Actualización de un modelo tentativo del mutismo selectivo

  1. Pablo J. Olivares-Olivares 1
  2. José Olivares Rodríguez 1
  1. 1 Universidad de Murcia
    info

    Universidad de Murcia

    Murcia, España

    ROR https://ror.org/03p3aeb86

Revista:
Psicología conductual = behavioral psychology: Revista internacional de psicología clínica y de la salud

ISSN: 1132-9483

Año de publicación: 2018

Volumen: 26

Número: 1

Páginas: 115-140

Tipo: Artículo

DIALNET GOOGLE SCHOLAR

Otras publicaciones en: Psicología conductual = behavioral psychology: Revista internacional de psicología clínica y de la salud

Resumen

El mutismo selectivo es un trastorno del comportamiento infanto-juvenil de inicio temprano (generalmente entre los 3 y los 5 años) que consiste en la resistencia al habla o su inhibición en situaciones sociales concretas, caracterizadas por la presencia de extraños, personas a las que no se habla o a las que se ha dejado de hablar, lugares en los que no se habla o donde el niño piensa que puede ser escuchado por quien no quiere, etc. Su escasa prevalencia lo convierte en un trastorno de la conducta raro y la revisión de la literatura confirma que la ansiedad es la alteración prominente en quienes lo presentan, lo que ha llevado a que en la última edición del Manual diagnóstico y estadístico de los trastornos mentales (Asociación Americana de Psiquiatría, DSM-5; APA, 2013) haya sido reclasificado como un trastorno de ansiedad. Este hecho, así como los avances en su investigación y los retos que estos plantean respecto de su evaluación y tratamiento hacen necesaria una revisión y actualización de las propuestas explicativas existentes. Este es el marco en el que se inserta el trabajo que presentamos.

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Variables no evolutivas. Incluimos las alteraciones del funcionamiento biológico (estructurales como el daño cerebral o sistémicas como los desequilibrios bioquímicos) y los fenómenos asociados con el temperamento (Rothbart y Bates, 2007) que, salvo excepción, no remiten espontáneamente e incrementan la vulnerabilidad para presentar MS. Postulamos un papel relevante para (i) los trastornos del neurodesarrollo (Kolvin y Fundudis, 1981; Nowakowski et al. 2009; Steinhausen y Juzi, 1996), especialmente los que afectan el habla y el lenguaje, los implicados en el retraso general y las alteraciones neurológicas que alteran la interacción sistemática entre los mecanismos del habla y la audición (Muris y Ollendick, 2015); (ii) las variables de base biológica presentes en las diferencias individuales, que intervienen en la regulación de la reactividad emocional como precursoras de la ansiedad (inhibición conductual [IC], temperamento temeroso y timidez; véase García-Coll, Kagan y Reznick, 1984 y Möller, Nikolić, Majdandžić y Bögels, 2016). Con relación al alcance del efecto del temperamento asumimos que los cambios en su expresión temprana están mediados por el modo de interactuar de/con la figura de apego; los datos muestran una asociación longitudinal clara (van den Boom y Hoeksma, 1994) que modula la intensidad de las reacciones ante situaciones ansiógenas en función del comportamiento parental (p. ej., Atkinson, Gennis, Racine y Pillai, 2015). Otras variables como el sexo, las lesiones neurológicas o los problemas neurobioquímicos también se han mencionado en la literatura, pero sin contar con evidencia empírica concluyente (Camposano, 2011). Así ha ocurrido con el sexo, por ejemplo, cuyo efecto parecía relevante (p. ej., Kolvin y Fundudis, 1981), pero los datos actuales no lo confirman (APA, 2013).

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Fuente de los datos: Dialnet