Psicópatas versus trastornos de la personalidad: matices clínico-conceptuales y aspectos diferenciales / Psychopaths versus personality disorders: clinical-conceptual nuances and differential aspects

La psicopatía ha sido frecuentemente relacionada con los trastornos de la personalidad, sobre todo con el subtipo antisocial, debido a las características delictivas que, en ocasiones, este implica. A pesar de esta asociación, y sin obviar los matices diferenciales, es importante recordar que los trastornos de la personalidad son diagnósticos clínicos, que vienen amparados por las nosologías psiquiátricas y recogidos en los manuales de trastornos mentales. En este sentido, no se debe entender la psicopatía como un trastorno mental, ni de la personalidad ni de cualquier otra índole psicopatológica. Si bien la psicopatía incorpora algunos rasgos aislados, también característicos de varios trastornos de la personalidad, es necesario establecer con exactitud los perfiles diferenciales entre estos y la psicopatía, ya que hay múltiples matices que podrán ayudar a establecer el diagnóstico diferencial pertinente y a evitar equiparar psicopatía con psicopatologías de la personalidad

Psychopathy has been frequently associated with personality disorders, particularly with the antisocial subtype due to the criminal features that it sometimes entails. Despite this link, and without ignoring the differential nuances, it is important to remember that personality disorders are clinical diagnoses, which are supported by psychiatric nosology and included in manuals of mental disorders. Therefore, psychopathy should not be understood as a mental disorder, neither of personality nor of any other psychopathological nature. Even though psychopathy incorporates some isolated features, also characteristic of several personality disorders, it is necessary to accurately establish the differential profiles between them and psychopathy, since there are multiple nuances that may help to establish the necessary differential diagnosis and to avoid equating psychopathy with personality psychopathologie

Influence of psychopathologies on craniomandibular disorders

Psychopathologies play a role in the etiology and maintenance of craniomandibular disorders (CMD). In this study, the craniomandibular index was applied to valuate signs and symptoms of CMD in 60 dentate patients, who were assigned to 2 groups: symptomatic (n=35) and asymptomatic (n=25). An interview on psychopathologies was carried out with the aim to detect the presence of some mood disorders, such as depression, dysthymic and bipolar I disorders. Among these disturbances, depression was the most significant aspect to be reported (p<0.05) since it was present in most symptomatic patients. This important interaction was also significantly correlated (p<0.05) with the Palpation Index. These results suggest that psychopathological aspects could increase muscle tenderness and pain in addition to sleep dysfuntions and other physical complaints. Therefore, psychopathologies should be regarded as an important aspect in patients with orofacial pains.

Os transtornos psíquicos podem desempenhar um importante papel na etiologia e manutenção das desordens craniomandibulares (DCM). Desta forma, neste estudo, foi aplicado o índice craniomandibular (ICM), o qual permite detectar a presença de sinais e sintomas de DCM em 60 pacientes totalmente dentados. Estes pacientes foram divididos em dois grupos: sintomáticos (n=35) e assintomáticos (n=25). Um teste psiquiátrico foi administrado para diagnosticar patologias psíquicas pertencentes ao DSM-IV, como a depressão e os transtornos distímico e bipolar I. Das patologias psíquicas relacionadas aos transtornos de humor, a depressão mostrou uma relação estatisticamente significante (p<0,05) com os pacientes sintomáticos para DCM. Ao analisar o índice de palpação separadamente, essa relação se manteve significante (p<0,05) numa escala crescente de valores, demonstrando a ação destes transtornos sobre a sintomatologia dolorosa muscular. Assim sendo, os transtornos mentais exerceriam uma influência considerável na etiologia da DCM, na medida em que potencializariam a dor. Isso ocorreria em função do aumento da tensão muscular, dos distúrbios do sono e de outras alterações fisiológicas advindas destes transtornos.

Evaluación de factores asociados a la ansiedad social y a otras psicopatologías en adolescentes / Assessment of factors associated to social anxiety and other psychopatologies in adolescents

Introduction The study of factors associated with anxiety and social phobia is a subject of recent interest in mental health. Specifically, shyness in children seems to act as an early expression of social phobia that may later consolidate into a clinical entity. The presence of certain psychopathologies and particular styles of child rearing in parents, are perceived by their children, are associated with the emergence of social phobia in adolescence. On the other hand, social anxiety disorder during adolescence or early adulthood may predict subsequent depressive disorders. The presence of both disorders (anxiety and social phobia) during adolescence increases the probability of suffering from them recurrently in early adulthood. Family structure and cohesion as well as stressful life events have been found to be associated with mood disorders during the childhood-youth period. However, studies conducted with young subjects are scarce, even though understanding the factors associated to different psychopathologies in the youth has proven of great value in clinical practice and epidemiology. For this reason, we attempt to evaluate, in a sample of three groups of adolescents (social anxiety, other psychopathologies and without psychopathologies) the possible demographical factors, competences and clinical indexes that could be associated with the different conditions under consideration. Methodology A sample of 1012 adolescents (582 women and 430 men) with an average age of 15.80 years (SD = 1.48) fulfilled a series of tests to assess demographical variables, psychosocial competences and clinical indexes. Results The difference between the average scores in the Escala de Ansiedad en Interacción Social -SIAS- was significant for the variables sex and the school year. Sex and couple relationships significantly affect the probability of manifesting social anxiety and other psychopathologies, respectively. Some competences significantly affect the probability of social anxiety, whereas others affect the probability of developing other psychopathologies. The majority of the 46 clinical indexes assessed demonstrate a significant effect on the probability of developing both conditions. Discussion and conclusions The results indicate that, in line with previous studies, the average score of women in the SIAS is slightly higher than in men. The average score in the SIAS of the young people from formative cycles was slightly higher than in the subjects from the obligatory secondary education and high schools. Very few studies have informed on the differences in social anxiety associated with the educational level. Women presented significantly higher probability of suffering from social anxiety than men. Unexpectedly, adolescents who maintained couple relationships also showed significantly higher probabilities than the rest of suffering from other psychopathologies. Some psychosocial competences, especially those related to the situations of social interactions, have a significant effect on the probability of developing social anxiety, whereas others (social and behavioural) influence other psychopathologies. In general and to a large extent, the findings are coherent and explainable, although some of them are contradictory. This could be caused by the difficulty to evaluate the complex construct of psychosocial competences. The majority of the evaluated clinical indexes showed a significant effect on the probability of developing of social anxiety and other psychopathologies. This effect is more evident in the group of young people with other psychopathologies than in the group of adolescents with social anxiety. Previous studies have found similar results, especially in the indexes referring to the general measures of anxiety and depression, specific measures of anxiety and avoidance of social situations and personality.

Introducción El estudio de factores asociados a la ansiedad y fobia social constituye un tema de reciente interés. Concretamente, la timidez infantil parece actuar como una expresión temprana de la fobia social que más tarde se puede consolidar como cuadro clínico. La percepción de los hijos sobre la presencia de ciertas psicopatologías y de determinados estilos de crianza de los padres se asocia a la aparición de la fobia social en la adolescencia. El trastorno de ansiedad social durante la adolescencia o la adultez temprana puede predecir trastornos depresivos subsecuentes. La presencia de ambos trastornos (ansiedad y fobia social) durante la adolescencia incrementaría la probabilidad de padecerlos de manera recurrente a lo largo de la adultez temprana. La estructura y la cohesión familiar, así como los sucesos estresantes de la vida, se han asociado con trastornos afectivos en la etapa infanto-juvenil. En la actualidad, los estudios realizados en estas edades son escasos, aun cuando el entendimiento de los factores asociados a distintas psicopatologías en la edad temprana reviste importancia clínica y epidemiológica. Por ello, pretendemos evaluar en una muestra de adolescentes formada por tres grupos (ansiedad social, otras psicopatologías y sin psicopatologías) los posibles factores demográficos, de competencias e índices clínicos que pueden estar asociados a las diferentes condiciones estudiadas. Metodología Una muestra de 1012 adolescentes (582 mujeres y 430 hombres) con una edad media de 15.80 años (DT = 1.48) completó en su medio escolar una serie de pruebas que evalúan variables demográficas, competencias psicosociales e índices clínicos. Resultados La diferencia de medias en las puntuaciones de la Escala de Ansiedad en Interacción Social -SIAS- fue significativa para las variables sexo y curso escolar. El sexo y la relación de pareja ejercieron un efecto significativo en la probabilidad de manifestar ansiedad social y otras psicopatologías, respectivamente. Algunas competencias mostraron un efecto significativo en la probabilidad de presentar ansiedad social, mientras que otras lo hicieron en la probabilidad de desarrollar otras psicopatologías. La mayoría de los 46 índices clínicos evaluados mostró un efecto significativo en la probabilidad de sufrir ambas condiciones. Discusión y conclusiones Los resultados indican que la puntuación media de las mujeres en la SIAS superó ligeramente a la de los hombres, lo que coincide con estudios previos. La puntuación media en la SIAS de los jóvenes que formaron los ciclos formativos fue ligeramente superior a la de los procedentes de educación secundaria obligatoria y de bachillerato. Hay pocos estudios que informen de diferencias en la ansiedad social asociadas al nivel de estudios. Las mujeres presentaron una probabilidad significativamente mayor que los hombres de sufrir ansiedad social. Los adolescentes que mantenían relaciones de pareja también mostraron significativamente más posibilidades que el resto de presentar otras psicopatologías, el cual es un resultado inesperado. Algunas competencias psicosociales, especialmente las que se relacionan con las situaciones de interacción social, han mostrado un efecto significativo en la probabilidad de sufrir ansiedad social, mientras que otras (sociales y de actuación) lo han hecho en la probabilidad de desarrollar otras psicopatologías. En general, gran parte de estos hallazgos tienen coherencia y explicación, aunque algunos son contradictorios, lo que puede deberse a la dificultad de evaluar el constructo de competencias psicosociales por su complejidad. Por último, la mayoría de los índices clínicos evaluados presentó un efecto significativo en la probabilidad de desarrollar ansiedad social y otras psicopatologías. Este último efecto fue más notorio en el grupo de jóvenes con otras psicopatologías que en el grupo de adolescentes con ansiedad social. Diversos estudios encuentran resultados parecidos a los hallados en éste, especialmente en los índices referentes a medidas generales de ansiedad o depresión, específicas de ansiedad y evitación en situaciones sociales, y de personalidad.

Comportamentos autodestrutivos, subprodutos da pós-modernidade? / Self-destructive behaviors, postmodernity byproducts?

O presente artigo aborda, através de uma exposição teórica, o quanto a forma de vida pós-moderna pode propiciar, ainda mais, a exacerbação de um sentimento de vazio e desesperança no homem contemporâneo, contribuindo para o aumento nas taxas de comportamentos desviantes e patológicos, como os voltados à autodestruição. Para isso, apresenta-se brevemente a idéia e o conceito de pós-modernidade, momento histórico e cultural que se vive hoje, caracterizado, dentre outras coisas, pelo sentimento de desamparo, perda de identidade e exacerbação do narcisismo, demarcando a influência disso nas formas de subjetivação do ser humano inserido neste contexto. A elevada incidência de psicopatologias, tais como a depressão, os quadros narcisistas e borderline, o uso e abuso de drogas e os transtornos de ansiedade, assim como atos violentos auto e hetero-infligidos, apontam para sintomas típicos do mundo pós-moderno. Discute-se também, até que ponto a sociedade contemporânea pode ser responsabilizada por estas manifestações, no momento em que tantos comportamentos desviantes, e inclui-se aqui os atos terroristas, a corrupção, os índices de suicídio, a busca por alívio e satisfação através de substâncias químicas, são tão freqüentes atualmente como nos tempos passados. Serão estes os sub-produtos da pós-modernidade? Destaca-se, ainda, o lugar e o papel da Psicologia neste contexto, no sentido de mostrar o seu compromisso com a promoção da saúde e do bem-estar dos indivíduos

This article discusses, within a theoretical approach, how postmodern lifestyle can exacerbate loneliness andhopelessness feelings in contemporary man, contributing to increase rates of deviant and pathologicalbehaviors, such as self-destruction. The paper briefly presents the idea and concept of postmodernity, thehistorical and cultural moment we currently live, characterized by feelings of helplessness, lost of identity andexacerbation of narcissism, outlining their influence on the subjectivation of the human being within thiscontext. The high incidence of psychopathologies such as depression, narcissism and borderline narcissisticmake-ups, drug use and abuse and anxiety disorders, as well as violent acts ­ self-inflicted or not - indicatetypical symptoms of the postmodern world. It is also discussed whether contemporary society could beconsidered responsible for these manifestations, as deviant behaviors such as terrorism, corruption, suicideand the search for relief and satisfaction through chemicals are as frequent as they were in the past. Wouldthey be postmodernity byproducts? The role of Psychology within this context is also highlighted, intendingto show its commitment to promote individuals' health and wellbeing