UNIVERSIDAD ABIERTA PARA ADULTOS
TEMA
TRASTORNOS RELACIONADOS CON TRAUMAS Y FACTORES DE ESTRÉS
PRESENTADO POR:
DARIELYS GARCIA MEJIA MATRICULA: 16-9680
ASIGNATURA
PSICOLOGIA GENERAL I
FACILITADOR
AMELFIS AMPARO, M.A
NAGUA, MARÍA TRINIDAD SÁNCE! REP"#LICA DOMINICANA A#RIL, $01%
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TRASTORNOS RELACIONADOS CON TRAUMAS Y FACTORES DE ESTRÉS
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INDICE INTRODUCCIÓN.....................................................................................................................................................4 TRASTORNOS DE APEGO REACTIVO.....................................................................................................................5 CRITERIOS
DIAGNOSTICOS...............................................................................................................................5
CARACTERÍSTICAS
DIAGNOSTICAS...................................................................................................................6
CARACTERÍSTICAS ASOCIADAS QUE APOYAN EL DIAGNOSTICO......................................................................6 PREVALENCIA....................................................................................................................................................6 DESARROLLO Y CURSO.....................................................................................................................................6 FACTORES DE RIESGO Y PRONOSTICO.............................................................................................................7 ASPECTOS DIAGNOSTICO RELACIONADOS CON LA CULTURA..........................................................................7 CONSECUENCIAS FUNCIONALES DEL TRASTORNO DE APEGO REACTIVO.......................................................7 DIAGNOSTICO
DIFERENCIA...............................................................................................................................7
COMORBILIDAD................................................................................................................................................ TRASTORNOS DE RELACIÓN SOCIAL DESIN!IBIDA............................................................................................... CRITERIOS
DIAGNÓSTICOS...............................................................................................................................
CARACTERÍSTICAS
DIAGNÓSTICAS..................................................................................................................."
CARACTERÍSTICAS ASOCIADAS QUE APOYAN EL DIAGNOSTICO......................................................................" PREVALENCIA...................................................................................................................................................." DESARROLLO Y CURSO...................................................................................................................................1# FACTORES DE RIESGO Y PRONÓSTICO...........................................................................................................1# CONSECUENCIAS FUNCIONALES DEL TRASTORNO........................................................................................1# DIAGNOSTICO
DIFERENCIAL...........................................................................................................................11
COMORBILIDAD..............................................................................................................................................11 TRASTORNOS DE ESTRÉS POSTRAUM$TICO.......................................................................................................11 CRITERIOS
DIAGNÓSTICOS.............................................................................................................................11
CARACTERÍSTICAS DE DIAGNÓSTICO.............................................................................................................1 CARACTERÍSTICAS ASOCIADAS APOYO DIAGNÓSTICO...................................................................................21 PREVALENCIA..................................................................................................................................................21 FACTORES DE RIESGO Y PRONÓSTICO...........................................................................................................22 PROBLEMAS DE DIAGNÓSTICO DE GÉNERO RELACIONADOS........................................................................22 RIESGO DE SUICIDIO......................................................................................................................................22 DIAGNÓSTICO
DIFERENCIAL...........................................................................................................................22
LA COMORBILIDAD.........................................................................................................................................24 TRASTORNOS DE ESTRÉS AGUDO......................................................................................................................24 CRITERIOS
DIAGNÓSTICOS.............................................................................................................................24
CARACTERÍSTICAS DE DIAGNÓSTICO.............................................................................................................27 CARACTERÍSTICAS ASOCIADAS APOYO DIAGNÓSTICO...................................................................................27 DESARROLLO Y CURSO...................................................................................................................................27 CONSECUENCIAS FUNCIONALES DEL TRASTORNO POR ESTRÉS AGUDO......................................................2 DIAGNÓSTICO
DIFERENCIAL...........................................................................................................................2
TRASTORNOS RELACIONADOS CON TRAUMAS Y FACTORES DE ESTRÉS NO ESPECIFICADOS...........................2" CONCLUSIÓN.......................................................................................................................................................%# BIBLIOGRAFÍA......................................................................................................................................................%1
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INTRODUCCIÓN T&'()*&+*( &'/*+'*( *+ )&'2' 3 4')*&( ()&5( (*+ '*( 7/* ' +' *(//+, + ;+)* )&'2<)/* * ()&('+), 4/=&' >/)'2+) *2* &/)&/* /'=+()/*. E()*( /+3+ )&'()*&+* '=* &')/;*, )&'()*&+* *2&*2/(* (*/' (/+?/7/*, )&'()*&+* ()&5( *()&'2<)/* @TEPT, )&'()*&+* ()&5( '=*, 3 )&'()*&+*( '')'/+. L' **'/+ () '>)* &4B' ' ()&?' &'/+ +)& ()*( /'=+()/*( 3 )&'()*&+*( + *( '>)*( &*'+ ' *( )&'()*&+*( '+(/', )&'()*&+*( *7((/;*- *2(/;*( 3 '4/+(, 3 *( )&'()*&+*( /(*/')/;*(.
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TRASTORNOS DE APEGO REACTIVO CRITERIOS DIAGNOSTICOS A. E( + ')&+ *+(/()+) /+?/7/&(, *+)' 2*/*+'2+) &)&'>' *+ *( /'*&( ')*(, ( 2'+/4/()' *& * (/=/+): 1. E +/* 7(' &'&'2+) *+(* '+* ()' '4/=/*. $. E +/* &(*+ &'&'2+) * ** ' *+(* ')*. #. P&)&7'/+ 2*/*+' 3 (*/' &(/()+) '&')&/'' *& ' 2+*( *( *( (/=/+)(: 1. S+(/7//' 2>+/2' *+ *)&*(. $. A4)* *(/)/;* /2/)'*. . L*( /(*/*( /&&/)'7//' /+/'7, )&/()' * )2*&( ( ;/+) /+(* &'+) '( /+)&'/*+( *+ *( /'*&(. C. E +/* ?' &/2+)'* + ')&+ + *( )&2*( + ' ')+/+ /+(4//+) *2* ( ;/+/' *& ' 2+*( + +* *( (/=/+)(: 1. N=/=+/' * &/;'/+ (*/' *7)+& (( +(/'( 2*/*+'( 3 7<(/'( '&' ( *2*/', ' ()/2'/+ 3 '4)* &/7/*( *& ' ')+/+ *+ *( ')*(. $. C'27/*( &)/)/;*( + *( /'*&( *( '( +* &2/) ('&&*'& + ;>+* '4)/;* @?*='&( &/'+' * /+()/)/*+(. . C&/'+' + ='&( ** ?'7/)'( /2/)'+ (;&'2+) '( **&)+/'( &'& ;>+*( '4)/;*( ()/;*( @?*='&( *+ =&'+ '+)/' +/*(. D. E /'* + &/)&/* C ( &(2 ( &(*+('7 ' *+)' + &/)&/* A.@B. C'+* *( &/)&/*( *2+'&*+ + A '4)'+* &/)&/* C.
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CARACTERÍSTICAS DIAGNOSTICAS E )&'()*&+* ;/+'/+ &')/;* ( '&')&/' *& + ')&+ *+)'( '=* +*)'72+) &)&7'* /+'&*/'* '&' ('&&**, + + +/* &'&' ; * 2>+/2'2+) =/&' &4&/72+) ' +' 4/=&' '=* '&' ' *2*/', '*3*, ' &*)/+ 3 ' &/'+'. L' '&')&>()/' &/+/' ( '=* '(+) * 23 ** ('&&*'* +)& +/* *( /'*&(. L*( +/*( *+ )&'()*&+* &')/;* 2()&'+ +' &(/+ /(2/+/' * '(+) 2*/*+( *(/)/;'( &'+) '( /+)&'/*+( &)/+'&/'( *+ *( /'*&(. E +/* 7 )+& +' ' ('&&** ' 2+*( +; 2((.
CARACTERÍSTICAS ASOCIADAS QUE APOYAN EL DIAGNOSTICO D7/* ' ' '(*/'/+ )/*= /' *2'&)/' *+ '7'+*+* (*/', )&'()*&+* ;/+'/+ &')/;' *&* ' 2+* &)&'(*( + ('&&**, (/'2+) + *( &)&'(*( + ' *=+//+ 3 +='B. O)&'( '&')&>() /'( '(*/''( /+3+ ()&*)/*( 3 *)&*( (/=+*( +=/=+/' =&'; @B. D(+)&//+ (/=+*( 2'' ')+/+. PREVALENCIA L' &;'+/' )&'()*&+* ;/+'/+ &')/;' +* ( *+*, &* )&'()*&+* ( *7(&;' *+ &')/;' *' 4&+/' + ' &<)/' >+/'. E() ( ?' +*+)&'* + +/*( *( '( ()<+ ()*( ' +=/=+/' =&';( '+)( (& **'*( + ?*='&( (()/))*( * + /+()/)/*+(. E+ '27/* + +/*( *7'/*+( =&';2+) (')+/'( )&'()*&+* ( ** 4&+) 3 *&& + ' 2+*( 10 *( +/*(. DESARROLLO Y CURSO C*+//*+( '7'+*+* (*/' ()<+ ' 2+* &(+)( + *( &/2&*( 2(( ;/' + +/*( *+ /'=+*()/* )&'()*&+* ;/+'/+ &')/;', /+(* '+)( ( /'=+*()/ )&'()*&+*. L'( '&')&>()/'( >+/'( ( 2'+/4/()'+ 2'+&' (/2/'& +)& '( '( 9 ' '*(. N* ()' '&* (/ )&'()*&+* &')/;* ' ;/+'/+ ( &* + +/*( 2'3*&( 3 + '(* '4/&2')/;*. D7/* ' ()*, /'=+*()/* 7 ?'&( *+ &'/+ + +/*( 2'3*&( '*(. 6
FACTORES DE RIESGO Y PRONOSTICO E '27/+) 3 '7'+*+* (*/' (*+ '=+*( *( &/(/)* '&' /'=+*()/* )&'()*&+* ;/+'/+ &')/;' 3 ( )'27/5+ H+/* 4') *& &/=* *+*/* '&' ' +4&2'. E &*+*()/* '& +& ' '/' 2/* '27/+) + '( 'B+)* +* ( ?' ()/'*. ASPECTOS DIAGNOSTICO RELACIONADOS CON LA CULTURA C*+)'( '=* (/2/'&( ( ?'+ (&/)* + +/*( *( + 2?'( )&'( )** 2+*. S/+ 27'&=*, ( 7 )+& & '/+ ' ?'& /'=+*()/* )&'()*&+* ;/+'/+ P&*72'( /'=+*()/* &'/*+'*( *+ ' )&'.
CONSECUENCIAS FUNCIONALES DEL TRASTORNO DE APEGO REACTIVO E() )&'()*&+* +)*& (&/'2+) ('&&** 3 ' ''/' *( +/*( *( &'/*+'&( /+)&&(*+'2+) *+ *( ')*( * *2'&*(, 3 ( '(*/' *+ + )&/*&* 4+/*+' + 2?*( <27/)*( ' &/2&' /+4'+/'. DIAGNOSTICO DIFERENCIA T&'()*&+* ()&* ')/()': *2*&)'2/+)*( (*/'( '7&&'+)( ( 2'+/4/()'+ + *( +/*( *( *+ + )&'()*&+* ;/+'/+ &')/;', (/+* )'27/5+ (*+ '( &/+/'( '&')&>()/'( )&'()*&+* ()&* ')/()'. E+ *+&)*, +/*( *+ () )/* 2'+/4()'/+ 2*/*+( *(/)/;'(, &)&'(*( *=+/)/;*( 3 +='B, 3 )&/*&* + ' &/&*/' (*/'. E()*( *( )&'()*&+*( ( /()/+=+ (( ?/()*&/ '( /4&+/'( '7'+*+* 3 ' &(+/' /+)&(( &()&/+=/*( * *2'&)/2/+)*( &/)'/'*(. L*( +/*( *+ ()&* ')/()' &'&'2+) )/++ ?/()*&/'( '7'+*+* (*/'. E( /2*&)'+) ('7& *( +/*( *+ '/&' ()'( *+//*+( + ?/7/& *2*&)'2/+)*( ()&*)>/*( )'( *2* 2&( * 2*;&(. Retraso mental (trastorno del desarrollo ntele!t"al#$
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L*( &)&'(*( ('&&** ' 2+* '*2''+ )&'()*&+* &')/;* ' ;/+'/+, &* +* 7 *+4+/&( *+ )&'()*&+*. L*( +/*( *+ /(''/' /+))' 7+ ?/7/& '( ?'7//'( (*/'( 3 2*/*+'( *2'&'7( ' (( ?'7//'( *=+/)/;'( 3 +* ' &/+ + '4)*( *(/)/;*( 3 &='/*+( 2*/*+'( + +/*( *+ )&'()*&+* '=* &')/;*. L*( )&'()*&+*( &(/;*( + +/*( *( )'27/5+ ( '(*/'+ *+ &/*+( + '4)* *(/)/;*. E/()+ &7'( /2/)''(, (/+ 27'&=*, (=/&+ *( +/*( *+ )&'()*&+*( &(/; *( )/++ ')&'/*+ ( + ' +/+. E( /&, *( +/*( ?'+ (/* /'=+*()/'*( *+ )&'()*&+*( &(/;*( 'H+ 1 7+ )&')'& &(*+& ' *( &*+4*&)'+)( (4&*( *( /'*&(.
COMORBILIDAD L'( *+//*+( '(*/''( *+ '7'+*+*, *2*, &)&'(*( *=+/)/;*(, &)&'(*( +='B, 3 *( ()&*)/*(, ' 2+* *&&+ *+ )&'()*&+* ;/+'/+ &')/;'. C*+//*+( 25/'(, )'( *2* (+)&//+ (;&', + '*2''& ' *( (/=+*( ' +4&2'. L*( (>+)*2'( &(/;*( )'27/5+ + */()/& *+ )&'()*&+* '=* &')/;*.
TRASTORNOS DE RELACIÓN SOCIAL DESIN!IBIDA CRITERIOS DIAGNÓSTICOS A. U+ ')&+ *2*&)'2/+)* + + +/* ( '&' ')/;'2+) /+)&')H' *+ ')*( (*+*/*( 3 *(//*+( ' 2+*( *( *( (/=/+)(: 1. R/+ ' '7*&'& * /+)&')'& *+ ')*( (*+*/*(. $. C*+)' ;&7' * 4>(/' 2'(/'* 4'2//'&@+* ( *+(/()+) *+ ' )&' 3 *+ *( /2/)( (*/'( '&*/''( '&' ( '. . D/(2/+/+ * '(+/' *+ /'*& =* ';+)&'&( B*(, /+(* +)*&+* 4'2//'&.
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. D/(*(//+ '&' /&( *+ + ')* (*+*/* *+ 2/+/2' * +/+=+' ;'/'/+. #. L*( *2*&)'2/+)*( + &/)&/* A +* ( /2/)'+ ' ' /2(/;/' , &* /+3 *2*&)'2/+)* (*/'2+) (/+?/7/* C. E +/* ? &/2+)'* + ')&+ *( )&2*( ' ')+/+ /+(4//+) *2* ( ;/+/' *& ' 2+*( + + *( (/=/+)(: 1. N=/=+/' * &/;'/+ (*/' )+& (( +(/'( 7<(/' '&' ( *2*/', ' ()/2'/+ 3 '4)* &/7/*( *( ')*(. $. C'27/*( &)/*( + *( /'*&( +* &**&/*+'+ ;>+*( '4)*(. . L' &>' + ='&( ** ?'7/)'( /2/)'+ ' &'/+ ;>+*( ()/;*( @?*='&( &/'+' /+()/)/*+(. D. E /'* + &/)&/* C ( &(2 ( &(*+('7 ' *+)' ')&'' + &/)&/* A. E. E +/* +* 2 *+ ' ' ('&&** *& * 2+*( 9 2((.
CARACTERÍSTICAS DIAGNÓSTICAS L' '&')&>()/' (+/' )&'()*&+* *2&*2/(* (*/' (/+?/7/' ( + ')&+ *2*&)'2/+)* /2/' )&'2+) + /+'&*/'* *2*&)'2/+)*, 2'(/'* 4'2//'& *+ )&'*( @&/)&/* A, () ;/*' *( /2/)( (*/'( ' )&' CARACTERÍSTICAS ASOCIADAS QUE APOYAN EL DIAGNOSTICO D7/* ' ' '(*/'/+ )/*=/' *2'&)/'( *+ '7'+*+* (*/', (/+?/7/* )&'()*&+* *2&*2/(* (*/' */()/& *+ &)&'(* + ('&&**, &)&'(*( *=+/)/;*( 3 +='B (*/', ()&*)/*(, 3 *)&*( (/=+*( +=/=+/' =&'; *2* (+)&//+ 3 2'' ')+/+.
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PREVALENCIA L' &;'+/' )&'()*&+* '=* (*/', (/+?/7/* ( (*+*/'. P'& (& ** 4&+), *&& + +' 2/+*&>' *( +/*(, /+(* + '*( ?'+ (/* (/'*( =&';2+) 3 **'*( + ?*='&( (()/))*( * /+()/)/*+(. DESARROLLO Y CURSO C*+//*+( '7'+*+* (*/' ()<+ ' 2+* &(+)( + *( &/2&*( 2(( ;/' + +/*( *+ /'=+()/* )&'()*&+* *2&*2/(* (*/' (/+?/7/', /+(* '+)( ( /'=+*()/' )&'()*&+*. S/ ( &* '7'+*+* )2&'+* 3 ''&+ (/=+*( ' +4&2', '( '&')&>()/'( >+/'( ' +4&2' (*+ 2*&''2+) ()'7( + )/2*, (*7& )** (/ '( *+//*+( '7'+*+* &(/()+. C'+* )&'()*&+* &(/() + ' 2/)' ' /+4'+/', '( '&')&>()/'( >+/'( ( 2'+/4/()'+ ;&7'2+) 3 4>(/'2+) (*7& ' 4'2//'&/' 3 ' &(/+ '( 2*/*+( +* ')+)/'(, + ' ' &(*'& ''& /+)&(/+ ;&7' 3 (*/' 2'( /2*&)'+), ' 2+* '*2''* *& +' *+)' 7H(' ')+/+.
FACTORES DE RIESGO Y PRONÓSTICO Am%ental:
A7'+*+* (*/' =&'; ( + &/(/)* /'=+*()/* '&' )&'()*&+* *2&*2/(* (*/' (/+?/7/* 3 )'27/5+ ( H+/* 4')*& &/(=* *+*/* '&' ' +4&2'. +&'7//' +&*7/*=/' /4&+/'& ' *( +/*( '7'+*+'*( 3 +* ('&&*'+ ' +4&2'. E+ 2?*( '(*(, )&'()*&+* &(/(), /+(* + +/*( 3* /'* *+ ( 2/* '27/+) 2B*&' +*)'72+). Mod&!adores del !"rso
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CONSECUENCIAS FUNCIONALES DEL TRASTORNO E )&'()*&+* +)*& (&/'2+) ' ''/' *( +/*( *( '&' &'/*+'&( /+)&&(*+'2+) *+ *( ')*( 3 *2'&*(.
DIAGNOSTICO DIFERENCIAL D7/* ' ' /2(/;/' (*/' ' ;( '*2'' )&'()*&+* ')+/+ *+ ?/&')/;/' @TDA, ( +('&/* /4&+/'& *( *( )&'()*&+*(. L*( )/+ )&'()*&+* *2&*2/(* (*/' (/+?/7/' + /()/+=/&( '( &(*+'( *+ TDA *& *( &/2&*( +* &(+)'+ /4/)'( + ' ')+/+ * ?/&')/;/'. COMORBILIDAD L'( *+//*+( '(*/''( *+ '7'+*+*, *2* &)&'(*( *=+/)/;*(, &)&'(*( +='B 3 *( ()&*)/*( + */()/& *+ )&'()*&+* *2&*2/(* (*/' (/+?/7/*. P+ (& /'=+*()/'*( *+ '27*( )&'()*&+*(.
TRASTORNOS DE ESTRÉS POSTRAUM$TICO CRITERIOS DIAGNÓSTICOS L*( )&'()*&+*( '')'/+ + (& /'=+*()/'*( 3 &(/()+ ?'()' @6 2(( (5( ' *(//+ ' ;+)* )&'2<)/*, 2/+)&'( )&'()*&+* ()&5( '=* *&&/& (*'2+) +)& @ >'( 3 @1 2( *(//+ ' 4')*& ()&5( 3 )&'()*&+* ()&5( *()&'2<)/* +* (& /'=+*()/'* ?'()' ?'3' )&'(&&/* ' 2+*( @1 2( ( ' ''&//+ ' (/)'/+ ()&('+). E &4/ (>+)*2'( &&/*( '&' )&'()*&+* ()&5( *()&'2<)/* 3 )&'()*&+* ()&5( '=* (*+ '( /4&+/' *( )&'()*&+*( '')'/+.
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.R'/*+( /(*/')/;'( @*& B2*, (+'( &)&*()/;'( , + /+/;/* (/+) * ')H' *2* (/ '*+)/2/+)* )&'2<)/* @( ( &/) . @T'( &'/*+( + *&&/& + + *+)/+* , *+ ' &(/+ )&2' (& +' *2)' 5&/' ' *+/+/' *( ')'( +)*&+*( N*)' : E+ *( +/*(, &&'/+ )&'2' (>4/* *&&/& + B=* . .M'()'& (/*=/* /+)+(* * &**+='* ' *+&( ' ()>2*( /+)&+*( * )&+*( (/27*/'+ * &&'+ + '()* '*+)/2/+)* )&'2<)/* @ ( . .M'&'* &'/*+( 4/(/*=/'( ' ()>2*( /+)&+*( * )&+*( (/27*/'+ * &&'+ + '()* '*+)/2/+)* )&'2<)/* @ ( . C.
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)&/*&* + '( <&'( (*/'(, *'/*+'(, *)&'( /2*&)'+)( 4+/*+'2/+)*. . E )&'()*&+* +* ( 7 ' *( 4)*( 4/(/ *=/*( +' (()'+/' @*& B2*, 2/'2+)*(, '*?* *)&' *+//+ 25/'. Es'e!&!ar s:
C*+ (>+)*2'( /(*/')/;*(: *( (>+)*2'( /+/;/* 2+ *+ *( &/)&/*( '&' )&'()*&+* ()&5( *()&'2<)/*, 3 '2<(, + &(()' ' 4')*& ()&5(, /+/;/* &/2+)' *( (>+)*2'( &(/()+)( * &&&+)( '/&' *( (/=/+)(: $
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('&'* , 3 *2* (/ +* 4&' + *7(&;'*& )&+* , +* *( &*(*( 2+)'( * &* @ *& B2*, (/+)/+* *2* (/ +* ();/&' + + (*, (/+)/+* +' (+('/+ /&&'/' 3* * &* * )/2* 2*;/5+*( +)'2+). +$ Dereal)aton: &/+/'( &(/()+)( * &&&+)( /&&'/' +)*&+*
@*& B2*, 2+* '&*& /+/;/* ( &/2+)' *2* /&&', *+>&/* , /()'+), * /()*&(/*+''. N*)' : P'&' )//'& () (7)/*, *( (>+)*2'( /(*/')/;*( +* 7+ ')&/7/&( ' *( 4)*( 4/(/*=/*( +' (()'+/' @*& B2*, *( ''=*+(, *2*&)'2/+)* &'+) ' /+)*/'/+ '*?* *)&' *+//+ 25/' @*& B2*, *+;(/*+( '&/'( *2B'(.
15
Es'e!&!ar s: Con e,'res*n tard-a: S/ *( &/)&/*( /'=+()/*( +* ( 2+ *& * 2+*(
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
16
. R'/*+( /(*/')/;'( @*& B2*, (+'( &)&*()/;'(, + +/* ( (/+) * ')H' *2* (/ '*+)/2/+)* )&'2<)/* @( ( &/). @T'( &'/*+( + *&&/& + + *+)/+* , *+ ' &(/+ )&2' (& +' *2)' 5&/' ' *+/+/' *( ')'( +)*&+*(. T' &&'/+ )&'2' (>4/* *&&/& + B=* . . M'()'& (/*=/* /+)+(* * &**+='* ' *+&( ' ()>2*( /+)&+*( * )&+*( (/27*/'+ * &&'+ + '()* '*+)/2/+)* )&'2<)/* @(. . M'&'* &'/*+( 4/(/*=/'( ' *( &&*( ;+)* )&'2<)/* @(. C.
U+* @* 2<( *( (/=/+)( (>+)*2'(, &&(+)' 3' (' ' ;/)'/+
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
D.
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
(/+)/+* +' (+('/+ /&&'/' 3* * &* * )/2* 2*;/5+*( +)'2+) . $. D(&'/'/+: &/+/'( &(/()+)( * &&&+)( /&&'/' +)*&+* @*& B2*, 2+* '&*& /+/;/* ( &/2+)' *2* /&&', *+>&/*, /()'+), * /()*&(/*+''. N*)' : P'&' )//'& () (7)/*, *( (>+)*2'( /(*/')/;*( +* 7+ ')&/7/&( ' *( 4)*( 4/(/*=/*( +' (()'+/' @*& B2*, *( ''=*+( *)&' *+//+ 25/' @*& B2*, *+;(/*+( '&/'( *2B'(. E(/4/'& (/: C*+ &(/+ )'&>': S/ *( &/)&/*( /'=+()/*( +* ( 2+ *& * 2+*( ?'()' 6 2(( (5( ;+)* @'+ ' ''&//+ 3 &(/+ '=+*( *( (>+)*2'( + (& /+2/')*(.
CARACTERÍSTICAS DE DIAGNÓSTICO S ('&&*'+ (>+)*2'( '&')&>()/*( =* ' *(//+ ' +* 0 2<( ;+)*( )&'2<)/*(. P&*2/+' &/2+)'& 2*/*+( 4&)( 3 (>+)*2'( *2*&)'2/+)*. E+ *)&*( '+?+/*( * ()'*( <+/2* ?/()&/*( 3 *=+//*+( +=')/;'( + (& '+=()/'+)(.. E+ +*( ' &')/;/'-)&/*&/'& (*+ &*2/+'+)( + *)&*(, *( (>+)*2'( /(*/')/;*( &*2/+'+. P ?'7& *27/+'/+ )**( *( '+)&/*&(. 6.E;+)*( )&'2<)/*( + @&/)&/* A /+3+, &* ( /2/)'+ ': *27'), '2+'' * '(')*( 4>(/*(, '2+''( * ;/*+/' (' @4*&'', '7(* (' 4'//)'* *& &*='(, *+)')* (' '7(/;*, (/+ *+)')*, )&<4/* (', (()&'*&( (& )*2'*( &?+(, ')' )&&*&/()', )*&)&', +'&'2/+)* @PO, ('()&( +')&'( * ??*( *& ?*27& 3 '/+)( ')*( * '2/*+( =&';(, ' 2&) +')&' 3 (/*+( =&'; 1"
E )&'()*&+* (& =&'; * &'&* '+* '=+) ()&('+) ( /+)&&(*+' /+)+/*+' @)*&)&', ;/*+/' ('. E ;+)* )&'2<)/* (& &('* /;&('( 4*&2'( @&/)&/* #1, + (*( &&&+)(, &&*( * 4'(?7'(, (*+ /+;*+)'&/*( /+)&(/;*( '+=()/*(*(. E 5+4'(/( ()' + *( &&*( &&&+)( /+3+ *+)'( (+(*&/'(, 2*/*+'( 3 (/*=/'( @&/)&/* #$ E/(*/*( /(*/')/;*( &'+ ** (=+*( ?'()' ;'&/'( ?*&'( /+(*, >'(. D&'+) ;+)* ( &;/ ; '*+)/2/+)* 3 ( *2*&)' *2* (/ 4&' 2*2+)* ')' @&/)&/* # L*( )&'2'( &'/*+'*( ' *( @&/)&/*( # * # (+'+'+ ((*( (/2/'&( &')/;/' 4/(/*=/' @EB. &'<+ =* 3 '/& '2+'' )*&2+)'. E()* ')/;' (/()2' >27/* '2/+/()&')/;* 3 +*( *+ + ()'* '&)'.
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
CARACTERÍSTICAS ASOCIADAS APOYO DIAGNÓSTICO R=&(/+ + ('&&**, )'( *2* ' 5&/' +='B + +/*( *(, ( &*/&. S*-'/+'/*+( '/)/;'(, )'( *2* )+& ' &/+/' (+(*&/' *>& *( +('2/+)*( +* ?'7' + +' * ;'&/'( ;*( /4&+)(, '(> *2* /'/+ '&'+*/, + ()'& &(+)(. T&'( &**+='', &)/' 3 ;+)*( )&'2<)/*( =&';( @*& B2*, '7(* /+4'+)/, ' )*&)&', /+/;/* , '2<(, )+& /4/)'( '&' &='& '( 2*/*+( * 2'+)+& &'/*+( /+)&&(*+'( ()'7(, * (>+)*2'( /(*/')/;*(. C'+* ;+)* )&'2<)/* &* ' 2&) ;/*+)', (>+)*2'( )'+)* * &*72<)/* 3 )&'()*&+* ()&5( *()&'2<)/* + ()'& &(+)(. 21
PREVALENCIA E+ *( E()'*( U+/*(, &/(=* *& ;/' &*3)'' '&' TEPT )//'+* &/)&/*( DSM-I ' ' ' % '*( ( 8.% . P&;'+/' * 2(( +)& *( ')*( + E()'*( U+/*( ( '&*/2''2+) . . E()/2'/*+( 2<( 7'B'( ( *7(&;'+ + E&*' 3 *( '>(( '(/<)/*(, '4&/'+*( 3 ')/+*'2&/'+*(, ' '=&'/+ + )*&+* ' 0. -1.0 . E+ *2'&'/+ *+ *( 7'+*( +* ')/+*( E()'*( U+/*(, '( )'('( 2<( ;''( )&'()*&+* ()&5( *()&'2<)/* ( ?'+ &*&)'* +)& *( ')/+*( + EE.UU., *( '4&*'2&/'+*( 3 *( /+/*( '2&/'+*(, 3 '( )'('( 2<( 7'B'( ( ?'+ &*&)'* +)& *( ()'*+/+(( *&/=+ '(/<)/*, (5( 'B() ' *(//+ )&'2<)/' 3 '( ;'&/'7( 2*=&<4/'(. C*+ 4&+/', ' &'/+ + /+/;/* ' + )&'2' /+//'2+) 2 *+ *( &/)&/*( '&' )&'()*&+* ()&5( '=* + &>** /+2/')'2+) *()&/*& ' )&'2'. D&'/+ *( (>+)*2'( )'27/5+ ;'&>', *+ &&'/+ *2)' +)&* 2(( *&&+ + '&*/2''2+) ' 2/)' *( ')*(, 2/+)&'( '=+*( /+/;/*( &2'++ (/+)*2<)/*( &'+) 2<( 1$ 2(( 3 ' ;( &'+) 2<( 0 '*(.
FACTORES DE RIESGO Y PRONÓSTICO L*( 4')*&( &/(=* @3 &*)/+ ( /;/+ =+&'2+) + &)&'2')/*, &/)&'2<)/* 3 4')*&( *()&'2<)/*.
PROBLEMAS DE DIAGNÓSTICO DE GÉNERO RELACIONADOS E PTSD ( 2<( 4&+) +)& '( 2B&( +)& *( ?*27&( &'+) )*' ' ;/'. RIESGO DE SUICIDIO L*( ;+)*( )&'2<)/*( *2* '7(* ' /+4'+/' '2+)'+ &/(=* (///* +' &(*+'. TEPT ( '(*/' *+ /'/+ (//' /+)+)*( 22
(///*, 3 ' &(+/' ' +4&2' /+/'& '( &(*+'( *+ /'/+ 4/+'2+) ?'& + '+ (///* * /+)+)*( (///* + &'/'.
DIAGNÓ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
E )&'()*&+* &(/;* 2'3*&. L' &(/+ 2'3*& * +* (& &/* *& + ;+)* )&'2<)/* 3 ( 7 /'=+*()/'& (/ *)&*( (>+)*2'( PTSD ()<+ '(+)(. T&'()*&+*( ' &(*+'/'. D/4/)'( /+)&&(*+'( );/&*+ ( ''&//+, * ( '&7'+ + =&'+ 2/', (5 ( ' *(//+ ' + ;+)* )&'2<)/* + (& +' /+/'/+ )&'()*&+* ()&5( *()&'2<)/*, + ='& + )&'()*&+* ' &(*+'/', + ( (&' /++/+)2+) '/& *(//+ )&'2<)/' )'( /4/)'(.
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T&'()*&+*( /(*/')/;*( . A2+(/' /(*/')/;', )&'()*&+* /+)/' /(*/')/;*, 3 )&'()*&+* (&(*+'/'/+-(&'/'/+ * +* (& &/* *& ' *(//+ ' + ;+)* )&'2<)/* * + * + +* )+& (>+)*2'( TEPT *+&&+)(. E )&'()*&+* *& *+;&(/+ @(>+)*2' )&'()*&+* +&*=/* 4+/*+' E( +' '4/+ (' 2+)' + ' ' +' &(*+' &(+)' =&', '&</(/( *)&*( (>+)*2'( (/()2' +&;/*(* @+&*=/*( +* ( + /'& *& 2/* +' ;'*&'/+ 25/'.. L*( )&'()*&+*( (/)/*(. F'(?7'( + TEP 7+ /()/+=/&( '( /(/*+(, '/+'/*+( 3 *)&*( )&'()*&+*( ' &/+ ( '+ &*/& + ' (/*4&+/', )&'()*&+* (/)/* 7&;, 3 *)&*( )&'()*&+*( (/)/*(, )&'()*&+*( &(/;*( 3 7/*'&( *+ '&')&>()/'( (/)/'(, /&/*, (()'+/' K )&'()*&+*( /+/*( *& 4<&2'*( 3 )&'()*&+*( (/)/*( 7/* ' *)&' *+//+ 25/'. L' (/+ &7&' )&'2<)/'. C'+* +' (/+ &7&' ( &* + *+))* + ;+)* )&'2<)/* @*& B2*, + '/+) )&'2<)/*, *(/+ ' 7*27', ' '&'/+ K &'/+ )&'2', + ''&& (>+)*2'( )&'()*&+* ()&5( *()&'2<)/*.
LA L'( COMORBILIDAD &(*+'( *+ )&'()*&+* ()&5( *()&'2<)/* (*+ 80 2<( &*7'7 '*( (/+ )&'()*&+* ()&5( *()&'2<)/* ' )+& (>+)*2'( 2'+ *+ *( &/)&/*( /'=+()/* '&' ' 2+*( *)&* )&'()*&+* 2+)' @*& B2*, &(/+, )&'()*&+* 7/*'&, '+(/', * )&'()*&+*( (* (()'+/'(. T&'()*&+* *& (* (()'+/'( No se en!"entran entradas de -nd!e$*2&7/*( 3 )&'()*&+*( *+)' (*+ 2<( *2+( +)& *( ?*27&( +)& '( 2B&(. E+)& *( 2//)'&( ()'*+/+(( 3 *( ;)&'+*( =&&' ( ?'+ (='* + '( H)/2'( =&&'( + A4='+/()<+ I&', 24
**&&+/' TEPT 3 LCT ; ( 8. A+ ' 2'3*&>' *( +/*( *+ )&'()*&+* ()&5( *()&'2<)/* )'27/5+ )/++ ' 2+*( *)&* /'=+()/*, *( ')&*+( *2*&7//' (*+ /4&+)( + *( ')*(, *+ )&'()*&+* +=')/;/()' ('4/'+) 3 )&'()*&+* '+(/' *& ('&'/+ &*2/+'+). P*& H)/2*, /() +' *+(/&'7 *2*&7//' +)& )&'()*&+* ()&5( *()&'2<)/* 3 )&'()*&+* +&**=+/)/;* /2*&)'+) 3 '=+*( *( (>+)*2'( ( (&*++ +)& ()*( )&'()*&+*(.
TRASTORNOS DE ESTRÉS AGUDO CRITERIOS DIAGNÓSTICOS A. L' *(//+ ' ' 2&) &' * '2+'', (/*+( =&';( * ;/*'/+ (' + +' @* 2<( '( (/=/+)( 2'+&'(: D/&)'2+) &/2+)'& ;+)* )&'2<)/* @(. S& )()/=*, + &(*+', ;+)* @( + *&&/ ' *( 2<(. A +)&'&( ;+)* @( *&&/ ' + 2/27&* &'+* ' 4'2//' * + '2/=* &'+*. N*)': E+ '(* 2&) * ' '2+'' + 4'2//'& * '2/=*, ;+)* @( 7 ?'7& (/* ;/*+)' * '/+)'. E&/2+)'& &)/' * *(//+ )&2' ' *( )'( ';&(/;*( ;+)* )&'2<)/* @( @*& B2*, *( &/2&*( + &(*+& &*=/+* &()*( ?2'+*(, */>'( ()*( &)/'2+) ' *( )'( 2'*( )&')*(. N*)': E()* +* ( '/' ' ' *(//+ ' )&';5( 2/*( )&+/*(, ' );/(/+, '( >'( * /2<=+(, ' 2+*( ' *(//+ ()< &'/*+'' *+ )&'7'B*. #. P&(+/' +; @* 2<( *( (/=/+) ( (>+)*2'( '/&' '( /+* ')=*&>'( ' /+)&(/+, ()'* <+/2* +=')/;*, ' /(*/'/+, ' ;/)'/+ 3 ' /)'/+, *2/+* * 2*&'2/+)* (5( ;+)* )&'2<)/* @( *&&/: I+)&(/+ S-ntomas
25
R&&+)(, /+;*+)'&/*( /+)&(/;'( &&*( **&*(*( ;+)* )&'2<)/* @(. N*)': E+ *( +/*(, *&&/& B=* &)/)/;* + ( &('+ *( )2'( * '()*( ;+)* )&'2<)/* @(. S*( '+=()/*(*( &&&+)( + *( *+)+/* 3 K * '4)'+ (* ()<+ &'/*+'*( *+ ;+)* @(. N*)': E+ *( +/*( ?'7& (*( )&&*&>4/*( *+)+/* /&&*+*/7. R'/*+( /(*/')/;*( @*& B2*, (+'( &)&*()/;'(, + /+/;/* (/+) * ')H' *2* (/ '*+)/2/+)* )&'2<)/* @( ( &/). @T'( &'/*+( + *&&/& + + *+)/+*, *+ ' &(/+ )&2' (& +' *2)' 5&/' ' *+/+/' *( ')'( +)*&+*(. N*)': E+ *( +/*(, &&'/+ )&'2' (>4/* *&&/& + B=*. M'()'& (/*=/* /+)+(* * &**+='* * &'/*+( 4/(/*=/'( 2'&''( + &(()' ' ()>2*( /+)&+*( * )&+*( (/27*/'+ * &&'+ + '()* '*+)/2/+)* )&'2<)/* @(. Estado de .nmo ne/at0o
. L' /+''/' &(/()+) &/2+)'& 2*/*+( *(/)/;'( @*& B2*, /+''/' '&' &/2+)'& ' 4//', ' (')/(4'/+, * (+)/2/+)*( '2*&. Los s-ntomas dso!at0os
6. U+' ')&'/+ + (+)/* ' &'/' * +*( &*' * +* 2/(2* @*& B2*, ;&( ' (> 2/(2* ( ' &()/; ' *)&' &(*+', ()' & + + (*, )/2* ('&'/+. %. L' /+''/' '&' &*&'& + '() * /2*&)'+) ;+)* )&'2 <)/* @( @*& * =+&' 7/* ' ' '2+(/' /(*/')/;' 3 +* ' *)&*( 4')*&( )'( *2* (/*+( + ' '7', '*?*, * &*='(. Los s-ntomas de e0ta!*n
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8. E(4&*( '&' ;/)'& &&*( **&*(*(, +('2/+)*( * (+)/2/+)*( (*7& * ()&?'2+) &'/*+'*( *+ '*+)/2/+)* )&'2<)/* @(. 9.
E(4&*( '&' ;/)'& &*&')*&/*( )&+*( @&(*+'(, ='&(,
*+;&('/*+(, ')/;/'(, *7B)*(, (/)'/*+( (/&)'+ &&*( **&*(*(, +('2/+)*( * (+)/2/+)*( (*7& * ()&?'2+) &'/*+'*( *+ '*+)/2/+)* )&'2<)/* @(.
Los s-ntomas de alerta
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CARACTERÍSTICAS DE DIAGNÓSTICO L' '&')&>()/' (+/' )&'()*&+* ()&5( '=* ( ('&&** (>+)*2'( '&')&>()/*( &'+ >'( ' 1 2( (5( ' *(//+ ' +* * 2<( ;+)*( )&'2<)/*(. @S*+ (/2/'&( ' '( '&')&>()/'( PTSD
CARACTERÍSTICAS ASOCIADAS APOYO DIAGNÓSTICO L*( /+/;/*( *+ )&'()*&+* ()&5( '=* ?'7/)'2+) '&)//'+ + +('2/+)*( ')'()&4/*( * 23 +=')/;*( (*7& ( ' + ;+)* )&'2<)/*, ( &(()' ' ' &/+/' )&'2<)/', * ' &*7'7//' '*( 4)&*(. P*& B2*, + /+/;/* *+ )&'()*&+* ()&5( '=* (+)/&( (/;'2+) '7 *& +* ?'7& /2/* ;+)* )&'2<)/* * +* '')'&( ' ' &/+/' *+ 2<( 5/)*.
DESARROLLO Y CURSO T&'()*&+* *& ()&5( '=* +* ( /'=+*()/'& ?'()' >'( (5( + ;+)* )&'2<)/*. A+ )&'()*&+* ()&5( '=* &*=&('& ' )&'()*&+* ()&5( *()&'2<)/* @TEPT (5( 1 2(, )'27/5+ (& +' &(()' ()&5( )&'+(/) *&/' &2/) '* 1 2( *(//+ ' )&'2' 3 +* ' ='& ' )&'()*&+* ()&5( *()&'2<)/*. A&*/2''2+) ' 2/)' '( &(*+'( 4/+'2+) ('&&*'+ TEPT &(+)'+ /+//'2+) *+ )&'()*&+* ()&5( '=*. CONSECUENCIAS FUNCIONALES DEL TRASTORNO POR ESTRÉS AGUDO P&*72'( 4+/*+'2/+)* + *( <27/)*( (*/'(, /+)&&(*+'( * '7*&'( ( ?' 2*()&'* ' )&';5( *( (*7&;/;/+)( '/+)(, '=&(/*+( 3 ;/*'/+ ('&&*'+ )&'()*&+* ()&5( '=*. L*( +/;( )&2*( '+(/' + ()'& '(*/'*( *+ )&'()*&+* ()&5( '=* + /+)&4&/& *+ (*, *( +/;( +&=>', 3 ' ''/' '(/()/& ' '( )'&'(.
2
DIAGNÓSTICO DIFERENCIAL Los trastornos de ada'ta!*n . E+ )&'()*&+* ()&5( '=*, 4')*&
()&('+) (& '/& =&'* =&';' + ='& ' =&';' 3 )/* &&/* *& &/)&/* A )&'()*&+* ()&5( '=*. Trastorno de '.n!o$ E )&'()*&+* <+/* ( /'=+*()/' (* (/ *( ')'(
<+/* (*+ /+(&'*( 3 +* ?'3 '+(/' '&' ')'( 4)&*( * '27/*( + *2*&)'2/+)* ( '')')/;*( '(*/''( *+ 2/* '( *+(+/'( +4'()'( *( ')'(. Trastornos dso!at0os . R(()'( /(*/')/;*( =&';( @+ '(+/'
(>+)*2'( '&')&>()/*( )&'()*&+* *& ()&5( '=* + (& /'=+*()/'*( *2* )&'()*&+* (&'/'/+ K (&(*+'/'/+. Trastorno de estr1s 'ostra"m.t!o . T&'()*&+* *& ()&5( '=* ( /()/+=
)&'()*&+* ()&5( *()&'2<)/* 7/* ' ')&+ (>+)*2'( )&'()*&+* ()&5( '=* 7 *&&/& +)&* 1 2( (5( ;+)* )&'2<)/* 3 &(*;& +)&* ( &>** 1 2(. S/ *( (>+)*2'( &(/()+ *& 2<( 1 2( 3 2+ &/)&/*( )&'()*&+* ()&5( *()&'2<)/*, /'=+()/* ( '27/' )&'()*&+* ()&5( '=* ' TEPT. El trastorno o%ses0o2!om'"ls0o$ E+ )&'()*&+* *7((/;*-*2(/;*, ?'3
+('2/+)*( /+)&(/;*( &&&+)(, &* 5()'( 2+ ' 4/+//+ +' *7((/+. A2<(, *( +('2/+)*( /+)&(/;*( +* ( &'/*+' *+ + ;+)* )&'2<)/* &/2+)'*, *2(/*+( (+ ()'& &(+)(, 3 *)&*( (>+)*2'( )&'()*&+* ()&5( '=* (+ (& '(+). Los trastornos 's!*t!os$ F'(?7'( + )&'()*&+* ()&5( '=* 7+
/()/+=/&( '( /(/*+(, '/+'/*+( 3 *)&*( )&'()*&+*( ' &/+ ( '+ &*/& + ' (/*4&+/', *)&*( )&'()*&+*( (/)/*(, &(/+ * )&'()*&+* 7/*'& *+ (>+)*2'( (/)/*(, /&/*, ' (()'+/' K /+/*( *& 4<&2'*(, +4&2'( 3 )&'()*&+*( (/)/*( 7/*( ' *)&' *+//+ 25/'. La les*n !ere%ral tra"m.t!a$ C'+* ( &* +' (/+ &7&' +
*+))* + ;+)* )&'2<)/* @*& B2*, '/+) )&'2<)/*, *(/+ 2"
+' 7*27', ' '&'/+ K &'/+ )&'2')/(2*, + ''&& (>+)*2'( )&'()*&+* ()&5( '=*.
TRASTORNOS RELACIONADOS CON TRAUMAS Y FACTORES DE ESTRÉS NO ESPECIFICADOS E )&'2' * ')=*&>' +* (/4/'' )&'()*&+* ()&5( &'/*+'* ( )//' + (/)'/*+( + '( 25/* *) *& +* (/4/'& ' &'+ *( &/)&/*( +* ( 2+ *& + )&'2' 3 )&'()*&+* (>4/* ()&5( &'/*+'* /+3 &(+)'/*+( + '( /() /+4*&2'/+ /+(4//+) '&' ?'& + /'=+()/* 2<( (>4/* @*& B2*, + (/)'/*+( &=+/'(
CONCLUSIÓN A *+/& () )&'7'B* * /& T&'2' ( + 4')*& *2+/&(+) + ' ?/()*&/' ' ?2'+/', 3 + ' ;/' *)//'+' '( &(*+'(. S 4/+//+, /'=+()/*, 2'+/(2*( '/+ 3 )&')'2/+)* ()<+ + +' ;*/+. U+' &/+/' )&'2<)/' *+()/)/& +' /(*+)/+/' (H7/)' + ' ;/' +' &(*+', *& * (/2& ( /2*&)'+) ;''& ' +(/' +' /+)&;+/+ &* &2/)' ' )/+ (>+)*2'( T&'()*&+* *& E()&5( /+//'& + )&')'2/+)* &;+=' ' &*+/4/'/+ 3 *2B/'/*+ '&*.
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'3 ()''& 2'+' /'=+()/* 3 ()'>()/* *( )&'()*&+*( 2+)'( ( ' 2</2' &4&+/' ')*&/'' *& ' &<)/' >+/' + '2* ' (' 2+)'. L*( '27/*( ()&)&'( 3 /'=+()/*( ' /+)' //+ (*+ + 2')&/' )**( *( >+/*( 7+ *+*&.
BIBLIOGRAFÍA DSM-. M'+' D/'=+()/* 3 E()'>()/* *( T&'()*&+*( M+)'(.
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