Funciones del estilo personal del terapeuta en profesionales del campo de las adicciones / Functions of the Personal Style of the Therapist in Specialists from the Field of Drug Addiction / Funções do estilo pessoal do terapeuta em profissionais do campo das adições

Objetivo. Comparar el estilo personal del terapeuta entre dos grupos de profesionales, uno dedicado a la atención de pacientes drogodependientes (grupo adicciones) y otro a la atención clínica en general (grupo clínico). Método. La muestra estuvo formada por 100 psicoterapeutas que trabajan en instituciones públicas y privadas de tres provincias del interior de Argentina, pareados por las variables socioprofesionales (sexo, edad, años de experiencia profesional, enfoque teórico, grupo etario de trabajo, tipo de abordaje predominante, duración del tratamiento y grado de especialización). El instrumento empleado fue el Cuestionario de Estilo Personal del Terapeuta. Resultados. Para el análisis de datos se emplearon pruebas de comparación de medias y se analizó su tamaño del efecto. Se obtuvieron diferencias significativas en la función expresiva: grupo clínico (M = 40.36) y grupo adicciones (M = 29.86); así como también en la función instruccional: grupo clínico (M = 28.01) y grupo adicciones (M = 32.67). Esto indica una mayor distancia emocional y un incremento en la rigidez del encuadre terapéutico en los terapeutas de pacientes adictos. Conclusión. Se discuten estos resultados en función de postulados previos que señalan la complejidad del vínculo terapéutico y el énfasis en las características del encuadre terapéutico, tal como la puesta de límites.

Objective. The aim of this article was to compare the Personal Style of the Therapist (PST) between two groups of professionals: one specializing in the tending of drug addicted patients (Addiction Group), and the other specializing in general clinical practice (Clinical Group). Method. The sample was comprised of 100 psychotherapists who work in public and private institutions in three provinces from the interior of Argentina; an effort was made to standardize the demographic variables of both groups (similar proportion of gender, average age and years of experience, theoretical framework, treatment extension and skill of specialization). The Personal Style of the Therapist Questionnarie was used as an instrument of data collection, to assess the different functions of the PST. The subjects who belonged to the Addiction Group were contacted in specific institutions of treatment. Results. For the data analysis, means comparison tests were used and the effect size was calculated. Significant differences were obtained in the Expressive Function: Clinical Group (M = 40.36) and Addiction Group (M = 29.86), similarly in the Instructional Function: Clinical Group (M = 28.01) and Addiction Group (M = 32.67). This would indicate a greater emotional distance and increased rigidity of the therapeutic setting in the addicted patients' therapists. Conclusion. These results are discussed in terms of previous assumptions that point out the complexity of the therapeutic relationship and the emphasis on the characteristics of the therapeutic setting, such as setting limits.

Escopo. O propósito deste artigo foi comparar o estilo pessoal do terapeuta entre dois grupos de profissionais, um dedicado à atenção de pacientes drogo-dependentes (Grupo Adições) e um outro à tenção em geral (Grupo Clínico). Metodologia. A amostra esteve formada por 100 psicoterapeutas que trabalham em instituições públicas e privadas de três províncias do interior da Argentina, pareados pelas variáveis sociodemográficas (gênero, idade e anos de experiência de média, enfoque teórico, duração do tratamento predominante e grado de especialização). O instrumento empregado foi o Questionário de Estilo Pessoal do Terapeuta. Resultados. Para a análise de dados foram empregadas provas de comparação de médias e foi analisado seu tamanho do efeito. Foram obtidas diferenças significativas na função expressiva: Grupo Clínico (M = 40.36) e Grupo Adições (M = 29.86), assim como também na função instrucional: Grupo Clínico (M = 29.86) e Grupo Adições (M = 32.67). Isto indica uma maior distancia emocional e um incremento na rigidez do enquadre terapêutico nos terapeutas de pacientes adictos. Conclusão. São discutidos estes resultados em função de postulados prévios que assinalam a complexidade do vínculo terapêutico e o ênfase nas características do enquadre terapêutico, tal como a posta de limites.

A short history of the 5-HT2C receptor: from the choroid plexus to depression, obesity and addiction treatment.

This paper is a personal account on the discovery and characterization of the 5-HT2C receptor (first known as the 5-HT1C receptor) over 30 years ago and how it translated into a number of unsuspected features for a G protein-coupled receptor (GPCR) and a diversity of clinical applications. The 5-HT2C receptor is one of the most intriguing members of the GPCR superfamily. Initially referred to as 5-HT1CR, the 5-HT2CR was discovered while studying the pharmacological features and the distribution of [3H]mesulergine-labelled sites, primarily in the brain using radioligand binding and slice autoradiography. Mesulergine (SDZ CU-085), was, at the time, best defined as a ligand with serotonergic and dopaminergic properties. Autoradiographic studies showed remarkably strong [3H]mesulergine-labelling to the rat choroid plexus. [3H]mesulergine-labelled sites had pharmacological properties different from, at the time, known or purported 5-HT receptors. In spite of similarities with 5-HT2 binding, the new binding site was called 5-HT1C because of its very high affinity for 5-HT itself. Within the following 10 years, the 5-HT1CR (later named 5-HT2C) was extensively characterised pharmacologically, anatomically and functionally: it was one of the first 5-HT receptors to be sequenced and cloned. The 5-HT2CR is a GPCR, with a very complex gene structure. It constitutes a rarity in the GPCR family: many 5-HT2CR variants exist, especially in humans, due to RNA editing, in addition to a few 5-HT2CR splice variants. Intense research led to therapeutically active 5-HT2C receptor ligands, both antagonists (or inverse agonists) and agonists: keeping in mind that a number of antidepressants and antipsychotics are 5-HT2CR antagonists/inverse agonists. Agomelatine, a 5-HT2CR antagonist is registered for the treatment of major depression. The agonist Lorcaserin is registered for the treatment of aspects of obesity and has further potential in addiction, especially nicotine/ smoking. There is good evidence that the 5-HT2CR is involved in spinal cord injury-induced spasms of the lower limbs, which can be treated with 5-HT2CR antagonists/inverse agonists such as cyproheptadine or SB206553. The 5-HT2CR may play a role in schizophrenia and epilepsy. Vabicaserin, a 5-HT2CR agonist has been in development for the treatment of schizophrenia and obesity, but was stopped. As is common, there is potential for further indications for 5-HT2CR ligands, as suggested by a number of preclinical and/or genome-wide association studies (GWAS) on depression, suicide, sexual dysfunction, addictions and obesity. The 5-HT2CR is clearly affected by a number of established antidepressants/antipsychotics and may be one of the culprits in antipsychotic-induced weight gain.

Pilot clinical observations between food and drug seeking derived from fifty cases attending an eating disorder clinic.

Background The reward deficiency syndrome hypothesis posits that genes are responsible for reward dependence and related behaviors. There is evidence that both bulimia and anorexia nervosa, especially in women, have been linked to a lifetime history of substance use disorder (SUD). There are difficulties in accepting food as an addiction similar to drugs; however, increasingly neuroimaging studies favor such an assertion. Case presentations We are reporting the evidence of comorbidity of eating disorders with SUD found within these case presentations. We show 50 case reports derived from two independent treatment centers in Florida that suggest the commonality between food and drug addictions. In an attempt to provide data from this cohort, many participants did not adequately respond to our questionnaire. Discussion We propose that dopamine agonist therapy may be of common benefit. Failure in the past may reside in too powerful D2 agonist activity leading to D2 receptor downregulation, while the new methodology may cause a reduction of "dopamine resistance" by inducing "dopamine homeostasis." While this is not a definitive study, it does provide some additional clinical evidence that these two addictions are not mutually exclusive. Conclusion Certainly, it is our position that there is an overlap between food- and drug-seeking behavior. We propose that the studies focused on an effort to produce natural activation of dopaminergic reward circuitry as a type of common therapy may certainly be reasonable. Additional research is warranted.

Drogadicção e adolescência: o "corpo do transbordamento" / Drug addiction and adolescence: the "body of overflowing" / Dépendance chimique et adolescence: le "corps du dépassement" / Addicción a las drogas y adolescencia: el "cuerpo del trasbordamiento"

Voltando nosso olhar para a adolescência atual, observamos significativa presença do fenômeno da drogadicção. Nesta situação clínica, as modalidades prioritárias de defesa são agenciadas por uma convocação do corpo e do ato, implicando a expulsão violenta de uma excitação interna desorganizadora, traumática. Investigar as determinações desse fenômeno - e cuja emergência tantas vezes se dá na travessia da infância à vida adulta - constitui o principal objetivo do presente artigo.

Drug addiction has become a major problem in adolescence today. In such addictions, primary modes of defense lead the body to act, a process that implies the expulsion of disruptive internal traumatic excitation. The aim of this paper is to examine the causes of this phenomenon that frequently arises in the transition from childhood to adulthood.

En tournant notre regard vers l'adolescence actuelle, nous pourrons y découvrir une présence expressive du phénomène de la dépendance chimique. Dans cette situation clinique, les modalités prioritaires de défense sont traitées par la convocation du corps et de l'acte, ce qui implique l'expulsion violente d'une excitation interne désorganisatrice, traumatique. Cet article a comme but d'examiner les déterminations de ce phénomène qui se produit si souvent lors du passage de l'enfance à l'âge adulte.

Volviendo nuestra mirada para la adolescencia contemporánea, observamos la presencia importante del fenómeno de la drogadicción. En esta situación clínica los modos prioritarios de defensa son negociados por la convocación del cuerpo y del acto, lo que implica la expulsión violenta de una excitación interna traumática perturbadora. El principal objetivo de este artículo es investigar las determinaciones de este fenómeno que suele aparecer en la travesía de la infancia a la edad adulta.

Drogadicção e adolescência: o "corpo do transbordamento" / Drug addiction and adolescence: the "body of overflowing" / Dépendance chimique et adolescence: le "corps du dépassement" / Addicción a las drogas y adolescencia: el "cuerpo del trasbordamiento"

Voltando nosso olhar para a adolescência atual, observamos significativa presença do fenômeno da drogadicção. Nesta situação clínica, as modalidades prioritárias de defesa são agenciadas por uma convocação do corpo e do ato, implicando a expulsão violenta de uma excitação interna desorganizadora, traumática. Investigar as determinações desse fenômeno - e cuja emergência tantas vezes se dá na travessia da infância à vida adulta - constitui o principal objetivo do presente artigo.(AU)

Drug addiction has become a major problem in adolescence today. In such addictions, primary modes of defense lead the body to act, a process that implies the expulsion of disruptive internal traumatic excitation. The aim of this paper is to examine the causes of this phenomenon that frequently arises in the transition from childhood to adulthood.(AU)

En tournant notre regard vers l'adolescence actuelle, nous pourrons y découvrir une présence expressive du phénomène de la dépendance chimique. Dans cette situation clinique, les modalités prioritaires de défense sont traitées par la convocation du corps et de l'acte, ce qui implique l'expulsion violente d'une excitation interne désorganisatrice, traumatique. Cet article a comme but d'examiner les déterminations de ce phénomène qui se produit si souvent lors du passage de l'enfance à l'âge adulte.(AU)

Volviendo nuestra mirada para la adolescencia contemporánea, observamos la presencia importante del fenómeno de la drogadicción. En esta situación clínica los modos prioritarios de defensa son negociados por la convocación del cuerpo y del acto, lo que implica la expulsión violenta de una excitación interna traumática perturbadora. El principal objetivo de este artículo es investigar las determinaciones de este fenómeno que suele aparecer en la travesía de la infancia a la edad adulta.(AU)

La prevención del tabaquismo y el alcoholismo en adolescentes y jóvenes desde las instituciones educativas / Actions to prevent tobacco and alcoholism addiction in teenagers and young adults from educational institutions

One of the most complex problems in the world is drug addiction. Studies conducted by the World Health Organization revealed a decreasing life span beginning at the early onset of the consumption of addictive, portable drugs such as tobacco and alcohol, which are being consid-ered for consumption by most adolescents in their young stages of life. Educational institutions cannot put aside their task of educating "at-drug-use-risk" adolescents since this is one of their missions. However, sometimes teachers cannot rely on, nor do not they have the necessary train-ing and/or experience to develop and implement preventative measures, given the complexity of the problem requires a cross-sectional approach. This summary aims to avail teachers as well as academic leaders with some theoretical and methodological tools to ensure greater effectiveness in their development and implementation of drug use, preventative measures.

Las drogadicciones constituyen una de las más complejas problemáticas del mundo. Estudios realizados por la Organización Mundial de la Salud revelan una disminución de la edad de inicio del consumo de sustancias adictivas como el tabaco y el alcohol que constituyen drogas porteras; siendo consideradas la adolescencia y la juventud etapas de riesgo. Las instituciones educativas no pueden permanecer ajenas a esta tarea pues tienen la misión de formar integralmente a sus estudiantes. Sin embargo, en ocasiones, los docentes no cuentan con la formación y experiencia necesarias para desarrollar acciones preventivas, dado que la complejidad de esta problemática exige un abordaje multisectorial. El presente artículo de revisión persigue como propósito ofrecer a los maestros y líderes académicos algunos referentes teórico-metodológicos para garantizar una mayor efectividad en las acciones preventivas.

Psicologia analítica e as dependências: uma revisão / A review about addiction and analytical psychology

O objetivo deste artigo é fazer uma revisão da literatura junguiana sobre as dependências. Foram encontrados quatro grandes troncos de explicação dentro da psicologia analítica para esse fenômeno: o arquétipo do herói e seus ritos; uma relação com o dinamismo arquetípico dionisíaco; uma relação de simbiose/ruptura com o dinamismo matriarcal; e uma relação entre persona e sombra. As outras explicações referem-se, por exemplo, ao gerenciamento de ansiedade. A dependência é um fenômeno com múltiplas facetas e que comporta várias explicações, sendo inviável escolher apenas uma delas para explicar o fenômeno (AU)

The article aims to review Jungian literature on addictions. Four large streams of explanation were found on analytical psychology for this phenomenon: the hero archetypal and his rites, a link with Dionysian archetypal, a symbiotic relation/rupture with matriarchal dynamism, and a persona and shadow dynamism. Other explanations are related to dealing with anxiety fpr example. Addiction is a phenomenon with many facets and involves several explanations; and it is unfeasible to choose only one to explain the phenomenon (AU)

The development and use of Provider Profiles at the organizational and systems level.

While the use of quality of life-related personal outcomes has been broadly reported during the last decade, little attention has been paid to the use of such data as a basis for developing and using Provider Profiles at the organizational and systems level. This article illustrates a way in which these evidence-based outcomes may be used not only to improve clinical decisions, but also managerial and policy strategies. To that end, the quality of life of 11,624 social service recipients was assessed by means of the application of the GENCAT Scale, a questionnaire to assess quality of life according to the eight-domain model (Schalock & Verdugo, 2002). Data were analyzed at organizational and the systems level in order to develop Provider Profiles. Once implemented, these profiles can be used to compare individuals in different diagnostic groups, develop province-level performance standards, encourage continuous program improvement, and guide the development of evidence-based policies.

Que lugar para as drogas no sujeito? Que lugar para o sujeito nas drogas?: Uma leitura psicanalítica do fenômeno do uso de drogas na contemporaneidade / Which place of the drugs is in the subject? Which place of the subject is in the drugs?: A psychoanalytical view on the phenomenon of drug use nowadays

Universal e milenar é a prática humana de consumir drogas. Para a psicanálise, a maior visibilidade desse uso na contemporaneidade está relacionada ao que Lacan denominou discurso do capitalista. Tomando esse discurso como orientador do agir na atualidade, pretende-se discutir como esse discurso se relaciona ao uso de drogas na sociedade contemporânea, como incide sobre cada sujeito, que influência tem sobre a forma como cada um se relaciona com as substâncias tóxicas e como contribui para delimitar a diferença entre o que tem sido denominado de 'toxicomanias' e a prática configurada como o simples uso de drogas.

The human practice of consuming drugs is universal and millenary. According to psychoanalysis, the widest visibility of this use in the present time is related to what Lacan coined as address of the capitalist. In a sense, taking this form of address as guidance for acting nowadays, this paper aims at discussing how this discourse relates to the alarming use of drugs in the present time, how it affects each single subject and what influence it has on the way each one relates to drugs and also how it contributes to delimitate the difference between what has been named as 'drug addictions' and the practice of simple drug use.

El esquema referencial operativo en relación con la familia y la drogodependencia / The operational reference scheme in relation to the family and drug dependence

El presente ensayo tiene como finalidad la aplicación de los conceptos fundamentales que sustentan la psicología social de Enrique Pichón Rivière. La conceptualización del fenómeno a analizar la he denominado "FAMILIA Y DROGADEPENDENCIA". Dicha problemática permite la articulación al esquema teórico planteado por E. Pichón Rivière como se irá mostrando en la presente formulación teórica. El recorrido se apoya en algunos postulados tomados de la literatura sistémica, línea de pensamiento que puede convertirse en instrumento conceptual para pensar el trabajo con individuos, familias, grupos e instituciones.

The purpose of this essay is to apply the fundamental concepts that underpin Enrique Pichón Rivière's social psychology. The conceptualization of the phenomenon to be analyzed has been called "FAMILY AND DRUG ADOPTION". This problem allows the articulation to the theoretical scheme proposed by E. Pichón Rivière as will be shown in the present theoretical formulation. The tour is based on some postulates taken from systemic literature, a line of thought that can become a conceptual instrument for thinking about working with individuals, families, groups and institutions.