Maltrato y suicidio infantil en el Estado de Guanajuato

• Autores: Daniel Páramo Castillo, Ana María Chávez Hernández
• Localización: Salud mental, ISSN 0185-3325, Vol. 30, Nº. 3, 2007, págs. 59-67
• Idioma: español
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• Resumen
  • español

    La comprensión del suicidio infantil ha asimilado cada vez más nociones específicas. Ahora se reconoce la implicación de factores como la evolución del concepto de muerte, el deseo de unirse a una persona significativa ausente, la intencionalidad del acto suicida, la participación del medio familiar como factor contribuyente o protector y la experiencia previa de maltrato.

    Tanto el suicidio como el maltrato infantil suelen estar sub-registrados a causa de la variabilidad de criterios que los definen o por influencias culturales. Se postula que la mecánica del maltrato infantil atrapa a los actores en una dinámica basada en la desigualdad de condiciones físicas, intelectuales y morales, y que esto impide la terminación de esa situación a no ser mediante otro acto violento como podría ser el suicidio. Complementario a esto, las consecuencias en el menor víctima de maltrato infantil pueden actuar como factores contribuyentes para la consumación de conductas suicidas. Se habla entonces de que trastornos cognitivos del estado de ánimo, de identidad, del apego, la desesperanza y el dolor emocional, propios del maltrato, pueden favorecer el suicidio. Por tanto, el objetivo del presente estudio fue determinar la presencia de algún tipo de maltrato infantil en los niños que cometieron suicidio en el Estado de Guanajuato entre 1995 y 2001.

    La metodología utilizada en este estudio descriptivo fue ex-postfacto, dado que la técnica de recolección de datos fue la autopsia psicológica. Esta técnica facilita acceder a la dinámica familiar e intrapsíquica del suicida, así como reconocer las circunstancias previas a su deceso. Se realizó mediante entrevistas con personas cercanas al occiso, además del análisis de todos los efectos residuales del mismo, que en este caso fueron las notas póstumas. El método de análisis fue la distribución de frecuencias y correlaciones, y se llevó a cabo mediante el paquete estadístico SPSS. Los datos cualitativos derivados del análisis de contenido de las notas póstumas fueron verificados mediante la técnica interjueces. Los casos estudiados fueron los pertenecientes a los suicidas menores de ocho a 14años que consumaron su muerte en el Estado de Guanajuato en el lapso de 1995 al 2001 y cuyo expediente fue elaborado por la Procuraduría General de la República.

    Resultados:

    Fueron analizados 29 casos, lo que representa 69% de los suicidios de menores de ocho a 14 años, en el Estado. De los casos examinados, 19 (65.5%) fueron de varones. El rango de edad de los menores suicidas fue de ocho a 14 años, con una media de 12.55 años y desviación estándar de 1.62 años. Asimismo, se trabajó con cinco notas póstumas que pertenecían a cuatro menores: 3 mujeres, una de ellas dejó dos notas, y un varón. La mayoría de las personas entrevistadas fueron familiares en primer grado (72.4% de los casos), el resto eran familiares en segundo grado que reportaron haber tenido relación cercana con el occiso. Tres de cada cuatro entrevistados fueron varones.

    La mitad de los suicidas (51.7 %) padecieron algún tipo de violencia: 31% de ellos sufrió maltrato psicológico, 41.1% recibió algún tipo de maltrato físico, 10.34% maltrato por negligencia y 3.4% abuso sexual. Poco más de la cuarta parte sufría de dos o más tipos de maltrato. Cuatro de las notas póstumas incluyeron declaraciones explícitas de vivencias de maltrato. Otras características de las notas fueron evaluadas mediante la técnica de análisis de contenido y el porcentaje de correlación interjueces fue de 95.5%.

    Otras variables con presencia significativa fueron intentos de suicidio previos en la familia del menor en 26.3% de los casos, y consumo de alcohol y drogas en 65.5% y 24% respectivamente. El maltrato psicológico se correlacionó significativamente con intentos previos de suicidio.

    Se concluye que un importante porcentaje de menores que cometieron suicidio fueron también víctimas de algún tipo de maltrato infantil. De éstos destacó el maltrato físico, sin embargo, ni éste ni el sexual se pueden deslindar del componente emocional que conllevan. Estudios de naturaleza eminentemente cualitativa podrían contribuir al estudio de ambos fenómenos. Se considera que la prevención del maltrato infantil impactaría directamente en el suicidio, en el mismo grupo de edad y acaso también en poblaciones adultas con reducción en su prevalencia.

  • English

    The understanding of child suicide has achieved more and more specific notions since it started to be studied from the theory of adult suicide. Now, the implication of certain factors such as the evolution of death conceptualization, the desire of joining an absent significant person, the premeditation of the suicidal act, the involvement of family environment as a contributing or protective factor, or a previous mistreatment experience, has become clearly recognized.

    Suicides which occur during the childhood period have been associated to previous sexual-nature abuse experiences. In adult suicides, the presence of some kind of mistreatment during their childhood period has also been found. Both phenomena, mistreatment and child suicide, are usually under-registered because of the variability of their defining approaches or because of some cultural influences such as violence occurring naturally or negation of child suicide or premeditation.

    It is postulated that the mechanics of child mistreatment traps the abuser into a dynamics based on the inequality of physical, intellectual and/or moral conditions; this reality plus the defenseless nature of children, impedes the termination of that situation unless it finishes by means of another violent act such, as a suicide. Furthermore, the consequences suffered by a child victim of mistreatment can become contributing factors for a suicidal behavior consummation. Consequently, dysfunctions or disturbances on cognitive, psychological, identity, belonging or hopelessness state of the victim, as well as the emotional pain caused by the mistreatment may favor a suicide behavior. Therefore, the purpose of this study is to determine the presence of any given type of child mistreatment in children (since eight to 14 years old) that incurred in a suicide in the State of Guanajuato between 1995 and 2001.

    The methodology used for this descriptive, observational, retrospective and transversal study, was ex-post-facto (after the event), since the technique for data gathering was carried out by psychological autopsy. This technique facilitates an access into the families and to the understanding of their dynamics, and also to recognizing the circumstances prior to the decease. This technique included one or several interviews with people close to deceased child, besides a detailed analysis of the suicidal event and of all the deceased child’s residual belongings (suicide notes in this case). This study searched some direct and indirect indicators of a possible child mistreatment suffered by suicidal children. The psychological autopsy was conformed by a Questionnaire of Psychosocial data, a Suicidal Act Evaluation Questionnaire and by an Informant’s Reliability Scale. Because of the lack of specific backgrounds for the cases of child suicide, the Psychological Questionnaire was specifically developed for this study.

    Studied cases were those belonging to child suicides, up to 14-year-old children, who consummated their death in the State of Guanajuato in the 1995 to 2001 period. The files were obtained by the General Attorney Department. With the information extracted from such files, we proceeded to establish phone and mail contact with relatives of the deceased children. Later on, some interviews were carried out with one or more people close to each child; these interviews were held by psychologists qualified in Psychological Autopsy and Emotional Contention Techniques.

    The examined data came basically from the Psycho-Social Questionnaire and from the Content Analysis of suicide notes. The analysis method for first data, of quantitative nature, was by frequency distribution and correlation, computed by SPSS statistical software. Qualitative data resulting from the analysis of suicide notes content were verified by a technical jury integrated by three participating clinical psychologists.

    Results: Twenty nine suicide cases were analyzed, representing 69% of child suicides up to 14-year-old children in the State of Guanajuato within the aforementioned period. The rest of the files were not included in this research because the impossibility for locating the victim’s relatives due to changes of residence, and in a lower percentage because they refused to participate in the study due to the emotional pain of talking about the suicide event, or because they ignored the minor child’s data regarding the circumstances and causes of his death.

    Of all the examined cases, 19 (65.5%) were men and 10 (34.5%) were women. The range of child suicides’ age was from eight to 14 years old, with a 12.55 year-old average and a 1.62 year-old standard deviation. Five suicide notes were analyzed, which belonged to 4 children: 3 girls (one of them left two notes) and one boy. With respect to 72.4% of the cases, the interviewed persons were first-degree relatives and regarding the remaining percentage, they were cousins, uncles or grandparents who reported having had a close relationship with the deceased child. The average age of the interviewees was 43 years, with a standard deviation age of 17.19 years.

    In almost half of the suicides (51.7%) some kind of violence was suffered. According to the interviewees’ statements, 31% of the children who committed suicide had suffered some kind of psychological mistreatment, 41.1% of them had received some of kind of physical mistreatment, 3.4% were victims of sexual abuse and 10.34% were neglected. Almost a quarter of all the children had suffered two or three kinds of mistreatment. Additionally, 41.4% of suicidal children had seen physical violence at home. Four of the suicide notes included explicit declarations of mistreatment experiences.

    Other variables that were found were the presence of previous suicide attempts in 20.7% of the cases; and a 26.3% of cases where a relative also had a previous suicide attempt. Family alcohol consumption was detected in 65.5% and drug consumption in 24% of the cases. Further analysis show a correlation between child previous suicide attempts and psychological mistreatment (p= 0.004) or any other kind of violence exposure (p= 0.015).

    It is concluded that an important percentage of children who incurred in a suicide were indeed victims of some kind of child mistreatment, of which physical one was particularly evident. However, neither physical nor sexual abuse can be separated from their implicit component: the emotional mistreatment. Studies of pure qualitative nature could contribute with more information about the dynamics that associates both phenomena. It is deemed that child mistreatment prevention would directly impact both suicide occurrence for the same group of age, and probably also within adult populations thus reducing its prevalence.