Rôle de l’impulsivité dans la relation entre surpoids et TDAH chez l’enfant : étude exploratoire des caractéristiques cliniques,neuropsychologiques et neurobiochimiques

ObjectivesRelationship between Attention Deficit Hyperactivity Disorder (ADHD) and obesity in adults and children had previously been established in research studies. Brain imaging studies pointed out the important role of the prefrontal region in both ADHD and obesity. However, the underlying link between ADHD and obesity is not well understood. The hypothesis that impulsivity could play a role has been explored in clinical studies of ADHD and Binge Eating Disorders or Loss of Control Eating, with contradictory results. Our study aims to compare children with ADHD and obesity to children with ADHD and normal weight. We propose to compare these two populations with clinical, neuropsychological and brain spectroscopy investigation, focusing specifically on impulsivity items.MethodTen children presenting overweight or obesity were selected from a larger population of children with ADHD (5–12y) and paired with regard to gender and age with ten children with ADHD and normal weight from the same population. Conners Rating scales version parents (CPRS) and teachers (CTRS), Conners’ Continuous Performance Test II (CPT-II), and Magnetic Resonance Spectroscopy (MRS) metabolites in five regions of interest (left and right prefrontal, left and right striatal and left cerebellum regions) were measured for all the children. For MRS, ratio to creatinine levels of following metabolites were measured: glycerophosphocholine + phosphocholine/creatinine (GPC + PCh/Cr), glutamate + glutamine (Glu + Gln/Cr), myoinositol (mI/Cr) et N-acétylaspartate + N-acétylaspartylglutamate (NAA + NAAG/Cr).ResultsHyperactivity/Impusivity and Conners Global Index (CGI) subscales of Conners rating scales showed a higher rate of impulsivity in children with ADHD and obesity as compared to children with ADHD and normal weight. Neuropsychological results were comparable in the two groups. Finally, MRS showed a higher GPC + PCh/Cr ratio in right prefrontal cortex in children with ADHD and obesity as compared to children with ADHD and normal weight.ConclusionsOur results are concordant with the hypothesis that impulsivity could be the link between obesity and ADHD in a population of children with ADHD. The right prefrontal regions seem to be areas of interests that need more research in the study of the link between obesity and ADHD.     

Liens entre la dépression et la dépendance interpersonnelle : l’importance du locus de contrôle

Context

Empirical researches have proved that there are powerful correlations between dependent personality and depression. Different hypotheses were described to conceptualize links between these two entities. The dysfunction of attributive style seems to be linked to dependency and to depression. Interpersonal dependency can be considered to be a mode of adaptation to the external direction of the locus of control. The self-esteem so subjected to the climate of social interactions can lead, by the discontinuity of its protective relations, to the depression. In a coordinated model, this study explores psychopathological aspects between depressive cognition, self-esteem and interpersonal dependency.

Étude de la qualité de vie et des processus d’ajustement des parents d’un enfant ayant un trouble autistique ou un syndrome d’Asperger : effet de plusieurs variables socio-biographiques parentales et caractéristiques liées à l’enfant

Parents of an autistic child go through many periods of transition, which may be perceived as stressful. Bruchon-Schweitzer and Dantzer (1994) developed a model to study the coping behaviours, which takes into account both the stressors and transactional variables. Until now, many researches have focused on stress endured by parents and strategies used by them to cope with the disorder of their child. However, those considering the impact of autism on quality of life are not frequent. We met 160 parents who filled out several questionnaires and self-rating scales we have adapted or created for assessing: (1) information about the child and the family situation; (2) perceived stress; (3) perceived social support; (4) perceived control; (5) coping strategies and (6) quality of life. Our results provide some interesting elements for clinicians and support the already existing data: Autism puts a strain on the life of parents who, as a consequence, would need more substantial breaks in their daily life. The results also support our hypotheses: The child's autonomy, his or her school and social insertion, as well as the partnership between parents and professionals are at the root of a successful adaptation. Finally, they indicate the relevance of a program for parents focused on the management of stress and emotions, adjustment of cognitions and resolution of problems.     

Hyperphagie boulimique : liens avec la personnalité et l’émotionnalité

Objectives

Our two objectives were: (1) to investigate the relationship between binge eating disorder, dimensions of personality (according to the Big Five model of Costa and McCrae) and those of emotionality in the “tripartite” model of emotions of Watson and Clark; (2) to evaluate the correspondence between the Binge Eating Scale (BES) and the Eating Disorder Inventory (EDI-2) scores.

La théorie des cinq facteurs. Profils de personnalité selon la théorie des cinq facteurs et troubles de la personnalité chez des patients déprimés

ObjectivesThe aim of this study was to investigate in a clinical sample the relationships between the specific personality disorders (PD) and the personality traits as defined by the Big Five Model.Patients and methodsFifty-eight patients with major depressive disorder without psychotic symptoms were administered the NEO Personality Inventory Revised and the Structured Interview for DSM-IV Personality Disorders.ResultsAbout the two thirds of them presented at last one PD, the most frequent being obsessive-compulsive, avoidant, paranoid and borderline PDs. These four PDs exhibited a common Five Factor profile characterized by high neuroticism (domain and four facets), and low warmth, positive emotions, openness to values and trust. Three of them showed specific traits in addition: low extraversion and especially gregariousness and activity among paranoid, and low extraversion (especially gregariousness, assertiveness, and activity), openness to actions, competence, achievement striving and self-discipline but high straightforwardness among avoidant, and low extraversion (gregariousness and activity), openness to actions, and self-discipline among obsessive-compulsive patients.ConclusionsThese findings are fundamentally similar to the literature, with the exception of the relatively low conscientiousness among obsessive-compulsive patients. This discrepancy might be due to the fact that our patients were clinically depressed, while most previous research paradoxically studied the PD/FFM relationships among healthy non-consulting participants.     

Les tests de terrain d’évaluation de la condition physique chez l’enfant paralysé cérébral – Validité et fidélité test-retest –

Practice of regular physical activities improve the physical and mental health of children and adults. Numerous studies on children, teenagers and adults with normal growth have seen the light of day for over 10 years and have enabled the establishment of a national and international public health policy in favor of daily physical activity. For children and teenagers with cerebral palsy, we currently do not find recommendations for the physical activities. In order to support cerebral paralyzed children and teenagers as closely as possible to their health needs, an initial assessment of their physical condition seems essential. Thus, this article shows the results of the current publications and studies concerning field tests of physical condition, validated and reliable, in children and/or teenagers with cerebral palsy.     

Lecture des troubles de personnalité limite à travers la théorie de l’attachement

Borderline personality disorders concern clinicians and caregivers because of the violent and impulsive nature of their behavioral and affective reactions, which often confronts them to a feeling of helplessness and incomprehension. Indeed, it may be difficult to deal with self-harm, massive anxiety, intense affects and interpersonal ruptures, which are often present in the life course of the borderline patients. Their distress is particularly difficult to accept as it takes place in the therapeutic link, which reveals the core of the patient's attachment problematic. This paper aims to draw up an overview of borderline personality disorders, in light of attachment theory, which could help to clarify the involved mechanisms and gather the described behaviors in a coherent unit. Many studies relating to borderline personality disorder and attachment theory highlight what constitutes the specificity of these disorders through an integrative approach. Thus, the combination of an insecure attachment style, biological vulnerabilities and environmental stressors like traumatisms may induce the establishment of many defensive mechanisms, such as attachment system hyperactivation, emotional dysregulation or mentalization's failure. People suffering of borderline personality disorder activate these mechanisms as soon as they have to deal with real or imagined abandonments related to one of their attachment figures. However, in view of the massive anxiety and the severe disruption, those inefficient mechanisms cannot enable a good resolution of stressful situations. Consequently, borderline patients are likely to resort to new kind of emotional regulation such as suicidal, destructive and impulsive behaviors. Attachment based theories focus on these defensive mechanisms and inadequate attempts of emotional regulation, in order to propose an appropriate treatment for borderline personality disorder.     

Étude d’une population d’enfants porteurs de paralysie cérébrale : description de caractéristiques cliniques potentiellement corrélées à la morbidité respiratoire

ObjectiveDescribe the history of respiratory morbidity in a population of 30 children with cerebral palsy and to link this development with different clinical signs that may have an impact on lung function. The prospects of such a study would identify some clinical criteria, risk markers for respiratory pathologies, easy to detect outside a hospital setting.MethodsData collection from folder items of each child: health record, nursing records, medical and paramedical folder, and gathering additional information by questionnaires to speech therapists and educators.ResultsIt appears that the more children with cerebral palsy are severely affected in their motor skills, the more they have substantial respiratory history. Children who belong to category 5 on the scale of Gross Motor Function Classification System (GMF-CS) present the following common characteristics: more episodes of inflammations and/or infections of the upper and lower airways than children having lower quotes GMF-CS, postural weakness of the trunk (100%), control deficits of breath and speech (100%), deficits in motor control and sensory integration of the buccal cavity, pharynx and larynx, characterized by impaired swallowing (100%), salivary leakage (100%), a suitable diet and risk of aspiration in 8 of 9 cases, an underweight in 7 of 9 cases. Children of categories GMF-CS below do not include all these features so significantly. However, some children rated 4 have some of these features added.ConclusionChildren with cerebral palsy do not seem all equal faced to respiratory events; the motor and nutritional characteristics identified in our work should be studied as part of a prospective cohort study in order to determine their relevance or not as a respiratory disease risk factor disabling on medium-term. The final aim would be to develop the preventive aspect of the respiratory care of children with cerebral palsy.     

Création et validation d’une échelle de qualité de vie et d’une grille d’observation des caractéristiques personnelles et environnementales pour les enfants polyhandicapés : enseignements d’une étude

Measuring the quality of life of people with profound intellectual and multiples disabilities (PIMD) is a major issue for the affected persons themselves, for their families and for the professionals working near them, but raises serious methodological issues for researchers. A study was lead in 2011 by a team of researchers from Comité d’études, d’éducation et de soins auprès des personnes polyhandicapées (CESAP – Comity for studies, education and care for people with PIMD), in order to build a quality of life scale for children with PIMD from 6 to 14 years old. In this paper, we present its theoretical as well as methodological learnings: the scale could not be statistically verified, but we gathered very rich data about personal and environmental features of children with PIMD nowadays in France. Moreover, this study opens up interesting perspectives to imagine other ways to investigate those children's quality of life.     

Sur l’émergence d’un sujet : dialectique entre neurosciences et psychanalyse autour de la notion de perception

Actually, there are lot of questions for psychoanalysis and neurosciences. Even if sometimes these two theories seem to be distant, and even if some questions are too different to be worked in the same way, some of them can be discussed by these two approaches. It certainly does not make sense to try to find a consensus between psychoanalysis and neurosciences: it's a real risk because, in this case, they’ll probably lose their specificity. But, even if differences and oppositions exist, there are some similar questions, which are related to both fields of research. Some concepts used by Freud are evoked in neurosciences. And, even if they affirm their differences with the creator of the psychoanalysis, neuroscientists speak about him and underline that he found out a lot of concepts still useful today. To build the unconscious in psychoanalysis, Freud needed different concepts. Some have fallen into disuse but through current discoveries in neuroscience, these notions, which are sometimes old but still fundamental in Freudian logic, can again be questioned. This is the case of perception. This phenomenon studied by Freud from its first researches (since 1896), is, in neuroscience, a very important support of experiences: many researches aim to understand the operations in cerebral treatment of information. And the first filters are the perceptions. They are a vector of very dynamic researches about the unconscious or, more precisely, about what it should be named “cognitive unconscious”. But even if we have to establish the difference between Freudian unconscious and cognitive unconscious, the notion of perception really becomes a possible support for a dialectic exchange between psychoanalysis and neuroscience about the unconscious, but more specifically about subjectivity.     

L’évaluation et l’efficacité des psychothérapies psychanalytiques et de la psychanalyse

AimThis article proposes a review of the literature concerning the evaluation and the efficacy of psychoanalytic psychotherapy and psychoanalysis (PPP).MethodAfter proposing a global overview of the evaluation of psychotherapy, we sum up the empirical and quantitative evaluation of PPPs before focusing on their qualitative and process-based evaluation.ResultsPsychotherapies are very effective both in the short and in the long term. Their effectiveness is largely independent of the clinician's theoretical affiliation. Common factors such as the therapeutic alliance or the particularities of the therapist are prevalent, as are the duration and the frequency of the session throughout the therapy. Concerning more specifically the evaluation of PPPs, they have been empirically demonstrated to be effective for most psychiatric conditions. Several characteristics of PPPs are also specifically correlated with therapeutic effectiveness. Moreover, they produce long-term therapeutic effects, particularly concerning personality and after the end of the therapy.DiscussionThe qualitative and process-based evaluation of PPPs appears complementary to empirical evaluation, the latter suffering from several limitations (allegiance bias, indistinction of processes, questionable research practices, etc.) highlighted in particular by the recent crisis of reproducibility. The methodology of Randomized Controlled Trials should be associated with research based on clinical material. The approach of the Boston group, the analysis of psychotherapeutic processes with the Psychotherapy Q-Sort (PQS) and the modeling of the symbolization processes by the School of Lyon are three qualitative research paradigms that are particularly rich from this point of view.ConclusionPPPs are effective for most psychiatric disorders in the short term, at the end of the therapy, and for several years afterwards. They generate lasting transformations in terms of the reduction of symptoms and of personality evolution. They often appear to be more effective than pharmacotherapy and lead to substantial savings when they are implemented in health care facilities for patients suffering from a large variety of pathologies.     

De l’attachement au crime : une revue systématique des relations entre styles d’attachement et nature du passage à l’acte criminel

ObjectiveBased on the premises that attachment theory is an innovative paradigm for studying crime in its various facets, this article aims to present and clarify the current state of knowledge about the relationship between attachment and criminal behavior.MethodsA systematic literature review identifying all meta-analyses and reviews published over the past twenty years – from 1998 to 2018 inclusive – was therefore conducted in order to question the clinical and even explanatory value of the various attachment styles with respect to a certain type of offending. The bibliographic databases Science Direct, PsycInfo, PsycArticles, EMBASE and PubMed were examined using the following keywords and boolean operators: (attachment style) AND (criminal behavior) AND (offenders).ResultsThe data indicate that an insecure attachment style is significantly associated with all types of crime (violent behaviors, sexual violence, domestic violence, rule-breaking and antisocial behaviors), regardless of gender or age. The results also provides a network of correspondences and entanglements between particular attachment patterns and specific criminal acts; perpetrators of sexual violence are indeed characterized by a more anxious attachment style than perpetrators of violent offences, who themselves are more insecure in their relationships than perpetrators of non-sexual violence.ConclusionsThe present review emphasizes the decisive role – and the discriminatory value – of attachment dynamics in the protean nature of criminal behaviors.     

Délivrance du titre de psychologue en France : entre nécessité et absence de formation à l’exercice des psychothérapies

In France, the establishment and professional activity of psychologists develops in many areas, while their initial training remains deficient in terms of expectations and needs of their patients. This is particularly the case with psychotherapy. While the denomination of psychologist also allows the use of the appellation “psychotherapist”, regulated since 2010, academics in psychology, despite this regulation, continue to massively issue this appellation to students whom they have not trained in the area of psychotherapies. Many of these academics are even not qualified psychologists and many more do not have significant experience as psychologists, but yet, must train psychology students. Through these deleterious practices, these so-called psychologists/psychotherapists, often without the expected qualifications, are thus unnecessarily growing each year. At the end of the chain, it is the users who suffer from these serious and costly malfunctions. Logically, the denomination of psychologist should be awarded only to students who have validated a good level of skills to carry out their professional acts, in particular those performing psychotherapies in institutional and liberal settings. This question is inseparable from that of the essential revision of the qualification and recruitment criteria for academics in psychology. The requirement of long and high-level professional experience should be the most important qualification and recruitment criteria for lecturers and professors in psychology. Being well trained by experienced and competent trainers is an essential requirement which psychologists can no longer make exceptions to. In this interview, Professor Cyril Tarquinio makes a critical analysis of the serious shortcomings in the psychotherapies’ training for qualified psychologists in France.     

Utilisation de l’activité physique pour la prise en charge thérapeutique de l’épisode dépressif caractérisé chez l’adulte

The impact of exercise has been the subject of significant work for two to three decades. The results of these studies have enabled national and international comities to issue specific recommendations. Their impact on physical health is now well documented. The effect of physical activity on mental health in general, and for the management of major depressive disorder in particular, is the subject of more recent interest. The purpose of this article is first to carry out a review of the literature on this subject in order to identify the level of evidence of the effectiveness of use of exercise in the treatment of major depressive disorder. Secondly, the known data on the impact of physical exercise on physical health are summarized. Finally, the article provides an update on the regulatory framework for its use in France and the methods of use in current practice by the clinician.     

La prévisibilité de l’intensité de la douleur et de la détresse psychologique par suggestibilité et attitude face aux menstruations chez les étudiantes

ObjectiveThis investigation has aimed to assess Predictability of pain intensity and psychological distress by suggestibility and attitude to menstruation among Iranian population of women.MethodsThis cross-sectional study was performed on 130 female students between 20 to 35 years old. Significant level was set at 0, 05. The analysis method was standard regression.Results130 female students of Shahed university of Tehran participated in investigation and their data was analyzed. Pearson correlation between total score of attitudes to menstruation and subscales of DASS-42 stress, anxiety and depression was respectively (0, 77), (0, 75) and (0, 77). After that, correlation between pain intensity and total score of attitudes to menstruation was (0.732). Moreover, results showed correlation between suggestibility score with subscales of DASS-42 stress, anxiety and depression was respectively (0, 73), (0, 73) and (0, 87). Finally, data analysis demonstrated that correlation between suggestibility score with pain intensity was (0, 73). About all of indexes, Sig = 0, 05.ConclusionResults showed that attitude to menstruation and suggestibility can predict significantly all three subscales of psychological distress (depression, anxiety and stress), so do data analysis demonstrated that more negative attitude to menstruation can predict significantly pain intensity of menstruation among females(Sig = 0,05).