Faulstich M E, Moore J R, Roberts R W, Collier J B
Duke University School of Medicine, Durham, NC 27710.
Psychiatry. 1988 Nov;51(4):398-416. doi: 10.1080/00332747.1988.11024416.
THIS paper provides a selective overview of behavioral approaches for conduct-disordered behavior. Although no definitive statement can be made regarding etiology, some empirical support exists for behavioral strategies. Assessment approaches discussed include the behavioral interview, behavioral observations, and behavioral checklists. Decisions regarding types of behavioral interventions to be employed directly follow from assessment data. Assessment information can be formulated in terms of a behavioral excess/skill deficit model. Hence, conduct-disordered behavior can be a function of excessive disruptive behavior and/or a lack of requisite skills necessary to obtain satisfaction. Parental training strategies in contingency management and contingency contracting are discussed regarding behavioral excesses. Relative to skill deficits, contingency procedures along with skills training in communication, problem-solving and self-control are reviewed, using parental training and cognitive-behavioral frameworks. In general, these interventions have empirically demonstrated efficacy. However, future research is required to identify specific factors that account for successful treatment, and attention should be directed toward preventive issues. Important data could be obtained from the identification of high-risk environmental situations. A predictive understanding of high-risk populations could result in the development of early intervention programs, which might to some extent obviate the occurrence of conduct disorders.
本文对针对品行障碍行为的行为学方法进行了选择性概述。尽管关于病因学无法给出确切论断,但行为策略有一定的实证支持。所讨论的评估方法包括行为访谈、行为观察和行为清单。关于采用何种行为干预类型的决策直接基于评估数据。评估信息可以依据行为过度/技能缺陷模型来制定。因此,品行障碍行为可能是过度破坏性行为和/或缺乏获得满足所需必要技能的结果。针对行为过度,讨论了在应急管理和应急契约中的家长培训策略。相对于技能缺陷,运用家长培训和认知行为框架,对应急程序以及沟通、解决问题和自我控制方面的技能培训进行了综述。总体而言,这些干预措施已在实证上证明了其有效性。然而,需要未来的研究来确定促成成功治疗的具体因素,并且应关注预防问题。从识别高风险环境状况中可以获得重要数据。对高风险人群的预测性了解可能会促成早期干预项目的开展,这在一定程度上可能避免品行障碍的发生。