Aversive therapy represents one of the most clinically potent and historically controversial interventions developed within the behavioral sciences. By deliberately pairing a maladaptive behavioral pattern or appetitive impulse with an unpleasant, noxious stimulus, this behavioral method seeks to systematically diminish the valence of undesirable responses. While contemporary clinical paradigms prioritize positive reinforcement and cognitive restructuring, understanding the physiological, learning, and ethical dimensions of aversive conditioning remains essential to the history of psychopathology, behavioral pharmacology, and contemporary learning theory.
Aversion Therapy
1. Concise Definition
Aversive therapy (frequently termed aversion therapy or aversive conditioning) is a form of behavioral intervention grounded in the principles of classical and operant conditioning in which an undesirable, problematic, or harmful target behavior is systematically paired with an unpleasant, noxious, or noxious-associated stimulus. The primary objective of this intervention is to condition a negative emotional, physiological, or cognitive response to the previously reinforcing behavior or cue, thereby reducing or extinguishing its occurrence.
In clinical practice, the noxious unconditioned stimulus (UCS)—such as an emetic agent, a mild electrical stimulus, an offensive odor, or a vivid noxious mental image—elicits an automatic, distressing unconditioned response (UCR). Through repeated contiguous pairings, the formerly rewarding conditioned stimulus (CS)—such as the sight or smell of alcohol, a ritualized habit, or a compulsive behavioral urge—comes to trigger an automatic conditioned aversive response (CR). Consequently, the patient experiences avoidance or distress rather than craving or gratification when exposed to the conditioned stimulus.
2. Etymology & Linguistic Origin
The term aversive derives directly from the Latin verb avertere, meaning “to turn away,” “to ward off,” or “to divert,” composed of the prefix ab- (“from” or “away”) and vertere (“to turn”). Its participial stem avers- entered Late Latin as aversio, reflecting a psychological or physical act of turning away in disgust, antipathy, or hostility.
The companion noun therapy traces its lineage to the ancient Greek therapeia (θεραπεΑ), denoting “healing,” “service,” “cure,” or “attendance,” derived from the verb therapeuein (“to attend,” “to treat medically”). The synthesized phrase aversion therapy gained widespread traction in English during the mid-20th century, emerging predominantly through the publications of early behaviorists such as Hans Eysenck and Stanley Rachman, who sought to operationalize conditioned avoidance into structured clinical treatments.
3. Pronunciation & Grammatical Form
Pronunciation: The standard International Phonetic Alphabet (IPA) transcription for the phrase is /æˈvɜːr.sɪv ˈθεr.ə.pi/ (American English: [əˈvɚ.sɪv ˈθεɹ.ə.pi]; British English: [əˈvɜː.sɪv ˈθεr.ə.pi]). The alternative formulation, aversion therapy, is pronounced /əˈvɜːr.ʒən ˈθεr.ə.pi/.
Grammatical Form: Grammatically, the term functions as a compound noun phrase. Aversive operates as an attributive adjective modifying the singular non-count or count noun therapy. Related grammatical variants include:
- Avert (verb): To turn away or prevent.
- Aversion (noun): A strong feeling of dislike, antipathy, or repugnance.
- Aversive (noun/adjective): Functioning as a descriptor of unpleasant stimuli (e.g., “an aversive event”) or as a standalone noun designating an unpleasant stimulus (e.g., “delivering an aversive”).
- Aversively (adverb): In an aversive manner (e.g., “conditioned aversively”).
4. Detailed Conceptual Explanation
At its core, aversive therapy relies on the principle that many self-destructive, addictive, or disordered behaviors are sustained because their immediate consequences are profoundly reinforcing, even if their long-term consequences are disastrous. Addictive substances, paraphilic patterns, compulsive trichotillomania, or severe habits trigger rapid dopamine release within mesolimbic reward pathways. Because the human nervous system has evolved to prioritize immediate hedonic feedback over delayed negative outcomes, abstract knowledge of future harm frequently fails to disrupt compulsive cycles. Aversive therapy intervenes by actively reversing this hedonic valence, replacing positive appetitive anticipations with immediate, visceral sensations of nausea, pain, or distress.
The conceptual framework operates across two interactive learning modalities: classical (Pavlovian) counterconditioning and operant conditioning. In classical counterconditioning, the patient does not need to emit a motor response; the pairing of the conditioned cue with the noxious stimulus reorganizes autonomic nervous system reactivity. Over time, autonomic sympathetic activation, nausea, or revulsion replaces parasympathetic or dopaminergic anticipation. In operant paradigms, the noxious stimulus acts as a positive punisher: emitting the undesirable motor act brings about an intolerable sensory state, leading to escape and active avoidance behaviors.
However, the conceptual boundaries of aversive therapy are sharply defined. Aversion therapy is fundamentally an extinction and suppression methodology; it does not in itself teach adaptive alternative behaviors. If an individual ceases smoking or compulsive alcohol intake due to conditioned disgust, they remain vulnerable to relapse if they have not acquired compensatory coping mechanisms for stress, emotional dysregulation, or environmental triggers. Consequently, modern behavioral theorists conceptualize aversive techniques not as standalone treatments, but as auxiliary, short-term stabilizers intended to break the initial cycle of compulsive behavior long enough for cognitive, social, and functional coping skills to take root.
Furthermore, the therapeutic efficacy of aversive conditioning depends heavily on contextual generalization. Conditioned stimuli are subject to stimulus discrimination: an individual might develop a conditioned taste aversion to alcohol in an emetic clinic setting where alcohol is paired with nausea, yet experience a resurgence of cravings (spontaneous recovery or renewal effect) when placed back into a peer-laden social context absent the aversive threat. Addressing this boundary requires practitioners to account for associative learning variables such as latent inhibition, cue exposure breadth, and temporal contiguity.
5. Historical Development
Techniques resembling aversive therapy trace back to antiquity. The Roman physician Pliny the Elder documented an early intervention for chronic drunkenness that involved steeping putrefied wine with rotting eel or dead spiders, forcing the drinker to consume the nauseating concoction in an effort to evoke visceral revulsion. Indigenous traditions around the world have similarly employed bitter herbs, botanical emetics, and physical discomfort to extinguish undesirable habits or mark transitional rites of passage.
The systematic, laboratory-based development of aversive therapy began in the early 20th century alongside the rise of Russian reflexology. Following the seminal work of Ivan Pavlov, the Russian neurologist and psychologist Nikolai Kantorovich conducted early experiments in 1929 by administering electric shocks to individuals diagnosed with alcohol dependence upon the presentation of alcohol cues. Kantorovich reported rapid suppression of drinking behavior, igniting widespread international interest in conditioned reflex therapies.
In the 1930s and 1940s, American physicians Charles Voegtlin and Frederick Lemere refined chemical aversion protocols at the Shadel Sanatorium in Seattle, Washington. Utilizing emetine and apomorphine to reliably induce severe nausea and vomiting at the precise moment a patient tasted, smelled, and swallowed liquor, they established one of the first highly structured clinical programs for chemical aversion therapy. Over several decades, Voegtlin and Lemere treated thousands of patients, reporting notable long-term abstinence rates, though their rigorous chemical protocols demanded medical hospitalization.
The 1960s and 1970s marked both the zenith and the beginning of the ethical downfall of aversion therapy. During this period, behaviorists expanded the technique beyond addictions to treat compulsive sexual behaviors, obsessive-compulsive manifestations, and severe self-injurious behavior in developmentally disabled populations. Tragically, this era was characterized by the widespread use of aversive conditioning in so-called “conversion therapy” targeting homosexual and gender-nonconforming individuals. Researchers such as Martin P. Feldman and M.J. MacCulloch employed electric shocks paired with homoerotic imagery in attempts to extinguish homosexual arousal—practices that caused severe psychological trauma and failed to alter sexual orientation.
The backlash against these coercive practices, coupled with the emergence of cognitive-behavioral therapy (CBT) and pharmacotherapies with lower side-effect profiles, led to a dramatic decline in the clinical application of physical aversives. The American Psychological Association and the American Psychiatric Association subsequently condemned conversion therapy and established strict ethical guidelines regarding physical punishment and patient autonomy. Today, traditional physical aversives are largely obsolete, though specialized manifestations survive in chemical deterrents (e.g., disulfiram), covert imagery-based sensitization, and non-painful sensory interventions.
6. Theoretical Foundations
Aversive therapy is supported by several core behavioral and neurobiological theories:
1. Classical Pavlovian Conditioning and Counterconditioning:
In Pavlovian terms, a neutral stimulus becomes a conditioned stimulus (CS) when paired contiguously with an unconditioned stimulus (UCS) that naturally produces an unconditioned response (UCR). In counterconditioning, the goal is to replace a pre-existing appetitive conditioned response with an incompatible aversive response. If the sight of liquor (CS) previously elicited dopaminergic reward expectation (CR1), pairing that sight with an emetic agent (UCS) causing vomiting (UCR) forces a re-association, resulting in nausea and avoidance (CR2).
2. Operant Conditioning and Negative Reinforcement Cycles:
B. F. Skinner formulated the laws of operant behavior, identifying positive punishment (the presentation of an aversive stimulus contingent upon a behavior) as a mechanism that decreases the probability of that behavior. Furthermore, avoidance learning plays a prominent role: once the conditioned aversion is formed, abstaining from the problematic stimulus removes the unpleasant anticipation of nausea or distress, thereby negatively reinforcing sobriety or behavioral restraint.
3. Conditioned Taste Aversion and Biological Preparedness:
Psychologist John Garcia demonstrated in the 1960s that organisms are biologically prepared by evolution to associate gustatory and olfactory cues with visceral gastrointestinal illness, a phenomenon known as the Garcia effect. Unlike standard classical conditioning, which requires millisecond contiguity, conditioned taste aversion can occur after a single trial even with hours separating ingestion and sickness. This biological preparedness explains why chemical emetics are uniquely effective for ingestive addictions (such as alcohol), whereas electric shock produces weak and transient aversions to ingestive cues.
4. Mowrer’s Two-Factor Theory:
Orval Hobart Mowrer synthesized classical and operant paradigms to explain avoidance. First, classical conditioning establishes a fear or disgust response to a stimulus. Second, operant conditioning maintains avoidance because physically retreating from or abstaining from the cue terminates the unpleasant conditioned state. In aversive therapy, this two-factor model accounts for both the initial establishment of revulsion and the subsequent maintenance of avoidance habits.
7. Key Components, Types & Dimensions
Aversive therapy encompasses several distinct modalities, ranging from biological interventions to purely cognitive paradigms:
- Chemical Aversion Therapy: Involves the administration of pharmacological agents (such as emetine, apomorphine, or lithium chloride) that induce profound nausea, diaphoresis, and emesis. The patient is instructed to view, smell, taste, and swallow the targeted substance (e.g., alcohol) precisely as the pharmacological nausea reaches its physiological climax.
- Pharmacological Deterrent Therapy: Differs from classic Pavlovian conditioning in that the medication is taken daily as an internal deterrent. The most prominent example is disulfiram (Antabuse), which blocks aldehyde dehydrogenase. If alcohol is consumed, toxic levels of acetaldehyde accumulate rapidly within minutes, producing flushing, tachycardia, violent vomiting, and severe headache.
- Covert Sensitization: Developed by Joseph Cautela in the late 1960s, this cognitive-behavioral variant replaces real-world noxious physical stimuli with vivid, therapist-guided mental imagery. The patient visualizes engaging in the problematic behavior, vividly imagines experiencing sudden, repulsive nausea, vomiting over themselves and their surroundings, and then visualizes immediate relief upon walking away and choosing an adaptive alternative.
- Electrical Aversion Therapy: Historically involved administering contingent, mild-to-moderate skin shocks via electrodes attached to the arm or leg upon the presentation of targeted stimuli or behaviors. Largely abandoned in modern psychotherapy due to low ecological validity, high relapse rates, and severe ethical limitations.
- Olfactory and Gustatory Sensory Aversives: Mild, non-injurious interventions such as applying denatonium benzoate (a bitter-tasting substance) to fingernails to extinguish onychophagia (nail biting), or exposing patients to noxious aromatic compounds (e.g., concentrated valeric acid or ammonium salts) upon the emergence of compulsive urges.
- Rapid Smoking Technique: A specialized behavioral variant previously used for tobacco cessation where clients were instructed to inhale deeply from a cigarette every six seconds until physiological dizziness, nausea, and carbon monoxide toxicity symptoms arose, rapidly transforming the sensory properties of tobacco smoke into an aversive cue.
8. Examples & Illustrative Cases
The following case vignettes illustrate how aversive paradigms have been conceptualized and implemented across different clinical contexts:
Case 1: Chemical Aversion in Severe Alcohol Use Disorder
A 48-year-old male with chronic alcohol use disorder and multiple failed rehabilitation attempts enrolls in a specialized medical conditioning program. Under medical supervision, he receives an injection of an emetic solution. As severe nausea begins to build, the clinician places a tray containing his preferred alcoholic beverages directly under his nose. He is directed to swish the bourbon in his mouth and swallow. At that precise second, violent emesis occurs. This sequence is repeated over five separated sessions across two weeks. Post-treatment, the olfactory cue of whiskey provokes an automatic, conditioned visceral gag reflex, suppressing his immediate appetitive craving and enabling him to engage actively in outpatient psychosocial counseling.
Case 2: Covert Sensitization for Compulsive Stealing (Kleptomania)
A 32-year-old female presents with kleptomania, reporting uncontrollable surges of excitement when shoplifting cosmetic products. Her cognitive-behavioral therapist implements covert sensitization. In a relaxed state, she is guided to vividly imagine walking into a department store, picking up an expensive cosmetic item, and concealing it. The therapist then introduces a vivid script: she suddenly feels a wave of sickness, develops projectile vomiting over the store display, attracts the horrified attention of onlookers, and experiences profound embarrassment. She then visualizes placing the item back, stepping outside into fresh air, and feeling immediate physical relief and emotional calm. After several sessions and daily home practice, the client reports that entering retail spaces automatically activates the imagined unpleasant visceral response, dissipating the compulsive urge.
Case 3: Mild Gustatory Aversion for Chronic Onychophagia
An 8-year-old child presents with severe, chronic nail-biting that has led to localized skin infections around the nail beds. With the child’s and parents’ consent, a clear, safe, extremely bitter topical solution (denatonium benzoate) is applied to the fingertips daily. When the child absentmindedly places a finger into their mouth while reading or watching television, the intense bitter taste acts as an immediate positive punisher and conditioned interruptive cue, disrupting the automatic motor loop and permitting the adoption of a competing habit (e.g., squeezing a stress ball).
9. Measurement & Assessment
Assessing the efficacy, safety, and validity of an aversive conditioning intervention requires continuous quantitative and qualitative monitoring:
Behavioral and Physiological Tracking:
Objective tracking relies on recording target behavior frequency through self-monitoring logs, collateral reporting (e.g., family members), or wearable tracking devices. In experimental or specialized settings, autonomic indices are measured to assess conditioned physiological responses, including:
- Galvanic Skin Response (GSR) / Electrodermal Activity: Measures autonomic sympathetic arousal during cue exposure.
- Heart Rate Variability (HRV): Tracks changes in vagal tone and stress reactivity when confronted with conditioned cues.
- Pupillometry: Measures pupil dilation and constriction as indices of emotional valence and processing effort.
- Biochemical Validation: Biological assays, such as breathalyzer tests, urine ethyl glucuronide (EtG) testing for alcohol, or salivary cotinine testing for nicotine, provide objective confirmation of abstinence.
Standardized Psychological Instruments:
Subjective craving and compulsive drive are typically measured using established psychological inventories, such as:
- Obsessive Compulsive Drinking Scale (OCDS): Assesses cognitive preoccupation and compulsive impulses toward alcohol consumption.
- Penn Alcohol Craving Scale (PACS): Measures the frequency, intensity, and duration of cravings.
- Visual Analog Scales (VAS): 100-millimeter continuous scales where patients self-rate subjective disgust, desire, or anxiety upon exposure to targeted stimuli.
10. Applications & Practical Significance
While broad, unconstrained aversive methods have been largely phased out of mainstream mental health care, targeted applications persist in distinct domains:
Clinical Addictions Treatment:
Pharmacological deterrents remain an evidence-based adjunctive intervention for substance use disorders. Disulfiram remains approved by major health authorities worldwide for highly motivated individuals or those under directly observed therapy. Similarly, naltrexone, while primarily an opioid receptor antagonist rather than a direct aversive, blunts the pleasurable reinforcement of alcohol, diminishing the appetitive drive via pharmacological extinction.
Habit Reversal and Trichotillomania:
In habit reversal training (HRT) for body-focused repetitive behaviors (BFRBs), such as chronic excoriation (skin picking) and trichotillomania (hair pulling), non-injurious sensory interrupts (such as textured finger sleeves, mild tactile alarms, or bitter coatings) are utilized as stimulus control mechanisms to elevate conscious awareness of automated motor actions.
Ecological and Veterinary Applications:
Beyond human medicine, aversive conditioning is widely applied in wildlife conservation and animal management. Conditioned taste aversion is employed to protect endangered species: predatory animals (such as wolves, coyotes, or crows) are fed carcasses or eggs laced with non-lethal emetic agents (like lithium chloride). After a single exposure, predators develop a powerful conditioned aversion to the scent and flavor of the livestock or endangered bird eggs, curtailing predatory behavior without lethal culling.
11. Research & Empirical Evidence
The empirical literature on aversive conditioning reveals a complex balance between immediate conditioned suppression and long-term relapse vulnerabilities.
The foundational clinical studies of chemical aversion conducted by Lemere and Voegtlin (1950) evaluated over 4,000 patients treated with emetic conditioning for alcohol use disorder over a 10-year span. Their retrospective reports demonstrated an overall 60% abstinence rate at one year and approximately 38% maintained abstinence at ten or more years among patients who completed reinforcement booster sessions. Contemporary re-evaluations, such as studies reviewed by Elkins (1991), corroborated that chemical counterconditioning produced measurable suppression of craving and elevated conditioned disgust responses that significantly outpaced non-conditioned control interventions.
However, comparative clinical trials investigating electrical aversion therapy in the 1970s revealed marked limitations. Studies evaluating electrical shock for smoking cessation or weight loss found that while conditioned suppression was rapid during laboratory sessions, extinction occurred swiftly once participants returned to environments absent the shock apparatus. The phenomenon of stimulus discrimination rendered the conditioning context-bound, leading researchers to conclude that electric shock had little clinical utility for ingestive appetitive disorders.
Research into pharmacological deterrents, particularly disulfiram, underscores the distinction between pharmacological efficacy and real-world compliance. A landmark multi-center randomized controlled trial by Fuller et al. (1986), published in the Journal of the American Medical Association, demonstrated that unmonitored disulfiram was no more effective than placebo in sustaining continuous abstinence, primarily due to high patient non-adherence. However, subsequent meta-analyses (e.g., Krampe et al., 2006; Skinner et al., 2014) established that when disulfiram administration is supervised (directly observed therapy), it demonstrates substantial effect sizes in maintaining abstinence and reducing drinking days compared to controls.
12. Cultural & Cross-Cultural Considerations
Cultural norms heavily dictate the societal acceptability, ethical reception, and legal regulation of aversive therapies. In Western individualistic societies, modern clinical ethics centers primarily on personal autonomy, informed consent, and minimizing physical or emotional distress. Consequently, the historical utilization of punitive interventions has produced considerable cultural wariness, fostering a preference for positive reinforcement, mindfulness-based approaches, and humanistic or cognitive therapies.
Conversely, historical analyses reveal distinct variations in state-sanctioned psychiatric practices. In the mid-to-late 20th century, behavioral reflexology programs in the Soviet Union and parts of Eastern Europe extensively utilized chemical aversion and sleep therapies within state-run sanatoriums, consistent with a materialist reflexology framework that viewed conditioning as an objective physiological reorganization rather than an infringement on personal subjective comfort.
Furthermore, attitudes toward physical discomfort as an agent of personal discipline vary across cultures. In some non-Western or traditional contexts, ascetic practices, fasting, and physical hardship are culturally integrated methods for cultivating self-restraint and moral character. When implementing behavioral habit modifications cross-culturally, clinicians must remain deeply sensitive to how authority dynamics, family structures, and cultural definitions of discipline influence patient perceptions of aversive interventions.
13. Criticisms, Debates & Limitations
Aversive therapy has attracted extensive criticism across behavioral, psychological, and bioethical domains. The primary critiques encompass:
Ethical Concerns and Human Rights Abuses:
The darkest chapter in the history of aversive conditioning remains its application to diverse sexual orientations and gender identities. Throughout the mid-20th century, gay, lesbian, and transgender individuals were subjected to painful electric shocks, nausea-inducing chemical injections, and severe verbal shaming in attempts to eliminate same-sex attraction. These interventions resulted in profound trauma, severe depression, anxiety, and elevated suicide risk without altering sexual orientation. Major global health bodies, including the World Health Organization, now unequivocally classify such practices as human rights violations and psychological abuse.
High Attrition and Poor Treatment Adherence:
Aversive therapy requires individuals to undergo substantial physical or psychological discomfort. Consequently, drop-out rates in aversion programs are exceptionally high. In unmonitored pharmacological settings, patients frequently discontinue their medication (e.g., ceasing disulfiram) simply to resume consumption without experiencing sickness, limiting the clinical viability of the technique to a narrow subset of highly motivated individuals.
Context-Bound Conditioning and Extinction:
Pavlovian extinction is an inevitable neurobiological phenomenon. Unless a conditioned response is periodically reinforced with booster sessions, the association between the conditioned cue and the noxious stimulus naturally weakens over time. If a patient is exposed to alcohol cues repeatedly in the real world without experiencing sickness, the conditioned nausea fades, paving the way for spontaneous recovery of the original appetitive drive.
Absence of Skill Acquisition:
Aversive therapy functions entirely through behavioral suppression; it provides no pedagogical mechanism for cultivating emotional regulation, problem-solving skills, social competencies, or functional coping strategies. Suppressing a symptom does not resolve underlying psychopathology, interpersonal trauma, or existential despair.
14. Related Terms & Distinctions
To avoid conceptual confusion, aversive therapy must be distinguished from related behavioral and psychological modalities:
- Covert Sensitization vs. In Vivo Aversive Therapy: Covert sensitization relies entirely on guided mental imagery and visualization of noxious events within a cognitive framework, whereas in vivo aversive therapy utilizes actual physical noxious stimuli (chemicals, taste, odors).
- Aversive Conditioning vs. Systematic Desensitization: While both are classical conditioning techniques, they operate in diametrically opposite directions. Systematic desensitization couples an anxiety-provoking stimulus with deep physiological relaxation to eliminate fear, whereas aversive conditioning couples an appetitive stimulus with distress to create avoidance.
- Positive Punishment vs. Negative Reinforcement: Positive punishment introduces an unpleasant stimulus to decrease a behavior (the foundation of operant aversives), whereas negative reinforcement removes an unpleasant stimulus to increase or maintain an adaptive behavior.
- Pharmacological Deterrence vs. Pharmacological Extinction: Deterrents (such as disulfiram) cause active, severe sickness upon substance ingestion. Extinction agents (such as naltrexone used in the Sinclair Method) do not induce sickness; rather, they block opioid receptors so that alcohol consumption produces no euphoria, leading to gradual behavioral extinction.
- Exposure Therapy vs. Aversion Therapy: Exposure therapy exposes an individual to feared cues in a safe environment until anxiety naturally extinguishes, teaching the brain that the stimulus is benign. Aversion therapy exposes the individual to desirable cues paired with noxious agents, teaching the brain that the stimulus is harmful.
15. Summary / Key Takeaways
Aversive therapy represents a foundational, historically prominent behavioral methodology that deliberately reorganizes the motivational valence of an undesirable habit or substance by pairing it with an unpleasant, noxious stimulus. Through the combined mechanisms of Pavlovian counterconditioning and operant positive punishment, the technique transforms positive appetitive cues into signals of visceral disgust, nausea, or autonomic distress.
While early clinical programs demonstrated notable short-term success—particularly when utilizing chemical emetics to induce biologically prepared taste aversions in severe alcohol use disorder—the broad application of physical aversives suffered from severe limitations, including rapid contextual extinction, extreme drop-out rates, and a failure to provide adaptive coping alternatives. Furthermore, widespread historical abuses, particularly the coercive application of electrical and chemical aversion in so-called conversion therapies, led to profound ethical reckonings and professional condemnations.
In contemporary clinical psychology and psychiatry, traditional physical aversives have been largely supplanted by cognitive-behavioral therapies, motivational interviewing, and contingency management paradigms that prioritize positive reinforcement. Nevertheless, modified, non-punitive iterations—ranging from pharmacological deterrents under observed adherence protocols to covert sensitization and sensory habit-reversal tools—continue to occupy defined, specialized roles within evidence-based behavioral medicine.
References
- Cautela, J. R. (1967). Covert sensitization. Psychological Reports, 20(2), 459–468. https://doi.org/10.2466/pr0.1967.20.2.459
- Elkins, R. L. (1991). An appraisal of chemical aversion (emetic therapy) approaches to alcoholism treatment. Behaviour Research and Therapy, 29(5), 387–413. https://doi.org/10.1016/0005-7967(91)90022-7
- Fuller, R. K., Branchey, L., Brightwell, D. R., Derman, R. M., Emrick, C. D., Iber, F. L., James, K. E., Lacoursiere, R. B., Lee, K. K., Lowenstam, I., Maany, I., Neiderhiser, D., Nocks, J. J., & Shaw, S. (1986). Disulfiram treatment of alcoholism: A Veterans Administration cooperative study. Journal of the American Medical Association, 256(11), 1449–1455. https://doi.org/10.1001/jama.1986.03380110055026
- Garcia, J., & Koelling, R. A. (1966). Relation of cue to consequence in avoidance learning. Psychonomic Science, 4(3), 123–124. https://doi.org/10.3758/BF03342209
- Krampe, H., Stawicki, S., Ehrenreich, H., & Clinical Alcohol Research Group. (2006). Supervised disulfiram program for alcoholics: 10-year follow-up of long-term outpatients. European Addictive Research, 12(4), 187–193. https://doi.org/10.1159/000094421
- Lemere, F., & Voegtlin, W. L. (1950). An evaluation of the aversion treatment of alcoholism. Quarterly Journal of Studies on Alcohol, 11(2), 199–204. https://doi.org/10.15288/qjsa.1950.11.199
- Skinner, M. D., Lahmek, P., Pham, H., & Aubin, H. J. (2014). Disulfiram efficacy in the treatment of alcohol dependence: A meta-analysis. PLOS ONE, 9(2), e87366. https://doi.org/10.1371/journal.pone.0087366