Electroconvulsive therapy (ECT) has multiple uses in psychiatry, but its mechanisms of action (MA) in patients with schizophrenia (PS) are poorly understood. We synthesize and discuss the available evidence in this regard. We conducted a search for primary human studies and systematic reviews searching MA of ECT in PS published in PubMed/Medline, SciELO, PsycInfo, and the Cochrane Library, including 24 articles. Genetic findings are scarce and inconsistent. At the molecular level, the dopaminergic and GABAergic role stands out. The increase in brain derived neurotrophic factor (BDNF) after ECT, is a predictor of positive clinical outcomes, while the change in N-acetyl aspartate levels would demonstrate a neuroprotective role for ECT. This intervention would improve inflammatory and oxidative parameters, thereby resulting in a symptomatic improvement. ECT is associated with an increase in functional connectivity in the thalamus, right putamen, prefrontal cortex and left precuneus, structures that play a role in the neural default mode network. A decrease in connectivity between the thalamus and the sensory cortex and an enhanced functional connectivity of the right thalamus to right putamen along with a clinical improvement have been reported after ECT. Moreover a volumetric increase in hippocampus and insula has been reported after ECT. These changes could be associated with the biochemical pathophysiology of schizophrenia. Most of the included studies are observational or quasi-experimental, with small sample sizes. However, they show simultaneous changes at different neurobiological levels, with a pathophysiological and clinical correlation. We propose that the research on ECT should be carried out from neurobiological dimensions, but with a clinical perspective.

Background: Both perfectionism and social anxiety have been described in patients with eating disorders (ED) and medical students. Academic stress also can increase the risk of developing ED. Aim: To analyze the dimensions of perfectionism, social anxiety, and academic stress associated with the risk of developing ED in female medical students. Material and Methods: The Multidimensional Perfectionism Scale, the Liebowitz Social Anxiety Scale, the SISCO academic stress inventory and the Eating Attitudes Test-26, were applied to 163 female medical students from all levels of the career. The groups with and without risk of ED were compared according to these variables. Results: Twenty-four percent of respondents were at risk of ED. There were significant differences between scores of perfectionism, social anxiety, and academic stress between respondents with and without risk for ED. In general, there was a significant correlation among the variables. In a multivariate analysis, the predictors of ED risk were the perception of academic stress (Odds ratio (OR) 1.09; 95% confidence intervals (CI) 1.03-1.16) and personal standards in the context of perfectionism (OR 1.16; 95% CI 1.06-1.27). Conclusions: A substantial proportion of female medical students were at risk for ED. The risk of ED was determined mainly by academic stress and personal standards in the context of perfectionism. In this sample, social anxiety did not play a relevant role.

ABSTRACT Decision-making is influenced by multiple unaware factors. We synthesize some neurobiological correlates of the affective and social components on decision-making, including the impact of acute and chronic stress. We also address the impact of heuristics and biases on clinical practice from the cognitive perspective. At an affective level, the hypothesis of the somatic marker has associated the peripheral body response with central nervous structures in the configuration of decisions; structures such as the orbitofrontal cortex and the hippocampus intervene. The reward and motivation dimensions are involved in social decision-making. In these types of decisions, the ability to mentally engage others and integrate their perspective into decision making is crucial. This function has been related to the posterior superior temporal sulcus, the temporoparietal junction, the anterior cingulate cortex, and the medial prefrontal cortex. However, compliance with socially established norms is also integrated into social decision-making. Acute or chronic stress may affect decision-making, positively or negatively. The hypothalamic-pituitary-adrenal axis has been involved in these processes together with corticostriatal, prefrontal, amygdala and hippocampal circuits. In clinical decision-making, “pre-reflective” emotional, social and cognitive factors are combined, influencing the decisions towards patients. We recommend emphasizing research in this field and strengthening education in this area to recognize these aspects adequately.

RESUMEN: La toma de decisiones está influenciada por múltiples factores muchas veces no conscientes. En este artículo se sintetizan algunos correlatos neurobiológicos del componente afectivo y social sobre la toma de decisiones, incluyendo el impacto del estrés agudo y crónico y la perspectiva cognitiva de las heurísticas y los sesgos en la práctica clínica. A nivel afectivo, la hipótesis del marcador somático ha asociado la respuesta corporal periférica con estructuras nerviosas centrales en la configuración de las decisiones; intervienen estructuras como la corteza orbitofrontal y el hipocampo. En la toma de decisiones sociales se involucran las dimensiones recompensa y motivación. En este tipo de decisiones es crucial la capacidad de mentalizar a otro e integrar su perspectiva en la toma de decisiones. Esta función se ha relacionado con el surco temporal posterosuperior, la unión temporoparietal, la corteza cingulada anterior y la corteza prefrontal medial. No obstante, en la toma de decisiones sociales también se integra el cumplimiento de normas socialmente establecidas. El estrés agudo o crónico puede afectar la toma de decisiones, positiva o negativamente. En estos procesos se han involucrado al eje hipotálamo-hipófiso-adrenal junto con circuitos corticoestriados, prefrontales, amigdalinos e hipocampales. En la toma de decisiones clínicas se conjugan factores “prerreflexivos” emocionales, sociales y cognitivos que influyen directamente en las conductas adoptadas con los pacientes. Recomendamos enfatizar la investigación en esta área y fortalecer su enseñanza para reconocerlos adecuadamente.

Introduction: Eye movement desensitization and reprocessing (EMDR) has abundant evidence of efficacy in traumatic spectrum disorders. Its efficacy in anxiety disorders (AD) and depressive disorders (DD) in children and adolescents has been scarcely studied. Methods: We conducted a narrative review to describe the available evidence on the efficacy of EMDR in AD and DD in children and adolescents. We searched for articles available in PubMed/Medline, SciELO, PsycInfo and the Cochrane Library. All primary and secondary studies evaluating the effect of EMDR on AD and DD in children and adolescents were included. Their references were reviewed as a second method of inclusion. Results: nine studies were identified (five in AD and four in DD); three were observational and six experimental. All had small sample sizes. In AD, studies corroborated the efficacy of EMDR on phobic fear in spider phobia, but not on avoidance behavior, where in vivo exposure would be superior. Two case series reported the efficacy of EMDR in choking phobia and AD associated with epilepsy. In DD, EMDR was effective in reducing depressive symptomatology in the context of major depressive disorder, acute stress disorder, and conduct disorders. EMDR was comparable to cognitive behavioral therapy. Conclusions: The evidence corroborates the efficacy of EMDR in AD and DD in children and adolescents. However, it is very scarce and has methodological limitations. It is necessary to carry out experimental studies with standardized and specialized EMDR protocols for AD and DD in the child and adolescent population.

Resumen Introducción: la desensibilización y reprocesamiento por movimientos oculares (EMDR) tiene abundante evidencia de eficacia en desórdenes del espectro traumático. Su eficacia en trastornos ansiosos (TA) y depresivos (TD) en niños, niñas y adolescentes ha sido escasamente estudiada. Método: se realizó una revisión narrativa para describir la evidencia disponible sobre eficacia de EMDR en TA y TD en población infantojuvenil. Se buscaron artículos disponibles en PubMed/Medline, SciELO, PsycINFO y Cochrane Library. Se incluyeron todos los artículos primarios y secundarios que evaluaron el efecto de EMDR en TA y TD en población infantojuvenil. Se revisaron sus referencias como segundo método de inclusión. Resultados: se identificaron nueve estudios (cinco en TA y cuatro en TD); tres fueron observacionales y seis experimentales. Todos tuvieron tamaños muestrales reducidos. En TA, los estudios corroboraron la eficacia de EMDR sobre el temor fóbico en fobia a las arañas, pero no sobre la conducta evitativa, donde sería superior la exposición in vivo. Dos series de casos expusieron la utilidad de EMDR en fagogobia y en TA asociados a epilepsia. En TD, EMDR fue eficaz en la reducción de sintomatología depresiva en el contexto del trastorno depresivo mayor, trastorno de estrés agudo y trastornos conductuales. EMDR fue comparable a terapia cognitivo-conductual. Conclusiones: la evidencia corrobora la eficacia de EMDR en TA y TD en niños, niñas y adolescentes. Sin embargo, es muy escasa y cuenta con limitaciones metodológicas. Es necesario realizar estudios experimentales con protocolos estandarizados y especializados de EMDR para TA y TD en población infantojuvenil.

The coronavirus pandemic, the etiologic agent of coronavirus disease 2019 (COVID-19), has had sanitary, socioeconomic and psychosocial consequences associated to greater levels of anxiety, stress and emotional alterations on general population. An increase in substance consumption in the general population is presumed, as well as problematic consumption. In this line, people with substance use disorder constitute a more vulnerable population to the impact of the pandemic, especially in lockdown. We conducted a systematic search in the main databases about the impact of COVID-19 pandemic on substance consumption, performing a narrative synthesis of the available evidence based on the main substances addressed by the publications. We discuss the trends of alcohol, tobacco, opioids and cannabis consumption, and the recommendations regarding follow-up and therapeutic support. Mostly, the level of the evidence of the articles included is low, since they correspond to expert opinions and exploratory observational studies. Most of the conclusions derive from the extrapolation of data obtained during infectious outbreaks of previous forms of coronavirus. We suggest conducting primary studies on substance consumption and maintaining the clinical surveillance of people with substance use disorders in the post-pandemic period.

Resumen La pandemia por coronavirus, agente etiológico de la enfermedad por coronavirus 2019 (COVID-19), ha tenido consecuencias sanitarias, socioeconómicas y psicosociales que se asocian a mayores niveles de ansiedad, estrés y a alteraciones emocionales en la población general. Se presume un aumento en el consumo de sustancias en la población general, como también en el consumo problemático. En efecto, las personas con trastorno por uso de sustancias constituyen una población más vulnerable a los impactos de la pandemia, sobre todo en condiciones de confinamiento. Se realizó una búsqueda sistemática en las principales bases de datos sobre el impacto de la pandemia de COVID-19 sobre el consumo de sustancias, presentando una síntesis narrativa de la evidencia disponible en función de las principales sustancias abordadas por las publicaciones. Se discuten las tendencias en el consumo de alcohol, tabaco, opioides y cannabis, así como las recomendaciones en cuanto al seguimiento y acompañamiento terapéutico. En general, el nivel de evidencia de los artículos incorporados es bajo, ya que corresponden a opiniones de expertos y estudios observacionales exploratorios. Gran parte de las conclusiones provienen de la extrapolación de los datos obtenidos durante los brotes infecciosos de las formas previas de coronavirus. Sugerimos la realización de estudios primarios sobre consumo de sustancias y el mantenimiento de la vigilancia clínica en el periodo posterior a la pandemia en la población de personas con trastornos por uso de sustancias.

ABSTRACT Background: The importance of foods or food constituents in mental health is increasingly recognized, and “nutritional psychiatry” is a growing discipline. Objective: This narrative review aims to present work supporting associations between food or food constituents and mental health, specifically depressive disorders. Methods: The data presented is derived from preclinical and clinical work, including in vitro and in vivo assays, as well as observational studies and randomized clinical trials of dietary interventions. The focus of the review is the mediation of inflammatory processes and oxidative stress by dietary constituents that are an integral part of a healthy diet, such as the Mediterranean diet and similar. Results and Discussion: We present evidence for the role of the diet in prevention and management of depressive disorders, beyond the effect of individual nutrients. The findings indicate that among the dietary components with higher degree of evidence to influence depressive disorders are long chain n-3 polyunsaturated fatty acids (EPA and DHA), and various dietary bioactive compounds, especially plant-derived secondary metabolites represented by polyphenols such as flavonoids and resveratrol. Conclusion: Diet exerts an important role on mental health, and evidence indicates that some dietary constituents contribute to the prevention of depressive disorders.

Introduction: Suicide is a global public health problem. At the regional level, the analysis of the psychopathological and sociodemographic dimensions of suicide attempt (SA) are scarce. Methods: We conducted a cross-sectional study to analyze psychopathological and sociodemographic characteristics of adults hospitalized for SA in a public hospital in Chile. We describe participants according to sociodemographic and clinical characteristics, appraising neuropsychiatric syndromes, personality disorders, and levels of hopelessness, impulsiveness, intentionality, lethality and aggressiveness of the SA. Non-parametric statistics were applied. Results: 45 participants were included, with a median of 39 years of age. The majority lived in urban areas, belonged to low socioeconomic status, were single, had some stressful life event and a history of SA. The most frequent SA method was drug intake. The most frequent diagnoses were alcohol use disorder and borderline personality. In half of the cases the hopelessness was low or inexistent. Lethality was positively and significantly correlated with suicidal intent, as was impulsivity with aggressiveness. Family history of SA and psychological trauma were significantly higher in women and chronic pain in men. Severe cases showed high levels of hopelessness, intentionality, and lethality, while impulsivity was significantly less than in non-severe cases. In this group, the most frequent diagnosis was depressive episode. Conclusions: The analyzed sample showed distinctive psychopathological and sociodemographic characteristics. The lethality and intent of the SA must be systematically appraised. The severe cases of SA showed particular psychopathological characteristics.

Resumen Introducción: El suicidio es una problemática de salud pública global. A nivel regional, el análisis de las dimensiones psicopatológicas y sociodemográficas del intento de suicidio (IS) son escasas. Método: estudio transversal que analizó psicopatológica y sociodemográficamente a adultos hospitalizados por IS en un hospital público de Chile. Los participantes se caracterizaron sociodemográficamente y clínicamente, evaluando síndromes neuropsiquiátricos, trastornos de la personalidad y niveles de desesperanza, impulsividad, intencionalidad, letalidad y agresividad del IS. Se aplicó estadística no paramétrica. Resultados: 45 participantes fueron incluidos, con una mediana de 39 años de edad. La mayoría residió en zonas urbanas, pertenecía a un nivel socioeconómico bajo, eran solteros, presentó algún evento vital estresante y antecedente de IS. El método de IS más frecuente fue la ingesta medicamentosa. Los diagnósticos más frecuentes fueron trastorno por consumo de alcohol y personalidad límite. En la mitad de los casos la desesperanza fue leve o inexistente. La letalidad se correlacionó positiva y significativamente con la intencionalidad suicida, así como la impulsividad con la agresividad. El antecedente familiar de IS y el trauma psíquico fueron significativamente mayores en mujeres y el dolor crónico en hombres. Los casos graves mostraron altos niveles de desesperanza, intencionalidad y letalidad, mientras que la impulsividad fue significativamente menor que en los casos no graves. En este grupo, el diagnóstico más frecuente fue episodio depresivo. Conclusiones: La muestra analizada mostró características psicopatológicas y sociodemográficas distintivas. La letalidad y la intencionalidad del IS deben ser sistemáticamente evaluadas. Los casos graves de IS mostraron características psicopatológicas diferenciales.

Background: Attentional deficit hyperactivity disorder (ADHD) in adults is associated with borderline personality characteristics or cluster B (emotional instability), but in certain populations, such as medical students, it might be associated with cluster C traits (perfectionism, dependency, anxiety). This may be compensatory to ADHD. Aim: To analyze the association between ADHD and cluster C personality traits in medical students. Material and Methods: Biodemographic characteristics, the presence of ADHD and personality traits according to clusters A, B and C were evaluated in medical students. These characteristics were compared between students with unlikely diagnosis of ADHD (Group 1) and likely or very likely diagnosis of ADHD (Group 2). Results: We included 336 participants (44% women). A likely or very likely diagnosis of ADHD was present in 64% (Group 2). Concerning personality traits, 45% exhibited traits of cluster A, 57% of cluster B, and 67% of cluster C. Compared to their counterparts of Group 1, participants in Group 2 were more likely to have a history of psychiatric/psychological care, previous diagnosis of ADHD and traits of cluster B (37 and 68% respectively) and C (55 and 74% respectively). The odds ratio of having A, B or C traits when a likely or very likely ADHD was present, were 1.29 95% confidence interval (CI) [0.8-2.07], 3.79 95% CI [2.3-6.22] and 2.4 95% CI [1.46-3.96], respectively. Conclusions: Cluster C personality traits were frequent among medical students and were significantly associated with ADHD.

Background: Patients with diabetes mellitus show a higher risk of developing depressive symptoms when compared to healthy people, hampering the management and prognosis of both diseases. However, national studies on the topic are scarce. Aim: To study the frequency and severity of depressive symptoms in patients with type 2 diabetes. Material and Methods: Beck Depression Inventory-IA and Morisky Green Levine scale were administered to diabetic patients under control at a primary care center. Pharmacological compliance was evaluated using glycosylated hemoglobin levels obtained from their clinical records. Results: We included 323 patients aged 64 ± 12 years (49% women). The frequency of depressive symptoms was 34.7%. Compared with their counterparts without depressive symptoms, patients with depression showed higher glycosylated hemoglobin levels (7.2 ± 1.7 and 6.7 ± 1.3% respectively), a higher frequency of non-compliance with treatment (63 and 43% respectively) and a higher frequency of metabolic decompensation (38 and 23% respectively). Depressive symptomatology was more common among women. Conclusions: Patients with type 2 diabetes mellitus and depressive symptoms exhibit a poorer treatment compliance and worse metabolic control as compared to their non-depressive counterparts.

Abstract Background Delusional characteristics have been largely ignored in patients suffering from anorexia nervosa (AN). Objectives To review the literature on delusional features in AN from phenomenological, neurobiological, and clinical viewpoints. Methods Data were obtained through searches of Medline, PubMed, SciELO and Cochrane Library. Results Distorted beliefs in AN may range from an overvalued idea to an overt delusion, involving affective, personality and/or psychotic disorders. Studies confirm alterations in monoaminergic systems. It has also been seen a decreased integration of visual/proprioceptive information, and alterations in neural networks involved in body processing. It is known that body image distortion may present “delusional proportions” as a consequence of great concern about body. Concomitantly, “embodied defence hypothesis” has been proposed. Restrictive AN exhibits higher levels of delusionality, and a particular delusional type of AN has been suggested, associated with a worse long-term outcome. Low doses of atypical antipsychotics are recommended combined with cognitive techniques. Discussion Delusional thinking in AN is likely a dynamic and dimensional phenomenon that can vary, both in nature and/or severity, whereas high insight levels, before and after refeeding, result in positive outcomes. Neurobiological research on this topic must be encouraged, since clinical and phenomenological approaches are comparatively more frequently reported.

Introduction: Body-focused repetitive impulsive behaviors (BFRIB) are characterized by skin, nail and hair removing, scratching and/or biting, that configurate a mental disorder in some cases. Excoriation disorder (ED) or dermatillomania has been recently added as a specific disorder in DSM-5 obsessive-compulsive spectrum. Its phenomenology describes a behavior that emerges from anxiety, followed by a progressive psychic tension and then a pleasurable sensation, concluding in many times in guilt. Evidence has reported a greater incidence of ED in college students; however, studies in Latin America are scarce. Objective: To establish frequence and phenomenological features of BFRIB and ED in college students. Methods: We performed a cross-sectional study through the application of a self-administered questionnaire about ED aspects in college students. Results: 440 students were included; 22.2% felt always or almost always the impulse to scratch their skin until they were injured; 13.2% made these actions many times a day and 4.3% deployed considerable efforts in resisting them. Most frequent reported affects were guilt, shame, repentance, and self-reproach; 24.1% thought these behaviors were abnormal and 6.1% considered they constitute a pathology. According to DSM-5 and authors’ criteria, four cases of ED were found (0.91%), when psychiatric and medical comorbidities were discarded. Conclusion: Although BFRIB were frequent in college students, dermatillomania frequency was similar to general population. A characteristic phenomenology was described, similar to the evidence reported one.

Resumen Introducción: Las conductas repetitivas impulsivas orientadas hacia el cuerpo (CRIOC) se caracterizan por el rascado, mordido y/o remoción de uñas, pelos y piel, pudiendo llegar a constituir un desorden mental. El trastorno por excoriación (TE) o dermatilomanía ha sido recientemente incorporado como desorden específico al DSM-5 como parte del espectro obsesivo-compulsivo. Su fenomenología describe una conducta reactiva a la ansiedad, seguida de tensión psíquica progresiva y luego placentera al realizarla, finalizando muchas veces en culpa. Se ha reportado una mayor incidencia de TE en estudiantes universitarios, sin embargo, los estudios en Latinoamérica son escasos. Objetivos: Establecer la frecuencia y las características fenomenológicas de las CRIOC y del TE en población universitaria. Métodos: Se realizó un estudio transversal mediante la aplicación de un cuestionario de autorreporte sobre aspectos relacionados con el TE en estudiantes universitarios. Resultados: 440 estudiantes fueron incluidos. Un 22,2% sintió siempre o casi siempre el impulso de rascar su piel hasta lesionarse; 13,2% ejecutó estas acciones varias veces al día y 4,3% desplegó mucho esfuerzo en resistirlas. Los afectos más frecuentemente asociados fueron culpa, vergüenza, arrepentimiento y autorreproche. Un 24,1% creyó que estos comportamientos fueron anormales y 6,1% que constituyeron una patología. Según criterios DSM-5 y establecidos por los autores, se hallaron cuatro casos compatibles con TE (0,91%), al descartar patologías psiquiátricas y médicas comórbidas. Conclusión: Aunque las CRIOC fueron frecuentes en población universitaria, la frecuencia de TE fue similar a la de la población general, describiendo una fenomenología característica congruente con la reportada por la literatura.

Prenatal stress (PS) has been mainly investigated in animal models. It could trigger permanent neurobiological changes in the offpring through fetal programming, displayed as behavioral, cognitive, anxious, affective and psychotic disorders during infancy and adulthood. Main effects of PS have been related to the functioning of hypothalamic-pituitary-adrenal axis (HPA), serotonergic, glutamatergic and GABAergic systems, cortical (prefrontal, temporal and insular cortex) and subcortical structures (amygdala, hippocampus), cerebellum and placenta. Glucocorticoids are the most recognized transmission factors of maternal-fetal stress, with distinctive effects according to the moment of action, developmental stage and fetal gender. Alteration pattern of the HPA axis by PS would be similar to the one observed in some mental disorders. Other neuromodulators involved in the neurotoxicity of PS are nitric oxide and brain derived neurotrophic factor, associated to synaptic potentiation and depression. Also, serotonergic system has an important relationship with HPA axis, verifyinga decreased number of serotonin transporters and an impaired placental synthesis of the neurotransmitter, essential for fetal neurodevelopment. Other epigenenomic mechanisms would be the modulation of synaptic plasticity by neurotrophins, adhesion and membrane molecules. Treatment with selective serotonin reuptake inhibitors has shown controversial outcomes. PS would affect fetal programming causing significant and permanent neurobiological alterations with clinical manifestations. This complex phenomenon must be further investigated, especially in human models.

El estrés prenatal (EP), investigado mayoritariamente en modelos animales, podría desencadenar modificaciones neurobiológicas permanentes en la descendencia mediante la programación fetal, manifestadas como alteraciones conductuales, cognitivas, ansiosas y afectivas, hasta trastornos psiquiátricos durante la niñez y la adultez. Los principales efectos del EP se han hallado en el eje hipotalámico-hipofisiario-adrenal (HHA), los sistemas serotoninérgicos, glutamatérgicos y GABAérgicos, y en estructuras nerviosas corticales (corteza prefrontal, temporal, insular), subcorticales (amígdala, hipocampo), cerebelo y placenta. Los glucocorticoides son los factores de transmisión de estrés materno-fetal más estudiados, con efectos diferenciales según la temporalidad de su acción, la fase del desarrollo y el sexo fetal. El patrón de alteración del eje HHA ante el EP sería similar al observado en algunos desórdenes mentales. Otros neuromoduladores involucrados en la neurotoxicidad del EP son el óxido nítrico y el factor neurotrófico derivado del cerebro, implicados en los procesos de potenciación y depresión sináptica. A su vez, el sistema serotoninérgico posee una relación intrínseca con el eje HHA, verificándose una disminución en la cantidad de transportadores de serotonina y una alteración de la síntesis placentaria del neurotransmisor, esencial para el neurodesarrollo fetal. Otros mecanismos epigenéticos serían la modulación de la plasticidad sináptica mediante neurotrofinas, moléculas de adhesión y de membrana. El tratamiento con inhibidores selectivos de la recaptura de serotonina ha demostrado resultados controvertidos. El EP afectaría a la programación fetal provocando alteraciones neurobiológicas significativas y permanentes con un correlato clínico. Mayor investigación y difusión es necesaria en este complejo fenómeno, sobre todo, en modelos humanos.

Abstract: Body image (BI) is a core feature for identity development; nevertheless amongst male population there is scarce empirical evidence. The aim of this study was to describe the experiences and meanings associated to the construction of BI in male, based on a methodological-qualitative approach. Participated 16 young men aged 15 to 25 years. Data were collected by semi-structured interviews and two focus groups, both analised by open codification. Meanings and procedures related to BI were classified in the following categories: physical appearance care, beauty ideal, self-concept and BI. Participants perceived differences in their physical appearance care compared with women, homosexuals and men of previous generations. In BI construction it is highlighted the drive for being attractive to the opposite sex by the increase of the muscle development. However body dissatisfaction do not represent a relevant topic for participants, since they display a pragmatic value of their BI, which may be an index of a new relationship with their own masculinity and BI that must be explored.

Resumen: La imagen corporal (IC) es fundamental en el desarrollo de la identidad; sin embargo, en la población masculina la evidencia empírica es escasa. El propósito de este estudio es describir las vivencias y significados asociados a la construcción de la IC en varones, a partir de una aproximación metodológica cualitativa. Participaron 16 varones de entre 15 y 25 años de edad. Los datos fueron recolectados mediante entrevistas semiestructuradas y se formaron dos grupos focales, ambos analizados por medio de codificación abierta. Los significados y procesos asociados a la IC se clasificaron en tres categorías: Cuidado de la apariencia física, Ideal estético, Autoconcepto e IC. Los participantes percibieron diferencias en su preocupación y cuidado de la apariencia física respecto a las mujeres, los varones homosexuales o los varones de generaciones previas. En la construcción de la IC destaca el papel de la motivación por resultar atractivo al sexo opuesto, con énfasis en el incremento del desarrollo muscular. No obstante, la insatisfacción corporal no representa un tópico particularmente relevante en los participantes, dado que hacen una valoración práctica de su imagen, lo que podría ser un indicador de una nueva relación con su propia masculinidad e IC que es necesario explorar.