RESUMO
Autism spectrum disorder (ASD) is diagnosed based on socio-communicative difficulties, which are believed to result from deficits in mentalizing, mainly evidenced by alterations in recognizing and responding to the mental states of others. In recent years, efforts have been made to develop mentalization-based treatment (MBT) models for this population. These models focus on enhancing individuals' ability to understand and reflect on their own mental states, as well as those of others. However, MBT approaches for people with ASD are limited by their existing theoretical background, which lacks a strong foundation grounded in neuroscience-based evidence properly integrated with attachment, and mentalizing. These are crucial aspects for understanding psychological processes in autism, and as such, they play a pivotal role in shaping the development of tailored and effective therapeutic strategies for this specific population. In this paper we review evidence related to the neurobiological, interpersonal, and psychological dimensions of autism and their implications for mentalizing processes. We also review previous mentalization-based frameworks on the psychosis continuum to provide a comprehensive understanding of attachment, neurobiology, and mentalization domains in therapeutic approaches for autism. After presenting a synthesis of the literature, we offer a set of clinical strategies for the work with children with autism. Finally, we provide recommendations to advance the field towards more robust models that can serve as a basis for evidence-based therapeutic strategies.
RESUMO
Espectro autista corresponde a un trastorno generalizado del desarrollo, abarcando trastornos cognitivos, del lenguaje y comunicación social y de conducta (hiperactividad, agresividad, estereotipias, etc.) Todos estos de severidad variable.Es conocida la importante asociación entre epilepsia y espectro autista, describiéndose en la literatura una frecuencia que varía entre un 7 a 40 por ciento en los pacientes con espectro autista.Se realizó un estudio descriptivo protocolizado con 45 pacientes con el diagnóstico de espectro autista y se hizo una evaluación clínica y electroencefalográfica de cada uno.Del total de pacientes evaluados 66 por ciento presentó crisis epilépticas, y un 73 por ciento mostró anomalías en la polisomnografía.Estos resultados muestran una mayor prevalencia que la descrita en la literatura.
The Autistic Spectrum is a generalized disorder of development, which includes cognitive, language, social communication and behavioral conditions (hyperactivity, aggressiveness, stereotypes, etc.), all of these, presenting with variable severity.The important association between epilepsy and autistic spectrum is well known, and reports in literature range from 7 to 40 percent among patients with autistic spectrum. A descriptive study protocol involving 45 patients with a diagnosis of autistic spectrum wasperformed. Each patient underwent a clinical and electroencephalographic assessment. Of all patients assessed, 66 percent evidenced seizures and 73 percent showed an abnormal polysomnography. Such results demonstrate that Autistic Spectrum has a greater prevalence of that described in literature.
