3.02 Facultad de Medicina

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Browsing 3.02 Facultad de Medicina by Subject "150"

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    Abordaje y tratamiento de la disforia de género en niños preadolescentes : visiones antropológicas y algunas consideraciones éticas.
    (2019) Cox Cruzat, Paula; Carrasco, Alejandra; Pontificia Universidad Católica de Chile. Facultad de Medicina
    La Asociación Americana de Psiquiatría define la Disforia de Género como una marcada incongruencia entre el sexo que uno siente o expresa y el que se le asigna al nacer, asociado a un malestar clínicamente significativo o deterioro en lo social, pudiendo darse en niños, adolescentes y adultos. En relación a los pacientes pediátricos, no existe actualmente un completo consenso en su tratamiento, así como tampoco evidencia que apoye claramente un enfoque por sobre otro. En la literatura se describen principalmente tres tipos de abordajes en niños preadolescentes: “modelo terapéutico”, “watchful waiting” (espera atenta) y “modelo afirmativo”. La decisión de un profesional de la salud de adoptar un determinado enfoque está influenciada por la visión antropológica que posea y no solo por la evidencia disponible. En este trabajo se realiza una breve revisión de la literatura existente sobre la disforia de género, se describen los tres abordajes en niños y se analizan las visiones antropológicas que los sustentan. En los distintos modelos de abordaje se pueden distinguir diferentes concepciones sobre la relación sexo-género en la persona (completa separación o coimplicancia), derivando así en dos visiones antropológicas (dualismo o unidad del hombre). Es imprescindible que los profesionales reflexionen sobre las visiones que dirigen su actuar y las conversen con los pacientes y familias, para que puedan tomar una decisión informada, conscientes de las limitaciones de cada enfoque, de la visión antropológica que les subyace, y de las reales posibilidades de los tratamientos ofrecidos, siempre orientados a lo mejor para el niño.
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    Children's sociemotional development at 12 and 30 months and its relationship with mother's mentalization : comparison of chilean and U.S. mothers
    (2018) Espinoza Díaz, Nancy Alejandra; Farkas K., Chamarrita; Pontificia Universidad Católica de Chile. Escuela de Psicología; Universidad de Chile. Facultad de Medicina
    Socio-emotional development refers to the ability of infants to regulate their emotions and behavior in order to adapt to the world in which they live. It is a complex process that requires the conjugation of biological mechanisms of the infant him/herself, and the context where development unfolds. In order to achieve an adequate socio-emotional development, the quality of the primary bond relationships is fundamental. However, a competence that has not been studied is the capacity of mothers to perceive their children, at 12 months, as individuals with minds, through the mentalizing language that they use in the interaction, and the impact they have on their children's socio-emotional development at 12 and 30 months, in different contexts. The objective of this research was to describe the relationship between the socioemotional development of infants at 12 and 30 months of age and the mentalization capacity of mothers in Chilean and US dyads. In order to achieve the proposed objective, a quantitative methodology, with a non-experimental and longitudinal design, was used. The sample consisted of 142 mother-child dyads, 90 Chilean and 52 US. The instruments used were the assessment standard of Mentalization in the adult and The Bayley Scales of Infant and Toddler Development, Third Edition. The results showed that there are significant differences in the increment of socio-emotional child development according to country; however, the maternal educational level mediates these differences. Significant differences were observed between the type of mentalizing language used by Chilean and US mothers, that is, the study suggests the existence of specificity related to the context. Finally, the relationship between mentalizing language and socio-emotional development is confirmed, finding that talking about emotions at 12 months is significantly associated with socioemotional development at 30 months.
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    Episodes of meeting as relevant episodes for the study of change in psychoterapy
    (2017) Duarte Soto, Javiera; Martínez Guzmán, Claudio; Pontificia Universidad Católica de Chile. Escuela de Psicología; Universidad de Chile. Facultad de Medicina
    The study of the change process in psychotherapy has advanced considerably during the last 30 years, focusing its efforts on the study of relevant intra-session episodes in order to contribute to a better understanding of psychotherapy and how change occurs. Although there are different conceptualizations of relevant episodes, up to the present, the different episodes developed and the conception of change that emerges from each one, have focused mainly on the patient, neglecting the dyadic and relational aspects of the therapeutic process, which emphasize that new experiences of relationship with the therapist would be the essence of change. In this line an approach to relevant episodes, which includes change in psychotherapy as a relational and interactive phenomenon between patient and therapist, is that of Daniel Stern and the Boston Group (1998, 2004) which propose moments of meeting in psychotherapy as central moments for reorganizing the patient’s implicit relational knowing. However, despite its theoretical solidity, this approach lacks empirical systematization, which hinders its study. The aim of this dissertation was to design a procedure for identifying and outlining episodes of meeting between therapist and patient during the psychotherapeutic process and to establish the main characteristics (verbal, non-verbal and relational) of the interaction between patient and therapist during its occurrence. This descriptive-relational exploratory study was based on a qualitative methodological approach, that combined grounded theory with a phenomenological approach called the micro analytic interview. Eight therapeutic dyads, thirteen therapists, nine patients and five experts were interviewed to approach this phenomenon from different perspectives and grasp its central features. This thesis is considered relevant as it is a contribution for the investigation of the psychotherapeutic process and for clinical practice.
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    Impacto subjetivo del éxito y fracaso terapéutico sobre las vivencias de bienestar/malestar del terapeuta
    (2018) Fischersworring, Martina María; Krause Jacob, Mariane; Pontificia Universidad Católica de Chile. Escuela de Psicología; Universidad de Chile. Facultad de Medicina
    En la presente investigación se buscó indagar en el impacto que tiene el quehacer profesional en los terapeutas, teniendo por objetivo reconstruir la relación entre las experiencias de éxito y fracaso y el bienestar/malestar subjetivo en terapeutas chilenos y alemanes en diferentes etapas de su desarrollo profesional. Esta investigación de metodología cualitativa y de corte transversal utilizó el método de análisis narrativo orientado al descubrimiento (Duarte, Fischersworring, Martínez & Tomicic, 2017). Se realizaron dos estudios con perspectivas complementarias, con un total de 35 entrevistas realizadas a terapeutas chilenos y alemanes en diferentes etapas de su desarrollo profesional. El desarrollo profesional se produce en gran medida en torno a las experiencias del terapeuta vinculadas al quehacer terapéutico y al manejo de éstas. Tanto en las experiencias de éxito y fracaso, como en el manejo que se le da, se manifiesta el aspecto cultural del desarrollo profesional; en tanto los contextos en los que se realizan las experiencias con los pacientes se vinculan al desarrollo de una identidad profesional. Por otro lado, las vivencias de bienestar y malestar están vinculadas a las experiencias de trabajo con los pacientes y a la relación con los mismos, siendo la percepción de cambio que tiene el terapeuta del paciente un elemento central. Los resultados se discuten a la luz de la evidencia tanto en torno al desarrollo profesional como también de los efectos del terapeuta.
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    Manifestations of silences in therapist-patient interaction and the psychotherapeutic process
    (2018) Guzmán Sánchez, Marcela Fernanda; Martínez Guzmán, Claudio; Pontificia Universidad Católica de Chile. Facultad de Medicina
    This research addresses the manifestations of silences in the therapist-patient interaction and along the psychotherapeutic process. It is intended to establish the participation of silences in several forms of interaction between patient and therapist and also through out the sessions of a long-term therapy. To achieve these objectives, a mixed methodology, consisting of two sequential studies. To achieve these goals, was created a Coding System of Silences for Therapists and Patients (PICS-TP), based on the adaptation of a coding system of silences for patients in psychotherapy, and created categories of silences for therapists. A study of the reliability of the PICS-TP from the encoding of a long-term therapy psychodynamic counselling. Results of descriptive and inferential statistical analysis are presented. Those results allow to set and describe characteristics of the participation of silences between patient and therapist and the psychotherapeutic process. The central points of the discussion and conclusion indicate that it was not possible to determine strategies for the participation of the silences that were statistically significant, with good predictive and explanatory properties. However, it exposed the strengths and contributions possible PICS-TP, emphasizing its descriptive results of the types of silences in types of interactive scenarios and results obtained by actor (therapist or patient), as well as their potential contribution to the training of therapists in training.