« S’attacher pour bien grandir » : résultats préliminaires d’un groupe thérapeutique de guidance parentale et de mise en situation centré sur l’attachement

BackgroundPreventive and therapeutic settings are very common in perinatal and early childhood mental health services. However, their theoretical basis, their methods and their efficacy are rarely described.AimsIn this paper, we present and describe the first feedback from parents about a new group therapeutic setting model that relies on parental guidance and practical experiences designed to prevent and to treat attachment-related parent–infant/child problematic issues.MethodThe group is designed to enhance the quality of parent-child attachment by promoting parents’ awareness of the nature and the importance of attachment bonds for child development and parent–child relationship, and by bringing parents and child to experience new interactions that promote child attachment security. The group is led by two psychologists, a pediatric nurse and a childcare assistant. It is designed to receive up to five families referred by a child psychiatrist after a consultation. Children are aged 1 to 3 years old. Parents and children are received for an assessment interview prior and after they complete their participation to the group, including measures of parental stress (PSI-SF), infant relational withdrawal (ADBB), parent-child relationship (PIRGAS), and child social and emotional competences and problems (BITSEA). Families attend six thematic sessions each of which addresses one of the main attachment pillars: sensitivity, reciprocity, engagement, proximity, emotional regulation and support network. Contents are delivered via slides, video clips, group discussions, practical situations and home tasks. Both parents are encouraged to participate. The feedback from the first families (n = 17) who attended the group are presented.ResultsPreliminary results on the first families who participated in this group show that all of them were satisfied about the group contents and setting. Most parents reported they have acquired new insights on their child's attachment needs and behaviors, felt more comfortable with regulating their own and their child's emotional needs and expression, and became more able to manage problematic behaviors, separation and conflict situations. Slides, video clips and experiencing practical situations and home tasks were also greatly appreciated.PerspectivesThe preliminary positive feedback from the parents supports the relevance of this new intervention model targeted on attachment issues. The group setting, the concrete materials and the active participation of parents and children promote the awareness of attachment needs and the experience of new and safer parent–child interactions.     

Understanding the Influence of Nanocarrier-Mediated Brain Delivery on Therapeutic Performance Through Pharmacokinetic-Pharmacodynamic Modeling

This study aimed at evaluating how encapsulation in a regular nanocarrier (NC) (providing extended circulation time) or in a brain-targeting NC (providing prolonged circulation time and increased brain uptake) may influence the therapeutic index compared with the unformulated drug and to explore the key parameters affecting therapeutic performance using a model-based approach. Pharmacokinetic (PK) models were built with chosen PK parameters. For a scenario where central effect depends on area under the unbound brain concentration curve and peripheral toxicity relates to peak unbound plasma concentration, dose-effect and drug-side effect curves were constructed, and the therapeutic index was evaluated. Regular NC improved the therapeutic index compared with the unformulated drug due to reduced peripheral toxicity, while brain-targeting NC enhanced the therapeutic index by lowering peripheral toxicity and increasing central effect. Decreasing drug release rate or systemic clearance of NC with drug still encapsulated could increase the therapeutic index. Also, a drug with shorter half-life would therapeutically benefit more from a NC encapsulation. This work provides insights into how a NC for brain delivery should be optimized to maximize the therapeutic performance and is helpful to predict if and to what extent a drug with certain PK properties would obtain therapeutic benefit from nanoencapsulation.     

Parcellation influence on the connectivity‐based structure–function relationship in the human brain

One of the fundamental questions in neuroscience is how brain structure and function are intertwined. MRI‐based studies have demonstrated a close relationship between the physical wiring of the brain (structural connectivity) and the associated patterns of synchronization (functional connectivity). However, little is known about the spatial consistency of such a relationship and notably its potential dependence on brain parcellations. In the present study, we performed a comparison of a set of state‐of‐the‐art group‐wise brain atlases, with various spatial resolutions, to relate structural and functional connectivity derived from high quality MRI data. We aim to investigate if the definition of brain areas influences the relationship between structural and functional connectivity. We observed that there is a significant effect of brain parcellations, which is mainly driven by the number of areas; there are mixed differences in the SC–FC relationship when compared to purely random parcellations; the influence of the number of areas cannot be attributed solely to the reliability of the connectivity estimates; and beyond the influence of the number of regions, the spatial embedding of the brain (distance effect) can explain a large portion of the observed relationship. As such the choice of a brain parcellation for connectivity analyses remains most likely a matter of convenience.     

边疆少数民族地区寄宿制小学生同伴关系、亲子沟通与孤独感之间的关系

目的:分析边疆少数民族地区的农村寄宿制小学生同伴关系、亲子沟通和孤独感之间的关系,探讨影响孤独感的内在机制。方法:采用同伴关系量表、亲子沟通问卷和孤独感量表对463名边疆少数民族地区寄宿制小学生进行调查,用结构方程对三者之间的因果关系构建模型,并用收集来的数据进行模型拟合。结果:1同伴关系、亲子沟通和孤独感有密切的相关关系;2亲子沟通对孤独感产生直接影响,路径系数分别为-0.45和-0.30;3同伴关系是亲子沟通对孤独感产生影响的中介因素,亲子沟通通过同伴接受和同伴恐惧自卑影响孤独感的路径系数分别为-0.47和0.57。结论:亲子关系、同伴关系和孤独感之间的关系表现为亲子关系不仅对孤独感产生直接影响,还通过同伴关系这一中介对孤独感产生影响。