THE EFFECTS OF A NEUROLEPTIC DRUG ON ADAPTIVE AND DISRUPTIVE BEHAVIOR OF RETARDED ADULTS.
AuthorWESTLAKE, LAURIE ANNE.
KeywordsPeople with mental disabilities -- Care -- United States.
People with mental disabilities -- Institutional care -- United States.
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PublisherThe University of Arizona.
RightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
AbstractSingle subject research procedures were used to evaluate the following effects of Mellaril, a neuroleptic, on adaptive and disruptive behaviors of three institutionalized retarded people: (1) documentation of social interactions, activity level, vocational performance, repetitive motoric behavior, disruptive incidents, and possible tardive dyskinesia to determine which behaviors changed during drug and placebo conditions, and (2) individualized clinical evaluation to determine whether drug therapy decreased disruptive behavior and increased or interfered with adaptive functioning. Each subject received individualized Mellaril dosages and served as his/her own control in reversal designs. All subjects were abruptly withdrawn from the drug. One subject (125 mg.) underwent B-A-B while two subjects (60 mg., 250 mg.) underwent B-A-B-A phases, where B indicated the drug condition and A indicated the placebo condition. Each phase lasted approximately one month. A fourth subject underwent B-A phases and was dropped from the study due to an epileptic convulsion. Pharmacotherapy for this disorder confounded Mellaril-behavior relationships. A trained observer recorded occurrence of behavior on weekdays within the institution including 15 minutes per subject in residential settings and five minutes per subject in vocational settings. Institutional staff documented daily frequencies of incidents including aggression and property destruction. Institutional staff, the trained observer, and the subjects were not told the timing of drug/placebo changes. The results indicated that the following behaviors increased following drug withdrawal: vocational performance, talking, looking at and proximity to others, and talking/laughing to self. Activity level decreased upon drug withdrawal. The following patterns of disruptive behavior were subject-unique: one subject (250 mg.) clearly showed the most incidents while on-drug; one subject (60 mg.) did not show changes during the first drug withdrawal, but showed increases during the second; and the third subject (125 mg.) engaged in incidents at steadily increasing rates during all conditions. The applicability of single subject designs to applied behavioral pharmacology is discussed. Variables within an applied setting which potentially obfuscate drug-behavior relationships are identified. Suggestions for future research are offered.