Escala de bienestar de Ryff: análisis comparativo de los modelos teóricos en distintos grupos de edad / Ryff scale of well-being: factorial structure of theoretical models in different age groups

La escala de bienestar psicológico surge a partir del modelo multidimensional propuesto por Ryff (1989). Pese a su amplia utilización, su estructura teórica inicial no ha sido confirmada completamente, debido a que se han encontrado otro tipo de soluciones factoriales distintas a las 6 dimensiones propuestas por la autora. Estas divergencias podrían estar relacionadas al tipo de muestras y poblaciones utilizadas. Ante esto, la siguiente investigación compara el ajuste factorial de los modelos tradicionalmente aplicados de corrección en distintos grupos en edad adulta. Se describen las propiedades psicométricas de la adaptación al español realizada por Díaz et al. (2006), analizando los niveles de confiabilidad (consistencia interna y estabilidad temporal) y estructura factorial confirmatoria, en datos de 1646 personas entre 18 y 90 años de edad. Se encuentran diferencias en los indicadores de confiabilidad para la escala total y las dimensiones, así como en los indicadores de bondad de ajuste dependiendo del grupo de edad. El modelo que presenta mejores indicadores de ajuste en la mayoría de los rangos etarios evaluados fue el de seis factores de primer orden.

The scale of psychological well-being arises from the multidimensional model proposed by Ryff (1989). Despite its wide use, its initial theoretical structure has not been completely confirmed because other factorial solutions which are different from those 6 dimensions proposed by the author have been found. These differences may be related to the type of sample and population used. Given this fact, the current study compares the adjustment factor of correction models traditionally used in different groups of adults. We describe the psychometric properties of the Spanish adaptation done by Díaz et al. (2006) and analyze the levels of reliability (internal consistency and temporal stability) and confirmatory factorial structure with data from 1,646 people aged from 18 to 90 years old. Differences are found in the indicators of reliability for the total scale and its dimensions as well as in the indicators of goodness of fit depending on the age group. The model that presents the best indicators of adjustment for most age ranges evaluated was the one of six first-order factors.

Estudio multicéntrico para la validación de la versión en español del Eating Disorder Diagnostic Scale / Validation of the Spanish version of the Eating Disorders Diagnostic Scale

Background: The Eating Disorders Diagnostic Scale (EDDS) is a self-administered low cost psychometric instrument with excellent levels of temporal reliability and validity. Aim: To adapt and validate the EDDS in Chile. Material and Methods: Thefactorial structure, internal consistency and test-retest reliability ofthe Spanish-language version of the EDDS was analyzed in a sample of1964 university and high school students. The concurrent validity was tested in a sample of 50 primary care patients with ED and 59 controls, comparing its results with those of a structured psychiatric interview (CIDI). Results: The EDDS showed a high internal consistency, moderate test-retest reliability, an appropriate factorial structure (in women) and an excellent convergent validity. Also, the diagnosis of ED obtained with the EDDS is moderately consistent with the structured psychiatric interview. Conclusions: The Spanish-language version of the EDDS showed a satisfactory psychometric behavior and a good capacity for detecting ED, according to the DSM criterion.

Descomponiendo el síndrome de déficit atencional en el adulto: hacia un entendimiento de su heterogeneidad pronóstica / Prognostic heterogeneity of attention deficit/hyperactivity disorder in adults

Attention Deficit/Hyperactivity Disorder (ADHD) is a clinical syndrome characterized by an onset in early life. More than 65% of patients persist with manifestations of ADHD in adulthood. These symptoms may interfere in activities of daily-living, interpersonal relationships and professional and academic achievement. Nevertheless, the observation of an important group of adults with ADHD who do not show significant difficulties in the areas mentioned before puts into evidence the prognostic heterogeneity of this disorder. One of the current, most accepted explanations is the Double-Pathway Model: two double-dissociated deficits (Executive Disorders and Delayed-Reward Processing impairments) are involved in the genesis of ADHD, which explains the existence of different behavioral phenotypes. Moreover, personality traits like tenacity or perseverance are associated with higher levels of achievement in adults. On these grounds, we propose the hypothesis that the neurobiological correlate of tenacity/perseverance is a preserved Delayed-Reward Processing capacity, although further studies are needed to verify this idea.

International affective picture system (IAPS) in Chile: a cross-cultural adaptation and validation study / El sistema internacional de imágenes afectivas (International Affective Picture System-IAPS) en Chile: estudio de adaptación y validación transcultural

The International Affective Picture System (IAPS) (Lang, Ohman, & Vaitl, 1988) is a standardized set of photographs to induce emotions in the context of experimental investigations. The aim of this study was determine the psychometric behavior of the IAPS for the preparation of standards in the Chilean population and the subsequent validation of the instrument for its use in Chile. 208 university students participated (40 percent men) and had an affective experience induced using the presentation of visual stimuli extracted from sets 7 and 14 of the IAPS. In order to evaluate valence, arousal and dominance, the self-assessment manikin (SAM) was used, made up of pictographic scales for each dimension and a scale of continuous variation of emotional reactions. The IAPS showed psychometric behavior comparable to the original, with the same boomerang-shaped distribution of scores being found in the valence/arousal relationship. The IAPS is a reliable tool for inducing emotions in studies related to affectivity.

El Sistema Internacional de Imágenes Afectivas (International Affective Picture System-IAPS) (Lang, Ohman, & Vaitl, 1988) es un conjunto estandarizado de fotografías para la inducción de emociones en el contexto de investigaciones experimentales. El objetivo de este estudio fue conocer el comportamiento psicométrico del IAPS para la confección de normas en la población chilena y la validación consiguiente del instrumento para su uso en Chile. Participaron 208 estudiantes universitarios (40 por ciento hombres) a quienes se les indujo una experiencia afectiva mediante la presentación de estímulos visuales extraídos del set 1 y 14 del IAPS. Para evaluar valencia, arousal y dominancia, se utilizo el maniquí de auto-evaluación o SAM (Self - Assessment Manikin), compuesto por escalas pictográficas para cada dimensión y una escala de variación continua de reacciones emocionales. El IAPS muestran un comportamiento psicométrico comparable al original, encontrándose la dispersión de puntajes de boomerang en la relación Valencia/Arousal. El IAPS es una herramienta confiable para la inducción de emociones en estudios ligados a la afectividad.

Asociación de polimorfismos de los genes CRF-BP, SLC6A4 y restricción alimentaria crónica: un estudio preliminar / CRF-BP and SLC6A4 gene polymorphisms among restrained eaters

Background: Restrained eaters (RE) are a group of individuals who constantly restrict their eating. However, they usually alternate restriction with periods of overeating. Aim: To evaluate the possible association of CRF-BP and SLC6A4 gene polymorphisms with chronic alimentary restriction. Material and Methods: The Spanish version of the Revised Restraint Scale was applied to 132 women aged 18 to 25 years. They were divided in a group classified as restrained eaters (RE) and a group of unrestrained eaters. The 5-HTTLPR and CRF-BPs11 polymorphisms of the SLC6A4 and CRF-BP genes were evaluated by polymerase chain reaction (PCR) and PCR-restriction fragment length polymorphism (RFLP), respectively. Results: There was a significant association between the s/s homozygous genotype for the 5-HTTLPR polymorphism of SLC6A4 gene and RE condition (p = 0.033). However, this association was not observed for the CRF-BPs11 polymorphism. Conclusions: The presence of s/s genotype is associated with the RE condition, being the presence of a s allele, a risk factor for this condition.

Maestro de la psiquiatría chilena: entrevista con Fernando Oyarzún / Master of Chilean psychiatry: an interview with Fernando Oyarzún

El Dr. Fernando Oyarzún es Maestro de la Psiquiatría Chilena y ha dedicado su carrera académica al desarrollo de un enfoque clínico-antropológico en psiquiatría. Desde su perspectiva elaboró una "idea médica de la persona', la que promueve la personalización del acto médico en psiquiatría y medicina. Método: En una entrevista personal este trabajo describe los logros profesionales del Dr.Oyarzún y sus concepciones clínicas-antropológicas. Conclusión: El legado intelectual del Dr. Oyarzún va más allá del campo de la medicina, conformando una perspectiva original de las relaciones humanas.

Dr. Fernando Oyarzún is a Master of Chilean Psychiatry, who has devoted his academic career to the development of a clinical-anthropologic approach in psychiatry. From this perspective, he elaborated a "medical idea of the person", which promote the personalization of medical act in psychiatry and medicine. Method: In a personal interview, this paper describe Dr. Oyarzún s professional achievements and his clinical-anthropologic conceptions. Conclusion: Dr. Oyarzún’s intellectual legacy goes beyond the medicine field, conforming an original perspective of human relationships.

La contribución de la neurociencia a la comprensión de la conducta: El caso de la moral / The contribution of neuroscience to the understanding of moral behavior

The neuro-scientific study of moral actions and judgments is particularly relevant to medicine, especially when assessing behavior disorders secondary to brain diseases. In this paper, moral behavior is reviewed from an evolutionary and neuro-scientific perspective. We discuss the role of emotions in moral decisions, the role of brain development in moral development and the cerebral basis of moral behavior. Empirical evidence shows a relationship between brain and moral development: changes in cerebral architecture are related to changes in moral decision complexity. Moral development takes a long time, achieving its maturity during adulthood. It is suggested that moral cognition depends on cerebral regions and neural networks related to emotional and cognitive processing (i.e. prefrontal and temporal cortex) and that moral judgments are complex affective and cognitive phenomena. This paper concludes with the suggestion that a satisfactory clinical/legal evaluation of a patient requires that the neural basis of moral behavior should be taken into account.

Restricción alimentaria y sobrealimentación: un modelo de la neurociencia afectiva: [revisión] / Overeating and restrained eaters: an affective neuroscience perspective: [review]

Some subjects may overeat when they experience anxiety even if they chronically restrict their food consumption. This contradictory behavior is a dysfunctional emotional regulation mechanism, which promotes the development of obesity and eating disorders. We review studies from a research program where alimentary restriction and overeating are conceived under the perspective of affective neuroscience. In this framework, restrained eaters (RE) are descríbed as subjects that are emotionally vulnerable and have dysfunctional emotional modulation strategies. We discuss empine evidence about the influence of motivational systems on alimentary behavior. Electrophysiological observations in RE reveal a self-referential processing of food stimulus as well as dysfunctional processing duríng the differentiation of emotional expressions. We stress the role of emotional education and the creation of psychometríc instruments designed for early detection of restrained eaters.

Sobrealimentación inducida por la ansiedad, Parte II: un marco de referencia neurocientífico para el desarrollo de técnicas psicoterapéuticas y programas de prevención: [revisión] / Anxiety induced overeating, Part II: a reference framework for the development of psychotherapeutic techniques and prevention programs: [revision]

Los dietantes crónicos (DC) o comedores emocionales presentan un patrón de restricción-sobrealimentación característico. Usualmente, los estados emocionales negativos, especialmente la ansiedad, favorecen la aparición de estas conductas alternantes. En este artículo se revisa un programa de investigación emergente en neurociencia afectiva, bajo el cual se asume que el estilo afectivo vulnerable es un aspecto esencial en la conformación de esta condición. En este contexto, se destaca el rol de las asimetrías funcionales frontales en la organización temporal de la conducta motivada y en la delimitación del estilo afectivo vulnerable del DC. Se describe un conjunto de estudios psicofisiológicos que sustentan esta noción y se presentan cuatro principios fundacionales para el desarrollo de técnicas psicoterapéuticas y programas de prevención. En su conjunto, estos principios enfatizan la importancia del estilo afectivo del DC y el efecto de la diferenciación emocional sobre el control de la conducta alimentaria.

Restrained eaters (RE) or emotional eaters show a prototypical restriction-overeating pattern. Usually, negative emotional states, particularly anxiety, induce the emergence of these alternating behaviors. In this paper, it is reviewed an emergent affective-neuroscience-based research program, under which it is assumed that vulnerable affective style is a key aspect in RE's behavior. In this context, it is highlighted the role of functional frontal asymmetries in temporal organization of motivated behavior and RE's vulnerable affective style. A collection of psychophysiological studies supporting this notion is described and four foundational principles for the development of psychotherapeutic techniques and prevention programs are presented. Taken together, these principles stressed RE's affective style and the effect of emotional differentiation over alimentary behavior control.

Sobrealimentación inducida por la ansiedad Parte I: evidencia conductual, afectiva, metabólica y endocrina / Anxiety induced overeating: Part I: behavioral, affective, metabolic and endocrine evidence

Bajo estrés la restricción alimenticia crónica usualmente alterna con episodios de sobrealimentación. Los dietantes crónicos (DC), son especialmente propensos a presentar ese patrón paradójico. Este artículo revisa la evidencia conductual, afectiva, metabólica y endocrina relacionada con tal condición. Los estudios de laboratorio y campo han revelado que los DC se sobrealimentan especialmente durante situaciones experimentales evocadoras de ansiedad. Esta observación ha sido explicada por varias teorías psicológicas, tales como la teoría psicosomática, la teoría de la distracción cognitiva y la hipótesis de enmascaramiento. Sin embargo, los datos empíricos no apoyan de manera equivalente estas perspectivas. Al mismo tiempo, la investigación metabólica y endocrina sugiere que los DC podrían tener una predisposición a ganar peso debido a la exposición crónica al estrés, lo que a su vez conlleva un riesgo de obesidad. La revisión concluye con controversias surgidas en la literatura y recomendaciones acerca de la dirección futura del campo de estudio.

Under stress, chronic alimentary restraint behaviors usually alternate with overeating. Restrained eaters (RE) are especially prone to show these paradoxical patterns. This paper reviews behavioral, affective, endocrine and metabolic evidence related to that condition. Laboratory and field studies have shown that RE overeat mainly under anxiety-related experimental setting. This observation has been explained by several psychological theories, such as the psychosomatic theory, the cognitive distraction theory and the masking hypothesis. However, empirical data does not support all these views in an equivalent way. At the same time, endocrine and metabolic research suggest that RE may have predisposition to weight gain due to chronic stress exposure, which in turn lead to increased risk of obesity. The review concludes with controversies in the literature and recommended directions for future research in the field

Evaluación de rasgos personales, "self", esquizofrenia y estructuras de la línea media cortical / Evaluation of personal traits, self, schizophrenia and cortical mid line structures

There is no consensus about the definition of self however it is traditionally associated to identity. Many researchers are searching the neural regions that process self related information. Some studies have observed an activation of midline structures during the processing of information related to self. Self perturbations are not a part of diagnostic criteria for schizophrenia, nevertheless they are implicitly considered as part of the clinical picture. Some studies have tried to determine its perturbation using psychometric tests, but there are no studies that assess the association between brain activity and the performance of schizophrenics in tasks that require self-referential evaluations. The attempt to find a neural substrate for self is polemical. However, this model could be evaluated studying if, in schizophrenic patients, the tasks related to self processing are different from normal subjects at the psychophysiological and behavioral levels. This line of research could provide new diagnostic tools for early diagnosis and prevention inpsychiatry.

Diferencias individuales en dietantes crónicos: Influencia de los sistemas motivacionales en la alimentación / Differences among chronic restrained eaters: the influence of motivational systems

Background: Restrained eaters (RE) are individuals who restrain their food intake on a regular basis as they are frightened to gain weight. However, they tend to overeat under conditions of anxiety. It has been shown that RE possess a behavioral inhibition system that is more active in tonic terms, which would partially explain their affective vulnerability. Even so, the influence of variations in the activation levels of the emotional systems on the eating behavior of a RE is still unknown. Our hypothesis is that variations of such systems will give place to two types of RE: a successful or a non-successful one. Aim: To assess the influence of variations on the activation of motivational systems in food intake of RE. Materials and methods: As part of a factorial experimental design, 105 undergraduate university students were part of an experimental test for inducting food intake. Then they reported their levels of dietary restraint and their emotional behavioral preferences. Results: Differences in the activation of motivational systems were significantly related to differences in food intake (F= 7.210; p= 0.001). Additionally, food intake for those RE with a predominant inhibition system tended to be higher than for those with a more active approach system, though the latter did not reach a significant difference (F=0.718; p=0.399). Conclusions: Although more investigations are required, our data suggest that the success of retaining the diet among the RE would depend on their profile of affective reactivity (affective style). There are putative implications for research on anorexia and obesity.

Modelos neurocognitivos en la esquizofrenia: rol del córtex prefrontal / Neurocognitive models of schizophrenia: the prefrontal cortex role

Los modelos neurocognitivos han dado lugar a un importante avance en la comprensión de diversos desórdenes mentales tales como la esquizofrenia (EQZ). En ese contexto, la disfunción del córtex prefrontal (CPF) es un hallazgo central para explicar su sintomatología. Se ha observado que los niveles anormales de activación de la CPF, así como disfunciones en la conectividad con otras estructuras cerebrales, juegan un importante rol en la delimitación de la enfermedad. Material y Métodos: A través de una revisión teórica, empírica y clínica se describirán cinco aproximaciones neurocognitivas de la esquizofrenia. Conclusiones: Aunque la etiología de la EQZ es probablemente múltiple, un desorden de la interconectividad neuronal, y especialmente de la CPF explican un amplio espectro de su sintomatología.

Introduction: Neurocognitive models gave place to an important improvement in our understanding of several mental disorders such as schizophrenia. In this context, Prefrontal cortex (PFC) dysfunction is an essential variable for its symptomatology account. It has been observed that abnormal level of PFC activation, as well as connectivity dysfunctions with other cerebral structures, play a central role in the delimitation of the disease. Materials and Methods: Through a theoretical, empirical, and clinical review, five neurocognitive approach of schizophrenia will be described. Conclusion: Although schizophrenia etiology is probably multiple, neural interconnectivity disorders and specially those related to PFC, explain a broad range of its symptoms.

Asimetrías funcionales frontales en el trastorno depresivo mayor / Functional frontal asymmetries in the depressive mayor disorder

Introducción: Las asimetrías funcionales de la corteza prefrontal son un importante parámetro predictor del estilo afectivo. Consecuentemente, diversos trastornos del afecto se asocian a diferencias individuales en dicho índice. En ese contexto, el trastorno depresivo mayor puede ser caracterizado por patrones anormales de activación de la corteza prefrontal izquierda. Material y métodos: Apoyados en los datos experimentales relevantes se presentan los fundamentos de un modelo del trastorno depresivo mayor que enfatiza los aspectos funcionales de la corteza cerebral. Conclusiones: Tanto el diagnóstico, como el tratamiento de la depresión dependen de nociones adecuadas de su etiología. Dada la heterogeneidad del paciente depresivo, así como los múltiples factores psicofisiológicos asociados, se propone una estrategia de investigación que considera marcadores objetivos para guiar el desarrollo de nuevos métodos de diagnóstico.