Maturity fears in anorexia nervosa / Temor a la madurez en la anorexia nerviosa

Abstract Maturity fears (MF) is a relevant feature of patients suffering from anorexia nervosa (AN). The presence of MF is described and its implications in the outcome of AN. A review of specialized textbooks and the available literature in PubMed was made. Bruch (1974) and Crisp (1997) models have related the psychosexual immaturity to the regression to a prepubescent body as a maladaptative mechanism to confront the bio-psycho-social changes due to the transition to adulthood; as well as the individual vulnerability, family dynamics and deficits in mother/daughter bond. These findings show that MF are significantly correlated to an early onset of the disorder, primary amenorrhea, restrictive subtype of AN, feminine gender role, asceticism, self-discipline, hypercontrol, self-injury behaviors, treatment drop out, and negative outcome. There was a significant improvement of MF in anorexic adolescents included in a psycho educational programme and family therapy. One of the core characteristics of the AN is the MF underlined in classical paradigms and based on the current scientific evidence. MF should be considered central therapeutic aspect and a prognostic index in AN. Key words: Maturity fears, Adolescence, Anorexia nervosa, Eating disorders, Puberty. Resumen El temor a la madurez (TM) es un rasgo relevante en pacientes portadoras de anorexia nerviosa (AN). Se analiza descriptivamente la presencia de TM y sus impli- cancias evolutivas en la AN, efectuandose una revision de la literatura disponible en PubMed y textos de consulta especializados. Los modelos de Bruch (1974) y Crisp (1997) relacionan la inmadurez psicosexual en la AN con la regresion a un cuerpo prepubescente como mecanismo maladaptativo para enfrentar los cambios biopsicosociales inherentes a la transicion hacia la adultez, ademas de la vulnerabilidad individual, dinamica familiar y vinculo madre-hija deficitario. Segun los hallazgos, el TM se asocia significativamente con inicio precoz de la patologia, amenorrea primaria, anorexia nerviosa restrictiva, rol de genero femenino, ascetismo, autodisciplina, hipercontrol, conductas auto-agresivas, abandono del tratamiento y desenlace negativo. Hubo mejoria significativa en el TM en anorecticas adoles- centes sometidas a un programa de psico-educacion y terapia familiar. Una de las caracteristicas nucleares de la AN es el TM, enfatizado en los paradigmas clasicos y fundamentados en la evidencia cientifica actual. El TM deberia considerarse un aspecto terapeutico central e indice pronostico en la AN. Palabras clave: Temor a la madurez, Adolescencia, Anorexia nerviosa, Trastornos de la conducta alimentaria, Pubertad. 0 0 2013-12-09T17:55:00Z 1 411 2266 Casa 18 5 2672 14.0 Normal 0 21 false false false ES-TRAD JA X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabla normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:Cambria; mso-ascii-font-family:Cambria; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Cambria; mso-hansi-theme-font:minor-latin;} 0 0 2013-12-09T17:55:00Z 1 411 2266 Casa 18 5 2672 14.0 Normal 0 21 false false false ES-TRAD JA X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabla normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:Cambria; mso-ascii-font-family:Cambria; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Cambria; mso-hansi-theme-font:minor-latin;}