Análises funcionais molares associadas à terapia de aceitação e compromisso em um caso de transtorno obsessivo-compulsivo / Molar functional analyses associated to acceptance and commitment therapy in a case of obsessive-compulsive disorder

O Transtorno Obsessivo-Compulsivo (TOC) é um quadro caracterizado por obsessões e compulsões, provocando prejuízos em contextos sociais, familiares e de trabalho. O presente estudo teve como objetivo demonstrar a relevância de análises funcionais molares associadas ao instrumental da ACT, ilustrando com um caso clínico de TOC. Ao longo de 68 sessões, foi possível identificar padrões comportamentais amplos de comunicação agressiva, busca de controle e habilidade de argumentação verbal, funcionalmente relacionados ao TOC, bem como ampla sensibilidade a contextos sócio-verbais de literalidade e de dar razões, relacionados a forte padrão de esquiva experiencial. A compreensão das contingências atuais e históricas propiciaram a aceitação dos estados privados aversivos e o comprometimento com a exposição a contextos terapêuticos, no sentido de enfraquecer comportamentos funcionalmente semelhantes aos obsessivo-compulsivos, porém com menor relevância emocional, o que levou ao enfraquecimento dos sintomas de TOC e a melhorias nas relações com familiares e colegas de trabalho...

Obsessive-Compulsive Disorder (OCD) is a psychiatric disorder characterized by obsessions and compulsions, with losses in social, family and labor contexts. This study aimed to show the relevance of molar functional analyses associated to ACT interventions, illustrating it with a case of OCD. Along 68 sessions, it has been possible to identify ample behavior patterns of aggressive communication, search for control and verbal argumentation skills, functionally related to OCD symptoms, as well as ample sensitivity to social/verbal contexts of literality and reason giving, leading to a strong pattern of experiential avoidance. Understanding of current and historical contingencies led to the acceptance of aversive private states and commitment to the exposure to therapeutic contexts, in order to weaken behaviors that were functionally related to the obsessive-compulsive ones, but less emotionally relevant, which led to weakening of OCD symptoms and improvements in relationships with relatives and coworkers...

Análisis preliminar de un protocolo para la evaluación de marcos deícticos / Preliminary Analysis of an Assessment of Deictic Frames Protocol

El propósito de esta investigación es explorar diferencias en la ejecución de tareas deícticas presentadas en el protocolo de McHugh, Barnes-Holmes y Barnes-Holmes (2004a), en relación con variaciones procedimentales que consistieron en exponer a unos participantes al protocolo en un formato de entrevista y a otros en una versión computarizada. La muestra estuvo conformada por 63 participantes entre 9 y 12 años, que fueron pareados por género, edad y nivel educativo, asignados a alguna de las condiciones de aplicación. Se calculó el número de errores cometido por cada participante y grupo de edad en cada marco deíctico y nivel de complejidad relacional, al igual que se estimó el efecto intersujetos mediante un ANOVA de dos vías con edad y versión (cara-a-cara y computador) como variables independientes y tipo de ensayo como variable dependiente. El efecto de la edad fue significativo para el caso de las relaciones invertidas ahora-antes y el de versión para las relaciones simples yo-tú y aquí-allá. En todos los grupos de edad se halló una tendencia a cometer mayor cantidad de errores en la versión computarizada en todos los tipos de ensayo. Los hallazgos se discuten en términos de confiabilidad del procedimiento y validez ecológica de las estrategias no automatizadas para la evaluación de relaciones de estímulo derivadas.

The aim of this study was to explore differences in the performance of deictic tasks presented in the protocol of McHugh, Barnes-Holmes y Barnes-Holmes (2004a) related to procedural variations that consisted of a group of participants exposed to the protocol in a face-to-face interview format, in contrast with another group exposed to the protocol in a computerized version. 63 participants (9 to 12 years old) were paired by gender, age and grade and were assigned to one of the conditions. The number of errors was calculated for each participant and age group in each of the deictic frames and levels of relational complexity and inter-subjects effects were estimated using a two-way ANOVA with age and version (face-to-face and computer) as the independent variables and trial type as the dependent variable. The effect of age was significant for reversed NOW-THEN relations and the effect of version for simple I-YOU and HERE-THERE relations. A trend to produce more errors across all trial types in the computerized version was identified. Findings are discussed in terms of procedural reliability and ecological validity of non automated strategies for the assessment of derived stimulus relations.

Relaciones deíciicas simples, toma de perspectiva y competencia socall / Simple dectic reelations, perspective-taking and social competence

En la Teoría de Marcos Relacionales (Hayes, Barnes-Holmes, & Roche, 2001) se ha planteado que la toma de perspectiva se puede entender como un repertorio de respuestas relacionales deícticas personales, espaciales y temporales, derivadas y aplicables arbitrariamente. Bajo esta óptica, en esta investigación se evaluó el impacto de múltiples ejemplares de reforzamiento por responder relacional en función de claves contextuales en el establecimiento de relaciones deícticas simples y el impacto de este entrenamiento en puntajes de ToM y competencia social. Se implementó un diseño de línea de base múltiple con cuatro participantes (41 a 58 meses), residentes en una fundación de protección y restitución de derechos. Los participantes requirieron entrenamiento en relaciones personales y/o temporales, siendo éstas últimas las más difíciles de aprender a partir de contingencias de reforzamiento. No se identificó una clara relación entre cambios en el repertorio de relaciones deícticas simples y los puntajes en tareas de teoría de la mente y competencia social. Se discuten las implicaciones teóricas y metodológicas de estos hallazgos.

Relational Frame Theory (Hayes, Barnes-Holmes & Roche, 2001) states that perspective-taking can be understood as a repertoire of personal, spatial and temporal deictic relations that are derived and arbitrarily applicable. Under this rubric, this research evaluated the impact of multiple reinforcement exemplars for relational responding according to contextual cues in establishing simple deictic relations and the impact of this training on ToM and social competence scores. A multiple baseline design was implemented with four participants (41 to 58 months old) raised in an institutional setting. Participants required training in personal and/or temporal relations, the latter being harder to learn after being exposed to reinforcement contingencies. No clear relationships among changes in the deictic relations repertoire and ToM and social competence scores were identified. Theoretical and methodological implications of these findings are discussed.

El razonamiento analógico desde el modelo de la teoría de los marcos relacionales / Analogical reasoning from the perspective of relational frame theory

El objetivo del presente trabajo es exponer una breve revisión del estudio del razonamiento analógico desde la Teoría de los Marcos Relacionales (TMR), considerando los modelos formulados hasta la actualidad y la exploración experimental. A sua vez, se abordará el estudio del desarrollo del razonamiento analógico en la infancia, surgido en el marco de las controversias generadas por los distintos enfoques de la psicología. Se expondrán los hallazgos obtenidos utilizando métodos de imágenes cerebrales desde las ciencias cognitivas. Finalmente se comentarán las posibles aplicaciones de este paradigma. Los estudios revisados acerca del razonamiento analógico desde la TMR proveen relevante evidencia empírica, principalmente en el ámbito de la evaluación y sugieren ventajas de este paradigma en comparación con aproximaciones cognitivistas. A su vez, se propone su implementación como instrumento de entrenamiento cognitivo. En conclusión, la TMR propone un modelo útil al estudio del razonamiento analógico desde la perspectiva del análisis del comportamiento.

The main goal of the present work is to summarize the Relational Frame Theory (RFT) account of analogical reasoning, reviewing theoretical models and experimental studies published so far. Additionally, developmental studies of analogical reasoning during childhood will be addressed, considering the alternative hypothesis and controversies between different psychological theories. Findings from cognitive studies using neuroimaging techniques will also be discussed. Finally, the potential applications of the paradigm will be considered. The studies reviewed about analogical reasoning from the RFT provide relevant empirical evidence, mainly in the field of assessment and suggest advantages of this paradigm compared to cognitivist approaches. In turn, its implementation is proposed as a tool for cognitive training. In conclusion, the RFT offers a useful model to study analogical reasoning from the behavior analysis perspective.

Fobia de deglutição: discussão analítico-comportamental de seus determinantes e da amplitude da mudança / Choking phobia: a behavior-analytic discussion concerning its determinants and the amplitude of change

A terapia analítico-comportamental de uma mulher de 35 anos, cujo caso foi anteriormente publicado estritamente em termos de seus aspectos psiquiátricos, é agora abordada com relação aos determinantes encontrados na história de vida da fobia de deglutição e de outras respostas da mesma classe funcional, todas envolvendo a esquiva experiencial. A psicoeducação envolveu uma detalhada análise funcional da fobia de deglutição e dos problemas de relacionamento, correlacionando numa única perspectiva ambos os fenômenos. A teoria dos quadros relacionais oferece uma possível explicação para o fato de que a cliente promoveu uma extensa e progressiva mudança no padrão alimentar e no relacionamento com pessoas significativas, após unicamente uma série de sessões de exposição gradual, com a presença do terapeuta, a diferentes grupos de alimentos, num delineamento de linha de base múltipla.

The behavior-analytic therapy of choking phobia in a 35 yrs-old woman, a case previously published focusing strictly on its psychiatric aspects, is now presented concerning specific life history determinants of both choking phobia and other responses of the same functional class, all of them involving experiential avoidance. Psychoeducation included detailed functional analysis of choking phobia and relationship problems, correlating both set of phenomena under a single perspective. By means of therapist-assisted graded exposure sessions to different sets of foods, according to a multiple baseline design, the fear subsided and ingesta returned to normal levels. In parallel, significant changes occurred in relationship patterns. Relational frame theory provides a possible explanation to the fact that the client promoted extensive and progressive changes in her eating pattern and relationship with significant others.

Evaluación y entrenamiento de la toma de perspectiva: una propuesta analítica funcional / Assessment and training of perspective taking: a functional analytical proposal

La toma de perspectiva difícilmente se desarrolla en los niños antes de los cuatro años de edad, según las investigaciones. Los protocolos usados hasta ahora están basados en situaciones hipotéticas con un alto nivel de abstracción y presentan un número limitado de ejemplos. Por esto, se desarrolló un protocolo para el entrenamiento de toma de perspectiva con base en situaciones reales, múltiples ejemplares y entrega de retroalimentación, manteniendo como constante las relaciones deícticas (YO-TÚ, AQUÍ-ALLÍ y AHORA-ENTONCES, simples e inversas). Bajo un diseño intrasujeto ABA, el protocolo fue efectivo para desarrollar las habilidades de toma de perspectiva en una niña de 3 años y 7 meses de edad, que no las presentaba al momento de la medición inicial. También, se analizan los datos correspondientes al número de sesiones requeridas para cada uno de los marcos y su complejidad a la luz de las investigaciones previas.

According to previous research, perspective-taking can't be easily developed before ages of four years old. Nevertheless, that studies used protocols based on hypothetical situations with a high level of abstraction and, additionally, with a limited number of examples. For this reason, a training protocol for perspective taking, based on real situations was developed. The protocol used a multiple exemplar training, and feedback was provided when was needed. Deictic frames was keeped as a constant (I-YOU, HERE-THERE and NOW-THEN, simple and reversed). An intrasubject ABA design was used in this research. It was obtained that the protocol was effective to develop the abilities of perspective taking in a girl of 3 years and 7 months old. She didn't show the abilities at the first measurement. Also the data of the number of sessions required for training each frame, and their complexity are analyzed under the light of previous research.

Transformación de funciones: Marcos de coordinación y oposición de acuerdo con equivalencia / Function transformation: Frames of coordination and opposition in equivalence relations

Esta investigación responde al interés por la dificultad que a veces tienen los sujetos para "cambiar" o "transformar" sus patrones de comportamiento. Investigaciones y teorías recientes desde el campo del análisis experimental del comportamiento y, más concretamente, desde una perspectiva de la Teoría de los Marcos Relacionales (RFT), abordan dicho fenómeno de una manera funcional y contextual. Desde este marco conceptual, el objetivo de este trabajo es establecer una historia experimental necesaria para generar repertorios de respuesta relacional de simetría y equivalencia en el marco de coordinación, y ver cómo son transformadas las funciones a un marco de oposición con base en las consecuencias que reciben los sujetos. Para ello, se diseñó y llevó a cabo un primer estudio cuyos resultados condujeron a variaciones en el procedimiento, lo que supuso la realización de un segundo experimento. La muestra estuvo compuesta de 16 sujetos, 7 en el primer experimento (5 mujeres y 2 hombres) y 9 en el segundo experimento (6 mujeres y 3 hombres) con edades comprendidas entre 20 y 40 años, quienes debían realizar una tarea de igualación a la muestra. Dicha tarea estuvo compuesta por dos fases y una evaluación final de las relaciones derivadas. La variable dependiente se definió como la ejecución del sujeto (número de ensayos) y la variable independiente como la introducción de imágenes aversivas y agradables en pro de la transformación de funciones. Finalmente, se discuten los datos intra e inter sujeto de los experimentos y algunas implicaciones prácticas.

This research is motivated by our interest in the difficulty that individuals show when trying to "change" or "convert" their behavioral patterns. Recent research and theories developed inside the experimental analysis of behavior, specifically from a Relational Framework Theory (RFT), expose that phenomenon from a functional-contextual way. From this conceptual frame, the purpose of this paper is to establish the experimental history needed to develop sets of symmetry relational responses and equivalence in the frames of sameness, and show the way the functions are transformed into a frame of opposition based upon the consequences that individuals receive. In order to achieve this goal, a first study was designed and carried out. The results obtained from this study led to several variations in the procedure and a second experiment was held. The sample was composed by 16 participants, ages between 20 and 40 who had to execute a matching-to-sample task. 7 individuals were used for the first experiment (5 females and 2 males) and 9 for the second (6 females and 3 males). The task was composed by two phases and a final evaluation of the derived relations. The dependent variable was defined as the execution of the individual (number of trials) and the independent variable as the introduction of aversive and pleasant pictures. Finally, the data obtained from both experiments is discussed intra e inter individual and some practical implications are outlined.

Comportamento verbal: uma análise da abordagem skinneriana e das extensões explicativas de Stemmer, Hayes e Sidman / Verbal Behavior: analysis of the skinnerian perspective and theexplaining extensions of Stemmer, Hayes and Sidman

Para Skinner comportamento verbal é um operante modelado e mantido por conseqüências mediadaspor outros. Portanto, poderia ser explicado por meio da descrição de relações funcionais organismoambiente. Entretanto, ao categorizar os operantes verbais Skinner não tratou satisfatoriamente com comportamentos de tipo relacional, provavelmente em função da dificuldade em determinar suas variáveis de controle. Este trabalho procurou analisar a abordagem skinneriana do comportamento verbal e três propostas que buscam ampliá-la (Stemmer, Hayes e Sidman). Stemmer amplia o alcance da explicação skinneriana descrevendo processos de aprendizagem relacional e sintático-gramaticalem termos do estabelecimento de discriminações e generalizações, enfatizando o papel de ouvintecomo condição necessária à aprendizagem de falante. Hayes e Sidman apresentam, respectivamente, a descrição de um novo tipo de operante e de um novo processo comportamental subjacente à aprendizagem de relações. Ainda que as propostas de Hayes e Sidman estejam alcançando resultados promissores no ensino de repertórios relacionais, não existe um consenso sobre quais mecanismos e processos bio-comportamentais são necessários para a aquisição e o desenvolvimento lingüístico. Sugere-se a necessidade de uma padronização conceitual no que se refere às noções de aprendizagemrelacional, classes de estímulos e classes de respostas generalizadas, visando um re-direcionamento das pesquisas sobre comportamento verbal.

Skinner defines verbal behavior as an operant shaped and maintained by consequences mediated by others. Therefore, it could be explained through the description of organism-environment functionalrelations. However, in his categorization of verbal operants Skinner didn?t treat satisfactorily withbehaviors of relational type, probably due to the difficulty to determine the controlling variables. Thiswork analyzed Skinnerian approach to verbal behavior and three proposals that aim to extend it(Stemmer, Hayes and Sidman). Stemmer extends the scope of Skinnerian explanation describingrelational and syntactic-grammatical learning processes in terms of the establishment ofdiscriminations and generalizations, emphasizing the listening role as a necessary condition to thelearning of speaking. Hayes and Sidman present, respectively, the description of a new kind of operant and a new behavioral process underlying relational learning. Although Hayes and Sidman?s proposals are reaching interesting results in teaching relational repertoires, there is not a consensus about what mechanisms and biobehavioral processes are necessary to the language acquisition and development.This work points to the need of a standardization of concepts related to the notions of relationallearning, stimuli classes formation, and generalized response classes, in order to redirect the researchon verbal behavior.