Self monitoring and intervention for ring fidgeting habit

Self monito aura and intervention for ring fidgeting manipulationHabits are said to form when utilizing the same behaviour regularly and consistently in a similar situation for the same purpose. They are performed with minimal thinking and little deliberation and can be considered an automatising of behaviour. While efficiency in cognitive capabilities is achieved garments beat information to be ignored, neer influencing performance of the costume as outcomes as a resoluteness of the manipulation are overly satisfactory. It has been suggested that smashing intentions are not acted upon if interfered by the costume meaning the short term rewards become opposing to long term intentions. It is then that behaviours are identified as bad apparels, substance abuses that lead actions providing positive outcomes in the short term, and ca exploitation negative outcomes in the long run including vile habits, motor tics and stuttering.Nervous habits are defined as unchanging, auto matic behaviours that do not serve any social purpose. Examples include apply to head habits such as nail biting or hairsbreadth pulling oral habits such as lip or tongue biting or any repetitive movement such as lettuce or object manipulation. Hansen, Tishelman, Hawkins Doepke (1990) and forest, Miltenberger, Flach, (1996), suggest that hand to head and oral habits are or so prevalent in the everyday population. In a study of college students, Woods et al. (1996) reported that 15% of students engaged in hair manipulation, 10% nail biting, 22% chewing of their mouth or lips, charm 22% reported manipulating objects such as pens or jewelry. Fidgeting is defined as engaging in actions that are peripheral or nonessential to ongoing focal tasks or yields (Mehrabian Friedman, 1986) involving engagement in actions, movement or manipulation of ones own body or implementation of actions onto other objects and can hereby be categorized as a offensive habit. Woods and Miltenberger (1996) concluded that habits such as hair and face manipulation were present in fretfulness- agitative conditions while object manipulations were recorded when players felt bored. terzetto potential explanations exist in relation to how such habits are developed and maintained. Firstly, habits are said to be negatively reinforced by decreasing latent hostility, imputable to automatic negative advantages, such as reduction in anxiety and dialect. Secondly, habits provide self- stimulatory advantages, such as increase in concentration or focus, and so aiding in production of reinforced outcomes. Nervous habits are to a fault hypothesized to represent a group of behaviours that are dod by schedule-induced or adjunctive behaviours occurring as a result of cartridge holder- base schedules such as fixed-time or fixed-interval schedules (Miltenberger, Fuqua, Woods, 1998), possibly to fill time between reinforces and other behaviours. However, habits do not tend to interfere great ly in a persons functioning, as in some cases they whitethorn help the individual focus, concentrate or feel aroused scarcely are known to bewilder annoyance to the individual or those around them. In some cases, where the frequency may become unwarranted numerous negative outcomes can be attri aloneed to nervous habits. For instance hand related habits can lead to risk of transmission while others cause negative social consequences, such as little or no social acceptance. It is when habits occur frequently or intensely that treatment is sought.Several new behavioural technologies name been developed by means of the assessment of treatments using group treatment- outcome and individual histrion designs as tumesce as several case study experiments with the latter seen inadequate for drawing valid, scientific interpretations. Controlled single and group experiments, specifically those using repeated, objective measures with mouse or multiple base line designs sacrifice bee n shown to have scientific merit (Peterson, Campise and Azrin, 1994), detailing impacts of treatments on the behaviour. Such treatments have been effective in reducing the frequency of habit disorders by over 90% and eliminating them in 40 to 70% of the cases (Peterson et al., 1994) with habit reversal treatment ( hormone-replacement therapy) found to be consistent in demonstrating high effectiveness and applic susceptibility to a range of habits.Habit reversal involves several components aimed at change magnitude habit sensory faculty, developing competing responses, building and sustaining motivation and compliance as well as incorporating operant and anxiety management techniques (Piacentini Chang, 2005) to effectively treat habits. Azrin and Nunn (1973) successfully do by 12 clients who exhibited habits for up to 7 course of instructions, through the implementation of the 4 key stages of hormone replacement therapy awareness readying, competing response training, habit c hair motivation and generalized training. cognisance training included components such as response description, where clients are asked to describe the details of the habit behaviour response detection where therapists reported occurrences of the habit to the participant almost immediately after occurrence an early warning procedure where clients became aware of the earliest signs of the habit and situation awareness where an analysis was implemented to arrive at high-risk situations where the habit may occur. Competing response practice abstruse the client developing a short and socially acceptable behavioural pattern setback to the habit, ordinarily through a shaping technique. In the case of nervous habits involving hands clients were instructed to place his/her hands down by the sides, and to clench their fists until they could feel tension in their arms and hands (Azrin and Nunn, 1973). Motivational procedures such as habit inconvenience and social support procedures were used with reviews of the inconveniences, embarrassment or suffering experienced implemented while family members positively reinforced the individuals efforts when habit free distributor points was noted. Clients were asked to perform the CR correctly in the presence of a councilor, while also taught a symbolic rehearsal technique, where clients imaged habit eliciting situations, their detection of the habit behaviour and performance of the appropriate CR for a required 15 minutes. Clients were also reinforced and reminded of their habit under more casual situations, and were required to elicit the CR for 3 minutes, a technique known as generalized training. The study reported a significant reduction in habit occurrence of 90% after a single session, with an increase to 99% three months after treatment.Similarly, Azrin, Nunn, and Frantz (1980) investigated the effects of HRT on habits, comparing it to negative practice a technique similar to HRT, but diverse, as the habit was perf ormed for 30 second periods over an hour period, for from each one one day until four days after the habit was undetectable while participants were telling themselves they should not be doing the habit. It was reported that the HRT was more effective, as HRT reduced habits by one third. Woods, Miltenberger Lumley (1996) reviewed the effectiveness of awareness training, self-monitoring, social support, and competing responses in 4 children. Woods et al. concluded that, while all stages were successful, self-monitoring should be used as the initial stage in treatment, with other components implemented after awareness has been detected. Additionally, the use of anxiety and operant techniques, have also rearn successful in treatment of habits. Anxiety management techniques, such as breathing exercises, muscle relaxation and imagery have been implemented as increases in stress and anxiety lead to concomitant increases in tic frequency, intensity and duration (Cohen, Friedhoff, Leckma n, Chase, 1992). Although unsuccessful individually, benefits have been detected in multi-component treatments such as HRT. Similarly, operant techniques, in forms of contingency management, stand for the manipulation of environmental contingencies so that tic-free intervals are positively reinforced, and tic behaviors are punished (Piacentini Chang, 2005).They should only be used in instances where a clear relationships between the habit and the environmental contingencies are observed. The aim of this study is to suggest an effective intervention or treatment to reduce the occurrence of object fidgeting in a 19 year old female. It is hoped that through the implementation of this HRT, the habit in brain is effectively treated, hereby providing the client with a long term solution.Method musicianThe participant of this study was a 19 year old Western, middle class, female undergraduate psychology student who expressed interest in reducing the frequency of a nervous habit, specif ically the habit of fidgeting in form of manipulation of an object.Operational definitionFidgeting, in this instance, was the engaging in one particular proposition action, non-essential and external to ongoing tasks. Focus was primarily upon the manipulation of an object in this case the action of fidgeting with a ring. Actions involved the individual using their right hand or left hand fingers to turn the ring into a circle around the finger of which the ring was present. The instance where the individual may have been pathetic the ring back and forth while on the finger was also counted. Taking the ring on and off the finger meaning the individual took the ring off and put the ring back on was not taken into account. Ring fidgeting can be classified as an excess nervous behavior that is unwanted, and therefore should be decreased in frequency, duration or intensity. This behavior was monitored due to its relative high frequency in Participant Xs everyday life. excerption and jus tification of monitoring methodAssessment of the behavior was achieved through the method of an event save, self- monitoring method. The participant was asked to record the frequency of the habit over a period of 14 days as well as the time the behavior occurred, when and where it occurred, who was around and what happened before and after the habit was detected. Event recording measures the occurrence, either frequency or duration of a low to medium occurring behavior during a specific time interval. This method was used as event recording has been proven effective when wanting to increase or decrease the occurrence of a habit or behavior, while also allowing the behavior in question to be clearly identified as having a beginning and an end. In this case also the habit did not happen at such an positive high rate that the event itself was difficult to record. Similarly, a self-monitoring method, while less costly and convenient, could prove ineffective as it is possible the act of self behavioural assessment may actually reduce the frequency of the habit, with the individual becoming highly aware of the behavior and as a result consciously or subconsciously decrease the act of the behaviour.ResultsResults obtained from the self-monitoring of Participant Xs ring fidgeting habit over the 14 day, self monitoring period are illustrated in Figure 1 below. As the graph illustrates, participant Xs mean of ring fidgeting (M = 3.93) over the 14 day period proves comparatively low. A range between extreme gobs of 7 was obtained, while the lowest number of fidgets occurred on Day 14 and the highest on Day 7 of monitoring. It is hypothesized that due to the participants preoccupied nature, no incidences were recorded on day 14 of monitoring. It is possible that the reason for high detection of fidgets on Day 7 could be as a result of Xs high levels of stress and fatigue and anxiety associated with her university lifestyle. The frequency of the behavior increased for the first three days, decreased for a day, increased for the following three days, reaching its peak on Day 7. The behavior then decreased abruptly, occasionally increasing, before leveling off for two days and finally becoming undetectable by the hold up day of monitoring. Of all days, day 14 proved to be different to the other days of monitoring, with no detection of the habit recorded.ContextualStudying for university exams recalling facts and information, usually when aloneWorking on assignments and essays mainly when researching or planning, even writing, usually aloneOn the train/ waiting for train to go to university in the dayspring and afternoon- around raftFeeling tired after long day at university or after long day studying around people and when aloneWhen not really doing anything waiting to get home on the train, or waiting for the trainImmediateFeeling stressed or unhinged about exams, too many assignments a lot to do, little time to do it inFeeling overwhelmed and stressed about amount of work required to be done for university- things like assignments, studying for examsFrustration when not able to recall facts and information for examsFeelings of boredom when not doing much usually when knows has much to do- in particular when on the train to university or back home as most of the time it is very busy and cannot do much university work- feels like she is wasting timeFeeling annoyed about what is calamity in life, even in the rest of the world (war etc)- annoyed at the fact that she may not be doing enough in regards of her assignment work or studying some instances annoyance may be due to hearing something on the news or reading about something that she may not agree withFeeling tired- usually effects the participant in terms of lack of concentration and allows the forbearing to leave out focus on the taskThe participant sometimes lacks self-confidence, sometimes feels anxious and uncertain when doing assignment work, university work or when in situations where things seem to go ravish unexpectedlyThe participant sometimes experiences soupcons of overwhelm, annoyance and frustration when unable to do certain tasks most prominently task relating to her university public lifeBelieves that she needs to do well at university and therefore is mindful of what she is required to do must perform well in order to gain excellent qualifications and therefore build a relatively valuewhile careerKnows that her university life depends on her ability to study efficiently to produce high standard assignments for her psychology coursesAlso highly believes that what is happening in the world now is going to affect everyone and everything including her family, her friends and herself- somehow hopes to make a difference which may lead again to the pressure which the patient feels when it comes to her career or in this case- how her university exams and assignments (grades) will impact on her ability to get to that level = pre ssure = anxiety, stress, frustration and feelings of overwhelmRing FidgetingFidgeting, in this instance, was defined as engaging in one particular action, non-essential and external to ongoing tasks. Focus was primarily upon the manipulation of an object in this case the action of fidgeting with a ring. Actions involved the individual using their right hand or left hand fingers to turn the ring into a circle around the finger of which the ring was present. The habit was observed during the participants waking hours.ImmediateReduction in anxiety and stress levels = feels calmer and peacefulReduction in levels of frustration or disappointmentReduction in boredom = preoccupation- has a distraction from her anxiety provoking thoughts feels like she is doing something and able to fill timeIncrease in ability to recall facts and information for university exams, ability to work efficiently and faster on assignmentsIncrease in ability to focus and concentrate on the task at hand and make g ood progress on the taskNo reduction in level of tiredness still reports to feel fatigueReduction in self-consciousnessAllows the patient to take time out from her busy life and reflect, possibly clear her thoughtsLong TermPossible injure to surrounding skin areasRisk of infection if the behaviour becomes excessiveAs a result of above consequence possible inability to write or typePossible loss of feeling if the behavior is excessiveAs a results of all these, the individual could experience little social acceptance meaning that as a result of the damage to skin areas, which does not look nice and is not very attractive- people around the individual may never make friends or even possibly marryThis may lead to depression- as such a problems as being cast out of a social groups, or possibly never having a partner or friends can lead to the patient becoming depressed- feeling down, or feeling like everything may pointless and not worth itNegative reinforcementNegative reinforcementN egative reenforcementPositive ReinforcementPositive ReinforcementPositive PunisherNegative reinforcementPositive ReinforcementPositive PunisherPositive PunisherNegative PunisherNegative PunisherNegative PunisherPositive PunisherAs seen in the Table 1 above, participant X is a 19 year old female who has suffered from habitual ring fidgeting for the last year and a half. Historically, X reports the habit to have begun recently possibly since the commencement of her university life. The behavior may also be as a result of observations, while her busy university lifestyle and lack of sleep may elicit, but not directly cause the occurrence of the habit. Contextually, Xs habit occurs during times when completing university assignments, studying for university tests at home, travelling to and from university or when really not doing anything and reports feelings of anxiety, stress, worry, annoyance, frustration, fatigue or boredom when performing the behavior. She describes herself as lac king self-confidence, feeling pressured and uncertain at times about her university work, believing that she must perform well, while highly regarding current world events to play a part in her future. X reports that when fidgeting she experiences relief from anxiety, frustration, boredom and self-consciousness and experiences increased ability to recall facts and information, concentrate and focus and to clear and reflect on her thoughts, but report little change in her level of tiredness. Long term consequences in this instance were not detected as the client has experienced the habit for a short time. Hereby, based on the immediate consequences it can be said that the relief and increase in abilities which X feels when fidgeting appears to surpass any variety show of immediate negative outcome the habit may impose.DiscussionThe aim of this study was to implement an effective treatment to reduce the occurrence of object fidgeting of a 19 year old female. It is hoped that through the implementation of this treatment the habit in question is effectively reduced and controlled by the participant. Frequency monitoring of the habit suggests that ring fidgeting in this case was not severe, as the mean fidgets over the 14 days were relatively low. The participant reports that she feels stressed, worried, annoyed, frustrated, tired or bored when performing the behavior but reports that as a result she experiences relief from anxiety, frustration, boredom and self-consciousness as well as increased ability to recall facts and information, concentrate and focus on the task at hand but reports little change in her level of tiredness. The findings seem consistent with the literature outlined previously. As pointed out by Woods and Miltenberger (1996), nervous habits are prevalent in anxiety- provoking conditions with object manipulation habits recorded when participants feel bored. In this case, the habit seemed to have been present in both(prenominal) types of situat ions, with immediate stimuli including feelings of anxiety, frustration and boredom. Overall, it is evident that in this case the habit was negatively reinforced by a decrease in tension, mainly through negative reinforcements, such as reductions in anxiety, stress and boredom. Additionally, the participant also reported self-stimulatory advantages, with an increase in focus and concentration. Nervous habits were also hypothesized to be caused by schedule-induced or adjunctive behaviours occurring as a result of time-based schedules such as fixed-time or fixed-interval schedules (Miltenberger et al., 1998). It is possible that Xs habit may be a way to fill in time between behaviours in everyday life and normal reinforces, or be due to the specific stimuli or events. atrocious and long term consequences due to the habit could not be detected but it can be postulated that were the habit to occur excessively, X would possibly be at risk of infection, could experience little social acc eptance and as a result possibly depression.The frequency of ring fidgeting in this case was relatively small, causing no severe damage or impairment in the short term. But because of the possibility of it becoming over excessive, a modified stochastic variable of habit reversal treatment could be implemented to reduce the habit. This method is proposed for this case as HRT has been successful in decreasing frequency of habits by 90% after implementation, with further increase after treatment. X will be exposed to the 3 stages of HRT awareness training, competing response training and habit control motivation as well as operant and anxiety reducing techniques. X will be exposed to response description, where she will be asked to describe and demonstrate in detail the actions and behaviours of the habit response detection where those around X would report the occurrence of the habit immediately after each occurrence an early warning system where the client will be taught to be aware of even the earliest signs of fidgeting and finally situation awareness training where the client will be made aware of the high risk situations in which fidgeting may occur. It is known that awareness training would be effective in this case by making the occurrence of the tic an aversive event (via evaluation or demand characteristics) or that monitoring activities serve as punishers for tic expression (Piacentini Chang, 2005), while also reducing frequency of the habit.Participant X will also be asked to develop a short, acceptable competing response, performed on each occasion when the participant feels the urge to fidget implemented through shaping. In this case the action of placing her hands down by her side, simultaneously clenching her fists until tension is felt in both arms and hands, could serve as her CR. Shaping allows expression of the habit, while not blocking it but rather weakening the severe aspects of the habit behaviour. Appropriately, the habit could be shape d into more normal behaviours, meaning the CR should be designed to slow down the frequency of the habit, with X not eliciting the habit, but rather something different and appropriate, while also providing X with a different physical expression contingent, still allowing the reduction in negative feelings and positive outcomes. As more control is gained over the habit, the CR becomes increasingly more forceful with the ultimate goal of greater tic control (Piacentini Chang, 2005), and therefore fidgeting would be eliminate.In addition, several motivation procedures, including habit inconvenience and social support procedures are suggested. Reviews will be conducted in regards to the inconveniences experienced allowing a breakdown of symptoms, while also enhancing motivation for treatment and answer as a step forward in the acceptance of the habit. Close individuals will also be asked to reinforce each habit free period and correct use of techniques. In addition to the 3 intervent ion stages discussed X will also be exposed to several operant techniques, preferably through the manipulation of environmental contingencies. As there is a clear relationship between the habit and numerous contingencies, the participants habit free intervals, in the contexts where the habit is most frequent will be positively reinforced each time through a rewards system boosting compliance, while ring fidgets would be pointed out but not rewarded. In addition, strategies of reducing anxiety and stress should be introduced as a clear relationship exists between stress and anxiety triggers and habit frequency. The participant should be taught possible relaxation techniques, such as deep breathing or muscle relaxation, asked to monitor her relaxation levels and instructed to use them before anxiety provoking or stressful events, hereby possibly never eliciting the habit or reducing it greatly.While the above intervention could be used in its entirety, it must be pointed out that the habit of ring fidgeting is was not overly severe. Results did indicate a relatively low mean for the behaviour, which does indicate the habit as present, but only in relatively low frequencies over 14 days. All stages of the treatment above would have been more appropriate if the participant may have actually experienced severe long term consequences, or possibly more punishers in terms of contingencies. As most of the contingencies proved to be reinforces of reductions in negative feelings, it is possible that anxiety management individually, would serve appropriate, as a clear relationship exists between stress and anxiety triggers and habit frequency. Operant techniques and reinforcement of fixed-habit free periods could also prove successful, as X would learn, after some time that a reward would be given each time the desirable behaviour occurs, in this case the absence of the habit. Awareness training could also have been successful individually, as awareness of the habit to b e an aversive event could reduce the habit and also serve as a possible punisher to the participant hereby decreasing the habit and achieving the goal of this study. Because of the habit was detected as relatively low in frequency, possibly due the fact that X has only experience the habit for a short time a general HRT treatment would be considered to be inappropriate as such treatment has been successful at treating more long term and highly excessive habits.Additionally, ingrained self-monitoring and SORCK analyses used to analyze the patterns of antecedents and consequent events may not serve as valid in this case. Self monitoring in particular could prove ineffective, with a possibility that the act may actually reduce the frequency of the habit, with the individual becoming highly aware of the behavior and as a result consciously or subconsciously decreasing the act of the behaviour. Similarly, SORCK analyses were in turn based on self- monitoring and recording, and could be deemed equally as subjective. This study was based on the habit frequency of one subject and not a population of the individuals experiencing ring fidgeting. As this is the case, it is highly hypothesized that the data itself could be rather subjective and non representative of the whole population. Many individuals who self monitor may do so incorrectly and subjectively, as some habits are engaged in without awareness and can be missed, while it is also possible that participants could also underestimate overestimate occurences.