|
| Behavioral Developmental Treatment of Personality Disorders |
| Monday, May 25, 2009 |
| 1:30 PM–2:50 PM |
| North 224 A |
| Area: CBM; Domain: Applied Behavior Analysis |
| Chair: Michael Lamport Commons (Harvard Medical School) |
| Abstract: The current clinical approach to personality disorders considers them to be properties of the individual, but distinct from mental illness. This view places blame on the individual and turns the disorder into a moral issue. This symposium lays out a new behavioral developmental conceptual framework for studying the development of personality disorders. As a central hypothesis to this approach, we argue that personality disorders and mental illness lie on a continuum, and the major difference between the two is the rate of psychotic incidents and the generality of the context. The first presentation introduces two sets of dimensions we use in our approach to observing personality disorders: The first being social interpersonal perspective taking and intrapersonal perspective taking, and the second being how a person handles value, discounting and delay, risk and change of value in reinforcement and punishment. The second presentation uses a behavioral developmental perspective to address the consequences of various types of traumatic events. The third presentation explores failures in social perspective taking that occur in personality disorders and their resultant negative behaviors. The final presentation focuses on the process of Behavioral Developmental Treatment. This focus clearly defines steps and goals in the treatment of personality disorders. |
| |
| Behavioral Developmental Perspective on Personality Disorders |
| JOSEPH ANTHONY RODRIGUEZ (Dare Institute), Michael Lamport Commons (Harvard Medical School), Jonas G. MIller (Dare Institute) |
| Abstract: This symposium lays out a behavioral developmental conceptual framework for studying the development of personality disorders. We argue that all personality disorders can be described using two sets of dimensions. The first set is social interpersonal perspective taking and intrapersonal perspective taking. The second set of dimensions is how a person handles value, discounting and delay, risk and change of value in reinforcement and punishment. On the one hand, it accounts for abnormal behavior by examining the retarded stage of functioning of the person on social/intrapersonal performance. On the other hand, it accounts for abnormal behavior by examining the person’s discrimination of the changes of value of consequences. The reason for using these two sets of dimensions to view personality disorder is that neither of them have any specific content, nor do they refer to any particular set of symptoms. What these two sets of dimensions accomplish is they describe, using just a few dimensions rather than large lists of symptoms, how a person is behaving in a counterproductive way. This approach emphasizes continuity across many forms of personality disorders and mental illness. |
| |
| Trauma and Development of Personality Disorders |
| JOSEPH ANTHONY RODRIGUEZ (Dare Institute), Michael Lamport Commons (Harvard Medical School), Jonas G. MIller (Dare Institute) |
| Abstract: About 1/3 of children who experience trauma seem to develop severe problems. The resultant disorders may include anxiety, conduct and personality disorders. Progress has been made in treating some of these disorders using behavior-analytic techniques. Although behavior-analytic practitioners work with victims of trauma, there is no clearly stated and widely accepted behavioral analytic or learning account for the development of trauma-related problems. Also, there is no behavioral theory, nor many studies, that detail the relationship between the forms of traumas, when they occur, and their behavioral outcomes. Trauma can take place in three major forms: Physical/sexual abuse, psychological abuse and abandonment. Both physical and psychological abuse involve strong aversive stimulation. Abandonment may also involve strong aversive stimulation but in situations in which attachment objects are not available. That stimulation has been shown to elicit “fear” responses and inhibit many behaviors present at the time of the occurrence. Our hypothesis is that the effect of trauma will vary with form, intensity and length of trauma and the hierarchical complexity of relationships that can be discriminated by the individual at the time of the trauma. The consequences of trauma should be able to be clearly delineated from a behavioral point of view. |
| |
| Failures in Social Perspective Taking at Different Behavioral Developmental Stages and Negative Behavioral Outcomes |
| JONAS G. MILLER (Dare Institute), Michael Lamport Commons (Harvard Medical School) |
| Abstract: Social perspective taking is defined as understanding, acknowledging, and integrating the view point of another person with one’s own. For example, when individuals are involved in a social conflict they literally take the other individuals’ perspectives of the conflict and integrate them with their own. According to Commons and Rodriguez (1990), individuals must identify what causes their behavior and what effect it has on both themselves and others. Individuals benefit from anticipating what effects complex social arrangements have on other peoples’ behavior as well as on their own. Social perspective taking is a developmental skill that can be measured from a behavioral developmental stage theory perspective. Failures in social perspective taking are observed through deficient interpersonal strategies that result in problematic social relations. Depending on stage of development, different impairments in social perspective taking are associated with different negative behavioral outcomes. For example, individuals with Psychopathic, Antisocial and Borderline Personality Disorder do not understand social norms. This would require an understanding of how most others view social behaviors. Non-understanding of how others view them results in behaviors such as acting out in public, lying and cheating. This paper explores various failures in social perspective taking and their related negative behaviors. |
| |
| Behavioral Developmental Treatment |
| JONAS G. MILLER (Dare Institute), Michael Lamport Commons (Harvard Medical School) |
| Abstract: Behavioral developmental treatment begins with a discussion of problems and recognition of the patient’s suffering. The therapist also focuses on what the patient’s short and long term reinforcers are. Patients are asked what they like to do, what they value, etc. Interest tests are often used along with a discussion of what kinds of reinforcers the interests represent. Behavior-development treatment utilizes many behavior teaching techniques to develop social perspective taking skills. These include: role playing, guessing what people think and then asking them what they did think, predicting how they will behave and checking the actual outcome, asking them how others will feel and then asking them how they felt, interviewing others about how they make their decisions and justify their behavior towards others; and asking them who is doing what to whom in a situation. Most personality disorders involve fears, especially over issues of delays and risk of bad outcomes due to possible loss, rejection, abandonment, etc. People describe their fears so that behavioral desensitization can be used. These also include the setting of and adherence to strict contingencies of reinforcement. There is a discussion of the experimental methods used in this treatment and its possible benefits and dangers. |
|
| |