Avaliação Funcional e Intervenção em Respostas de Dor

Abstract

The main objective of this study was to identify the control exerted by antecedent events such as motivational operations (OM), discriminative stimuli (SD) and consequent reinforcing events on chronic pain responses, from four participants from a pain outpatient clinic in a hospital located in the Federal District. In order to do so, it was based on the indirect functional evaluation, which involved interviews with participants and family members, direct functional evaluation, which consisted of observation of the participants in different moments of their routines and the experimental functional evaluation with four main conditions: attention, demand, alone and control; the attention condition was subdivided into three other subconditions. All conditions were controlled by the delineation of multiple elements, both in application and in replication. Differential reinforcement of alternative behaviors (DRA) controlled by the ABA type reversal design, using two baseline (A) and one intervention (B) phases, were used for the intervention of pain responses. The results showed that in the minimal-attention sub- department the reports and facial expressions of P1 pain reached the highest frequency. In demand condition the highest frequency was for P3. Already in the condition of alone, only P1 emitted expressions of pain. In the control condition, no reports or expressions of pain were issued. Treatment data showed that DRA was effective in reducing P1 and P3 pain reports. Finally, the results were discussed in terms of the fact that pain has an adaptive function that allows the individual to escape situations that are harmful to their survival, although it can be harmful and incapacitating mainly when it becomes chronic; in a behavioral analytical perspective, pain is a private sensory response, which we have learned to describe from exposure to social contingencies and which, when expressed, provides access to potentially reinforcing consequences