A Systematic Review of the Effectiveness of Behavioral Treatments for Pica in Youths.

The objective of this study is to systematically review the empirical evidence for the effectiveness of behavioral interventions for pica in children and adolescents and to generate treatment recommendations. A systematic search yielded 823 articles extracted from five databases: CINALH, Family and Society Studies Worldwide, Medline, PsycINFO, and Web of Science. Two reviewers completed initial sorting based on article titles and abstracts. Five reviewers completed sorting based on full article review. Thirty articles were included and double coded for demographic information, comorbid conditions, and intervention characteristics. These studies were case studies involving behavioral treatments for pica. Seventeen behavioral interventions were categorized into four treatment approaches: reinforcement-based, response interruption, "other" interventions, and punishment-based procedures. Interventions that resulted in near-zero rates of pica were deemed effective. Findings showed support for contingent reinforcement, discrimination training as part of a combination treatment, physical restraint, time out, and contingent aversive stimulus. No evidence supported the effectiveness of response interruption procedures, including response blocking and visual facial screen. "Other" coded procedures did not appear effective. We recommend that the least restrictive procedures are implemented first, including a combination treatment with contingent reinforcement and discrimination training...
Source: Clinical Psychology and Psychotherapy - Category: Psychiatry Tags: Clin Psychol Psychother Source Type: research