RESUMO
La voz es un elemento particular de los primeros años de vida en el sujeto debido a que es una de las formas de manifestar su necesidad, un deseo, u otro, por lo cual se adopta como una herramienta que se vincula a los procesos anímicos; puede ser una forma de ver síntomas o malestares que el paciente no quiere ni confesarse, ni confesar en una consulta. Objetivo: Comprender la manifestación del malestar a través de la voz del sujeto y la forma subjetiva del saber hacer con el conflicto, que apertura la importancia de la voz en el proceso psicoterapéutico. Materiales y métodos: Se enmarcó en un paradigma fenomenológico, es una investigación de campo con enfoque cualitativo mediante un estudio de caso. Resultados: A partir de este estudio se pudo determinar que el malestar incide en la voz del sujeto cuando no puede ser expresado con anterioridad, por tanto, la voz es una forma de expresión inconsciente que en ocasiones no es percibida por el sujeto que manifiesta un malestar. Conclusiones: El fenómeno de la voz está presente en los sujetos que formaron parte de esta investigación, pero cada uno de ellos lo formula de manera distinta, haciendo del malestar un saber hacer individual; por medio de la voz se manifiestan los silencios, el grito, el llanto y variadas formas orales que indican que hay asuntos pendientes, reflejando el conflicto que tiene el individuo con lo que está refiriendo, así deja huellas fonéticas en todo lo que nos relata(AU)
The voice is a particular element of the first years of life in the subject due to which is one of the ways to express their need, a desire, or another, for which it is adopted as a tool that is linked to psychic processes; it may be a way of seeing symptoms or discomforts that the patient does not want to confess or confess in a consultation. Objective:Understand the manifestation of discomfort through the voice of the subject and the subjective form of knowing how to deal with conflict, which opens up the importance of the voice in the psychotherapeutic process. Materials and methods:It was framed in a phenomenological paradigm, it is an investigation of field with a qualitative approach through a case study. Results:From this study it was possible to determine that discomfort affects the voice of the subject when it cannot be expressed with previously, therefore, the voice is a form of unconscious expression that sometimes is not perceived by the subject who manifests discomfort. Conclusions:The phenomenon of the voice is present in the subjects who were part of this investigation, but each one of them formulates it in a different way, making discomfort an individual know-how; through the voice silences, screaming, crying and various oral forms that indicate thatthere are issues pending, reflecting the conflict that the individual has with what he is referring to, thus leaving traces phonetics in everything he tells us(AU)
Assuntos
Regressão Psicológica , Comportamento e Mecanismos Comportamentais , Consultórios Médicos , Afeto , Ajustamento Emocional , Psicologia Clínica , Sinais e Sintomas , Voz , FonéticaRESUMO
O artigo aborda alguns pontos teóricos sobre a técnica, pontos estes relacionados aos pacientes que funcionam de forma ao nível da falha básica, como descreve o psicanalista Michael Balint. O objetivo é trazer reflexões para o atendimento dos pacientes que apresentam quadros regressivos, no sentido de permitir a vivência do novo começo. O texto discute algumas ideias da teoria balintiana sobre a questão da regressão em psicanálise (Au)
The article addresses some theoretical points about the technique related to patients who function more at the level of basic failure, as described by psychoanalyst Michael Balint. The objective is to bring reflections for the care of patients who present regressive conditions in order to allow the experience of the new beginning. The text discusses some ideas of the Balintian theory on the issue of regression in psychoanalysis.
El artículo aborda algunos puntos teóricos sobre la técnica, puntos que se relacionan con pacientes que funcionan en el nivel de falla básica, como lo describe el psicoanalista Michael Balint. El objetivo es traer reflexiones para el cuidado de los pacientes que presentan condiciones regresivas, a fin de permitir la experiencia de un nuevo comienzo. El texto analiza algunas ideas de la teoría balintiana sobre el tema de la regresión en psicoanálisis
Assuntos
Regressão Psicológica , Transtornos de Ansiedade , Teoria Psicanalítica , Comportamento Infantil , Técnicas PsicológicasRESUMO
Difficulties in advancing effective patient-specific therapies for psychiatric disorders highlight a need to develop a stable neurobiologically grounded mapping between neural and symptom variation. This gap is particularly acute for psychosis-spectrum disorders (PSD). Here, in a sample of 436 PSD patients spanning several diagnoses, we derived and replicated a dimensionality-reduced symptom space across hallmark psychopathology symptoms and cognitive deficits. In turn, these symptom axes mapped onto distinct, reproducible brain maps. Critically, we found that multivariate brain-behavior mapping techniques (e.g. canonical correlation analysis) do not produce stable results with current sample sizes. However, we show that a univariate brain-behavioral space (BBS) can resolve stable individualized prediction. Finally, we show a proof-of-principle framework for relating personalized BBS metrics with molecular targets via serotonin and glutamate receptor manipulations and neural gene expression maps derived from the Allen Human Brain Atlas. Collectively, these results highlight a stable and data-driven BBS mapping across PSD, which offers an actionable path that can be iteratively optimized for personalized clinical biomarker endpoints.
Assuntos
Mapeamento Encefálico/métodos , Encéfalo/fisiopatologia , Modelos Neurológicos , Transtornos Psicóticos/fisiopatologia , Transtornos Psicóticos/psicologia , Adulto , Disfunção Cognitiva/etiologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Vias Neurais , Regressão Psicológica , Adulto JovemRESUMO
Na clínica psicanalítica contemporânea temos nos defrontado, cada vez mais, com impasses técnicos que nos exigem repensar a teoria sobre a técnica psicanalítica. Essa revisão teórica se justifica a partir de uma maior incidência de quadros clínicos cujo dinamismo psíquico não se encontra balizado hegemonicamente pela lógica do recalque, mas pela predominância de outros mecanismos defensivos, como a clivagem/splitting do eu, e formas de expressão não verbais como passagens ao ato e acting outs. Diante da necessidade de reconfigurar alguns parâmetros da técnica psicanalítica, delimitamos como objetivo deste artigo a investigação do tema do manejo clínico das regressões em análise a partir das contribuições teórico-clínicas de Sándor Ferenczi e de seus desdobramentos e avanços propostos Michael Balint. Assim, pretendemos extrair das modificações no dispositivo analítico propostas por esses autores, elementos que nos ajudem a pensar o manejo clínico com pacientes cujo sofrimento remete às falhas traumáticas dos primórdios da constituição subjetiva.
In contemporary psychoanalytic clinic we have faced increasingly technical deadlocks that require to rethink the psychoanalytic technique theory. This situation requires a revision of psychoanalysis technical theory. This theoretical revision is justified by a higher incidence of clinical conditions whose psychic dynamic is not hegemonic marked by the logic of repression, but the predominance of other defensive mechanisms, e.g. splitting, and non-verbal forms of expression such as acting out. Given the need to reconfigure some parameters of the psychoanalytic technique, we set as the objective of this article the investigation of clinical management of regressions under analysis from the theoretical and clinical contributions of Sándor Ferenczi and from developments and advances by Michael Balint. Therefore, from the changes proposed by these authors, we will attempt to extract elements that will help us think different clinical management of patients whose suffering refers to traumatic failures in the early stages of development, in an analytical setting.
En la clínica psicoanalítica contemporánea nos hemos enfrentado, cada vez más, con impases técnicos que nos obligan a repensar la teoría sobre la técnica psicoanalítica. Esta revisión teórica se justifica por una mayor incidencia de cuadros clínicos cuyo dinamismo psíquico no responde a la lógica de la represión, sino por el predominio de otros mecanismos defensivos, como el clivaje / escisión del yo, y formas de expresión no verbal como pasajes al acto y "acting outs". Ante la necesidad de reconfigurar algunos parámetros de la técnica psicoanalítica, el objetivo de este artículo es delinear la investigación del tema del manejo clínico de las regresiones en análisis, a partir de las contribuciones teórico-clínicas de Sándor Ferenczi y sus desdoblamientos y avances en la teoría de Michael Balint. Así, pretendemos extraer, de las modificaciones en el dispositivo analítico propuestas por esos autores, elementos que nos ayuden a pensar sobre el manejo clínico con pacientes cuyo sufrimiento remite a los fracasos traumáticas de los primordios de la constitución subjetiva.
Assuntos
Humanos , Masculino , Feminino , Regressão Psicológica , Defesa Perceptiva , Terapia Psicanalítica/métodos , Teoria Fundamentada , Apego ao ObjetoRESUMO
Phelan McDermid syndrome (PMcD) is a neurogenetic disease associated with haploinsufficiency of the SHANK3 gene due to a spectrum of anomalies in the terminal region of the long arm of chromosome 22. SHANK3 is the abbreviation for SH3 domain and ankyrin repeat-containing protein, a gene that encodes for proteins of the postsynaptic density (PSD) of excitatory synapses. This PSD is relevant for the induction and plasticity of spine and synapse formation as a basis for learning processes and long-term potentiation. Individuals with PMcD present with intellectual disability, muscular hypotonia, and severely delayed or absent speech. Further neuropsychiatric manifestations cover symptoms of the autism spectrum, epilepsy, bipolar disorders, schizophrenia, and regression. Regression is one of the most feared syndromes by relatives of PMcD patients. Current scientific evidence indicates that the onset of regression is variable and affects language, motor skills, activities of daily living and cognition. In the case of regression, patients normally undergo further diagnostics to exclude treatable reasons such as complex-focal seizures or psychiatric comorbidities. Here, we report, for the first time, the case of a young female who developed progressive symptoms of regression and a dystonic-spastic hemiparesis that could be traced back to a comorbid multiple sclerosis and that improved after treatment with methylprednisolone.
Assuntos
Doenças Autoimunes/tratamento farmacológico , Transtornos Cromossômicos/complicações , Metilprednisolona/administração & dosagem , Esclerose Múltipla/complicações , Regressão Psicológica , Anormalidades Múltiplas/genética , Anormalidades Múltiplas/fisiopatologia , Administração Intravenosa , Adulto , Transtorno do Espectro Autista/complicações , Doenças Autoimunes/líquido cefalorraquidiano , Doenças Autoimunes/complicações , Doenças Autoimunes/imunologia , Deleção Cromossômica , Transtornos Cromossômicos/líquido cefalorraquidiano , Transtornos Cromossômicos/diagnóstico por imagem , Transtornos Cromossômicos/genética , Cromossomos Humanos 21-22 e Y/genética , Cromossomos Humanos Par 22/genética , Feminino , Humanos , Imageamento por Ressonância Magnética , Esclerose Múltipla/líquido cefalorraquidiano , Proteínas do Tecido Nervoso/genética , Deleção de Sequência , Punção EspinalRESUMO
Multiple births (twins or higher order multiples) are increasing in developed countries and may present higher risk for cerebral palsy (CP). However, few studies can reliably investigate trends over time because these outcomes are relatively rare. OBJECTIVE: We pooled data from European CP registers to investigate CP birth prevalence and its trends among single and multiple births born between 1990 and 2008. DESIGN: Population cohort study. SETTING: 12 population-based registers from the Surveillance of Cerebral Palsy in Europe collaboration. PARTICIPANTS: 4 446 125 single and multiple live births, of whom 8416 (0.19%) had CP of prenatal or perinatal origin. MAIN OUTCOMES: CP diagnosis ascertained in childhood using harmonised methods; CP subtype; Motor impairment severity among CP cases. RESULTS: The rate of multiple births increased from 1990. Multiples displayed higher risk for CP (RR=4.27, 95% CI 4.00 to 4.57). For singletons and multiples alike, risk for CP was higher among births of lower gestational age (GA) or birth weight (BW). However, CP birth prevalence declined significantly among very preterm (<32 weeks) and very low BW (<1500 g) multiples. Singletons and multiples with CP displayed similar severity of motor impairment. CONCLUSIONS: Between 1990 and 2008, CP birth prevalence decreased steadily among multiples with low GA or BW. Furthermore, multiples with CP display similar profiles of severe motor impairment compared with CP singletons. Improvements in management of preterm birth since the 1990s may also have been responsible for providing better prospects for multiples.
Assuntos
Paralisia Cerebral/epidemiologia , Prole de Múltiplos Nascimentos/estatística & dados numéricos , Peso ao Nascer , Europa (Continente)/epidemiologia , Idade Gestacional , Humanos , Nascimento Prematuro/epidemiologia , Prevalência , Regressão PsicológicaRESUMO
As shown in our previous paper ('Regression I. Experimental approaches to regression', JAP, 65, 2, 345-65), the common mechanism of regression can be described as reversible dedifferentiation, which is understood as a relative increase of the proportion of low-differentiated (older) systems in actualized experience. Experimental data show that regression following disease (chronic tension headache) is followed by adaptation and an increase in system differentiation in that experience domain which contains systems responsible for that adaptation. The results of mathematical modelling support the idea that reversible dedifferentiation can be one of the mechanisms for increasing the effectiveness of adaptation through learning. Reversible dedifferentiation, which is phenomenologically described as regression, is a general mechanism for restructuring the organism-environment interactions in situations where behaviours that were effective in the past become ineffective. Reversible dedifferentiation has evolved as a component of adaptation when new behaviours are formed and large-scale modifications in the existing behaviours are required in the face of changes in the external and/or internal environment. Thus, the authors believe that this article provides evidence for Jung's view that regression is not only a 'return' to past forms of thinking, affects and behaviour, but that regressive processes provide a significant impetus for psychological growth and development.
Comme nous l'avons montré dans notre article précédent (« Régression I. Les approches expérimentales de la régression ¼), le mécanisme propre à la régression peut être décrit en tant que dé-différentiation réversible, ce que l'on peut comprendre comme une hausse relative de la proportion de systèmes peu différentiés (plus vieux) dans l'expérience actualisée. Les données expérimentales montrent que la régression suite à une maladie (mal de tête de tension chronique) est suivie par une adaptation et un accroissement dans la différentiation des systèmes dans le domaine d'expérience qui contient les systèmes responsables de cette adaptation. Les résultats de la modélisation mathématique soutiennent l'idée que la dé-différentiation réversible peut être l'un des mécanismes pour accroitre l'efficacité de l'adaptation par l'apprentissage. La dé-différentiation réversible, qui est décrite phénoménologiquement comme régression, est un mécanisme général pour restructurer les interactions organisme-environnement dans des situations où les comportements qui fonctionnaient par le passé sont devenus inefficaces. La dé-différentiation réversible a évolué comme un élément de l'adaptation quand de nouveaux comportements se développent et que des changements dans l'environnement extérieur ou intérieur requièrent des modifications à grande échelle dans les comportements existants. Ainsi, les auteurs pensent que cet article apporte un soutien à la perspective de Jung selon laquelle la régression n'est pas seulement un « retour ¼ à des formes anciennes de fonctionnement, d'affects et de comportement, mais que les processus régressifs fournissent un élan significatif pour la croissance et le développement psychologiques.
Como hemos mostrado en nuestros trabajos previos ('Regresión I. Abordajes experimentales hacia la regresión'), el mecanismo común de la regresión puede ser descripto como desdiferenciación reversible, el cual es comprendido como un relativo incremento en la proporción de sistemas de baja-diferenciación en la experiencia actual. Data experimental muestra que la regresión luego de una enfermedad (tensión de cabeza crónica) es seguida por la adaptación y por un incremento en la diferenciación de sistemas en aquel dominio de la experiencia, que contiene sistemas responsables para tal adaptación. Los resultados del modelo matemático sostienen la idea de que la desdiferenciación reversible puede ser uno de los mecanismos para incrementar la efectividad de la adaptación a través del aprendizaje. La desdiferenciación reversible, la cual fenomenológicamente se describe como regresión, es un mecanismo general para restructurar las interacciones entre el organismo y el medio ambiente, en situaciones en las que las conductas que eran efectivas en el pasado se vuelven ineficaces. La desdiferenciación reversible ha evolucionado como un componente de la adaptación cuando se forman nuevas conductas y se requieren modificaciones a gran escala en las conductas existentes frente a los cambios en el medio ambiente externo y/o interno. Así, los autores consideran que el artículo proporciona evidencia a la perspectiva de Jung sobre la regresión, no solamente como un 'retorno' a formas de pensar, sentir y actuar del pasado sino que los procesos regresivos proveen un estímulo significativo para el desarrollo y el crecimiento psicológico.
Assuntos
Regressão Psicológica , Adaptação Psicológica , Humanos , Teoria JunguianaRESUMO
The concept of regression is schematically reviewed, focusing on the complexities and confusions that have surrounded this contested notion in the course of psychoanalytic history. Clinical illustrations are used to suggest descriptive differences in regressive functioning occurring in the course of psychoanalysis. It is argued that there may be an important distinction between the sense-making (adaptational, maturational, and integrative) aims of therapeutic discourse and the distinctively deconstructive conditions of a psychoanalytic process. In this context, the "regressive" impact of the free-associative method is illustrated, and on this basis, it is suggested that there is a significant and profound difference between "free association" conceived simply as uncensored storytelling and "full-on free association" as closer to the babbling of a stream of consciousness.
Assuntos
Associação Livre , Teoria Psicanalítica , Terapia Psicanalítica , Regressão PsicológicaRESUMO
BACKGROUND: Phelan-McDermid syndrome (PMS) is a genetic condition characterized by intellectual disability, speech and language deficits, hypotonia, autism spectrum disorder, and epilepsy. PMS is caused by 22q13.33 deletions or mutations affecting SHANK3, which codes for a critical scaffolding protein in excitatory synapses. SHANK3 variants are also known to be associated with an increased risk for regression, as well as for psychiatric disorders, including bipolar disorder and catatonia. This study aimed to further describe these phenomena in PMS and to explore any relationship between psychiatric illness and regression after early childhood. METHODS: Thirty-eight people with PMS were recruited to this study through the Phelan-McDermid Syndrome Foundation based on caregiver report of distinct development of psychiatric symptoms. Caregivers completed a clinician-administered semi-structured interview focused on eliciting psychiatric symptomatology. Data from the PMS International Registry were used to confirm genetic diagnoses of participants and to provide a larger sample for comparison. RESULTS: The mean age of the 38 participants was 24.7 years (range = 13 to 50; SD = 10.06). Females (31 of 38 cases; 82%) and sequence variants (15 of 38 cases; 39%) were over-represented in this sample, compared to base rates in the PMS International Registry. Onset of psychiatric symptoms occurred at a mean age of 15.4 years (range = 7 to 32), with presentations marked by prominent disturbances of mood. Enduring substantial loss of functional skills after onset of psychiatric changes was seen in 25 cases (66%). Symptomst indicative of catatonia occurred in 20 cases (53%). Triggers included infections, changes in hormonal status, and stressful life events. CONCLUSIONS: This study confirms that individuals with PMS are at risk of developing severe neuropsychiatric illness in adolescence or early adulthood, including bipolar disorder, catatonia, and lasting regression of skills. These findings should increase the awareness of these phenotypes and lead to earlier diagnosis and the implementation of appropriate interventions. Our findings also highlight the importance of genetic testing in the work-up of individuals with intellectual disability and acute psychiatric illness or regression. Future research is needed to clarify the prevalence and nature of psychiatric disorders and regression among larger unbiased samples of individuals with PMS.
Assuntos
Transtornos Cromossômicos/psicologia , Transtornos Mentais/epidemiologia , Regressão Psicológica , Adolescente , Adulto , Transtorno Bipolar/epidemiologia , Catatonia/epidemiologia , Deleção Cromossômica , Cromossomos Humanos Par 22 , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fenótipo , Adulto JovemRESUMO
Drawing on Winnicott's renowned concept of regression to dependence, the author elaborates on both the creative potential and limitations of this notion, examining some theoretical and clinical contributions from his own psychoanalytic practice with neurotic and psychotic children. First, the author questions and discusses the theoretical difficulties that arise in the conception of regression to dependence. In particular, he analyses the matter of psychic temporality and passivity. Second, the author considers how analysts can receive and foster the regression to dependence, and examines the use of limited physical contact in the treatment of severely disturbed children.
Assuntos
Dependência Psicológica , Teoria Psicanalítica , Regressão Psicológica , Criança , Feminino , Humanos , Masculino , Interpretação PsicanalíticaRESUMO
This study explored regression patterns in 100 children with ASD (3-11 years) using several approaches to enhance the validity of retrospective parent report. Both early development and outcome were examined in regression groups defined by 36 months age cut-off and two underlying empirical patterns based on type and onset age. Results over regression groups were generally consistent. During early development, children with regression showed a similar amount of social atypicalities and stereotyped behaviour as compared to children without regression. However, parents indicated less communication skills which could be a valuable predictor of regression. Development after regression was characterised by early language delay and more restricted and repetitive behaviour. The findings provide insight into the diagnosis and prognosis of regression in ASD.
Assuntos
Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/psicologia , Desenvolvimento Infantil/fisiologia , Pais/psicologia , Regressão Psicológica , Idade de Início , Transtorno do Espectro Autista/terapia , Criança , Pré-Escolar , Feminino , Humanos , Transtornos do Desenvolvimento da Linguagem/diagnóstico , Transtornos do Desenvolvimento da Linguagem/psicologia , Transtornos do Desenvolvimento da Linguagem/terapia , Masculino , Estudos Retrospectivos , Comportamento Estereotipado/fisiologia , Resultado do TratamentoRESUMO
Este artigo procura expor e discutir o uso que Ferenczi faz da ideia de pulsão de morte, ainda na década de 1910. Apresentamos a história e o contexto da utilização da ideia entre os primeiros psicanalistas e, em seguida, argumentamos que a primeira hipótese do analista húngaro sobre a pulsão de morte procurava relacionar um estágio de onipotência incondicional, característico, a seu ver, da vida intrauterina, com um estado de quietude originário, uma tendência à regressão e uma concepção do narcisismo primitivo. Cada um desses aspectos é problematizado junto à teoria freudiana. Ao final, fazemos uma análise crítica da hipótese à luz das postulações de outros autores.
Este artículo busca exponer y discutir el uso que Ferenczi hace de la idea de pulsión de muerte, aún en la década de 1910. Presentamos la historia y el contexto de la utilización de la idea entre los primeros psicoanalistas y, a continuación, argumentamos que la primera hipótesis del analista húngaro sobre la pulsión de muerte buscaba relacionar una etapa de omnipotencia incondicional, característico, a su ver, de la vida intrauterina, con un estado de quietud originario, una tendencia a la regresión y una concepción del narcisismo primitivo. Cada uno de estos aspectos es problematizado junto a la teoría freudiana. Al final, hacemos un análisis crítico de la hipótesis a la luz de las postulaciones de otros autores
This article seeks to present and discuss Ferenczi's use of the idea of a death drive in the 1910s. We present the history and context of the use of the idea among the first psychoanalysts, and then argue that Ferenczi's first hypothesis on the death instinct sought to relate a stage of unconditional omnipotence, characteristic, in his view, of intrauterine life, with an original state of quietness, a tendency to regression and a conception of primitive narcissism. We then compare each one of these aspects with the Freudian theory. In conclusion, we make a critical analysis of the hypothesis using the ideas of other authors.
Assuntos
Psicanálise , Regressão PsicológicaRESUMO
It is well known that people who read print or braille sometimes make eye or finger movements against the reading direction. The way these regressions are elicited has been studied in detail by manipulating linguistic aspects of the reading material. Actually, it has been shown that reducing the physical intensity or clarity of the visual input signal can also lead to increased regressions during reading. We asked whether the same might be true in the haptic realm while reading braille. We set the height of braille dots at three different levels (high, medium, and low) and asked adult blind, practiced braille readers to read standardized texts without any repetition of content. The results show that setting the braille dot height near the tactile threshold significantly increased the frequency of regressive finger movements. Additionally, at the lowest braille dot height, braille reading speed significantly diminished. These effects did not occur at braille dot heights that were closer to the height of standard braille (medium and high). We tentatively conclude that this effect may be due to a heightened sense of uncertainty elicited by perception near the threshold that seems to be common to the reading process, independent of the sensory input modality. Furthermore, the described effect may be a feature of a brain area that contributes to the reading process mediated by vision as well as touch.
Assuntos
Cegueira/reabilitação , Leitura , Auxiliares Sensoriais , Adulto , Idoso , Cegueira/fisiopatologia , Cegueira/psicologia , Encéfalo/fisiologia , Feminino , Dedos/fisiologia , Humanos , Linguística , Masculino , Pessoa de Meia-Idade , Movimento , Regressão Psicológica , Limiar Sensorial , Tato/fisiologia , Percepção do Tato/fisiologia , Adulto JovemRESUMO
Until the last decade, studies of the timing of early symptom emergence in autism spectrum disorder (ASD) relied upon retrospective methods. Recent investigations, however, are raising significant questions about the accuracy and validity of such data. Questions about when and how behavioral signs of autism emerge may be better answered through prospective studies, in which infants are enrolled near birth and followed longitudinally until the age at which ASD can be confidently diagnosed or ruled out. This review summarizes the results of recent studies that utilized prospective methods to study infants at high risk of developing ASD due to family history. Collectively, prospective studies demonstrate that the onset of ASD involves declines in the rates of key social and communication behaviors during the first years of life for most children. This corpus of literature suggests that regressive onset patterns occur much more frequently than previously recognized and may be the rule rather than the exception.
Assuntos
Transtorno do Espectro Autista/epidemiologia , Transtorno do Espectro Autista/psicologia , Comportamento do Lactente , Regressão Psicológica , Comportamento Social , Idade de Início , Criança , Desenvolvimento Infantil , Humanos , Lactente , Estudos Prospectivos , Psicologia da Criança , Estudos Retrospectivos , Fatores de RiscoRESUMO
Machine learning approaches are increasingly used to extract patterns and insights from the ever-increasing stream of geospatial data, but current approaches may not be optimal when system behaviour is dominated by spatial or temporal context. Here, rather than amending classical machine learning, we argue that these contextual cues should be used as part of deep learning (an approach that is able to extract spatio-temporal features automatically) to gain further process understanding of Earth system science problems, improving the predictive ability of seasonal forecasting and modelling of long-range spatial connections across multiple timescales, for example. The next step will be a hybrid modelling approach, coupling physical process models with the versatility of data-driven machine learning.
Assuntos
Big Data , Simulação por Computador , Aprendizado Profundo , Ciências da Terra/métodos , Previsões/métodos , Reconhecimento Automatizado de Padrão/métodos , Reconhecimento Facial , Feminino , Mapeamento Geográfico , Humanos , Conhecimento , Regressão Psicológica , Reprodutibilidade dos Testes , Estações do Ano , Análise Espaço-Temporal , Fatores de Tempo , Tradução , Incerteza , Tempo (Meteorologia)RESUMO
Two community-based cohorts of children with autism spectrum disorder, examined using similar assessment protocols, were pooled (n = 301) and subdivided according to history of regression. Those with regression (n = 62), 20.5% of the combined cohort, were contrasted with those without regression (n = 241) at first assessment (age range 19-60 months) and at 2-year follow-up on a range of measures. The regression group was significantly more functionally impaired, with regard to intellectual function (p < .001), language development (p < .001), and to severity of autism (p < .01) at both T1 and T2. Only 14 (23.3%) had a clearly identified underlying etiology [24 (18.6%) in the non-regressive group]. There were no significant differences between those who had regressed 'from normal' and those who had regressed 'from low' functioning.
Assuntos
Transtorno do Espectro Autista/epidemiologia , Transtorno do Espectro Autista/psicologia , Desenvolvimento da Linguagem , Vigilância da População , Regressão Psicológica , Transtorno do Espectro Autista/diagnóstico , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Vigilância da População/métodos , Estudos Prospectivos , Suécia/epidemiologiaRESUMO
Jung e a Psicologia Analítica não contemplaram em profundidade o estudo da psicoterapia de grupos, tendo privilegiado o trabalho clínico individual. O presente artigo tem como objetivo principal fornecer um panorama descritivo das pesquisas sobre como a participação em pequenos grupos psicoterapêuticos pode influenciar no processo de individuação de seus membros, no referencial da Psicologia Analítica, e também, como um objetivo secundário, recapitular e confrontar com o que a literatura da área expõe sobre o tema. Para isso, foi feito num primeiro momento uma revisão estruturada, em bases de dados. Os critérios de seleção do material é que fossem artigos, em português e inglês, que tratassem do desenvolvimento da personalidade no interior de pequenos grupos de desenvolvimento pessoal, na área da psicologia analítica. Na sequência foi feita uma pesquisa não estruturada, levantando artigos frequentemente citados e também através da literatura da área e posteriormente uma revisão integrativa que aponta a dificuldade do tema no campo da psicologia analítica, especialmente pelo receio dos processos de identificação e regressão entre os membros do grupo - que para Jung operariam invariavelmente contra a individuação. Os artigos levantados questionam essa afirmação e apresentam possibilidades de desenvolvimento psíquico no interior desses grupos e correlacionam individuação com vida em sociedade. Eles também propõem métodos de psicoterapia grupal no referencial da psicologia analítica. Considera-se que pequenos grupos fazem parte do contexto de vida de qualquer indivíduo, e seu potencial para favorecer a individuação ainda precisa ser melhor compreendido.(AU)
Jung and Analytical Psychology did not contemplate in depth the study of the psychotherapy of groups, having privileged the individual psychotherapy. The main objective of this article is to provide a descriptive overview of the researches on how the participation in small psychotherapeutic groups can influence the individuation process of its members in the framework of Analytical Psychology and - as a secondary objective - to recapitulate and confront it with what the literature of the area exposes about this subject. In order to do that, a structured review was firstly carried out in the databases. The criteria for selecting the material were them to be articles, in both Portuguese and English, dealing with the development of personality, within small groups of personal development, in analytical psychology field. Secondly, an unstructured research was executed, with the examination of the most cited articles, and also a thorough search through the literature of the matter. Lastly an integrative revision was made and that signalized the difficulty of the subject in the field of analytical psychology, especially because of the fear of the processes of identification and regression between the members of the group - which for Jung would invariably work against individuation. The examined articles question this statement and present possibilities of psychic development within these groups and correlate individuation with life in society. They also propose methods of group psychotherapy in the framework of analytical psychology. Small groups are considered part of the life context of any individual, and their potential for individuation still needs to be better understood.(AU)
Jung y la Psicología Analítica no contemplaron en profundidad el estudio de la psicoterapia de los grupos, habiendo privilegiado trabajo clínico del individuo. El presente artículo tiene como objetivo principal proporcionar un panorama descriptivo de las investigaciones sobre cómo la participación en pequeños grupos psicoterapéuticos puede influir en el proceso de individuación de sus miembros, en el enfoque de la Psicología Analítica, y también, como un objetivo secundario, recapitular y confrontar con lo que la literatura del área expone sobre el tema. Para ello, se hizo en un primer momento una revisión estructurada, en bases de datos. Los criterios de selección de materiales es que fuesen artículos en portugués y inglés, que tratasen del desarrollo de la personalidad dentro de pequeños grupos de desarrollo personal en el campo de la psicología analítica. En la secuencia se realizó una investigación no estructurada, buscando artículos frecuentemente citados y también a través de la literatura del área y posteriormente una revisión integrativa que apunta la dificultad del tema en el campo de la psicología analítica, especialmente por el temor de los procesos de identificación y regresión entre los miembros del grupo - que para Jung operaría invariablemente contra la individuación. Los artículos encontrados cuestionan esa afirmación y presentan posibilidades de desarrollo psíquico en el interior de esos grupos y correlacionan individuación con vida en sociedad. También proponen métodos de psicoterapia grupal en el referencial de la psicología analítica. Se considera que pequeños grupos forman parte del contexto de vida de cualquier individuo, y su potencial para favorecer la individuación aún necesita ser mejor comprendido.(AU)
Assuntos
Psicoterapia de Grupo , Individuação , Regressão PsicológicaRESUMO
O autor examina primeiramente a ambiguidade dos conceitos de P. Marty (regressão, desorganização). Considera a necessidade da revisão do conceito de pulsão, que, tal qual concebido, explica insuficientemente as desorganizações da psicossomática. Propõe a hipótese de uma dissociação precoce entre a pulsão e o objeto nas estruturas psicossomáticas. Conclui com o exemplo de Goya, que sofreu crises somáticas que quase o levaram à morte, e sua produção das Pinturas negras, posterior a esse período
The author first examines the ambiguity in the concepts of Pierre Marty (regression, disorganisation). He considers the need to revise the concept of the drive which as it now stands, does not account well enough for disorganisations in psychosomatics. He proposes the hypothesis of an early dissociation between the drive and the object in psychosomatic structures. He concludes using the example of Goya who suffered from somatic crises which almost killed him, afterwards leading him to produce the Black paintings
El autor destaca en primer lugar la ambigüedad de los conceptos de Pierre Marty (regresión, desorganización) y contempla la necesidad de revisar el concepto de pulsión que, tal cual, no refleja las desorganizaciones de la psicosomática. Propone la hipótesis de una disociación precoz entre la pulsión y el objeto en las estructuras psicosomáticas. Concluye con el ejemplo de Goya y las crisis de somatización que le llevaron al borde de la muerte y desembocaron en la producción de las Pinturas negras
Assuntos
Regressão Psicológica , Apego ao ObjetoRESUMO
The way in which the behavioral manifestations of autism spectrum disorder (ASD) emerge in infancy is variable. Regression-loss of previously acquired skills-occurs in a subset of children. However, the etiology and significance of regression remains unclear. Until recently, investigation of regression relied on retrospective report by parents or examination of home videos from early in life. However, home videos and retrospective report of the nature and timing of regression, and association with factors such as illness or immunization, is potentially subject to bias. The advent of prospective studies of infant siblings at familial high-risk of ASD has the potential to document regression as it occurs. Recent research has suggested that subtle loss of skills occurs in a larger proportion of children with ASD than previously assumed; however, there are few reports of clear-cut regressions, such as that involving dramatic loss of language and other established skills, in the prospective literature. This could be because of the following: clear-cut regression occurs less commonly than parent report suggests, study design limits the potential to detect regression, or there are differences between multiplex and simplex families in the rate of de novo genetic mutations and therefore regression risk. This review will bring together literature from retrospective and prospective research and attempt to reconcile diverging findings, with a specific focus on methodological issues. Changing conceptualizations of regression will be discussed, as well as etiological factors that may be associated with regression. The main challenges that need to be addressed to measure regression in prospective studies will be set out. Autism Research 2018, 11: 1602-1620. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Regression-a loss of previously established skills-occurs in a subset of children with ASD. Parental recall is not always accurate but studying younger siblings of children with ASD, 10-20% of whom will develop ASD, should make it possible to measure regression as it occurs. Clear-cut regression, like loss of language, has not often been reported in infant sibling studies, but recent research suggests that gradual loss of social engagement might be more common. This review looks at the evidence for regression from infant sibling studies and asks how study design affects the likelihood of capturing regression.