21 Scientific Studies on Aversion Therapy and Bad Habits

For nearly a century, doctors and scientists have studied the efficacy of electric shock and aversion to bad habits and changing behaviors. After rigorous testing, these researchers reported their results in peer-reviewed journals which are often cited in further studies.

This is a collection of scientific reports from the world’s top academic and medical institutions on aversion and bad habits. We’ve included summaries of each to help you better understand the science Pavlok is built on. ⚡️⌚️

1. 61.4% of subjects quit smoking with 5 days of aversive conditioning

A follow-up study was conducted at approximately one year post-treatment of a group of 832 clients treated at a commercial stop-smoking program. The treatment program employed five days of aversive conditioning for various smoking behaviors. It also included an educational and counseling component and a six-week support phase with weekly support groups and one conditioning reinforcement treatment in the second week.

The clients were contacted a mean of 13.7 months after completion of treatment. Fifty-two percent of all clients achieved their goal of total abstinence from cigarettes since the completion of the program. The factor most predictive of success or failure was whether or not the client returned to a home containing a smoker. Of those returning to a nonsmoking home, 61.4% of the men and 60.2% of the women were successful. Of those who returned to a smoking household, 70.2% returned to smoking.

This study demonstrates that the treatment process appears to be free of complications and is associated with successful outcomes in the majority of clients. Further improvement in outcome might result from simultaneous treatment of all household smokers.

Reference: Journal of Substance Abuse Treatment, Long Term Outcome of Clients Treated in a Commercial Stop Smoking Program, Vol. 5. pp. 33-36, 1988

2. 81.8% of nail biters have significant nail growth with electric shock therapy

Subjects (N=61) 31 males and 30 females, with a mean age of 19.75 yr and an average of 12 yr of nail-biting were randomly assigned to one of four groups: (1) shock, (2) negative practice, (3) bitter substance, and (4) attention-placebo control. A shock generator capable of delivering a measured voltage of 200 V at 10 mA was used to administer the faradic shock. Half of the subjects from each treatment condition were instructed to self-monitor their nail biting throughout treatment. All groups experienced an increase in nail growth, with no significant difference among the groups. However, self-monitoring subjects exhibited significantly greater increases in nail growth than non-self-monitoring subjects (p<.05).

Compared to the control condition, a significantly greater proportion of subjects in each of the three aversion treatment conditions had either ceased biting their nails or were biting less frequently 3 months later (p<.05). Moreover, there was a significant increase in awareness of nailbiting among individuals still biting their nails (p<.01). This increased awareness was experienced primarily by self-monitoring subjects. Awareness appears to be a crucial factor in the reduction of nail biting.

Reference: Vargas, John M., and Vincent J. Adesso. ‘A Comparison Of Aversion Therapies For Nailbiting Behavior’. Behavior Therapy 7.3 (1976): 322-329. Web.

3. Aversion study results in sustained weight loss of 9.17 pounds

PFavorite foods (CS) were paired with noxious odors (UCS) to help overweight Ss achieve and maintain weight loss. The average age of Ss was 39.56 years with a range of 18-60 years and the average weight was 181.67 lbs with a range of 152-237 lbs. All Ss had been defined as “overweight” according to the New Weight Standards (Statistical Bulletin, November 1959) and also by their physicians. After the 9-week conditioning period, a significant (obtained p = 0.002, significant at p<0.05) average weight loss for the six experimental Ss of 13.33 lbs compared with an average weight loss of 1.00 lb for the six control Ss was reported. After 48 weeks, the experimental Ss had an average weight loss of 9.17 lbs, while the control group had a weight gain of 1.33 lbs.

Reference: Foreyt, John Paul, and Wallace A. Kennedy. ‘Treatment Of Overweight By Aversion Therapy’. Behaviour Research and Therapy 9.1 (1971): 29-34. Web.

4. Skin scratching and hair picking disappear completely with 20-minute sessions

Behavior therapy provides important psychotherapeutic possibilities for the treatment of dermatological disorders. Compulsive scratching and trichotillomania can be treated by aversive conditioning. In documented case, a man aged 33 suffered from severe lichen simplex on the scrotum, thighs, and ankles, which had been present for 4 years and for which he had been admitted to the clinic three times, without any lasting result. The patient was seen once a day for a 20-minute session. He was instructed to bring his hand to scratch at a sign by the therapist. At the moment his hand reached the site he received an unpleasant, though not painful, electric shock via electrodes on the moving hand. He then had to draw back his hand and say aloud, ‘Don’t scratch’. After 19 days of treatment, the scratching disappeared completely.

Reference: BAR, LOUIS H. J., and BEN R. M. KUYPERS. ‘Behaviour Therapy In Dermatological Practice’. Br J Dermatol 88.6 (1973): 591-598. Web.

5. 12 hours of treatment can extinguish a 12-year habit

When contrasted with other psychiatric treatments the duration of aversion therapy necessary to break a chronic habit such as compulsive gambling is extremely short. Case 1 required only 12 hours of treatment to extinguish a behavior pattern that had persisted for 12 years. He showed no tendency to resume gambling for 18 months. He relapsed once after a domestic upheaval and after losing his job. He was readministered for four “booster” treatments, during which he showed a marked reluctance to gamble. Apart from this single relapse, he has not returned to gambling for more than two years. Mainly because of its convenience and practicability, electrical aversion therapy is now tending to replace all other aversion techniques. (1, 38.).

Reference: Barker, J.C., and Mabel Miller. ‘AVERSION THERAPY FOR COMPULSIVE GAMBLING’. The Lancet 287.7435 (1966): 491-492. Web.

6. The elimination of chronic cough by electric shock

The study presents a case in which aversion therapy was successfully used to eliminate a chronic cough in a 15 yr old boy. Treatment included electric shock aversion therapy employing a response suppression shaping paradigm to remove the cough, and ancillary family treatment to alter the reinforcement pattern which maintained the inappropriate behavior. The S has been free of cough for 1 1/2 yr since treatment. Significant aspects of the case relating to the use of aversion techniques are discussed. This paper is based in part on a presentation given at the Fifth Annual Meeting of the Association for the Advancement of Behavior Therapy, Washington, D.C., September 1971.

Reference: Barney Alexander, A. et al. ‘The Elimination Of Chronic Cough By Response Suppression Shaping’. Journal of Behavior Therapy and Experimental Psychiatry 4.1 (1973): 75-80. Web.

7. One year later: 66.7% of smokers who complete 5 shock sessions still not smoking

Electric aversion was administered to 14 cigarette smokers. Six of the nine Ss who completed the treatment were still abstinent at the one-year follow-up. The overall average of 21.5 cigarettes on the day before treatment dropped to an average of 1.4 cigarettes per day after the third aversion session and most patients stopped smoking within five sessions. It is concluded that electric aversion is a powerful suppressor of cigarette smoking.

Reference: Russell, M. A. H. ‘Effect Of Electric Aversion On Cigarette Smoking’. BMJ 1.5688 (1970): 82-86. Web.

8. In three sessions, electric shock creates inhibition of craving for prescription drugs

It seems likely that an important reason for the limited success of aversion treatment of drug addiction has been that the aversion is applied only to extrinsic stimuli associated with the drug. No attempt is ordinarily made to combat the endogenous habit. In the present experiment, a subject with a Demerol (Pethidine) addiction of 3 years standing was instructed to give himself a severe shock from a portable apparatus whenever he felt a desire for the drug arise endogenously. On three occasions he gave himself 4, 3, and 2 shocks respectively, dispelling the craving. For a period of 12 weeks, the patient remained free from any but minor cravings that he could easily control.

Reference: Wolpe, Joseph. ‘Conditioned Inhibition Of Craving In Drug Addiction: A Pilot Experiment’. Behaviour Research and Therapy 2.2-4 (1964): 285-288. Web.

9. Aversion therapy and sensory modalities: Clinical impressions

Clinical findings suggest that the results of aversion therapy may be enhanced by choosing aversive stimuli which match the specific modalities under treatment. “White noise” was most effective in reducing auditory hallucinations; tactile stimuli (electric shocks) were most effective with motor compulsions, and an unpleasant olfactory-gustatory stimulus (an especially foul mixture of smelling salts) worked best with compulsive eaters. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

Reference: Lazarus, Arnold A. ‘AVERSION THERAPY AND SENSORY MODALITIES-CLINICAL IMPRESSIONS’. Perceptual and Motor Skills 27.1 (1968): 178-178. Web.

10. Aversion therapy in the treatment of trichotillomania

This paper presents a single case study of a patient with compulsive hair-pulling (trichotillomania) of 16 years’ duration, who was successfully treated using electric aversion therapy. All previous attempts at treatment and self-help had been unsuccessful. A behavioral self-control program was tried initially with some success, but the progress was not maintained following an unplanned break in treatment and this treatment was ineffective when re-instated. Electric aversion therapy eliminated hair pulling almost immediately and the results were maintained on follow-up, with the exception of a minor relapse at a time of stress.

Reference: Crawford, David A. ‘Aversion Therapy In The Treatment Of Trichotillomania: A Case Study’. Behavioral Psychology 16.01 (1988): 57. Web.

11. The control of violence and aggression through electric shock

This study deals with the use of faradic shock administered as a punishment for the purpose of curbing the assaultive and violent behaviors of a 31-year-old, hospitalized, chronic schizophrenic female. Three levels of behaviors were chosen for modification: 1) aggressive acts, 2) verbal threats, and 3) accusations of being persecuted and abused. The aversive conditioning approach was employed for each of these levels in a stepwise fashion, with each successive level being included as punishable offenses once effective control over behaviors on the previous level had been demonstrated. The results indicated that a marked reduction in the incidence of the behaviors on all three levels was accomplished by means of this treatment approach. Shortly after instituting the punishment program for accusatory verbalizations, the patient began to show appropriate, socialized behavior which continued throughout the remainder of the program. Moreover, the patient’s weekly behavior rating scores indicated a significant improvement in general functioning over time following the initiation of the aversive therapy program.

Reference: Ludwig, Arnold M. et al. ‘THE CONTROL OF VIOLENT BEHAVIOR THROUGH FARADIC SHOCK’. The Journal of Nervous and Mental Disease 148.6 (1969): 624-637. Web.

12. Aversive Shock Analysis: Physical danger, emotional harm, effectiveness, and dehumanization

Four major objections to the use of faradic stimulation are reviewed and responded to. It is concluded that aversive stimulation is no more dangerous physically or emotionally than traditional forms of treatment, that some aversive procedures have provided controlled evidence of effectiveness, and that charges of dehumanization are invalid.

Reference: Tanner, Barry A. ‘Aversive Shock Issues: Physical Danger, Emotional Harm, Effectiveness And “Dehumanization”’. Journal of Behavior Therapy and Experimental Psychiatry 4.2 (1973): 113-115. Web.

13. In 10 weeks, electric aversion therapy cured a chronic heroin user

A 23-year-old male graduate student who had been using heroin for 3 yr was treated with electrical aversion conditioning. Treatment was carried out in twenty 20-minute sessions over approximately 10 weeks. The drug-taking behavioral sequence was broken into discrete phases which the patient imagined and verbalized. An 8-month follow-up has shown him to be drug-free.

Reference: Lubetkin, Barry S., and Steven T. Fishman. ‘Electrical Aversion Therapy With A Chronic Heroin User’. Journal of Behavior Therapy and Experimental Psychiatry 5.2 (1974): 193-195. Web.

14. Aversion therapy is more effective than other common treatments

Operant (N = 11), aversion (N = 12), and transactional analysis (N = 12) approach to the development of self-control in excessive cigarette smoking were compared with each other and with a no-treatment control group (N = 15). 10 group treatment sessions were administered to Ss assigned to each of the treatment groups. After treatment and a 1-mo follow-up period, the smoking rates of all treatment conditions were significantly lower than the control group (p < .001). No significant treatment, therapist, or interactional differences or indications of symptom substitution were found. (32 refs.) (Psy- cINFO Database Record (c) 2012 APA, all rights reserved).

Reference: Ober, D. C. ‘Modification Of Smoking Behavior.’. Journal of Consulting and Clinical Psychology 32.5, Pt.1 (1968): 543-549. Web.

15. Nine of 20 nail-biters quit on Day 1; 13 of 20 quit by Day 4

Twenty unpaid volunteers were obtained through advertisements and notices. Most were UCLA students. Most reported biting in early teen or preteenage years, with sporadic efforts at self-control. Some reported occasional periods of abstinence. Two devices were used, to provide a choice of shock intensity. Aversive stimulation was used in this study to produce suppression. Ss chronic nailbiters were instructed to carry a portable shock device and use it following the act of placing a finger in the mouth or on the lips, and to discontinue the behavior as soon as it was discovered. The procedure was quite effective; in 9 of 20 cases, no biting was reported from the first day. In 4 other cases, none was reported after 4 days. All visual checks of nails corroborated subject reports.

Reference: Bucher, Bradley D. ‘A Pocket-Portable Shock Device With Application To Nailbiting’. Behaviour Re- search and Therapy 6.3 (1968): 389-392. Web.

16. Training device takes chronic hair pulling to near-zero levels

The chronic hair pulling of a 36-year-old woman with moderate mental retardation was initially treated with a simplified habit-reversal (SHR) procedure that consisted of awareness training, competing response training, and social support. When SHR did not produce large and sustained reductions in hair pulling, an awareness enhancement device was added, and it reduced hair pulling to near-zero levels in two settings. The results are discussed, and directions for future research with this device are provided.

Reference: Rapp, J T, R G Miltenberger, and E S Long. ‘Augmenting Simplified Habit Reversal With An Awareness Enhancement Device: Preliminary Findings.’. Journal of Applied Behavior Analysis 31.4 (1998): 665- 668. Web.

17. An automated aversion device in the treatment of a compulsive handwashing ritual

A 49-year-old male with a long history of compulsive handwashing was treated by the implementation of a self-control procedure. This turned out to be effective only when a powerful external reinforcer (shock) was added to the procedure to increase the patient’s capacity for initiating self-control. Ritualistic handwashing had virtually ceased after 42 days and remained absent at 12 months follow-up.

Reference: Le Boeuf, Alan. ‘An Automated Aversion Device In The Treatment Of A Compulsive Handwashing Ritual’. Journal of Behavior Therapy and Experimental Psychiatry 5.3-4 (1974): 267-270. Web.

18. Faradic disruption of obsessive ideation in the treatment of obsessive neurosis

Faradic disruption of verbal phrases and mental images was used with five chronic obsessive patients in an attempt to reduce obsessive ideation connected with their obsessive fears, doubts, and horrific temptations and to reduce or eliminate their compulsive or ritualistic behavior such as handwashing and checking. As a result, three of the five patients were vastly improved, and one experienced moderate improvement.

Reference: Kenny, F.T., L. Solyom, and C. Solyom. ‘Faradic Disruption Of Obsessive Ideation In The Treatment Of Obsessive Neurosis’. Behavior Therapy 4.3 (1973): 448-457. Web.

19. Sadistic fantasies modified by aversive conditioning and substitution

A case study involving unpleasant electric shocks as the consequence of sadistic fantasies seems to have successfully helped to suppress or extinguish them while incompatible “normal” sex fantasies were strengthened.

Reference: Mees, H. ‘Sadistic Fantasies Modified By Aversive Conditioning And Substitution: A Case Study’. Behaviour Research and Therapy 4.1-2 (1966): 317-320. Web.

20. Electric shock selectively and retroactively strengthens your memory

Here we show, in humans, that information is selectively consolidated if conceptually related information, putatively represented in a common neural substrate, is made salient through an emotional learning experience. Memory for neutral objects was selectively enhanced if other objects from the same category were paired with shock. Retroactive enhancements as a result of emotional learning were observed following a period of consolidation but were not observed in an immediate memory test or for items strongly encoded before fear conditioning. These findings provide new evidence for a generalized retroactive memory enhancement, whereby inconsequential information can be retroactively credited as relevant, and therefore selectively remembered if conceptually related information acquires salience in the future.

Reference: Davichi, Lila, and Dunsmoor, Joseph E., and Murty, Vishnu P., and Phelps, Elizabeth A. ‘Emotional learning selectively and retroactively strengthens memories for related events’. Nature (2015). Web.

21. 84.2% of marijuana smokers quit and their collective IQ increased by 6%

Twenty-two chronic marijuana smokers participated in a smoking cessation clinical trial. The mean age of the 16 male and 6 female subjects was 29.8 years. The mean number of years of marijuana smoking was 13.7. The mean number of daily marijuana cigarettes smoked was 3.4. The clinical trial consisted of five consecutive days of 50-minute aversion therapy sessions (faradic, rapid smoking, and quick puffing) utilizing THC-free marijuana.

Three weekly 60-minute group cohort sessions in self-management counseling followed. The treatment period spanned four weeks. All 22 subjects achieved abstinence (by self-report) by the end of the five days of aversion therapy; 19 of 21 subjects (90.5%) reported abstinence at the conclusion of the clinical trial, following the group sessions. At six months post-treatment follow-up 15 of the 20 subjects (75.0%) reported abstinence; at 12 months posttreatment follow-up, 16 of the 19 subjects (84.2%) achieved abstinence. The mean number of daily marijuana cigarettes smoked decreased from a baseline pretreatment level of 3.40 to 0 at the conclusion of aversion therapy, .07 at the conclusion of the clinical trial, .26 at the six-month post-treatment follow-up, and .23 at the 12-month posttreatment follow-up.

The mean scores on the Shipley Institute of Living Scale were: IQ 106 and CQ 92 at pretreatment; IQ 112 and CQ 104 at posttreatment. The investigators conclude the treatment procedure offers promise as a marijuana smoking cessation treatment program.

Reference: Knowles, P.L, & Schmeling, G, & Smith, J.W. A marijuana smoking cessation clinical trial utilizingTHC-free marijuana, aversion therapy, and self-management counseling. J Subst Abuse Treat. 1988;5(2):89-98. Web.

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