A chronic psychiatric inpatient unit awards plastic tokens to patients whenever they perform desired behaviours such as attending ward activities and maintaining hygiene. Tokens can later be exchanged for privileges like extra television time. This behavioural technique is based on which principle?

• A Positive reinforcement using secondary reinforcers ✓
• B Classical conditioning using conditioned stimuli
• C Punishment of maladaptive responses
• D Extinction of undesirable behaviours

Explanation

Token economies apply operant conditioning: tokens are secondary (conditioned) reinforcers delivered contingent on target behaviours, later exchangeable for primary or other reinforcers such as privileges. They are used in chronic schizophrenia units and child settings. Extinction involves withholding reinforcement, and punishment involves adding an aversive consequence, neither of which occurs here. Classical conditioning pairs stimuli without voluntary behaviour, unlike this response-contingent system.

Reference: Kaplan and Sadock's Synopsis of Psychiatry, 12th ed.

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