Hacia un modelo Transdiagnóstico integrador de la Psicopatología externalizante [Towards an Integrative Transdiagnostic Model of the Externalizing Psychopathology]

2021 
Resumen La investigacion de las psicopatologias del espectro externalizante ha tenido avances significativos desde modelos transdiagnosticos integradores. En el presente articulo se presenta un analisis de los avances y las direcciones de integracion, haciendo un enfasis particular en las principales variables y modelos teoricos considerados relevantes. En primer lugar, se resalta la importancia de una perspectiva dimensional espectral de los diagnosticos, segun sus mecanismos etiologicos y mantenedores comunes, no solamente a nivel sintomatico sino procesal. Entre las variables con mayor evidencia se presentan la disregulacion emocional y la rumiacion ira, ambas asociadas a la aparicion y modulacion de la respuesta agresiva reactiva y proactiva. Al finalizar, se propone la integracion de los aportes derivados de la teoria de la sensibilidad al refuerzo y los sistemas de dominancia conductual, en un modelo transdiagnostico integrador. Esta propuesta involucra los avances teoricos a nivel motivacional como la inhibicion y la activacion conductual, cuya capacidad explicativa permite comprender las dificultades relativas a la impulsividad, la psicopatia, y la autorregulacion emocional y conductual. Estos avances convergen en el marco de investigacion de criterio dominante, un verdadero avance en los estudios de la salud mental actual.  Abstract Research on externalizing spectrum psychopathologies has had significant advances from integrative transdiagnostic models. This article analyzes the progress and directions of integration, with particular emphasis on the main variables and theoretical models considered relevant. First, the importance of a spectral dimensional perspective of the diagnoses is highlighted based on their common etiological mechanisms and maintainers, not only at the symptomatic level but also at the procedural level. Emotional dysregulation and anger rumination are among the variables with the most evidence, both associated with the appearance and modulation of the reactive and proactive aggressive response. In the end, the integration of the contributions derived from the theory of reinforcement sensitivity, and behavioral dominance systems is proposed in an integrative transdiagnostic model. This proposal involves theoretical advances at the motivational level, such as inhibition and behavioral activation, whose explanatory capacity allows understanding the difficulties related to impulsivity, psychopathy, and emotional and behavioral self-regulation. These advances converge in the dominant criterion research framework, a real breakthrough in current mental health studies.
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