Reducción de las conductas autolesivas y autoestimulatorias disfuncionales en los trastornos del espectro del autismo a través de la terapia ocupacional / Reduction of dysfunctional self-injurious and self-stimulatory behaviors in autism disorders spectrum through occupational therapy

Las conductas auto estimulatorias y auto lesivas son muy frecuentes en los trastornos del neurodesarrollo, siendo una fuente de ansiedad y sufrimiento importante tanto para las personas que las presentan como para sus familias. En ocasiones estas conductas son tan intensas y frecuentes que llegan a ser un peligro para la salud del sujeto. Se realiza una revisión bibliográfica sobre las diferentes vías de atención de estas conductas desarrolladas hasta el momento, y se expone la metodología aplicada en nuestra clínica, presentando datos recopilados sobre el efecto de la terapia sobre las conductas auto lesivas y auto estimulatorias en 20 casos, como punto de partida para próximas investigaciones. Se destaca el modelo de integración sensorial que complementa el tratamiento farmacológico y el cognitivo conductual, ya que considera relevante las necesidades sensoriales y entrena la capacidad de auto regulación funcional.

Self-stimulatory and self-injurious behaviors are very frequent in neurodevelopmental disorders, being a source of anxiety and suffering for persons who have that behavior and their families. Sometimes these behaviors are so intense and frequent that it becomes a self-integrity risk. A bibliographic review was conducted on the different approaches that have been developed until today; in addition, this article explains the methodology applied in our clinic, with a data collection on the effect of therapy on self-injurious and self-stimulatory behaviors in 20 cases, as a starting point for future research. The sensory integration model that complements pharmacological and behavioral cognitive treatment is highlighted, since it considers sensory needs relevant and trains the capacity for functional self-regulation.

Push-in Head Restraining Apparatus for Intracranial Self Stimulation Tasks in Rats

Head restraining is an experimental technique that firmly secures the animal's head to a fixation apparatus for the precise control and sensing of behaviors. However, procedural and surgical difficulties and limitations have been obstructing the use of the technique in neurophysiological and behavioral experiments. Here, we propose a novel design of the head-restraining apparatus which is easy to develop and convenient for practical use. Head restraining procedure can be completed by sliding the head mounter, which is molded by dental cement during implantation surgery, into the port, which serves as matching guide rails for the mounter, of the fixation bar. So neither skull-attached plates nor screws for fixation are needed. We performed intracranial self stimulation experiment in rats using the newly designed device. Rats were habituated to acclimatize the head-restraint environment and trained to discriminate two spatially distinguished cues using a customized push-pull lever as an operandum. Direct electrical stimulation into the medial forebrain bundle served as reward. We confirmed that head restraining was stable throughout experiments and rats were able to learn to manipulate the lever after successful habituation. Our experimental framework might help precise control or sensing of behavior under head fixed rats using direct electrical brain stimulation as a reward.

Colapso de Eros nas adicções sexuais / The breakdown of Eros in the sexual addictions

O objetivo deste artigo é analisar uma modalidade particular de adicção, a compulsão sexual, e definir essa patologia examinando os fatores implicados em sua gênese. Nas adicções sexuais, o recurso à passagem ao ato monopoliza o campo de respostas possíveis para a descarga da força pulsional. Sucede-se, então, a repetição, a automação de um circuito que reduz as possibilidades de encaminhamento criativo para a sexualidade. O gozo sexual, buscado numerosas vezes por dia, de forma imperativa e irremediável, diz respeito a um processo situado "além do princípio de prazer". Buscamos analisar o que estaria na base desse imperativo destrutivo e mortífero de obtenção de prazer sexual.

The aim of this paper is to analyze a particular mode of addiction, the sexual compulsion, and define this pathology by examining the factors involved in its genesis. In sexual addictions, the recourse to acting out monopolizes the field of possible answers for the discharge of the drive force. It follows then the repetition, the automation of a circuit that reduces the possibilities of a creative path towards sexuality. Sexual enjoyment searched many times a day in such imperative and irremediable way is related to a process situated "beyond the pleasure principle". We try to analyze what could be the basis of such destructive and deadly imperative to obtain sexual pleasure.

Mejoras cognitivas y perceptivo-motrices en personas mayores participantes en un programa de estimulación integral cognitivo-motriz / Cognitive and perceptual-motor improvements in ederly participating in a cognitive - motor integrated stimulation program

Este artículo tiene como objetivo mostrar los efectos cognitivos y perceptivo-motrices obtenidos tras la aplicación de un programa de estimulación cognitiva a través de la motricidad para personas mayores llamado "Memoria en Movimiento". Se trata de una investigación cuasi-experimental en la que participaron 234 personas mayores con una media de edad de 69.92±7.23 distribuidas en grupo experimental inactivo físicamente y grupo control praticantes de Tai-chi y Gimnasia. La evaluación se realizó antes de la aplicación del programa y tras su finalización. Se utilizaron el Mini Examen Cognoscitivo, el Test de Dígitos - Total, Directo e Inverso -, una Prueba de Memoria Motriz y una Prueba de Orientación Espacial - Total, 1 y 2 -. Se constató una mejoría significativa (p0.05) del grupo experimental en todas las mediciones de estudio excepto en Dígitos Directo y Orientación Espacial 2. El grupo control consigue mejoras significativas (p0.05) exclusivamente en Orientación Espacial Total y Espacial 1 y deterioro significativo (p0.05) en Memoria Motriz. El programa "Memoria en Movimiento" mejora la atención, la memoria, la conciencia corporal y la estructuración espacial de las personas mayores mediante tareas cognitivas con implicación motriz integral.

Psychological problems and family functioning as risk factors in addiction

Family provides a rich mixture of stimuli to the offspring that often affects both physical and psychological development. Instilling in children the beliefs, values, and suitable behavior of their society remains a fundamental function of the family. The manner in which the family interaction goes about this process contributes to a range of developmental outcomes. The purpose of the present research was to determine the role of family functioning and psychological problems of drug addicts and non addicts by assessing the difference between the two groups. A cluster sampling method was used. Sample of present research consisted of 240 adolescents divided into two groups of 120 addicts and 120 non addicts each from different socioeconomic status. Cohort study. General scale of Family Assessment Measure, Version III [FAM-III] was administered in order to measure the level of communication, value and norms whereas dyadic Relationship Scale was used to measure affective expression and control among the family members of addicts and non addicts. Renold Adolescent Adjustment Screening Inventory was administered in order to assess anger control problems, emotional distress and positive self in addicts and non addicts. Student's t-test was calculated in order to determine the difference in the level of communication, value and norms, affective expression and control among families of addicts and non addicts. Difference in anger control problems, emotional distress and positive self between the addicts and non addicts was also determined by calculating t-test. Results showed significant differences in the variables among the family members and there is also a significant difference between addicts and non addicts. The family occupies an important place among other groups that socially influence addicts. The problem of relation between the family and addicts should be taken into consideration while designing effective programs for the prevention of addiction. Psychological problems in young persons are playing an equal role in the development of addiction

Autofala e esporte: estímulo discriminativo do ambiente natural na melhora de rendimento / Self-talk and sports: discriminative stimulus of natural environment to improve performance

Estar concentrado é um aspecto importante para o bom desempenho no esporte. A concentração é a capacidade de colocar a atenção no que é relevante para a tarefa realizada, isto é, isolar estímulos discriminativos que exerçam controle sobre o desempenho. Este estudo utilizou a prática encoberta em forma de imaginação e autofalas para colocar o comportamento do atleta sob controle dos estímulos da corrida, a fim de melhorar a concentração e conseqüentemente a velocidade de cinco corredores barreiristas. O objetivo foi verificar se a utilização de autofalas que especificam contingências presentes de velocidade pode melhorar o desempenho. Foi utilizado o delineamento experimental de linha de base múltipla entre sujeitos, durante 14 dias, com introdução do tratamento em dias diferentes para cada atleta, o que permitiu verificar o efeito das variáveis estudadas. Os resultados mostram que quatro entre cinco corredores melhoraram a velocidade em tiros de 60 metros com barreiras, após a utilização do tratamento. Discutem-se os resultados em base à correspondência entre falar e fazer, o efeito da regra instruída sobre o desempenho motor

A key point for a good performance in sports is to be concentrated. The concentration is the ability to put the attention into what is relevant to the task, that is, to isolate relevant cues in the athletic environment that exert stimulus control over skilled athletic behavior. This study used a covered practice and self-talks to bring the athlete behavior under stimulus control appropriate of the run, to increase concentration and consequently the speed on 60 meters hurdles to five elite runners. The purpose of this study was to investigate the effects of a specific self-talk on speed performance. A multiple-baseline design across people was employed. Results have shown that four of five runners improved their speed performance on 60 meters hurdles after treatment. The results are discussed in terms of correspondence between verbal and nonverbal behavior, specifically, the effects of rules on motor performance

Comparison of International Erectile Function Index Scores and Penile Doppler Ultrasonographic Findings in Erectile Dysfunction Patients / 대한비뇨기과학회지

PURPOSE: Of the various methods for evaluating erectile dysfunction, International Index of Erectile Function (IIEF) questionnaires and penile color Doppler ultrasonography are commonly performed. In this study, the total IIEF scores and erectile function domain scores of the IIEF were compared with the etiology diagnosed from the indices of penile color Doppler ultrasonography. MATERIALS AND METHODS: A total of 54 patients, with erectile dysfunction, who underwent penile color Doppler ultrasonography and IIEF, were retrospectively examined. Various blood flow parameters, including the peak systolic velocity, end diastolic velocity, mean flow rate and resistive index, were observed and recorded for about 30 minutes following an intracorporeal injection of alprostadil and self stimulation. According to the causes of the erectile dysfunction, as diagnosed with penile color Doppler ultrasonography, the total IIEF and erectile function domain scores of the IIEF were compared. RESULTS: There was no statistically significant difference in the total IIEF and IIEF scores of the erectile function domain between the causes of erectile dysfunction as diagnosed by the penile color Doppler ultrasonography. CONCLUSIONS: The IIEF scores did not statistically differentiate the specific etiologies of erectile dysfunction determined by penile color Doppler ultrasonography. Therefore, it is believed that the IIEF score alone cannot predict the etiologies of erectile dysfunction.

Teoria da percepção no behaviorismo radical / Radical behaviorism's theory of perception

A percepção é explicada por Skinner através do conceito de comportamento perceptivo - um comportamento complexo que se inter-relaciona com muitos outros. O estudo da percepção na teoria skinneriana pode ser dividido em duas etapas: estudo do comportamento perceptivo como precorrente e estudo dos precorrentes do comportamento perceptivo. No primeiro caso, a investigação passa pelo processo de resolução de problemas, no qual o comportamento perceptivo desempenha um papel fundamental modificando o ambiente, o que permite a emissäo do comportamento discriminativo e a soluçäo do problema. No segundo caso, a investigaçäo trata com uma série de outros comportamentos, tais como, propósito, atenção, e consciência, que modificam a probabilidade de emissão do comportamento perceptivo. A análise das relações entre o comportamento perceptivo e demais comportamentos culmina no esboço de uma teoria da percepçäo no behaviorismo radical, que é mais convincente do que explicaçöes mentalistas que fazem uso da "teoria da cópia"

Técnica baseada na função de coerência para avaliar o grau de sincronismo no EEG durante estimulação sensorial / A coherence-based technique for evaluating the degree of synchronism in the EEG during sensory stimulation

The coherence between the stimulation signal and the EEG has been used in the detection of evoked responses to rhythmic stimulation. Such detection is based on the knowledge of the sampling distribution of coherence estimate under the null hypothesis of lack of evoked response (zero coherence). In this work, the technique is extended for quantifying the degree of activation due to sensory stimulation. With this aim the sampling distribution for the non-zero response is investigated for evaluating the performance of the detector as well as obtaining the confidence limits of coherence estimate. The latter are obtained using an approximation to the probability density function of the estimate, since the closed-form inverse for the cumulative density function, and hence the critical values for non-zero coherence, cannot easily be found. The theoretical results are verified in Monte Carlo simulations and the techniques is further applied to the EEG signals from 14 subjects during t]rhythmic photic stimulation. The results indicate inter-hemispheric symmetry at homoloque posterior regions in the stimulation frequency of 6 Hz and also its harmonics for most of the subjects. As expected, such symmetry is more pronounced at occipital regions. Further, in 28 per cent of the subjects, the strength of the responses in 12 Hz depends on either such frequency is the stimulation frequency or the second harmonic of it. This difference may be due the fact that the stimulation frequency is lower or higher the subjects' alpha rhythm and need to be further investigated.

Salud y violencia intrafamiliar: manual de normas y procedimientos para la atención / Health and family violence: manual of standars and procedures for care

El presente documento constituye un instrumento capaz de proporcionar insumos básicos sobre el tratamiento y la prevención de la violencia intrafamiliar dirigida al personal de salud, especialmente en los niveles I y II de complejidad, con la perspectiva de enriquecer la práctica institucional en le marco del Plan de Acción Estratégico de Salud (PES) y de la multisectorial necesaria para el abordaje de la problemática

Evaluación de los costos en 2 métodos inductores del parto / Cost evaluation of 2 induced labor methods

Se evaluaron de forma comparativa los costos de 2 métodos inductores del parto: el de venoclisis con oxitocina y el de autoestimulación del pezón, en 2 grupos de gestantes (80) ingresadas en el Hospital Ginecoobstétrico Docente Este de Santiago de Cuba, durante el primer semestre de 1993. Se calcularon las siguientes variables: consumo de medicamentos y gastos de material, promedio de estadía, calidad. Se aplica un formulario para la recogida de estas variables. A los datos se les aplicó el porcentaje y el chi cuadrado. Se representan los datos en tablas. El autoestímulo del pezón resultó ser el más económico por el ahorro de material gastable y medicamentos; pero la estadía hospitalaria y los resultados perinatales en cuanto al tipo de parto y estado del recién nacido fueron similares con ambos métodos

Dose-response functions of apomorphine, SKF 38393, LY 171555, haloperidol and clonidine on the self-stimulation evoked from lateral hypothalamus and ventral tegmentum.

The experimental animals were implanted with two bipolar electodes, one in the lateral hypothalamus including medial forebrain bundle (LH-MFB) and other in ipsilateral ventral tegmental area-substantia nigra (VTA-SN) and were trained to press a pedal for self-stimulation. This provided the scope to compare directly the effect of a given dose of a drug on the two reward regions in the same animal in the same testing situation. The current intensity was set to produce intracranial self-stimulation (ICSS) response rates of 50% less than the maximal shaping response rates for the respective animals (M60). Following systemic (intraperitoneal) administration of apomorphine (a dopamine receptor D1/D2 mixed agonist), SKF 38393 (D1 > D3 > D2 agonist), LY 17155 or quinpirole (D3 > D2 and D1) agonist), haloperidol (a DA-D2 antagonist), and clonidine (noradrenaline receptor alpha 2 agonist), the ICSS response rates evoked from LH-MFB and VTA-SN were compared with vehicle or saline-treated animals on the basis of dose-response functions. A dose-dependent inhibitory effect at M50 was observed with apomorphine (0.01-1.00 mg/kg) and haloperidol (0.05-0.30 mg/kg) for both the sites of stimulation. These doses of haloperidol did not produce any motor deficits like catalepsy and muscular rigidity. The dose-response and time-effect functions of SKF 38393 and LY 171555 at M50 showed the facilitation and suppression of ICSS of VTA-SN and LH-MFB respectively. Clonidine (0.05-0.25 mg/kg) also produced inhibitory effect on ICSS rates, but this suppression was of different magnitude with respect to the site of stimulation. These doses of clonidine were in the range that did not prevent active pedal pressing responses. ED50 (the dose required to reduce the ICSS response rate 50% of the rate after administration of vehicle) for LY 171555 was 0.8 and 4.4 mg/kg for the ICSS of VTA-SN and LH-MFB respectively and thus statistically different ED50 for apomorphine was 0.27 and 0.36 mg/kg; and for haloperidol was 0.75 and 0.90 mg/kg for LH-MFB and VTA-SN respectively and thus not different significantly. ED50 for clonidine was 0.25 and 0.08 mg/kg for VTA-SN and LH-MFB respectively and thus statistically different. The two-way analysis of variance (ANOVAR) of interaction of dose-response function of alpha 2 agonist with respect to LH-MFB and VTA-SN showed significant independence in their suppressive effects.

Plasticity of hippocampal and motor cortical pyramidal neurons induced by self-stimulation experience.

The self-stimulation (SS) induced neuronal plasticity was observed in CA3 hippocampal and layer V motor cortical pyramidal neurons. SS experience was allowed daily for a total of 1 hour for 10 days through four bipolar electrodes implanted bilaterally in lateral hypothalamus (LH) and substantia nigra-ventral tegmental area (SN-VTA) in adult male Wistar rats. Examination of pyramidal neurons stained by rapid Golgi technique was made in a total of 1,600 neurons out of 80 rats consisting of 4 groups. The dendritic intersections were quantified upto 200 and 120 microns radial distances in apical and basal dendrites respectively. The CA3 hippocampal and layer V motor cortical pyramidal neurons of SS group revealed significant increase (P < 0.001, two-way ANOVA) in dendritic intersections in both apical and basal dendrites, compared to normal control (NC), sham control (SH) and experimenter-administered (EA) group of animals. These results demonstrate that SS experience promotes increase in dendritic length in hippocampal and motor cortical pyramidal neurons.

Comparative assessment of pedal pressing rates of self-stimulation of hypothalamus and midbrain with both square wave and sine wave stimulus parameters.

In Wistar rats, the regional differences of pedal pressing rates of self-stimulation (SS) of lateral hypothalamus (LH) and substantia nigra-ventral tegmental area (SN-VTA) were assessed with electrodes implanted in both regions in each subject. Average of SS rates of SN-VTA sites was significantly higher than that of LH sites, tested with both sine wave and square wave types of stimuli. There was no significant difference in SS rates between males and females, and also in the females between different days of oestrus cycles. The high rates of robust SS observed in this study relative to SS rates reported in past literature were probably due not only to the placements of electrodes in the main substrates of SS, but also to the parameters of stimulus used (0.25 sec trains of sine waves through bipolar electrodes).

Inhibition of positively rewarding behavior by the heightened aggressive state evoked either by pain-inducing stimulus or septal lesion.

Using a footshock elicited aggression paradigm, aggressive responses were scored in normal and in septal-lesioned adult male Wistar rats. Septal lesions were made electrolytically to include the medial and lateral septal nuclei. The lesion was confirmed by behavioral criteria (septal aggression) and post-mortem histology. The aggressive response types (threat, attack) of the septal animals were compared with their corresponding age and weight matched controls. Results showed a statistically significant increase (P = 0.05) in the number of attack responses but not the threat responses in septal animals. The modulatory role of the aggressive experience on responsiveness to positively rewarding or hedonic stimuli was assessed by quantifying the intracranial self-stimulation (SS) rates that were obtained before and after an aggression schedule. For testing the SS behavior bipolar electrodes were implanted in the ventral tegmental area--substantia nigra (VTA-SN). Results showed a decrease in SS pedal press rates in post-aggression schedule as compared to the pre-aggression period in the normal subjects. This depressing effect lasted for over a week. In septal lesioned rats the SS rates were virtually abolished even without having an aggressive schedule. These experiments revealed the effect of environment and of a brain area in provoking aggressive mood and its inhibitory consequence on responding for positive experience.

Bloqueo del ritmo alfa producido por la autoadministracion de un estimulo sensorial / Blocking of the alpha rhythm induced by sensory self stimulation

La estimulación sensorial produce reacción de bloqueo del ritmo alfa del EEG, respuesta que se habitúa con la repetición de la hetroestimulación. La autoestimulación sensorial produce potenciales evocados de menor amplitud que los generados por la estimulación aplicada por el investigador al sujeto experimental. En el presente trabajo se trata de demostrar que la autoadminstración de estímulos sensoriales produce reacción de bloqueo del ritmo alfa desde antes de la presentación del estímulo. A un grupo de voluntarios universitarios se les registró el EEG ininterrumpidamente, centro-occipital, y se les instruyó para que se autoadministraran estímulos acústicos ("clicks") y fóticos ("flashes of Light") durante el tiempo y momento que quisieran una vez iniciado el experimento. El EEG presentaba ritmo alfa dominante, el cual desaparecía durante la estimulación sensorial. La administración de cualesquiera de los dos estímulos producía reacción de bloqueo del ritmo alfa desde antes de la presentación del estímulo. Esta respuesta producida por la autoestimulación no se habituaba como consecuencia de la repetición del estímulo. Estos resultados sugieren que la auto-administración del estímulo implica para el sujeto experimental cierto grado de ansiedad y estado de atención de alguna consideración para escoger el momento de autoaplicarse el estímulo, además de los procesos neuronales que implica la realización del movimiento voluntario correspondiente, todo lo cual genera cambios importantes en el EEG, como es el bloqueo del Ritmo Alfa

Investigation of influence of diazepam, valproate, cyproheptadine and cortisol on the rewarding ventral tegmental self-stimulation behaviour.

Experiments were carried on in the Wistar rats having self-stimulation (SS) electrodes implanted chronically in substantia nigra-ventral tegmental area (SN-VTA) to examine whether modulations of GABAergic, serotonergic, histaminergic, dopaminergic, and glucocorticoid neuronal receptor functions will affect or not the brain reward system and the SS behaviour. The modulators are the wellknown drugs: diazepam which is a facilitator of some of the GABA receptors, and used clinically for its tranquilizing, anxiolytic, sedative-hypnotic and anti-convulsant properties; sodium valproate which is known to enhance the GABA synapse function, and used clinically for its anti-convulsant property; haloperidol which is a dopaminergic receptor (D2) blocker, and clinically used for its anti-psychotic property; cyproheptadine which is both anti-histaminic and anti-serotonergic (blocks 5-HT2 receptor), used clinically for its antihistaminic and other beneficial properties; and hydrocortisone which is the stress-resisting glucocorticoid having direct effects on both brain and body cells, used clinically for the wide-ranging glucocorticoid therapeutic effects. The results revealed that systemic administration of these drugs, except haloperidol, caused no significant influence on the SS behaviour, thereby indicating that these nondopaminergic drugs have no effect on brain-reward system and also these categories of synaptic actions are not likely to be involved in the primary organization of the mechanisms of the brain-reward system.

Participación de la dopamina en la motivación / Participation of the dopamine in the motivation

Numerosos experimentos que involucran la estimulación o la lesión de vías dopaminérgicas indican que el fenómeno de la autoestimulación intracerebral depende de la activación de dichas vías. Esta indicación se ha visto reforzada por el hecho de que la aplicación sistémica de fármacos que bloquean o incrementan las acciones sinápticas de la dopamina inducen un decremento y una mejoría, respectivamente, de la conducta de autoestimulación. Sin embargo, estos datos no permiten afirmar que la autoestimulación intracerebral sea debida a la estimulación directa de fibras dopaminérgicas; se decir, esta conducta podría ser debida a la estimulación directa de axones que contienen otros neurotrasnmisores, y que la actividad dopaminérgica represente un eslabón secundario en dicho proceso conductual. Recientemente, estas posibilidades han sido sometidas a pruebas experimentales. Se ha encontrado, en estudios electrofisiológicos, que las características funcionales de las fibras que son directamente activadas durante la autoestimulación difieren de las fibras dopaminérgicas. Por otra parte, se han hecho correlaciones entre la densidad relativa de dopamina de las zonas de autoestimulaciones y las características de ésta (umbrales y frecuencia de respuesta), no existiendo ninguna correlación significativa entre ellas . Estos datos sugieren fuertemente que en la autoestimulación intracerebral no se activan directamente células dopaminérgicas, sino que estas son activadas indirectamente (transinápticamentes)

Designing of a brain stimulator suitable for intracranial self-stimulation experiments for studying the brain-stimulation reward system.

A circuit design has been developed and described for fabricating and using in the intracranial self-stimulation experiments on rat to study the brain-stimulation reward behaviour, and to explore into the underlying mechanisms of drives and motivated behaviours. The stimulator can be fabricated with parts available in India. It has been continuously used and tested during the last four years in different research studies.