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

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

ISSN: 1132-9483

Année de publication: 2018

Volumen: 26

Número: 1

Pages: 115-140

Type: Article

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D'autres publications dans: Psicología conductual = behavioral psychology: Revista internacional de psicología clínica y de la salud

Résumé

Selective mutism is a disorder of early-onset behavior (usually between 3 and 5 years) consisting in a resistance to speech or its inhibition in specific social situations, characterized by the presence of strangers, people who are not spoken to or to whom the child has stopped talking, places where the child doesn’t speak or where the child thinks he/she can be heard by unwanted people, etc. Its low prevalence makes it a rare behavior disorder and the review of the literature confirms that anxiety is the prominent alteration in those who present it, which has led to the result that in the last edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, DSM-5; APA, 2013) the behavior has been reclassified as an anxiety disorder. This fact, as well as the advances in its research and the challenges that it poses regarding its evaluation and treatment, make it necessary to review and update the existing explanatory proposals. This is the framework of the work presented here.

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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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