Ideación y conducta suicida en contexto clínico asistencial
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2023
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24/01/2023
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Universidad Complutense de Madrid
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Abstract
La conducta suicida es un concepto complejo, de enorme relevancia social y sanitaria que ha cobrado un renovado interés a consecuencia del aumento de suicidios consumados e intentos en los últimos años (INE, 2021). El continuo suicida (ideación, planificación, intentos suicidas y suicidios consumados) hace referencia al carácter multidimensional del fenómeno (Kessler et al., 1999; May & Klonsky, 2016), con diversos factores de riesgo que median tanto en la aparición de las ideas suicidas como en su transición a las tentativas suicidas. Tomando como referencia la propuesta de Acosta & Borrego (2014), estos factores pueden ser: personales (edad, sexo o nivel socioeconómico), clínicos (trastornos psicológicos, intentos de suicidio previos o factores psicológicos relacionados), contextuales (crisis socioeconómicas) y socio-situacionales (situación laboral, estado civil o redes de apoyo), afectando todos ellos de manera diferente al bienestar psicológico. Existen modelos explicativos del desarrollo de la conducta suicida que enfatizan en la importancia de la interacción entre diferentes variables, como el dolor, la desesperanza, la despertenencia, la desconexión social o la capacidad adquirida, para que esto ocurra. Estos modelos teóricos parten del supuesto de “trastorno latente común” (Borsboom & Cramer, 2013), en el que los síntomas son consecuencias de una causa “interna”, con limitaciones al conducir a razonamientos tautológicos. Los modelos de redes aplicados a la psicopatología, al concebir los síntomas como redes que se relacionan entre sí de forma causal, intentan superar las limitaciones propias del modelo categorial e impulsar una nueva vía de explorar y desarrollar hipótesis...
Suicidal behaviour is a complex concept of enormous social and health relevance that has gained renewed interest as a result of the increase in completed and attempted suicides in recent years (INE, 2021). The suicidal continuum (ideation, planning, suicide attempts and completed suicides) refers to the multidimensional nature of the phenomenon (Kessler et al., 1999; May & Klonsky, 2016), with several risk factors that mediate both in the appearance of suicidal ideas and their transition to suicide attempts. These factors can be (Acosta & Borrego, 2014): personal (age, sex or socioeconomic level), clinical (psychological disorders, previous suicide attempts or related psychological factors), contextual (socioeconomic crisis) and socio-situational (employment, marital status or support networks), all of which affect psychological well-being in a different manner. There are explanatory models of the development of suicidal behaviour that emphasize the importance of the interaction between different variables, such as pain, hopelessness, lack of a sense of belonging, social disconnection or acquired capacity, for this to happen. These theoretical models are based on the "common latent disorder" model (Borsboom & Cramer, 2013), in which symptoms are consequences of a latent cause, which present limitations by leading to tautological reasoning. By conceiving symptoms as networks that are causally related to each other, network models applied to psychopathology try to overcome the limitations of the categorical model and promote a new way of exploring and developing hypotheses...
Suicidal behaviour is a complex concept of enormous social and health relevance that has gained renewed interest as a result of the increase in completed and attempted suicides in recent years (INE, 2021). The suicidal continuum (ideation, planning, suicide attempts and completed suicides) refers to the multidimensional nature of the phenomenon (Kessler et al., 1999; May & Klonsky, 2016), with several risk factors that mediate both in the appearance of suicidal ideas and their transition to suicide attempts. These factors can be (Acosta & Borrego, 2014): personal (age, sex or socioeconomic level), clinical (psychological disorders, previous suicide attempts or related psychological factors), contextual (socioeconomic crisis) and socio-situational (employment, marital status or support networks), all of which affect psychological well-being in a different manner. There are explanatory models of the development of suicidal behaviour that emphasize the importance of the interaction between different variables, such as pain, hopelessness, lack of a sense of belonging, social disconnection or acquired capacity, for this to happen. These theoretical models are based on the "common latent disorder" model (Borsboom & Cramer, 2013), in which symptoms are consequences of a latent cause, which present limitations by leading to tautological reasoning. By conceiving symptoms as networks that are causally related to each other, network models applied to psychopathology try to overcome the limitations of the categorical model and promote a new way of exploring and developing hypotheses...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Psicología, leída el 24-01-2023