3.03 Tesis doctorado

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Adolescent Life Satisfaction and Its Relationship with Triadic Family Interactions and Mental Health
(2022) Álvarez Kozubová, Karla; Olhaberry Huber, Marcia; Širová, Eva; Pontificia Universidad Católica de Chile. Escuela de Psicología
Adolescents experience changes, discomfort and increased risk of psychopathology (Vicente et al., 2012), whose approach has been insufficient from the perspective focused on vulnerability/risk. The multidimensional perspective of health that considers protective and opportunity factors of development (Steinberg, 2014) becomes important. Subjective well-being (SWB) has been positioned as a multidimensional health assessment (Suldo & Shaffer, 2008), and the life satisfaction construct (LS) (Diener et al., 1985) as the most stable measure of SWB in constituting the overall judgment of the adolescents regarding their lives and the achievement of their aspirations, values and interests influenced by culture (Eid & Diener, 2004; Maddux, 2018; Seligman, 2011) in addition to their discomfort or symptoms. Objectives: to assess the relationship between life satisfaction, quality of triadic interactions (QIT) and mental health (MH) characteristics (risk and protection) in two groups of Chilean adolescents. Method: casecontrol study (Case: 30 triads with adolescent receiving care in mental health and Control: 15 triads with adolescent not receiving), non-experimental, cross-sectional with correlational analysis. Measurement with self-report and observational methodology was used (Satisfaction with Life Scale Adapted for Children, Family APGAR, Parenting Alliance Inventory, Relationship Assessment Scale, Strengths and Difficulties Questionnaire, Millon Adolescent Clinical Inventory, KIDSCREEN-52, Survey of Variables Associated with Life Satisfaction and Lausanne Trilogue Play). Results: in the case group, adolescents self-reported significantly lower LS and lower perception of protective mental health factors, higher levels of internalizing and externalizing problems, and on average, each adolescent reported more expressed concerns, clinical syndromes and personality prototypes. The QTI, triad structure and dynamics, and co-parenting observed were significantly lower. Meanwhile, triad involvement and adolescent 14 engagement was similar in both groups. Self-reported co-parenting was significantly different between mothers and fathers in each case triad, and mothers were less satisfied in the co-parenting and couple relationship domain than controls. The relationship between adolescent APGAR and that of their respective father figure was inverse in both groups. Case group adolescent LS correlated negatively with emotional and peer problems and in both groups with depressive affect and personality traits in the pain and dependency polarities. Meanwhile, in both groups, the association between LS, adolescent APGAR and protective factors such as physical and psychological well-being, family, school and peer relationships, etc. was positive. In the case group, LS correlated positively with the ability of the triad to co-construct and focus on a task (LTP). The group variable contributed 9.8% of the variance of LS, and the multivariate model implemented with adolescent, father, mother and group APGARs, 52%, without maternal perception being significant. Discussion: evaluating LS, from a context of triadic interactions, with observational LTP methodology in middle adolescence and case-control design, places this study as a pioneer. It is suggested to replicate the study, correcting its limitations, mainly the sample size. In addition, the results on the inverse relationship between paternal perception of the family, co-parenting and couple and adolescent LS should be considered. All of the above will make it possible to strengthen the conclusions and guide prevention and intervention strategies, reinforcing co-parenting in families with adolescent children.
Análisis de episodios y momentos de cambio relacional en terapia de pareja: una propuesta de indicadores genéricos de cambio relacional
(2022) Díaz Dosque, Carmen Gloria; Rivera, Diana; Pontificia Universidad Católica de Chile. Escuela de Psicología
La investigación en Terapia de Pareja se ha centrado en estudios clínicos que permitan medir la eficacia de estas intervenciones, no solo en su objetivo principal, que es la mejoría de la satisfacción de la relación de pareja, sino que también en el tratamiento de diversas problemáticas de salud. A pesar de sus avances en esta área, aún quedan muchas interrogantes, respecto al proceso de cambio que lleva a estos resultados, de allí que surge la necesidad de investigar sobre Episodios y Momentos de Cambio en la relación de pareja. Debido a esto, se desarrolla esta investigación exploratoria descriptiva de casos múltiples de terapia de pareja que caracteriza los contenidos y curso del cambio individual en cada uno de los miembros de la pareja, a través de los Indicadores Genéricos de Cambio, en sesiones de Terapia de Pareja y proponer un listado de Indicadores de Cambio Relacional para Terapia de Pareja a partir de la observación y análisis de cuatro terapias. La metodología del estudio consideró la estructura y secuencia de la Investigación Consensual Cualitativa para el estudio de Casos. Los principales resultados son la distinción entre Momentos de Preparación para el Cambio Relacional y Cambio Relacional, y la necesidad de evaluar metodologías que permitan medir el cambio individual en terapia de pareja. Se concluye, por una parte, que los IGC no es una metodología apropiada para investigar el cambio individual en terapia de pareja, dado lo poco concluyente de los datos, y lo recogido en la literatura que destaca que el cambio debe ser estudiado desde una perspectiva sistémica que considere el contexto relacional en que se realiza la intervención. Finalmente, se presenta una Propuesta de Indicadores Genéricos de Cambio Relacional para Terapia de Pareja.
Efectos de la jornada laboral en el desempeño de operadores expertos en sistemas con altas exigencias de seguridad : una aproximación neuroergonómica
(2022) Álvarez Ruf, Joel Esteban; Rodríguez B., Eugenio; Pontificia Universidad Católica de Chile. Escuela de Psicología
Introducción: Un puesto laboral de alta demanda cognitiva es el de los controladores de tránsito aéreo (CTA). El factor temporal de sus respuestas es crítico para la seguridad operacional en aeronáutica. Considerando el trabajo de los CTA, la fatiga mental es esperable y de alto riesgo. Sin embargo, en la literatura revisada no se ha reportado un modelamiento de los efectos de la fatiga mental producida de manera natural por la jornada laboral sobre el desempeño neuroergonómico de los CTA. Métodos: Cuantificación antes y después de turno de 12 horas de variabilidad de la frecuencia cardiaca (HRV), control postural (CP), somnolencia y ansiedad. Se realizo análisis de cuantificación de recurrencia para HRV y CP. Resultados: HRV y CP se comportaron de forma más dinámica al final del turno de manera significativa. La ansiedad aumento significativamente y no se observaron cambios en la somnolencia. Conclusiones: La jornada laboral de 12 horas influyo en el nivel de estado de ansiedad y comportamiento dinámico de la HRV y CP. La preferencia matutina aparece como un factor protector frente a la somnolencia. En general lo resultados aportan al sustento del modelo de U-Invertida entre estrés o nivel de excitación y desempeño humano.
Experiencias y significados asociados a las transiciones y las relaciones familiares en el período postdevelación del abuso sexual infantil intrafamiliar, desde las narrativas de figuras parentales y hermanos no ofensores
(2023) Latorre Latorre, María Soledad; Cornejo Cancino, Marcela; Pontificia Universidad Católica de Chile. Escuela de Psicología
La presente investigación aborda el fenómeno del abuso sexual infantil, el cual es una problemática social y de salud pública (Collin-Vézina et al., 2013; Mathews & Collin-Vézina, 2019; OMS, 2020), que significa una violación de los derechos humanos de los niños, niñas y adolescentes víctimas (INDH, 2018). Su alcance trasciende a las víctimas directas e impacta a sus familiares y figuras significativas de sus entornos.
Guided internet-based intervention for postpartum depression symptoms: Development and feasibility trial
(2024) Franco Vivanco, Pamela Verónica; Olhaberry Huber, Marcia; Pontificia Universidad Católica de Chile. Escuela de Psicología
Postpartum depression (PPD) represents a significant concern in Chile due to its high prevalence and considerable treatment gap. Amidst this challenge, the prevalent use of digital technologies and parenting applications offers new avenues for delivering Internet-based psychological interventions (IBIs), which have shown effectiveness in mitigating depression symptoms and hold potential for addressing PPD. This doctoral thesis project embarked on developing and assessing an IBI tailored for PPD, named “Mamá, te entiendo” (“Mom, I get you”). This 8-week guided intervention, aiming to diminish depressive symptoms among postpartum women, is rooted in cognitive-behavioral therapy, incorporating insights from mentalization and attachment theories, and delivered through a web app. Developed in line with the CeHRes Roadmap framework, this human-centered approach involved a systematic review, online surveys, focus groups, usability tests, interviews, and a technical pilot for its creation. To assess the intervention’s feasibility, acceptability, and preliminary efficacy, a pilot randomized controlled trial with 65 postpartum women diagnosed with minor to major depression was conducted. Participants were allocated to either the intervention or a waitlist control group, with assessments at the baseline, post-intervention (8 weeks), and one-month post-intervention (12 weeks). This mixed-methods approach combined quantitative and qualitative analyses to gain insights into participant experiences. Primary outcomes focused on feasibility and acceptability measures like recruitment rates, attrition, and participant satisfaction and engagement. Secondary outcomes examined depression symptoms, perceived social support, mother-infant bonding, and maternal self-efficacy. “Mamá, te entiendo” showed promising feasibility and acceptability, characterized by high satisfaction and engagement levels, although adherence posed a challenge. Participants highlighted several strengths: emotional support, beneficial content, practical exercises, empathetic e-coach feedback, and a user-friendly interface. However, some faced barriers like extensive texts, difficulty tracking progress, and time constraints. Initial efficacy findings indicated no significant differences across outcomes between the intervention and control groups. Nonetheless, both groups experienced improvements in PPD symptoms, mother-infant bonding, and maternal self-efficacy, which could be attributed to spontaneous recovery or concurrent mental health treatments. This study marks the first attempt in Chile to evaluate a psychological IBI for PPD symptoms, underscoring the potential and acceptability of technology-driven mental health solutions.
Parental personality traits and emotion regulation difficulties: their relationship with early triadic interactions and infant’s socioemotional development
(2024) Muzard Costa, Antonia María; Olhaberry Huber, Marcia; Pontificia Universidad Católica de Chile. Escuela de Psicología
Background: socioemotional development is a pivotal aspect of human life, particularly during infancy, and is intricately woven within the personal and interpersonal dynamics of caregiver- infant interactions. This longitudinal study represents a pioneering exploration into the associations between mothers’ and fathers’ personality traits, emotion regulation difficulties, triadic interactions, and infants’ socioemotional development during the perinatal period. Objective: The primary objective was to investigate the complex interplay between parental personality traits and emotion regulation difficulties in mother-father-baby triads with its impact on early triadic interactions and infants’ socioemotional development. Methods: In this non-experimental, longitudinal study, 55 Chilean mother-father-baby triads were assessed from pregnancy until infant’s sixth month after birth. Additionally, parental levels of personality functioning, relationship satisfaction, depressive symptomatology and childhood adverse experiences were considered as potential covariables. Results: Findings revealed that maternal and paternal attributes have particular predictive values and exert distinct influences on both triadic interactions as well as infant’s socioemotional development from pregnancy until infants’ 6-months postpartum. Notably, maternal emotionality and paternal agreeableness, as well as both significant caregiver’s emotion regulation difficulties emerged as significant factors when fostering collaborative triadic interactions and enhancing infant’s socioemotional development. Additionally, when cofounding variables were included, maternal depressive symptomatology emerged as a significant predictor of infant’s socioemotional difficulties at 6-months postpartum. Moreover, the study highlights the moderating role of triadic interactions, emphasizing their significance in influencing the relationship between maternal emotion regulation difficulties and infant’s socioemotional development. Discussion: This research stresses the need for a comprehensive longitudinal perspective in understanding the impact of significant caregivers’ characteristics upon early triadic interactions and infant’s socioemotional development. Therefore, it acknowledges the unique dynamics of the perinatal period, while considering the individualities within each family triad which is crucial for unraveling the complexities inherent in the intricate fabric of family relationships and infant’s socioemotional development.
Psychotherapeutic work focused on structural personality functioning deficits : systematization of tools for clinical practice
(2022) Gómez-Barris Chandía, Elyna; Krause Jacob, Mariane; Pontificia Universidad Católica de Chile. Escuela de Psicología
Background: Psychotherapists working in institutional contexts, especially in public health centers, must quickly resolve cases of multiple levels of severity due to the high demand for care and multiple obstacles that make long treatments unfeasible. Focal psychotherapy makes it possible to abbreviate treatments, but it is difficult to implement in patients with personality functioning difficulties. Objective: To propose an operational system of psychotherapeutic tools focused on structural personality functioning deficits, incorporating the perspectives of specialists and the analysis of video-recorded psychotherapy sessions. Methodology: Two qualitative studies were implemented: first, an open-coding analysis to determine and classify the therapeutic guidelines of the Manual of Structure-Oriented Psycho-therapy (Rudolf, 2013) and those obtained from interviews with specialists in the Operationalized Psychodynamic Diagnosis System (OPD-2); second, a study consisting in the observation of 45 psychotherapy sessions to identify and characterize the psychotherapeutic guidelines and interventions categorized earlier and create new interventions not considered in the first study. The results of both studies were integrated to develop an operational system of psychotherapeutic tools. Results: The operational system of psychotherapeutic tools developed comprises three levels and features the characterization of six Therapeutic Principles, 33 Therapeutic Guidelines, and 59 Therapeutic Interventions with their respective clinical examples. The system is characterized by the presence of common factors for an effective psychotherapy and elements that typify supportive therapies, complemented with specific components for dealing with structural deficits susceptible of modularization. Conclusions: The system is expected to allow practitioners to work focally with patients with a wide range of structural deficits of multiple levels of severity. The clinical tools proposed are flexible enough and include the necessary components to be well received by professionals from a wide range of clinical training backgrounds and be implemented as an initial approach within a tiered treatment system for personality problems.
The experience of social status in a Chilean sample as a predictor of health outcomes
(2024) Rodríguez González, Laura Cristina; Repetto Lisboa, Paula Beatriz; Pontificia Universidad Católica de Chile. Escuela de Psicología
This dissertation explores the complex relationship between social status and health outcomes within a Chilean sample, offering a comprehensive examination of the status syndrome proposed by Michael Marmot. The research adopts a multidisciplinary approach to investigate how the psychological experience of social status, particularly autonomy and social integration, influences physiological stress markers. The dissertation comprises two empirical studies and a theoretical discussion presented in three manuscripts.The first manuscript provides a theoretical exploration linking the status syndrome with Self-Determination Theory (SDT). By integrating concepts of autonomy and social integration from the Capability Approach with the basic psychological needs posited by SDT. In addition, this manuscript proposes a structured intervention model aimed at enhancing well-being through health promotion strategies tailored to individuals' social contexts. The second manuscript focuses on adapting and validating a measurement instrument assessing the perception of economic inequality within the Chilean context.The third manuscript empirically investigates the association between social status experiences and cardiovascular health markers, specifically blood pressure and C-reactive protein (CRP) levels. This study builds on the work of Seeman et al. (2014), which measured generalized control and social integration in relation to allostatic load, by incorporating negative affectivity as a critical component of the status syndrome. Collectively, this dissertation raises important questions about the status syndrome and underscores the need to further explore its mechanisms, particularly in diverse populations and healthcare contexts. Understanding these complexities is crucial for informing population health interventions and addressing less visible health indicators that exert a detrimental effect on health.
Vivencias subjetivas de enfermedad en pacientes con epilepsia generalizada con crisis tónico clónicas y su relación con el proceso de construcción de la identidad personal
(2023) Rossi Mery, José Luis; Behn Berliner, Alex Joseph; Pontificia Universidad Católica de Chile. Escuela de Psicología
Introducción. Vivir epilepsia se asocia en general con una percepción de estigma social, especialmente en presencia de afectos negativos y problemas de autoestima. Los factores psicosociales adversos están entre los que con más frecuencia suelen desencadenar las manifestaciones agudas de la epilepsia. Además, son escasos los estudios que abordan aspectos psicológicos de la epilepsia, como por ejemplo el posible impacto que la enfermedad puede tener en el desarrollo de la personalidad y la identidad personal. Objetivo. Describir las vivencias subjetivas en pacientes con epilepsia generalizada con crisis tónico clónicas, en relación a la experiencia de enfermedad y su potencial impacto en el proceso de construcción de la identidad personal. Método. Se realizó una investigación con enfoque cualitativo, de tipo exploratorio, descriptivo y transversal. Se estudió una muestra de 16 pacientes adultos, con epilepsia generalizada con crisis tónico clónicas, provenientes de 2 centros clínicos de la Región Metropolitana. Para garantizar los criterios de inclusión, se realizó un tamizaje en base a los cuestionarios MMSE, MINI y OPD-SQ y posteriormente, se utilizó una entrevista semi estructurada como principal instrumento de recolección de datos. Para cada entrevista se realizó un proceso de codificación abierta, selectiva y axial. Posteriormente, se realizó un análisis narrativo de tipo temático, en base a los objetivos específicos de la investigación. Resultados. En base a las narrativas de los participantes, fue posible establecer una relación entre las vivencias subjetivas de enfermedad y la identidad de los pacientes. Se evidencia una relación negativa entre las vivencias subjetivas de la enfermedad y el proceso de construcción de la identidad personal, identificando temas centrales en torno a la “limitación”, la vivencia de ser “diferentes” y percibir una identidad “frágil”. Estas vivencias se relacionaron con las diversas repercusiones psicosociales de la enfermedad. Se identifican además estrategias de afrontamiento, tales como el escape/evitación y la sobrecompensación, que pueden tener un impacto potencialmente disfuncional para la construcción de una identidad saludable y el desarrollo de trastornos emocionales comórbidos. Discusión. Los resultados revelan una percepción negativa de la enfermedad en el proceso de construcción de la identidad de los pacientes, que sugieren que las intervenciones farmacológicas deben ser complementadas con estrategias psicosociales de tratamiento. Se sugiere una aproximación teórica y clínica al estudio de la identidad en los pacientes con epilepsia, con el objetivo desarrollar dispositivos de intervención centrados en el abordaje de la experiencia subjetiva de los pacientes, mejorar su calidad de vida y prevenir el desarrollo de psicopatología comórbida. Finalmente se proponen futuras líneas de investigación, que permitan establecer diferencias por variables sociodemográficas, y variables clínicas. Se considera también la potencial relevancia clínica de los hallazgos para el diseño de intervenciones psicosociales y psicoterapéuticas centradas en el abordaje de la identidad de las personas con epilepsia.

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