ABSTRACT
Resumen La teoría de la mente emerge en el desarrollo con anterioridad a la memoria episódica, posibilitando a través de la capacidad de metarrepresentación el desdoblamiento y viaje mental que ella misma implica. Para la evaluación de los procesos se administraron las Historias Extrañas de Happé, el Test de las miradas, el Test de Aprendizaje Verbal España-Complutense y una tarea experimental a 20 mujeres con diagnóstico de Síndrome de Turner y sus respectivos controles. Los resultados indican dificultades en ambos procesos cognitivos y correlaciones entre la teoría de la mente e indicadores de memoria episódica de contenido y de la fuente. Se hipotetiza que la anatomía cerebral atípica, propia de esta población, traería problemas en el desarrollo de la teoría de la mente y esto, a su vez, podría asociarse con dificultades en los mecanismos de metarrepresentación y reexperimentación subjetiva de vivencias que la memoria episódica implica. Los resultados obtenidos permiten una mayor comprensión del perfil neuropsicológico de las mujeres con diagnóstico de Síndrome de Turner y podrían servir de insumo teórico para el diseño de estrategias clínicas y psicoeducativas que tiendan a fomentar, en esta población, las habilidades de teoría de la mente y memoria episódica.
Abstract The present study explores the relations between the cognitive and affective processes of theory of mind and verbal episodic memory in women diagnosed with Turner Syndrome, a chromosomal disorder caused by a missing or incomplete X chromosome in females. Women with this diagnostic present an atypical cerebral morphology affecting frontal and temporoparietal zones. These areas match the neuroanatomic substratum shared by both theory of mind and episodic memory. The concept of theory of mind refers to the ability to anticipate others' social behavior through the attribution and understanding of mental entities such as desires, beliefs, emotions and intentions. It is a complex skill that involves not only the mental representation of something that cannot be observed directly, but also the decentration of one's own perspective and the use of these skills to predict behaviors. This ability is composed by two different processes: a cognitive theory of mind that refers to the ability to make inferences about desires, beliefs and intentions of other people; and an affective theory of mind, related to the ability to infer others' emotions, understanding the affective mental states and adopting the point of view of the other person, without experiencing these emotions. In the particular case of women diagnosed with Turner Syndrome, there is evidence supporting the hypothesis that this population presents general difficulties in this ability, showing a greater deficit in cognitive theory of mind. On the other hand, episodic memory consists of the memory that one has of past experiences. This memory system is a psychological process of paramount importance for human beings, since it enables the remembrance of something that has happened a long time ago. It allows the person to re-experience events that occurred earlier in his or her life, involving the ability to generate meta-representational comments on how knowledge was obtained. This way, people revive, through self-awareness, previous experiences and also project similar experiences to the future. Episodic memory can be divided into the memory about the occurrence of an event (item memory) and the memory of the phenomenological context of the event, which involves the handling of spatial, temporal, emotional and perceptual information (source memory). It is considered that theory of mind has an earlier development than episodic memory, enabling through the capacity of meta-representation the unfolding and mental journey that episodic memory implies. In order to evaluate these processes, a battery of four tests was administered to 20 women diagnosed with Turner Syndrome and their respective controls: Happé Strange Stories, the Reading the Mind in the Eyes Test, the Spain-Complutense Verbal Learning Test and an experimental task. Results indicate difficulties in both cognitive processes, as well as correlations between theory of mind and indicators of item and source memory. A possible hypothesis could argue that the atypical cerebral anatomy of women diagnosed with Turner Syndrome would result in theory of mind deficits, and these in turn could be associated with difficulties in the capacities of meta-representation and subjective re-experimentation of past events needed by episodic memory. These results enable a better comprehension of the neuropsychological profile of women diagnosed with Turner Syndrome and could serve as a theoretical input for the design of clinical and psychoeducational strategies that tend to promote theory of mind and episodic memory in this population.
ABSTRACT
El objetivo del presente trabajo fue identificar la existencia de perfiles distintivos en las escalas de personalidad en relación con la aplicación o no de hormona de crecimiento en 73 mujeres adultas con diagnóstico de Síndrome de Turner de Latinoamérica. Para ello se administró, en formato online, el Inventario Clínico Multiaxial de Millon II y un cuestionario clínico para recabar datos sobre la realización o no de tratamiento con hormona de crecimiento durante el desarrollo con el fin de omparar ambos grupos. Los resultados encontrados muestran que el grupo que no realizó tratamiento con hormona de crecimiento obtiene medias más altas en casi la totalidad de las escalas de personalidad básicas y patológicas en comparación con el grupo que sírealizó tratamiento, siendo dicha diferencia significativa en la escala esquizotípica. Esta escala se asocia con necesidades afectivas mínimas, aislamiento social y apego empobrecido. Estos resultados podrían dar cuenta que el tratamiento con hormona de crecimiento sería un factor positivo para esta población, favoreciendo el desarrollo de características de personalidad más adaptativas en relación a lo social.
The aim of this study was to identify the existence of distinctive profiles on the personality scales in relation to the application or not of the growth hormone in 73 adult women diagnosed with Turner Syndrome in Latin America. For it was administered, in online form, the Millon Clinical Multiaxial Inventory II and a clinical questionnaire to collect data on the realization or non-treatment with growth hormone during development in order to compare both groups. The results show that the group did not make growth hormone treatment gets highest averages in nearly all of the basic and pathological personality scales compared to the group that if he completed treatment, being such significant difference in schizotypal scale. This scale is associatedwith minimal emotional needs, social isolation and impoverished attachment. These results might note that treatment with growth hormone could be a positive factorfor this population, favoring the development of more adaptive personality characteristics in relation to the social aspects.
Subject(s)
Humans , Adolescent , Adult , Female , Young Adult , Middle Aged , Growth Hormone/administration & dosage , Millon Clinical Multiaxial Inventory , Personality , Turner Syndrome/psychology , Turner Syndrome/drug therapyABSTRACT
El Síndrome de Turner es el trastorno cromosómico, no heredable, de mayor incidencia poblacional en el sexo femenino, determinado por la deleción parcial o total del cromosoma X. En el desarrollo de las mujeres con este diagnóstico intervienen factores genéticos, familiares, educacionales y sociales que resultan relevantes en la consolidación de la personalidad. El objetivo del trabajo realizado fue caracterizar la personalidad de mujeres adultas con Síndrome de Turner residentes en Latinoamérica. La muestra fue de tipo no probabilístico intencional y corresponde a 60 mujeres entre 18 y 55 años. Los datos se recabaron a través de una versión virtual del Inventario Clínico Multiaxial de Millon II. Se transformaron las puntuaciones directas en puntuaciones Tasa Base y se obtuvieron estadísticos descriptivos de frecuencias y medidas de tendencia central para caracterizar a las participantes de la muestra. Posteriormente se calculó la razón de momios para obtener el índice de la probabilidad que las mujeres con diagnóstico de Síndrome de Turner presentaran trastornos de la personalidad. Los resultados obtenidos muestran que la probabilidad que presenta dicha población de padecer trastornos de personalidad, en comparación con una muestra clínica normativa, resulta superior para todos los trastornos, siendo las escalas autodestructiva, compulsiva y antisocial aquellas que presentan los porcentajes más altos. Los datos obtenidos dan cuenta de la vulnerabilidad que presenta la población estudiada de padecer trastornos de personalidad y son útiles para el desarrollo de terapias específicas que consideren dichas características en pos de una mejor calidad de vida.
Turner Syndrome is a chromosomal, not inherited, disorder highest population incidence in females, determined by the partial or complete deletion of chromosome X. Is characterized by short stature and digenesia gonadal and, in a psychosocial level, one of the most common traits are the difficulties in establishing interpersonal relationships. In the development of women with diagnosis of Turner syndrome involves genetic, family, educational and social factors that are relevant in the establishment and consolidation of personality. This last one results from the interaction between biological and environmental factors among which are the inheritance and the learnings. The influence of the personality is a determining factor in the behavior and in the way to adapt to the environment, and may be favorable or pathological depending on the degree of flexibility in the situations of stress. The study of the influence of biological and environmental factors on human development is part of the new contributions of the biopsychosocial paradigm, which seeks to understand the psychological processes through a comprehensive vision that takes into account the interaction between biological, psychological and social factors in the development. This interdisciplinary approach oriented perspective becomes more conducive to addressing people with genetic disorders frame, since the differential impact of each of these factors in psychosocial development directly affect their quality of life. The study of personality in people with genetic disorders, and especially in the Turner Syndrome, is currently a vacant area in psychological research. The aim of the present study was to characterize the personality of adult women with Turner syndrome living in Latin America. The sample was intentional non-probability and corresponds to 60 women between 18 and 55 years. The data were gathered through a virtual version of the Millon Multiaxial Clinical Inventory II in the Spanish version. The direct scores transformed on scores Rate-Base and descriptive statistics of frequencies and measures of central tendency were obtained to characterize the sample. Subsequently the odds ratio was calculated to obtain the index of the probability of women with a diagnosis of Turner syndrome present personality disorders. The presence of a personality disorder was considered when the score in the Rate-Base was greater than 84. The results show that the probability that women with a diagnosis of Turner syndrome presents of suffering from personality disorders, in comparison with a clinical normative sample, is higher for all disorders, being antisocial, self-destructive and compulsive scales those presenting the highest percentages. Thus, despite the limitations encountered, it is important to consider that, according to the finding of the scientific literature, personality is partly determined by biological factors, and in this sense the Turner syndrome has a particular specificity to result from loss of genetic material and therefore cause physical and neuropsychological distinctive characteristics. At the same time, environmental factors would be responsible for modular the development of biological predispositions of certain personality traits, and in this sense social relations, the process of socialization and stimulation that provide girls with a diagnosis of Turner Syndrome from the early years of life, could have a strong impact on the development of what in future will be formed personality style. The results are important for therapeutic work with women diagnosed with Turner syndrome because as having empirical information about their characteristics and personality disorders may be possible to diagramming programs specific treatments they consider their particular way of relating to themselves and the environment, seeking to develop new strategies to improve their quality of life. And at the same time, suggests possible interventions at the family level, especially during childhood, aimed at the prevention of development of dysfunctional personality characteristics.