Classificação e Diagnóstico na Clínica:
Possibilidades de um Modelo Analítico-Comportamental
Palavras-chave:
Sistemas de classificação, Categorias diagnósticas, Análise funcional, Behaviorismo radicalResumo
Este artigo discute o desenvolvimento de sistemas classificatórios para diagnóstico e tratamento de problemas psicológicos, revisando, brevemente, as mudanças implementadas no Manual Diagnóstico e Estatístico de Transtornos Mentais, DSM, e apontando restrições ao seu uso de uma perspectiva analítico-comportamental. Discute-se o potencial da análise funcional para engendrar um sistema alternativo de diagnóstico e classificação e argumenta-se que: (a) a proposição e uso de um sistema alternativo estarão limitados pelas peculiaridades da análise funcional no contexto clínico; e (b) no delineamento de sistemas alternativos, o critério de instrumentalidade deve incorporar uma perspectiva relacionai e externalista de explicação do comportamento
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Referências
Anderson, СМ., Hawkins, R.P. & Scotti, J.R. (1997). Private events
in behavior analysis: Conceptual basis and clinical relevance.
Behavior Therapy, 28, 157-179.
Associação Psiquiátrica Americana (1995). Manual Diagnóstico e
Estatístico de Transtornos Mentais - DSM-IV (Dayse Batista,
Trad.). Porto Alegre: Artes Médicas.
Barlow, D.H., Rapee, R.M., Brown, TA. (1992). Behavioral treatment
of generalized anxiety disorder. Behavior Therapy, 23,
551-570.
Beck, J.G. & Zebb, B.J. (1994). Behavioral assessment and treatment
of panic disorder: Current status, future directions. Behavior
Therapy, 25, 581-611.
Beutler, L.E. (1998). Identifying empirically supported treatments:
What if we didn't? Journal of Consulting and Clinical Psychology,
66, 113-120.
Blashfield, R.K., Draguns, J.G. (1976). Toward a taxonomy of psychopathology:
The purpose of psychiatric classification. British
Journal of Psychiatry, 129, 574-83.
Caar, E.G. (1993). Behavior Analysis is not ultimately about behavior.
The Behavior Analyst, 16, 47-49.
Carr, E.G. (1994). Emerging themes in the functional analysis of
problem behavior. Journal of Applied Behavior Analysis, 27,
393-399.
Ciminero, A.R. (1986). Behavioral Assessmemt: An overview. Em
Anthony Ciminero, Karen S. Calhoun & Henry E. Adms (Orgs.),
Handbook of Behavior Assessment (pp. 3-11). New York: John
Willey & Sons.
Craighead, L.W., Craighead, W.E., Kazdin, A.E. & Mahoney, M.J.
(1994). Cognitive and behavioral interventions. An empirical
approach to mental heatlh problems. Boston: Allyn & Bacon.
Ferster, C.B. (1973). A functional analysis of depression. American
Psychologist, 28 (10), 857-870.
Follette, W.C. & Houts, A.C. (1996). Models of scientific progress
and the role of theory in taxonomy development: A case study
of the DSM. Journal of Consulting and Clinical Psychology,
64, 1120-1132.
Hawkins, R.P. (1986). Selection of target behaviors. Em Hayes, S.
C. & Nelson, R.O. (Orgs.), Conceptual foundations of behavioral
assessment (pp. 331-385). New York: Guilford.
Hayes, S.C & Follette, W.C. (1992). Can functional analysis provide
a substitute for syndrome classification? Behavior Assessment,
14, 345-365.
Hayes, S.C. & Hayes, L. (1992). Some clinical implications of
contextualistic behaviorism: The example of cognition. Behavior
Therapy, 23, 225-249.
Hayes, S.C, Wilson, K.G., Gifford, E. Y, Follette, V. M. & Strosahl,
K. (1996). Experiential avoidance and behavioral disorders: A
functional dimensional approach to diagnosis and treatment.
Journal of Consulting and Clinical Psychology, 64, 1152-1168.
Haynes, S.N. (1986). The design of intervention programs. Em
R.O. Nelson & S.C. Hayes (Orgs.), Conceptual Foundations
of Behavioral Assessment (pp. 386-429). New York: Guilford.
Hersen, M. (1988). Behavioral assessment and psychiatric diagnosis.
Behavioral Assessment, 10, 107-121.
Holburn, S. (1997). A renaissance in residential behavior analysis?
A historical perspective and a better way to help people with
challenging behavior. The Behavior Analyst, 20, 61-85.
Kanfer, F.H. & Grinnim, L.G. (1977). Behavioral analysis: Selecting
target behaviors in the interview. Behavior Modification, 1,
7-28.
Psic.: Teor. e Pesq., Brasilia, Mai-Ago 1998, Vol. 14 n. 2, pp. 139-147
Kazdin, A. (1983). Psychiatric diagnosis dimensions of disfunction
and child behavior therapy. Behavior Therapy, 14, 73-99.
Maser, J.D., Kaelber, С & Weise, R.E. (1991). International use
and attitudes toward DSM-III and DSM-III-R: Growing consensus
in psychiatric classification. Journal of Abnormal Psychology,
100, 271-279.
Millon, T. (1991). Classification in psychopatology: Rationale, alternatives,
and standards. Journal of Abnormal Psychology, 100,
245-261.
Morey, L.C., Skinner, H.A. & Blasshfield, R.K. (1986). Trends in
the classification of abnormal behavior. Em A. Ciminero, K.S.
Calhoun & H.E. Adams (Orgs.), Handbook of Behavior Assessment
(pp. 47-75). New York, John Willey & Sons.
Pepper, S.C. (1970). World hypotheses: A study in evidence. Berkeley,
CA: University of California Press. (Originalmente
publicado em 1942)
Pessotti, I. (1994). A loucura e as épocas. Rio de Janeiro, Editora
34.
Pichot, P. (1994). Nosological models in psychiatry. British Journal
of Psychiatry, 164, 232-240.
Shapiro, M.B. (1989). A phenomenon-oriented strategy in depression
research. British Journal of Clinical Psychology, 28, 289-
305.
Skinner, B.F. (1965). Science and human behavior. New York/London:
Free Press/Collier MacMillan. (Originalmente publicado
em 1953)
Skinner, B.F. (1989). The operant side of behavior therapy. Recent
issues in the analysis of behavior (pp.121-135). Columbus,
Ohio: Merrill. (Originalmente publicado em 1988)
Skinner, B.F. (1969). Behaviorism at fifty. Em Skinner, B.F. (1969).
Contingencies of reinforcement: A theorical analysis (pp. 221-
268). New York: Appleton-Century-Crofts. (Originalmente
publicado em 1963)
Sobell, L.C., Toneatto, T. & Sobell, M.B. (1994). Behavioral assessment
and treatment planning for alcohol, tobacco and other
drug problems: Current status with an emphasis on clinical
applications. Behavior Therapy, 25, 533-580.
Steketee, G. (1994). Behavioral assessment and treatment planning
with obsessive compulsive disorder: A review emphasizing
clinical application. Behavior Therapy, 25, 613-633.
Sturmey, PS. (1996). Functional analysis in clinical psychology.
England: John Willey & Sons.
in behavior analysis: Conceptual basis and clinical relevance.
Behavior Therapy, 28, 157-179.
Associação Psiquiátrica Americana (1995). Manual Diagnóstico e
Estatístico de Transtornos Mentais - DSM-IV (Dayse Batista,
Trad.). Porto Alegre: Artes Médicas.
Barlow, D.H., Rapee, R.M., Brown, TA. (1992). Behavioral treatment
of generalized anxiety disorder. Behavior Therapy, 23,
551-570.
Beck, J.G. & Zebb, B.J. (1994). Behavioral assessment and treatment
of panic disorder: Current status, future directions. Behavior
Therapy, 25, 581-611.
Beutler, L.E. (1998). Identifying empirically supported treatments:
What if we didn't? Journal of Consulting and Clinical Psychology,
66, 113-120.
Blashfield, R.K., Draguns, J.G. (1976). Toward a taxonomy of psychopathology:
The purpose of psychiatric classification. British
Journal of Psychiatry, 129, 574-83.
Caar, E.G. (1993). Behavior Analysis is not ultimately about behavior.
The Behavior Analyst, 16, 47-49.
Carr, E.G. (1994). Emerging themes in the functional analysis of
problem behavior. Journal of Applied Behavior Analysis, 27,
393-399.
Ciminero, A.R. (1986). Behavioral Assessmemt: An overview. Em
Anthony Ciminero, Karen S. Calhoun & Henry E. Adms (Orgs.),
Handbook of Behavior Assessment (pp. 3-11). New York: John
Willey & Sons.
Craighead, L.W., Craighead, W.E., Kazdin, A.E. & Mahoney, M.J.
(1994). Cognitive and behavioral interventions. An empirical
approach to mental heatlh problems. Boston: Allyn & Bacon.
Ferster, C.B. (1973). A functional analysis of depression. American
Psychologist, 28 (10), 857-870.
Follette, W.C. & Houts, A.C. (1996). Models of scientific progress
and the role of theory in taxonomy development: A case study
of the DSM. Journal of Consulting and Clinical Psychology,
64, 1120-1132.
Hawkins, R.P. (1986). Selection of target behaviors. Em Hayes, S.
C. & Nelson, R.O. (Orgs.), Conceptual foundations of behavioral
assessment (pp. 331-385). New York: Guilford.
Hayes, S.C & Follette, W.C. (1992). Can functional analysis provide
a substitute for syndrome classification? Behavior Assessment,
14, 345-365.
Hayes, S.C. & Hayes, L. (1992). Some clinical implications of
contextualistic behaviorism: The example of cognition. Behavior
Therapy, 23, 225-249.
Hayes, S.C, Wilson, K.G., Gifford, E. Y, Follette, V. M. & Strosahl,
K. (1996). Experiential avoidance and behavioral disorders: A
functional dimensional approach to diagnosis and treatment.
Journal of Consulting and Clinical Psychology, 64, 1152-1168.
Haynes, S.N. (1986). The design of intervention programs. Em
R.O. Nelson & S.C. Hayes (Orgs.), Conceptual Foundations
of Behavioral Assessment (pp. 386-429). New York: Guilford.
Hersen, M. (1988). Behavioral assessment and psychiatric diagnosis.
Behavioral Assessment, 10, 107-121.
Holburn, S. (1997). A renaissance in residential behavior analysis?
A historical perspective and a better way to help people with
challenging behavior. The Behavior Analyst, 20, 61-85.
Kanfer, F.H. & Grinnim, L.G. (1977). Behavioral analysis: Selecting
target behaviors in the interview. Behavior Modification, 1,
7-28.
Psic.: Teor. e Pesq., Brasilia, Mai-Ago 1998, Vol. 14 n. 2, pp. 139-147
Kazdin, A. (1983). Psychiatric diagnosis dimensions of disfunction
and child behavior therapy. Behavior Therapy, 14, 73-99.
Maser, J.D., Kaelber, С & Weise, R.E. (1991). International use
and attitudes toward DSM-III and DSM-III-R: Growing consensus
in psychiatric classification. Journal of Abnormal Psychology,
100, 271-279.
Millon, T. (1991). Classification in psychopatology: Rationale, alternatives,
and standards. Journal of Abnormal Psychology, 100,
245-261.
Morey, L.C., Skinner, H.A. & Blasshfield, R.K. (1986). Trends in
the classification of abnormal behavior. Em A. Ciminero, K.S.
Calhoun & H.E. Adams (Orgs.), Handbook of Behavior Assessment
(pp. 47-75). New York, John Willey & Sons.
Pepper, S.C. (1970). World hypotheses: A study in evidence. Berkeley,
CA: University of California Press. (Originalmente
publicado em 1942)
Pessotti, I. (1994). A loucura e as épocas. Rio de Janeiro, Editora
34.
Pichot, P. (1994). Nosological models in psychiatry. British Journal
of Psychiatry, 164, 232-240.
Shapiro, M.B. (1989). A phenomenon-oriented strategy in depression
research. British Journal of Clinical Psychology, 28, 289-
305.
Skinner, B.F. (1965). Science and human behavior. New York/London:
Free Press/Collier MacMillan. (Originalmente publicado
em 1953)
Skinner, B.F. (1989). The operant side of behavior therapy. Recent
issues in the analysis of behavior (pp.121-135). Columbus,
Ohio: Merrill. (Originalmente publicado em 1988)
Skinner, B.F. (1969). Behaviorism at fifty. Em Skinner, B.F. (1969).
Contingencies of reinforcement: A theorical analysis (pp. 221-
268). New York: Appleton-Century-Crofts. (Originalmente
publicado em 1963)
Sobell, L.C., Toneatto, T. & Sobell, M.B. (1994). Behavioral assessment
and treatment planning for alcohol, tobacco and other
drug problems: Current status with an emphasis on clinical
applications. Behavior Therapy, 25, 533-580.
Steketee, G. (1994). Behavioral assessment and treatment planning
with obsessive compulsive disorder: A review emphasizing
clinical application. Behavior Therapy, 25, 613-633.
Sturmey, PS. (1996). Functional analysis in clinical psychology.
England: John Willey & Sons.
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Publicado
2012-09-12
Como Citar
Neno Cavalcante, S., & Zagury Tourinho, E. (2012). Classificação e Diagnóstico na Clínica:: Possibilidades de um Modelo Analítico-Comportamental. Psicologia: Teoria E Pesquisa, 14(2), 139–147. Recuperado de https://periodicos.unb.br/index.php/revistaptp/article/view/17319
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