RESUMO
Objective: To identify clinical and sociodemographic factors that increase or decrease suicidal risk in a clinical sample of subjects seeking mental health care. Method: A cross-sectional study was performed at three health centers in Santiago, Chile. The Parental Bonding Instrument (PBI), Depressive Experience Questionnaire (DEQ), Outcome Questionnaire (OQ-45.2), Reasons for Living Inventory (RFL), and State Trait Anger Expression Inventory (STAXI-2), in addition to a sociodemographic survey, were applied to 544 participants (333 with suicidal behavior and 211 without current suicidal behavior). Through hierarchical clustering analysis, participants were grouped by similarity regarding suicidal risk. Then, a regression analysis was performed using the Least Absolute Shrinkage and Selection Operator (LASSO) technique, and factors that decrease or increase suicide risk (SR) were identified for each cluster. Results: The resultant clusters were grouped mainly by the age of participants. The most important protective factor was having confidence in one's own coping skills in difficult situations. Relevant risk factors were major depressive disorder (MDD), poor anger management, and difficulties in interpersonal relationships. Conclusions: Suicidal risk manifests differently throughout the life cycle, and different types of bonds may protect from or increase risk of suicide.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Ideação Suicida , Fatores Socioeconômicos , Análise por Conglomerados , Estudos Transversais , Medição de Risco , Pessoa de Meia-Idade , Modelos PsicológicosRESUMO
OBJECTIVE: To identify clinical and sociodemographic factors that increase or decrease suicidal risk in a clinical sample of subjects seeking mental health care. METHOD: A cross-sectional study was performed at three health centers in Santiago, Chile. The Parental Bonding Instrument (PBI), Depressive Experience Questionnaire (DEQ), Outcome Questionnaire (OQ-45.2), Reasons for Living Inventory (RFL), and State Trait Anger Expression Inventory (STAXI-2), in addition to a sociodemographic survey, were applied to 544 participants (333 with suicidal behavior and 211 without current suicidal behavior). Through hierarchical clustering analysis, participants were grouped by similarity regarding suicidal risk. Then, a regression analysis was performed using the Least Absolute Shrinkage and Selection Operator (LASSO) technique, and factors that decrease or increase suicide risk (SR) were identified for each cluster. RESULTS: The resultant clusters were grouped mainly by the age of participants. The most important protective factor was having confidence in one's own coping skills in difficult situations. Relevant risk factors were major depressive disorder (MDD), poor anger management, and difficulties in interpersonal relationships. CONCLUSIONS: Suicidal risk manifests differently throughout the life cycle, and different types of bonds may protect from or increase risk of suicide.
Assuntos
Ideação Suicida , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise por Conglomerados , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Psicológicos , Medição de Risco , Fatores Socioeconômicos , Adulto JovemRESUMO
AIM: In efforts to develop reliable methods to detect the likelihood of impending suicidal behaviors, we have proposed the following. OBJECTIVE: To gain a deeper understanding of the state of suicide risk by determining the combination of variables that distinguishes between groups with and without suicide risk. METHOD: A study involving 707 patients consulting for mental health issues in three health centers in Greater Santiago, Chile. Using 345 variables, an analysis was carried out with artificial intelligence tools, Cross Industry Standard Process for Data Mining processes, and decision tree techniques. The basic algorithm was top-down, and the most suitable division produced by the tree was selected by using the lowest Gini index as a criterion and by looping it until the condition of belonging to the group with suicidal behavior was fulfilled. RESULTS: Four trees distinguishing the groups were obtained, of which the elements of one were analyzed in greater detail, since this tree included both clinical and personality variables. This specific tree consists of six nodes without suicide risk and eight nodes with suicide risk (tree decision 01, accuracy 0.674, precision 0.652, recall 0.678, specificity 0.670, F measure 0.665, receiver operating characteristic (ROC) area under the curve (AUC) 73.35%; tree decision 02, accuracy 0.669, precision 0.642, recall 0.694, specificity 0.647, F measure 0.667, ROC AUC 68.91%; tree decision 03, accuracy 0.681, precision 0.675, recall 0.638, specificity 0.721, F measure, 0.656, ROC AUC 65.86%; tree decision 04, accuracy 0.714, precision 0.734, recall 0.628, specificity 0.792, F measure 0.677, ROC AUC 58.85%). CONCLUSION: This study defines the interactions among a group of variables associated with suicidal ideation and behavior. By using these variables, it may be possible to create a quick and easy-to-use tool. As such, psychotherapeutic interventions could be designed to mitigate the impact of these variables on the emotional state of individuals, thereby reducing eventual risk of suicide. Such interventions may reinforce psychological well-being, feelings of self-worth, and reasons for living, for each individual in certain groups of patients.
RESUMO
La pareja ha sido comentada y estudiada desde diferentes disciplinas y, por lo tanto, con distintos énfasis. En las últimas cinco décadas, en la psicología y, más específicamente, en la psicoterapia se han levantado una serie de reflexiones e investigaciones acerca del ser y estar en pareja, como un asunto de la mayor relevancia para la salud mental de las personas, de las familias y de la sociedad toda. Este artículo busca describir las características que tienen las relaciones de pareja como una díada distinta de otras díadas, enfatizar la importancia que las respectivas familias de origen tienen, tanto para la formación de la pareja como para su posterior desarrollo, y cómo este tópico ha sido considerado en el encuadre terapéutico. En síntesis, interesa observar a la pareja como una de las formas de estar-con-otro-en-el-mundo (Cornejo, 2008).
The couple has been discussed and studied from different disciplines and, therefore, with different emphases. In the last five decades, in psychology and, more specifically, in psychotherapy have been raised a series of reflections and investigations about being-in-couple, as a matter of the greatest importance for mental health of individuals, families and society as a whole. This article seeks to describe the characteristics of couple relationships, as a dyad different from other dyads; to emphasize the importance that the respective families of origin have, both in the formation of the couple as for further development, and how this topic has been considered in the therapeutic setting. In short, what matters is observing couple as one way of being-in-the-world-with-other (Cornejo, 2008).
Assuntos
Humanos , Identificação Psicológica , Privacidade , Terapia de Casal/métodosRESUMO
El encuentro terapéutico se traduce en un espacio intersubjetivo, en una experiencia única e irreplicable, en donde dos o más personas interactúan y sus subjetividades cambian por la presencia de la alteridad. Para comprender lo anterior se ha dispuesto revisar primero los conceptos de subjetividad y de intersubjetividad. Entendiendo ambos conceptos en un permanente juego dialéctico, en donde la subjetividad contrae deudas con la alteridad, puesto que ésta última la constituye y, al mismo tiempo, se diferencia, quedando siempre un aspecto de la alteridad que excede al sujeto. La alteridad es lo otro, que revela al sujeto algo de sí mismo que, hasta entonces, no sabía. La constitución del sujeto implica aprender una forma de estar con otros en el mundo. En un segundo apartado se revisa el concepto de intersubjetividad, venido desde la filosofía y llevado al psicoanálisis relacional, como constructo teórico que aporta a la comprensión del desarrollo de los vínculos entre las personas. Se termina con un tercer apartado, en donde se aplica el concepto de intersubjetividad planteado aquí y se lo conecta con el proceso psicoterapéutico.
The therapeutic encounter results in an intersubjective space; a unique and irreplicable experience, where two or more people interact and their subjectivities change by the presence of otherness. To understand the above we first review the concepts of subjectivity and intersubjectivity. Understanding both concepts in an ongoing dialectical interplay, where subjectivity incurs into debts with otherness, since the latter constitutes it and, at the same time, differentiates from it, remaining always an aspect of otherness that exceeds the subject. Otherness is the other, that reveals to the subject something of himself that until then he did not know. The constitution of the subject involves learning a way of being with others in the world. In the second section is reviewed the concept of intersubjectivity, that comes from philosophy and was led to relational psychoanalysis as a theoretical construct that contributes to understanding the development of bonds between people. This article is finished with a third section, where the concept of intersubjectivity raised here is applied and connected to the psychotherapeutic process.