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Processo terap?utico anal?tico-comportamental em dois casos de Transtorno Dism?rfico Corporal / Behavior analytic therapeutic process in two cases of Body Dysmorphic Disorder

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Previous issue date: 2007-04-13 / The Body Dysmorphic Disorder (DDB) consists of an exaggerated preoccupation with a minimal or imaginary defect in the appearance. Diagnosed individuals develop characteristic behaviors such as: checking in the mirror, trying to disguise and asking about the defect; comparing themselves to other people; searching for plastic surgery; isolating themselves from social life. The DDB has been considered as a disorder of difficult treatment. Different approach therapists have been studying the specific procedures that cause the changes, during the therapeutic process and behavior analysts have been searching for an applied research method which might be close to the clinical practice. The objective of this study was to describe ten initial sessions of two DDB cases, from functional relations among verbal descriptions of the participant-therapist match. It was sought to describe the procedures of modeling of observation behaviors and description of the contingencies, controlled behaviors in natural environment. The therapeutic objective was to raise incompatible behaviors to indicative behaviors of social problems, chosen as analysis and interventions. The researcher was the therapist. The participants were selected from a file identification, which together with a diagnosis auxiliary scale and a semistructured interview itinerary, allowed the raising of the problem behaviors and the general repertory of each one. With the collected data, it was made a descriptive functional analysis, which indicated the behaviors to be developed in each case. It was made a systematization of the raised behaviors delivered to the patients so that they could register their problem behaviors. The participants were guided to observe and describe their behaviors and determined involved stimulus in daily registrations. In each session when the registrations were read, it was sought to model more elaborated verbal descriptions about the relations among environmental contingencies and the target and incompatible behaviors towards them. After the sessions transcriptions, 30 verbal episodes were selected to each one of the matches. First of all, episodes which indicated changes in the participants verbalizations were identified, and after, the ones which were probably related to these changes. Verbalizations related to the descriptions of the relations among the environmental contingencies and behaviors were raised; to descriptions of incompatible behaviors emitted in natural environment; to descriptions of self-instruction and selfcontrol. The developed behaviors seem to have widened the source of natural positive reinforcements, mainly social ones. Despite of presenting the same diagnosis, the therapeutic process was well particular for each participant. The used procedures depended on the initial repertory and on the natural contingencies to which their descriptions were under control every session. Participants verbalizations could be seen as coming up with descriptions of more elaborated functional relations. Environmental contingencies seem to control target behaviors out of the sessions and participants verbal relations in them. / O Transtorno Dism?rfico Corporal (TDC) consiste em uma preocupa??o exagerada com um defeito m?nimo ou imaginado na apar?ncia. Indiv?duos diagnosticados desenvolvem comportamentos caracter?sticos como: checar no espelho, tentar camuflar e perguntar sobre o defeito; comparar-se com outras pessoas; buscar cirurgias pl?sticas; isolar-se socialmente. O TDC tem sido considerado como um transtorno de dif?cil tratamento. Terapeutas de diferentes abordagens v?m estudando os procedimentos espec?ficos que causam as mudan?as, durante o processo terap?utico e analistas do comportamento t?m buscado um m?todo de pesquisa aplicada, que se aproxime da pr?tica cl?nica. O objetivo deste estudo foi descrever dez sess?es iniciais de dois casos de TDC, a partir de rela??es funcionais entre relatos verbais das d?ades terapeuta-participante. Buscou-se descrever como procedimentos de modelagem de comportamentos de observa??o e descri??o das conting?ncias controlaram comportamentos em ambiente natural. O objetivo terap?utico era aumentar comportamentos incompat?veis a comportamentos indicativos de problemas sociais, escolhidos como alvo da an?lise e das interven??es. A pr?pria pesquisadora foi a terapeuta. Os participantes foram selecionados a partir de uma ficha de identifica??o, que juntamente com uma escala auxiliar de diagn?stico e um roteiro de entrevista semiestruturada, possibilitaram levantar os comportamentos-problema e o repert?rio geral de cada um. Com os dados coletados foi feita uma an?lise funcional descritiva, que indicou os comportamentos a serem desenvolvidos em cada caso. Foi feita uma sistematiza??o dos comportamentos levantados, que foi entregue aos participantes, para que registrassem, em um roteiro di?rio, seus comportamentos-problema. Os participantes eram orientados a observar e descrever, em registros di?rios, seus comportamentos e determinados est?mulos envolvidos. A cada sess?o, em que os registros eram lidos, procurava-se modelar descri??es verbais mais elaboradas sobre rela??es entre conting?ncias ambientais e comportamentos-alvo e incompat?veis a eles. Ap?s a transcri??o das sess?es, foram selecionados 30 epis?dios verbais para cada uma das d?ades. Primeiramente, foram identificados epis?dios que indicavam mudan?as nas verbaliza??es dos participantes, depois, foram procurados epis?dios anteriores, tanto intra, como intersess?es, que provavelmente, estivessem relacionados ?s mudan?as. Aumentaram verbaliza??es referentes ?s descri??es de rela??es entre conting?ncias ambientais e comportamentos; a relatos de comportamentos incompat?veis emitidos em ambiente natural; a relatos de autoinstru??o e autocontrole. Os comportamentos desenvolvidos parecem ter ampliado a fonte de refor?adores positivos naturais, principalmente sociais. Apesar de apresentarem o mesmo diagn?stico, o processo terap?utico foi bem particular para cada participante. Os procedimentos utilizados dependeram do repert?rio inicial e das conting?ncias naturais a que seus relatos estavam sob controle a cada sess?o. Verbaliza??es dos participantes puderam ser vistas como chegando a descri??es de rela??es funcionais mais elaboradas. Conting?ncias ambientais pareceram controlar comportamentos-alvo fora das sess?es e relatos verbais dos participantes dentro delas.

Identiferoai:union.ndltd.org:IBICT/oai:tede.bibliotecadigital.puc-campinas.edu.br:tede/383
Date13 April 2007
CreatorsMoriyama, Josy de Souza
ContributorsAmaral, Vera Lucia Adami Raposo do, Hubner, Maria Martha Costa, Banaco, Roberto Alves, Laloni, Diana Tosello, Brasio, Karina Magalh?es
PublisherPontif?cia Universidade Cat?lica de Campinas, Programa de P?s-Gradua??o em Psicologia, PUC-Campinas, BR, CCV ? Centro de Ci?ncias da Vida
Source SetsIBICT Brazilian ETDs
LanguagePortuguese
Detected LanguageEnglish
Typeinfo:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis
Formatapplication/pdf
Sourcereponame:Biblioteca Digital de Teses e Dissertações da PUC_CAMPINAS, instname:Pontifícia Universidade Católica de Campinas, instacron:PUC_CAMP
Rightsinfo:eu-repo/semantics/openAccess

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