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Resumo Este artigo tem por finalidade geral apresentar a visão de Skinner sobre a interpretação, seja como objetivo ou como método. Além disso, tem como propósitos específicos (a) definir a interpretação, conforme Skinner, (b) apontar quando e como o autor defende a sua realização, (c) relacionar a interpretação a outros objetivos e métodos propostos por Skinner e (d) indicar contribuições e limites da interpretação, segundo o autor. Para isso, examinamos 35 textos de Skinner ligados ao assunto, publicados entre 1931 e 1990. Seja como objetivo ou como método, mostramos que a interpretação oferece contribuições teóricas, metodológicas e tecnológicas à ciência de Skinner, ainda que ela apresente limites relacionados à sua natureza inferencial e especulativa, bem como ao seu caráter plausível e, às vezes, temporário.
Abstract This paper has the general purpose of presenting Skinner's vision of interpretation, both as aim and method. Besides, it has as specific purposes (a) to define interpretation, according to Skinner; (b) to indicate when and how the author defends its accomplishment; (c) to relate interpretation with other aims and methods proposed by Skinner; (d) to indicate contributions and limits of interpretation, according to the author. In this regard, we examined 35 texts of Skinner related to the subject, published between 1931 and 1990. Both as aim and method, we show that interpretation offers theoretical, methodological, and technological contributions to Skinner's science, although it presents limits related to its inferential and speculative nature, as well as to its plausible and sometimes temporary format.
ABSTRACT
RESUMO Este artigo tem por objetivo esclarecer a posição de B. F. Skinner sobre a definição, os tipos e as funções de regras no controle do comportamento humano. Para identificar publicações do autor sobre o assunto, foi realizada uma análise de três fontes de dados: (a) 295 referências de trabalhos de Skinner realizados entre 1930 e 2004; (b) o acervo de uma universidade; (c) índices remissivos de 17 livros do autor. Dezoito publicações foram identificadas. Embora seja possível apontar, na obra de Skinner, algumas funções de estímulo previstas para as regras (e.g., discriminativa, motivacional e alteradora da função de estímulos), o autor admite a existência de regras sem incluir suas eventuais funções no controle do comportamento. Ao mesmo tempo, Skinner apresenta critérios para diferenciar as regras, facilitando a pesquisa experimental sobre o tema.
ABSTRACT This paper aims to clarify B. F. Skinner's position on definition, types, and functions of rules on the control of human behavior. In order to identify the author's publications on the subject, we performed an analysis of three data sources: (a) 295 references of Skinner's work published between 1930 and 2004; (b) a collection of a university; (c) indexes of 17 of Skinner's books. Eighteen publications were identified. Although it is possible to point out some stimulus functions for rules in Skinner's work (e.g., discriminative, motivational, and function altering of stimuli), the author admits the existence of rules without including the eventual functions they might have on the control of behavior. Skinner also presents criteria to differentiate rules, facilitating experimental research on the theme.
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INTRODUCTION: In obsessive-compulsive disorder, early treatment discontinuation can hamper the effectiveness of first-line treatments. OBJECTIVE: This study aimed to investigate the clinical correlates of early treatment discontinuation among obsessive-compulsive disorder patients. METHODS: A group of patients who stopped taking selective serotonin reuptake inhibitors (SSRIs) or stopped participating in cognitive behavioral therapy before completion of the first twelve weeks (total n = 41; n = 16 for cognitive behavioral therapy and n = 25 for SSRIs) were compared with a paired sample of compliant patients (n = 41). Demographic and clinical characteristics were obtained at baseline using structured clinical interviews. Chisquare and Mann-Whitney tests were used when indicated. Variables presenting a p value <0.15 for the difference between groups were selected for inclusion in a logistic regression analysis that used an interaction model with treatment dropout as the response variable. RESULTS: Agoraphobia was only present in one (2.4 percent) patient who completed the twelve-week therapy, whereas it was present in six (15.0 percent) patients who dropped out (p = 0.044). Social phobia was present in eight (19.5 percent) patients who completed the twelve-week therapy and eighteen (45 percent) patients who dropped out (p = 0.014). Generalized anxiety disorder was present in eight (19.5 percent) patients who completed the twelve-week therapy and twenty (50 percent) dropouts (p = 0.004), and somatization disorder was not present in any of the patients who completed the twelveweek therapy; however, it was present in six (15 percent) dropouts (p = 0.010). According to the logistic regression model, treatment modality (p = 0.05), agoraphobia, the Brown Assessment of Beliefs Scale scores (p = 0.03) and the Beck Anxiety Inventory (p = 0.02) scores were significantly associated with the probability of treatment discontinuation irrespective of interactions with other variables. DISCUSSION AND CONCLUSION: Early treatment discontinuation is a common phenomenon in obsessive-compulsive disorder patients from our therapeutic setting. Psychiatric comorbidities were associated with discontinuation rates of specific treatments. Future studies might use this information to improve management for increased compliance and treatment effectiveness.
Subject(s)
Adult , Female , Humans , Male , Cognitive Behavioral Therapy , Obsessive-Compulsive Disorder/therapy , Patient Compliance/psychology , Selective Serotonin Reuptake Inhibitors/administration & dosage , Combined Modality Therapy , Comorbidity , Epidemiologic Methods , Obsessive-Compulsive Disorder/psychology , Socioeconomic Factors , Time Factors , Treatment OutcomeABSTRACT
OBJECTIVE: To describe the recruitment of patients, assessment instruments, implementation, methods and preliminary results of The Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders, which includes seven university sites. METHOD: This cross-sectional study included a comprehensive clinical assessment including semi-structured interviews (sociodemographic data, medical and psychiatric history, disease course and comorbid psychiatric diagnoses), and instruments to assess obsessive-compulsive (Yale-Brown Obsessive-Compulsive Scale and Dimensional Yale-Brown Obsessive-Compulsive Scale), depressive (Beck Depression Inventory) and anxious (Beck Anxiety Inventory) symptoms, sensory phenomena (Universidade de São Paulo Sensory Phenomena Scale), insight (Brown Assessment Beliefs Scale), tics (Yale Global Tics Severity Scale) and quality of life (Medical Outcome Quality of Life Scale Short-form-36 and Social Assessment Scale). The raters' training consisted of watching at least five videotaped interviews and interviewing five patients with an expert researcher before interviewing patients alone. The reliability between all leaders for the most important instruments (Structured Clinical Interview for DSM-IV, Dimensional Yale-Brown Obsessive-Compulsive Scale, Universidade de São Paulo Sensory Phenomena Scale) was measured after six complete interviews. RESULTS: Inter-rater reliability was 96 percent. By March 2008, 630 obsessive-compulsive disorder patients had been systematically evaluated. Mean age (±SE) was 34.7 (±0.51), 56.3 percent were female, and 84.6 percent Caucasian. The most prevalent obsessive compulsive symptom dimensions were symmetry and contamination. The most common comorbidities were major depression, generalized anxiety and social anxiety disorder. The most common DSM-IV impulsive control disorder was skin picking. CONCLUSION: The sample was composed mainly by Caucasian individuals, unmarried, with some kind...
OBJETIVO: Descrever o recrutamento de pacientes, instrumentos de avaliação, métodos para o desenvolvimento de estudos colaborativos multicêntricos e os resultados preliminares do Consórcio Brasileiro de Pesquisa em Transtornos do Espectro Obsessivo-Compulsivo, que inclui sete centros universitários. MÉTODO: Este estudo transversal incluiu entrevistas semi-estruturadas (dados sociodemográficos, histórico médico e psiquiátrico, curso da doença e diagnósticos psiquiátricos comórbidos) e instrumentos que avaliam os sintomas do transtorno obsessivo-compulsivo (Escala para Sintomas Obsessivo-Compulsivos de Yale-Brown e Escala Dimensional para Sintomas Obsessivo-Compulsivos de Yale-Brown), sintomas depressivos (Inventário de Depressão de Beck), sintomas ansiosos (Inventário de Ansiedade de Beck), fenômenos sensoriais (Escala de Fenômenos Sensoriais da Universidade de São Paulo), juízo crítico (Escala de Avaliação de Crenças de Brown), tiques (Escala de Gravidade Global de Tiques de Yale) e qualidade de vida (questionário genérico de avaliação de qualidade de vida, Medical Outcome Quality of Life Scale Short-form-36 e Escala de Avaliação Social). O treinamento dos avaliadores consistiu em assistir cinco entrevistas filmadas e entrevistar cinco pacientes junto com um pesquisador mais experiente, antes de entrevistar pacientes sozinhos. A confiabilidade entre todos os líderes de grupo para os instrumentos mais importantes (Structured Clinical Interview for DSM-IV, Dimensional Yale-Brown Obsessive-Compulsive Scale, Universidade de São Paulo Sensory Phenomena Scale ) foi medida após seis entrevistas completas. RESULTADOS: A confiabilidade entre avaliadores foi de 96 por cento. Até março de 2008, 630 pacientes com transtorno obsessivo-compulsivo tinham sido sistematicamente avaliados. A média de idade (±SE) foi de 34,7 (±0,51), 56,3 por cento eram do sexo feminino e 84,6 por cento caucasianos. Os sintomas obsessivo-compulsivos mais prevalentes foram...