Aversion therapy
| Aversion therapy | |
|---|---|
| Intervention | |
| ICD-9-CM | 94.33 |
| MeSH | D001348 |
Aversion therapy is a form of psychological treatment in which the patient is exposed to a stimulus while simultaneously being subjected to some form of discomfort. This conditioning is intended to cause the patient to associate the stimulus with unpleasant sensations with the intention of quelling the targeted (sometimes compulsive) behavior.
Aversion therapies can take many forms, for example: placing unpleasant-tasting substances on the fingernails to discourage nail-chewing; pairing the use of an emetic with the experience of alcohol; or pairing behavior with electric shocks of mild to higher intensities.
The major use of aversion therapy is for the treatment of addiction to alcohol and other drugs. This form of treatment has been in continuous operation since 1932. The treatment is discussed in the Principles of Addiction Medicine, Chapter 8, published by the American Society of Addiction Medicine in 2003.
Among more-casual members of the self-help community, minor behavioral issues have been treated with the aid of an elastic band; the user snaps the band against his/her wrist while performing the undesirable behavior, seeking to create an unpleasant association and, ultimately, stop or the behavior pattern.
A strong precedent of the successful effects of aversion therapy is Disulfiram, or Antabuse,is an acetaldehyde dehydrogenase inhibitor. This enzyme is responsible for a portion of the metabolism of alcohol and, when inhibited, causes hangover-like effects almost immediately after consuming alcohol, thus promoting an unpleasant association with a chemical dependence. However, most patients never drink on it because they are aware of the negative effect, and instead, use it to help counter urges to drink while they are developing other coping skills and hope that over time the craving for alcohol will be extinguished from not being reinforced. Prior studies have shown Antabuse brings relief to the majority of its users, describing, "Patients who could not remain sober from one visit to the next achieved many months of continuous sobriety." More recent studies have compared aversion to "Minnesota Model" programs and have found patients matched on 17 baseline characteristics, to have higher abstinence rates at 6 and 12 months with the aversion. Traditional aversion therapy, which employed either chemical aversion or electrical aversion while effective, is commonly replaced with aversion imagery, a technique which is known as covert sensitization. Covert sensitization, or covert conditioning, involves provoking mental imagery to create associations with undesirable habits. While the efficacy of covert conditioning may be comparable to that of more-prevalent techniques in aversion therapy, these treatments may be combined to enhance an individual's likelihood for success in ending an unwanted habit.
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