Page 54

S3

O "3 HH

n 5/3

5/3

m > C/3 w

and head jerking and shaking, to eyelash plucking, fingernail biting and thumb sucking. All were first involved in a week's recording of the frequency of their behaviour. This process was termed 'registration'. It was an integral part of the treatment programme, as the behaviour in question had to be made conscious before modification could be successful. Each patient then required a tailormade new behaviour pattern which (a) was opposite to the old habit, (b) could be maintained for several minutes, (c) was socially acceptable and compatible with normal activities, and (d) strengthened the muscles antagonistic to those used in the old habit. Those with head jerking and head shaking were instructed about isometric contraction of the neck muscles. For eyelash picking, thumb sucking and fingernail biting the advice was to grasp a suitable object until muscular tension could be subjectively detected in the arms. Habit reversal reduced the undesired behaviours by at least 90% for all subjects after three weeks. A longer term follow-up showed excellent results for seven of the subjects. It was concluded that habit reversal could be an effective behavioural technique for patients of all ages and for both high and low frequencies of undesirable habitual behaviours.

3.3 Applications for Atopic Skin Disease — Research

44

Prior to the work done by Azrin and Nunn, the relationship between the histological appearance of long-standing atopic skin disease and rubbing and scratching had been clearly linked by experimental work using 'scratching machines': experiments with mechanical irritation on normal skin and patients with atopic skin disease produced similar histologic reactions, the main characteristics of which are identical to those seen in long-standing atopic skin disease (see Appendix 9 for References and Further Reading). Could the habit reversal techniques of Azrin and Nunn be adapted therefore for the management of scratching behaviour in atopic eczema? Here the nervous habit is

Profile for Christopher Bridgett

Atopic Skin Disease - A Manual For Practitioners  

An account of a new behavioural approach to the treatment of atopic eczema, written for practitioners, but also for patients

Atopic Skin Disease - A Manual For Practitioners  

An account of a new behavioural approach to the treatment of atopic eczema, written for practitioners, but also for patients