Vécus psychologiques des démarches d'assistance médicale à la procréation

Assisted Reproductive Technologies (ART) come along with important emotional and psychological burden, as well as the physical constraints, for both the woman and her partner. Couples entering ART programs are usually infertile ones, but some specific settings, like serodiscordant couples where the male partner is HIV positive, involving fertile couples. These couples are usually well-adjusted and motivated ones. During the treatments, waiting for the outcome, and the unsuccessful cycles are among the most stressfull experiences. Common reactions are stress, anxiety and depression, but for some couples, the difficulties are so great that they discontinue the program after only one attempt. When parents, the couples usually experience good parenting competencies, and the “precious” children, despite a greater genetic risk, usually have a normal development, but some specific psychological difficulties may arise, that may request a specific help.     

Young people at risk of psychosis: a user-led exploration of interpersonal relationships and communication of psychological difficulties

Aim: The aim of the present study was to qualitatively explore experiences and perceptions of interpersonal relationships and interpersonal communication among young people at risk of psychosis. Method: Semi-structured interviews were conducted using a qualitative grounded theory approach. Participants had entered into a service providing psychological interventions for young people assessed to be at a high risk of developing psychosis (Northwest UK). Our sample comprised one female and seven male participants (n = 8), ranging in age from 16 to 28 years, with a mean age of 22.4 years. Results: Analyses identified three central themes: difficulty with interpersonal relationships and reduced opportunities for helpful communication, difficulty talking to others about psychological problems, and experiences of talking to others about psychological problems. Conclusions: Individuals at risk of psychosis may have experienced significant difficulties with interpersonal relationships. Such difficulties may contribute directly to the development of unusual psychological experiences, and to an inability or reluctance to communicate these to others. In addition, commonly held stigmatizing ideas associated with unusual psychological experiences may contribute to a fear among at-risk individuals that they are ‘going mad’, and this may lead to concealment of their difficulties, and to delayed help-seeking. For at-risk individuals, helpful communication of psychological distress offers significant benefits, including improved psychological and emotional well-being and reduced risk of psychosis. Thus, while concealment of distress may directly impact on the development of unusual psychological difficulties, communication of such difficulties may be central to recovery.     

Psychobiological profiles in infertile men

To investigate the psychosomatic impact in male infertility, we analysed relationships among psychological (life events, personality attitudes) and biological (gonadotrophins, sex steroids, seminal parameters) variables in 101 husbands of barren couples. In patients with subnormal fertility parameters, personality attitudes were not different from those of a reference group of the questionnaire (FAPK) used in this study. However, patients with high scores on test scales such as regression, hypochondria, or emotional vacuity showed better fertility characteristics. These results agree with previously reported data, suggesting that social assertiveness and extraversion but not introversion and depression are associated with male infertility.     

Legitimate love: the meaning of civil partnership for the positioning of lesbian and gay people in society

The Civil Partnership Act (CPA) came into force in the UK on 5 December 2005, entitling same-sex relationships to formal legal recognition. It is the second piece of legislation (following the Adoption & Children Act, 2002) that begins to redress the legal inequalities between opposite-sex and same-sex couples by giving civilly partnered (CP'd) couples similar civil and financial benefits to married couples. The study was a qualitative exploration of the experiences of individuals who have registered a CP. The analysis showed that same-sex couples face many challenges living in a heteronormative society. Civil partnership led to a sense of increased social recognition of same-sex relationships and increased feelings of social support. Many participants also felt that CPs challenged negative stereotypes regarding the identity of lesbian, gay and bisexual individuals and relationships. However, difficulties were expressed in their attempts to find a coherent sense of their new positioning in society as a CP'd couple.     

Psychosomatic aspects in idiopathic infertility: Effects of treatment with autogenic training

It has long been recognised that there is a relationship between emotional stress and some forms of infertility. We have endeavoured to estimate ‘stress’ levels before and after Autogenic Training in 15 couples with infertility of at least two years' duration.Potential stress markers were: plasma prolactin, total urinary free cortisol and catecholamines, and four psychological tests: Spielberger State-Trait anxiety scale, Taylor Manifest Anxiety Scale, the Cattell 16 personality factor questionnaire, and the Eysenck Personality Questionnaire. A control group of ten normal couples was included for comparison.The biochemical finding of higher mean prolactin levels in the female patients vs their controls was of particular interest. The significant reduction of the prolactin level, in parallel with decreased anxiety scores following treatment, supports the hypothesis that the elevated prolactin levels in these patients are indeed linked with emotional stress.     

"Truth at the bedside" and coping with it by incurably ill and dying patients

Psychiatrists are increasingly consulted in the treatment of incurably ill and dying patients. They are not only confronted with the multiple anxieties and depressive syndromes of the patients, but they also have to deal with disturbances of the communication between doctors and patients and difficulties in the information of the patient about the diagnosis. Different attitudes of patients and doctors with regard to informing the patient relative to his previous knowledge will be pointed out. Arguments are presented for or against an open communication about the diagnosis. In addition, the risks of too much information as well as legal aspects of informing the patient are mentioned. "Truth" and "truthfulness" have a fundamental meaning in the doctor-patient relationship. The doctor's dealing with the various forms of anxiety and depression in incurably ill and dying patients is often accompanied by special difficulties. It is a prerequisite for the doctor to perceive and critically reflect his own emotional reactions in order to adequately accompany the patient to his death.     

上海市中学生网络过度使用者心理特征的调查

目的 调查网络过度使用（internetoveruse,IOU）在上海市中学生中的发生率,并研究IOU者的心理卫生问题和人格特征。方法 采用系统分层随机抽样的方法对上海市10所中学的3068名学生进行互联网过度使用的筛查,并用长处和困难问卷（Strengths and Difficulties Questionnaire,SDQ）及艾森克个性问卷（Eysenck Personality Questionnaire,EPQ）进行评估。结果 网络过度使用在上海市中学生中的发生率为2．62％,男生IOU的发生率明显高于女生（P〈0．05）;男生中IOU组EPQ中的L量表分高于对照组,E量表分低于对照组（P〈0．05）;女生中IOU组EPQ中的L得分高于对照组（P〈0．05）。IOU组SDQ中情绪症状、品行问题、多动注意不能、同伴交往问题4个因子均高于对照者,社会行为因子低于对照组（P〈0．001）。结论 网络过度使用者与对照组相比更多地受情绪和行为问题、同伴交往等问题的心理困扰;网络过度使用者存在特定的人格特征,需要给予社会心理干预。     

Parent-child communication and adolescent self-esteem in separated, intercountry adoptive and intact non-adoptive families

The purpose of the present study was to verify whether there are some differences in parent-child communication and in adolescent self-esteem among adoptive, separated and intact non-adoptive families and to investigate the extent to which parent-child communication is related to adolescent self-esteem in the three types of families. The study sample was composed of 450 adolescents aged between 11 and 17 years (160 from intact non-adoptive families, 140 from separated or divorced families and 150 from intercountry adoptive families). Subjects completed the Parent-Adolescent Communication Scale by Barnes and Olson, the Rosenberg Self-esteem Scale and some socio-demographic items. The results show that adolescents from separated families have more difficulties in their relationships with both the mother and the father than their peers, and that adoptive children perceive a more positive communication with their parents than biological children. Moreover, adoptees showed lower self-esteem than the other two groups of adolescents. Lastly, it emerged that male and female adolescents' self-esteem is related to positive communication with both parents in intact non-adoptive families, while no link was significant for male and female children of divorced parents or for adoptees.     

Parent–child communication and adolescent self-esteem in separated, intercountry adoptive and intact non-adoptive families

The purpose of the present study was to verify whether there are some differences in parent–child communication and in adolescent self-esteem among adoptive, separated and intact non-adoptive families and to investigate the extent to which parent–child communication is related to adolescent self-esteem in the three types of families. The study sample was composed of 450 adolescents aged between 11 and 17 years (160 from intact non-adoptive families, 140 from separated or divorced families and 150 from intercountry adoptive families). Subjects completed the Parent–Adolescent Communication Scale by Barnes and Olson, the Rosenberg Self-esteem Scale and some socio-demographic items. The results show that adolescents from separated families have more difficulties in their relationships with both the mother and the father than their peers, and that adoptive children perceive a more positive communication with their parents than biological children. Moreover, adoptees showed lower self-esteem than the other two groups of adolescents. Lastly, it emerged that male and female adolescents' self-esteem is related to positive communication with both parents in intact non-adoptive families, while no link was significant for male and female children of divorced parents or for adoptees.     

Facial expression of emotions in borderline personality disorder and depression

Borderline personality disorder (BPD) is characterized by marked problems in interpersonal relationships and emotion regulation. The assumption of emotional hyper-reactivity in BPD is tested regarding the facial expression of emotions, an aspect highly relevant for communication processes and a central feature of emotion regulation. Facial expressions of emotions are examined in a group of 30 female inpatients with BPD, 27 women with major depression and 30 non-patient female controls. Participants were videotaped while watching two short movie sequences, inducing either positive or negative emotions. Frequency of emotional facial expressions and intensity of happiness expressions were examined, using the Emotional Facial Action Coding System (EMFACS-7, Friesen & Ekman, EMFACS-7: Emotional Facial Action Coding System, Version 7. Unpublished manual, 1984). Group differences were analyzed for the negative and the positive mood-induction procedure separately. Results indicate that BPD patients reacted similar to depressed patients with reduced facial expressiveness to both films. The highest emotional facial activity to both films and most intense happiness expressions were displayed by the non-clinical control group. Current findings contradict the assumption of a general hyper-reactivity to emotional stimuli in patients with BPD.     

Early emotional prosody perception based on different speaker voices

Decoding verbal and nonverbal emotional expressions is an important part of speech communication. Although various studies have tried to specify the brain regions that underlie different emotions conveyed in speech, few studies have aimed to specify the time course of emotional speech decoding. We used event-related potentials to determine when emotional speech is first differentiated from neutral speech. Participants engaged in an implicit emotional processing task (probe verification) while listening to emotional sentences spoken by a female and a male speaker. Independent of speaker voice, emotional sentences could be differentiated from neutral sentences as early as 200 ms after sentence onset (P200), suggesting rapid emotional decoding.     

The dynamics and conceptualizations of non-exclusive relationships in gay male couples

Practitioners have debated the benefits of non-exclusive, or open, relationships in gay male couples. Much of the existing research on non-exclusive relationships has focused on either quantitative validation of non-exclusive relationship dynamics or transmission of the HIV virus due to non-exclusive sexual behavior. Along with previous qualitative studies, this study investigated the dynamics and conceptualizations of non-exclusive relationships using grounded theory methodology from a constructivist perspective. Eight gay men in non-exclusive relationships were interviewed for this study. An analysis of data resulted in four categories of conceptualizations and three categories of management strategies in non-exclusive gay relationships. Participants conceptualized these arrangements based on: their unconventional nature; the variety in sexual behavior; the distinction between sex for intimacy versus recreation; and/or the emotional bond with the primary partner. Participants used management strategies based on: trust; disclosure to the primary partner; and prioritization of the relationship with the primary partner. Despite limitations to this study, these conceptualizations and management strategies may be useful for practitioners who work with gay couples who may consider these arrangements.     

Dependency and suicidality in addictive disorders

Excessive interpersonal dependency has been described in depression and addictive disorders. Moreover, excessive dependency and suicidality are linked in psychiatric subjects, but their relationships have not been studied in specific addictions. Separate samples of female anorectic patients (n=150), female bulimic patients (n=95), male (n=150) or female (n=68) alcoholics, male (n=94) or female (n=54) drug abusers and non-psychiatric control subjects (n=683) were included in the study. On the basis of a structured interview, suicidal ideations, number of previous suicide attempts and diagnoses of dependent personality disorder (DSM-IV) were collected, and the subjects completed the Interpersonal Dependency Inventory and the Beck Depression Inventory. Logistic regression analysis revealed that excessive dependency and notably dependent personality disorder increased the likelihood of suicidal ideation or suicide attempts with a range of 2.65 to 9.42 in bulimic patients, female alcoholics and male drug abusers. Excessive dependency in specific addictive disorders as well as in male non-psychiatric subjects could constitute a risk factor for suicide. This hypothesis must be confirmed using prospective studies.     

White matter structure in autism: preliminary evidence from diffusion tensor imaging.

BACKGROUND: Individuals with autism have severe difficulties in social communication and relationships. Prior studies have suggested that abnormal connections between brain regions important for social cognition may contribute to the social deficits seen in autism. METHODS: In this study, we used diffusion tensor imaging to investigate white matter structure in seven male children and adolescents with autism and nine age-, gender-, and IQ-matched control subjects. RESULTS: Reduced fractional anisotropy (FA) values were observed in white matter adjacent to the ventromedial prefrontal cortices and in the anterior cingulate gyri as well as in the temporoparietal junctions. Additional clusters of reduced FA values were seen adjacent to the superior temporal sulcus bilaterally, in the temporal lobes approaching the amygdala bilaterally, in occipitotemporal tracts, and in the corpus callosum. CONCLUSIONS: Disruption of white matter tracts between regions implicated in social functioning may contribute to impaired social cognition in autism.     

Sexual function in patients with Parkinson''s disease and their partners.

Sexual function in patients with Parkinson's disease has received virtually no attention. There are many reasons (physical, psychological and social), why such patients might experience problems within their sexual relationships. A group of patients and their partners completed a series of self-report measures, aimed at assessing sexual function and a range of factors which might be associated with any difficulties. The results revealed a high level of dysfunction, not just in the patients but also in their partners. Most effected were the couples in which the patient was male. A range of problems were reported by both patients and their partners. These were, in turn, associated with a range of variables relating to the disease, psychological and social factors. No simple causal model was suggested, and a multimodal therapeutic approach might be expected to have most benefit.     

‘The body is a battleground for unwanted and unexpressed emotions’: exploring eating disorders and the role of emotional intelligence

Emotional difficulties have been observed in individuals with eating disorders across awide range of studies, including poor interoceptive awareness, confusion of emotional states and difficulties with emotional language. Literature has linked these difficulties with emotional functioning as being an important factor related to the core aetiology ofeating disorders, however limited knowledge exists to how this impacts on professionalability to engage patients within treatment as a result of such dysfunction. Using aqualitative design this paper explores how facets of Emotional intelligence (EI) are related to the experience of an eating disorder. The study sampled a total of 32 participants with either a professional background working with eating disorders (n=27)or participants with personal lived experience (n=5), with a number of the participants (n=13) identified as having dual roles. The findings of the study show that aspects of EIsuch as emotional regulation and lack of an emotional language are considered to beat the core of the onset and maintenance of these disorders. Additional aspects of emotional awareness and expression were found to be related to treatment disengagement and difficulties. Building on previous literature, this paper found suchemotional deficits as a transdiagnostic issue rather than specifically anorexia nervosa. Furthermore, such dysfunction was seen by professionals to have a considerable impact on therapeutic relationships and successful treatment. These findings provide insight into the potential applications that EI may have in addressing aspects of theeating disorder to create better outcomes for treatment and intervention models.     

Reduced activation in the mirror neuron system during a virtual social cognition task in euthymic bipolar disorder

Social cognition entails both cognitive and affective processing, and impairments in both have accounted for residual symptoms of bipolar disorder (BD). However, there has been a lack of studies identifying neural substrates responsible for social cognitive difficulties in BD patients. Fourteen euthymic BD patients and 14 healthy normal controls underwent functional MRI while performing a virtual reality social cognition task, which incorporated both cognitive and emotional dimensions, simulating real-world social situations. During the scanning, subjects tried to guess (attribute) possible reasons for expressed emotion of virtual humans (avatars) while viewing their facial expressions, just after observing their verbal and nonverbal (facial) expressions which were emotionally valenced (happy, angry and neutral). BD patients compared to normal controls showed delayed reaction times in emotional conditions, with comparable response accuracy. Healthy normal controls activated the right anterior cingulate cortex, inferior frontal, and insular cortex in emotional conditions contrasted with neutral control conditions, that is, the regions that have been related to empathic processes during viewing others' emotional expression. Relative to normal controls, BD patients showed reduced activations in the ‘mirror neuron system’, including the right inferior frontal cortex, premotor cortex, and insula, mainly in angry or happy condition. These results may suggest that, even during euthymic state, BD patients have difficulties in recruiting brain regions for the utilization of emotional cues as a means for understanding others. Clinical attention should be paid to emotion-related residual symptoms to help improve social outcomes in these patients.     

Implications of psychosocial stress on memory formation in a typical male versus female student sample

Stress is known to differentially modulate memory function. Memory can be impaired or strengthened by stress, depending on e.g. the memory type and phase under study, the emotional value of the learned information and the sex of the subjects. Here, we addressed the latter and investigated the impact of psychosocial stress on long-term memory for neutral and emotional pictures and working memory in typical samples of male versus female students. In total, 77 subjects (54 women of which 39 used oral contraceptives) were exposed to either the Trier Social Stress Test (TSST) or a control condition, and then engaged in a long-term memory task (emotionally arousing and neutral pictures; surprise recall after one week) and a working memory (n-back) task. During the experiment salivary cortisol and alpha-amylase levels as well as subjective affect state were assessed. As expected, stress hormone concentrations as well as subjective negative affect states increased significantly in response to the stress task. Men reacted more to the stressor in terms of cortisol responses than women, probably due to oral contraceptive use of the latter. Results show that, in male as well as in female students, memory for emotional arousing information was better than for neutral information, in both the stress and control condition. Stress enhanced recognition memory for emotional versus neutral pictures only in male subjects. Moreover, stress enhanced working memory, particularly in males, during the first block of a 2-back task. The lack of stress effects on memory in women might be explained by oral contraceptive use, leading to blunted HPA-axis responses and secondary to reduced stress effects on memory. The results emphasize that stress affects both long-term and working memory differentially in male versus female students.     

The cognitive, emotional, and social sequelae of stroke: psychological and ethical concerns in post-stroke adaptation

In the clinical domain, ethical analyses involve examination of complex individual responses, psychological processes, and social context. Psychological aspects of stroke adaptation include the risk for depression and anxiety, changes in identity and personality processes, and potential for social isolation. Depression and anxiety are heterogeneous constructs and can affect individuals' emotional functioning and cognitive abilities. Executive function, self-agency, and volition may be affected. Alterations in identity and personality may also result from the interaction of fluctuating emotional, cognitive, and physical abilities as well as from changes in social context and family dynamics. Social isolation, or lack of access to social contact or resources, can be a consequence of difficulties in cognitive and emotional function that influence interpersonal relationships, changes in social roles, communication difficulties, and challenges in transportation and employment. Social stigma and marginalization also contribute to isolation. The authors describe these psychological phenomena in the context of brain damage and recovery and raise ethical concerns including impact on decision-making capacity, pre- and postinjury selves and interests, and the social milieu in which strokes are experienced.     

Altered processing of communication signals in the subcortical auditory sensory pathway in autism

Autism spectrum disorder (ASD) is characterised by social communication difficulties. These difficulties have been mainly explained by cognitive, motivational, and emotional alterations in ASD. The communication difficulties could, however, also be associated with altered sensory processing of communication signals. Here, we assessed the functional integrity of auditory sensory pathway nuclei in ASD in three independent functional magnetic resonance imaging experiments. We focused on two aspects of auditory communication that are impaired in ASD: voice identity perception, and recognising speech‐in‐noise. We found reduced processing in adults with ASD as compared to typically developed control groups (pairwise matched on sex, age, and full‐scale IQ) in the central midbrain structure of the auditory pathway (inferior colliculus [IC]). The right IC responded less in the ASD as compared to the control group for voice identity, in contrast to speech recognition. The right IC also responded less in the ASD as compared to the control group when passively listening to vocal in contrast to non‐vocal sounds. Within the control group, the left and right IC responded more when recognising speech‐in‐noise as compared to when recognising speech without additional noise. In the ASD group, this was only the case in the left, but not the right IC. The results show that communication signal processing in ASD is associated with reduced subcortical sensory functioning in the midbrain. The results highlight the importance of considering sensory processing alterations in explaining communication difficulties, which are at the core of ASD.