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Aim
Even though sociological and demographic changes have led to an increased recognition of grandparents’ psychological roles and functions, their specific contribution in families where one of their grandchildren is disabled is still not well known. In the literature, their role is typically described in terms of instrumental and emotional support they may or may not provide to parents. But how do they live the situation themselves? How do they cope with the upheaval that arises from a grandchild's disability? How are family relationships affected by such an unexpected event?Methods
We present two clinical cases based on research interviews conducted with parents and grandparents of two 10-year-old disabled children. Families we met were contacted through the special school attended by the children. Parents and grandparents were interviewed separately using semi-structured questionnaires. Our analysis here focuses on grandparents’ point of view.Results
The grandparents that we met tend to step aside in front of the distress felt by the parents, trying this way to protect them. They say that they support each other and do not seek any specific help. But the analysis provides an understanding of how, on the basis of this adaptation, they can provide certain types of support to which they give a meaning according to their personal or couple story, or to a broader family background.Conclusion
Grandparents’ specific contribution is still not well known but we better understand the benefits of the grandparents’ potential support on the family unit. By their attention and special place, they help parents reach a fully fulfilled parenting role and help constructing a welfare home. The yet recent uncovering of their functions and their roles in the specific context of disability should allow institutions that receive their grandchildren to better recognize their specificity. 相似文献3.
Objective
In this article, authors sought to understand issues raised by adolescents with multiple disabilities (MD) through content analysis of five siblings.Methods
Discourses have been collected from semi-structured interviews. The content analysis allows opening up the exploration of the specificity of conflicts inherent to fraternal relationship in a disabled family member.Findings
Findings suggest that the adolescent with MD seems to be an organizer of the whole family dynamics; an organiser to whom the hostility, strengthened by disability, increases an overwhelming sense of guilt.Conclusion
This family configuration seems to contribute intensifying difficulties of separation for the siblings, standing out from a mutual psychological space where differentiations in generation are sometimes blurred, and all the more so / especially as is raised the question of the placement for adolescent with MD. 相似文献4.
Background
The emotional and psychological impact of chronical disease among children is considerable. The aim of this study was to explore the emotional representations of sickle cell children followed up at Bordeaux University Hospital in both qualitative and quantitative ways.Methods
Prospective observational study, conducted from February to May 2010 among 22 sickle cell children (SS, SC and Sβ) followed at Bordeaux University Hospital and among their parents. A questionnaire evaluating depressive symptoms and emotional representations was proposed to children and to their parents separately, measuring their child's emotions. Children were asked to draw themselves during sickle cell crisis and without any painful episode, in order to illustrate their perception of their disease.Results
Emotional and psychological impact on sickle cell children was important in this study. Eighty-six percent of children have commonly had negative feelings such as sadness, anger or fear. Thirty-six percent of them had depressive symptoms. Parents largely underestimated this impact. Drawings and answers to the questionnaire emphasized an important lack of disease understanding, social consequences, and depressive affects.Conclusion
Psychological and emotional difficulties in sickle cell children should be identified and supported. Resources for psychological and educational support are necessary to improve the quality of life of sickle cell patients in France. 相似文献5.
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C. Kayser E. Jaunay M. Giannitelli E. Deniau J. Brunelle O. Bonnot A. Consoli J.-M. Guilé D. Cohen 《Neuropsychiatrie de l'enfance et de l'adolescence》2011
Background
Children and adolescents involved with foster care are a population at high risk of developing psychiatric disorders. Here, we aimed to assess in children and adolescents admitted in a University Department of Child and Adolescent Psychiatry whether being involved with foster care would change psychopathology and risk factors they face.Method
We conducted a case-control study in a sample of 103 inpatients aged 6 to 18 years (52 supported by foster care; 51 not supported). Assessment included family and medical histories, psychopathology using the MINI neuropsychiatric interviews (Kid and parents) for axis 1 diagnoses and the diagnostic interview for borderline for axis 2 diagnoses. We also scored the following scales: Global Assessment Functioning, Eysenck Impulsivity and Empathy Scale, Buss and Durkee Hostility Inventory, Harvey Affective Liability Scale.Results
We found more psychosocial life events, both past and recent (occurring less than 2 years) in inpatients involved with foster care (family conflicts, single parent, repeated breaks in places of life, academic failures). We also found more family history of antisocial personality disorder, alcoholism and other drug abuses in first-degree relatives. Regarding axis 1 psychopathologies, we found significantly more conduct disorders, specific developmental disorders and learning difficulties among youths supported by foster care. Finally, we found several prevalent traits of the borderline personality and higher scores of impulsivity, emotional liability and hostility. However, we did not find significant difference for empathy score between the two groups. The results emphasize a condition of cumulative risk factors in the inpatients population involved with foster care.Conclusion
The severity and prevalence of psychiatric disorders among youths involved with foster care and requiring psychiatric inpatient stay show the impact of interactions with the environment on the development of psychopathology in children and, for some of them, the inadequacy of the means of prevention. 相似文献7.
A. Gaillard R. Charles Y.-C. Blanchon V. Rousselon 《Neuropsychiatrie de l'enfance et de l'adolescence》2013
Background
The medical program of the JET (jardin d’enfants thérapeutique or Therapeutic Kindergarten) located in the University Hospital of Saint-Étienne offers early care to children suffering from pervasive development disorders, aged from three to six until they reach the age of a specialized orientation (medico-educational institute, class for scholar inclusion) in sector-specific healthcare structures. This institutional and multidisciplinary medical care is part of a varied and sometimes controversial healthcare supply, leaving professional caregivers in a state of uncertainty.Objective
The aim of this work was to evaluate how parents experienced early care and which therapeutic path they chose.Method
A qualitative study was lead from June 2011 to April 2012 on a judgmental sample of 15 families of children presenting a pervasive development disorder amongst the 91 who attended the JET between 1994 and 2010.Results
The arrival at the JET was described by parents as a scary experience: affected by the recent confirmation of their child's disorder diagnosis, and also by family and social isolation (at the moment of the admission of the child), they were entering an unknown place-receiving children with heterogeneous symptomatology. Trust in the JET was usually established quickly, thanks to an area unanimously referred to as « safe and protective ». Other resorts were described in the different fields of healthcare (biomedical, popular or traditional) more or less initiated and controlled by the institution or, on the contrary, completely alternative or occult. All together, they helped families to build hybrid knowledge of « expert-parents ». A feeling of abandon was often observed when the children left the JET since the handover is constrained by a lack of medico-social services and because of the low engagement of professional resources within liberal practitioners.Perspective
A networking organization between primary care and hospital could help homogenize resorts and extend support. 相似文献8.
Background
In its most simple definition, the dictionary points out that sibling is “all the brothers and sisters of a family”. Brothers and sisters are persons having family ties, usually children descended from the same couple, or with only one parent in common, or bound by adoption.Methods
From the observation of several siblings who lived through a separation, we offer a reflection on the meaning of siblings. We present two clinical vignettes to illustrate this reflection. The first case is a seven year-old child, placed in a foster care family, who built his brotherly identity in relation to this family and not to his biological family. Contacts with his biological parents and siblings are offered to him, but it is the feeling of belonging to the foster care family that makes sense to him. Secondly, we present, through the therapeutic coverage of a 21 year-old woman, formerly adopted, the fantasmatic stake of the brotherly in her psychic elaboration. She is an only daughter in her family, but she elaborates her psychic identity in reference to a fantasmatic space made of brotherly representation in relation to a hypothetical biological sibling.Results
These illustrations bring to light the fact that sibling is not only a notion ensuing from the emotional bonds woven between its members. It is neither necessarily a matter of blood ties, but also, we realize how thinking out sibling and brotherhood creates a psychic space, necessary to any individual, in order to think of himself as a member of society. This second dimension is mainly born by the parents’ desire, which they express in front of their child. It is, indeed, because the parents wish to pass on and give a meaning to sibling that the children will be able to develop brotherly bonds.Perspective
The brotherly group defines brothers and sisters as those who were raised together. This definition is not a demographic nor a biological one, but definitely a psychological one. As a conclusion, we emphasize that, in a situation of separation of the biological siblings, due to placement in a foster care family or an adoption, it is necessary to talk within the family about sibling in its biological and psychological reality, so the “making of sibling” can be elaborated serenely. 相似文献9.
V. Bréjard A. Bonnet A. Pasquier J.-L. Pedinielli 《Neuropsychiatrie de l'enfance et de l'adolescence》2011
Aim of the study
The aim of the study was to analyze the relating contribution of personality dimensions referring to Cloninger's model and emotional awareness to depressive symptoms intensity, in a community sample of adolescents. Our purpose was also to investigate the mediating role of the emotional awareness on the personality-depression relationship.Method
A sample of 372 school students completed the following questionnaires: the Tridimensional Personality Questionnaire (TPQ), the Level of Emotional Awareness Scale (LEAS), and the Center for Epidemiologic Studies Depression Scale (CES-D).Results
Correlationnal and multiple hierarchical regressions analysis confirmed the existence of direct links between each personality dimensions and depression, and the partial mediating effect of emotional awareness, but only for the novelty seeking and the harm avoidance dimensions.Conclusion
Our results confirm the relationships observed in previous research between emotion awareness and depression on one hand, and between personality and depression on the other hand. They highlight the major role played by personality and emotional processing in the vulnerability to present depressive symptoms. The importance of taking in account and assess the emotional processing in the adolescent's depression clinical support is discussed. 相似文献10.
Objective
Authors propose clinical research data about psychic functioning of adolescent siblings of children with autism. Literature review shows that the main purpose is about adolescent development with atypical environment.Methods
Clinical scales and personality tests give information about self-esteem, anxiety, self-image, narcissism, body image. Samples comparisons, clinical group of adolescent of siblings versus control group of typical adolescent. Statistic method and clinical analyses are given to discuss clinical data.Results
Self-image is perturbed but adaptative functioning is generally observed in the clinical group. A real psychic suffer exists for adolescents of siblings that can be described by means of three process screening self-image, nevertheless it does not clearly appear during childhood and adolescenthood. 相似文献11.
Objectives
Despite its longevity, the phenomenon of pregnancy denial remains without satisfactory explanation, and easily lends itself to building social imaginary. The aim of our study was to investigate on a population of professionals of maternity, the social representations of the denial of pregnancy and their relationship to professional practice.Methods
A questionnaire was distributed by email to a population of professionals of maternity.Results
Two hundred and forty professionals and future professionals replied to the questionnaire. Data showed differences in the representation of the denial of pregnancy, the central role of clinical experience towards the medical approach of the case and a discrepancy between the official statement and the subjective perception of this phenomenon. The participants of the study massively agreed to a systematic intervention of adult and child psychiatry for the mother-child dyad.Conclusion
The results point the disparity of the representations of the pregnancy denial, the significance of the emotional content associated with this phenomenon and the need to develop training on the denial of pregnancy. 相似文献12.
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J.-L. Sudres M. Dupuy F. Ghrib H. Desjardins I. Hubert M. Glattard G. Diene C. Arnaud M. Tauber B. Jouret 《Neuropsychiatrie de l'enfance et de l'adolescence》2013
Background
Adolescence is identified as a critical period for obesity and its complications.Objective
To evaluate body image, self-esteem, anxiety and depression in obese adolescents.Methods
Hundred and six obese adolescents benefited from an exploration of body image (Body Prominence, BPQ; Figure Rating Scale, FRS; Questionnaire of Body Preoccupation, QPC), self-esteem (Self-Esteem Scale, SES), anxiety (Revised children Manifest Anxiety Scale, RCMA-S), depression (Center for Epidemiologic studies–Depression Scale, CES-D).Results
Globally, body image is disturbed. The BPQ shows a level of body consciousness greater in girls. Concerning the choice of the perceived figure, boys position themselves more frequently than girls in plump figures. For wished figures, girls choose more slim figures. However, there is no sex difference concerning body dissatisfaction that is relatively important for both sexes. The QPC indicates that girls have higher body preoccupation level than boys with specific focus on certain body area according to sex. The SES indicates that one out of two adolescents shows a low self-esteem and according to the RCMA-S, one out of three shows a high anxiety level without sex difference. Moreover, from the CES-D, one out of five adolescents, more frequently girls, exhibits a moderate to severe depression.Conclusion
These results, with a differential interpretation (statistical vs clinical), partly confirm the data from the literature, and underline the need to perform a comprehensive investigation of body image, self-esteem, anxiety and depression in obese adolescents. In order to optimize the quality of the management provided to these youths, we proposed to physicians a pragmatic guide as “the somato-psychic pyramid”. It is important to remind that while escaping from the rule of the body fat regulation, obese adolescents may demonstrate a transgression and an adaptative marginalization. 相似文献14.
Background
Child welfare literature underlines a higher prevalence of health problems and psychiatric disabilities in fostered young people than in the general population. Questions remain about their social integration and health in the long term: Which risk factors continue to alter their pathway? Which protective factors have minimized a problematic psychosocial adaptation over time?Purpose
A follow-up study in the past was conducted on a SOS children's village on 123 young people who had been reared for more than 3 years and left care after the age of 14. A survey was mailed to these adults aged 23–50 years old, followed by face-to-face interviews. All relevant institutional files were analysed. Attrition rates were very low in this high-risk population. An overall score of social integration aggregates data regarding: occupational situation, family life, relationships, general psychosocial state. Health-related quality of life (Duke Profile) was analyzed by means of multiple dimensions including mental and social health, self-esteem, depression and disability. Multivariate analyses by logistic regression were used to examine the specific roles of decisive factors on social integration.Key findings
At a mean age of 36.5 years, two thirds were well integrated socio-economically, only one out of five had psychosocial problems. Three factors increased the risk of poor socioeconomic integration: accumulation of parental risk factors, having been placed with two or more siblings’ groups and persisting mental health problems when leaving care. The quality of life was significantly associated with a better perception of social and mental health and with self-esteem. It varied positively, taken into account with professional integration, relationships and supportive environment, and negatively according to past adversities: parental domestic violence, maltreatment, and persisting mental health problems. Except from disabilities and to a lesser degree sociability, globally, these former fostered population did not seem different from counterparts in terms of health measures, anxiety and depression.Implications
Results highlight the importance of continuity and stability in placement. For the professionals, it is necessary to give more attention to the question of rearing together several groups of siblings. Persisting mental health problems during placement and when leaving care would suggest a vital need for the staff to identify and to implement intensive, appropriate therapeutic care. 相似文献15.
Objectives
While the reception arrangements for child psychiatric emergencies seem increasingly frequented by adolescents, we sought to identify clinical and sociodemographic characteristics of these patients, yet poorly explored and understood.Methods
We conducted an analysis of the literature review listed from the major search engines.Results
Attendance at child psychiatric emergencies is increasing for over 20 years, with a predominance of adolescents and accompaniment by an overrepresentation of social assistance to children (child welfare): 22,7% to 43% of patients. The first emergency department visit patterns are agitation and violence. The main diagnoses that are registered are mood disorders and conduct disorders, including oppositional defiant disorder. A significant proportion of these adolescents come back to emergencies procedures within the year: nearly one third of adolescents, including a history of child welfare monitoring as a risk factor.Discussion
In the different studies, the same proportion of internalizing problems and externalizing problems are registered by clinician investigators. The most striking characteristics relate more to the environment of these teenagers, including a significant proportion who are followed by child welfare. For those teenagers consulting in an emergency service, a therapeutic issue is to reintegrate them into a sufficient long-term care, thanks to disponibility, accessibility and an essential preliminary work and partnership coordination between the various professionals who accompany them.Conclusion
Based on literature data, knowledge about clinical and sociodemographic adolescents referred for “psychiatric emergency services” need to be developed in order to better understand an important issue and to propose care projects closer to the needs of this high-risk population. 相似文献16.
Background
The differentiation process is both a crucial and central issue in gemellar psychodynamics. It is a complex, multifaceted process (conscious and unconscious) and therefore important to specify. This approach in parallel prompted important questions concerning what would be the best therapeutic setting in the perspective of a psychotherapeutic treatment, particularly concerning the need for a separate setting or not for each child.Method
This study is based on the analysis of a clinical case concerning 11 years old twin boys under psychotherapeutic treatment.Findings
Different stages and their dynamics in the psyche that underlie the differentiation process are analysed, both in the twins and in those close to them. A hypothesis emerged which suggested that differentiation can be forced on and be more seemingly established than truly accomplished. As for the modalities of a therapeutic setting, they need to be thought over again and again in close echo to the twins state of differentiation.Conclusion
In twins, differentiation can be more apparent than achieved. Therefore, the state of the differentiation process needs to be determined because it closely interacts with the choice of the therapeutic setting. 相似文献17.
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Objective
To analyze relationships between the frequency of family meals, clear communication, support within the family and subjective health and life satisfaction of 11–15-year-olds.Material and Methods
The study was conducted in 2012 among 319 primary and lower secondary school pupils. Young people filled the anonymous questionnaire about family meals, family relations, health and life satisfaction. Statistical analysis included partial correlations, linear regression analysis and structural modelling.Results
The vast majority of the young people at least once a week, ate each of the main meals with their parents, 31% daily ate breakfast with their parents, and 46% – lunch and dinner. Frequency of family meals was significantly correlated with clarity of communication and support within the family. Family meals and family relationships positively correlated with subjective health and life satisfaction of young people. Frequency of eating family meals was a predictor of subjective adolescents’ health (direct and indirect relationship) and life satisfaction (indirect relationship). In both cases, support and communication within the family were the mediators.Conclusion
Promoting family meals should be an important method of improving the quality of life of young people. 相似文献19.
P. Bellusso M. Maumy-Bertrand Y. Desnos H. Segond 《Neuropsychiatrie de l'enfance et de l'adolescence》2014
Background
Sensory and emotional disorders are typical in autism spectrum and were analyzed by psychological, neuropsychological and psychodynamic models of interpretation. Our theoretical analysis revealed that sensory-based solicitation of the autistic patients with intellectual disabilities could allow the revival of the intersubjectivity development. Therefore, the emergence of a relational and communicative dynamic. We conceptualized an approach of psychotherapy with sensory mediation intended to formulate therapeutic proposals for remediation of relationship and communication disorders.Objectives
In this study, we aim: to present our care devices and method and their application within the framework of a developmental, clinical and experimental research program; to report the main results obtained with five patients as a clinical illustration.Method
During 18 months, we exposed five patients to individual weekly sessions of psychotherapy with sensory mediation. Our experimental group, constituted of three children presenting severe intellectual disability associated with autistic disorders. It was compared to a control group with two children showing the similar level of intellectual deficiency but without autistic disorders. Quantitative (i.e. statistical) and qualitative analyses of the therapeutic effects were performed in the following domains: sensory integration, social interaction, communication, stereotypies, “positive” behaviors and “negative” behaviors.Results
The specificity of the sensory profile of children with autistic disorders was shown. Moreover, we calculated a Sensory Integration Index allowing observation of the improvement of the autistic children's sensory integration capacity along the continuous care. Both groups increased significantly their investment of the plurimodal stimulations (i.e. associated proximal and distal stimulations). In parallel, the psychotherapy sessions allowed an increased level of social interaction and communicative skills for both groups. Furthermore, the number of stereotypies decreased for the autistic children in the course of care. 相似文献20.