A translational evaluation of potential iatrogenic effects of single and combined contingencies during functional analysis

Abstract

Recent research suggests that combining putative reinforcers for problem behavior into a single, synthesized contingency may increase efficiency in identifying behavioral function relative to traditional functional analysis (FA). Other research suggests potential shortcomings of synthesized contingency analysis (SCA), such as the potential for false-positive outcomes. In prior comparisons of traditional FAs and SCAs, investigators could not ascertain with certainty the true function(s) of the participants' problem behavior for use as the criterion variable. We conducted a translational study to circumvent this limitation by training a specific function for a surrogate destructive behavior prior to conducting a traditional FA and SCA. The traditional FA correctly identified the previously established function of the target response in all six cases and produced no iatrogenic effects. The SCA produced differentiated results in all cases and iatrogenic effects (i.e., an additional function) in three of six cases. We discuss these findings in terms of the mechanisms that may promote iatrogenic effects.

Further comparison of isolated and synthesized contingencies in functional analyses

“…The results of both analyses therefore matched the results of both the structured and unstructured observations. However, the finding that problem behavior served a tangible function as identified by the isolated FA should be interpreted with caution as it was not observed until after problem behavior had been exposed to the synthesized contingency, suggesting an iatrogenic effect (Retzlaff et al, 2020).…”

On the validity of data produced by isolated and synthesized contingencies during the functional analysis of problem behavior

“…For this reason, treatment outcomes alone cannot be used to characterize an assessment's accuracy in identifying the true presence or absence of a nominated moderator. Retzlaff et al (2020) provided a unique, third approach that could be used to characterize assessment accuracy (i.e., the sensitivity and specificity of functional analysis results). In this translational, laboratory-based evaluation, the experimenters taught participants to engage in an "analog" to problem behavior (e.g., touching a foam square) resulting in access to a preferred leisure item, attention, or the termination of instruction.…”

Efficiency in functional analysis of problem behavior: A quantitative and qualitative review

“…As such, additional research is needed involving within‐subject comparisons of the results of the synthesized contingency analysis with those of other types of FAs to determine whether synthesizing contingencies in this manner obtains its efficiency at the cost of accuracy (potentially increasing false positive or negative outcomes; cf. Fisher, Greer, Romani, Zangrillo, & Owen, ; Greer, Mitteer, Briggs, Fisher, & Sodawasser, ; Retzlaff, Fisher, Akers, & Greer, ).…”