Exposition des enfants à la violence conjugale : troubles mentaux et facteurs de résilience. Étude transversale tunisienne

Conjugal violence is a social problem whose impact extends beyond the couple, to the children who are exposed.ObjectiveTo study the psychological impact of exposure to conjugal violence in children and adolescents in child psychiatry consultation and the factors associated with their capacity for resilience.Patients and methodsWe conducted a cross-sectional study on a sample of 30 children and adolescents, aged between 6 and 18 years and exposed to conjugal violence. Patients were recruited from the child psychiatry unit of the Hospital University of HediChaker of Sfax. We conducted clinical interviews to identify the psychological impact of conjugal violence on children. The resilience evaluation was done by self or hetero passation of the Child and Youth Resilience Measure (CYRM).ResultsChildren and adolescents exposed to conjugal violence suffered from trauma-related disorders and stressors in 40% of cases, mood disorders in 33.3% of cases and externalized disorders in 6.6% of cases. We found that children were more resilient than adolescents in the area of emotional care provided by their parents (12.66 ± 2.02 vs. 9.46 ± 2.69 among adolescents; P = 0.001). In contrast, adolescents were significantly more resilient than children in the area of contextual factors including spirituality (6.46 ± 1.4 vs. 4.53 ± 1.06; P = 0.000), education (11.13 ± 2.13 vs. 8.4 ± 1.54; P = 0.000) and culture (11.13 ± 2.13 vs. 8.4 ± 1.54; P = 0.000). The child's education and good mental health for the mother were associated with better resilience in the children. The child's exposure to conjugal violence by being both a witness and a victim was associated with a reduced capacity for resilience.ConclusionExposure to conjugal violence has a significant impact on the mental health of children exposed. The study of resilience and associated factors could thus be useful in order to limit the deleterious repercussions on children and provide them with harmonious development both on the somatic and psychological levels.     

Positive social interaction offsets impact of low socioeconomic status on stress

Background

Stress is associated with unhealthy behaviors and premature morbidity and mortality, especially among those of low socioeconomic status (SES). Clarifying the roles of stress-related risk and protective factors can guide interventions designed to reduce stress and improve health among socioeconomically disadvantaged populations.

Inoculation stress hypothesis of environmental enrichment

One hallmark of psychiatric conditions is the vast continuum of individual differences in susceptibility vs. resilience resulting from the interaction of genetic and environmental factors. The environmental enrichment paradigm is an animal model that is useful for studying a range of psychiatric conditions, including protective phenotypes in addiction and depression models. The major question is how environmental enrichment, a non-drug and non-surgical manipulation, can produce such robust individual differences in such a wide range of behaviors. This paper draws from a variety of published sources to outline a coherent hypothesis of inoculation stress as a factor producing the protective enrichment phenotypes. The basic tenet suggests that chronic mild stress from living in a complex environment and interacting non-aggressively with conspecifics can inoculate enriched rats against subsequent stressors and/or drugs of abuse. This paper reviews the enrichment phenotypes, mulls the fundamental nature of environmental enrichment vs. isolation, discusses the most appropriate control for environmental enrichment, and challenges the idea that cortisol/corticosterone equals stress. The intent of the inoculation stress hypothesis of environmental enrichment is to provide a scaffold with which to build testable hypotheses for the elucidation of the molecular mechanisms underlying these protective phenotypes and thus provide new therapeutic targets to treat psychiatric/neurological conditions.     

团体辅导对青少年复原力的作用

目的 探究团体辅导对青少年复原力干预效果.方法 16名学生,随机分成实验组(n=8)和对照组(n=8),实验组接受8次的团体辅导,比较干预前后青少年复原力量表评分并分析.结果 实验组后测在复原力、目标专注、情绪控制、积极认知、家庭支持和人际协助分别高于前测(t=-6.782,P＜0.03),也高于对照组(t=4.101,P＜0.03).结论 团体辅导可以提高复原力的水平.     

The resilience status of empty-nest elderly in a community: A latent class analysis

ObjectiveThe aim of this study was to examine the status and characteristics of resilience among empty-nest elderly in a community in China using exploratory latent class analysis (LCA).MethodsThis study enrolled 250 empty-nest elderly as the study respondents. General information regarding the resilience of empty-nest elderly was investigated using the General Information Questionnaire and Connor-Davidson Resilience Scale, Chinese version, and we then used LCA and multivariate logistic regression to discuss the characteristics of resilience among empty-nest elderly individuals.ResultsThrough the analysis, we found that the resilience of empty-nest elderly had obvious group characteristics and that statistical indicators can support the three categories of potential model. On the basis of the conditional probability on the various items of the questionnaire in each category, they were named “high resilience group,” “low pressure resilience group,” and “low resilience group,” and the proportion was 26.6%, 40.4%, and 32.9%, respectively. Further study showed that age, marital status, education level, relationship with children, and physical exercise had a significant effect on the high resilience group compared to the low resilience group. Gender, education level, relationship with children, and physical exercise had a significant effect on the low pressure resilience group compared to the low resilience group.ConclusionsThe resilience status of empty-nest elderly in communities can be divided into three categories. Each category had different characteristics of demographic information.     

Systems biology of resilience and optimal health:integrating Chinese and Western medicine pe8rspectives

Western science has been strong in measuring details of biological systems such as gene expression levels and metabolite concentrations, and has generally followed a bottom up approach with regard to explaining biological phenomena. Chinese medicine in contrast has evolved as a top down approach in which body and mind is seen as a whole, a phenomenological approach based on the organization and dynamics of symptom patterns. Western and Chinese perspectives are developing towards a ‘middle out’ approach. Chinese medicine diagnosis, we will argue, allows bridging the gap between biologists and psychologists and offers new opportunities for the development of health monitoring tools and health promotion strategies. In this paper, health, resilience and stress concepts are explored from an integrated systems biology perspective. This is followed by a discussion about measuring aspects of health and resilience. Then the issue of how to integrate different types of data is discussed. Semi-quantitative modeling appears to be very suitable and looks promising for building integrated health models. The challenge for the future lies in applying those models in developing personalized health monitoring and advice systems that will tempt people to lead more healthy lives.     

Supporting community participation in a pandemic

The invariable governmental approach to the impact of the COVID-19 pandemic has been to effect the White Knight stance of Don Quixote, defending the population from the “Virus Dragon” and dedicating its knight-errantry to the damsel Dulcinea. Though essential, new therapeutics, vaccines, physical distancing, rigorous hygiene standards and efficient health systems are not sufficient to counter the effects of the virus. Individual compliance to public health guidelines also matters, while remaining similarly insufficient to diminish the threat. Earthier, citizen-led, community participation strategies, however, lead to innovative, tailored solutions that better fulfil the needs of diverse neighbourhoods and assures greater virus resistance and increase in population health compared to a top-down, knightly approach or isolated individual efforts. The challenge of COVID-19 offers communities a moment to build more resilient, antifragile communities that not only survive the current crisis, but that thrive after it, and that are better equipped for the next challenge. This is not the time for the singular heroics of the White Knight, or the antics of Don Quixote, tilting at windmills. It is the time of Sancho Panza, which is to say of regular non-credentialed citizens, and their collective efforts, who up to now have largely been considered pawns in this contest. Asset-based community development (ABCD) rejects both the individual as an island and the institutional, knightly emphasis on assessing needs and deficits within communities. It favours identifying and mobilising available and latent assets within a community to forge closer connections among all people, the better to collectivise problem-solving efforts. Community-driven initiatives are assisted in this by localised not-for-profit agencies that practice subsidiarity.