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Antecedentes: Uno de los impedimentos más importantes en los traumatismos craneoencefálicos (TEC), revistan en las dificultades de interacción social, la Teoría de la Mente (ToM) es un factor fundamental de la cognición social, que permite una interacción satisfactoria del sujeto. Objetivo: Observar la capacidad de ToM en pacientes TEC moderado o severo, y su relación con dominios neurocognitivos. Método: Pacientes diagnosticados con TEC moderado o severo, evaluados neuropsicológicamente, edad 16 y 45 años, se aplicaron Test de la Mirada (TdlM) e Historias Extrañas (HT). Resultados: Se encontraron correlaciones entre TdlM y HT con memoria y funciones ejecutivas. Pacientes lesionados izquierdos, rinden significativamenie menos en HT. Conclusiones: Pacientes con TEC moderado o grave tienen una disminución de la capacidad de ToM. Existe una relación entre memoria episódica y ToM, podría deberse a que esta última requiere información a experiencias pasadas. Durante la infancia la ToM depende de la memoria episódica, pero cuando ambas se desarrollan adecuadamente, son independientes. Existe una relación entre funciones ejecutivas y ToM. Ambos constructos están vinculados en la infancia, pero luego comienzan a ser más independientes. Sin embargo, la ToM igualmente va a requerir de las funciones ejecutivas.
Background: One of the most important impediments in traumatic brain injuries (TBI), are the difficulties of social and family interaction. The Theory of Mind (ToM) is a fundamental factor of social cognition, which allows a satisfactory interaction of the individual with his environment. Objetive: To observe the ability of ToM in moderate or severe TBI patients, and its relationship with neurocognitive domains. Methods: Outpatients with diagnosis of moderate or severe TBI, evaluated neuropsychologically, age between 16 and 45 years, were applied Eyes Test (ET) and the Hinting task (HT). Results: Correlations were found between ET and HT with memory and executive functions. Injured left, perform significantly less in HT Patients with moderate or severe TBI have a decrease in ToM capacity. Conclusions: There is a relationship between episodic memory and ToM, which could be due to the latter 's need to request information from past experiences through episodic memory. During childhood ToM depends on episodic memory, but when both are achieved and developed properly, they are independent. There is a relationship between executive functions and ToM. Both constructs are linked in childhood, but then they begin to be more independent. However, ToM tasks will also require executive functions.
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ABSTRACT Numerous works and clinical research conducted in various institutions have cast fresh light on the notion of trauma and have contributed to the emergence of the concept of early relational trauma. Early relational trauma is a form of trauma rendered complex by the multiplicity of its sources and its modes of expression. Its main features are often attachment and acting-out disturbances. In families where such trauma occurs, links could sometimes be perverted and form a narcissistic configuration. This mode of functioning, organized around negativity, impacts the plurality of psychic processes and interferes with the treatment approaches of multidisciplinary teams. In order to promote a multifocal approach to care tailored to differences in situations, educational and socio-judicial practitioners.
RESUMO Inúmeros trabalhos e pesquisas clínicas realizados em diversas instituições trouxeram à luz a noção de trauma e contribuíram para o surgimento do conceito de trauma relacional precoce. O trauma relacional precoce é uma forma de trauma complexo pela multiplicidade de suas fontes e seus modos de expressão. Suas principais características são frequentemente distúrbios de apego e atuação. Nas famílias onde ocorre tal trauma que às vezes pode ser pervertido em configurações narcísicas, esse modo de funcionamento organizado em torno da negatividade impacta a pluralidade do psíquico e interfere nas abordagens de tratamento das equipes multidisciplinares. Para promover uma abordagem multifocal de cuidados adaptados às diferenças de situações, profissionais de educação e sócio judiciais.
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A insuficiência de condições seguras de apego pode estar associada a dificuldades no desenvolvimento infantil e vulnerabilidade para o surgimento de condições clínicas diversas, como o Transtorno do Déficit de Atenção com Hiperatividade (TDAH). Foi realizada uma revisão narrativa da literatura buscando contribuições da Teoria do Apego para a compreensão de fatores ambientais associados ao TDAH infantil. A revisão incluiu artigos teóricos e empíricos dos Portais do Index Psi, PubMed, Capes e Google acadêmico publicados nos idiomas português, inglês e espanhol entre 2002 a 2021. Os estudos apontaram que: crianças com TDAH apresentam em geral as mesmas dificuldades no desenvolvimento das que possuem apego primário inseguro; o apego de crianças com TDAH difere das crianças típicas, sendo predominantemente inseguro; estudos com pais dessas crianças têm encontrado dificuldades na função reflexiva destes. Conclui-se que o laço estabelecido entre criança e cuidador principal pode ser considerado um fator de proteção ou risco para o desenvolvimento infantil. A Teoria do Apego pode oferecer suporte para pensar diferentes fatores ambientais associados ao TDAH.(AU)
The insufficiency of secure attachment conditions may be associated with difficulties in child development and vulnerability to the onset of various clinical conditions, such as Attention Deficit Hyperactivity Disorder (ADHD). A narrative literature review was carried out seeking contributions from Attachment Theory to the understanding of environmental factors associated with childhood ADHD. Revision included theoretical and empirical articles from Index Psi, PubMed, Capes and Scholar Google published in Portuguese, English and Spanish between 2002 and 2021. The studies showed that: children with ADHD generally have the same difficulties in development of those with primary insecure attachment; the attachment of children with ADHD differs from typical children, being predominantly insecure; studies with parents of these children have found difficulties in their reflective function. It is concluded that the bond established between the child and the main caregiver can be considered a protective or risk factor for child development. Attachment Theory can support thinking about different environmental factors associated with ADHD.(AU)
La insuficiencia de las condiciones de apego seguro puede se asociar con dificultades en el desarrollo infantil y vulnerabilidad a la aparición de diversas condiciones clínicas, como el trastorno por déficit de atención con hiperactividad (TDAH). Se llevó a cabo una revisión de la literatura narrativa buscando contribuciones de la Teoría del Apego a la comprensión de los factores ambientales asociados con el TDAH infantil. La revisión incluyó artículos teóricos y empíricos de los portales Index Psi, PubMed, Capes y Academic Google publicados en portugués, inglés y español entre 2002 y 2021. Los estudios mostraron que: los niños con TDAH generalmente tienen las mismas dificultades de desarrollo que aquellos con inseguridad apego primario; el apego de los niños con TDAH difiere del de los niños típicos, ya que es predominantemente inseguro; Los estudios con padres de estos niños han encontrado dificultades en su función reflexiva. Se concluye que el vínculo que se establece entre el niño y el cuidador principal puede considerarse un factor protector o de riesgo para el desarrollo infantil. La Teoría del Apego puede apoyar el pensamiento sobre diferentes factores ambientales asociados con el TDAH.
Subject(s)
Attention Deficit Disorder with Hyperactivity , Mentalization , Object AttachmentABSTRACT
Objective:To explor the effects of mentalization-based family therapy (MBFT) on the emotions of anxiety and depression, reflective functions, and related brain regions of adolescents with depression.Methods:Thirty-two adolescent patients with depression were selected in Beijing Huilongguan Hospital.Among them, fifteen patients treated with conventional drugs were defined as the control group, the other seventeen patients served as the observation group.On the basis of routine drug treatment, patients in the observation group were treated with 1.5 h MBFT once a week, for a total of 3 months.Among them, 10 patients underwent resting functional magnetic resonance imaging(rs-fMRI) scans before and after the intervention.SPSS 23.0 was used for statistical analysis of scale evaluation data by using chi-square test and repeated-measure analysis of variance, and pairwise Pearson correlation was used to construct a brain network matrix for the MRI results.The patient's brain network matrix was put into Gretna to calculate, and then use repeated measures analysis of variance and t test for judgment. Results:(1)Repeated measurement analysis of variance showed, over time and group, before and after intervention, the group×time interactions of patients' reflective function, anxiety, depression were statistically significant ( F=5.113, 9.350, 5.264, all P<0.05). Further simple effect analysis showed, in the observation group, there were statistically significant differences in patients' anxiety ((55.09±14.35) vs (30.58±3.62)), depression ((61.58±16.81) vs (31.00±3.48)) before and after intervention (all P<0.01). There was no significant difference in reflective function ((8.71±0.51) vs (8.87±0.50) ) in the observation group before and after intervention( P> 0.05). The reflective function((8.92±0.33) vs (8.73±0.35)) and anxiety((50.67±13.88) vs (45.78±12.89)) scores of the control group were not statistically significant different before and after intervention(all P>0.05), and the depression scores of the control group before and after inter-vention((69.33±9.11) vs (50.94±7.99)) were statistically significant different( P<0.01). (2)rs-fMRI showed that, using the posterior parietal lobe and the medial prefrontal lobe as seed points, the group×time interactions with right inferior frontal gyrus, right fusiform gyrus, right superior temporal gyrus, left middle temporal gyrus and right superior frontal gyrus were statistically significant ( F=29.56, 20.63, 8.69, 9.49, 8.62, all P<0.05). The further simple effect analysis showed in the observation group, the pre-test was less than the post-test, and the difference was statistically significant( P<0.05). In the control group, there were not statistically significant differences in the functional connection strength before and after the test(all P>0.05). (3)The brain network analysis of 264 regions of interest (ROIs) in the whole brain showed that the number of modules in the observation group was less than that in the control group, and the difference was statistically significant ( t=-2.64, P=0.046). Conclusion:MBFT can improve the anxiety and depression of adolescent patients with depression.It enhances the functional link between mentalization related brain regions and the whole brain, and enhances the activity of the whole brain link to become more integrated.
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Objective:To observe the effect of methylphenidate hydrochloride (MPH) combined with mentalization-based family therapy (MBFT) on clinical efficacy and social function in children with attention deficit hyperactivity disorder (ADHD).Methods:Sixty-four children with ADHD diagnosed in Wuxi Children's Hospital and Affiliated Hospital of Jiangnan University from June 2019 to May 2021 were selected and divided into observation group ( n=32) and control group ( n=32) according to the random number table.Children in both groups received methylphenidate hydrochloride extended-release tablets, while those in the observation group were given additional MBFT.The duration of treatment was 12 weeks in both groups.The parent symptom questionnaire (PSQ), swanson nolan and pelham-version Ⅳ (SNAP-Ⅳ) parent Al scale, and Weiss impairment functional scale (WFIRS-P) were used to evaluate the effectiveness of treatment.Statistical analysis was performed by SPSS 25.0 statistical software.In particular, the χ2 test was used for counting data and the paired sample t test was used for comparison of measurement data between the two groups before and after treatment. Results:(1) All the PSQ dimension scores of patients in the observation group and the control group after treatment were significantly lower than those before treatment (all P<0.01). Compared with the control group after treatment, the PSQ dimension scores of personality and behavior problems ((1.25±0.15), (0.94±0.18), t=7.484, P<0.001), learning problems ((1.57±0.16), (1.32±0.20), t=5.522, P<0.001), psychosomatic disorders ((0.56±0.11), (0.44±0.13), t=3.986, P<0.001), impulse hyperactivity ((1.76±0.23), (1.54±0.25), t=3.663, P<0.001), anxiety ((0.94±0.12), (0.76±0.11), t=6.255, P<0.001) and hyperactivity index ((1.74±0.19), (1.51±0.16), t=5.238, P<0.001) decreased significantly in the observation group after treatment.(2) Compared with the pre-treatment period, the SNAP-Ⅳ scale scores of attention deficit, impulsivity-hyperactivity and oppositional defiance were significantly lower in both groups after treatment (all P<0.01); and compared with the control group, the SNAP-Ⅳ scale scores of the above three dimensions were significantly lower in the observation group (all P<0.01). (3) All six dimensions (family, learning and school, life skills, self-management, social activities, and risk-taking activities)of the WFIRS-P scale were significantly lower in the children in the observation group after treatment compared with those before treatment (all P<0.01), and all the six dimensions of the WFIRS-P scale were significantly lower in the observation group compared with those in the control group (all P<0.01). Conclusion:Methylphenidate hydrochloride extended-release tablets combined with MBFT can significantly improve the clinical symptoms and social function of children with ADHD.
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Mentalização é a habilidade de interpretar os próprios comportamentos e os de outros em termos de estados mentais. No presente estudo exploratório, objetivou-se avaliar a capacidade de mentalização de professoras de berçário que atuam com bebês entre quatro e dezoito meses de idade, em escolas de Educação Infantil. Participaram do estudo quatro professoras que atuam em Porto Alegre e região Metropolitana, três delas na rede pública e uma na rede privada. Utilizaram-se os instrumentos: Ficha de Dados Sociodemográficos e Profissionais e Entrevista de História de Vida e Relações Atuais essa analisada através do Checklist for the clinical assessment of mentalizing. A classificação da capacidade de mentalização das participantes variou entre "boa" e "muito alta" nos quatro contextos avaliados pelo Checklist. Conclui-se que o resultado é positivo, pois uma boa capacidade de mentalização dos cuidadores está atrelada à oferta de cuidados de qualidade e à possibilidade de o professor pensar sobre como se relaciona com as crianças. Também contribui para o desenvolvimento da capacidade de mentalização delas. Indica-se a necessidade de novas pesquisas que validem instrumentos de avaliação da capacidade de mentalização no país, criem e testem intervenções que visem promovê-la, inclusive, em contextos diversos do escolar. (AU)
Mentalization is the ability to interpret one's own behaviors and those of others in terms of mental states. In the present exploratory study, we aimed to evaluate the mentalizing capacity of nursery educators that work with babies between four and eighteen months old in Early Childhood Education schools. Four educators working in Porto Alegre and the metropolitan region participated in the survey, three of them work in the public system and one in the private system. We employed the following instruments: Sociodemographic and Professional Data Questionnaire; and Life Story and Current Relationships Interview, which was analyzed according to the Checklist for the clinical assessment of mentalizing. The classification of the participants' mentalizing capacity ranged from "good" to "very high" in the four contexts evaluated by the Checklist. It is concluded that the result is positive because a good mentalizing capacity of the caregivers is attached to the offer of quality care and the possibility for the teacher to think about how he relates to the children. It also contributes to the development of their capacity to mentalize. There is a need for further research to validate instruments for assessing mentalization in the country, to create and test interventions that aim at promoting it, including in contexts other than schools. (AU)
La mentalización es la capacidad de interpretar los propios comportamientos y comportamientos ajenos en términos de estados mentales. Este estudio exploratorio tuvo como objetivo evaluar la capacidad de mentalización de maestras de guarderías infantiles que trabajan con bebés entre cuatro y dieciocho meses de edad, en escuelas de Educación Infantil. Participaron cuatro maestras que trabajan en Porto Alegre y la región metropolitana, tres de ellas en la red pública y una en la red privada. Los instrumentos utilizados fueron: Hoja de datos sociodemográficos y profesionales, Entrevista de historia de vida y relaciones actuales: esto se analizó a través del Checklist for the clinical assessment of mentalizing. La calificación de la capacidad de mentalización de las participantes varió de "buena" a "muy alta" en los cuatro contextos evaluados por el Checklist. Se concluye que tal resultado es positivo, ya que una buena capacidad de mentalización de los cuidadores está vinculada a la oferta de cuidados de calidad y a la posibilidad de que el profesor piense cómo se relaciona con los niños. También contribuye al desarrollo de su capacidad de mentalización. Se indica la necesidad de realizar más investigaciones para validar los instrumentos de evaluación de la mentalización en el país, crear y probar intervenciones que tengan como objetivo promoverla, incluso en contextos distintos de los escolares. (AU)
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Humans , Female , Adult , School Teachers , Mentalization , Child Day Care Centers , Child RearingABSTRACT
Abstract Objective This exploratory study locates countertransference as a pan-theoretical concept, comprising of thoughts, feelings, and behaviors expressed or experienced by therapists toward their patients. It aims to understand the patterns of countertransference experienced in working with borderline personality disorder. Associations between countertransference reactions and therapist-related variables of experience and mentalization ability are also examined. Method Psychotherapists (n = 117) completed the Therapist Response Questionnaire to assess patterns of countertransference experienced with a representative patient diagnosed with borderline personality disorder. They also completed a measure of mentalization ability that examined self-related mentalization, other-related mentalization, and motivation to mentalize. Results The profile of responses across eight countertransference dimensions is discussed, with the most strongly endorsed reactions being positive/satisfying, parental/protective, and helpless/inadequate. More experienced therapists reported less negative countertransference reactions in select dimensions. Therapists' self-reported ability to reflect on and understand their own mental states was negatively correlated with a range of difficult countertransference experiences. There were few associations between their ability to make sense of others' mental states, the motivation to mentalize, and the strength of their countertransference reactions. Conclusion The implications for countertransference management as well as therapist training and development are highlighted.
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Resumen Objetivo: Basado en la falta de medidas que permitan evaluar la mentalización como variable de proceso en psicoterapias con adolescentes, el siguiente estudio apunta a presentar el diseño de un sistema observacional para evaluar el despliegue de esta variable tanto en pacientes como en terapeutas. Método: mediante el proceso de codificación abierta de la teoría fundamentada y análisis temático de tres niveles, se analizó el despliegue de la mentalización tanto en terapeutas como en pacientes en 10 episodios de ruptura y 10 episodios de resolución elegidos aleatoriamente de cinco psicoterapias con adolescentes. Resultados: A partir del análisis efectuado se desarrolló un sistema observacional de seis dimensiones emergentes (foco en los estados mentales, opacidad de los estados mentales, comunicación contingente, causalidad de los estados mentales, naturaleza dinámica de los estados mentales y foco en el momento presente) denominado "Sistema de Observación de la mentalización en Psicoterapia con adolescentes" (OMP-A) que permite evaluar cuantitativamente la mentalización de terapeutas y pacientes. Discusión y conclusiones: el OMP-A es un instrumento que responde a debilidades de otros sistemas para evaluar mentalización en psicoterapia con adolescentes, permitiendo la observación de aspectos lingüísticos y paralingüísticos del mentalizar y toma en consideración aspectos particulares que caracterizan las intervenciones con adolescentes. Se discute su posible uso para la formación y supervisión en psicoterapia, y los desafíos metodológicos para desarrollos futuros.
Abstract Objective: Based on the need for measures for assessing mentalization in adolescent psychotherapy, this study aims to design an observational system to evaluate the deployment of reflective function in both patients and therapists during psychotherapy sessions. Method: 10 episodes of rupture and 10 episodes of resolution randomly chosen within 5 videotaped and transcribed psychotherapies were analyzed using grounded theory "s open coding procedure and a three-level thematic analysis. Results: An observational system with 6 emergent dimensions (focus on mental states, opacity of mental states, contingent communication, causality of mental states, dynamic nature of mental states and focus on the present moment) and a 5-point scale was developed. Discussion and conclusions: The "Observational System for mentalization adolescent psychotherapy" (OMP-A) is an instrument that responds to certain weaknesses of other instruments by considering linguistic and paralinguistic aspects of mentalization and particular aspects that characterize interventions with adolescents. It "s possible use for training and supervision is discussed as well as some methodological challenges for future research.
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Resumen El objetivo de esta revisión es presentar una delimitación del concepto de Mentalización dentro del campo de la psicología. Se describen antecedentes históricos y teóricos del tema y se establecen diferencias y similitudes entre éste y otros constructos psicológicos similares como la Teoría de la Mente (ToM), Mindfulness y la Conciencia Afectiva (AC). Por último, se revisan intervenciones clínicas aplicables a la población colombiana.
Summary The purpose of this study is to present a delimitation of the concept of Mentalization in the field of Psychology. The topic's theorical and historical backgrounds are described, and differences and similarities are established between this and other similar psychological constructs such as Theory of Mind (ToM), Mindfulness, and Affective Consciousness (AC). Finally, clinical interventions applicable to the Colombian population, are reviewed.
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A mentalização tem sido considerada um elemento importante no processo de mudança na psicoterapia psicodinâmica. No entanto, há uma escassez de instrumentos disponíveis para avaliar o constructo com a população infantil. O Método de Rorschach tem sido sugerido como um procedimento capaz de avaliar a mentalização. Assim, o objetivo deste estudo foi analisar possíveis mudanças no funcionamento psíquico global e na capacidade de mentalização na psicoterapia psicodinâmica de crianças, de acordo com o Método de Rorschach (Sistema Exner). Foi realizado um estudo descritivo e longitudinal baseado no procedimento de Estudo de Caso Sistemático, do qual participaram três crianças em idade escolar. O Método de Rorschach foi aplicado no início e ao final do tratamento. As crianças apresentaram deficit na capacidade de mentalização no início do tratamento, associado a prejuízos no funcionamento psíquico global. Foi possível identificar mudanças na mentalização, ao final da psicoterapia, que se caracterizaram por avanços e retrocessos. O Método de Rorschach provou ser capaz de identificar mudanças na capacidade de mentalização das crianças analisadas.
Mentalization has been considered an important element in the process of change in psychodynamic psychotherapy. However, there is a shortage of available instruments to assess the construct in children. The Rorschach Method has been suggested as a procedure capable of evaluating mentalization. Thus, the aim of this study was to analyze possible changes in the global psychic functioning and in mentalization ability in child psychodynamic psychotherapy, according to the Rorschach Method (Exner System). A descriptive and longitudinal study based on the Systematic Case Study procedure was performed, in which three school-age children took part. The Rorschach Method was applied at the beginning and at the end of the treatment. The children presented impairments in their ability to mentalize at the beginning of the treatment, and it was possible to identify changes in this ability at the end of the psychotherapy. In addition, there was an association between deficits in mentalization and impairments in global psychic functioning. The changes in psychotherapy did not show a steady progress, but were marked by advances and setbacks. The Rorschach Method proved able to detect changes in the mentalization ability of the children.
La mentalización ha sido considerada un elemento importante en el proceso de cambio en la psicoterapia psicodinámica. Sin embargo, hay una escasez de instrumentos disponibles para evaluar el constructo con la población infantil. El método de Rorschach ha sido sugerido como un procedimiento capaz de evaluar la mentalización. Así, el objetivo de este estudio fue analizar posibles cambios en el funcionamiento psíquico global y en la capacidad de mentalización en la psicoterapia psicodinámica de niños, de acuerdo con el Método de Rorschach (Sistema Exner). Se realizó un estudio descriptivo y longitudinal basado en el procedimiento de Estudio de Caso Sistemático, en el que participaron tres niños en edad escolar. El método de Rorschach se aplicó al principio y al final del tratamiento. Los niños presentaron déficit en la capacidad de mentalización al inicio del tratamiento, que estuvieron asociados a pérdidas en el funcionamiento psíquico global. Fue posible identificar cambios en la mentalización, al final de la psicoterapia, que se caracterizaron por avances y retrocesos. El Método de Rorschach demostró ser capaz de identificar cambios en la capacidad de mentalización de los niños analizados.
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OBJECTIVES: The treatment of borderline personality disorder (BPD) in Korea has been based mainly on individual psychopharmacotherapy and psychotherapy. No quantitative study has examined the effectiveness of group psychotherapy for patients with BPD in Korea. In the present study, the mentalization-based treatment (MBT) program developed from the Anna Freud Center in London was conducted in the author's hospital. This article presents the results of a preliminary analysis of the treatment effects of the Korean MBT for BPD.METHODS: The recruited subjects are patients diagnosed with BPD at Gangnam Severance Hospital. A psychological assessment was conducted at baseline and every six months during the treatment. Statistical analysis was performed using the data of 62 people at the baseline assessment, and the treatment effectiveness was analyzed with the data from 21 people who participated in the treatment group over six months.RESULTS: Borderline personality features were positively correlated with depressive symptoms, anxious attachment, avoidant attachment, and novelty seeking trait, and negatively correlated with self-directedness. After the 12-month treatment, the depressive symptoms and self-disclosure scores were improved significantly. In addition, the self-directedness, cooperativeness factor scores of the temperament and character inventory, and the self-regulation ability score of the resilience scale were also improved significantly.CONCLUSION: This study suggests that the Korean MBT can improve depressive symptoms and induce positive changes in personality functioning. Although the number of people who continued MBT over 12 months was very small due to the high dropout rate, this study is the first quantitative study on the effects of the Korean MBT for BPD patients.
Subject(s)
Humans , Borderline Personality Disorder , Depression , Korea , Psychotherapy , Psychotherapy, Group , Self-Control , Temperament , Treatment OutcomeABSTRACT
El artículo es una síntesis operada sobre un trabajo de investigación cuyo objeto de estudio es el tratamiento de niños pequeños, con signos clínicos de condición autista y sus padres. Plantea nexos entre la vulnerabilidad innata a desarrollar un proceso autístico y las modalidades con que los padres ejercen su función. Dicha investigación se llevó a cabo en el ámbito de la Universidad de Ciencias Sociales y Empresariales (UCES) Buenos Aires, 2007, bajo la forma de tesis de doctorado, y fue actualizada con el material clínico de diez pacientes que recibieron atención psicoterapéutica en consultorio privado, entre 2008 y 2016. Se comprobó que en niños con signos clínicos de autismo el proceso de regulación emocional entre él y sus padres está alterado. Ambos tienen dificultades para anticipar lo que el otro siente, piensa o desea. Es decir que tanto el niño como sus padres carecen de una teoría acerca de lo que recíprocamente les sucede. El marco teórico referencial está conformado por conceptualizaciones psicodinámicas que toman en cuenta la experiencia intersubjetiva en la emergencia de la subjetividad. (Freud, 1895; Maldavsky,1995; Rizzolatti,2004; Fonagy, 2007)(AU)
The article is an synthesis operated of research work whose subject matter is the treatment of young children with clinical signs of autistic condition and their parents. It raises links between the innate vulnerability to developing an autistic process and the ways in which parents exercise their role. This research was carried out in the field of the University of Social and Business Sciences(UCES) Buenos Aires, 2007, in the form of a doctoral thesis, and was updated with the clinical of ten patients who received psychotherapeutic care in private office, between 2008 and 2016. It was found that in children with clinical signs of autism the process of emotional regulation between him and his parents is altered. Both have difficulty anticipating what the other feels, thinks, or desires. In other words, both the child and his parents lack a theory about what happens to them. The referential theoretical framework consists of psychodynamic conceptualizations that take into account the intersubjective experience in the emergence of subjectivity. (Freud, 1895; Maldavsky,1995; Rizzolatti,2004; Fonagy, 2007)(AU)
Subject(s)
Humans , Child , Autistic Disorder , Parents , Role , ChildABSTRACT
Abstract Mentalizing capacity refers to people's ability to interpret their own and other's behavior in terms of mental states. This can be accomplished through implicit mentalizing, which tends to be employed by people most of the time, tends to be procedural and generally requires minimal attention and reflection. This study sought to assess the implicit mentalizing of nursery teachers that work with babies between four and eighteen months of age in Early Childhood Education schools. Four nursery teachers participated in the study. The following instruments were employed: Sociodemographic and Professional Data Questionnaire and video recordings of observation sessions - analized through the indicators teachers' response in the babies' actions; and references to mental states in the teachers' vocalizations. The results indicated that two of the participants stood out positively, while the other two exhibited greater difficulties. These results are discussed, along with factors that potentially interfere with mentalizing capacity. The study points out the importance of future research on the subject, focused on developing instruments and planning interventions aimed at improving mentalizing capacity so as to promote mental health.
Resumo Capacidade de mentalização refere-se à possibilidade de um indivíduo entender seus comportamentos e os dos outros em termos de estados mentais, o que pode ser feito a partir de sua capacidade de mentalização implícita. Esta tende a ser empregada pelo sujeito na maior parte do tempo, a ser procedural e a demandar pouca atenção e reflexão. Este estudo objetivou avaliar a capacidade de mentalização implícita de educadores de berçário que atuam com bebês, entre quatro a dezoito meses de idade, em escolas de Educação Infantil. Participaram quatro educadoras. Empregaram-se os instrumentos: Ficha de Dados Sociodemográficos e Profissionais e filmagem das observações - analisada através dos indicadores respostas das educadoras frente às ações dos bebês e referências a estados mentais no discurso. Os resultados sugerem que duas participantes destacaram-se positivamente e as demais apresentaram dificuldades nesses dois indicadores. Discutem-se tais resultados e possíveis fatores intervenientes na capacidade de mentalização. Aponta-se a importância de novos estudos sobre a temática para a construção de instrumentos e planejamento de intervenções que almejem aprimorar a capacidade de mentalização para promover saúde mental.
Resumen La capacidad de mentalización se refiere a la posibilidad de un individuo entender sus comportamientos y los de otros en términos de estados mentales, lo que puede hacerse a partir de su capacidad de mentalización implícita. Esta tiende a ser empleada por el sujeto en la mayor parte del tiempo, a ser procedural ya demandar poca atención y reflexión. Este estudio objetivó evaluar la capacidad de mentalización implícita de educadores de guarderías infantiles que actúan con bebés, entre cuatro a dieciocho meses de edad, en escuelas de Educación Infantil. Participaron cuatro educadoras. Se emplearon los instrumentos: Ficha de Datos Sociodemográficos y Profesionales y filmación de las observaciones - analizada a través de los indicadores respuestas de las educadoras frente a las acciones de los bebés y referencias a estados mentales en el discurso. Los resultados sugieren que dos participantes se destacaron positivamente y los demás presentaron dificultades en estos dos indicadores. Se discuten tales resultados y posibles factores intervinientes en la capacidad de mentalización. Se apunta la importancia de nuevos estudios sobre la temática para la construcción de instrumentos y planificación de intervenciones que anhelan mejorar la capacidad de mentalización para promover salud mental.
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Resumen A través de esta investigación se buscó ver si existe relación entre alexitimia y el reconocimiento de estados mentales afectivos en la mirada; e indagar al mismo tiempo, en la posible influencia que la condición de cáncer pudiera tener. De este modo, se pretendió establecer diferencias en estas variables, en un grupo con y sin alexitimia de pacientes con cáncer (n = 98) y un grupo de contraste (n = 79) sin condición clínica. Para este estudio se trabajó con pacientes del área de oncología de dos hospitales en Chile, puesto que de manera consistente se ha vinculado a la alexitimia e inhibición como un rasgo de personalidad asociado a personas que padecen cáncer. Los resultados indicaron que el reconocido déficit en auto-conciencia emocional en alexitímicos se manifestaría, a su vez, en una capacidad disminuida en dar cuenta del trasfondo mental de los demás, y este resultado sería independiente de la condición de padecer o no cáncer.
Abstract This research study sought to determine the existence of a relationship between alexithymia and the recognition of emotion in people's eyes. Similarly, to investigate the possible influence that the cancer condition has in this emotional recognition deficits. Thus, we sought to identify differences in these variables in a group with and without alexithymia of patients with cancer and a contrast group without clinical condition. For this study, we worked with oncology patients in two hospitals in Chile, as it consistently has been linked to inhibition and alexithymia as a personality trait associated with people with cancer. The results indicated that the recognized deficit in self-consciousness emotional in alexithymics would manifest, in turn, in a diminished capacity in accounting for the mental background of others, and this result would be independent of the condition of suffering or not cancer.
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Resumen Las funciones ejecutivas son un grupo de habilidades que permiten la generación de respuestas adaptativas a las exigencias medioambientales. A su vez, la capacidad de mentalización refiere a la forma en que los humanos son capaces de discernir los estados mentales, intenciones y creencias de otros a través de la conducta observada. Este trabajo clarifica la forma en que debiéramos entender la relación entre estos dos conceptos. Tras revisar algunos de los aspectos más fundamentales de los conceptos en cuestión, se propone que la mentalización fundamenta, organiza y potencia el desarrollo de las funciones ejecutivas, esto, en oposición a la tesis dominante de Carlson, Moses y Brenton (2002) que indica que las funciones ejecutivas son las que fundamentan el desarrollo de la habilidad de mentalización. Luego de revisar la actual evidencia empírica que apoya la alternativa propuesta, se exploran algunas aplicaciones de esta en el estudio de la naturaleza neurofisiológica de lo social, la naturaleza subjetiva de la conciencia y el dominio de la psicopatología.
Abstract Executive functions are a set of abilities that allow the production of adaptive behaviours to specific challenges from the environment. Mentalization refers to the way in which humans are able to discern mental states, intentions and beliefs of others through observed behaviour. This paper clarifies the way in which we should understand the relationship between these two concepts. After presenting some of the most fundamental aspects of these concepts, it is proposed that mentalization underlies, organizes, and enhances the development of executive functions, this, contrary to the dominant approach defended by Carlson Moses, and Brenton (2002) that suggests that executive functions underlie the development of mentalization. After reviewing empirical evidence for the defended alternative, the last section explores some of its applications in areas such as the study of the neurophysiological nature of the social, the subjective nature of consciousness, and the domain of psychopathology.
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Prefrontal Cortex/pathology , Theory of Mind/classification , Neuropsychological Tests , Adaptation to DisastersABSTRACT
Objective To evaluate the reliability and validity of reflective functioning questionary-54 (RFQ-54) in China.Methods School sample:a total of 635 students were selected for the study.Clinical patients:another 75 patients with borderline personality trait who visited Department of Psychiatry in Shengjing Hospital of China Medical University were recruited.All subjects filled the RFQ-54,MIS-BPD,TAS,FFMQ.44 students accepted the retest after three weeks.Results The internal consistency for RFQ-C and RFQ-U were both 0.628.The test-retest reliability was 0.835,0.683,respectively.The correlations with TAS,FFMQ,MIS-BPD supported its validity.The RFQ subscales scores were significant1y different between only-child and non-only child,urban and country,school group and clinical group (22.11 ± 1.34 vs 18.97 ± 1.22,22.59 ± 1.36 vs 17.61 ± 1.12,21.39 ± 1.32 vs 15.34 ± 1.08,10.95 ± 8.43 vs 13.58 ± 8.19,10.95 ± 8.36 vs 13.88 ± 8.26,11.47 ± 8.02 vs 22.43 ± 1.24,respectively.P ＜ 0.01).Conclusion The Chinese version of RFQ-54 shows good reliability and validity,which can be used to assess the reflective function of adults in China.
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Objective To investigate the effect of mentalization based treatment on the negative emotion such as anxiety,depression and chronic drug craving among methamphetamine addicts.Methods Totally 612 methamphetamine addicts in 6 compulsory isolated detoxification center of Liaoning served as the study subjects and randomly divided into the experimental group (mentalization based treatment group) and control group,306 cases in each group.The Beck Anxiety Inventory (BAD,Beck Depression Inventory (BDI) and the Drug Craving Inventory were used to evaluate the anxiety,depression and chronic craving in the two groups.Results The scores of BAI,BDI and Drug Craving Inventory after mentalization base treatment in the experimental group were decreased compared with those of before intervention (P＜0.05).The declining trend of the scores of BAI,BDI and Drug Craving Inventory after intervention in the experimental group were more significant than that in the control group (P＜0.05).Conclusion The mentalization based treatment can improve the negative emotions such as anxiety and depression to some extent,and reduces the chronic drug craving among methamphetamine drug addicts.
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Objective To investigate the effect of mentalization based treatment on the negative emotion such as anxiety,depression and chronic drug craving among methamphetamine addicts.Methods Totally 612 methamphetamine addicts in 6 compulsory isolated detoxification center of Liaoning served as the study subjects and randomly divided into the experimental group (mentalization based treatment group) and control group,306 cases in each group.The Beck Anxiety Inventory (BAD,Beck Depression Inventory (BDI) and the Drug Craving Inventory were used to evaluate the anxiety,depression and chronic craving in the two groups.Results The scores of BAI,BDI and Drug Craving Inventory after mentalization base treatment in the experimental group were decreased compared with those of before intervention (P＜0.05).The declining trend of the scores of BAI,BDI and Drug Craving Inventory after intervention in the experimental group were more significant than that in the control group (P＜0.05).Conclusion The mentalization based treatment can improve the negative emotions such as anxiety and depression to some extent,and reduces the chronic drug craving among methamphetamine drug addicts.
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El GTF es un dispositivo diagnóstico-terapéutico grupal de orientación psicodinámica, de corto plazo y focalizado que incluye dos sesiones multifamiliares (primera y novena sesión) basadas en los principios fundamentales del Psicoanálisis Multifamiliar. En este artículo se analiza la última sesión multifamiliar de un Grupo de Terapia Focalizada-GTF para adolescentes violentos y se lo compara con la primera sesión multifamiliar. Se aplicó la Escala de Función Reflexiva para conocer el grado de mentalización de los adolescentes violentos en interacción con sus padres. A diferencia de la primera sesión multifamiliar, en la última se detectaron intervenciones espontáneas de los adolescentes para enunciar situaciones traumáticas de gravedad (puntaje 1) y un claro rechazo a la reflexión por parte de las madres (puntaje -1) representado por respuestas evasivas y bizarras que tendían a minimizar lo que estaban vivenciando sus hijos. Se destaca la posibilidad de que los adolescentes y sus padres comiencen a interactuar.
Focalized Therapy Group- FTG is a psychodynamic-oriented, short-termed and focalized diagnostic-therapeutic group device. It includes two multifamily sessions (first and ninth session) based on the fundamental Multifamily Psychoanalysis conceptualizations. In this paper the ninth multifamily session of a Focalized Therapy Group- FTG for violent adolescents is analyzed and compared with the first multifamily session. Reflective Function Scale was applied to determine the level of mentalization of violent adolescents in interaction with their parents. In contrast to the first multifamily session, in the last one, spontaneous interventions of adolescents were detected to verbalize severe traumatic situations (score 1) and a clear rejection of refection by mothers (score -1) represented by evasive and bizarre answers that tended to minimize what their children were experiencing. The possibility that adolescents and their parents begin to interact is highlighted.
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Adolescent , Adolescent , Family Therapy , Psychotherapy, Brief , ViolenceABSTRACT
Estudios recientes han mostrado la importancia de la mentalización y/o función reflexiva de los cuidadores como una de las variables que predice el desarrollo de esta habilidad y el apego seguro en el niño/a. A partir de estos antecedentes se revisa la literatura existente sobre intervenciones psicológicas focalizadas en promover la mentalización en padres y/o personal educativo de niños/as en etapa preescolar. Se consideran 17 estudios publicados entre los años 2000 y 2013. Los resultados muestran que gran parte de los estudios analizan y desarrollan modelos teóricos, siendo incipientes aquellos que consideran los estudios acerca de intervenciones basadas en la mentalización dirigidas a padres y/o agentes educativos. Dentro de estos últimos la mayoría están orientados a intervenciones tempranas en niños/as de 0 a 3 años, siendo escasos los estudios en preescolares (3 a 5 años de edad) dentro de un contexto educativo que reportan los efectos en los niños/as.
Recent studies have shown the importance of mentalizing or reflective function of caregivers as one of the variables that predict awareness and secure attachment in children. From this background there is a review of the literature on psychological interventions focused on promoting mentalizing or reflective function in parents and preschool educators. 17 studies published between 2000 and 2013 are considered. The results show that most of the studies analyzed and developed in theoretical models, with those who consider emerging studies based on mentalizing aimed at parents and educators interventions. Within the latter most are aimed at early intervention in children aged 0-3 years, with few studies in preschool children (3-5 years old) within an educational context that the effects reported in children.