Lingüística en el ejercicio de la psicoterapia infantil: desafíos para la práctica clínica / Linguistics in the practice of child psychotherapy: challenges for clinical practice

RESUMEN: Es sabido que, tanto psicólogos como psiquiatras infantiles, poseen escasa capacitación y formación en el área de lingüística, lo que sin duda tiene gran relevancia en la salud mental infantil. Consecuentemente, una mayor especialización en los aspectos evolutivos del lenguaje infantil, podría favorecer la eficacia en la psicoterapia con niñas y niños, potenciando las técnicas clásicamente utilizadas en setting, como lo son el juego y las actividades plásticas. Así, con mayor conocimiento en psicolingüística y pragmática, profesionales de la salud mental incrementarían su batería de herramientas prácticas para una efectiva comunicación momento a momento en el espacio terapéutico con el/la paciente. Esto no sólo ampliaría el uso de la psicolingüística infantil más allá del diagnóstico de los trastornos del lenguaje, sino que también contribuiría a converger los conocimientos teórico-prácticos para potenciar el trabajo psicológico con infancia, mediante una comunicación más efectiva del adulto con el/la niña/o.

ABSTRACT It is known that both child psychologists and psychiatrists have little training in linguistics, which undoubtedly has great relevance in children's mental health. A greater specialization in the evolutionary aspects of children's language could improve the effectiveness in psychotherapy, enhancing the techniques classically used in setting, such as games and artistic activities. Thus, with greater knowledge in psycholinguistics and pragmatics, mental health professionals could increase their battery of practical tools for effective moment-by-moment communication with the patient. This would expand the use of child psycholinguistics not only for the diagnosis of language disorders, but also contribute to converge theoretical and practical knowledge achieving a more effective communication between the adult and the child.

Síndrome de piernas inquietas/Willis Ekbom desde la mirada del psiquiatra / Restless legs syndrome from the perspective of psychiatry

Restless Legs Syndrome (RLS) or Willis-Ekbom Disease is an under-diagnosed chronic and progressive primary sensory-motor disorder. It can lead to severe sleep disturbances, a usual cause of consultation. It is characterized by an urgent need to move the legs in resting situations, a cardinal symptom that is usually accompanied by an unpleasant sensation in legs. These symptoms appear or aggravate at the end of the day and in resting situations and are alleviated with movement. Based on these clinical characteristics, it has been defined as a quiescegenic focal akathisia. The diagnosis is essentially clinical. As a guide, there are five cardinal diagnostic criteria. The treatment consists of non-pharmacological measures and the use of medications such as dopamine agonists. Despite the treatment, the symptoms persist in 40% of patients. Psychiatrists should be aware of the syndrome since many drugs used by them such as antipsychotics, antidepressants and anxiolytics can worsen the symptoms. Moreover, the syndrome may be associated with depressive and anxiety diseases.

Competencias emocionales: una asignatura complementaria en el Plan de estudios de la carrera de Odontología / Emotional competence: a supplementary subject in dentistry major's syllabus

El presente texto contiene los resultados de una revisión bibliográfica realizada con el objetivo de establecer la importancia de desarrollar competencias emocionales durante el proceso de formación de los profesionales de la salud, especialmente del área de odontología, atendiendo a que la especialidad está registrada como una de las profesiones más estresantes, situación que podría originarse durante el proceso educativo, ya que sus alumnos experimentan altos niveles de ansiedad o estrés durante su formación. Se entiende por competencia emocional el conjunto de conocimientos, capacidades, habilidades y actitudes necesarias para comprender, expresar y regular los fenómenos emocionales. Como conclusión, esta revisión permitió demostrar como la inclusión de estas competencias en el plan de estudios repercutiría significativamente en el bienestar psicológico de estos estudiantes.

This paper contains the results of a bibliographical review which was carried out aiming at establishing the importance of developing emotional competence in health professionals' training, especially on the dentistry area; providing that this specialty is one of the most stressful. The educational process might be at the root of this situation, since students experience high levels of anxiety or stress during their training. Emotional competence is understood as the group of knowledge, abilities and attitudes needed to understand, express and regulate emotional phenomena. In conclusion, this review enabled to demonstrate how the inclusion of emotional competence in dentistry major's syllabus would have an influence on student's psychological well-being.

Importancia de la interacción social en la retroalimentación, según residentes de Psiquiatría / The opinion of psychiatry residents about social interaction during the feedback in medical education

In Medical Education, feedback is an instrument that informs the trainees about their learning process and how to make the necessary changes. Feedback enables learners to monitor their progress and provides direction for improvement. Effective feedback is useful to improve the performance, clinical skills, communication skills, and treatment of patients. It is essential when teaching clinical interview skills to psychiatry residents. Feedback necessarily involves social interaction between teachers and trainees. Aim: To analyze the perception of psychiatry residents about social interaction during the feedback received during their training. Material and Methods: Qualitative study, using the Grounded theory method. Nine interviews were performed to adult psychiatry residents of the University of Concepción and one to a recently graduated psychiatrist. Data were analyzed using open coding. Results: We found four emerging categories: Socialization, roles and hierarchy, invitation to integration and teacher involvement. Conclusions: The effectiveness of feedback lies in the establishment of a minimal teacher-resident social relationship, in which feedback occurs naturally.

Abordaje narrativo y estratégico en el trastorno por ansiedad social / Narrative and strategic approach in social anxiety disorder

Social anxiety disorder (SAD) has great clinical relevance due to both, the impairment it causes and co-morbidity. The standard treatment is cognitive behavioral therapy, through exposure and cognitive restructuring, and additionally the use of psychotropic drugs. However, it is necessary to broaden the conceptualization and psychotherapeutic approach, adding a narrative approach through constructivist and constructionist perspectives. From this standpoint, there are contexts of invalidation and resignation processes. Therefore, the TAS is multidimensional and has two polarities, a constitutive and an operative, that guide therapy. This model increases the understanding and reflection regarding the phenomenon and make possible new options for intervention.

El trastorno por ansiedad social (TAS) presenta una gran relevancia clínica debido al menoscabo que genera y a la co-morbilidad asociada. El tratamiento estándar consiste en la terapia cognitivo-conductual, mediante exposición y reestructuración cognitiva, más el uso de psicofármacos. No obstante, se hace necesario ampliar la conceptualización y abordaje psicoterapéutico, por lo cual las visiones constructivistas y construccionistas agregan una mirada narrativa. Desde lo narrativo, hay contextos de invalidación y procesos de renuncia. Por lo tanto, el TAS es multidimensional y posee dos polaridades que orientan la terapia; una constitutiva y una operativa. Esta conceptualización amplía la comprensión y reflexión sobre el fenómeno y permite nuevas opciones de intervención.

Prevalencia de trastornos psiquiátricos en adolescentes infractores de ley: estudio caso-control / Prevalence of psychiatric disorder among juvenile offenders: case-control study

Introduction: The juvenile delinquency has grown worldwide in alarming form in the last time, a multicausality is recognized in the origin of this phenomenon, but it becomes necessary to identify the importance of each one of this causes, and its specific impact in the time. Objective: To identify individual, educational and family factors associated with criminal conduct in a sample of adolescent offenders. Method: Observational study, crossectional, of case-control. From a universe of adolescents between 12 years old and 17 years with 11 months and 30 days, offenders, imprisoned in penal or protection institutions, a convenience sample of 100 adolescents was chosen, which was equalled in gender, age range, and socioeconomic level with a control group of the same size. To both groups a battery of instruments, DISC IV, WISC-R or WAIS, and the Family History Screen, was applied. Results: During the 12 months prior to the study 64 percent of the offenders and 18 percent of the controls presented a psychiatric diagnosis. Among the offenders the most prevalent disorder were conduct disorder (46.99 percent), abuse of alcohol (26 percent) and dependence of other substances (18 percent); among the control group the most prevalent were attentional deficit disorder (5 percent) and conduct disorder (5 percent). There are statically significant differences between both groups when measuring the intellectual level of functiong, 31 percent) of the offenders were in the rank of borderline and 34 percent> of controls were classified as low average. Conclusions: Lower intellectual capacity, school failures, number of sexual partners and conduct disorder were the variables that better predicted inclusion in the group of juvenile offenders.

La delincuencia juvenil ha crecido en forma alarmante. Se reconoce en el origen del fenómeno una multicausalidad, pero se hace necesario identificar y ponderar eventuales causas y medir su impacto específico. Objetivo: Identificar prevalencias de patología psiquiátrica y variables individuales, educacionales y familiares asociadas con conductas delictivas en una muestra de adolescentes infractores de ley. Método: Estudio observacional, transversal, de caso-control. De un universo de adolescentes entre 12 y 17 años, infractores, recluidos en instituciones penales o de protección, se eligió una muestra por conveniencia de 100 sujetos y una muestra control pareada por edad y nivel socioeconómico. A ambos grupos se aplicó una batería de instrumentos, incluyendo DISC-IV, WISC-R ó WAIS, Cuestionario de Estilos de Vida y FHS. Resultados: Un 64 por ciento de los adolescentes infractores de ley y 18 por ciento de sus pares, presentaban algún diagnóstico psiquiátrico durante los doce meses previos a la entrevista. Los cuadros más prevalentes en los adolescentes infractores son trastorno disocial (46,9 por ciento), abuso de alcohol (26 por ciento) y dependencia a otras sustancias (18 por ciento). En los adolescentes no infractores son más prevalentes el déficit atencional con hieractividad (5 por ciento) y el trastorno disocial (5 por ciento). Hay diferencias estadísticamente significativas entre ambos grupos en la medición de coeficiente intelectual, un 31 por ciento) de infractores está en el rango de inteligencia limítrofe y un 34 por ciento en normal lento. Conclusiones: Menor capacidad intelectual, antecedentes de repitencia, mayor número de parejas sexuales y presencia de un trastorno disocial son las variables que mejor predicen la pertenencia al grupo de adolescentes infractores de ley.