Victimization and risk factors in children and adolescents admitted into outpatient protection center in northern Chile

The present study aimed to identify the proportion of victimization, types of victimization, and risk factors associated to children and adolescents who were admitted into an outpatient protection center for children and adolescents in northern Chile during the years 2016 and 2017. Secondary data from the database pertaining to the protection center was used. The sample was non-probabilistic and included 6,499 cases. The research was descriptive-comparative with a non-experimental retrospective cross-sectional design. The results showed a higher percentage of victimization by neglect, followed by witnessing domestic violence and child sexual abuse. The sociodemographic variables showed a higher percentage of victimization at the age of 6 to 9 and 14 to 17 years old, in children and adolescents who were in the first and second cycle of elementary school and were Chilean. It was found that children victimized by child sexual abuse and bullying also had a drug diagnosis record. Logistic regression analyses showed that gender, age, schooling, nationality, and a drug diagnosis record increase the probability of occurrence of certain types of victimization. The results showed the magnitude of the problem concerning victimizations experienced by children and adolescents in northern Chile and the need to generate prevention strategies for this population.

El presente estudio tuvo como objetivo identificar la proporción de victimización, tipos de victimización y factores de riesgo asociados a los niños, niñas y adolescentes que ingresaron a un Centro de Protección a la infancia en el norte de Chile durante los años 2016 y 2017. Se utilizaron datos secundarios de la base de datos del sistema de protección a la infancia. La muestra fue no probabilística e incluyó 6.499 casos. La investigación fue descriptiva-comparativa con un diseño no experimental retrospectivo de corte transversal. Los resultados mostraron un mayor porcentaje de victimización por negligencia, seguido por presenciar violencia doméstica y abuso sexual infantil. Las variables sociodemográficas mostraron un mayor porcentaje de victimización en la edad de 6 a 9 y de 14 a 17 años, en niños y adolescentes que cursaban el primer y segundo ciclo de primaria y eran chilenos. Se encontró que los niños víctimas de abuso sexual infantil y bullying también tenían un registro de diagnóstico de drogas. Los análisis de regresión logística mostraron que el género, la edad, la escolaridad, la nacionalidad y un registro de diagnóstico de drogas aumentan la probabilidad de ocurrencia de ciertos tipos de victimización. Los resultados evidencian la magnitud del problema de las victimizaciones que sufren los niños, niñas y adolescentes del norte de Chile y la necesidad de generar estrategias de prevención para esta población.

Propiedades psicométricas de la versión en español de la Escala de Intimidad Emocional en personas heterosexuales, gais y lesbianas en pareja / Psychometric properties of the Spanish version of the Emotional Intimacy Scale with heterosexual, gay and lesbian individuals in couple relationships

Resumen: La Escala de Intimidad Emocional (EIE) es un instrumento de auto-informe que evalúa la intimidad emocional en relaciones cercanas. El objetivo de esta investigación fue examinar las propiedades psicométricas de la EIE para su uso en personas heterosexuales, gais y lesbianas involucradas en una relación de pareja. La muestra incluyó 883 personas chilenas (404 hombres y 479 mujeres; 565 heterosexuales y 318 homosexuales), entre 18 y 72 años. Mediante un Análisis Factorial Confirmatorio, se replicó la estructura unidimensional de la escala logrando un buen nivel de ajuste a los datos, mientras que el análisis multigrupo reveló que la EIE-E (versión en español) es invariante según sexo y orientación sexual. Los índices de consistencia interna mediante el alfa de Cronbach y McDonald Omega fueron apropiados y se observó una asociación positiva entre la intimidad emocional y la satisfacción con la relación de pareja. Finalmente, se identificó que las mujeres lesbianas evidencian mayores niveles de intimidad que el resto de los grupos. Se concluye que la EIE-E es un instrumento apropiado para el estudio de la intimidad emocional en personas que se encuentran en una relación de pareja, sean estas hombres o mujeres heterosexuales, gais o lesbianas.

Abstract: The Emotional Intimacy Scale (EIE) is a self-report instrument that assesses emotional intimacy in close relationships. The aim of this research was to examine the psychometric properties of the EIE for its use in heterosexual, gay and lesbian people who are currently involved in a couple relationship. The sample consisted of 883 Chileans, (404 men and 479 women; 565 heterosexuals and 318 homosexual), between the ages of 18 and 72. Using a Confirmatory Factor Analysis, the one-dimensional structure of the scale was replicated, achieving a good fit to the data, while the multi-group analysis revealed that the EIE-E (Spanish version) is invariant according to sex and sexual orientation. The internal consistency indices using Cronbach's alpha and McDonald Omega were appropriate, and a positive association was observed between emotional intimacy and relationship satisfaction. Finally, results showed that lesbian women showed higher levels of intimacy relative to the other groups. It is concluded that the EIE-E is an appropriate instrument for the study of emotional intimacy in people who are in a couple relationship, be they heterosexual men or women, gays or lesbians.

Recomendaciones para la investigación psicológica con personas transgénero: Una aproximación desde una experiencia en Chile / Recommendations for psychological research with transgender people: an approach from an experience in Chile

Resumen El presente trabajo expone y fundamenta recomendaciones basadas en la experiencia de investigación en personas transgénero, con la intención de que puedan ser útiles a quienes realicen estudios con dicha población. Estas recomendaciones incluyen orientaciones conceptuales, metodológicas y éticas, aplicables a lo largo del proceso de investigación. En particular, las orientaciones cubren los siguientes temas: definir con precisión el colectivo con el que se trabaja, registrar la variedad de identificaciones de género posibles al interior del mismo, utilizar métodos de muestreo aptos para poblaciones de difícil acceso, retribuir la participación, incluir líderes e investigadores transgéneros como expertos, pilotar los instrumentos en la población que será investigada, optar por modalidades de recolección grupal de datos, ofrecer asistencia individualizada durante la recolección, utilizar un lenguaje no estigmatizante e inclusivo, convocar la participación en conjunto con organizaciones transgénero, atender a la movilidad geográfica de la población, realizar una escucha comprometida y contemplar protocolos de derivación, considerar las diferentes trayectorias de transición, realizar sesiones de interanálisis y, finalmente, difundir apropiadamente los hallazgos al interior de la población transgénero. Se discuten estas proposiciones en términos de sus efectos en las comunidades trans, su utilidad y alcances éticos, su articulación con exigencias generales de toda investigación y sus implicaciones para el activismo.

Abstract Prejudice and discrimination have important effects on the well-being and quality of life of trans people. Hence, investigating with said population implies, in addition to actions to obtain relevant and truthful information, having the necessary actions to attend to their needs and peculiarities. These are populations that are difficult to access (hard-to-reach), stigmatized, in which there is no defined sampling frame, that have physical and mental health indicators lower than those of any other group with which we have worked and that, therefore, it is necessary to take extreme the precautions not to reproduce types of relationships that may be harmful or offensive. The purpose of the present article was to systematize part of our field experience with transgender people, so that it can be useful for those who study with this population. These recommendations aim to provide some conceptual, methodological and ethical guidelines, useful throughout the research process. In particular, we made a series of recommendations that cover from the moment of taking conceptual decisions about the design of the study, through contact with the organizations, until the completion of the field work and subsequent stage of dissemination of results. In particular, a series of recommendations are made regarding: specifying the definition of the group with which one works, recording the variety of gender identifications as people present them, using to sampling methods for hard-to-reach populations or hidden populations, deliver a retribution for the participation (consider participants as experts to be compensated for their work), including activists as experts in every stage of the study (study design, field work, data analysis and dissemination of results), piloting the instruments in specific population, preferably opt for group applications modality and continue with a debriefing, have specific assistance for participants during the application (special needs derived from their age, educational level, reduced mobility, among others), use non-stigmatizing and inclusive language, call together with trans organizations (in order to establish greater trust in the population), attend to a mobility of the population (so as not to replicate the sample in different places), carry out a committed listening and contemplate referral protocols (if necessary given the type of situations described by the participants and their current degree of elaboration), consider different trajectories of transition, conduct inter-analysis sessions and disseminate appropriately within the transgender population. These propositions are discussed in terms of their effects on trans communities, their usefulness and ethical scope, their articulation with the general requirements of all research, and their implications for activism. On the other hand, these recommendations can serve as criteria for evaluating the ethical dimension of research projects with trans people. It may therefore be important to project reviewers, editors, and reviewers of manuscripts submitted for publication. The perspective that we assume in this work is aligned with those called "evidence-based activism", which implies articulating a variety of knowledge, scientifically accredited and of an "experiential" type, in order to explore situations in which the team members Research staff are part of networks that involve them personally in their study topics. It is precisely the relationship with groups that work for the rights of minorities, activists and members of these groups is essential, since they have knowledge acquired through their experience as part of discriminated groups and they can contribute to the mobilization of knowledge in the governance of health issues.

Salud mental en población transgénero y género no conforme en Chile

Background: Transgender population is at a higher risk of suffering mental health problems than cisgender population (people whose sex and gender identity are in agreement) and other sexual minorities (gays, lesbians, and bisexuals), partly due to the greater stress that they suffer or for being victims of sexual prejudice. Aim: To describe positive and negative mental health indicators in a sample of transgender people living in Chile. Material and Methods: An intentional sample of 377 transgender individuals older than 18 years, living in the country's northern, center and southern zones were studied. Sociodemographic and well-being features, negative emotional symptoms, suicidal behavior, and substance consumption were assessed. Results: A precarious mental health was confirmed among participants. A high frequency of depression, ideation and suicide attempts, and high levels of depression, anxiety, and stress symptoms were identified. Also, a high frequency of substance abuse was found. These mental health indicators varied according to the sex assigned at birth and gender self-identification. Conclusions: Transgender people experience precariousness and vulnerability in their mental health.

Efectos del prejuicio sexual en la salud mental de personas transgénero chilenas desde el Modelo de Estrés de las Minorías: Una aproximación cualitativa / Sexual prejudice effects on Chilean transgender individuals' mental health from Minority Stress Model: A qualitative approach

Resumen El Modelo de Estrés de las Minorías (Meyer, 2003) ha permitido explicar de qué forma el prejuicio sexual produce efectos negativos en la salud y bienestar de personas pertenecientes a las minorías sexuales, a través de la identificación de estresores de tipo distales y proximales. Este estudio buscó indagar los efectos del prejuicio sexual en la salud mental de personas transgénero en Chile desde un enfoque cualitativo. Se realizaron entrevistas semi-estructuradas a 17 personas transgénero femeninas y masculinas en cuatro ciudades del país. Los resultados nos permite identificar la presencia de factores distales asociados a discriminación manifiesta y factores proximales asociados a la vivencia del estigma y su relación con el autoconcepto. Finalmente, se describen efectos en la salud mental, entre los que destacan la presencia de sintomatología ansioso-depresiva, ideación e intentos suicidas, conductas autolesivas y consumo de alcohol y otras sustancias.

Abstract The Minority Stress Model (Meyer, 2003) has made it possible to explain how sexual prejudice produces negative effects on the health and wellbeing of people belonging to sexual minorities, through distal and proximal stressors. A qualitative study was conducted to investigate the effects of sexual prejudice on the mental health of transgender adults in Chile. Semi-structured interviews were conducted with 17 transgender people, both male and female, in four cities of the country. The results allow us to identify the presence of distal factors associated with overt discrimination, as well as, proximal factors associated with the experience of stigma and its effects on self-concept. Finally, effects on mental health are described, among which the presence of anxious-depressive symptomatology, suicidal ideation and attempts, self-injurious behavior and consumption of alcohol and other substances.

Neuroinflamación: el ying-yang de la neuroinmunología / Neuroinflammation: the ying-yang of neuroimmunology

Resumen El área de la neuroinmunología es un campo que se encuentra en gran desarrollo y que tiene como objetivo el entender las interacciones fisiológicas entre el sistema nervioso central (SNC) y el sistema inmune periférico, llegándose a encontrar que estas relaciones son más importantes de lo que se creía y que por lo tanto son 2 sistemas íntimamente conectados y con una gran dinámica. Por otro lado, la neuroinflamación es activada después de cualquier reto inmunológico, tanto dentro como fuera del SNC, y que puede llevar a generar tanto respuestas enfocadas a la limitación del daño y la restauración del tejido, como a ser un riesgo para el desarrollo de enfermedades neurodegenerativas en el caso de que este estímulo permanezca de manera crónica.

Abstract The field of neuroimmunology has recently had a development, and its primary goal is to understand the physiological interactions between the central nervous system (CNS) and the peripheral immune system. Various data has found that these relations are more important than what was previously thought. Also, that both systems are highly dynamic and are intimately connected. On the other hand, neuroinflammation is activated after any immune challenge, both inside and outside the CNS, leading to responses focused on limiting tissue damage and restoration; as well as being a risk for developing neurodegenerative diseases when this stimulus remains chronic.

Release and uptake of glutamate as related to excitatoxicity

It has been established that neurons exposed to high concentrations of glutamate or other excitatory amino acids degenerate and die. Neuronal damage appears to be due to the activation of different types of glutamate receptors, among which the ionotropic N-methyl-D-aspartate (NMDA) type seems particularly involved, since its channel is permeable to Ca2+ and an increase in the cytoplasmic concentration of this cation promotes a chain of events leading to cell death. The mechanism of such glutamate receptor-mediated neurodegeneration has been defined as excitotoxicity, and several pieces of evidence suggest that this mechanism might contribute to the neuronal death associated with certain neurological disorders, such as ischemia, cerebral trauma and some chronic neurodegenerative diseases. A relevant question is whether the origin of endogenous extracellular glutamate is important for the induction of excitotoxicity. An excess of glutamate release, or a deficiency in its clearance from the synaptic cleft, which depends mainly on its transport by high affinity carriers, are potential sources for the accumulation of extracellular glutamate. In the present article some experimental results from our laboratory, aimed at obtaining information on this question, are reviewed. These experiments include the use of 4-aminopyridine, a convulsant drug that enhances the release of glutamate, and of some inhibitors of glutamate transport, in vivo and in neuronal cell cultures. The results obtained indicate that an increase of endogenous extracellular glutamate due to these procedures is not sufficient to induce neuronal death, at least under the experimental condition used.