Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-26T07:03:50.789Z Has data issue: false hasContentIssue false

Comportamiento automutilador de pacientes psiquiátricos hospitalizados

Published online by Cambridge University Press:  12 May 2020

H. L. I. Nijman
Affiliation:
Hospital Psiquiátrico Welterhof, Heerlen, P.O. Box 4436, 6401 CX Departamento de Psicología, Universidad de Maastricht. Maastricht, Países Bajos
M. Dautzenberg
Affiliation:
Hospital Psiquiátrico Welterhof, Heerlen, P.O. Box 4436, 6401 CX
H. L. G. J. Merckelbach
Affiliation:
Departamento de Psicología, Universidad de Maastricht. Maastricht, Países Bajos
P. Jung
Affiliation:
Hospital Psiquiátrico Welterhof, Heerlen, P.O. Box 4436, 6401 CX
I. Wessel
Affiliation:
Departamento de Psicología, Universidad de Maastricht. Maastricht, Países Bajos
J. á Campo
Affiliation:
Hospital Psiquiátrico Welterhof, Heerlen, P.O. Box 4436, 6401 CX
Get access

Resumen

En el presente estudio se valoraron dos hipótesis generales sobre los orígenes de la automu-tilación en los pacientes psiquiátricos. La primera afirma que la automutilación tiene su origen en el abuso infantil y las experiencias de abandono y está relacionada con disociación en momentos posteriores de la vida. La segunda ve la automutilación como consecuencia de problemas del control de impulsos. Para examinar estas dos hipótesis, se recogieron datos acerca de experiencias infantiles traumáticas y síntomas disociativos (hipótesis 1), así como datos acerca de la agresividad, la conducta obsesivo-compulsiva y la búsqueda de sensaciones (hipótesis 2) en una muestra de 54 pacientes psiquiátricos hospitalizados. Veinticuatro de 54 pacientes (44%) comunicaron haberse mutilado. La edad media de comienzo de este comportamiento era 23 años. Las medidas de autoinforme de los pacientes que se mutilaron estaban más de acuerdo con la primera hipótesis que con la segunda. Es decir, los pacientes que se mutilaron comunicaban más experiencias infantiles traumáticas y síntomas disociativos que los pacientes de control. Los dos grupos no diferían por lo que se refiere a la agresividad, la conducta obsesivo-compulsiva y la búsqueda de sensaciones. De acuerdo con estudios anteriores, los presentes resultados indican que el comportamiento de automutilación se relaciona con una historia de abuso y abandono.

Type
Artículo Original
Copyright
Copyright © European Psychiatric Association 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bibliografía

Barstow, DGSelf-injury and self-mutilation. Nursing approaches. J Psychosoc Nurs 1995; 33: 1922.Google ScholarPubMed
Bernstein, DPChildhood Trauma Questionnaire (53 item version) Scoring Form. New York: Mount Sinai School of Medicine; 1995.Google Scholar
Bernstein, DPAhluvalia, TPogge, DHandelsman, LValidity of the childhood trauma questionnaire in an adolescent psychiatric population. J Am Acad Adol Psychiatry 1997; 36: 340–8.CrossRefGoogle Scholar
Bernstein, DPFink, LHandelsman, LFoote, JLovejoy, MWenzel, Ket al.Initial reliability and validity of a new retrospective measure of child abude and neglect. Am J Psychiatry 1994; 151: 1132–6.Google Scholar
Bernstein, EMPutman, FWDevelopment, reliability, and validity of a dissociation scale. J Nerv Ment Dis 1996; 174: 727–35.CrossRefGoogle Scholar
Brodsky, BSCloitre, MDulit, RARelationship of dissociation to self-mutilation and childhood abuse in borderline personality disorder. Am J Psychiatry 1995; 152: 1788–92.Google ScholarPubMed
Chu, JADill, DLDissociative symptoms in relation to childhood physical and sexual abuse. Am J Psychiatry 1990; 147: 887–92.Google ScholarPubMed
Darche, MAPsychological factors differentiating self-mutilatting and non-self-mutilating adolescent impatient females. Psychiatr Hosp 1990; 21: 31–5.Google Scholar
Dulit, RAFyer, MRLeón, ACBrodsky, BSFrancés, AJClinical correlates of self-mutilation in borderline personality disorder. Am J Psychiatry 1994; 151: 1305–11.Google ScholarPubMed
Favazza, ARWhy patients mutílate themselves. Hosp Comm Psychiatry 1989; 40: 137–45.Google ScholarPubMed
Favazza, ARConterio, KThe plight of chronic self-mutilators. Comm Ment Helth J 1988; 24: 2230.CrossRefGoogle ScholarPubMed
Favazza, ARosenthal, RJDiagnostic issues in self-mutilation. Hosp Comm Psychiatry 1993; 44: 134–40.Google ScholarPubMed
Feij, AZuilen, RW vanHandleiding Spanningsbe-hoefte Lijst, SBL (manual sensation seeking scale). Lisse: Swets & Zeitlinger; 1984.Google Scholar
Hillbrand, MAgression against self and aggression against others in violent psychiatric patients. J Consult Clin Psychol 1995; 63: 668–71.CrossRefGoogle Scholar
Jones, IHDaniels, BAAn ethological approach to self-injury. Br J Psychiatry 1996; 169: 263–7.CrossRefGoogle ScholarPubMed
Konicki, PESchulz, SCRationale for clinical trials of opiate antagonists in treating patients with personality disorders and self-injurious behaviour. Psychopharm Bull 1989; 25: 556–63.Google Scholar
Langbehn, DRPfohl, BClinical correlates of self-mutilation among psychiatric inpatients. Ann Clin Psychiatry 1993; 5: 4551.CrossRefGoogle ScholarPubMed
Lange, APahlich, ASarucco, MSmits, MSmits, GDehghani, BHanewald, GPsychometric characteristics and validity of the Dutch adaptation of the Buss-Durkee Hostility Inventory (the BDHI-D). Behav Res Ther 1995; 33: 223–7.Google Scholar
Lester, DPhysical abuse and physical punishment as ptecursors of suicidal behaviour. Stress Medicine 1991; 7: 255–6.CrossRefGoogle Scholar
Linnoila, VMIVirkunnen, MAggression, suicidality, and serotonin. J Clin Psychiatry 1992; 53 suppl 10: 4651.Google Scholar
Merckelbach, HMuris, PRassin, EFantasy proneness and cognitive failures as correlates of dissociative experiences. Pers Individ Diff; in press.Google Scholar
Merckelbach, HMuris, PThe causal link between self-reported trauma and dissociation: a critical review. Submitted for publication; 1998.Google Scholar
Nijman, HMuris, PMerckelbach, HPalmstierna, TWistedt, BVos, Aet al.The Saff Observation Aggression Scale-Revised (SOAS-R). Aggr Behav; in press.Google Scholar
Rachman, SHodgson, RJObssessions and Compulsions. Englewood Cliffs. Prentice-Hall Inc; 1980.Google Scholar
Shearer, SLPhenomenology of self-injury among impatient women with borderline personality disorder. J Nerv Ment Dis 1994; 182: 524–6.Google Scholar
Simeón, DStanley, BFrancés, AMann, JJWinchel, RStanley, MSelf-mutilation in personality disorders: psychological and biological correlates. Am J Psychiatry 1992 ; 149: 221–6.Google ScholarPubMed
Soloff, PHLis, JAKelly, TCornelius, JUlrich, RSelf-mutilation and suicidal behaviour in borderline personality disorder. J Pers Disorders 1994; 8: 257–67.CrossRefGoogle Scholar
Soutwick, SMKrystal, JHBremmer, JDMorgan, CA IIINico Laou, ALNagu, LMet al.Noradrenergic and serotonergic function in posttraumatic stress disorder. Arch Gen Psychiatry 1997; 54: 749–58.CrossRefGoogle Scholar
Suyemoto, KLThe functions of self-mutilation. Clin Psychol Rev 1998; 18: 531–54.CrossRefGoogle ScholarPubMed
Verkes, RJKerhof, GABeld, EHengeveld, MWvan Kempen, GMJSuicidality, circadian activity rhythms and platelet serotonergic measures in patients with recurrent suicidal behaviour. Acta Psychiatr Scand 1996; 93; 2734.CrossRefGoogle ScholarPubMed
Whichel, RMStanley, MSelf-injurious behaviour: a review of the behaviour and biology of self-mutilation. AM J Psychiatry 1991; 148: 306–15.Google Scholar
Zlotnick, CShea, MTPearlstein, TSimpson, ECostello, EBegin, AThe relationship between dissociative symptoms, alexithymia, impulsivity, sexual abuse, and self-mutilation. Compr Psychiatry 1996; 37: 12–6.CrossRefGoogle ScholarPubMed
Zuckerman, MSensation seeking: beyond the optimal level of arousal. Hillsdale: Erlbaum; 1979.Google Scholar