Researchers report increasing trends in psychotropic medication use to treat problem behavior in individuals with intellectual and developmental disability, despite some controversy regarding its application and treatment efficacy. A substantial evidence base exists supporting behavioral intervention efficacy, however research evaluating separate and combined intervention (i.e., concurrent application of behavioral and psychopharmacological interventions) effects remains scarce. This article demonstrates how a series of analyses on clinical data collected during treatment (i.e., four case studies) may be used to retrospectively explore separate and combined intervention effects on severe problem behavior. First, we calculated individual effect sizes and corresponding confidence intervals. The results indicated larger problem behavior decreases may have coincided more often with behavioral intervention adjustments compared to medication adjustments. Second, a conditional rates analysis indicated surges in problem behavior did not reliably coincide with medication reductions. Spearman correlation analyses indicated a negative relationship between behavioral intervention phase progress and weekly episodes of problem behavior compared to a positive relationship between total medication dosage and weekly episodes of problem behavior. However, a nonparametric partial correlation analyses indicated individualized, complex relationships may exist among total medication dosage, behavioral intervention, and weekly episodes of problem behavior. We discuss potential clinical implications and encourage behavioral researchers and practitioners to consider applying creative analytic strategies to evaluate separate and combined intervention effects on problem behavior to further explore this extremely understudied topic.

研究人员报告说，尽管关于精神药物的应用和治疗效果存在一些争议，但精神药物用于治疗智力和发育障碍个体的问题行为的趋势正在增加。存在大量支持行为干预效果的证据基础，但是评估单独和联合干预（即同时应用行为和心理药理学干预）效果的研究仍然很少。本文展示了如何使用对治疗期间收集的临床数据的一系列分析（即四个案例研究）来回顾性地探索单独和联合干预对严重问题行为的影响。首先，我们计算了个体效应大小和相应的置信区间。结果表明，与药物调整相比，更大的问题行为减少可能更频繁地与行为干预调整同时发生。其次，条件利率分析表明问题行为的激增与药物减少并不可靠一致。Spearman 相关分析表明，行为干预阶段进展与每周问题行为发作之间存在负相关关系，而药物总剂量与每周问题行为发作之间存在正相关关系。然而，非参数偏相关分析表明，总药物剂量、行为干预和每周问题行为发作之间可能存在个体化、复杂的关系。