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RESUMEN El Trastorno por Estrés Postraumático (TEPT) es una condición psiquiátrica que surge como respuesta a eventos traumáticos y puede afectar significativamente la funcionalidad del paciente. La sierra andina es una región cuya población ha estado expuesta a eventos altamente estresantes; sin embargo, existe escasa información sobre factores asociados a la ocurrencia de TEPT en la región. Objetivo: Determinar los factores sociodemográficos y clínicos (comorbilidad y funcionalidad) asociados al TEPT. Material y métodos: Se trata de un estudio secundario que utilizó la base de datos del adulto del Estudio Epidemiológico de Salud Mental en la Sierra - 2017. Instrumentos: Mini Entrevista Neuropsiquiátrica Internacional (MINI) en la versión en español de CIE-10, Cuestionario de Salud Mental de Colombia, Escala de Discapacidad y una ficha de datos demográficos e indicadores de pobreza. Resultados: Se encontraron asociaciones significativas entre TEPT y grupos de personas casadas y carentes de instrucción escolarizada. El episodio depresivo fue la comorbilidad más frecuente. Los principales estresores fueron la violencia política y los accidentes graves. Asimismo, hubo asociación de TEPT con pensamientos suicidas y dificultad para planificar, organizar y ejecutar diversas actividades. Conclusiones: Existe asociación relevante entre TEPT y algunos factores sociodemográficos, eventos traumáticos y trastornos clínicos. Los programas de intervención deben brindar atención inmediata a personas expuestas a eventos traumáticos y disminuir la presencia y el impacto de factores estresantes presentes en la región andina. SUMMARY Post-traumatic stress disorder (PTSD) is a psychiatric condition that occurs in response to traumatic events and can significantly affect the patient’s functional capacities. The Peruvian highlands is a region whose population has been exposed to highly stressful events; however, there is limited information on the factors associated with PTSD in the region. Objective: To determine sociodemographic and clinical factors (comorbidity and functionality) associated with PTSD. Material and methods: A secondary study was conducted using the adult database of the Epidemiological Study of Mental Health in the Peruvian Highlands - 2017. Instruments: Mini International Neuropsychiatric Interview (MINI) Spanish version ICD-10, Mental Health Questionnaire of Colombia, Disability Scale, and an intake form with demographic data and poverty indicators. Results: Significant associations were found between PTSD and groups of married people and those who had no school education. Depressive episode was the most frequent comorbidity. The main stressors were political violence and serious accidents. Likewise, there was an association of PTSD with suicidal thinking and difficulties in planning, organizing and executing a variety of activities. Conclusions: PTSD was associated with some sociodemographic factors, traumatic events and clinical disorders. Intervention programs should be aimed at providing immediate care to people exposed to traumatic events and at reducing the presence and impact of such stressors in the Andean region.

Since 2017, women in Chile are allowed to interrupt voluntarily a pregnancy on three grounds: 1) When a woman's life is at risk due to the pregnancy, 2) When there are fetal anomalies incompatible with life, or 3) When pregnancy is result of rape. Women who qualify for any of these three pregnancy interruption requirements are entitled to a psychosocial accompaniment program to promote an integrative approach. In this article we will discuss the role of the psychosocial team in cases of rape resulting pregnancy. Specifically, the clinical and ethical dilemmas posed by the need to certify the rape in a general hospital such as difficulties in assessment of the story's plausibility, clinician's dual role and the limits to confidentiality, are discussed.

Background: Potentially traumatic stressors can lead to various transdiagnostic outcomes beyond PTSD alone but no brief screening tools exist for measuring posttraumatic responses in a transdiagnostic manner. Objective: Assess the psychometric characteristics of a new 22-item transdiagnostic screening measure, the Global Psychotrauma Screen (GPS). Method: An internet survey was administered with English speaking participants recruited passively via the website of the Global Collaboration on Traumatic Stress (GC-TS) (nGC-TS = 1,268) and actively via Amazon’s MTurk (nMTurk = 1,378). Exploratory factor analysis, correlational analysis, sensitivity and specificity analysis, and comparisons in response between the two samples and between male and female respondents were conducted. Results: Exploratory factor analysis revealed a single factor underlying symptom endorsements in both samples, suggesting that such problems may form a unitary transdiagnostic, posttraumatic outcome. Convergent validity of the GPS symptom and risk factors was established with measures of PTSD and dissociative symptoms in the MTurk sample. Gender differences were seen primarily at the item level with women more often endorsing several symptoms and specific risk factors in the MTurk sample, and the GC-TS recruited sample endorsed more symptoms and risk factors than the MTurk sample, suggesting that the GPS may be sensitive to group differences. A GPS symptom cut-off score of 8 identified optimized sensitivity and specificity relative to probable PTSD based on PCL-5 scores. Conclusions: The current results provide preliminary support for the validity of the GPS as a screener for the concurrent measurement of several transdiagnostic outcomes of potentially traumatic stressors and the apparent unifactorial structure of such symptoms is suggestive of a single or unitary posttraumatic outcome. Future research is needed to evaluate whether similarly strong psychometric properties can be yielded in response to completion of the GPS in other languages., HIGHLIGHTS Global Psychotrauma Screen (GPS) is validated in English.

Background: Paediatric illness, injury and medical procedures are potentially traumatic experiences with a range of possible negative psychosocial consequences. To prevent psychosocial impairment and improve medical adherence, evidence-based psychotherapy should be offered if indicated. Eye movement desensitization and reprocessing (EMDR) has been found to reduce symptoms of posttraumatic stress disorder (PTSD) in adults. The evidence for the use with children is promising. Furthermore, recent studies indicate its effectiveness for the treatment of other psychological symptomatology. However, the effectiveness of EMDR in children with subthreshold PTSD after medically related trauma has not yet been investigated. Objective: Investigating the short-term effectiveness of EMDR on posttraumatic stress, anxiety, depression and sleep problems in children with subthreshold PTSD after hospitalization through a randomized controlled trial (RCT). Method: Following baseline screening of 420 children from various Dutch hospitals, 74 children (4–15 years old) with medically related subthreshold PTSD were randomized to EMDR (n = 37) or care-as-usual (CAU; n = 37). Follow-up assessment took place after M = 9.7 weeks. Generalized Estimating Equation (GEE) analyses were performed to examine the effectiveness of EMDR compared to CAU. Results: Children in both groups improved significantly over time on all outcomes. However, the EMDR group improved significantly more as to child-reported symptoms of blood-injection-injury (BII) phobia and depression, and child-, and parent-reported sleep problems of the child. There was no superior effect of EMDR compared to CAU on subthreshold PTSD symptom reduction. Conclusions: EMDR did not perform better than CAU in reducing PTSD symptoms in a paediatric sample of children with subthreshold PTSD after hospitalization. However, the study results indicate that EMDR might be superior in reducing symptoms of blood-injection-injury phobia, depression and sleep problems.

Background: Traumatic sexual experiences can negatively affect sexual functioning and increase pelvic floor activity in women, especially when post-traumatic stress disorder (PTSD) is developed. However, little is known about the effect of other types of interpersonal and non-interpersonal, traumatic experiences on sexual function and pelvic floor overactivity. Objective: The aim of this study was to examine the effects of lifetime traumatic experiences and subsequent PTSD symptoms on sexual function and pelvic floor activity and to investigate whether the effects differ for interpersonal and non-interpersonal trauma. Methods: Women (N=82) with obesity and a history of infertility, participating in a follow-up study of an RCT investigating a lifestyle intervention programme, completed questionnaires on lifetime exposure to traumatic events (LEC-5), PTSD symptoms (PC-PTSD-5), sexual function (MFSQ) and pelvic floor activity (AOPFS-SV). Results: A large majority of women (85%) reported exposure to at least one traumatic event during their lifetime. Sexual function and pelvic floor activity did not differ between women who experienced non-interpersonal or interpersonal (including sexual) trauma and those who did not experience traumatic events during their lifetime. Women who had developed PTSD symptoms, however, did have higher pelvic floor activity, but sexual function was not affected. Women with a positive screen for PTSD had the highest pelvic floor activity score, and individual PTSD symptoms nightmares and hypervigilance were associated with significantly higher pelvic floor activity scores. Conclusion: Trauma exposure is associated with pelvic floor overactivity in women with a positive screen for PTSD, such that pelvic floor overactivity is more severe with greater PTSD severity. These findings suggest that the development of PTSD after interpersonal trauma is pivotal in this association. Sexual function was unrelated to trauma exposure and pelvic floor function, perhaps related to the fact that the interpersonal trauma events reported in this study were mainly non-sexual.

Background: Traumatic sexual experiences can negatively affect sexual functioning and increase pelvic floor activity in women, especially when post-traumatic stress disorder (PTSD) is developed. However, little is known about the effect of other types of interpersonal and non-interpersonal, traumatic experiences on sexual function and pelvic floor overactivity. Objective: The aim of this study was to examine the effects of lifetime traumatic experiences and subsequent PTSD symptoms on sexual function and pelvic floor activity and to investigate whether the effects differ for interpersonal and non-interpersonal trauma. Methods: Women (N=82) with obesity and a history of infertility, participating in a follow-up study of an RCT investigating a lifestyle intervention programme, completed questionnaires on lifetime exposure to traumatic events (LEC-5), PTSD symptoms (PC-PTSD-5), sexual function (MFSQ) and pelvic floor activity (AOPFS-SV). Results: A large majority of women (85%) reported exposure to at least one traumatic event during their lifetime. Sexual function and pelvic floor activity did not differ between women who experienced non-interpersonal or interpersonal (including sexual) trauma and those who did not experience traumatic events during their lifetime. Women who had developed PTSD symptoms, however, did have higher pelvic floor activity, but sexual function was not affected. Women with a positive screen for PTSD had the highest pelvic floor activity score, and individual PTSD symptoms nightmares and hypervigilance were associated with significantly higher pelvic floor activity scores. Conclusion: Trauma exposure is associated with pelvic floor overactivity in women with a positive screen for PTSD, such that pelvic floor overactivity is more severe with greater PTSD severity. These findings suggest that the development of PTSD after interpersonal trauma is pivotal in this association. Sexual function was unrelated to trauma exposure and pelvic floor function, perhaps related to the fact that the interpersonal trauma events reported in this study were mainly non-sexual.

Background: Paediatric illness, injury and medical procedures are potentially traumatic experiences with a range of possible negative psychosocial consequences. To prevent psychosocial impairment and improve medical adherence, evidence-based psychotherapy should be offered if indicated. Eye movement desensitization and reprocessing (EMDR) has been found to reduce symptoms of posttraumatic stress disorder (PTSD) in adults. The evidence for the use with children is promising. Furthermore, recent studies indicate its effectiveness for the treatment of other psychological symptomatology. However, the effectiveness of EMDR in children with subthreshold PTSD after medically related trauma has not yet been investigated. Objective: Investigating the short-term effectiveness of EMDR on posttraumatic stress, anxiety, depression and sleep problems in children with subthreshold PTSD after hospitalization through a randomized controlled trial (RCT). Method: Following baseline screening of 420 children from various Dutch hospitals, 74 children (4–15 years old) with medically related subthreshold PTSD were randomized to EMDR (n = 37) or care-as-usual (CAU; n = 37). Follow-up assessment took place after M = 9.7 weeks. Generalized Estimating Equation (GEE) analyses were performed to examine the effectiveness of EMDR compared to CAU. Results: Children in both groups improved significantly over time on all outcomes. However, the EMDR group improved significantly more as to child-reported symptoms of blood-injection-injury (BII) phobia and depression, and child-, and parent-reported sleep problems of the child. There was no superior effect of EMDR compared to CAU on subthreshold PTSD symptom reduction. Conclusions: EMDR did not perform better than CAU in reducing PTSD symptoms in a paediatric sample of children with subthreshold PTSD after hospitalization. However, the study results indicate that EMDR might be superior in reducing symptoms of blood-injection-injury phobia, depression and sleep problems.

Indexación Scopus Objetivo. Conocer la frecuencia de la violencia, tanto física como verbal, hacia los profesionales de enfermería, a nivel mundial en los servicios de emergencias y su impacto en la salud y en el contexto laboral. Métodos. La investigación fue realizada mediante una revisión integrativa, en febrero de 2020, de las bases bibliográfícas MEDLINE, LILACS, CINAHL y SciELO, utilizando los descriptores “Nurses”, “Workplace Violence”, “Physical Aggression”, “Psychological Aggression”, “Stress, Psychological”, “Psychological Trauma”, “Aggression”, “Health Impact Assessment”, “Health Impact”, “Impacts on Health”, “Impact Assessment, Health” y “Occupational Health”. Resultados. De los artículos localizados, 18 fueron incluidos en el análisis. Los estudios confirmaron que los profesionales de la salud más afectados por la violencia eran los profesionales de enfermería y el tipo más común fueron las agresiones verbales, seguidas por la violencia física. El área intrahospitalaria más común donde ocurrían dichas agresiones era el servicio de emergencias. El impacto en la salud de los profesionales de enfermería se correlacionó con el estrés, el agotamiento emocional, la ansiedad y el miedo, entre otros síntomas. Con respecto al impacto laboral, se evidenciaron relaciones indirectas significativas vinculadas con la reducción de la productividad. Todos estos aspectos llevaban a los profesionales de enfermería a considerar el abandono de sus trabajos en los servicios de emergencias. Conclusiones. Los resultados permitieron identificar un perfil de riesgo de violencia contra los profesionales de enfermería en los servicios de emergencias evidenciado por la alta incidencia de violencia física y verbal que repercutió en la disminución de la productividad en su trabajo y la aparición de síntomas relacionados al síndrome de burnout. Objective. Learn the worldwide frequency of physical and verbal violence against emergency service nurses, and its health and occupational impact. Methods. An integrative review study was conducted in February 2020 of the MEDLINE, LILACS, CINAHL, and SciELO bibliographic databases, using the descriptors “Nurses,” “Workplace Violence,” “Physical Aggression,” “Psychological Aggression,” “Stress, Psychological,” “Psychological Trauma,” “Aggression,” “Health Impact Assessment,” “Health Impact,” “Impacts on Health,” “Impact Assessment, Health,” and “Occupational Health.” Results. Of the articles located, 18 were included in the analysis. The studies confirmed that the health workers most affected by violence were nurses, and the most common types of violence were verbal aggression, followed by physical violence. In the hospital, these assaults most often occurred in the emergency service. The correlated impact on nurses’ health included stress, emotional exhaustion, anxiety, and fear, among other symptoms. With regard to occupational impact, significant indirect accounts related to the reduction in productivity were evident. All these aspects led nurses to consider leaving their jobs in emergency services. Conclusions. The results enabled identifying a risk profile for violence against nurses in emergency services, seen in the high incidence of physical and verbal violence that led to reduced productivity on the job and the onset of symptoms of burnout syndrome. https://iris.paho.org/handle/10665.2/53140

El objetivo de esta investigación fue precisar, desde la perspectiva de la psicología jurídica crítica, los tipos de afectaciones y daño psicológico que presentan los excombatientes del conflicto armado en el marco del Derecho Internacional Humanitario, tanto de grupos ilegales como de las fuerzas públicas del Estado, para ello se contó con la participación de cuatro excombatientes de las FARC-EP y seis excombatientes de las fuerzas públicas en condición de discapacidad a causa de heridas de guerra, principalmente de la Policía Nacional. Por medio de una investigación cualitativa de tipo fenomenológico, se realizaron diez entrevistas semiestructuradas a profundidad, codificadas y analizadas en base a cinco categorías principales: historia de vida, daño vivido en la vinculación, permanencia y desvinculación, proceso de reintegración-rehabilitación, relación con el Estado y la sociedad y proyecto de vida. Se encontró que el daño psicológico de los participantes es transversal a todas las categorías, especialmente a la historia de vida, la relación con el Estado y el proceso de reintegración-rehabilitación. Se construyó el concepto de víctima-excombatiente para todos aquellos participantes del conflicto armado que obtienen perjuicios físicos y psicológicos a causa del mismo. Se propone que las víctimas-excombatientes sean vistas como víctimas del conflicto y sean involucradas en los programas de reparación, preferiblemente a partir de medidas de rehabilitación, satisfacción y garantías de no repetición. Palabras clave: conflicto armado, trauma psicosocial, daño psicológico, víctimas, reclutamiento, reintegración, excombatientes. The objective of this investigation was to determine, from the perspective of critical legal psychology, to determine the types of psychological damage and afflictions suffered by former combatants of the armed conflict within the framework of International Humanitarian Law, both from illegal groups and from the State's public forces. To this end, four former combatants of the FARC-EP and six former combatants of the public forces who were disabled due to war wounds, mainly from the National Police, participated in the study. By means of a qualitative phenomenological research, ten semi-structured in-depth interviews were carried out, which were codified and analyzed based on five main categories: life story, damage experienced in the bonding, permanence and detachment, reintegration-rehabilitation process, relationship with the State and society, and life project. It was found that the psychological damage of the participants cuts across all categories, especially life story, relationship with the State and the reintegration-rehabilitation process. The concept of victim-ex-combatant was constructed for all those participants in the armed conflict who suffer physical and psychological harm as a result of the conflict. It is proposed that victim-combatants be seen as victims of the conflict and be involved in reparation programmes, preferably on the basis of rehabilitation measures, satisfaction and guarantees of non-repetition. Key words: conflict, war, psychological trauma, victims, child soldier, reintegration, recruitment, excombatants. Magíster en Psicología Jurídica Maestría

Background: A history of child abuse is common and has a significant impact in the clinical course of patients diagnosed with bipolar disorders (BD). Aims: To assess the frequency of child abuse experiences in patients BD type I and to evaluate its association with clinical course and cognitive functioning variables. Material and Methods: 117 patients with BD aged 45 ± 14 years (66% women) answered the Childhood Trauma Questionnaire (CTQ). The clinical course (illness onset, history of suicide attempts and number of hospitalizations) was obtained from medical records. Cognitive functioning was evaluated through social and non-social cognition tasks. Results: 64% of participants reported some type of child abuse. This variable was associated with an early onset of the disease (Odds ratio (OR) = 3.3; p < 0.02), increased risk of suicide attempts (OR = 2.4; p < 0.04) and specific disturbances in social cognitive tasks. Conclusions: Our study supports evidence of a common history of child abuse in patients with BD. Although child abuse predicts a worse clinical course, major clinical practice guidelines, as well as research designs, do not highlight this evidence.

El present treball s'ha proposat investigar la Teràpia EMDR a la llum de l'obra de Sant Tomàs d'Aquino, seguint una triple aproximació: antropològica, teòrica i pràctica. La limitada concepció de l'ésser humà subjacent al model EMDR contrasta amb una teoria que conté importants encerts, però sobretot, amb una proposta psicoterapèutica que demostra un profund coneixement de la naturalesa humana. La psicologia tomista ofereix una nova manera de comprendre la Estimulació Bilateral, el Model SPIA i el Protocol Estàndard. Això permet fonamentar la pràctica EMDR en un sòlid cos de coneixement tradicional. A més, posa aquesta meravellosa eina en mans dels que volen basar la seva tasca terapèutica en l'antropologia del Aquinat. L'anàlisi de la Teràpia EMDR il·lumina una manera concreta d'aterrar la doctrina de Sant Tomàs en el context de la pràctica psicològica, el que suggereix que és possible idear un model de psicoteràpia basat íntegrament en l'obra del Doctor Humanitas., El presente trabajo se ha propuesto investigar la Terapia EMDR a la luz de la obra de Santo Tomás de Aquino, siguiendo una triple aproximación: antropológica, teórica y práctica. La limitada concepción del ser humano que subyace al modelo EMDR contrasta con una teoría que contiene importantes aciertos, pero sobre todo, con una propuesta psicoterapéutica que demuestra un profundo conocimiento de la naturaleza humana. La psicología tomista ofrece una nueva manera de comprender la Estimulación Bilateral, el Modelo SPIA y el Protocolo Estándar. Esto permite fundamentar la práctica EMDR en un sólido cuerpo de conocimiento tradicional. Además, pone esta maravillosa herramienta en manos de quienes desean basar su labor terapéutica en la antropología del Aquinate. El análisis de la Terapia EMDR ilumina un modo concreto de aterrizar la doctrina de Santo Tomás en el contexto de la práctica psicológica, lo que sugiere que es posible idear un modelo de psicoterapia basado íntegramente en la obra del Doctor Humanitas., The present work has been proposed to investigate the EMDR therapy in the light of the work of Saint Thomas Aquinas, following a triple approach: anthropological, theoretical and practical. The limited conception of the human being that underlies the EMDR model contrasts with a theory that contains important successes, but above all, with a psychotherapeutic proposal that demonstrates a deep knowledge of human nature. Thomist psychology offers a new way of understanding Bilateral Stimulation, the SPIA Model and the Standard Protocol. This allows EMDR practice to be based on a solid body of traditional knowledge. In addition, it puts this wonderful tool in the hands of those who wish to base their therapeutic work on the anthropology of Aquinas. The analysis of EMDR Therapy illuminates a concrete way of landing the doctrine of St. Thomas in the context of psychological practice, suggesting that it is possible to develop a model of psychotherapy based entirely on the work of Doctor Humanitas.

Exposure to traumatic events is frequent in the general population and psychiatric sequelae such as post-traumatic stress disorders are common. The symptoms of psychiatric sequelae after trauma are vague, with multiple psychological and physical symptoms, which can confuse the health care professional. This paper seeks to facilitate the work in primary care, providing practical information about the diagnosis, initial management and referral of patients who have suffered traumatic experiences. Some early interventions and treatments are suggested.

Exposure to traumatic events is frequent in the general population and psychiatric sequelae such as post-traumatic stress disorders are common. The symptoms of psychiatric sequelae after trauma are vague, with multiple psychological and physical symptoms, which can confuse the health care professional. This paper seeks to facilitate the work in primary care, providing practical information about the diagnosis, initial management and referral of patients who have suffered traumatic experiences. Some early interventions and treatments are suggested.

El propósito del estudio fue evaluar, en una población afectada por un desastre natural, la relación de algunas variables sociales y psicológicas con el bienestar psicológico y el crecimiento postraumático. Se obtuvo una muestra de 446 personas de la provincia de Concepción (Chile), afectadas por el terremoto del 27/F del 2010. Se emplearon el Inventario de Crecimiento Postraumático (PTGI), el Cuestionario de Orientación Vital (LOT-R) y la Flourishing Scale. Se analizó la relación entre severidad objetiva del evento (pérdida material, daño físico en alguien cercano y daño físico personal), severidad subjetiva del evento (conside -rar el evento como traumático o que alteró sus vidas) y optimismo disposicional, observándose que la interacción del optimismo con la severidad subjetiva u objetiva aporta significativamente en la predicción del bienestar y el crecimiento, moderando el impacto de dichas variables. Además, se evaluaron diferencias por sexo, edad y nivel socioeconómico. Se determinó la influencia relativa del nivel socioeconómico sobre el crecimiento postraumático. Este estudio resalta la importancia de las condiciones sociales sobre los efectos psicológicos de los desastres naturales y la importancia del optimismo para amortiguar dichos efectos. The aim of the study was to evaluate, in a population affected by a natural disaster, the relationship of social and psychological variables with the psychological well-being and posttraumatic growth. Participated 446 people of the province of Concepcion, Chile, affected by the earthquake on 27/F, 2010. We used the Posttraumatic Growth Inventory (PTGI), the Life Orientation Test (LOT-R) and the Flourishing Scale. We analyzed the relationship between objective severity of the event (material loss, physical damage to someone close and personal physical damage), subjective severity of the event (considering the event as traumatic or altered their lives) and dispositional optimism, showing that the interaction of optimism with subjective or objective severity contributes significantly to the prediction of well-being and growth, moderating the impact of these variables. In addition, we evaluated differences by sex, age and socioeconomic status. There was a relative influence of socioeconomic status on posttraumatic growth. This study shows the relevance of social conditions on the psychological effects of natural disasters and the importance of optimism to mitigate these effects.

A partir de los resultados obtenidos en diversas investigaciones ha podido comprobarse la incidencia de las experiencias violentas y los actos violentos ejercidos sobre otros en el despliegue del conflicto armado colombiano, lo cual afecta la salud mental de los sujetos. En este escrito se busca analizar esta forma de anudamiento entre las experiencias o acciones violentas con los traumatismos psíquicos y síntomas producidos en 36 sujetos -20 víctimas y 16 victimarios- a quienes se les escuchó en consultas psicológicas a través de los programas de la Alta Consejería para la Reintegración, Defensorías del Pueblo del Atlántico y Magdalena y la MAPP-OEA en el marco del proyecto de Investigación (121549326151) nanciado por Colciencias. Se realizaron entre 2 y 7 entrevistas en profundidad con cada uno dependiendo del interés de continuar con el proceso. Se utilizó el diseño de comparación multi-caso y la teoría fundamentada, anudados a partir de una matriz de análisis denominada ARIADGE (Análisis de Respuestas Inmediatas: Actos, Desplazamientos, Guerra y Excepciones). Se organizaron los resultados discursivos en categorías y subcategorías emergentes que representan la producción gradual de conocimientos respecto a la manera en que estos sujetos dieron cuenta de las situaciones traumáticas y los efectos producidos en su psiquismo a causa del conflicto armado desplegado en regiones del Magdalena, Atlántico, Bolívar y Cesar.. On the basis of the results obtained from several studies, the effects of the violent experiences and violent acts exerted on the others in the spread of the armed conict has been proved, affecting subjects' mental health. We study in this paper this type of link between violent actions or experiences and the psychological trauma and symptoms caused in 36 subjects (20 victims and 16 victimizers), who were listened in psychological counseling through Alta Consejería para la Reintegración, Defensorías del Pueblo del Atlántico and MAPP-OEA programmes, in the framework of the 121549326151 investigation project funded by Colciencias. 2 to 7 in-depth interviews were done with each one depending on their interest in going on with the process. Multi-case comparative design and well-founded theory were used linked through an Analysis Matrix called ARIADGE (Immediate Responses Analysis: Acts, Displacement, War and Exceptions). Discursive results were organized in emerging categories and subcategories representing gradual production of knowledge in relation to the way these subjects reported traumatic situations and the effects caused in their psyche because of the armed conict spread in regions of Magdalena, Atlántico, Bolívar and César.

Se evaluó la efectividad de un tratamiento psicológico centrado en el trauma de mujeres víctimas de violencia de pareja (VP). Las participantes fueron 73, con diagnóstico de TEPT (Trastorno de estrés postraumático). El diseño fue pre-experimental, los instrumentos utilizados fueron fiables para la población colombiana para medir el trauma (TEPT, depresión, ansiedad, autoestima e inadaptación). El estudio se dividió en tres fases: evaluación (características del trauma y sus consecuencias), tratamiento (breve en ocho sesiones, grupal, protocolizado en componentes: psicoeducación, activación, terapia cognitiva y exposición) y seguimientos a uno, tres y seis meses. Los resultados señalan que la VP es crónica, cíclica y suelen concurrir las tres formas de violencia. Las mujeres son víctimas y algunas maltratadoras (usan violencia física y verbal). También se demostró que la mayoría de las víctimas (74%) ha sufrido trauma complejo. Para demostrar la efectividad terapéutica se utilizó el estadístico g de Hedges que señala grandes tamaños del efecto en cada variable dependiente: TEPT (1.98), reexperimentación (2.07), evitación (1.55), hiperactivación (1.49), ansiedad (1.33), depresión (1.07), autoestima (1.58), inadaptación (1.24) y cogniciones postraumáticas (1.17). Respecto a la significancia clínica, la mayoría de mujeres mejoró la sintomatología después del tratamiento, de forma rápida en reexperimentación, ansiedad, depresión, autoestima e inadaptación y demorada en evitación, hiperactivación y las cogniciones postraumáticas. Los resultados del tratamiento se mantienen durante los seguimientos a nivel clínico y estadístico. Finalmente, se discuten los alcances del estudio y se plantean algunas recomendaciones para utilizar la guía de tratamiento en otras muestras. The effectiveness of a cognitive-behavioral treatment focused on the trauma of female victims of intimate partner violence (IPV) was evaluated. There were 73 participants diagnosed with PTSD (Post-Traumatic Stress Syndrome). The design was pre-experimental, the instruments valid for the Colombian population to measure trauma (PTSD, depression, anxiety, self-esteem and maladjustment). The study was divided into three phases: evaluation (characteristics and consequences of the trauma), treatment (brief in eight sessions, group therapy, protocolized in components: psychoeducation, hyper-arousal, cognitive therapy and exposure). Follow-up was performed at one, three, and six months. The results indicate that IP Vis chronic, cyclical with three forms of violence tending to occur. The women are victims and several are abusers (they use physical and verbal violence). It was also demonstrated that the majority of victims (74%) suffered complex trauma. In order to demonstrate the therapeutic effectiveness, the Hedges' g statistic was used, pointing out large sizes of the effect in each dependent variable: PTSD (1.98), reexperiencing (2.07), avoidance (1.55) hyper-arousal (1.49), anxiety (1.33), depression (1.07), self-esteem (1.58), maladjustment (1.24) and post-traumatic cognitions (1.17). With respect to clinical significance, the majority of women improved symptomatology after treatment, quickly in reexperiencing, anxiety, depression, self-esteem and maladjustment, and on a delayed basis in avoidance, hyper-arousal and post-traumatic cognitions. The results of the treatment were maintained during follow-ups on the clinical and statistical level. Finally, the scopes of the study are discussed and several recommendations posed for using the treatment guide in other samples.