically, appropriate behavior was trained in contexts without a history of reinforcement prior to intervening with problem behavior. Participants were 4 children with autism spectrum disorder. Treatment used telehealth to implement functional communication training (FCT) in three alternative contexts with minimal or no history of reinforcement for problem behavior before initiating FCT in the treatment context. Evaluations of the effects of treatment and tests of resurgence were conducted intermittently during treatment to evaluate maintenance. When FCT treatment was initiated in alternative contexts, initial results were comparable to more typical implementations of FCT. Resurgence was reduced to similar levels during tests of resurgence for all participants when compared to more typical previously published implementations of FCT, but clinically significant reductions in resurgence occurred more quickly in the present study. These findings support training appropriate behavior in an alternative context to mitigate the resurgence of problem behavior during differential reinforcement treatments.

Extinction of instrumental (operant) learning: interference, varieties of context, and mechanisms of contextual control

This article reviews recent research on the extinction of instrumental (or operant) conditioning from the perspective that it is an example of a general retroactive interference process. Previous discussions of interference have focused primarily on findings from Pavlovian conditioning. The present review shows that extinction in instrumental learning has much in common with other examples of retroactive interference in instrumental learning (e.g., omission learning, punishment, second-outcome learning, discrimination reversal learning, and differential reinforcement of alternative behavior). In each, the original learning can be largely retained after conflicting information is learned, and behavior is cued or controlled by the current context. The review also suggests that a variety of stimuli can play the role of context, including room and apparatus cues, temporal cues, drug state, deprivation state, stress state, and recent reinforcers, discrete cues, or behaviors. In instrumental learning situations, the context can control behavior through its direct association with the reinforcer or punisher, through its hierarchical relation with response-outcome associations, or its direct association (inhibitory or excitatory) with the response. In simple instrumental extinction and habit learning, the latter mechanism may play an especially important role.

Continuous nicotine exposure does not affect resurgence of alcohol seeking in rats

Alcohol is the most commonly used drug in the United States and alcohol abuse can lead to alcohol use disorder. Alcohol use disorder is a persistent condition and relapse rates following successful remission are high. Many factors have been associated with relapse for alcohol use disorder, but identification of these factors has not been well translated into preventative utility. One potentially important factor, concurrent nicotine use, has not been well investigated as a causal factor in relapse for alcohol use disorder. Nicotine increases the value of other stimuli in the environment and may increase the value of alcohol. If nicotine increases the value of alcohol, then nicotine use during and after treatment may make relapse more probable. In the current study, we investigated the effect of continuous nicotine exposure (using osmotic minipumps to deliver nicotine or saline, depending on group, at a constant rate for 28 days) on resurgence of alcohol seeking in rats. Resurgence is a type of relapse preparation that consists of three phases: Baseline, Alternative Reinforcement, and Resurgence Testing. During Baseline, target responses produced a dipper of alcohol. During Alternative Reinforcement, target responses were extinguished and responses on a chain produced a chocolate pellet. During Resurgence Testing, responses on the chain were also extinguished and a return to responding on the target lever was indicative of resurgence. Multilevel modeling was used to analyze the effect of nicotine on resurgence. Both the nicotine and saline group showed resurgence of alcohol seeking, but there was no difference in the degree of resurgence across groups. Future directions could involve testing alternative drug delivery techniques.

Factors that encourage generalization from extinction to test reduce resurgence of an extinguished operant response

Two experiments investigated methods that reduce the resurgence of an extinguished behavior (R1) that occurs when reinforcement for an alternative behavior (R2) is discontinued. In Experiment 1, R1 was first trained and then extinguished while R2 was reinforced during a 5- or 25-session treatment phase. For half the rats, sessions in which R2 was reinforced alternated with sessions in which R2 was extinguished. Controls received the same number of treatment sessions, but R2 was never extinguished. When reinforcement for R2 was discontinued, R1 resurged in the controls. However, the alternating groups showed reduced resurgence, and the magnitude of the resurgences observed during their R2 extinction sessions decreased systematically over Phase 2. In Experiment 2, R1 was first reinforced with one outcome (O1). The rats then had two types of double-alternating treatment sessions. In one type, R1 was extinguished and R2 produced O2. In the other, R1 was unavailable and R2 produced O3. R1 resurgence was weakened when O2, but not O3, was delivered freely during testing. Together, the results suggest that methods that encourage generalization between R1 extinction and resurgence testing weaken the resurgence effect. They are not consistent with an account of resurgence proposed by Shahan and Craig (2017).

Resurgence with and without an alternative response

Resurgence is the reemergence of a previously reinforced response that occurs after the elimination or reduction of reinforcement for an alternative response. Resurgence is problematic in the context of treatment because the reemergence of a previously reinforced destructive response could be detrimental to treatment gains. In the current translational study, we examined a modified resurgence procedure in which the alternative response was either present or absent during extinction. Four participants were exposed to three phases that consisted of (1) reinforcement of a target response, (2) extinction of the target response and differential reinforcement of an alternative response, and (3) extinction of both responses. Results for four out of five assessments showed greater resurgence when the alternative response was absent during Phase 3. Results suggest that more robust resurgence might occur if the alternative response is not available as opposed to the alternative response contacting extinction.

Beyond the breakpoint: reinstatement, renewal, and resurgence of ratio-strained behavior

Three experiments were conducted using pigeons to assess the recurrence of responding eliminated by increasing the value of a progressive-ratio schedule to the breakpoint of responding. The procedures used in these assessments were, in successive experiments, reinstatement, renewal and resurgence. Each was effective in returning temporarily the eliminated responding. Reinstatement occurred with both yoked-time and fixed-time food deliveries. Both renewal and resurgence resulted in immediate recurrence of the response, and, as in other experiments investigating resurgence, the key peck response resurged as the alternative response extinguished. The results of all three experiments suggest the generality of these recurrence procedures to responding under progressive-ratio schedules, indicating that strained performance under these schedules is amenable to recovery under the investigated conditions.

Longer treatment with alternative non-drug reinforcement fails to reduce resurgence of cocaine or alcohol seeking in rats

Provision of alternative non-drug reinforcement is among the most effective methods for treating substance use disorders. However, when alternative reinforcers become unavailable during treatment interruptions or upon cessation of treatment, relapse often occurs. Relapse following the loss of alternative reinforcement is known as resurgence. One factor that could reduce resurgence is longer duration of treatment with alternative reinforcement, but the available data are mixed. Further, the effects of length of treatment have previously only been examined with food seeking. The present experiments directly examined if duration of treatment impacted the magnitude of resurgence of cocaine or alcohol seeking in rats. First, rats were trained to self-administer cocaine (Experiment 1) or alcohol (Experiment 2) by performing a target behavior. Second, target behavior was extinguished and performing an alternative behavior produced an alternative non-drug (i.e., food) reinforcer. Finally, resurgence was assessed following removal of alternative reinforcement after either 5 or 20 sessions of treatment. Treatment duration did not differentially affect resurgence of cocaine seeking in Experiment 1 or Alcohol seeking in Experiment 2. These results suggest that extended treatment with alternative non-drug reinforcement may not decrease propensity to relapse. Further, these results may have implications for treatment of substance use disorders and for theories of resurgence.

Stimuli previously associated with reinforcement mitigate resurgence

Resurgence refers to the recurrence of an extinguished target behavior following subsequent suspension of alternative reinforcement. Delivery of reinforcers during extinction of alternative behavior has been shown to mitigate resurgence. The present experiment aimed to determine whether delivering stimuli associated with reinforcers during resurgence testing similarly mitigates resurgence. Three groups of rats pressed target levers for food according to variable-interval 15-s schedules during Phase 1. In Phase 2, lever pressing was extinguished, and an alternative nose-poke response produced alternative reinforcement according to a variable-interval 15-s schedule. Food reinforcement was always associated with illumination of the food aperture and an audible click from the pellet dispenser during Phases 1 and 2. Phase 3 treatments differed between groups. For one group, nose poking continued to produce food and food-correlated stimuli. Both of these consequences were suspended for a second group. Finally, nose poking produced food-correlated stimuli but not food for a third group. Target-lever pressing resurged in the group that received no consequences and in the group that received only food-correlated stimuli for nose poking. Resurgence, however, was smaller for the group that received food-correlated stimuli than for the group that received no consequences for nose poking. Target-lever pressing did not increase between phases in the group that continued to receive food and associated stimuli. Thus, delivery of stimuli associated with food reinforcement after suspension of food reduced but did not eliminate resurgence of extinguished lever pressing. These findings contribute to potential methodologies for preventing relapse of extinguished problem behavior in clinical settings.

Resurgence as Choice

Resurgence is typically defined as an increase in a previously extinguished target behavior when a more recently reinforced alternative behavior is later extinguished. Some treatments of the phenomenon have suggested that it might also extend to circumstances where either the historic or more recently reinforced behavior is reduced by other non-extinction related means (e.g., punishment, decreases in reinforcement rate, satiation, etc.). Here we present a theory of resurgence suggesting that the phenomenon results from the same basic processes governing choice. In its most general form, the theory suggests that resurgence results from changes in the allocation of target behavior driven by changes in the values of the target and alternative options across time. Specifically, resurgence occurs when there is an increase in the relative value of an historically effective target option as a result of a subsequent devaluation of a more recently effective alternative option. We develop a more specific quantitative model of how extinction of the target and alternative responses in a typical resurgence paradigm might produce such changes in relative value across time using a temporal weighting rule. The example model does a good job in accounting for the effects of reinforcement rate and related manipulations on resurgence in simple schedules where Behavioral Momentum Theory has failed. We also discuss how the general theory might be extended to other parameters of reinforcement (e.g., magnitude, quality), other means to suppress target or alternative behavior (e.g., satiation, punishment, differential reinforcement of other behavior), and other factors (e.g., non- contingent versus contingent alternative reinforcement, serial alternative reinforcement, and multiple schedules).

Renewed behavior produced by context change and its implications for treatment maintenance: A review

Behavioral treatment gains established in one setting do not always maintain in other settings. The present review examines the relevance of basic and translational research to understanding failures to maintain treatment gains across settings. Specifically, studies of the renewal effect examine how transitioning away from a treatment setting could evoke a return of undesirable behavior, rather than newly trained appropriate behavior. Studies of renewal typically arrange three phases, with a response trained and reinforced under a particular set of contextual stimuli in the first phase. Next, that response is extinguished, often under a different set of contextual stimuli. Finally, that response returns despite extinction remaining in effect upon returning to the original training context or transitioning to a novel context. Thus, removing the extinction context is sufficient to produce a recurrence of the response. The findings suggest treatment effects can become specific to the context in which the treatment was delivered. This literature offers promising methods for systematically assessing the factors contributing to treatment maintenance and improving generalization of treatment gains across contexts. Therefore, the present review suggests basic and translational research on renewal provides an empirical literature to bring greater conceptual systematization to understanding generalization and maintenance of behavioral treatment.

Beyond Intervention

Individuals diagnosed with autism spectrum disorder (ASD) and other developmental disabilities are at risk of engaging in severe problem behavior, including aggression and self-injury. Severe problem behavior is an obstacle to proper education and integration into society. Therefore, eliminating severe problem behavior is key to long-term academic and social success. However, problem behavior can be persistent in the face of interventions and likely to relapse following successful intervention. This article describes basic and translational research relevant to understanding what influences the persistence and relapse of severe problem behavior in individuals diagnosed with ASD and other developmental disabilities. Investing in research to better understand persistence and relapse will pay dividends for clients, parents, clinicians, and society in general.

Resurgence of instrumental behavior after an abstinence contingency

In resurgence, an extinguished instrumental behavior (R1) recovers when a behavior that has replaced it (R2) is also extinguished. The phenomenon may be relevant to understanding relapse that can occur after the termination of "contingency management" treatments, in which an unwanted behavior (e.g., substance abuse) is reduced by reinforcing an alternative behavior. When reinforcement is discontinued, the unwanted behavior might resurge. However, unlike most resurgence experiments, contingency management treatments also introduce a negative contingency, in which reinforcers are not delivered unless the client has abstained from the unwanted behavior. In two experiments with rats, we therefore examined the effects of adding a negative "abstinence" contingency to the resurgence design. During response elimination, R2 was not reinforced unless R1 had not been emitted for a minimum period of time (45, 90, or 135 s). In both experiments, adding such a contingency to simple R1 extinction reduced, but did not eliminate, resurgence. In Experiment 2, we found the same effect in a yoked group that could earn reinforcers for R2 at the same points in time as the negative-contingency group, but without the requirement to abstain from R1. Thus, the negative contingency per se did not contribute to the reduction in resurgence. These results suggest that the contingency reduced resurgence by making reinforcers more difficult to earn and more widely spaced in time. This could have allowed the animal to learn that R1 was extinguished in the "context" of infrequent reinforcement-a context more like that of resurgence testing. The results are thus consistent with a contextual (renewal) account of resurgence. The method might provide a better model of relapse after termination of a contingency management treatment.

Behavioral momentum theory fails to account for the effects of reinforcement rate on resurgence

The behavioral-momentum model of resurgence predicts reinforcer rates within a resurgence preparation should have three effects on target behavior. First, higher reinforcer rates in baseline (Phase 1) produce more persistent target behavior during extinction plus alternative reinforcement. Second, higher rate alternative reinforcement during Phase 2 generates greater disruption of target responding during extinction. Finally, higher rates of either reinforcement source should produce greater responding when alternative reinforcement is suspended in Phase 3. Recent empirical reports have produced mixed results in terms of these predictions. Thus, the present experiment further examined reinforcer-rate effects on persistence and resurgence. Rats pressed target levers for high-rate or low-rate variable-interval food during Phase 1. In Phase 2, target-lever pressing was extinguished, an alternative nose-poke became available, and nose-poking produced either high-rate variable-interval, low-rate variable-interval, or no (an extinction control) alternative reinforcement. Alternative reinforcement was suspended in Phase 3. For groups that received no alternative reinforcement, target-lever pressing was less persistent following high-rate than low-rate Phase-1 reinforcement. Target behavior was more persistent with low-rate alternative reinforcement than with high-rate alternative reinforcement or extinction alone. Finally, no differences in Phase-3 responding were observed for groups that received either high-rate or low-rate alternative reinforcement, and resurgence occurred only following high-rate alternative reinforcement. These findings are inconsistent with the momentum-based model of resurgence. We conclude this model mischaracterizes the effects of reinforcer rates on persistence and resurgence of operant behavior.

Behavioral momentum and resurgence: Effects of time in extinction and repeated resurgence tests

Resurgence is an increase in a previously extinguished operant response that occurs if an alternative reinforcement introduced during extinction is removed. Shahan and Sweeney (2011) developed a quantitative model of resurgence based on behavioral momentum theory that captures existing data well and predicts that resurgence should decrease as time in extinction and exposure to the alternative reinforcement increases. Two experiments tested this prediction. The data from Experiment 1 suggested that without a return to baseline, resurgence decreases with increased exposure to alternative reinforcement and to extinction of the target response. Experiment 2 tested the predictions of the model across two conditions, one with constant alternative reinforcement for five sessions, and the other with alternative reinforcement removed three times. In both conditions, the alternative reinforcement was removed for the final test session. Experiment 2 again demonstrated a decrease in relapse across repeated resurgence tests. Furthermore, comparably little resurgence was observed at the same time point in extinction in the final test, despite dissimilar previous exposures to alternative reinforcement removal. The quantitative model provided a good description of the observed data in both experiments. More broadly, these data suggest that increased exposure to extinction may be a successful strategy to reduce resurgence. The relationship between these data and existing tests of the effect of time in extinction on resurgence is discussed.

Resurgence of target responding does not exceed increases in inactive responding in a forced-choice alternative reinforcement procedure in humans

Resurgence following removal of alternative reinforcement has been studied in non-human animals, children with developmental disabilities, and typically functioning adults. Adult human laboratory studies have included responses without a controlled history of reinforcement, included only two response options, or involved extensive training. Arbitrary responses allow for control over history of reinforcement. Including an inactive response never associated with reinforcement allows the conclusion that resurgence exceeds extinction-induced variability. Although procedures with extensive training produce reliable resurgence, a brief procedure with the same experimental control would allow more efficient examination of resurgence in adult humans. We tested the acceptability of a brief, single-session, three-alternative forced-choice procedure as a model of resurgence in undergraduates. Selecting a shape was the target response (reinforced in Phase I), selecting another shape was the alternative response (reinforced in Phase II), and selecting a third shape was never reinforced. Despite manipulating number of trials and probability of reinforcement, resurgence of the target response did not consistently exceed increases in the inactive response. Our findings reiterate the importance of an inactive control response and call for reexamination of resurgence studies using only two response options. We discuss potential approaches to generate an acceptable, brief human laboratory resurgence procedure.

Reaparecimento de sequências com diferentes números de respostas em contextos de extinção e de variação

RESUMO O reaparecimento de uma resposta previamente extinta quando os reforços para uma resposta alternativa são descontinuados é denominado ressurgência. Foram investigados os efeitos de três variáveis sobre o reaparecimento de sequências de respostas: probabilidade da sequência (alta e baixa), contexto de teste (extinção e variação operante) e número de respostas por sequência (três e cinco). Sequências muito prováveis reapareceram mais frequentemente que sequências pouco prováveis, o reaparecimento da sequência alvo foi mais frequente no contexto de extinção do que de variação e o reaparecimento da sequência alvo variou inversamente ao número de respostas por sequência. O reaparecimento da sequência alvo, entretanto, não foi conceitualizado como ressurgência, uma vez que sua frequência foi menor que a das sequências controle.

Does Extended Pre Quit Bupropion Aid in Extinguishing Smoking Behavior?

INTRODUCTION

Understanding the mechanisms by which bupropion promotes smoking cessation may lead to more effective treatment. To the extent that reduced smoking reinforcement is one such mechanism, a longer duration of pre quit bupropion treatment should promote extinction of smoking behavior. We evaluated whether 4 weeks of pre quit bupropion (extended run-in) results in greater pre quit reductions in smoking rate and cotinine and, secondarily, greater short-term abstinence, than standard 1 week of pre quit bupropion (standard run-in).

METHODS

Adult smokers (n = 95; 48 females) were randomized to a standard run-in group (n = 48; 3-week placebo, then 1-week bupropion pre quit) or an extended run-in group (4-week pre quit bupropion; n = 47). Both groups received group behavioral counseling and 7 weeks of post quit bupropion. Smoking rate (and craving, withdrawal, and subjective effects) was collected daily during the pre quit period; biochemical data (cotinine and carbon monoxide) were collected at study visits.

RESULTS

During the pre quit period, the extended run-in group exhibited a greater decrease in smoking rate, compared to the standard run-in group, interaction p = .03. Cigarette craving and salivary cotinine followed a similar pattern, though the latter was evident only among women. Biochemically verified 4-week continuous abstinence rates were higher in the extended run-in group (53%) than the standard run-in group (31%), p = .033.

CONCLUSIONS

The extended use of bupropion prior to a quit attempt reduces smoking behavior during the pre quit period and improved short-term abstinence rates. The data are consistent with an extinction-of-reinforcement model and support further investigation of extended run-in bupropion therapy for smoking cessation.

Context change explains resurgence after the extinction of operant behavior

Extinguished operant behavior can return or "resurge" when a response that has replaced it is also extinguished. Typically studied in nonhuman animals, the resurgence effect may provide insight into relapse that is seen when reinforcement is discontinued following human contingency management (CM) and functional communication training (FCT) treatments, which both involve reinforcing alternative behaviors to reduce behavioral excess. Although the variables that affect resurgence have been studied for some time, the mechanisms through which they promote relapse are still debated. We discuss three explanations of resurgence (response prevention, an extension of behavioral momentum theory, and an account emphasizing context change) as well as studies that evaluate them. Several new findings from our laboratory concerning the effects of different temporal distributions of the reinforcer during response elimination and the effects of manipulating qualitative features of the reinforcer pose a particular challenge to the momentum-based model. Overall, the results are consistent with a contextual account of resurgence, which emphasizes that reinforcers presented during response elimination have a discriminative role controlling behavioral inhibition. Changing the "reinforcer context" at the start of testing produces relapse if the organism has not learned to suppress its responding under conditions similar to the ones that prevail during testing.

Renewal, resurgence, and alternative reinforcement context

Resurgence, relapse induced by the removal of alternative reinforcement, and renewal, relapse induced by a change in contextual stimuli, are typically studied separately in operant conditioning paradigms. In analogous treatments of operant problem behavior, aspects of both relapse phenomena can operate simultaneously. Therefore, the purpose of this study was to examine a novel method for studying resurgence and renewal in the same experimental preparation. An alternative source of reinforcement was available during extinction for one group of rats (a typical resurgence preparation). Another group experienced an operant renewal preparation in which the extinction context was distinguished via olfactory and visual stimuli. A third group experienced alternative reinforcement delivery in the new context, a novel combination of typical resurgence and renewal preparations. Removal of alternative reinforcement and/or a change in context induced relapse relative to an extinction-only control group. When alternative reinforcement was delivered in a novel context, the alternative response was less persistent relative to when extinction of the alternative response took place in the context in which it was trained. This methodology might be used to illustrate shared (or distinct) mechanisms of resurgence and renewal, and to determine how delivering alternative reinforcement in another context may affect persistence and relapse.

Effects of reinforcer distribution during response elimination on resurgence of an instrumental behavior

Resurgence has commonly been viewed as the recovery of an extinguished instrumental behavior that occurs when an alternative behavior that has replaced it is also extinguished. Three experiments with rat subjects examined the effects on resurgence of the temporal distribution of reinforcement for the alternative behavior that is presented while the first response is being eliminated. Experiments 1 and 2 examined resurgence when rich rates of reinforcement at the onset of response elimination became leaner over sessions (i.e., forward thinning) and when lean rates became richer (i.e., reverse thinning). Both procedures weakened resurgence compared with that in a group that received the richest rate during all sessions. However, forward thinning was more effective than reverse thinning at reducing the resurgence effect. Experiment 3 found that final resurgence was eliminated when the alternative behavior was reinforced and extinguished in alternating response elimination sessions. The results are consistent with the hypothesis that reinforcer delivery during response elimination provides a contextual stimulus for the extinction of the original behavior; its removal during resurgence testing causes ABC renewal to occur. The results are less consistent with an alternative account that emphasizes the removal of response disruption caused by alternative reinforcement (Shahan & Sweeney, 2011). Other theoretical and applied implications are discussed.

Resurgence of sucrose and cocaine seeking in free-feeding rats

Resurgence is relapse of an extinguished operant response following the removal of alternative reinforcement. In animal models of resurgence to date, rats have been food deprived and food is used as the source of alternative reinforcement. Thus, when the alternative reinforcer is removed, the only remaining source of food during experimental sessions is no longer available. Acute food deprivation is known to produce reinstatement of drug seeking, thus such deprivation has been suggested a potential mechanism of resurgence. The present experiments examined whether resurgence of sucrose and cocaine seeking could be obtained with rats that were not food deprived. Free-feeding rats were trained to press a lever for either sucrose (Experiment 1) or cocaine infusions (Experiment 2). Next, lever pressing was extinguished and an alternative response (nose poking) was reinforced with sucrose. When nose poking was also placed on extinction, resurgence of both sucrose and cocaine seeking was observed. Thus, resurgence of both sucrose and cocaine seeking can be obtained in rats that are not food restricted and it appears unlikely that an acute hunger state is responsible for resurgence. In addition, the present procedures for studying resurgence in the absence of interpretive complexities introduced by the use of food-deprivation may prove useful for further investigations of the neurobiological mechanisms of resurgence.

Why behavior change is difficult to sustain

Unhealthy behavior is responsible for much human disease, and a common goal of contemporary preventive medicine is therefore to encourage behavior change. However, while behavior change often seems easy in the short run, it can be difficult to sustain. This article provides a selective review of research from the basic learning and behavior laboratory that provides some insight into why. The research suggests that methods used to create behavior change (including extinction, counterconditioning, punishment, reinforcement of alternative behavior, and abstinence reinforcement) tend to inhibit, rather than erase, the original behavior. Importantly, the inhibition, and thus behavior change more generally, is often specific to the "context" in which it is learned. In support of this view, the article discusses a number of lapse and relapse phenomena that occur after behavior has been changed (renewal, spontaneous recovery, reinstatement, rapid reacquisition, and resurgence). The findings suggest that changing a behavior can be an inherently unstable and unsteady process; frequent lapses should be expected. In the long run, behavior-change therapies might benefit from paying attention to the context in which behavior change occurs.

Effects of inter-food interval on the variety effect in an instrumental food-seeking task. Clarifying the role of habituation

Food variety increases consumption and the rate of instrumental behavior that is reinforced by food in humans and animals. The present experiment investigated the relationship between the variety effect and habituation to food by testing the role of the interval between successive food presentations on responding in an operant food-seeking task. Habituation to food was expected at short, but not long, interfood intervals. The effects of variety on food's long-term reinforcing value were also tested. Four groups of rats were trained to lever-press on different random-interval (RI) schedules of reinforcement to earn 45-mg food pellets. Half the rats in each group received an unpredictable mix of grain and sucrose pellets, while the other half consistently received sucrose pellets. Response rate began at a high rate and then decreased within each 30-min session for groups that received short inter-pellet intervals (i.e., RI-3 s and RI-6 s reinforcement schedules) but not in groups that received longer inter-pellet intervals (i.e., RI-12 s and RI-24 s). A variety effect in the form of higher responding in the mix group than the sucrose-only group was also only evident at the shorter intervals. Habituation and variety effects were also most evident with the short intervals when we controlled for the number of reinforcers earned, suggesting that they were not merely due to rapid satiation. The variety effect also appeared quickly when groups trained with longer inter-pellet intervals (RI-12 s and RI-24 s) were transitioned to shorter intervals (RI-3 s and RI-6 s). There was no effect of variety on resistance to extinction or on resistance to the response-suppressing effects of pre-session feeding. The results more clearly link this version of the variety effect to the short-term effect of variety on food habituation.

Examination of the role of dopamine D₂ and adrenergic α₂ receptors in resurgence of food seeking

Resurgence refers to the reappearance of an extinguished operant behavior when reinforcement for an alternative behavior is also subsequently discontinued. Resurgence has been noted as a source of relapse to problem behavior following interventions involving alternative reinforcement, and has also been recently used as an animal model of relapse to drug seeking induced by reinforcement loss. Existing information about the neuropharmacology of resurgence is scarce, but suggests overlap between relapse observed in the resurgence model and relapse observed in reinstatement and renewal models. In the present experiment rats earned food pellets for pressing a target lever in Phase I. In Phase II lever pressing no longer produced food, but food was delivered for an alterative nose poke response. Finally in Phase III, neither response produced food deliveries. Prior to these Phase III sessions, separate groups of rats were injected with 0, 50, or 100 μg/kg of the dopamine D2 receptor antagonist raclopride or 0, 20, or 40 μg/kg of α 2 agonist clonidine. Both doses of raclopride were effective in blocking resurgence, but there was evidence that the higher dose did so via motor rather than motivational impairment. Only the higher dose of clonidine blocked resurgence, but did so with no evidence of motor impairment. Raclopride significantly impacted extinction of the alternative poke at both doses tested, whereas clonidine had no effect at either dose. The results of the present study provide additional information about the neuropharmacology of resurgence, as well as additional evidence of overlap between resurgence, reinstatement, and renewal.