Treatment of excessive crying in a terminal cancer patient: a time-series analysis

Spectral analysis was used to investigate the modification of the excessive crying (48% of waking time observed during baseline) of a terminal cancer patient. Initial assessment revealed a cyclic pattern of crying and dozing throughout the day and night. Intervention involved timeout from social stimulation contingent upon crying and differential social reinforcement for behaviors incompatible with crying. Analysis showed the gradual elimination of crying during the 15-day intervention. During the initial phase of intervention crying ceased to be emitted in the presence of hospital staff but was evoked by the presence of family members. As this pattern of crying diminished, the frequency and duration of family visits, as well as the frequency of positive patient utterances and conversation, increased. Clinical, ethical, and methodological issues surrounding the use of timeout are discussed.