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2002, Número 4

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Salud Mental 2002; 25 (4)


Percepción del dolor en el síndrome de comportamiento autolesivo

Mendoza Y, Pellicer F

Idioma: Español
Referencias bibliográficas: 70
Paginas: 10-16
Archivo PDF: 366.15 Kb.


RESUMEN

Un fenómeno frecuente y de difícil tratamiento en los pacientes psiquiátricos es el daño físico directo e intencional causado por conductas autolesivas que no se efectúan con una finalidad suicida. La conducta se puede presentar eventualmente en padecimientos psiquiátricos como estados depresivos o psicóticos. Sin embargo, cuando se presenta de manera frecuente, constituye lo que se denomina el síndrome de autolesión deliberada que se puede observar en pacientes con retraso mental y trastornos de personalidad. Este trabajo sustenta una implicación de las estructuras límbicas que procesan el componente cognoscitivo-afectivo del dolor en el desarrollo del comportamiento autolesivo (CAL). Proponemos que el CAL resulta de una disfunción en la percepción nociceptiva, particularmente en los mecanismos de alto orden de procesamiento, donde se integra el dolor como una experiencia consciente y se conceptúa como sensación desagradable. Suponemos que esta alteración en la percepción nociceptiva puede considerarse como una consecuencia, manifestación o síntoma, de una anomalía en la percepción de sí mismo. La alteración en la percepción nociceptiva y en la percepción de sí mismo, resultaría, en algunos casos, de la incidencia de factores ambientales desfavorables en personas biológicamente vulnerables, mientras que en otros, sería la anomalía biológica la determinante de la conducta.
Se ha encontrado una asociación entre la incapacidad de reconocer estímulos nociceptivos y la presencia de fenómenos disociativos. Esto ejemplifica la forma en que una respuesta altamente especializada y adaptativa en sujetos sanos ante condiciones amenazantes podría originar, de manera paradójica, conductas poco adaptativas. Los sujetos expuestos de manera crónica a situaciones amenazantes en edades tempranas, son susceptibles de desarrollar un patrón de respuesta patológico que podría poner en riesgo su vida.


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