The possible function of positive reinforcement in home-bound agoraphobia: a case study

We conducted an uncontrolled case study (ABA design) based upon the hypothesis that the behavior of a home-bound agoraphobic is at least partially maintained by positive reinforcement in the home and that a disruption of access to home-based reinforcement would lead to an increased frequency of out-of-the-home behavior. Data concerning the types and amounts of behavior engaged in by the subject within the confines of her home and yard were gathered during a 30-day base line period. In addition, potential reinforcers in the home were identified by a survey schedule and by self-report of time allocation. During an 18-day intervention period the subject agreed only to engage in certain reinforcing activities outside her home (e.g., only watching television at a neighbor's house). Postintervention results indicated that for the first time in over 7 years the subject began engaging in out-of-home activities, including walking to other parts of the street, visiting several neighbors' homes, and attending parties at neighbors' homes. Moreover, data suggested a positive trend in time spent outside the yard during both 2 and 18 month follow-up periods. However, significant restrictions in the range of mobility were still observed.