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Resumen de Estudos de pesquisa básica sobre transferência de extinção e suas implicações para as terapias baseadas em exposição

Leandro da Silva Boldrin, Daniel Afonso Assaz, Paula Debert

  • português

    As terapias baseadas em exposição colocam o cliente não só diante do evento aversivo, mas também diante de estímulos relacionados a esse evento (e.g., cenários imaginados e narrativas), produzindo resultados clinicamente positivos em ambos os casos. Com isso, surge o desafio de compreender como a exposição a estímulos relacionados ao evento aversivo podem ser capazes de reduzir as respostas de medo/ansiedade e fuga/esquiva do evento aversivo em si. Afinal, a identificação deste processo pode aumentar a efetividade das intervenções. O objetivo do presente artigo é fazer uma revisão dos estudos de pesquisa básica que avaliaram a transferência de extinção em classes de equivalência ou em outros tipos de relações derivadas e discutir as implicações deles para a prática clínica. Inicialmente, é apresentado uma breve síntese sobre transferência de função em classes de equivalência e sobre a transformação de função em outros tipos de relações derivadas. Em seguida, são descritos os principais estudos de pesquisa básica que avaliaram a transferência de extinção de respostas respondentes e operantes de esquiva em classes de equivalência ou em outros tipos de relações derivadas. Por fim, são discutidas implicações clínicas dos achados experimentais obtidos até o momento.

  • English

    In exposure-based therapies, the client is asked to contact events that he fears and also those that are related to the events that he fears. In this case, he is asked to imagine, for example, scenarios and narratives. Both situations produce clinically positive results. Traditional behavioral models of anxiety disorders explain the acquisition, maintenance and reduction of fear/ anxiety and escape/avoidance responses based on a learning history of direct conditioning.

    So, it does not provide a satisfactory understanding of how the fear/anxiety and escape/avoidance responses of a particular event may be acquired or reduced through exposure to related events. Research advances from the area of Stimulus Equivalence and Relational Frame Theory, on the other hand, provide an understanding of how fear/anxiety and escape/avoidance behavior can be acquired or reduced even in the absence of direct conditioning. This understanding may be helpful in attempting to provide a more complete account of anxiety disorders and improve the interventions’ effectiveness in clinical practice. The present paper reviews the basic research that investigated the transfer of extinction in equivalence classes and other derived relations and discusses their implications for clinical practice. First, a brief summary is provided about how transfer of function is produced after the establishment of equivalence classes and how transformation of function is produced after the establishment of other derived relations. Then, the basic experimental research that investigated the transfer of extinction of both respondent and operant avoidance responses in equivalence relations or in other derived relations are described and articulated. Lastly, the implications of these experimental findings for clinical practice are discussed. The results indicate that there are few studies investigating the transfer of extinction. These studies had several limitations regarding experimental control and their comparison is limited due to a lack of continuity in experimental parameters. Thus, despite the fact that Sidman’s theory about the establishment of equivalence classes and Relational Frame Theory provide a theoretical explanation for reducing of fear/anxiety and escape/avoidance responses through exposure to stimuli related to the aversive event feared by the client, the experimental basis necessary to comprehend this phenomenon is still incipient and does not allow a translation to clinical practice with a high degree of confidence. A basic research agenda will be necessary for advancing the understanding of basic processes that are involved in the transfer of extinction and to better inform clinical practice. During this research agenda, a dialogue between clinical and basic research will also be essential.


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