Treatment of laxative abuse in a female with bulimia nervosa using an operant extinction paradigm

J Subst Abuse. 1990;2(3):381-8. doi: 10.1016/s0899-3289(10)80010-0.

Abstract

Chronic laxative abuse was treated using an operant extinction paradigm in a 29-year-old woman with bulimia nervosa. Access to self-administration of laxative and placebo were alternated in an ABAB design. Outcome was measured by self-reported craving for laxatives and rates of drug self-administration. During baseline, the subject exhibited high rates of both craving and self-administration. During placebo phases, cravings and drug self-administration declined. Both measures increased when active drug was reinstated. The final return to placebo led to a decrease in craving and extinction of drug self-administration to zero doses per day. This paper introduces the concept of laxatives as reinforcers and provides a new approach to the treatment of laxative abuse in women with bulimia nervosa.

Publication types

  • Case Reports
  • Clinical Trial

MeSH terms

  • Adult
  • Behavior Therapy / methods*
  • Bulimia / psychology
  • Bulimia / rehabilitation*
  • Cathartics*
  • Cognitive Behavioral Therapy / methods
  • Combined Modality Therapy
  • Conditioning, Operant*
  • Double-Blind Method
  • Extinction, Psychological*
  • Female
  • Fluoxetine / administration & dosage
  • Humans
  • Substance-Related Disorders / psychology
  • Substance-Related Disorders / rehabilitation*

Substances

  • Cathartics
  • Fluoxetine