Prevalence of problematic Internet use and problematic gaming in Spanish adolescents.

Epidemiological studies on problematic Internet use and problematic gaming conducted so far have mainly been carried out with unrepresentative and self-selected convenience samples, resulting in unreliable prevalence rates. This study estimates the prevalence of problematic Internet use and problematic gaming in a large sample of Spanish adolescents (N = 41,507) and identifies risk and protective factors for these risky behaviours. Data were collected online using the Adolescent Problem Internet Use Scale and the Adolescent Gaming Addiction Scale. Using a cut-off approach with measurement instruments inspired by the DSM-5 framework, we found a prevalence of 33% for problematic Internet use and 3.1% for problematic gaming. With a more conservative approach inspired by the ICD-11 framework, prevalence rates decreased to 2.98% for problematic Internet use and 1.8% for problematic gaming. Female gender, higher parents' education, elevated Internet connection time, reporting being online after midnight and using the mobile phone in class predicted problematic Internet use; whereas male gender, "living situation" where families do not have a traditional structure or stable environment, elevated Internet connection time and reporting using the mobile phone in class predicted problematic gaming. A cut-off approach involving scales that recycle substance use criteria (as in the DSM-5) over-pathologize Internet use and gaming behaviours. In contrast, the ICD-11 approach seems to provide more realistic and reliable prevalence rates.

From self-management to depathologisation: the evolution of transgender health care and rights in Spain between 1970 and 2020.

Even though transgender people continue to experience violence and discrimination in many aspects of life, there has been progressive recognition of their experiences and demands in recent decades. This article analyses the process of claiming civil rights and the evolution of health care for transgender people in Spain, from the mid-1970s to the present day, paying particular attention to the narratives of key actors involved. To this end, three socio-historical periods are identified: (1) the travesti period (the mid-1970s to the early 1990s), characterised by strong social and institutional transphobia and resulting self-care practices; (2) the transexual period (mid-1990s to the 2000s), when demands for health care were institutionalised under a pathological medical model; and (3) the transgénero or trans period (2010s until the present) when identity and bodily autonomy have been re-claimed through a socio-cultural prism that has denounced pathologisation. At each stage, political, social and economic factors intervened at both national and international levels to trigger an ongoing negotiation between transgender movements and dominant social institutions, all within a changing universe of social values.

A history of lesbian politics and the psy professions.

This article explores the relationship between lesbian activists and the "psy professions" (especially psychology and psychiatry) in England from the 1960s to the 1980s. We draw on UK-based LGBTQIA+ archive sources and specifically magazines produced by, and for, lesbians. We use this material to identify three key strategies used within the lesbian movement to contest psycho-pathologisation during this 30-year period: from respectable collaborationist forms of activism during the 1960s; to more liberationist oppositional politics during the early 1970s; to radical feminist separatist activism in the 1980s. Whilst these strategies broadly map onto activist strategies deployed within the wider lesbian and gay movement during this time, this article explores how these politics manifested in particular ways, specifically in relation to the psy disciplines in the UK. We describe these strategies, illustrating them with examples of activism from the archives. We then use this history to problematise a linear, overly reductionist or binary history of liberation from psycho-pathologisation. Finally, we explore some complexities in the relationship between sexuality, activism and the psy professions.

How to survive the end of the future: Preppers, pathology, and the everyday crisis of insecurity.

Emergency preparedness is a distinctive feature of contemporary anticipatory politics, yet "preppers," a sub-culture who prepare to survive a range of possible crisis events through practices including stockpiling and survival skill development, are subject to media ridicule and academic dismissal. If the hoarder is the symbolic deviant figure of the consumer society, the prepper is that of the security society. Such constructions of prepper pathology, however, work to reinforce the neoliberal security state. By repositioning the prepper as an amplifier of conditions of the present, what emerges is an emblematic and anticipatory figure who troubles the cracks in the security state's governing logics, exposing its social differentiation and rehearsing the inevitability of its future failures. Drawing on qualitative research on UK prepping cultures, I define prepping across three constellations of imaginative-material practices, concerning "value," "temporalities," and "crisis." I argue that prepping exposes the contradictions of infrastructural weakening alongside the networked dependencies and restricted agency felt within late modernity, challenges the expert determination of what constitutes crisis, and unveils the myth of the universality of state security protection. Living with profound crisis attunement, preppers nevertheless recuperate pleasure in material potentiality and skilful practice, in thoughtful engagement with temporalities, and in the vitality of community and meaning formed in the times and spaces in, and around, crisis.

Debate: Why should gender-affirming health care be included in health science curricula?

BACKGROUND: Every person who seeks health care should be affirmed, respected, understood, and not judged. However, trans and gender diverse people have experienced significant marginalization and discrimination in health care settings. Health professionals are generally not adequately prepared by current curricula to provide appropriate healthcare to trans and gender diverse people. This strongly implies that health care students would benefit from curricula which facilitate learning about gender-affirming health care. MAIN BODY: Trans and gender diverse people have been pathologized by the medical profession, through classifications of mental illness in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Disease (ICD). Although this is changing in the new ICD-11, tension remains between depathologization discourses and access to gender-affirming health care. Trans and gender diverse people experience significant health disparities and an increased burden of disease, specifically in the areas of mental health, Human Immunodeficiency Virus, violence and victimisation. Many of these health disparities originate from discrimination and systemic biases that decrease access to care, as well as from health professional ignorance. This paper will outline gaps in health science curricula that have been described in different contexts, and specific educational interventions that have attempted to improve awareness, knowledge and skills related to gender-affirming health care. The education of primary care providers is critical, as in much of the world, specialist services for gender-affirming health care are not widely available. The ethics of the gatekeeping model, where service providers decide who can access care, will be discussed and contrasted with the informed-consent model that upholds autonomy by empowering patients to make their own health care decisions. CONCLUSION: There is an ethical imperative for health professionals to reduce health care disparities of trans and gender diverse people and practice within the health care values of social justice and cultural humility. As health science educators, we have an ethical duty to include gender-affirming health in health science curricula in order to prevent harm to the trans and gender diverse patients that our students will provide care for in the future.

'#WontBeErased': The effects of (de)pathologisation and (de)medicalisation on the legal capacity of trans* persons.

Over the last decade, trans* issues have increasingly gained attention all around the globe. While this increased social recognition has mostly resulted in higher acceptance rates of gender non-conformity, world-wide data show that trans* persons still remain among the most vulnerable groups in society. One of the most pressing issues facing trans* persons, is their inherent psycho-pathologisation and medicalisation in society and law. Indeed, in modern history, trans* issues have been predominantly addressed through the lens of medicine and psychiatry, which has had a clear impact on the legal capacity of gender non-conforming persons. Although this contribution shows that a human rights movement towards depathologisation and demedicalisation of gender non-conformity is rapidly getting up steam in several parts of the world, it needs to be questioned whether the current human rights approach is getting it 'right'. In this regard, it is argued that the present focus on trans* depathologisation and demedicalisation should only be the first step towards the full inclusion of all trans* persons in law and society.

Agora eu era o rei: o anacronismo temporal da criança / Now, I was the king: temporal anachronism of children / Ahora yo era el rey: el anacronismo temporal del niño / Maintenant, j'étais le roi: l'anachronisme temporel de l'enfant

O olhar pediátrico dirigido à criança contemporânea precisa ser menos incompleto e inocente. Nossa formação nos leva a ter um excesso de objetividade, situação paradoxal e perigosa, porque nossa tarefa se funda nas relações intersubjetivas. A criança tem que deixar o status de objeto de tutela para se constituir como um sujeito de desejo, de direito e de linguagem. Uma atenta escuta clínica torna-se uma ferramenta imprescindível na nossa clínica, acrescentada de um olhar atento e qualificado. A colaboração entre a pediatria e a psicanálise infantil é uma ponte a ser construída. A criança ganharia muito com isso porque acabariam as divergências promovidas pelos olhares diferentes dos observadores, apoiados por suas disciplinas específicas. Ela pode ser mais legível pelo que nos induz, exige e ensina.

The pediatric look at the contemporary child must be less incomplete and naive. Our training leads us to an excessive objectivity, which represents both a paradox and a dangerous situation, because our task is based on intersubjective relations. Children must leave the status of a protected object in order to develop themselves as a subject of desire, rights, and language. An acute listening becomes an essential tool in our clinical practice. Besides the listening, an aware and qualified look is also crucial. The collaboration between pediatrics and child psychoanalysis is a bridge to be built. It would bring a lot of gain to children because it would put an end to the divergences that arise from the observers' different looks. These views are either supported or not by their specific disciplines. Children may be more readable for what they teach us, demand from us, and induce us to do.

La mirada pediátrica dirigida al niño contemporáneo tiene que ser menos incompleta e inocente. Nuestra formación nos lleva a un exceso de objetividad, una situación paradójica y peligrosa, porque nuestra tarea se basa en las relaciones intersubjetivas. Los niños tienen que dejar el estatus de objeto de tutela para constituirse como un sujeto de deseo, de derecho y de lenguaje. Una escucha clínica cuidadosa se convierte en una herramienta imprescindible para nuestra clínica, así como una mirada atenta y cualificada. La colaboración entre la pediatría y el psicoanálisis infantil es un puente que debe construirse. El niño se beneficiaría mucho con esto, pues se acabarían las divergencias promovidas por distintas percepciones de los observadores, apoyados por sus disciplinas específicas. Él puede ser más legible por lo que nos induce, exige y enseña.

Il faut que le regard pédiatrique tourné vers l'enfant contemporain soit moins incomplet et innocent. Notre formation nos entraine à avoir un excès d'objectivité, une situation paradoxale et dangereuse, car notre tâche s'appuie sur des rapports intersubjectifs. Il faut que l'enfant abandonne le statut d'objet de tutelle pour se constituer comme un sujet de désir, de droit et de langage. Une écoute clinique attentive devient un outil dont on ne peut pas se passer dans notre clinique, en ajoutant encore un regard attentif et qualifié. La coopération entre la pédiatrie et la pédopsychiatrie est un pont qu'il faut construire. L'enfant gagnerait davantage avec cette coopération qui pourrait mettre fin aux désaccords favorisés par les différents regards des observateurs, appuyés par leurs disciplines spécifiques. Il peut être plus lisible en raison de tout à ce qu'il nous induit, tout ce qu'il exige, tout ce qu'il nous apprend.

Contestation, instrumental resistance and strategic conformation within the diagnostic process of gender dysphoria in Portugal.

This article aims to provide insights into the ways in which trans people (i.e. those whose gender identity or expression do not align with their assigned sex at birth) in Portugal make sense of the diagnosis of gender dysphoria. Drawing upon in-depth interviews with 10 trans men and 9 trans women carried out by the TRANSRIGHTS team, we identified three major themes: (a) contestation of gender dysphoria as a (mental) illness, (b) instrumental resistance to complete demedicalisation of gender dysphoria and (c) strategic conformation to gender essentialism within the diagnostic process of gender dysphoria. We found that the need to access medical treatments leads some trans people to approach the diagnosis strategically. While almost all trans people were in favour of the depathologisation of gender dysphoria and at the same time were against its demedicalisation, mainly for instrumental reasons, a few demonstrated contrasting positions whether by agreeing with the idea of gender dysphoria as a pathology or by rejecting medicalisation. The study offers a more nuanced perspective on gender dysphoria than that described in previous sociological and transgender literature.

Um olhar sobre a patologização da infância a partir do CAPSI / A look at children pathologization through the CAPSi / Una mirada sobre la patologización de la infancia a partir del CAPSi / Un regard vers la pathologisation de l'enfance à partir du CAPSi

A infância, no decorrer da história, foi ocupando lugar na produção do saber e do poder psiquiátrico, tornando-se alvo de investimentos das políticas públicas. No Brasil, a institucionalização do Sistema Único de Saúde (SUS), do Estatuto da Criança e do Adolescente (ECA) e da Reforma Psiquiátrica constitui-se um marco para a reorganização do cuidado em saúde mental para crianças e adolescentes. A compreensão da produção da infância passa pelos processos de desinstitucionalização das práticas de cuidado, do reconhecimento da criança como sujeito e a potência de criação de cada encontro. Este artigo problematiza a produção da infância a partir das práticas de cuidado no Centro de Atenção Psicossocial para infância e adolescência (CAPSi). Utilizamos a cartografia como estratégia metodológica, enfatizando o estudo da dimensão processual da subjetividade e de seu processo de produção. Acompanhamos as atividades em um CAPSi por quatro meses, realizando observações das ações desenvolvidas nesse serviço e grupos focais com os integrantes da equipe. Observamos que a patologização é um dos modos pelos quais a infância é produzida no CAPSi. Os processos de psiquiatrização e patologização da infância no percurso das crianças pelo CAPSi são percebidos nas diversas marcas impressas em seus processos de subjetivação. Uma dessas marcas ocorre pelo processo de atribuição de um diagnóstico às crianças. Afirmar o lugar do CAPSi como agenciador de novos encontros configura-se uma estratégia para que outras experiências sejam possíveis. O CAPSi é um lugar de encontro onde diversas instituições se cruzam, permitindo que o encontro das crianças se dê com cada uma dessas instituições que atravessam as práticas, tensionando a noção de identidade infantil como uma entidade criança, imóvel e universal. Isso permite que a criança seja um campo de forças e intensidades, inventando a sua experiência com o sofrimento e as práticas de cuidado.

Childhood, throughout history, has been taking place in the production of knowledge and psychiatric power, becoming a target for public policies investments. The institutionalization of the Unified Health System (SUS), the Statute of Child and Adolescent (ECA) and the Psychiatric Reform are, in Brazil, landmarks for the reorganization of mental health care for children and adolescents. The understanding of the production of childhood undergoes processes of deinstitutionalization of care practices, the recognition of children as individuals and the power of creating each meeting. This article problematizes the childhood production from care practices in a Psychosocial Care Center for children and adolescents (CAPSi). The research instrument used was the cartography, emphasizing the study of the procedural dimension of subjectivity and its production process. The activities in a CAPSi were followed for four months, conducting observations of the actions developed in this service and focus groups with team members. The pathologization is one of the ways in which childhood is produced in the CAPSi as it was observed in the study. The processes of childhood psychopathologization and pathologization are perceived in different marks printed in the processes of the children's subjectification. One of these marks occurs in the process of assigning a diagnosis to the children. Affirming that CAPSi is an agent for new meetings may be seen as a strategy, so that other experiences may become possible. CAPSi as the meeting place and a place where several institutions intersect allows the children's meeting to deal with each of these institutions that cross the practices, stressing the notion of child identity as an infant, static, and universal entity. This allows children to be a field of forces and intensities, inventing their experience through suffering and care practices.

En el transcurrir de la historia la infancia estuvo ocupando sitio en la producción del saber y del poder psiquiátrico, tornándose objetivo de investimentos de las políticas públicas. En Brasil, la institucionalización del Sistema Único de Salud (SUS), del Estatuto del Niño y del Adolescente (ECA) y de la Reforma Psiquiátrica, se constituye en punto de referencia para la reorganización del cuidado en salud mental de niños y adolescentes. La comprensión de la producción de la infancia pasa por los procesos de desinstitucionalización de las prácticas de cuidado, el reconocimiento del niño como sujeto, y la potencia de la creación de cada encuentro. Este artículo problematiza la producción de la infancia a partir de las prácticas de cuidado en el Centro de Atención Psicosocial para la infancia y adolescencia (CAPSi). Utilizamos la cartografía como estrategia metodológica, enfatizando el estudio de la dimensión procesual de la subjetividad y su proceso de producción. Seguimos las actividades en un CAPSi a lo largo de cuatro meses realizando observaciones de las acciones desarrolladas en ese servicio y grupos focales con los integrantes del equipo. Observamos que la patologización es uno de los modos por los cuales la infancia está producida en el CAPSi. Los procesos de psiquiatrización y patologización de la infancia en el recurrido de los niños por el CAPSi son percibidos en las diversas marcas que impresas en sus procesos de subjetivación. Una de esas marcas se da por el proceso de asignación de un diagnóstico a los niños. Afirmar la posición del CAPSi como administrador de nuevos encuentros se configura una estrategia para que otras experiencias sean posibles. El CAPSi es un sitio de encuentro donde diversas instituciones se cruzan permitiendo que el encuentro de los niños se dé con cada una de esas instituciones que cruzan las prácticas tensionando la noción de identidad infantil como una entidad niña, inmóvil y universal. Eso permite que el niño sea un campo de fuerzas e intensidades y que invente su experiencia con el sufrimiento y las prácticas del cuidado.

L'enfance, au cours de l'histoire, a eu de la place dans la production du savoir et du pouvoir psychiatrique en devenant la cible d'investissements des politiques publiques. Au Brésil, l'institutionalisation du Systhème Unique de Santé (SUS), du Statut de l'Enfant et de l'Adolescent (ECA) et de la réforme psychiatrique constitue un point fort de la réorganisation du soin de la santé mentale pour les enfants et les adolescents. La compréhension de la production de l'enfance passe par des processus de désinstitutionalisation des pratiques de soin, de la reconnaissance de l'enfant comme sujet, et la puissance de création de chaque rencontre. Cet article met em question la production de l'enfance à partir des pratiques de soin dans le Centre d'Attention Psychosocial pour l'enfance et l'adolescence (CAPSi). Nous avons utilisé la cartographie comme stratégie méthodologique en signalant l'étude de la dimension procédural de la subjectivité et de son processus de production. Nous avons accompagné les activités dans un CAPSi pendant quatre mois en y remarquant les actions développées et des groupes avec l'équipe. Nous avons remarqué que la pathologisation est l'un des modes par lequels l'enfance est produite dans le CAPSi. Les processus de psychiatrisation et celui de la pathologisation de l'enfance dans le parcours des enfants par le CAPSi sont aperçus dans des diverses marques imprimées dans leurs processus de subjectivation. L'une de ces marques se produit par le processus d'attribution d'un diagnostic aux enfants. Affirmer la place du CAPSi en tant qu'organisateur de nouvelles rencontres représente une stratégie pour que de nouvelles expériences soient possibles. Le CAPSi est un lieu de reencontre et où des plusieures institutions se croisent en permettant la reencontre des enfants avec chacune de ces institutions qui traversent les pratiques en tension avec la notion d'identité infantile comme une entité enfant, immobile et universel. Cela permet ainsi que l'enfant soit um champ de forces et d'intensités, en inventant son expérience avec la souffrance et les pratiques de soin.