Esquemas Iniciais Desadaptativos em Adultos com Histórico de Eventos Estressores Precoces / Early Maladaptive Schemas in Adults with a History of Early Life Stressors / Esquemas Maladaptativos Tempranos en Adultos con Antecedentes de Eventos Estresantes Tempranos

Esse estudo teve como objetivo principal investigar a relação entre os subtipos de Eventos Estressores Precoces e os Esquemas Iniciais Desadaptativos em adultos. Foram utilizados o Questionário sobre Traumas na Infância (Childhood Trauma Questionnaire) e o Questionário de Esquemas de Young - forma reduzida (Young Schema Questionnaire - short form) em uma amostra, não-clínica de 200 pessoas, na qual metade (n=100) apontou a presença de Eventos Estressores Precoces. Os dados foram processados no software IBM SPSS Statistics - versão 22, por meio de estatística descritiva, coeficiente de correlação de Pearson, e comparação de médias através do Teste t de Amostras Independentes. As análises de correlação revelaram que cada subtipo de abuso e negligência se relacionou de diferentes formas com os Esquemas Iniciais Desadaptativos, sugerindo que a influência diferencial de cada tipo deve ser estudada. Dentre todos os subtipos de Eventos Estressores Precoces, o abuso emocional se destacou, apresentando maior prevalência e correlações com mais esquemas.

This study aimed to investigate the relationship between the subtypes of Early Life Stressors and the Early Maladaptive Schemas in adults. The Childhood Trauma Questionnaire and the Young Schema Questionnaire (short form) were used in a non-clinical sample of 200 people in which half (n = 100) had a previous history of Early Life Stressors. The data was processed in the IBM SPSS Statistics - version 22 software, using descriptive statistics, Pearson's correlations coefficients and comparison of means by using the Independent Samples t-Test. Correlation analysis revealed that each type of abuse and neglect was related in different ways to the Early Maladaptive Schemes, which suggests that the differential influence of each type should be studied. Among all the subtypes of Early Stressful Events, the emotional abuse was the one that stood out, showing a higher prevalence and correlations with more schemes than other form of maltreatment, such as physical and sexual abuse.

Este estudio tuvo como objetivo investigar la relación entre los subtipos de Eventos Estresantes Tempranos y los Esquemas Maladaptativos Tempranos en adultos. Se utilizaron el "Cuestionario de Trauma Infantil" (Childhood Trauma Questionnaire) y el "Cuestionario de esquemas - forma reducida" (Young Schema Questionnaire - short form) en una muestra no clínica de 200 personas, en la que la mitad (n = 100) indicó la presencia de EEP. Los datos fueron processados en el software IBM SPSS Statistics, versión 22, utilizando estadística descriptiva, coeficiente de correlación de Pearson y comparación de medias utilizando la Prueba t para Muestras Independientes. Los análisis de correlación revelaron que cada subtipo de abuso y negligencia se relacionó de diferentes formas con los Esquemas Maladaptativos Tempranos, sugiriendo que se debería estudiar la influencia diferencial de cada tipo. Entre todos los subtipos de Eventos Estresantes Tempranos, se destacó el abuso emocional, que tuvo una mayor prevalencia y correlaciones con más esquemas.

Violencia intrafamiliar: un riesgo para el desarrollo de la primera infancia / Domestic violence. A risk to early childhood development

Los padres y cuidadores son los adultos que apoyan a los niños y niñas para el desarrollo de los aspectos que constituyen la naturaleza humana, les proporcionan los significados y las nociones que concretan la dignidad de la persona en la familia y en los otros escenarios fuera de esta, por tanto, la exposición a la violencia intrafamiliar se constituye un riesgo para el desarrollo integral de los niños y las niñas. Objetivo: identificar tipos y formas de violencia intrafamiliar que sufren las madres y cuidadoras como un factor de riesgo en el desarrollo integral de los niños y niñas de un programa de primera infancia. Metodología: estudio cuantitativo, descriptivo transversal mediante cuestionario. Participaron 308 mujeres. Resultados: las participantes son víctimas de violencia psicológica, física, económica y sexual por parte de los miembros de sus familias de origen, política y propia. Conclusiones: es evidente el riesgo para el desarrollo integral de los niños y las niñas sobre reproducir los modelos de trato violento, dado que los actos de violencia son repetitivos en la historia familiar.

Parents and caregivers are adults who support children for the development of the aspects that constitute human nature, provide them with meanings and notions that concretize the dignity of the person in the family and in other scenarios outside it, therefore, exposure to domestic violence is a risk to the integral development of children. Objective: to identify types and forms of domestic violence suffered by mothers and caregivers as a risk factor in the integral development of children in an early childhood program. Methodology: a quantitative, descriptive cross-sectional study by questionnaire. 308 women participated. Results: the participants are victims of psychological, physical, economic, and sexual violence by their family members, of origin, politics, and their own. Conclusions: the risk to the integral development of children of reproducing models of violent treatment is evident, given that acts of violence are repetitive in family history

Childhood trauma and bipolar spectrum: a population-based sample of young adults

Abstract Introduction Childhood trauma has been suggested to be involved in susceptibility to bipolar disorder (BP). However, it remains unclear whether the occurrence of childhood trauma is differently distributed in subthreshold bipolar disorder (SBP). Objective To assess childhood trauma in young adults with SBP, as compared to young adults with BP and population controls (PC). Method This was a cross-sectional, population-based study. The Mini International Neuropsychiatric Interview (MINI) was used to define the groups with BP (subjects with a lifetime or current manic episode or lifetime or current hypomania with a history of a depressive episode), SBP (subjects with a history of hypomanic episode without lifetime or current depressive episode), and subjects without mood disorders (PC). Childhood trauma was assessed using de Childhood Trauma Questionnaire (CTQ). We investigated differences regarding childhood trauma across the three groups (BP, SBP and PC). Result Except for sexual abuse, all subtypes of childhood trauma remained associated with the BP group as compared to PC. Additionally, when we compared SBP and BP, significant differences were found only for emotional abuse. No significant differences were found in relation to childhood trauma between the SBP and PC groups after adjusting for confounding factors. Conclusion These findings suggest that investigating childhood trauma, with a particular focus on emotional abuse, could be considered a preventive measure and potentially improve the prognosis.

Effects of childhood trauma on BDNF and TBARS during crack-cocaine withdrawal

Objective: To evaluate the association between childhood trauma (CT) and serum levels of brain-derived neurotrophic factor (BDNF) and thiobarbituric acid-reactive substances (TBARS) during crack-cocaine withdrawal. Method: Thirty-three male crack-cocaine users were recruited at admission to a public addiction treatment unit. Serum BDNF and TBARS levels were evaluated at intake and discharge. Information about drug use was assessed by the Addiction Severity Index-6th Version (ASI-6); CT was reported throughout the Childhood Trauma Questionnaire (CTQ). CTQ scores were calculated based on a latent analysis model that divided the sample into low-, medium-, and high-level trauma groups. Results: There was a significant increase in BDNF levels from admission to discharge, which did not differ across CT subgroups. For TBARS levels, we found a significant time vs. trauma interaction (F2,28 = 6.357, p = 0.005,ηp 2 = 0.312). In participants with low trauma level, TBARS decreased, while in those with a high trauma level, TBARS increased during early withdrawal. Conclusion: TBARS levels showed opposite patterns of change in crack-cocaine withdrawal according to baseline CT. These results suggest that CT could be associated with more severe neurological impairment during withdrawal.

Factores sociodemográficos y eventos de vida tempranos asociados con la felicidad en adultos de Lima Metropolitana / Socio-demographic factors and early life events associated with happiness in adults of Metropolitan Lima

RESUMEN Objetivos: Estimar los factores sociodemográficos y eventos de vida tempranos asociados con la feli cidad en adultos de Lima Metropolitana. Materiales y métodos: Se realizó un análisis secundario del Estudio Epidemiológico de Salud Mental de Lima Metropolitana 2012, el cual utilizó los instrumentos de índice de calidad de vida, la versión breve y modificada del EMBU, un cuestionario de eventos adver sos tempranos, un índice de felicidad construido a partir del ítem único sobre felicidad de Andrews y la escala de satisfacción con la vida. Se realizaron análisis multivariados ajustados. Resultados: La felicidad se asoció con el sexo, estado civil, pobreza y nivel de instrucción. Los estilos de crianza asociados con menor felicidad fueron: las conductas de rechazo y las actitudes machistas, y con mayor felicidad: el calor emocional. No se encontró asociación con prácticas de crianza de sobreprotección o favoritismo. Como eventos adversos tempranos se asociaron significativamente: discusiones dentro de la familia, padre con problemas de alcohol, ausencia paterna, conductas de amenazas o chantaje emocional. Conclusiones: Los hallazgos resaltan la importancia de desarrollar programas intensivos en los primeros años de vida que estimulen estilos de crianza y ambientes de desarrollo saludables.

ABSTRACT Objectives: To estimate socio-demographic factors and early life events associated with happiness in adults in metropolitan Lima. Materials and methods: A secondary analysis was carried out on the Epi demiological Study of Mental Health of Metropolitan Lima 2012. The instruments used were the Quality of Life Index; a brief and modified version of the EMBU; a questionnaire of early adverse events; a Hap piness Index built from Andrews' single item of Happiness and the Life Satisfaction Scale. Adjusted mul tivariate analyses were performed. Results: Happiness was significantly associated with gender, marital status, poverty, and level of education. Parenting styles associated significantly with less happiness were: behaviors of rejection and sexist attitudes; and with higher happiness: emotional warmth. No associa tion was found with overprotection or favoritism breeding practices. Early adverse events significantly associated with lower happiness were discussions within the family, father with problems of alcohol, parental absence, behaviors of emotional blackmail or threats. Conclusions: This study highlights the importance of developing intensive programs in the first years of life that promote parenting styles and healthy development environments.

Relações entre Eventos Estressores Precoces, personalidade e sintomas psiquiátricos: um estudo exploratório em amostra não clínica / Relations between early life stress, temperament and character and psychiatric symptoms: an exploratory study in a non-clinical sample / Relaciones entre eventos estresantes prematuros, personalidad y síntomas psiquiátricos: un estudio exploratorio en una muestra no clínica

A ocorrência de Eventos Estressores Precoces (EEPs) pode ser um fator determinante para o desenvolvimento de traços de personalidade disfuncionais e transtornos mentais. O objetivo do presente estudo foi analisar a possível relação entre EEPs, características de personalidade e sintomas psiquiátricos em uma amostra não clínica. Trata-se de uma investigação com delineamento transversal, onde foram utilizados para coleta de dados um questionário sociodemográfico, o Inventário de Autoavaliação para Adultos (ASRI), o Questionário sobre Traumas na Infância (QUESI) e o Inventário de Temperamento e Caráter (ITC-R). Os resultados expõem associação entre a ocorrência de EEPs e maior presença do fator de temperamento evitação de danos e menor presença do fator de caráter autodirecionamento, ambos também apresentaram correlações com sintomas psiquiátricos. Sugere-se que EEPs possam exercer influência sobre o desenvolvimento de traços de personalidade que funcionem como fatores de vulnerabilidade, contribuindo para o surgimento de sintomas psiquiátricos.

The occurrence of Early Life Stress (ELSs) can be a determining factor for the development of dysfunctional personality traits and mental disorders. The aim of this study was to analyze the possible relationship between ELSs, personality traits and psychiatric symptoms in a non clinical sample. It is an investigation with a cross-sectional design, where they were used for data collection: a sociodemographic questionnaire, the Inventory Self-Assessment for Adults (ASI), the Questionnaire on Trauma in Childhood (CTQ) and the Inventory of Temperament and Character (CTI-R). The results expose association between the occurrence of ELSs and greater presence temperament factor harm avoidance and minor character factor presence self-directedness, both also showed correlations with psychiatric symptoms. It is suggested that ELSs may influence the development of personality traits that serve as vulnerability factors for the emergence of psychiatric symptoms.

La ocurrencia de Eventos Estresantes Prematuros (EEPs) puede ser un factor determinante para el desarrollo de características de personalidad disfuncional y trastornos mentales. El objetivo del presente estudio fue analizar la posible relación entre EEPs, características de personalidad y síntomas psiquiátricos en una muestra no clínica. Se trata de una investigación con delineamiento transversal, para la recolección de datos fueron utilizados: un cuestionario socio-demográfico, el Inventario de Auto Evaluación para Adultos (ASI), el Cuestionario sobre Traumas en la Infancia (CTQ) y el Inventario de Temperamento y Carácter (ITC). Los resultados exponen una asociación entre la ocurrencia de Estrés EEPs y la mayor presencia del factor de temperamento prevención de daños y la menor presencia del factor carácter Auto direcionamiento, ambos también presentaron correlaciones con síntomas psiquiátricos. Se sugiere que el EEPs pueda ejercer influencia sobre el desenvolvimiento de características de la personalidad que funcionen como factores de vulnerabilidad, contribuyendo para el surgimiento de síntomas psiquiátricos.

Early trauma, attachment experiences and comorbidities in schizophrenia / Relação entre traumas precoces, experiências de apego e comorbidades na esquizofrenia

Abstract Objective To evaluate attachment patterns in subjects with schizophrenia and their relationships to early traumatic events, psychotic symptoms and comorbidities. Methods Twenty patients diagnosed with schizophrenia according to criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) underwent retrospective symptom assessment and careful assessment of the number and manner of childhood caregiver changes. The Diagnostic Interview for Psychosis and Affective Disorders (DI-PAD) was used to assess symptoms related to schizophrenia (positive and negative symptoms), depression and mania. Anxiety disorder comorbidities were assessed by the Liebowitz Social Anxiety Scale (LSAS), Yale-Brown Obsessions and Compulsions Scale (Y-BOCS) and Panic and Schizophrenia Interview (PaSI). Experience in Close Relationships - Relationship Structures (ECR-RS) and Early Trauma Inventory Self Report-Short Form (ETISR-SF) were used to assess attachment patterns and traumatic history, respectively. Results Moderate and significant correlations between attachment patterns and early trauma showed that greater severity of anxious attachment was predicted by a higher frequency of total early traumas (Spearman ρ = 0.446, p = 0.04), mainly general traumas (ρ = 0.526, p = 0.017; including parental illness and separation, as well as natural disaster and serious accidents). Among the correlations between early trauma and comorbid symptoms, panic attacks occurring before the onset of schizophrenia showed significant and positive correlations with ETISR-SF total scores and the sexual trauma subscale. Conclusion Children with an unstable early emotional life are more vulnerable to the development of psychopathology, such as panic anxiety symptoms. Traumatic events may also predict later schizophrenia.

Resumo Objetivos Avaliar o padrão de apego em portadores de esquizofrenia e discutir a relação que tais padrões apresentam com a sintomatologia psicótica e as comorbidades dos pacientes investigados. Métodos Vinte pacientes diagnosticados com esquizofrenia de acordo com os critérios do Manual Diagnóstico e Estatístico de Transtornos Mentais, 5ª edição (DSM-5) foram submetidos a avaliação de sintomas retrospectivos e avaliação cuidadosa do número e modo de mudança de cuidador da infância. A Entrevista Diagnóstica para Psicoses e Transtornos Afetivos (DI-PAD) foi utilizada para avaliar sintomas relacionados à esquizofrenia (sintomas positivos e negativos), depressão e mania. As comorbidades de transtorno de ansiedade foram avaliadas pela Escala de Ansiedade Social de Liebowitz (LSAS), Escala de Sintomas Obsessivo-Compulsivos de Yale-Brown (Y-BOCS) e Entrevista de Pânico e Esquizofrenia (PaSI). Os instrumentos Questionário das Experiências nas Relações Próximas-Estruturas Relacionais (ECR-RS) e Inventário de Autorrelato de Trauma Precoce - Forma Curta (ETISR-SF) foram utilizados para avaliar padrões de apego e histórico traumático, respectivamente. Resultados Foram identificadas correlações significativas entre a ocorrência de traumas precoces e o apego do tipo ansioso. Também foi verificada a relação entre traumas gerais e sintomas de pânico, constatando-se que as crises de pânico antecipam surtos quando predominam sintomas ansiosos, somáticos, alucinações e ideias delirantes. Foi observado que a ocorrência de traumas precoces contribui para o pânico, elevando o risco de episódios psicóticos. Conclusão . Os resultados indicam que as adversidades ambientais na infância estão associadas com o risco de desenvolvimento de esquizofrenia e de outras psicoses mais tarde na vida.

Suicide risk and childhood trauma in individuals diagnosed with posttraumatic stress disorder / Risco de suicídio e trauma na infância em indivíduos diagnosticados com transtorno de estresse pós-traumático

Abstract Introduction Posttraumatic stress disorder (PTSD) develops after exposure to a potentially traumatic event. Its clinical condition may lead to the development of risk behaviors, and its early detection is a relevant aspect to be considered. The aim of this study was to assess the association between childhood trauma and suicide risk in individuals with PTSD. Method This was a cross-sectional study conducted with individuals aged 18 to 60 years who were evaluated at a mental health research outpatient clinic. PTSD diagnosis and suicide risk identification were performed using specific modules of the Mini International Neuropsychiatric Interview (MINI-Plus). The Childhood Trauma Questionnaire (CTQ) was used to evaluate traumatic events in childhood. Results Of the 917 individuals evaluated, 55 were diagnosed with PTSD. The suicide risk prevalence in individuals with PTSD was 63.6%. Emotional neglect and emotional abuse scores tended to be higher in the suicide risk group (p<0.2). Conclusion Our findings showed a higher prevalence of suicide risk in individuals with PTSD and support the hypothesis that the investigation of childhood traumatic experiences, especially emotional neglect and abuse, may help in the early detection of suicide risk in individuals with PTSD.

Resumo Introdução O transtorno de estresse pós-traumático (TEPT) desenvolve-se após exposição a evento traumático grave. É uma condição clínica que pode levar ao desenvolvimento de comportamentos de risco, e sua detecção precoce é um aspecto relevante a ser considerado. O objetivo deste estudo foi verificar a associação entre trauma na infância e risco de suicídio em indivíduos com TEPT. Método Este foi um estudo transversal conduzido com indivíduos de 18 a 60 anos de idade avaliados em um ambulatório de pesquisa e extensão em saúde mental. O diagnóstico do TEPT e a identificação do risco de suicídio foram realizados através dos módulos específicos da Mini International Neuropsychiatric Interview (MINI-Plus). O Childhood Trauma Questionnaire (CTQ) foi utilizado para avaliar eventos traumáticos na infância. Resultados Dos 917 indivíduos avaliados, 55 foram diagnosticados com TEPT. A prevalência de risco de suicídio em indivíduos com TEPT foi de 63,6%. Os escores de negligência emocional e abuso emocional mostraram tendência a estarem mais elevados no grupo com risco de suicídio (p<0,2). Conclusão Nossos achados mostram a alta prevalência de risco de suicídio em indivíduos com TEPT e suportam a hipótese de que a investigação de experiências traumáticas na infância, especialmente a negligência e o abuso emocionais, poderá auxiliar na identificação precoce do risco de suicídio em indivíduos com TEPT.

Vinculação aos pais, adversidade na infância e desenvolvimento de psicopatologia / Attachment to parents, adverse childhood experiences and psychopathology / Vinculación a los padres, adversidad en la infancia y desarrollo de psicopatología

O presente estudo teve como principal objetivo analisar o papel da qualidade da vinculação aos pais na associação entre experiências adversas na infância e sintomatologia psicopatológica em adultos. A amostra foi constituída por 511 indivíduos com idades entre os 25 e os 50 anos de idade (M = 34,69; DP = 7,82). Para a recolha dos dados recorreu-se a questionários de autorrelato. Os resultados sugerem que a qualidade da vinculação aos pais e as experiências adversas na infância são relevantes na predição de sintomatologia psicopatológica (depressão, somatização e ansiedade). Os resultados serão analisados à luz da teoria da vinculação, considerando a importância das experiências adversas na infância na compreensão dos processos psicopatológicos na adultícia

The present study aims to analyze the role of quality of attachment to parents in the association between adverse childhood experiences and the psychopathological symptoms in adulthood. The sample was composed by 511 adults, aged 25 to 50 (M = 34.69; DP = 7.82). For data collection we resorted to the self-report questionnaires. Results suggest that the quality of attachment to parents and adverse childhood experiences are relevant in predicting psychopathological symptoms (depression, somatization and anxiety). The results will be discussed according to attachment theory, considering the importance of adverse childhood experiences in understanding the psychopathological processes in adulthood

Este estudio tuvo como objetivo analizar el papel de la calidad del apego a los padres en la relación entre las experiencias infantiles adversas y síntomas psicopatológicos en adultos. La muestra consistió en 511 individuos con edades comprendidas entre 25 y 50 años de edad (M = 34,69; DP = 7,82). Para la recolección de datos se utilizaron cuestionarios de autoinformes. El presente estudio tuvo como objetivo analizar el papel de la calidad de la vinculación a los padres en la asociación entre experiencias adversas en la infancia y sintomatología psicopatológica en adultos. La muestra fue constituida por 511 individuos con edades entre los 25 y los 50 años de edad (M = 34.69, DP = 7.82). Para la recogida de los datos se recurrió a cuestionarios de autoinformes. Los resultados sugieren que la calidad de la vinculación a los padres y las experiencias adversas en la infancia son relevantes en la predicción de sintomatología psicopatológica (depresión, somatización y ansiedad). Los resultados serán analizados a la luz de la teoría de la vinculación, teniendo en cuenta la importancia de las experiencias adversas en la infancia en la comprensión de los procesos psicopatológicos en la edad adulta

Depresión adulta y experiencias infantiles adversas: evidencia de un subtipo depresivo complejo en consultantes de la atención primaria en Chile / Association between adverse childhood experiences with depression in adults consulting in primary care

Background: Traumatic experiences during childhood may influence the development of mental disorders during adulthood. Aim: To determine clinical and psychosocial variables that are associated with a higher frequency of adverse childhood experiences (ACE) in patients who consult for depression in Primary Health Care clinics in Chile. Material and Methods: A socio-demographic interview, the mini international neuropsychiatric interview (MINI), a screening for ACE, a questionnaire for partner violence (PV), the Life Experiences Survey (LES) and the Hamilton Rating Scale for Depression (HRDS) were applied to 394 patients with major depression (87% women). Results: Eighty two percent of patients had experienced at least one ACE and 43% of them reported three or more. Positive correlations were observed between the number of ACE and severity of depressive symptoms (r = 0.19; p < 0.01), psychiatric comorbidities (r = 0.23; p < 0.01), partner violence events (r = 0.31; p < 0.01), vital stressful events (r = 0.12; p < 0.01), number of depressive episodes (r = 0.16; p < 0.01), duration of the longer depressive episode (r = 0.12; p < 0.05) and suicidal tendency according to HDRS (r = 0.16; p < 0.01). An inverse correlation was observed between frequency of ACE and age at the first depressive episode (r = -0.12; p < 0.05). Conclusions: These data are consistent with the hypothesis that early trauma is associated with more severe and complex depressive episodes during adulthood.

Experiencias contradictorias y demandantes: la infancia y la adultez en la perspectiva de niños y niñas de Santiago de Chile / Childhood and adulthood in Chile today: A discursive study with boys and girls from Santiago / Infância e idade adulta no Chile atual: Um estudo discursivo com meninos e meninas de Santiago

En este artículo, se presentan los resultados de un estudio que exploró los discursos acerca de la infancia y la adultez de niños y niñas de distintos estratos socioeconómicos de Santiago, a partir de entrevistas abiertas realizadas a grupos mixtos y de un sólo sexo (niñas y niños varones). Se da cuenta, en este marco, de discursos que, para hablar de infancia y adultez, construyen oposiciones: juego versus trabajo, libertad versus sometimiento, inocencia versus conciencia e infancias ricas versus infancias pobres. Además, se identifican algunas diferencias de clase social y de género y se analiza cómo se expresan, en los complejos discursos de los niños y las niñas, contradicciones y ambivalencias culturales respecto a la infancia y adultez, en el marco de un contexto de neoliberalización creciente.

In this article, the results of a study exploring the discourses on childhood and adulthood of boys and girls from different socioeconomic strata of Santiago are discussed, achieved through open group interviews carried out in mixed gender and single sex settings. Within this framework, children tended to construct discursive antonyms to represent their notions of childhood and adulthood, such as play vs. work, freedom vs. compliance, innocence vs. conscience and poor vs. wealthy childhoods. In addition, class and gender differences are also analyzed, as well as complex and contradictory conceptions of childhood and adulthood present in these discourses, which express cultural ambivalence within a context of increasing neo–liberalization.

Neste artigo, apresentam–se os resultados de um estudo que explorou os discursos a respeito da infância e da fase adulta de meninos e meninas de diferentes setores socioeconômicos de Santiago, a partir de entrevistas grupais abertas realizadas em contextos mistos (meninos e meninas) e em grupos separados por gênero. Neste marco, pode–se perceber por meio dos discursos que, para falar da infância e da idade adulta, são construídas oposições como: jogo versus trabalho, liberdade versus submissão, inocência versus consciência e crianças ricas versus crianças pobres. Além disso, identificam–se algumas diferenças de classe social e de gênero. Também são analisados, nos complexos discursos das crianças, como se expressam as contradições e ambivalências culturais com relação à infância e à fase adulta, dentro de um contexto de crescente neo–liberalização

Childhood trauma and dissociation in patients with obsessive compulsive disorder / Traumas de infancia y disociación en pacientes con trastornos obsesivo-compulsivos

BACKGROUND AND OBJECTIVE: The present study attempted to assess childhood trauma events and dissociative symptoms in patients with obsessive compulsive disorder (OCD). METHOD: The study included all patients who were admitted for the first time to the psychiatric outpa- tient unit over a 24-month period. Seventy-eight patients were diagnosed as having OCD during the two-year study period. Childhood traumatic events were assessed with a Childhood Trauma Questionnaire (CTQ). Obsessive compulsive disorder symptoms were assessed with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). A Dissociation Questionnaire (DIS-Q) was also used to measure dissociative symptoms. RESULTS: The mean of Y-BOCS points were 23.37 ± 7.27. Dissociation questionnaire scores were between 0.40 and 3.87 and the mean was 2.23 ± 0.76. Childhood trauma points were 1.27-4.77 and the mean was 2.38 ± 0.56. There was no statistically significant relationship between Y-BOCS points and childhood trauma points (p > 0.05). There was a statistically significant positive relationship between Y-BOCS points and DIS-Q points. There was no statistically significant relationship between DIS-Q points and childhood trauma points (p > 0.05) CONCLUSION: Childhood trauma questionnaire points might be significant clinically, although there was not a statistically significant correlation in our study. We also conclude that dissociative symptoms among patients with OCD should alert clinicians to treatment of the disorder.

ANTECEDENTES Y OBJETIVO: El presente estudio tuvo por objeto evaluar eventos traumáticos de la infancia, y síntomas disociativos en pacientes con trastorno obsesivo-compulsivo (TOC). MÉTODO: El estudio incluyó a todos los pacientes que fueron ingresados por primera vez en la Unidad Psiquiátrica, a lo largo de un período de 24 meses. A setenta y ocho pacientes les fue diagnosticado TOC durante un período de dos años. Los eventos traumáticos de la infancia fueron evaluados mediante un Cuestionario de traumas de infancia (CTQ). Los síntomas del trastorno obsesivo-compulsivo fueron evaluados mediante la Escala Yale-Brown para el trastorno obsesivo-compulsivo (Y-BOCS). Asimismo, para medir los síntomas disociativos, se usó un Cuestionario de disociación (DIS-Q). RESULTADOS: Los puntos promedios del cuestionario Y-BOCS fueron 23.37 ± 7.27. Las puntuaciones del Cuestionario de disociación estuvieron entre 0.40 y 3.87 y la media fue 2.23 ± 0.76. Los puntos por trauma de infancia fueron 1.27-4.77 y la media fue 2.38 ± 0.56. No hubo relación estadísticamente significativa entre los puntos de Y-BOCS, y los puntos por trauma de la infancia (p > 0.05). Hubo una relación positiva estadísticamente significativa entre los puntos de Y-BOCS y los puntos de DIS-Q. No hubo una relación estadísticamente significativa entre los puntos de DIS-Q y los puntos por trauma de la infancia (p > 0.05). CONCLUSIÓN: Los puntos del Cuestionario de traumas de infancia podrían ser clínicamente significativos, aunque no hubo una correlación estadísticamente significativa en nuestro estudio. También concluimos que los síntomas disociativos entre los pacientes con TOC deben alertar a los clínicos médicos al tratamiento de este trastorno.