Arturo Jos Snchez Hernndez

Doctor of Medicine , Master of Satisfactory Longevity , Medicine Specialist Comprehensive General and Psychiatry . Assistant Professor of Psychiatry . hospital Camaguey Psychiatric Commander Ren Vallejo Ortiz. Educational Department . The Central Highway , Km 7 . Camagey . Cuba . CP . 70600 . asanchez@finlay.cmw.sld.cu . _________________________________________________________________

ABSTRACT It was Reflected on the usual personality , its relationship to the ethical and moral values and aspects in Which the neurotic patient with personality deviates from normality and That various criteria of normality are clarifications of the moral value concept. It was Concluded That the neurotic personality moves away from the absence of psychopathology , the statistics , the interpersonal relationships , the evolutionary and functional criteria , que Constitute the majority of the criteria of regular Analyzed personality .

Keywords : personality , neurotic disorders , social values , psychiatry . _________________________________________________________________

INTRODUCTION

Psychiatry as a science not only need to be clear about what an individual sick, but also know what it means to an individual with a normal personality ; otherwise you run the risk of trying to make changes in those who do not need and which is a right to have those differences. To understand what a normal personality is imposed define conceptually , and given the large amount of theoretical positions from which it is addressed and the complexity of human beings, there is great diversity of concepts about it. It should be noted that the essential function of it is the autoregulation behavior, so that for an adequate conceptualization is based on the definition of the factors involved in the self and in what amounts , which will be from the idea that human beings are social by biopsychosocial its essence and its existence .

Undeniably the psychic involvement in the self-regulation of behavior , which is possible thanks to the integration of the information gathered by the receivers proprioceptive , interoceptive and exteroceptive , that subjective reflection as the objective world to organize behavior. Foregoing complex mediated interaction of psychological training , as attitudes, motives , hierarchy of motives , meaning of life , ideals, world outlook, life planning, self-assessment , among others, unique to each individual.

But personality and self-regulation of behavior that makes it possible, have a substrate material that is the brain, which requires a certain biological quality to function properly , both of himself and of the organs and organ systems with which it forms a unit which is systemic human organism as a whole. The difficulty in making decisions when is hungry , tired , cold or excessive heat , lack of sleep important in low oxygen conditions , severe pain , high fever, etc. . , account for factors biological predominantly affecting self-regulation of behavior. When these conditions pass and leave no permanent damage to the nervous system center, or some other body systemically that could affect the brain function, it is common that the individual returns to their ways usual self-regulate . But after certain insults that leave a damage permanent central nervous system, as in the case of major trauma, infection , poisoning, or cerebrovascular accidents tumors may result in persistent changes in self-regulation. This is the case of so-called personality disorders and behavior because illness, injury or cerebral dysfunction ( F07 according to the Cuban Glossary 3 and the Tenth International Classification of Diseases (ICD- 10) .1 To produce permanent changes in the self-regulation of behavior through alterations in the functioning of the central nervous system, the noxa not be necessarily of biological or physico- chemical . With type attacks psychosocial stress producing a high intensity to the individual above their capacity to handle it, may result in breakage permanent internal functional balance certain brain structures, and pathological conditionings , whose trace is recorded regularly in the dynamics of these structures , and are expressed through symptoms that usually make well-defined psychopathological . Such is the case of disorders neurticos.2 Thus far analyzed can be said that self-regulation of behavior is not exclusively biological neural or psychological exclusively mental but involved in it both psychological and biological factors . But the self is not made outside the sociocultural environment , where the individual will find satisfaction to their multiple needs and demands or prohibitions on certain types of behaviors.

The ways in which the individual regulates his behavior are shaped in his personal history through interaction with the sociocultural environment and takes place in according to the requirements of this , in their own development and satisfaction needs for himself and others , all this processed through the prism of their subjectivity unique and unrepeatable. Therefore, it can be argued that in the autoregulation behavior of biological and psychological factors involved must be effected , and and social, the latter creating the context in which this is possible and necessary . Between each of these factors are closely interrelated and influence mutual evolutionary development both as actual expression of each of them. Analyzed according to what can be defined as an integration personality complex , relatively stable and unique to each individual, factors biopsychological involved in self-regulation of behavior in a sociocultural environment determined . Once the above details and definitions it is to answer the following questions : What is a normal personality , What relationship does the

normal personality with moral ethical values ? , in what ways the patient's personality with neurotic disorders could be considered abnormal ? What is a normal personality ? There are several difficulties in defining when a personality is normal or not . One of them is on the criteria that are assumed for this, as there many proposals , each with exceptions and weaknesses , so it should be an entire system using them, so that some offset deficiencies others. Within the current psychoanalytic concepts have the following 3 Freud Sigmung normality is a ideal fiction . To this conception normality is impossible to achieve, and all humans are abnormal and pathological in some sense. Klein notes that is determined by the strength of character, ability to cope with emotional conflicts , to experience pleasure without conflict and love. According to Erikson , is the ability to know how to handle the different periods of life. To Kubie is the ability to learn from experience, to be flexible and adapt to the changing environment . Adler believes normality and mental health of a person is related to its ability to develop social feelings and be productive. Money- Kryle states that it is the capacity for psychological insight . Finally , Rank is defined as the ability to live without anxiety , guilt or anxiety and learn responsibility for their own actions. Except the Freudian for which no normal talk sense , the rest of the authors mentioned addresses some isolated aspect of the personality, which while important individually insufficient . There are many other approaches to normal within which can mentioned those of Offer and Sabshin , which describe four perspectives of the same : As health as utopia , as mean and as process.3 Normality and health : A behavior is within the limits of the normally when not observed psychopathology or symptoms and signs suggestive of some of them . Normality should not rely solely on the non-correspondence with certain diagnostic criteria , but imposes a positive definition of this , in terms of what qualities an individual must have in order to possess healthy or normal personality . Although there are well-defined diagnostic criteria that give little room for error when specifying what mental disorder afflicting the individual disorders themselves mental have different manifestations in different historical and social media cultural . Take the case of the now called dissociative disorders , whose demonstrations have been significant changes through history, which have been greatly influenced by the prevailing ideas at the time. Syndromes are also collected in the various classifiers mental diseases mediated by culture. . Normality as Utopia: Normality is harmonious mix Perfect various elements of mental apparatus which allow optimum performance. This concept confuses normality with the proposal of an ideal human being

from the psychological point of view , and since that " perfect harmonious blend the elements of the psyche " is virtually unattainable and unreachable also be normal and would not even make sense to speak of it. . The average normal : Normal is the middle range of behavior , while both ends are deviations , so has a personality who meets standard features common in most of the members of sociocultural half . This criterion does not specify the essence of normality , and the boundaries between health and disease , so it has limited usefulness and validity in the scientific context Psychiatry . Furthermore, there are personal characteristics that are not present in most individuals in a population , such as coefficients extraordinarily high intellectual , revolutionary ideas , sexual habits , etc . which are far removed from the average , but at no other criteria failing normally, there is no basis for considering them normal . Also fall outside this criterion ethnic minorities have mediated by culture peculiarities regarding ways to self-regulate behavior and are therefore different from the majority of the population in that respect.

. Normality as a process: The normal individual must be able to handle the different periods of his life according to what is expected for the stage of the life cycle therethrough.

Evolutionary changes are extremely important when describing the normal, and certain forms of self-regulation of behavior can be considered normal in a stage of the life cycle , be considered frankly abnormal in others. The poor emotional control of a child's preschool , which is expected for their age , should not exist in the adolescence or young adulthood . The psicorigidez an old man should exist in childhood. Gonzlez Menndez poses the following criteria: 4.5 . Social productivity pattern : The individual must be provided with resources to fend for themselves and be useful in their social environment. . Statistical Pattern : It is identical to the criterion of normality as Daniel average Offer and Melvin Sabshin . . Pattern frustration tolerance : The individual must be equipped with sufficient resources to adequately address environmental contingencies moderately significant . . Pattern Relationships: The individual must be able to feel love and achieve reciprocal feelings engender in others . . Legal Pattern : When there is adaptation of the individual to the rules of legal coexistence and social environment in which they live . Because in this method are included in addition to other legal rules , the author of this study believes that it should be called pattern adaptation to social norms.

This approach has the weakness that standards can be left behind with relation to the objective needs of self-regulation of behavior or entering in contradiction with them , and in such cases the contravention of the same on a effort because there are performance standards can not be considered abnormal . . Functional pattern : performance related individual according to the expected development according to their personal history. Although these criteria are functional as a whole , would be useful to add : . Absence of psychopathology . Should be absent psychopathologies Permanently cause social dysfunction and suffering in the individual, those around him or both. When it comes to personality refers to forms relatively stable self-regulation of behavior, not a manifestation Transient this . Even with severe forms of self-regulation changes behavior, but transient , as is the case of acute psychotic disorders , can not be said that an individual's personality is abnormal if it passes this state, this takes their usual ways of regulating itself . It is important to note that the presence of certain psychiatric symptoms low intensity or short duration , or both , and does not significantly affect the individual's relationship with others, with himself and with things, does not mean that This is a carrier of a psychopathology . Such is the case of anxiety and the depression as common as isolated episodes of low intensity in the population healthy , or hallucinations that occur during extreme fatigue , or in states between sleep and wakefulness. There are also short-lived reactive processes , such as the acute stress reaction , which appears exceptional situations stressors such as natural disasters, accidents , battles , robbery , rape, loss of several loved ones , fire, housing , etc. . , which could considered a normal response to an extremely abnormal situation . The risk of occurrence of acute stress reaction also increases if the extraordinary social demands are present physical exhaustion , processes infectious or other organic factors . . Evolutionary pattern : Like the criterion of normality as a process, proposed by Daniel Offer and Melvin Sabshin , the individual must have sufficient resources to meet the demands of the stage of life you are going through, and be able to handle and overcome the conflicts that arise in it , so that no come to be and drag other stages , deep intrapsychic conflicts . For the purposes of this investigation will be made as normal criteria those posed by Gonzlez Menndez , with the correction made to the legal standard , and expanded by the absence of psychopathology and evolutionary pattern . To define what a normal personality pattern has to start or criteria for it, but is not limited to issues dealt with them. Even with a system functional criteria are doubtful or borderline cases in which even applying all exploratory techniques existing to date are not obtained elements conclusive , as in the case of changes that occur in early dementia Alzheimer 's disease , which are difficult to differentiate from expected changes in normal aging .

With an abundant symptomatology in the line to the pathological , it is easy abnormal rate of how an individual is self-regulating , which can be seen in psychiatric conditions with psychotic level operation which loses contact with reality, rudely disturbed the subjective reflection of this , it

lose critical judgment on itself and its disorders , and violate the most harmonious relations . But not so easy assess normal or abnormal when in the presence of psychiatric conditions with a level of performance where the neurotic alterations of subjective reflection of reality and the medium adaptive capacity not are rude, remains critical judgment on itself and its disorders , and Common symptoms predominate in normal populations such as anxiety. What relation do the normal criteria of personality and moral ethical values ? Before answering the previous question prevails specify the relationship between personality and ethical- moral values , and define the concept of the latter. An essential function of personality is self-regulation of behavior, but the results of this function does not always have a positive social significance , so not always typify ethical and moral values . This self-regulation will be valuable from the ethical - moral if makes possible the existence of relationships adaptive with himself , with others and with things. It should be noted that not all qualities of objects surrounding the moral act human, and even the very qualities of the moral subject , have the same importance for the aforesaid adaptive , so that for it to be possible is necessary that the individual is able to properly orient the world of meanings . What are the moral and ethical values ? They may be defined as meaning socially positive, personality traits , in the sense of allowing adaptive relationships with oneself, with others and with things, through a

orientation in the world of meanings and self-regulation adecuadas.6 behavior -9

Any criterion of normal personality consistent with the existence of adaptive relationships with oneself, with others and with things through a orientation in the world of values and self-regulation of the activity appropriate , could be regarded as accurate to this concept of ethical value moral . But normal personality does not mean complete absence of moral-ethical anti-values , since every individual , together with its axiological values of this area , which allow adaptive social functioning , it also presents a great deal of negative values if they are not related to the current demands of self-regulation of behavior, determined by the characteristics of the medium and its own development evolutionary desadaptarlo not reach , although there as potentials for self desadaptadora to certain requirements . Associate normalcy antivalues absolute absence of ethical and moral , if it would , as Freud himself , an ideal fiction , and therefore the proposed normality ideal personality of the human being that is drawn from the moral standpoint ,

must be humanly achievable . It is also important not to confuse normal personality with the presence of exceptional qualities to perform a task or group of them . the conception that assumes normality must contemplate the infinity of cases without achieving extraordinary social performance , they have a functioning social framework.

Artculo Relacin entre criterios de normalidad de la personalidad, trastornos neurticos y valores tico-morales

Relationship between normality of personality criteria, neurotic disorders and ethical-moral values Arturo Jos Snchez Hernndez Doctor en Medicina, Mster en Longevidad Satisfactoria, Especialista en Medicina General Integral y en Psiquiatra. Profesor Asistente de Psiquiatra. Hospital Psiquitrico de Camagey Comandante Ren Vallejo Ortiz. Departamento Docente. Carretera Central Este, Km 7. Camagey. Cuba. CP. 70600. asanchez@finlay.cmw.sld.cu. _________________________________________________________________

RESUMEN Se reflexion sobre la personalidad normal, su relacin con los valores tico-morales, y los aspectos en los que la personalidad del paciente con trastornos neurticos se aparta de la normalidad y que varios criterios de la normalidad constituyen precisiones del concepto de valor tico-moral. Se concluy que la personalidad del paciente con trastornos neurticos se aparta de la mayora de los criterios analizados de normalidad de la personalidad: los criterios de ausencia de psicopatologa, el estadstico, el de relaciones interpersonales, el evolutivo, y el funcional.

Palabras clave: personalidad, trastornos neurticos, valores sociales, psiquiatra. _________________________________________________________________

ABSTRACT

It was reflected on the normal personality, its relationship to the ethical-moral values and aspects in which the neurotic patient with personality deviates from normality and that various criteria of normality are clarifications of the moral value concept. It was concluded that the neurotic personality moves away from the absence of psychopathology, the statistics, the interpersonal relationships, the evolutionary and functional criteria, which constitute the majority of the analyzed criteria of normal

personality.

Keywords: personality, neurotic disorders, social values, psychiatry. _________________________________________________________________

INTRODUCCIN La psiquiatra como ciencia no slo necesita tener claridad sobre qu es un individuo enfermo, sino tambin saber lo que significa un individuo con una personalidad normal; de lo contrario se corre el riesgo de intentar producir cambios en aquellos que no lo necesitan y para los cuales constituye un derecho tener esas diferencias. Para comprender lo que es una personalidad normal se impone definirla conceptualmente, y dada la gran cantidad de posiciones tericas desde la que es abordada y de la propia complejidad del ser humano, existe gran diversidad de conceptos sobre ella. Cabe sealar que la funcin esencial de la misma es la autorregulacin del comportamiento, por lo que para una conceptualizacin adecuada ha de partirse de la definicin de los factores que participan en esa autorregulacin y en qu cuanta, lo cual se har desde la concepcin de que el ser humano es social por su esencia y biopsicosocial por su existencia. Es innegable la participacin de lo psquico en la autorregulacin del comportamiento, que es posible gracias a la integracin de la informacin recogida por los receptores propioceptivos, interoceptivos y exteroceptivos, que en forma de reflejo subjetivo del mundo objetivo permite organizar la conducta. Todo lo anterior mediado por la compleja interaccin de formaciones psicolgicas, como actitudes, motivos, jerarqua de motivos, sentido de la vida, ideales, concepcin del mundo, proyecto de vida, autovaloracin, entre otras, nica en cada individuo.

Pero la personalidad y la autorregulacin del comportamiento que ella hace posible, tienen un substrato material que es el cerebro, el cual requiere de una determinada calidad biolgica para funcionar adecuadamente, tanto de l mismo como de los rganos y sistema de rganos con los cuales forma una unidad sistmica que es el organismo humano en su conjunto. Las dificultades para tomar decisiones cuando se est hambriento, agotado, con fro o excesivo calor, con falta importante de sueo, en condiciones de poco oxgeno, dolor intenso, fiebre alta, etc., dan cuenta de factores predominantemente biolgicos que afectan la autorregulacin del comportamiento.

Cuando estas condiciones pasan y no dejan dao permanente en el sistema nervioso central, o en algn otro rgano, que de forma sistmica pudiera afectar el funcionamiento del cerebro, lo comn es que el individuo retorne a sus maneras habituales de autorregularse. Pero luego de determinadas noxas que dejan un dao permanente en el sistema nervioso central, como es el caso de importantes traumatismos, infecciones, envenenamientos, accidentes vasculares enceflicos o tumoraciones, pueden producirse cambios persistentes en la autorregulacin. Tal es el caso de los llamados trastornos de personalidad y del comportamiento debido a enfermedad, lesin o disfuncin cerebral (F07 segn el Glosario Cubano 3 y la Dcima Clasificacin internacional de enfermedades (CIE-10).1 Para producir cambios permanentes en la autorregulacin de la conducta por medio de

alteraciones en el funcionamiento del sistema nervioso central, la noxa no tiene que ser necesariamente de tipo biolgica, o fsico-qumica. Con agresiones de tipo psicosociales, que producen un estrs de gran intensidad para el individuo, por encima de sus capacidades para manejarlo, puede producirse una ruptura permanente del equilibrio funcional interno de determinadas estructuras del cerebro, y condicionamientos patolgicos, cuya huella se registra de forma habitual en la dinmica de esas estructuras, y se expresan a travs de sntomas que habitualmente conforman cuadros psicopatolgicos bien definidos. Tal es el caso de los trastornos neurticos.2 Con lo hasta aqu analizado puede decirse que la autorregulacin del comportamiento no es algo exclusivamente biolgico neural, ni exclusivamente psicolgico mental, sino que en l participan factores tanto psicolgicos como biolgicos. Pero la autorregulacin no se efecta al margen del medio sociocultural, en donde el individuo va a encontrar satisfaccin a sus mltiples necesidades, y las exigencias o prohibiciones a determinados tipos de comportamientos.

Las formas en que el individuo autorregula su comportamiento se van conformando en su historia personal a travs de la interaccin con el medio sociocultural y se efecta en funcin de las exigencias de este, de su propio desarrollo y de la satisfaccin de necesidades para l y para otros, todo lo anterior procesado a travs del prisma de su subjetividad nica e irrepetible. Por tanto, puede plantearse que en la autorregulacin del comportamiento participan factores biolgicos y psicolgicos efectundola, as como sociales, creando estos ltimos el contexto en el que esta es posible y necesaria. Entre cada uno de estos factores existe una estrecha interrelacin e influencia recproca, tanto en el desarrollo evolutivo como en la expresin actual de cada uno de ellos. De acuerdo con lo analizado, puede definirse la personalidad como una integracin compleja, relativamente estable y nica en cada individuo, de factores biopsicolgicos que intervienen en la autorregulacin del comportamiento en un medio sociocultural determinado. Una vez realizada las anteriores precisiones y definiciones queda dar respuesta a las siguientes interrogantes: Qu es una personalidad normal?, Qu relacin guarda la normalidad de la personalidad con los valores tico morales?, En qu aspectos la personalidad del paciente con trastornos neurticos pudiera considerarse anormal?

Qu es una personalidad normal? Existen varias dificultades a la hora de definir cuando una personalidad es normal o no. Una de ellas es la relativa a los criterios que se asuman para esto, ya que existen muchas propuestas, cada una con excepciones y debilidades, por lo que habra que utilizar todo un sistema de ellos, de manera que unos compensen las deficiencias de los otros. Dentro de la corriente psicoanaltica tenemos las siguientes concepciones: 3 Para Sigmung Freud la normalidad es una ficcin ideal. Para esta concepcin la normalidad es imposible de alcanzar, y todos los seres humanos somos anormales y patolgicos en algn sentido. Klein seala que viene determinada por la fortaleza del carcter, la capacidad de enfrentarse a conflictos emocionales, para experimentar placer sin conflicto y para el amor. Segn Erikson, es la capacidad de saber manejar los distintos periodos de la vida.

Para Kubie consiste en la capacidad de aprender de la experiencia, de ser flexible y adaptarse a los cambios del entorno. Adler estima la normalidad y salud mental de una persona est relacionada con su capacidad de desarrollar sentimientos sociales y ser productivo. Money-Kryle plantea que es la capacidad para conseguir la introspeccin psicolgica. Por ltimo, Rank la define como la capacidad de vivir sin angustia, culpabilidad o ansiedad y saber responsabilizarse de los propios actos. Exceptuando la concepcin freudiana para la cual hablar de normalidad carece de sentido, el resto de los autores mencionados aborda algn aspecto aislado de la personalidad, que aunque importante resulta insuficiente por separado.

Existen muchos otros planteamientos de normalidad dentro de los que pueden mencionarse los de Offer y Sabshin, los cuales describen cuatro perspectivas de la misma: Como salud, como utopa, como promedio y como proceso.3 . Normalidad como salud: Un comportamiento est dentro de los lmites de la normalidad cuando no se observa psicopatologa, o sntomas y signos indicativos de alguna de ellas. La normalidad no debiera basarse nicamente en la no correspondencia con determinados criterios diagnsticos, sino que se impone una definicin positiva de esta, en trminos de qu cualidades tiene que tener un individuo para poder poseer una personalidad sana o normal. Aunque existen criterios diagnsticos bien definidos que dan escaso margen al error a la hora de precisar qu trastorno mental aqueja al individuo, los propios trastornos mentales tienen manifestaciones diferentes en diferentes medios socio-histricos y culturales. Tenemos el caso de los hoy llamados trastornos disociativos, cuyas manifestaciones han tenido variaciones importantes a travs de la historia, las cuales han sido grandemente influenciadas por las ideas imperantes en la poca. Tambin existen sndromes recogidos en los diferentes clasificadores de enfermedades mentales mediados por la cultura. . Normalidad como utopa: La normalidad consiste en la mezcla armoniosa y perfecta de los distintos elementos del aparato mental que permiten un funcionamiento ptimo. Tal concepcin confunde la normalidad con la propuesta de un ser humano ideal desde el punto de vista psquico, y dado que esa mezcla armoniosa y perfecta de los elementos del psiquismo es prcticamente inalcanzable, as de in alcanzable tambin sera la normalidad y no tendra siquiera sentido hablar de la misma. . La normalidad como promedio: Normal es el rango medio de comportamiento, mientras que ambos extremos son desviaciones, por lo que tiene una personalidad normal quien rene caractersticas frecuentes en la mayora de los integrantes de un medio sociocultural. Este criterio no especifica la esencia de la normalidad, ni los lmites entre salud y enfermedad, por lo que tiene escasa utilidad y validez en el contexto cientfico de la psiquiatra. Adems, existen caractersticas personales que no estn presentes en la mayora de los individuos de una poblacin, como es el caso de coeficientes intelectuales extraordinariamente elevados, ideas revolucionarias, hbitos sexuales, etc., que son muy alejados del promedio; pero al no incumplir otros criterios de normalidad, no hay fundamento alguno para considerarlos no normales.

Tambin quedan fuera de este criterio las minoras tnicas que presentan peculiaridades mediadas por la cultura en cuanto a formas de autorregular la conducta y son por lo tanto, diferentes a la mayora de la poblacin en ese sentido. La normalidad como proceso: El individuo normal debe ser capaz de manejar los distintos perodos de su vida acorde a lo esperable para la etapa del ciclo vital que atraviesa. Los cambios evolutivos son de extraordinaria importancia a la hora de describir la normalidad, y determinadas formas de autorregulacin del comportamiento que pueden considerarse normal en una etapa del ciclo vital, pudieran considerarse francamente anormal en otras. El insuficiente control emocional de un nio de la etapa preescolar, lo cual es esperable para su edad, no debera existir en la adolescencia o en la etapa de adulto joven. La psicorigidez de un anciano no debera existir en la niez. Gonzlez Menndez plantea los siguientes criterios:4,5 . Patrn de productividad social: El individuo debe estar dotado con recursos para valerse por s mismo y ser til en su medio social. . Patrn estadstico: Es idntico al criterio de normalidad como promedio de Daniel Offer y Melvin Sabshin. . Patrn de tolerancia a las frustraciones: El individuo debe estar equipado con recursos suficientes para enfrentar en forma adecuada contingencias ambientales de moderada significacin. . Patrn de relaciones interpersonales: El individuo debe ser capaz de sentir amor y lograr engendrar en otros sentimientos recprocos. . Patrn jurdico: Cuando existe adaptacin del individuo a las normas de convivencia y jurdicas del medio social en que vive. Debido a que en este criterio se incluyen otras normas adems de las jurdicas, el autor de la presente investigacin considera que debiera llamarse patrn de adecuacin a normas sociales.

Este criterio tiene como debilidad que las normas pueden quedar rezagadas con relacin a las necesidades objetivas de autorregulacin del comportamiento o entrar en contradiccin con ellas, y en tales casos la contravencin de las mismas en un esfuerzo porque existan normas funcionales no puede considerarse anormal. . Patrn funcional: Relacionado con el rendimiento del individuo de acuerdo con el desarrollo esperable segn su historia personal. Aunque estos criterios en su conjunto resultan funcionales, sera til aadirles: . Ausencia de psicopatologas. Debe haber ausencia de psicopatologas que causen de forma permanente una disfuncionalidad social y sufrimiento en el individuo, en los que le rodean o en ambos.

Cuando se habla de personalidad se hace referencia a formas relativamente estables de autorregulacin del comportamiento, y no a manifestaciones transitorias de este. Aun con formas graves de alteraciones de la autorregulacin de la conducta, pero transitorias, como es el caso de los trastornos psicticos agudos, no puede decirse que la personalidad del individuo es anormal si cuando pasa este estado, este retoma sus formas habituales de autorregularse.

Es importante aclarar que la presencia de determinados sntomas psiquitricos de baja intensidad o corta duracin o ambos, y que no afectan significativamente la relacin del individuo con los dems, con l mismo y con las cosas, no significa que este sea portador de una psicopatologa. Tal es el caso de la ansiedad y la depresin tan frecuente como episodios aislados de baja intensidad en la poblacin sana, o las alucinaciones que aparecen durante una fatiga intensa, o en los estados entre el sueo y la vigilia. Adems existen procesos reactivos de corta duracin, como es el caso de la reaccin al estrs agudo, la cual aparece ante situaciones excepcionalmente estresantes como catstrofes naturales, accidentes, batallas, atracos, violaciones, prdidas de varios seres queridos, incendio de la vivienda, etc.; lo cual pudiera considerarse una respuesta normal a una situacin extraordinariamente anormal. El riesgo de que se presente una reaccin a estrs agudo aumenta si adems de la exigencia social extraordinaria estn presentes un agotamiento fsico, procesos infecciosos u otros factores orgnicos. . Patrn evolutivo: Semejante al criterio de normalidad como proceso, planteado por Daniel Offer y Melvin Sabshin, el individuo debe contar con recursos suficientes para enfrentar las demandas de la etapa del ciclo vital que est atravesando, y ser capaz de manejar y superar los conflictos que en ella surjan, de manera que no llegue a tener y arrastrar a otras etapas, profundos conflictos intrapsquicos. A los efectos de la presente investigacin sern asumidos como criterios de normalidad los planteados por Gonzlez Menndez, con la correccin realizada al patrn jurdico, y ampliados con el de ausencia de psicopatologa y el patrn evolutivo. Para definir qu es una personalidad normal se ha de partir de patrones o criterios para ello, pero la problemtica analizada no se agota con los mismos. Aun con un sistema funcional de criterios, existen casos dudosos o borderline, en los que aun aplicando todas las tcnicas exploratorias existentes hasta la fecha, no se obtienen elementos concluyentes, tal es el caso de los cambios que ocurren en los inicios de una demencia en la enfermedad de Alzheimer, los cuales resultan difciles de diferenciar de los cambios esperables en el envejecimiento normal. Con una sintomatologa abundante, en la lnea divisoria hacia lo patolgico, resulta fcil calificar de anormal la forma en que un individuo se autorregula, lo cual puede verse en condiciones psiquitricas con un funcionamiento de nivel psictico en el que se pierde el contacto con la realidad, se altera de forma grosera el reflejo subjetivo de esta, se pierde el juicio crtico sobre s mismo y sus trastornos, y se transgreden las ms elementales normas de convivencia. Pero no es tan fcil evaluar de normal o anormal cuando se est en presencia de condiciones psiquitricas con un nivel de funcionamiento neurtico en el que las alteraciones del reflejo subjetivo de la realidad y de la capacidad adaptativa al medio no son groseras, se conserva el juicio crtico sobre s mismo y sus trastornos, y predominan sntomas comunes en la poblacin normal como es el caso de la ansiedad. Qu relacin guardan los criterios de normalidad de la personalidad y los valores tico morales? Antes de dar respuesta a la anterior interrogante se impone precisar la relacin entre personalidad y valores tico-morales, y definir el concepto de estos ltimos. Una funcin esencial de la personalidad es la autorregulacin del comportamiento, pero los resultados de esta funcin no siempre tienen una significacin social positiva, por lo

que no siempre tipificarn valores tico-morales. Esta autorregulacin ser valiosa desde el punto de vista tico-moral si hace posible la existencia de relaciones adaptativas consigo mismo, con los dems y con las cosas.

Cabe precisar que no todas las cualidades de los objetos que rodean el acto moral del ser humano, e incluso las propias cualidades del sujeto moral, tienen la misma importancia para la relacin adaptativa antes mencionada, por lo que para que esta sea posible es necesario que el individuo sea capaz de orientarse adecuadamente en el mundo de las significaciones.

Qu son los valores tico morales? Ellos pudieran ser definidos como la significacin socialmente positiva, de cualidades de la personalidad, en el sentido de que permiten relaciones adaptativas consigo mismo, con los dems y con las cosas, a travs de una orientacin en el mundo de las significaciones y una autorregulacin del comportamiento adecuadas.6-9 Cualquier criterio de normalidad de la personalidad congruente con la existencia de relaciones adaptativas consigo mismo, con los dems y con las cosas a travs de una orientacin en el mundo de los valores y una autorregulacin de la actividad adecuadas, pudiera considerarse como una precisin de este concepto de valor ticomoral. Pero personalidad normal no significa ausencia absoluta de antivalores tico-morales, ya que todo individuo, conjuntamente con sus valores de esta zona axiolgica, que le permiten un funcionamiento social adaptativo, tambin presenta una gran dosis de antivalores que si no estn relacionados con las exigencias actuales de autorregulacin de la conducta, dadas por las caractersticas del medio y de su propio desarrollo evolutivo, no llegan a desadaptarlo, aunque s existen como potencialidades para una autorregulacin desadaptadora ante determinadas exigencias. Asociar la normalidad a ausencia absoluta de antivalores tico-morales, si sera, como plante Freud, un ideal de ficcin; y tanto la propuesta de normalidad de la personalidad como del ideal de ser humano al que se aspira desde el punto vista moral, deben ser humanamente alcanzables.

Tambin es importante evitar confundir la personalidad normal con la presencia de cualidades excepcionales para el desempeo de una tarea o grupo de ellas. La concepcin que se asuma de normalidad ha de contemplar la infinidad de casos que sin llegar a tener un desempeo social extraordinario, s tienen un funcionamiento social adecuado.

What aspects of the patient 's personality with neurotic disorders not meets the criteria of normality ?

Neurotic disorders are a group of disease entities with guidelines well defined for diagnosis of diseases in current classifiers mental , within which may be mentioned Third Cuban Glossary Psychiatry , 1, the Diagnostic and Statistical Manual of Mental Disorders ( DSM IV ), 10 the International Classification of Diseases ICD- 10, 11 and Guide Diagnostic American Psiquitrico.12 These disorders cause suffering in the individual, those around him, and some degree of social dysfunction in whom the suffering , so fail the criterion of absence of psychopathology.

They are present in most of the population so violate the pattern Statistical .

They iteratively affect the individual's relationships with others, an expression , first character anomalies patient's own neurotic disorders , given by insecurity, lack of assertiveness, psicorrigidez , complex defenses hypertrophy , etc. . These patients have attitudes negative toward others, that are triggered in response to associations they make between these people and the causes of their conflicts or needs With the above insatisfechas.2 breach pattern relationships.

At some stage of life of patients with neurotic disorders has been a set of socio-environmental experiences such that this could not handle conditionings produced properly and pathological various types. but has not learned to overcome today , so it can barely evade, conceal, distort or suppress the subjective reflection of the current problems intrapsychic conflicts related to drag , and having to face or envision it should, it structures their psychic balance and triggers set of symptoms that characterize this disease entity neurotic

padezca.2 With all the above can be said that patients with neurotic disorders conflicts has not passed earlier in his life , so it violates the evolutionary pattern .

Current stressors and emotional triggers that trigger conflicts patient 's intrapsychic neurotic disorders and trigger the symptoms own nosological variety is present , usually could be considered trivial for most individuals in their social and cultural environment . Thus can be expressed in breach with the pattern of frustration tolerance . in contrast, the patient could effectively address without disorganized , situations of great significance for most people .

In patients with neurotic disorders are disturbances of the processes cognitive inhibition induced anxiety generated . When a patient with neurotic disorders have a crisis , affective disturbances typical of these disorders , make this performance well below the expected development according to previously attained, at which Alonso lvarez called neurotic inhibition of inteligencia.13 In this case the employer fails functional .

The socialization process of patients with neurotic disorders has been inadequate so you have internalized social norms that conflict with the satisfaction important needs for him, and even culturally accepted forms exist to meet them , it does not. The learning proper social norms has existed in these patients is expressed in attitudes that hinder their adaptation in social environment . With the above it can be noted that the pattern matching fails to social norms .

Thus far analyzed can ensure that the patient's personality neurotic disorders is abnormal because it fails to meet most of the criteria normally assumed in the present study.

CONCLUSIONS

In the literature there are plenty of approaches to what is a Normal personality , which is assumed in this study as follows: for social productivity , the statistician , frustration tolerance , relationships interpersonal adaptation to social norms, the functional, the absence of psychopathology and evolution.

The "normal" personality and ethical- moral values have common aspects , although they are not the same thing. Any criterion of normal personality consistent with the existence of adaptive relationships with self, others and things , could be considered as a value concept accuracy ethical raised morale . While it is important not to confuse the normality of the personality with the complete absence of moral-ethical antivalues , which is an ideal humanly unattainable.

The personality of patients with neurotic disorders fails to meet the criteria for absence of psychopathology , the statistician , the interpersonal relationships , the evolutionary and functional , which are some of the criteria considered .

REFERENCES

1. AA Ojeda Otero , Rabelo Perez V , Echazbal Campos A, Calzadilla Fierro L , Duarte Castaneda F , Magriat Fernndez JM , et al. Third Cuban Glossary Psychiatry . Havana : Havana Psychiatric Hospital , 2001 . p. 76 .

Two . Portieles Clavijo A. Crisis, and family psychotherapy. 2nd ed . Havana : Editorial Medical Sciences , 2011 .

Three . Kaplan HI , Sadock BJ . Grebb JA . Synopsis of psychiatry : behavioral sciences : Clinical Psychiatry . 7th Ed . Buenos Aires : Editorial Medica Panamericana , 1997 .

April . Gonzlez Menndez R. The physician and minor psychiatric disorder . Santiago de Cuba : Editorial Oriente , 1980 .

May . Gonzlez Menndez R. Current Basic Psychiatric Clinic . Havana : Editorial Scientific and Technical , 1998 .

June . Corzo Fabelo JR . Epilogue : assessment Frondizi Risieri axiological thinking . In : Thinking axiological : anthology. Cali -Havana : American Library , Universidad del Valle- Cuban Book Institute , 2011 . p. VII -XXIII

July . JR Corzo Fabelo values and current challenges. Lima : National Library Peru , 2007 .

August . AJ Sanchez Hernandez . Impact of ethical and moral values , artistic -

aesthetic , scientific and technological excellence in psychiatric services . Hum Rev Med [Internet ] . 2007 Apr [cited 21 May 2012 ] , 7 ( 1). Available at: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S172781202007000100005 & lng = en.

9. AJ Hernandez Sanchez axiological approach neurotic disorders . Rev Hum Med [Internet ] . Aug 2009 [cited 21 May 2012 ] , 9 ( 2). Available at: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S172781202009000200008 & lng = en.

10 . Psicomed . DSM IV : Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association). [Internet ] . Madrid : Psicomed , 2013 - [ cited 10 Jan 2013 ] . Available at: http://personal.telefonica.terra.es/web/psico/index.html

11. WHO . International Classification of Diseases and Related Healt Problems, Tenth Revision ( ICD-10) . Geneva 1992.

12. Latin American Psychiatric Association . American Diagnostic Guide Psychiatric ( GLADP ) . Latin American Psychiatric Association . Latin America ; 2003 [Internet ] . Available at: http://www.sld.cu/galerias/pdf/sitios/desastres/guia_latinoamerticana_diagn_psiq_gladp.pdf

13. Alonso Alvarez A, Tabares E. Mendoza Study of intellectual capacity subjects with neurotic disorders . Cuban Rev Psychol . 2003 , 20 (2): 110.

Received : 01/10/2012

Approved: 08/03/2013

Arturo Jose Sanchez Hernandez. Doctor of Medicine , Master of Longevity Satisfactory , Specialist in General Medicine and Psychiatry . teacher Assistant Psychiatry . Camaguey Psychiatric Hospital Commander Ren Vallejo Ortiz . Educational Department . The Central Highway , Km 7 . Camagey . Cuba . CP . 70600 . asanchez@finlay.cmw.sld.cu