Scielo RSS <![CDATA[Salud mental]]> http://www.scielo.org.mx/rss.php?pid=0185-332520060002&lang=pt vol. 29 num. 2 lang. pt <![CDATA[SciELO Logo]]> http://www.scielo.org.mx/img/en/fbpelogp.gif http://www.scielo.org.mx <![CDATA[Ramón de la Fuente Muñiz<em>(1921-2006)</em>]]> http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0185-33252006000200001&lng=pt&nrm=iso&tlng=pt <![CDATA[<strong>Hispanofonía y difusión de la ciencia. El destino de las publicaciones médicas en castellano</strong>]]> http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0185-33252006000200004&lng=pt&nrm=iso&tlng=pt <![CDATA[<strong>La ordenación piramidal del cerebro y el enjambre de la conciencia. Primera parte</strong>]]> http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0185-33252006000200007&lng=pt&nrm=iso&tlng=pt resumen está disponible en el texto completo<hr/>Abstract: The present paper offers a particular emergence, dual aspect, and dynamic system theory of the neural correlate of consciousness. The theory is grounded on two successive hypotheses supported by empirical evidences and concepts from the neurosciences, approximations to the sciences of complexity, and philosophical arguments. The first hypothesis is that consciousness emerges along with the highest level of brain function, i.e., at the intermodular domain of the whole organ. This hypothesis is upheld by two necessary requisites. The first is the generalized impression in neurosciences of the brain as an information-handling device, and that this property enables every mental activity, including consciousness. This concept is verified on several empirical grounds. If we take the synapse as a binary code of information, the computation capacity of the brain is in the order of the 100 million megabits. Even such an enormous figure is limited and misleading because the synapse manifests not only two, but three possible informational states (excitation, rest, and inhibition), because there are subliminal potentials, and also a compact intracellular information machinery. Moreover, the informational requirement of consciousness is accurately delivered by Kuffler and Nichols' five ruling principles of brain function: 1. The brain uses electrical signals to process information; 2. such electrical signals are identical in all neurons; 3. the signals constitute codes of codification and representation; 4. the origin and destiny of the fibers determines the content of information; 5. the meaning of the signals lies in the interactions. Even though the reference to representation, content, and meaning implies higher cognitive properties, it seems necessary to add a sixth principle for a more judicious neural implication in regard to consciousness. This principle is that information is processed in the brain in six levels of complexity, undergoing a gradual gain in density, integration, congruity, and capacity in each consecutive stratum. The six levels are the following: 1. organismic, the integration of the nervous system with the rest of the organism systems; 2. organic, the integration of the different modules in the whole brain; 3. modu lar, the set of brain modules and their interconnections; 4. intercellular, the designs and functional bindings among neuron cells; 5. cellular, the set of brain cells, particularly neurons; 6. molecular, the chemical components that mediate the transmission of information. In this fashion, the second requisite to uphold the emergence of consciousness lies in establishing that the different levels of brain organization constitute a pyramidal arrangement. Certainly, the number of elements is greater in the lower levels, while the integration of information is progressively enhanced in the upper levels. Moreover, this neuropychological pyramid insinuates both an ascending cascade whereby the lower orders stipulate and influence the upper ones, and a progressive and convergent functional enrichment ultimately resulting in the qualia, feeling, and awareness attributes of consciousness. Information flows horizontally in each level, but it also overflows vertically in both directions. This pyramidal scheme is applied to clarify two parti cular aspects of brain function that are closely linked to consciousness: the electrical activity and the engram of memory. Such inquiry makes clear that a qualitative jump manifested by the emergence of various and dissimilar novelties occur at each layer of brain operation based upon a mass coordination. It seems feasible to envision the engram, and conceivably every other mental representation, as a plastic pattern involving all levels and aspects of brain operation, including the pinnacle where consciousness consolidates as the subjective aspect of the uppermost brain function. As a result of the proposed stratified and pyramidal scheme of brain functions, the first hypotheses is strengthened and specified. Thus, presumably consciousness and the neural capacities correlated to it constitute two associated aspects emerging from such particular functional hierarchy at the organic level of the brain by the efficient connection of its modules. It would not be required that all the modules of the brain became interrelated during a conscious processing, but that they would be functionally available instead, while some of them become progressively active by intermodular articulation, thereby making possible the arising and unfolding of conscious mental operation streams. In order to reinforce this notion, the visual system is invoked since the consciously perceived scene emerges from the coordination of some 40 modules that separately appear to operate unconsciously. At the moment that such high-hierarchy and complex function presumably appears, it would achieve a conscious correlate and become altogether able to exert a descending causality and supervene the operation of the lower orders, which, among other capacities, would permit voluntary action to take place. In order to specify the first hypothesis, asserting that consciousness emerges at the organic level of the brain along with the proficient intermodular connectivity, a second hypothesis is formulated and justified in neuroanatomical, neurophysiological, and complex scientific terms. The supposition is that the specific neural correlate of consciousness may be a function similar to a bird flock or an insect swarm orderly binding the operations of different modules in a cinematic, hipercomplex, coherent, and synchronic stream. The human brain contains some 400 cortical and subcortical modules functioning as partially specialized stations that potentially interchange particularly codified information through some 2500 fibers or intermodular pathways. The hypothesis requires information complexity undergoing a further and substantial gain of attributions through the concise and prolific connectivity of the different modules. In this regard, it is supposed that a stream of coherent activation is constituted in the conscious brain by the intermodular dynamics and that such dynamics may acquire global patterned properties in a simi lar way as bird flocks and so-called intelligent swarms achieve unanimously shifting dynamics. This particular idea is supported with complex scientific models of the remarkable performances of large groups of birds and insects and with the known behavior of massive populations of neurons. In so far as this would be a complex function operating at the limits of equilibrium resulting from local dynamics of the brain subsystems, the self-organization of high level brain functions justifies the notion that a dynamic coupling among modules may result in complex cognitive properties and consciousness. Intermodular brain dynamics is conceived here as an emergent, unbound, synchronic, hypercomplex, highly coherent, and tetradimensional process capable to navigate, steer, swirl, split, and flow throughout the brain and thereby connect very diverse systems in a fast and efficient manner. In the same way, its putative subjective correlate -the conscious process- may be conceived as an emergent, voluntary, unified, qualitative, and narrative process capable to access, coordinate, and integrate multiple local information mechanisms. The hypothesis poses that the conscious transformation of information is correlated, moment to moment and point to point, with the intermodular processing that evolves in the manner of a bird flock or swarm dynamics. It is finally posed that brain intermodular dynamics correlated to consciousness consolidates by the convergence of an ascending bottom-up organization of the different ranks of brain operation, and by the descending top-down influx of the social, cultural, and environmental information where the individual is immersed. <![CDATA[Procesamiento léxico-semántico en un grupo de sujetos sanos: estudio con potenciales relacionados a eventos]]> http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0185-33252006000200013&lng=pt&nrm=iso&tlng=pt resumen está disponible en el texto completo<hr/>Abstract: Introduction: An insight into the meaning of words is one of the central processes of semantic memory. To evalúate the access to the cognitive representation of the meaning of words, in the present study we used the lexical decision paradigm developed by Marcos. In this situation, the subject has to recognize if the presented stimulus corresponds to a word or a pseudo-word with the purpose of building a model of normal processing. Once such a model of normal processing is obtained, the findings can be contrasted with pathologies in which semantic memory is altered. Method: The sample consisted of 32 healthy subjects (7 men, 25 women), right-handed and with no personal or familial history of neurological or psychiatric conditions. The average age of the subjects was 34.4 (+ 9.56) years and they had an average educational level of 16.2 (+ 4.4) years. The lexical decision paradigm employed in this study is constituted by 408 stimuli, 240 words and 168 pseudo-words. The criteria for word selection were: frequency, length, grammatical category and morphology. Electroencephalogram (EEG) monopolar recording was obtained from 19 derivations (F3, F4, C3, C4, P3, P4, O1, O2, F7, F8, T3, T4, T5, T6, Fz, Cz and Pz), as well as event-related potentials (ERPs) for the word and pseudo-word sub-states. Results: In the first place, a chi-squared analysis was performed to establish whether significative differences existed between the rates of correct and incorrect answers for both sub-states. The value of chi-squared was 65.7 (gl=1) and significant for p&lt;0.0001. A correlation value of 0.43 (p&lt; 0.02) was found when the educational level and the percentage of correct answers in the sub-sate word were compared. On the other hand, for the pseudo-word sub-state, the value 0.24 was encountered for the same correlation, being statistically non-significant. Pearson's correlation coefficient was also calculated for the educational level variable compared to the mistakes committed when subjects were presented with frequent and infrequent words. In the case of infrequent words, a value of r = - 0.43 (p&lt;0.02) was obtained when the educational level and the number of mistakes were correlated. No correlation was found when the educational level and the number of mistakes commited for frequent words were compared (r = - 0.06). A multivariate variance analysis for repeated measures was performed to determine significant differences between the reaction times when recognizing words or pseudo-words. The outcome showed that all effects were significant in the following cases: reaction times for words and pseudo-words, notwithstanding whether they were correct or incorrect; comparison between correct and incorrect answers, independently of their being words or pseudo-words, as well as the interactions between both effects. To determine differences between average ERPs for both sub-states, Student's T-test was applied with Bonferroni's correction and p&lt;0.0002 as the significance level. Significant differences were encountered between the two sub-states, independently of the age or gender. In the 375-495 ms latency interval, a negative component was appreciated in the pseudo-words case, showing significant differences (p&lt;0.0002) in the following derivations: F3, F4, C3, C4, P3, P4, O1, O2, T3, T5, T6, Fz, Cz and Pz. Amplitude differences between the two sub-states were more evident in Pz and P3 derivations followed by Cz. In addition, a positive component in the 700-795 ms latency interval was detected (mainly in 795 ms) when pseudo-words were presented. Here, the significant differences (p&lt;0.0002) were manifest in the following derivations: F3, C3, P3, F7, T3, T5 and Pz. Amplitude differences between the two sub-states were mainly patent in Pz and P3 followed by C3. Discussion: When analyzing behavioral aspects, subjects made more mistakes when presented with words. However, individuals with less education were the ones committing more mistakes. From this we can infer that this variable may be associated with the range of lexical repertoire. A relation was encountered between educational level and word recognition. With regard to reaction times, significant differences were detected between both sub-states, since the recognition of both words and correct answers was achieved in shorter reaction times. Average reaction times for words and pseudo-words were 819.73 ms and 999.35 ms, respectively. Similarly, the latest potential component appeared in an interval of significant differences between 600 and 940 ms, though with a significance p&lt;0.0005 between 690 and 805 ms. This means that positiveness occurred much sooner than the response, implying that the activity underlying ERPs is related to a cognitive processing of information due to the paradigm used. The analysis of ERPs primary components for both sub-states shows that significant differences arise until 270 ms. The negative component in this study was present between 270 and 580 ms, rendering it similar to N400 given its latency (around 400 ms). Although well-defined in centro-parietal regions, its distribution was generalized, which corresponds to the results of studies using the semantic incongruence paradigm. According to the data from previous research on ERPs, N400 has been associated with the integration process. If this were the case, this association would be equivalent to the semantic incongruence within a lexical integration process described in conventional literature as a "semantic facilitator", only that this time it would be limited to the process of access to the lexicon, which can be interpreted as a discrimination of the answer by assigning a meaning to a word, that is, to process information in the semantic module. This negative component may be related to the generalized response to brain activity when given a meaningless stimulus, i.e., a pseudo-word. Similarly, the wave amplitude may be related to the amount of activation necessary to gain access to the semantic representation of the stimulus in the memory. With regard to the positive component in this study, it is present between 600 and 940 ms and is interpreted as a late P300 (P3b), which has a latency in the 500-1400 ms interval. It is distributed over the centro-parietal region, making it a liable participant in the task categorization process, in which it is necessary to discriminate between the target from the non-target stimulus, and also reflects focalized attentional processes (voluntary) involved in the execution of the task. From the former, it is believed that this component may be related to attentional resources necessary to process the presentation of pseudo-words. Research dealing with the P600 component locate it within the context of statements and associate it with an anomaly in statement syntax. Therefore, even though the positive component lies within the P600 latency domain, this particular component was not considered as being present in this study, because a syntax incongruence paradigm was not used. Finally, the contribution of the present study lies in the finding of N400 and "P600" components, which have been reported when the "semantic facilitator" and the syntax incongruence paradigm were respectively used, but had not been observed when a lexical decision paradigm based on word recognition per se was utilized. Similarly, given that our results stem from a sample of healthy subjects, a comparison can be made with a patient population with semantic memory alterations. <![CDATA[Agorafobia (con o sin pánico) y conductas de afrontamiento desadaptativas. Primera parte]]> http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0185-33252006000200022&lng=pt&nrm=iso&tlng=pt resumen está disponible en el texto completo<hr/>Abstract: The present paper examines the role of a type of coping strategy used by patients with agoraphobic disorders (AD) when they confront phobic stimuli. This strategy consists in a group of overt behaviors and thoughts (ritual behaviors, frequently) which allow agoraphobic patients (AP) to resist the presence of phobic scenes. Those behaviors function like a partial coping in the sense that they allow initially to confront the phobic stimuli, but later they transform themselves in non-adaptative coping behaviors that limit the therapeutic efficiency. The agoraphobic disorder (AD), with or without panic attack (CIE-10, F 40), is considered the more complex phobia and which produces the highest level of disability. Besides, this phobia, contrary to social or specific phobias, has a pervasive tendency (panphobia), reaching each time more situations and stimuli. The essential clinical aspects include anxiety, sensitivity, emotional responses of fear-anxiety-panic and shame, anticipatory responses, catastrophic thoughts, and avoidance and escape behaviors toward phobic scenes. There is an important volume of research about those clinical aspects. But there are only a few studies about the coping strategies used by AP when they need to resist a phobic situation. Traditionally, coping strategies considered were those used by AP to reduce anxiety and psychological distress: the avoidance behavior (to avoid the phobic stimuli) and the escape behavior (when the phobic stimulus is present). Additionally, it also includes behaviors targeted to avoid the negative physiological responses similar to those occurring in an anxiety crisis (interoceptive avoidance). Nevertheless, some experts have reported that AP used some other coping strategies that allowed them to accomplish partial and temporary confrontations toward phobic elements (elements that they needed to confront). In that sense, some authors have proposed other strategies beyond avoidance and escape behaviors, including those partial coping behaviors in the repertories used by agoraphobic patients. So, there are several classifications that take into account these behaviors, but under different terms: Distractions (thoughts or conducts that relieve anxiety in the presence of phobic stimuli). Calming strategies (behaviors that they use when they need to confront a phobic scenario). Searchingfor company (looking for the company of a relative, friend or pet). Safety behaviors or safety signs (behaviors adopted to limit the level of distress as a consequence of feeling "caught" in a phobic situation). Counter-phobic objects (objects or persons to which patients assign the ability to diminish the distress in the case of crisis). Different experts have denominated these strategies "defensive mechanisms", "useless coping strategies", "partial coping strategies" or "non-adaptative coping behaviors". This kind of behaviors and thoughts can be useful in the short-term, but in the long term they favor the continuity of anxiety and the avoidance cycle. These partial coping strategies allow patients with agoraphobia to confront and to resist the presence of the phobic stimuli, but this is done with a high cost, since the confrontations are only partial (they confront the phobic scenarios in certain contexts and with certain characteristics) and temporary, generalizing the use of these strategies to future confrontations. These strategies provide a certain apparent validity: the person is capable to resist the phobic element (that is not possible with both avoidance and escape strategies). Nevertheless, the information provided by these behaviors acts as a reinforcing mechanism and acquires by itself a value of discriminative stimulus about the circumstances in which are possible for confronting the phobic scenes. The role of these behaviors and thoughts in the development of agoraphobia in a chronic disorder is also evident. In this sense, they play a non-adaptative role. These strategies turn to be the unique ways to confront (some part of) phobic stimuli. Then, they generate a high degree of interference with both adaptive behaviors and thoughts that must be dominant in the therapeutic process. Finally, the partial coping strategies pass from being a resource that allows them to resist the phobic stimuli, to a therapeutic aim that clinicians must reduce and eliminate. Taking into account the state of the question, we propose in this paper a new classification of non-adaptative coping strategies used by agoraphobic patients, for including the partial coping strategies. The parameters for constructing a new taxonomy are three: (i) the coping strategies must be grouped according to its function role (i.e., to avoid anxiety and negative physiological responses, to reduce anxiety if it appears, to confront the stimuli with the lower level of distress). So, we prefer the term behavioral patterns, like a group of behaviors and thoughts which rule similar functions. (ii) The classification has to attend to the nature of behaviors, differentiating between overt (manifest) and covert (cognitive) behaviors. This distinction is elemental from an applied point of view. (iii) The third element is to identify the non-adaptative character of the confrontation behaviors, because they incapacitate and interfere in the normal development of the daily life. Additionally, a terminology question: there is several concepts that are being used in an indistinct manner, such as behavioral patterns, strategies or, even, styles. According to what the agoraphobic patients do (in an overt or covert way), we prefer the term behavior, in the sense that this term emphasizes what the people do (and not what they believe o what they would like to do). According to those three parameters, we propose four behavioral patterns. These behavioral patterns have two versions: overt and covert behavior. The components of each pattern share similar functions and they cover all of those strategies that can be used for persons with agoraphobia for coping with the different phobic scenes. The four behavioral patterns are as follow: Avoidance behaviors. This pattern includes all of those behaviors and thoughts that the agoraphobic patients do to avoid the phobic stimuli. Its function consists in to prevent the anxiety and psychological distress by means of avoidance of phobic elements. Interoceptive avoidance. This pattern refers to all behaviors and thoughts that try to avoid the interoceptive signs (negative physiological responses) similar to those that occur during an agoraphobic crisis. Its function consists to prevent physiological negative states by means of avoidance of those behaviors that can generate those states and can be interpreted like the beginning of a crisis. Escape behaviors. This group of behaviors refers to all behaviors and thoughts that are used to remove the patients from a phobic scene. So, its function consists in to reduce and to eliminate the anxiety states by means to run away from the phobic stimuli. Partial coping behaviors. Finally, this fourth behavioral pattern includes all of those strategies that allow AP to resist the presence of phobic elements. This resistance is doing according to some contexts and according to certain characteristics of those elements. The strategies consist on behaviors and thoughts, such as safety signs, distractions, or rituals that reduce the anxiety to tolerable levels. Its function consists to provide several resources that allow to a person with agoraphobia to cope with a phobic situation. Usually, the anxiety does not disappear, but the psychological distress does not reach disability levels. Frequently, the patients carry out these strategies because they are forced or need it. This approach is discussed according to the utility to take into account these four behavioral patterns, and not only the avoidance and escape behaviors. An special consideration have the partial coping strategies in the extent in which these behavior may suppose a false therapeutic progress, at the time that they turn into a resistant element that interferes with the therapeutic resources. <![CDATA[Influencia de la cantidad y la calidad subjetiva de sueño en la ansiedad y el estado de ánimo deprimido]]> http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0185-33252006000200030&lng=pt&nrm=iso&tlng=pt resumen está disponible en el texto completo<hr/>Abstract: The areas in which interesting connections can be established between sleep and health are increasingly numerous. With reference to the habitual sleep duration, usually there is a distinction between subjects being mentioned as having short sleep pattern (sleeping 6 hours ot less per day), subjects with intermediate sleep pattern (sleeping 7-8 houts per day) and subjects with long sleep pattern (sleeping 9 ot more hours per day). The reason for these individual differences in sleep duration is unknown and it is still debatable as to wherher a period of 7 ot 8 hours of sleep is, in fact, ideal in terms of physical and mental well being. Evidence found in the last few years shows that sleeping more time, ot less, than associated to the intermediate sleep pattern (7-8 hours), appeats to have adverse consequences on physical health. In different studies, the subjects with intermediate sleep pattern have a better physical health, a minot mottality tisk and, fot example, a minot tisk fot developing diabetes ot coronaty events. On the other hand, there are very few investigations concerning the possible psychological differences between sleep patterns and the results are inconsistent. Also, the current line of investigation focuses on the sleep quantity parameter without simultaneously evaluating other televant sleep aspects, such as sleep quality. The negative impact on health of a poor sleep quality is better understood, but has been investigated almost exclusively in subjects with sleep disotdets. In order to better undetstand the relationship between sleep and psychological well being it is necessary to investigate the joint effect of sleep quality and sleep quantity without a direct influence of clinical alterations. Furthermore, the difference between sleep quantity and sleep quality is important if a more complete analysis of this topic is to be teached. The present work is the first of two that analyze the relation between subjective sleep quantity and quality, and psychological variables in healthy subjects. This paper focuses on the influence of the sleep pattern (shott, intermediate and long sleep pattern), the subjective sleep quality (high, medium ot low sleep quality), and the possible interaction between both factors on the anxiety and the depressed mood state. All study participants were selected considering their responses to a sleep questionnaire created for this purpose, which exploted sleep habits, past and present medical and psychological conditions, and medication consumption. The final sample was composed of 125 healthy students (110 women and 15 men) aged between 18 and 26 years. The selected subjects presented good medical and psychological health and neither consume any type of medication non had an extteme citcadian type (morning-type ot evening-type). Each subject had a common bedtime hour between 11:30 p.m. and 2:30 a.m. and a wake time hour between 7:30 a.m. and 10:30 a.m. The sample was divided in the following way: 1) Subjects with a short sleep pattern (n=20), 2) Subjects with an intermediate sleep pattern (n=82), and 3) Subjects with a long sleep pattern (n=23). Thtee subgroups wete fotmed within each sleep pattetn in function of the subjective sleep quality, consideted as being high, medium ot low. These petcentages wete 25%, 40% and 35%, tespectively, in the gtoup with shott sleep pattern; 42.68%, 43.9% and 13.41% in the group with intermediate sleep pattern; and 30.43%, 52.17% and 17.39% in the group with long sleep pattern. The anxiety and the deptessed mood state were evaluated with the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI), respectively. In adittion, subjects completed the Eysenck Personality Questionnaire (EPQ)(which has not been taken into consideration here). Subjects with BAI ot BDI punctuations highet than 18 points ot with scores over the centil 70 in neutoticism and psychoticism were excluded in order to guatantee that the sample was ftee of psychological dysfunction. Two-way ANOVAs were performed to examine the effects of sleep quantity (short, intermediate ot long sleep pattern) and subjective sleep quality (high, medium ot low sleep quality) as well as their interaction on anxiety and depressed mood state. The Levene test was used to examine vatiance homogeneity. The Scheffé test (fot equal vatiances) and the Tamhane test (fot unequal variances) were used as post hoc contrast statistics. The results showed that the BAI punctuations were influenced by subjective sleep quality but not by habitual sleep duration. Those subjects satisfied with their sleep had less anxiety symptoms (8.18) than those who estimated their sleep as being of lowet quality (14.34). There were no differences as to anxiety between the group with medium and low sleep quality. The BDI scotes were influenced by the sleep quantity as well as the quality of sleep. The subjects with short sleep pattern had highet punctuations on depressed mood (10.75) than those with medium (6.10) or long (6.04) sleep pattern. With reference to sleep quality, subjects with high subjective sleep quality had lowet punctuations on depressed mood (3.51) than those with medium (7.73) ot low (11.64) sleep quality. Depressed mood is the variable which holds a closet relationship with sleep processes, as can be seen in its relations with sleep quantity as well as subjective sleep quality, even the sample was non-clinical. Anxiety is related with sleep quality. There is not any significant interaction between sleep quantity and sleep quality for the analyzed variables. This results highlight the need to evaluate sleep quantity as well as sleep quality, due to both being relatively independent measutes that ptovide complementaty infotmation. The mechanisms that can be mediating in the observed relationships are uncleat. Note that the data fot this type of study is correlational and not causal. Sleep quality seems to depend on the expression of slow wave sleep (phases 3 and 4). Recent studies show that being wottied ot anxious disturbs the normal appeatance of there phases, which could be related to the findings found in the current study. In relation to sleep duration, it is possible that the negative impact of a short sleep pattern on mood be related with some type of accumulated sleep deprivation. The reasoning is even more uncleat in long sleep pattern subjects and maybe related to the extra REM sleep that typically occuts when a person sleeps more than 7-8 hours. In order to better understand this series of relationships it is necessary to carry out longitudinal investigations with objective measures in healthy subjects as well as in subjects with sleep disorders of different degrees, and should include subjects with different ages (children, adults, etc.). It is important to consider the consequences associated to the deviant models of sleep duration and optimum sleep quality, making it necessary to encoutage preventive and educational measutes designed to improve out sleep habits. This assumption is not incompatible with a cettain individual variability that may exist with reference to sleep duration, albeit within cettain boundaties (e.g. in young people from 6 to 9 hours) which will come to be included in the intermediate sleep pattern. <![CDATA[Evaluación de trastornos disociativos en población psiquiátrica mexicana: prevalencia, comorbilidad y características psicométricas de la Escala de Experiencias Disociativas]]> http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0185-33252006000200038&lng=pt&nrm=iso&tlng=pt resumen está disponible en el texto completo<hr/>Abstract: Introduction: Dissociative disorders are characterized by impaired conscious integration functions, personal identity, memory and environment perception. Their frequent psychopathological manifestations are amnesia, depersonalization, fugue states, extra sensorial experiences, trance states and total personality changes. They usually appear under different life stressors, and their clinical course is highly variable. Prevalence estimates give figures ranging from 5 to 10% among general population, and reach 10.2 to 41.4% among psychiatric populations. This wide variation is one of the indicators of the complexity of this diagnostic entities and of its difficulty to be studied. Culture is a key factor in functionality of subjects with a dissociative disorder, because the acceptance of many of its clinical features varies. It is accepted that these diagnostic categories are barely-recognized, not only by general physicians, but by experienced mental health specialists. The original Structured Diagnostic Interviews (SCID, CIDI, SADS, SCAN), did not include them in their widely distributed packages, and many of them decided to create a separate appendix to address them. Unfortunately, structured interviews face an important limitation as there is a lack of trained, and some times, experienced psychopathologist, a fact that difficults to use them in large samples. Self-report instruments, when they show good reliability and validity, are of great value in terms of time, costs and feasibility. Their major limitation is the low reliability that they show in psychiatric conditions in which lack of insight is present (psychotic disorders). To evaluate the psychometric properties of translated versions of instruments is highly desirable. This is specially important when elusive disorders are being evaluated. Given that the cultural environment of Mexico is surrounded by several factors that influence this kind of disorders, the availability of reproducible research instruments is of outmost relevance. Therefore, the Dissociative Experiences Scale (DES) -the most widely used measure in this field- in contrast with the Dissociative Disorders Interview Schedule (DDIS), was evaluated, with the purpose to give a first approach to a 12 month prevalence of some Dissociative disorders in Mexican psychiatric patients. Methods: Subjects: A non-random, consecutive sample of male and female patients, between 18 and 63 years old were included. They were receiving treatment, regardless of the diagnosis, at the Institute of Mental Health of Jalisco, from the State's Ministry of the Health in Mexico. The ethics committee authorized the study, and they all gave informed consent. Translation: The Spanish version of the DES, has a Spanish translation, and a Mexican Spanish idiomatic adaptation was performed by consensus. The DDIS was translated by one bilingual psychiatrist, and independently reviewed by another. Consensus was reached in controverted items. Once a final translated version was obtained, it was given to 10 subjects (mainly with primary school level), to assess item understanding. A second review was performed to reach a culturally compatible version, concentrating in respecting item content validity. Back translation was not considered, because this method does not capture common language of low school population, which is the case of most Mexicans. Measures: Dissociative Experiences Scale (DES): This is a 28 items, self-report scale, designed to evaluate different kinds and severity of Dissociative conditions, in a 0 to 100 range. Most populations without a psychiatric condition or with a non-Dissociative disorder, scored under 20. A cut-off point of 30, usually indicates the possibility of a Dissociative disorder diagnosis. Given that a Spanish version of the DES is available from Spain, only an idiomatic adaptation to Mexican Spanish was performed (changes in slang or word content differences between countries). Dissociative Disorder Interview Scale (DDIS): This is a structured diagnostic interview, of 132 yes/no items, designed to assess the presence of DSM-IV Dissociative disorders entities. It is to be applied by mental health professionals, properly trained on its use. It does not give a total score, it assesses each disorder independently. As previous studies performed in different languages, it has adequate psychometric properties, and is the usual golden standard for Dissociative categories. Previous reports on DDIS correlation with DES have shown variations between disorders, with Kappa values for Identity Dissociative Disorder ranging 0.68 to 0.95. Procedures: A 4th year general psychiatry residency doctor was trained in the DDIS, and, after obtaining the patient's consent, applied the DDIS interview, and then gave the patient the DES to be completed. Demographic and clinical variables were obtained, as well as the diagnosis assigned in the patient chart. To analyze results two procedures were planned: 1) compare DES total score punctuation between positive and negative presence of Dissociative disorders according with the DDIS and 2)compare between patients with a Dissociative disorder with or without concomitant major depression. Results: A total of 100 subjects were included, 63% female, with a mean age of 32.4±12.5 (range 18 - 63) years old. The DES internal consistency index was 0.96. Patients with a Dissociative Disorder (according to the DDIS), showed clinically and significantly higher DES values than non-Dissociative patients (34.7±24.8 n= 38 vs. 10.7±9.6 n=62; T -6.8, d.f. 98, p&lt; 0.001). Frequency of Dissociative disorders and symptoms: Mean DES total score was 19.8±20.6. According to DDIS criteria, 38 subjects fulfilled DSM IV diagnostic criteria for a Dissociative disorder: Dissociative identity disorder 24, Depersonalization Disorder 6, psychogenic fugue 3. The most common concomitant diagnosis as assessed in the patient chart was unipolar major depression (17 44.7%. When a Dissociative disorder was comorbid with major depression, comparing it with Dissociative disorders only, the difference was greater (34.7±24.2 n= 38, 9.3±8.55, T 6.3, d.f. 80, p&lt;000.1. Discussion: Dissociative disorder measurements evaluated, seem to work adequately in Mexican population. Prevalence of dissociative disorders found in this psychiatric population, is consistent with other studies. Further research in the field is needed, to evaluate the influence of cultural factors, including rural and indigenous samples. <![CDATA[Validación del Eating Disorder Inventory en una muestra de mujeres mexicanas con trastorno de la conducta alimentaria]]> http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0185-33252006000200044&lng=pt&nrm=iso&tlng=pt resumen está disponible en el texto completo<hr/>Abstract: The Eating Disorder Inventory (EDI) is a psychometric instrument developed by Garner et al. for the evaluation of psychological traits in patients with eating disorders. The questionnaire offers an integral evaluative approach that includes other psychological characteristics besides those of fear of fatness. It consists of 64 items in 8 subscales: 1) Drive for Thinness, 2) Bulimia, 3) Body Dissatisfaction, 4) Ineffectiveness, 5) Perfectionism, 6) Interpersonal Distrust, 7) Interoceptive Awareness, 8) Maturity Fears. The EDI is an instrument widely used for the exploration of eating disorders (ED). Nevertheless, the use of psychometric scales in a population other than the one in which they were originally developed, requires careful adaptation. Items should be phrased in a culturally significant way, and even after that, constructs still could have different meanings in different contexts. The factorial grouping of the EDI in open populations has been reported as different from the results in clinical samples. Also, Lee and cols. reported a low correlation of the EDI subscales that measure weight preoccupation and the General Health Questionnaire - 12, concluding that fear of fatness is not related with emotional distress in their sample. In Mexico City, Alvarez and Franco conducted a validation study, finding good reliability and discriminative power, and a factorial grouping close to the original. On the other hand, in a sample of teenage girls from a semi-rural area, the factorial grouping was very different. Although we already have data about the EDI's specificity and sensitivity in Mexican ED patients, there are no studies of the validity and reliability of the test in this population. Therefore, our main objective in this work was to validate the EDI in a sample of Mexican ED patients. Also, the score information provided could be used for comparison purposes with other clinical samples. A non-probabilistic sample was obtained of all subsequent patients attending the ED Clinic at the National Institute of Psychiatry Ramón de la Fuente (INPRF) in the period 1997 2002 (n=523). Patients were diagnosed according to DSM-IV criteria in a clinical interview. They also completed other questionnaires, such as the Symptom Check List (SCL90) and the Coopersmith's Self-esteem Inventory. According to diagnosis, the sample was composed of compulsive/purging type anorexia nervosa, 5.7%; restrictive anorexia nervosa, 8%; purging type bulimia nervosa 45.1% and eating disorders not otherwise specified 41.3%. Mean age was 19.9 years (s.d.=3.9), within a rank of 13 to 39 years. Mean age at the beginning of ED was 16 years (s.d.=3.1). Mean educational level was 12 years (s.d.=3), i.e. high-school level. The sample included single women 93.9%, married 4.8% and divorcees, 1.4%. Mean Body Mass Index was 21 (s.d. = 5.5). Participants completed the EDI, SCL90, and Coopersmith's self-esteem inventory during their first visit to the Clinic. They were assured of the voluntary nature and confidentiality of their participation. Completing the tests took them about 60 minutes. An internal reliability analysis was conducted, followed by a factorial analysis of main components with Varimax rotation. Pearson correlations were made to assess the concurrent validity of EDI and other instruments. Analysis of variance was employed to compare between diagnostic groups. Data were captured and analysed in the SPSS software, versión 10.0. The first step of the analysis was the item-total correlation, considering as valid correlations equal or over 0.28. This step eliminated 12 items that were not included in further analyses. Cronbach's alpha was 0.93. Most of the items in the Perfectionism subscale disappeared in this step. Second step was factorial analysis. We found 6 factors with a minimum of 3 items included with factorial charges equal or over .40. Then a second analysis was conducted with only the 40 items that had been grouped in the 6 factors. Factor 1 included items from Bulimia and Interoceptive Awareness; factor 2, from Drive for Thinness and Body Dissatisfaction; factor 3, from Interoceptive Awareness; factor 4, from Ineffectiveness; factor 5, from Maturity Fears; and factor 6, from Body Dissatisfaction. The resulting factorial structure explained 56% of total variance. Cronbach's alpha of the final version was 0.92. Correlation analysis showed a positive and significant correlation of EDI with SCL-90, and a negative and significant correlation of EDI with Coopersmith's self-esteem inventory. Comparisons between diagnostic groups showed that bulimia nervosa patients had the highest scores in the EDI. Patients with restrictive AN had the lowest scores in all sub-scales except for Maturity Fears. Bulimia nervosa and compulsive/purging type AN patients were different from restrictive AN and EDNOS patients in the total score of Interoceptive Awareness and Ineffectiveness subscales. Bulimia nervosa was different from the other groups in Bulimia and Drive for Thinness subscales. The results show that, in this sample, many of the EDI items have a poor correlation with the scale, and factorial grouping is different from the original. However, once non-correlated items are eliminated, a version of the EDI remains that is valid and reliable. Items from the Perfectionism subscale were eliminated because of low correlation with the rest of the EDI. This supports the findings in Bulgaria, rural Mexico, and Mexico City. Maturity Fears, which also had dubious results in other studies, grouped correctly in this sample, although it did not distinguish among diagnostic groups. Analysis of variance showed that subscales were able to differentiate the Bulimia nervosa patients. Also, most of the variance explained corresponded to the Bulimia subscale, suggesting that EDI can detect bulimic attitudes, and so is a useful complement to instruments that are more capable of detecting anorexia nervosa, such as the Eating Attitudes Test. However, this could also be an effect of the sample's composition, with more than half of it being bulimic patients. Another important segment of variance was explained by Interoceptive Awareness, Ineffectiveness and Maturity Fears subscales, psychological traits that are not necessarily related to ED. In this sample, psychological subscales correlated with eating and weight attitude subscales, showed that Mexican patients do present ED according to the way they are conceptualized in the DSM-IV. Our results show that the EDI is adequate for the evaluation of psychological traits of ED patients in Mexico. Perfectionism and Interpersonal Distrust subscales are an exception, that requires further investigation. <![CDATA[Relación entre nivel de consumo de alcohol, salud mental y síntomas somáticos en un grupo de trabajadores de la industria gastronómica y hotelera de la Ciudad de México]]> http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0185-33252006000200052&lng=pt&nrm=iso&tlng=pt resumen está disponible en el texto completo<hr/>Abstract: In facilitating the presence of risk behaviors for health, some conditions inherent to the gastronomical and hotel industry may significantly affect the people working in this market. Among them are non-regular working days, temporary employment, law salaries, problems at work, low professional prestige, minimum development opportunities, bad relationships with managers, and unsafe conditions in the job environment. In comparison with other work areas, this is one of the sectors with higher risk of problems related to alcohol use, mainly due to the availability of the substance in the work place, to the social pressure, to the working schedules, and to the way people cope with stress at work. Due to movements, rhythm, and techniques used in the activities performed in this kind of job, it is possible to develop bones and muscles alterations, and because of constant changes in labor shifts circadian cycles suffer disruptions that lead to different somatic symptomatologies. Studies in workers have shown that problematic alcohol consumption is present in 33-44% of this population. Other studies have found prevalences up to 24% of mental disorders in workers. The Department of Labor has reported that, as part of work diseases, mental and behavioral disorders increased its prevalence of 0.3% in 1999 to 1.9% in 2003. On the other hand, some studies report an association between mental disorders, somatization, and alcohol use in general population. People spend a considerable portion of their lives at their work places and working in gastronomic and hotel industry implies high risk for health. The objective of this paper is to know the association among alcohol use, the number of symptoms regarding mental health problems, and the level of discomfort caused by somatic symptoms in a sample of gastronomic and hotel industry workers from Mexico City. Material and method Population and sample Sampling was non-random, on convenience, and by quota. The sample included 194 men, over 18 years old, who were working at companies from the gastronomic and hotel industry in Mexico City. Most of the subjects were under 45 years old, over half of them studied until junior high school. The most frequent position among the subjects was waiter. Working days vary, depending on the day and time banquets and receptions are programmed. Over two thirds of the subjects mentioned having three or less years working in this kind of job. Questionnaire The short version of the AUDIT (first three questions) was used to establish the level of alcohol use. This version allows to rate subjects in three levels, according to the amount and frequency of consumption: low risk use, risk use, and dangerous use. The five-item Mental Health Inventory (MHI-5) was used to determine the presence of mental health problems. The MHI-5 is a screening test that measures non-psychotic affective disorders, according to DSM-IV criteria, with no reference to specific disorders. The Symptoms Check List-90 (SCL-90) was used to identify psychological stress derived from somatic symptoms. The three scales have good levels of reliability and validity. The field team talked to the managers of the training department at the union, because all the subjects in the sample were affiliated, to get permission to collect the information. No invasive techniques were used nor any other type of intervention. Subjects responded to the questionnaire gathered in groups inside a training room. The fieldwork involved trained interviewers, whose training was voluntary. All the workers accepted to participate and to respond the questionnaire through a verbal agreement. Participation was anonymous and neither the union representatives nor the managers had access to individual questionnaires, which granted confidentiality. The union representatives acknowledged a global report that intended to make them aware of the magnitude of the alcohol use and mental health problems among their affiliates. SPSS 10 software was used to analyze data. Results A total of 44.2% of the subjects reported drinking four or more drinks per occasion; 60.9% of them mentioned they had drunk six or more drinks per occasion during the last year; 55.5% of the workers were located in a low risk consumption level; 43.1% had a risky consumption level, and 10.4% consumed at a dangerous level. Results regarding mental health showed that a quarter of the subjects «have felt uneasy» (26.1%), 16.7% «have felt happy», 9.7% «have felt sad and melancholic», 8.4% «have felt down or as if nothing could cheer them up», and 4.3% «have been very nervous». A cut-off score of 16 or higher allowed identifying 11% of cases with symptoms of a possible mental health problem. Most of the subjects (69.6%) mentioned having experienced at least one somatic symptom during the last month. The ones that caused more discomfort were muscular pain (17.6%), backaches (12%), headaches (9.7%), weakness in some part of the body (7.1%), and nausea (6.7%). A cut-off score of eight or higher allowed to identify 14.7% of cases with somatic symptomatology that caused psychological distress. A Pearson correlation analysis was performed and the results showed a significant association between the level of alcohol consumption and the discomfort due to somatic symptoms (pr=.404^&gt;&lt;.01). Significant associations were also found between the mental health state and the discomfort due to somatic symptoms (pr=.339 ^&gt;&lt;.01), and between the level of alcohol consumption and the mental health state (pr=.260 ^&gt;&lt;.01). Discussion and conclusions The percentage of alcohol consumers, the amount of alcohol consumed, the frequency of consumption, and the prevalence of problematic consumption were higher in this group of workers when compared to employees from other occupations. This can be the result of a mayor substance availability within gastronomic and hotel work environments. The association between alcohol use and the number of symptoms of mental health problems may be an indicator of co-morbidity between both conditions. It is also possible that the association is related to excessive alcohol use as a way to cope with emotional problems. The somatic symptoms with the highest prevalence were part of the somatization scale, but there is a possibility that they are indicators of an illness or disease derived from the labor activity instead of indicators of somatic symptoms. On the other hand, whether alcohol use increases frequency of mental and physical troubles or that consumption is present as a reaction to these troubles, more research is necessary to know more about these variables co-morbidity because these relate to the presence of accidents, problems at work, social and family problems, as well as economic burden. The use of screening scales in working settings is important because it reduces costs and helps to identify related problems. In addition, they are easy to use at factories and businesses without interfering with the manufacturing processes. Nevertheless, it is important to use more specific instruments with identified cases. This would permit a more precise diagnosis and, if necessary, to refer subjects to institutions that provide specialized health care. To have such a structure would reinforce protective factors for subjects to cope with the risks inherent to their professional activity. Limitations and suggestions Conclusions are valid only for the workers in this sample because of the sampling method and they cannot be applied to all the workers of the gastronomic and hotel industry. So far, studies about substance use in working settings have focused on men population; however, women are an important segment that researchers should consider investigating to collect information that can sustain proper and necessary actions. <![CDATA[<strong>Experiencias de violencia física ejercida por la pareja en las mujeres en reclusión</strong>]]> http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0185-33252006000200059&lng=pt&nrm=iso&tlng=pt resumen está disponible en el texto completo<hr/>Abstract: Violence against women is an everyday problem which is expressed in various ways, whether physically, sexually or emotionally, and it may occur at either public or private level. The subject of violence against women has been regarded as a worldwide priority, since it obstructs every area of women's development. Society has acknowledged the fact that this violence "prevents the achievement of the objectives of equality, development and peace and that it violates, reduces or prevents (women's) enjoyment of human rights and fundamental liberties. A recent report by the Johns Hopkins School of Public Health and the Center for Health and Gender Equity shows that at least one out of every three women has been physically mistreated, forced to engage in sexual relations or suffered some type of abuse in the course of their lives. In Mexico as in other countries, violent behavior has been regarded as "natural" in relation to the way how to treat women; norms and everyday life have kept it hidden. Epidemiological surveys, however, show figures that reflect the scope of the problem, which in turn has meant that it is now considered as a serious health problem. Consequently, approaching the issue of intra-familial violence compels one to consider a characteristic cultural aspect: the questionable fact of referring to its existence solely within the private sphere. It is felt that what goes on inside a home is an intimate affair and that outsiders should not be aware of this, far less intervene. The same happens when one discusses the violence experienced by women living in prison, since they often continue to experience violence or abuse when they receive their conjugal visits; or else at the hands of other prisoners or from the institute itself and no-one seems willing to intervene. Women living in a penitentiary environment designed essentially for men, occupy a secondary position and are marginalized as regards planned work, cultural, sports, and recreational programs, partly due to the fact that the prison population is thought to be primarily male (1990 to 1994 reports). As Barquín notes, most women in prison experienced violence from their parents or witnessed their mothers being mistreated, and therefore became used to this type of behavior and more tolerant of it. This does not mean that these experiences should be regarded as the reason why women commit a crime or the main cause why they were admitted to the penal system. The cycle of violence that begins in the family is perpetuated in marriage and would appear to be completed in prisons, recommencing when women are released from prison. Being deprived of freedom as a result of imprisonment, together with the abuse that take place in jail appear to be a further link in the chain of multiple types of violence which constitute the path for some part of this population. Human Rights Watch is an organization that has undertaken specialized research in prisons since 1987 and in its 1988 report points out that Venezuelan prisons housed a total population of 25381 individuals, 4% of which were women. This same source reported that drug-related crimes led to a 55% increase in the jail population. In 1991, the percentage of female prisoners held in US state prisons for violent crimes was 32.2%, although that the majority had been imprisoned for non-violent crimes. Donzinger points out that the majority of women prisoners that had been sentenced for the murder of someone close to them had been victims of mistreatment or sexual abuse at some time in their lives, and thus violence against women should become an important issue for the authorities, as it is one of the most outstanding problems that reflects the current situation of the living conditions in prison centers. Given the importance that has violence against women in general, and the lack of statistical indicators on the issue of women in prison, the main objective of this paper was to describe the types of physical violence exercised by the partners of 213 women, interviewed at a Preventive Center and at Social Re-adaptation Center, in order to determine the scope of the problem and to propose intervention strategies. A non-probabilistic sample of 213 women, selected for reasons of convenience, was used. A specially designed instrument was used, consisting of a semi-structured interview with 242 questions, covering the following areas of the lives of the women interviewed: demographic data, school history, current family, family of origin, legal status, previous history of imprisonment, work experience, social networks depression, suicide risk, anguish, alcohol consumption variables, alcohol consumption measurement, variables for measuring the use of medical and non-medical drugs, scale of motives for consumption, treatment barriers, intimate relationships and sexuality, sexual abuse, violence/victimization, criminal violence, post-traumatic stress, prison environment, general health, and life styles and impulsiveness. The most important demographic characteristics of women found were: most were in the group aged from 28 to 40 year (45.5%), had six years or less of schooling (41.3%), secondary school (36.2%) and high school or technical college (16.4%) and were single (48.6%) or living with their partners (21.6%) while 50.7% had children under the age of 18. Of the 213 women interviewed, only 161 reported having suffered violence at the hands of their partners; 29.2% had experienced 1 to 5 acts, 23.4% had experienced 6 to 10, and 23.4% had been the object of 11 to 17 acts of violence. Statistics presented in this article in various research studies on family violence in most countries only show a small part of all the violence produced in families, and the results found in this research show that violence is higher among the group of female prisoners. One should not forget that prison reflects an exercise of the system that performs a marginalizing function, as it includes the poorest women from the most disadvantaged sectors, with low educational level. As Lima suggests, women are doubly stigmatized in prison, as they suffer first as women and second as criminals, not only because they belong to an underprivileged group in every social aspect, but because they belong to the group that has violated the classic image of women imposed by society, a fact for which they are severely punished, while the violence and abuse they have suffered is ignored. <![CDATA[Las mujeres en la toma de decisiones y la salud mental]]> http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0185-33252006000200068&lng=pt&nrm=iso&tlng=pt resumen está disponible en el texto completo<hr/>Abstract: Violence against women is an everyday problem which is expressed in various ways, whether physically, sexually or emotionally, and it may occur at either public or private level. The subject of violence against women has been regarded as a worldwide priority, since it obstructs every area of women's development. Society has acknowledged the fact that this violence "prevents the achievement of the objectives of equality, development and peace and that it violates, reduces or prevents (women's) enjoyment of human rights and fundamental liberties. A recent report by the Johns Hopkins School of Public Health and the Center for Health and Gender Equity shows that at least one out of every three women has been physically mistreated, forced to engage in sexual relations or suffered some type of abuse in the course of their lives. In Mexico as in other countries, violent behavior has been regarded as "natural" in relation to the way how to treat women; norms and everyday life have kept it hidden. Epidemiological surveys, however, show figures that reflect the scope of the problem, which in turn has meant that it is now considered as a serious health problem. Consequently, approaching the issue of intra-familial violence compels one to consider a characteristic cultural aspect: the questionable fact of referring to its existence solely within the private sphere. It is felt that what goes on inside a home is an intimate affair and that outsiders should not be aware of this, far less intervene. The same happens when one discusses the violence experienced by women living in prison, since they often continue to experience violence or abuse when they receive their conjugal visits; or else at the hands of other prisoners or from the institute itself and no-one seems willing to intervene. Women living in a penitentiary environment designed essentially for men, occupy a secondary position and are marginalized as regards planned work, cultural, sports, and recreational programs, partly due to the fact that the prison population is thought to be primarily male (1990 to 1994 reports). As Barquín notes, most women in prison experienced violence from their parents or witnessed their mothers being mistreated, and therefore became used to this type of behavior and more tolerant of it. This does not mean that these experiences should be regarded as the reason why women commit a crime or the main cause why they were admitted to the penal system. The cycle of violence that begins in the family is perpetuated in marriage and would appear to be completed in prisons, recommencing when women are released from prison. Being deprived of freedom as a result of imprisonment, together with the abuse that take place in jail appear to be a further link in the chain of multiple types of violence which constitute the path for some part of this population. Human Rights Watch is an organization that has undertaken specialized research in prisons since 1987 and in its 1988 report points out that Venezuelan prisons housed a total population of 25381 individuals, 4% of which were women. This same source reported that drug-related crimes led to a 55% increase in the jail population. In 1991, the percentage of female prisoners held in US state prisons for violent crimes was 32.2%, although that the majority had been imprisoned for non-violent crimes. Donzinger points out that the majority of women prisoners that had been sentenced for the murder of someone close to them had been victims of mistreatment or sexual abuse at some time in their lives, and thus violence against women should become an important issue for the authorities, as it is one of the most outstanding problems that reflects the current situation of the living conditions in prison centers. Given the importance that has violence against women in general, and the lack of statistical indicators on the issue of women in prison, the main objective of this paper was to describe the types of physical violence exercised by the partners of 213 women, interviewed at a Preventive Center and at Social Re-adaptation Center, in order to determine the scope of the problem and to propose intervention strategies. A non-probabilistic sample of 213 women, selected for reasons of convenience, was used. A specially designed instrument was used, consisting of a semi-structured interview with 242 questions, covering the following areas of the lives of the women interviewed: demographic data, school history, current family, family of origin, legal status, previous history of imprisonment, work experience, social networks depression, suicide risk, anguish, alcohol consumption variables, alcohol consumption measurement, variables for measuring the use of medical and non-medical drugs, scale of motives for consumption, treatment barriers, intimate relationships and sexuality, sexual abuse, violence/victimization, criminal violence, post-traumatic stress, prison environment, general health, and life styles and impulsiveness. The most important demographic characteristics of women found were: most were in the group aged from 28 to 40 year (45.5%), had six years or less of schooling (41.3%), secondary school (36.2%) and high school or technical college (16.4%) and were single (48.6%) or living with their partners (21.6%) while 50.7% had children under the age of 18. Of the 213 women interviewed, only 161 reported having suffered violence at the hands of their partners; 29.2% had experienced 1 to 5 acts, 23.4% had experienced 6 to 10, and 23.4% had been the object of 11 to 17 acts of violence. Statistics presented in this article in various research studies on family violence in most countries only show a small part of all the violence produced in families, and the results found in this research show that violence is higher among the group of female prisoners. One should not forget that prison reflects an exercise of the system that performs a marginalizing function, as it includes the poorest women from the most disadvantaged sectors, with low educational level. As Lima suggests, women are doubly stigmatized in prison, as they suffer first as women and second as criminals, not only because they belong to an underprivileged group in every social aspect, but because they belong to the group that has violated the classic image of women imposed by society, a fact for which they are severely punished, while the violence and abuse they have suffered is ignored.