Stimulus control and extinction of psychosomatic symptoms in cancer patients in protective isolation

Evaluated the use of multiple therapists in the extinction of psychosomatic symptoms (coughing and retching) in 2 acute leukemia patients--a 24-yr-old male and a 63-yr-old female. Baseline assessments of symptom frequency showed that Ss were under stimulus control of ward nurses (WNs). Intervention involved the application of extinction (ignoring symptoms) and differential reinforcement (social attention) by WNs assigned to patient care. The 1st WN to implement these procedures for each patient achieved symptom suppression after 32 (S 1) and 40 (S 2) applications. In the presence of all other WNs, however, symptom occurrence continued. During the next phase a 2nd WN applied these procedures and, after 25 (S 1) and 23 (S 2) entrances, the symptoms were extinguished. However, the symptoms continued in the presence of hospital staff until 4 separate WNs had successfully applied the extinction/differential-reinforcement procedure. Extinction occurred more rapidly (requiring fewer entrances) with each successive WN. At 2-wk and 6-mo follow-up evaluations, the symptoms had not reappeared, and no new problems had developed. (16 ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved).