ABSTRACT
Introducción: La literatura científica reporta que la autopsia psicológica desde sus inicios fue utilizada con la finalidad de ayudar a determinar las circunstancias de muerte de una persona, no obstante, en la actualidad se acoge más como concepto que como una herramienta procedimental. Objetivo: Establecer si en Colombia se ha utilizado para reconstruir los aspectos pre mortem de quienes han fallecido en extrañas circunstancias, de acuerdo con la finalidad de esta. Metodología: Se realizó una revisión sistemática de la literatura científica en 10 bases de datos; se emplearon como palabras clave "autopsia psicológica" y "Colombia", bajo una ventana de observación entre 2010 al 2021; por medio del método PRISMA. Resultados: Se evidencia que en Colombia durante los últimos 10 años el número de estudios asciende a 19, publicados en bases de datos, de los cuales 16 no emplearon el procedimiento de autopsia psicológica y solo tres de ellos sí lo hicieron. Discusión: Existe una tendencia a emplear la autopsia psicológica como concepto desde un enfoque clínico para respaldar los análisis retrospectivos, que, como técnica o procedimiento, se distancia de la posibilidad de reconstruir la criminodinámica del delito, así como la reconstrucción de aspectos de la personalidad, el estado mental y el estilo de vida de quién ha fallecido. Conclusiones: Se resalta que en Colombia la autopsia psicológica se ha utilizado exclusivamente en el campo clínico, sin el rigor científico, metodológico y sin la validez del protocolo empleado.
Introduction: The scientific literature reports that psychological autopsy from its beginnings was used with the purpose of helping to determine the circumstances of death of a person, however, it is currently embraced more as a concept than as a procedural tool. Objective: to establish if in Colombia it has been used to reconstruct the pre-mortem aspects of those who have died under strange circumstances, according to its purpose. Methodology: a systematic review of the scientific literature was carried out in 10 databases, using as keywords psychological autopsy and Colombia, under a window of observation between 2010 and 2021; using the PRISMA method. Results: they show that in Colombia during the last 10 years the number of studies published in databases amounts to 19, of which 16 did not use the psychological autopsy procedure and only three of them did. Discussion: There is a tendency to use psychological autopsy as a concept from a clinical approach to support retrospective analyses rather than as a technique or procedure, distancing us from the possibility of reconstructing the criminodynamics of the crime, as well as reconstructing aspects of the personality, mental state and lifestyle of the deceased. Conclusions: it is highlighted that in Colombia the psychological autopsy has been used exclusively in the clinical field, without the scientific and methodological rigor and without the validity of the protocol used.
ABSTRACT
Resumen La Autopsia Psicológica (AP) es una técnica de evaluación retrospectiva útil en el campo clínico-forense que desde sus inicios de aplicación ha sido utilizada para reconstruir el perfil psicológico y el estado mental de personas fallecidas, permitiendo, además, aclarar la causa o circunstancia de una muerte, pero que, a pesar de la diversidad de instrumentos utilizados, hoy en día sigue presentando algunos vacíos metodológicos y no cuenta con una herramienta estandarizada que facilite su utilización. Es por ello que, a través de un estudio de diseño teórico, se realizó una revisión bibliográfica para analizar la literatura existente en Iberoamérica, mediante las siguientes categorías: métodos de aplicación y de estudio, modelos y evaluación. Con ellas se logró identificar 37 artículos seleccionados de siete bases de datos científicas que muestran los resultados de estudios desarrollados durante el periodo 2001-2017. Se evidencian como hallazgos significativos una mayor producción de investigación teórica, orientadas a definir y clarificar el objetivo y proceso de aplicación de la AP y la implementación de entrevistas semiestructuradas como principal medio de recolección de información. Finalmente, se destaca la importancia de generar investigaciones centradas en la validación de instrumentos de AP que permitan consolidar su carácter científico.
Abstract The Psychological Autopsy (PA) is a retrospective evaluation technique useful in the clinical forensic field that since its beginning of application has been used to reconstruct the psychologic profile and the mental status of deceased people, allowing, furthermore, to clarify the cause or circumstance of a death, but that, despite the diversity of instruments used, today it still presents some methodological lacks and does not count on a standardized tool that facilitates its use. That is why, through a study of theoretical design, a bibliographic revision to analyze the existing literature in Ibero-America was performed, by means of the following categories: methods of application and study, models and evaluation. With them one can identify 37 studies selected from seven scientific databases that show the results of studies developed during the 2001-2017 period. As significant findings are evinced a greater production of theoretical investigation, oriented to define and clarify the objective and process of applicationof the PA, and the implementation of semi-structured interviews as main way to collect the information. Finally, one highlights the importance of generate investigations centered in the validation of instruments of PA that allows consolidate its scientific character.
Resumo A Autópsia Psicológica (AP) é uma técnica de avaliação retrospectiva útil no campo clínico-forense que desde os seus inícios de aplicação tem sido utilizada para reconstruir o perfil e o estado mental de pessoas falecidas, permitindo, além disso, aclarar a causa ou circunstância de uma morte, mas que, apesar da diversidade de instrumentos utilizados, hoje em dia segue apresentando alguns vazios metodológicos e não conta com una ferramenta estandardizada que facilite a sua utilização. É por isso que, através de um estudo de projeto teórico, foi realizada uma revisão bibliográfica para analisar a literatura existente em Ibero-América, mediante as seguintes categorias: métodos de aplicação e de estudo, modelos e avaliação. Com elas alcançou-se identificar 37 artigos selecionados de sete bases de dados científicas que mostram os resultados de estudos desenvolvidos durante o período 2001-2017. Evidencia-se como descobertas significativas uma maior produção de investigação teórica, orientada para definir e clarificar o objetivo e proceso de aplicação da AP, e a implementação de entrevistas semiestruturadas como principal meio de recolecção de informação. Finalmente, destaca-se a importância de gerar investigações centradas na validação de instrumentos de AP que permitam consolidar o seu caráter científico.
Subject(s)
Humans , Autopsy , Cause of Death , Indicators of Morbidity and Mortality , DeathABSTRACT
Resumo O objetivo deste artigo é discutir o método de autópsia psicossocial como instrumento de investigação retrospectiva utilizado em estudos aprofundados sobre o suicídio. Optou-se por fundamentar conteúdos referentes aos aspectos estruturais das autópsias psicossociais, bem como acerca das finalidades e possíveis resultados de seu uso. Buscou-se, também, explorar a aplicabilidade, vantagens e limitações do método em questão. Constatou-se a riqueza desse método retrospectivo na realização de estudos que objetivem compreender o suicídio em profundidade, à medida que os resultados possibilitam conhecer em detalhes a atmosfera que envolveu o fenômeno, suas motivações, possíveis causas, fatores psicossociais e aspectos subjetivos associados à morte. Os resultados oportunizam a reunião de informações imprescindíveis para o embasamento de ações eficazes de prevenção ao suicídio.
Abstract The aim of this article is to discuss the method of psychosocial autopsy as a retrospective research tool used during in-depth suicide studies. The content related to the structural aspects of psychosocial autopsies was provided with a foundation, as well as the purposes and possible results of its use. Furthermore, the applicability, advantages and limitations of the method in question were explored. The richness of this retrospective method was noted in conducting in-depth studies aimed at understanding suicide, as the results make it possible to know in detail the atmosphere that involved the phenomenon, its motivations, possible causes, psychosocial factors and subjective aspects associated with death. The results allow the gathering of information essential for the foundation of effective actions to prevent suicide.
ABSTRACT
Este artigo objetiva analisar e descrever os fatores de risco e seus determinantes, associados a 24 casos de suicídios ocorridos na cidade de Palmas (TO), no período de 2006 a 2009. Utilizou-se o método de autópsia psicológica e psicossocial, a qual, por meio de entrevistas com familiares, busca investigar os suicídios consumados, contextualizando características da vida do sujeito, e compreender os processos familiares e as circunstâncias afetivas, sociais, econômicas e culturais, fundamentando-se na reconstrução da história e da personalidade da pessoa. Os fatores socioeconômicos associados foram: ser do sexo masculino, solteiro, de cor parda, estar na faixa etária de 20 a 40 anos e com ensino fundamental. Os principais fatores de risco identificados foram: transtornos mentais, abuso de álcool e outras drogas, relacionamento familiar conturbado e histórico de tentativas anteriores. Buscamos contextualizar e refletir sobre alguns casos relatados pelos familiares e sobre a resposta das equipes de saúde às demandas das famílias. A necessidade de implantar programas de prevenção e de capacitar os profissionais da atenção básica foi verificada. .
The scope of this article is to analyze and describe the risk factors and determinants linked to 24 suicides in the city of Palmas in the state of Tocantins between 2006 and 2009. The psychological and psycho-social autopsy method was used in order to investigate the consummated suicides by interviewing family members. It contextualized the subjects' life characteristics to understand the family dynamics and the affective, social, economic and cultural background, based on the reconstruction of the history and personality of the individuals. The associated socio-economic factors were: being male, aged between 20 and 40, single, with mixed ethnicity and basic education. The major risk factors identified were: mental disorder, alcohol and other drug abuse, disturbed family relationship and a history of previous suicide attempts. An attempt was made to contextualize and reflect on some cases reported by family members, as well as on the response of the health care teams to the demands of the families. The need to implement prevention programs and to train the primary health care professionals was considered a priority. .
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Suicide/psychology , Suicide/statistics & numerical data , Brazil/epidemiology , Risk Factors , Time FactorsABSTRACT
O artigo analisa diferentes faces da depressão associadas a suicídio em idosos, a partir de autópsias psicológicas. Utilizou-se um método retrospectivo para o estudo de mortes indeterminadas, a partir de entrevistas e laudos, que analisa circunstâncias psicossociais associadas ao suicídio. O artigo traz uma predominância de gênero, classe social e raça - mulheres, classe média e alta, brancos - e contextualiza de modo inédito a depressão numa população de alto risco de suicídio, pouco estudada no Brasil e no mundo. Buscou-se reconstituir o nível de saúde física e mental, as circunstâncias sociais e os traços biográficos marcantes para compreender a magnitude da depressão no suicídio. A depressão apareceu na quase totalidade dos casos como diagnóstico primário ou secundário, como sintoma associado a outras comorbidades ou como reação a estressores sociais, demandando diferentes condutas e procedimentos terapêuticos. A associação entre depressão e comorbidade múltipla agrava o prognóstico do caso e amplia cumulativamente o risco de suicídio. A depressão acompanhada de ideações suicidas é um fator de risco que justifica medidas preventivas e imediatas. Recomenda-se ampliar as formas de diagnosticar e tratar assertivamente a depressão em idosos.
This article analyzes different aspects of depression association with suicide among the elderly based on psychological autopsies. The retrospective method was used to study indeterminate deaths, based on interviews and reports, which analyze psychosocial circumstances related to suicide. The paper reveals the predominance of gender, social class and race - women, middle and upper class, white - and, in an unprecedented manner, contextualizes depression in a poorly studied population in Brazil and in the world with high risk of suicide. The physical and mental health, social circumstances and predominant biographical characteristics of the suicide victim were reconstructed in order to assess the impact of depression on suicide. Depression was presented in almost all cases, in primary or secondary diagnosis, as the symptom associated with other co-morbidities or as a reaction to social stressors, demanding different therapeutic approaches and procedures. The association between depression and multiple co-morbidity accentuates the case prognosis and cumulatively increases the risk of suicide. Depression followed by suicidal tendencies is a risk factor which justifies immediate preventive measures. Increasing assertive ways to diagnose and treat depression in old age is recommended.
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Depressive Disorder/complications , Depressive Disorder/psychology , Suicide/psychology , Retrospective StudiesABSTRACT
Analisam-se 51 casos de suicídio de idosos em dez municípios brasileiros, visando a conhecer a interação de variáveis associadas ao fenômeno. Uma revisão sobre o tema dá suporte teórico ao estudo. Tendo como base o método da autópsia psicológica, o estudo parte de um roteiro de entrevista semiestruturada, aplicada e analisada por pares de pesquisadores, mediante um mesmo procedimento de coleta, organização e análise dos dados. O conjunto foi reexaminado através de uma meta-análise de enfoque psicossocial e qualitativo sobre dados dos familiares entrevistados, interpretações dos pesquisadores, contextualização socioantropológica e categorias de relevância. Foram estudadas formas de perpetração e letalidade por sexo, faixa etária, perfil socioeconômico; fatores associados; e motivos atribuídos. Analisou-se a interação de fatores precipitantes relevantes. As conclusões apontam convergências entre estudos epidemiológicos e qualitativos. Doenças graves, deficiências e transtornos mentais juntos formam as principais causas, seguidas de depressão, conflitos familiares e conjugais. Recomenda-se atenção à qualidade de vida dos idosos, especialmente dos homens, que constituem o grupo de maior risco para suicídio.
The authors analyze 51 cases of suicide among the elderly from ten Brazilian municipalities. The objective is to understand the interaction of variables associated with suicide among the elderly. A bibliographic review gives theoretical support to this study. Based on psychological autopsy, the study begins with a semi-structured interview format, which was applied and analyzed by peer researchers, using the same procedure for gathering, organizing and analyzing the data. This material was reviewed using a psychosocial and qualitative meta-analysis approach based on family interview data, researchers' interpretations, socio-anthropological contextualization and relevance categories. Ways of committing suicide, reasons for suicide, associated factors, attributed motives and lethality were studied by sex, age and socioeconomic characteristics. The interaction of major precipitant factors was analyzed. The conclusions showed that there are convergences among epidemiological and qualitative studies. Severe illness, disabilities and mental disorders are the major causes, followed by depression and family and marital conflicts. Close attention to the quality of life of the elderly is recommended, especially of men who constitute the main suicide risk group.
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Middle Aged , Suicide/psychology , Brazil , Socioeconomic FactorsABSTRACT
O artigo descreve as etapas de realização do trabalho de campo da pesquisa. É possível prevenir a antecipação do fim? Suicídio de Idosos no Brasil e possibilidades de Atuação do Setor de Saúde, realizada em 10 municípios das cinco regiões do país. A amostra composta por 51 autópsias psicossociais abrangeu cinco idosos que faleceram por suicídio em nove municípios e seis em um deles. Oitenta e quatro familiares foram entrevistados. Trabalhou-se com um roteiro denominado autópsia psicossocial e com observação do contexto. Cada entrevista durou 60 minutos em média, e na maioria dos casos, houve mais de um encontro com os familiares. O estudo foi construído por meio de um processo coletivo que abrangeu compartilhamento da revisão bibliográfica, discussão do universo, das amostras, das estratégias de abordagem, dos resultados de campo e das análises empíricas. Este artigo destaca a preparação teórica, conceitual e prática dos pesquisadores; o processo de elaboração dos instrumentos para o trabalho de campo; informações sobre as fontes de dados existentes e sobre as efetivamente acessadas; apresentação de credencial institucional; entrada no contexto das famílias, dificuldades e estratégias para realização do estudo empírico; entrada e saída do campo; e impacto da pesquisa sobre os investigadores.
The article describes the research realization phases of field work in ten municipalities in five regions entitled "Is it possible to prevent the anticipation of the end? Suicide among the elderly in Brazil and the possibilities for action by the Health Sector." The sample comprises 51 psychosocial autopsies of 5 elderly people who committed suicide in 9 locations and 6 in another. 84 family members were interviewed. Semi-structured psychosocial autopsies and contextual observations were used. Each interview lasted 60 minutes on average and in the majority of the cases there was more than one encounter with family members. The study consisted of a collective process that involved bibliographic review, discussion of the samples, approach strategies, field results and empirical analysis. This article highlights the theoretical, conceptual and practical preparation of researchers and production and standardization of instruments; information about existing data sources and those that are actually used; introduction of institutional credentials; assessment of the family context, difficulties and strategies for empirical study; entrance to and exit from the field; and the impact of the research on the investigators.
Subject(s)
Aged , Humans , Suicide/psychology , Brazil , Interviews as Topic , ObservationABSTRACT
O artigo analisa a qualidade e a consistência de um roteiro de entrevista semiestruturada, adaptado para o estudo do suicídio de pessoas idosas e apresenta o método das autópsias psicossociais que resultou da aplicação desse instrumento. O objetivo é demonstrar como o uso da entrevista em profundidade e sua forma de organização e análise de dados foram testados e aperfeiçoados por uma rede de pesquisadores de vários centros de pesquisa do Brasil. O método envolveu a aplicação do instrumento em que se socializou um manual de instruções sobre a coleta, sistematização e análise de dados. A metodologia foi aplicada no estudo de 51 casos de idosos que faleceram por suicídio em dez municípios brasileiros, e permitiu a verificação da consistência do instrumento usado e a aplicabilidade do seu método, durante o processo e ao final, por meio de uma avaliação em rede. O roteiro aperfeiçoado e as instruções para replicá-lo e analisá-lo são aqui apresentados. Os resultados apontam o rigor e a credibilidade dessa abordagem metodológica testada e qualificada de um modo interdisciplinar e interinstitucional.
The article analyzes the quality and consistency of a semi-structured interview script, adapted for the study on suicide among elderly people, and presents the psychological and psychosocial autopsy method, which is the result of application of this instrument. The objective is to demonstrate how the in-depth interview and subsequent data organization and analyses were tested and improved by a network of researchers from eight regions in Brazil. Evaluation of the method was conducted before and after the application of the instruments to collect, systematize and analyze the data. This methodology was applied in 51 cases of elderly people who committed suicide in ten Brazilian municipalities. The study did more than just collect data with scientific rigor, since it also verified the consistency of the instrument used and the applicability of the method. The improved script and the instructions of how to apply and analyze it are thus presented here. The results reveal the rigor and credibility of this methodological approach tested and qualified by a multidisciplinary and inter-institutional procedure.
Subject(s)
Aged , Aged, 80 and over , Humans , Middle Aged , Suicide/psychology , Interviews as Topic/methods , Surveys and Questionnaires , RecordsABSTRACT
El presente documento contiene una serie de consideraciones en torno una de las técnicas más importantes y utilizadas en la comprensión de los comportamientos a través del peritazgo psicológico. En el cual el psicólogo despliega todos sus conocimientos en el ámbito legal y psicológico. Entre estos peritajes se encuentra la denominada Autopsia Psicológica. La autopsia psicológica es considerada un proceso de recolección de datos del occiso que permite reconstruir el perfil psicológico y el estado mental antes del deceso (Acevedo, Núñez y Pinzón, 1999). Esta técnica pericial surge en los EE.UU. como una necesidad administrativa de definir la etiología médico legal en los casos de muertes dudosas donde no se contaba con los elementos suficientes para afirmar si se trataba de un suicidio o un accidente.
This document contains a series of considerations around one of the most important and used techniques in the understanding of behaviors through psychological expertise. In which the psychologist displays all his knowledge in the legal and psychological field. Among these expert opinions is the so-called Psychological Autopsy. The psychological autopsy is considered a data collection process of the deceased that allows reconstructing the psychological profile and mental state before the death (Acevedo, Núñez and Pinzón, 1999). This expert technique arises in the United States as an administrative need to define the medico-legal etiology in cases of doubtful deaths where there were not enough elements to confirm whether it was a suicide or an accident.
Subject(s)
Humans , Forensic Psychology/methods , Autopsy/methods , Suicide , Cause of DeathABSTRACT
resumen está disponible en el texto completo
SUMMARY The understanding of child suicide has achieved more and more specific notions since it started to be studied from the theory of adult suicide. Now, the implication of certain factors such as the evolution of death conceptualization, the desire of joining an absent significant person, the premeditation of the suicidal act, the involvement of family environment as a contributing or protective factor, or a previous mistreatment experience, has become clearly recognized. Suicides which occur during the childhood period have been associated to previous sexual-nature abuse experiences. In adult suicides, the presence of some kind of mistreatment during their childhood period has also been found. Both phenomena, mistreatment and child suicide, are usually under-registered because of the variability of their defining approaches or because of some cultural influences such as violence occurring naturally or negation of child suicide or premeditation. It is postulated that the mechanics of child mistreatment traps the abuser into a dynamics based on the inequality of physical, intellectual and/or moral conditions; this reality plus the defenseless nature of children, impedes the termination of that situation unless it finishes by means of another violent act such, as a suicide. Furthermore, the consequences suffered by a child victim of mistreatment can become contributing factors for a suicidal behavior consummation. Consequently, dysfunctions or disturbances on cognitive, psychological, identity, belonging or hopelessness state of the victim, as well as the emotional pain caused by the mistreatment may favor a suicide behavior. Therefore, the purpose of this study is to determine the presence of any given type of child mistreatment in children (since eight to 14 years old) that incurred in a suicide in the State of Guanajuato between 1995 and 2001. The methodology used for this descriptive, observational, retrospective and transversal study, was ex-post-facto (after the event), since the technique for data gathering was carried out by psychological autopsy. This technique facilitates an access into the families and to the understanding of their dynamics, and also to recognizing the circumstances prior to the decease. This technique included one or several interviews with people close to deceased child, besides a detailed analysis of the suicidal event and of all the deceased child's residual belongings (suicide notes in this case). This study searched some direct and indirect indicators of a possible child mistreatment suffered by suicidal children. The psychological autopsy was conformed by a Questionnaire of Psychosocial data, a Suicidal Act Evaluation Questionnaire and by an Informant's Reliability Scale. Because of the lack of specific backgrounds for the cases of child suicide, the Psychological Questionnaire was specifically developed for this study. Studied cases were those belonging to child suicides, up to 14-year-old children, who consummated their death in the State of Guanajuato in the 1995 to 2001 period. The files were obtained by the General Attorney Department. With the information extracted from such files, we proceeded to establish phone and mail contact with relatives of the deceased children. Later on, some interviews were carried out with one or more people close to each child; these interviews were held by psychologists qualified in Psychological Autopsy and Emotional Contention Techniques. The examined data came basically from the Psycho-Social Questionnaire and from the Content Analysis of suicide notes. The analysis method for first data, of quantitative nature, was by frequency distribution and correlation, computed by SPSS statistical software. Qualitative data resulting from the analysis of suicide notes content were verified by a technical jury integrated by three participating clinical psychologists. Results: Twenty nine suicide cases were analyzed, representing 69% of child suicides up to 14-year-old children in the State of Guanajuato within the aforementioned period. The rest of the files were not included in this research because the impossibility for locating the victim's relatives due to changes of residence, and in a lower percentage because they refused to participate in the study due to the emotional pain of talking about the suicide event, or because they ignored the minor child's data regarding the circumstances and causes of his death. Of all the examined cases, 19 (65.5%) were men and 10 (34.5%) were women. The range of child suicides' age was from eight to 14 years old, with a 12.55 year-old average and a 1.62 year-old standard deviation. Five suicide notes were analyzed, which belonged to 4 children: 3 girls (one of them left two notes) and one boy. With respect to 72.4% of the cases, the interviewed persons were first-degree relatives and regarding the remaining percentage, they were cousins, uncles or grandparents who reported having had a close relationship with the deceased child. The average age of the interviewees was 43 years, with a standard deviation age of 17.19 years. In almost half of the suicides (51.7%) some kind of violence was suffered. According to the interviewees' statements, 31% of the children who committed suicide had suffered some kind of psychological mistreatment, 41.1% of them had received some of kind of physical mistreatment, 3.4% were victims of sexual abuse and 10.34% were neglected. Almost a quarter of all the children had suffered two or three kinds of mistreatment. Additionally, 41.4% of suicidal children had seen physical violence at home. Four of the suicide notes included explicit declarations of mistreatment experiences. Other variables that were found were the presence of previous suicide attempts in 20.7% of the cases; and a 26.3% of cases where a relative also had a previous suicide attempt. Family alcohol consumption was detected in 65.5% and drug consumption in 24% of the cases. Further analysis show a correlation between child previous suicide attempts and psychological mistreatment (p= 0.004) or any other kind of violence exposure (p= 0.015). It is concluded that an important percentage of children who incurred in a suicide were indeed victims of some kind of child mistreatment, of which physical one was particularly evident. However, neither physical nor sexual abuse can be separated from their implicit component: the emotional mistreatment. Studies of pure qualitative nature could contribute with more information about the dynamics that associates both phenomena. It is deemed that child mistreatment prevention would directly impact both suicide occurrence for the same group of age, and probably also within adult populations thus reducing its prevalence.
ABSTRACT
Se estudiaron diez casos de suicidio, cinco varones y cinco mujeres, mediante entrevista con dos familiares cercanos en cada caso. Los resultados de confiabilidad obtenidos con los diferentes instrumentos utilizados son indice de que el recurrir a terceras personas para obtener informacion del suicidio, es confiable. Las areas en las que el grado de concordancia difirio fueron las relacionadas mas de cerca con el suicidio: lo que significa que posiblemente, hay mayor distorsion en la informacion