¿Influye el trauma infantil en el reconocimiento de las emociones faciales independientemente del diagnóstico de trastorno mental grave? / Can childhood trauma influence facial emotion recognition independently from a diagnosis of severe mental disorder?

INTRODUCCIÓN: El reconocimiento de las expresiones faciales (REF) es un componente fundamental en la interacción social. Sabemos que dicho REF se encuentra alterado tanto en los pacientes con trastorno mental grave (TMG) como en los que padecen antecedentes de trauma infantil. MATERIAL Y MÉTODOS: Pretendemos analizar la posible relación entre la existencia de trauma en la infancia más allá de la presencia de un TMG, medido mediante la escala CTQ y el reconocimiento de las expresiones faciales, en una muestra con tres tipos de sujetos (n=321): controles sanos (n=179), pacientes con TLP (n=69) y primeros episodios psicóticos (n=73). Así mismo, se recogieron variables clínicas y datos sociodemográficos. Se analizó dicha relación mediante una técnica de regresión multivariante ajustando por el sexo, la edad, el CI, el consumo actual de tóxicos y el grupo al que pertenece el sujeto. RESULTADOS: El trauma sexual y/o físico en la infancia se relacionó de forma independiente de la existencia de TMG con un peor ratio de REF total, además de con una peor tasa de reconocimiento en las expresiones de felicidad. Además, los sujetos con antecedentes de trauma en la infancia atribuyeron con mayor frecuencia expresiones de enfado y miedo a las caras neutras y felices, independientemente de otras variables. CONCLUSIONES: La existencia de trauma en la infancia parece influir de manera independiente al TMG en la capacidad de los sujetos de reconocer expresiones faciales. Dado que el trauma es un factor prevenible y con un tratamiento específico, se debería prestar atención a la existencia de este antecedente en las poblaciones clínicas

INTRODUCTION: Facial emotion recognition (FER) is a fundamental component in social interaction. We know that FER is disturbed in patients with severe mental disorder (SMD), as well as those with a history of childhood trauma. MATERIAL AND METHODS: We intend to analyze the possible relationship between the existence of trauma in childhood irrespective of a SMD, measured by the CTQ scale and facial expression recognition, in a sample of three types of subjects (n=321): healthy controls (n=179), patients with BPD (n=69) and patients with a first psychotic episode (n=73). Likewise, clinical and socio-demographic data were collected. The relationship was analyzed by a technique of multivariate regression adjusting for sex, age, IQ, current consumption of drugs and group to which the subject belonged. RESULTS: Sexual and/or physical trauma in childhood related independently to the existence of SMD with a worse total FER ratio, as well as to a worse rate of recognition in expressions of happiness. Furthermore, the subjects with a history of childhood trauma attributed expressions of anger and fear more frequently to neutral and happy faces, irrespective of other variables. CONCLUSIONS: The existence of trauma in childhood seems to influence the ability of subjects to recognize facial expressions, irrespective of SMD. Trauma is a preventable factor with specific treatment; therefore, attention should be paid to the existence of this background in clinical populations

Can childhood trauma influence facial emotion recognition independently from a diagnosis of severe mental disorder? / ¿Influye el trauma infantil en el reconocimiento de las emociones faciales independientemente del diagnóstico de trastorno mental grave?

INTRODUCTION: Facial emotion recognition (FER) is a fundamental component in social interaction. We know that FER is disturbed in patients with severe mental disorder (SMD), as well as those with a history of childhood trauma. MATERIAL AND METHODS: We intend to analyze the possible relationship between the existence of trauma in childhood irrespective of a SMD, measured by the CTQ scale and facial expression recognition, in a sample of three types of subjects (n=321): healthy controls (n=179), patients with BPD (n=69) and patients with a first psychotic episode (n=73). Likewise, clinical and socio-demographic data were collected. The relationship was analyzed by a technique of multivariate regression adjusting for sex, age, IQ, current consumption of drugs and group to which the subject belonged. RESULTS: Sexual and/or physical trauma in childhood related independently to the existence of SMD with a worse total FER ratio, as well as to a worse rate of recognition in expressions of happiness. Furthermore, the subjects with a history of childhood trauma attributed expressions of anger and fear more frequently to neutral and happy faces, irrespective of other variables. CONCLUSIONS: The existence of trauma in childhood seems to influence the ability of subjects to recognize facial expressions, irrespective of SMD. Trauma is a preventable factor with specific treatment; therefore, attention should be paid to the existence of this background in clinical populations.

Affectively salient signal to random noise might be used to identify psychosis vulnerability in severe mental disorders.

BACKGROUND: Subclinical psychotic symptoms are present in the general population. Furthermore, they are quite common in diagnostic categories beyond psychosis, such as BPD patients. METHODS: We want to assess the differences between 3 groups: BPD (n = 68), FEP (n = 83) and controls (n = 203) in an experimental paradigm measuring the presence of speech illusions in white noise. The Positive and Negative Syndrome Scale was administered in the patient group, the Structured Interview for Schizotypy-Revised, and the Community Assessment of Psychic Experiences in the control and BPD group. The white noise task was also analysed within a signal detection theory (SDT) framework. Logistic regression analyses and the general linear models were used to analyse the adjusted differences between groups. RESULTS: Differences were more prevalent in signals that were perceived as affectively salient in patients groups (9.6% in FEP vs 5.9% in BPD and 1% in controls; OR: 10.7; 95%CI: 2.2-51.6, p = 0.003 in FEP; OR: 6.3; 95%CI: 1.1-35.0, p = 0.036 in BPD). Besides, we found a worse general performance and more false alarms in the task for FEP group using SDT framework. CONCLUSIONS: Experimental paradigms indexing the tendency to detect affectively salient signals in noise may be used to identify liability to psychosis in people with vulnerability. Its predictable value in other diagnostic categories and general population requires further research.

Identidad, relación y construcción del self en el encuentro psicoterapéutico / Identity, relationship and building of the self in psycotherapeutic encounters

Las distintas representaciones del self se van solapando, perfilando una identidad global que contiene matices propios de todas las representaciones sucesivas. Los autores aprovechan una viñeta clínica que parece contradecir este planteamiento (AU)

Several consecutive self representations overlap delineating a total identity containing aspects from all different perceived representations. Authors examine this subject departing from clinical vignette which seems to contradict this approach (AU)