Autorégulation et conduites d'observance thérapeutique : exemple de l'hypertension artérielle

In many pathologies, therapeutic non-observance leads to poor adaptation. Sociocognitive theories about psychological variables involved in behaviour change have allowed a part of intention of new behaviour to be explained, but have failed to predict the adoption of this behaviour. In the present study, we take into account behavioural self-regulation views to explain the adoption of therapeutic observance behaviours in the case of arterial hypertension. Results show that features of personal goals structure as well as motivational regulatory variables are relevant to study therapeutic observance among hypertensive patients. Results will be developed and discussed in this article.     

Quelle thérapie possible pour la pédophilie ?

Are paedophiles treatable? The present case study gives an example of how a paedophile can evolve in group psychotherapy. Didier is a 22 year-old exclusive homosexual paedophile, only attracted by pre-pubescent boys. He has been sentenced for sexual offences on four boys aged four to seven. After three years' therapy, he has experienced seduction, has had his first sexual experience with an adult and is living with a woman. This experience has enlarged his object-choice and Didier describes himself as less obsessed by his paedophilic sexual fantasies. His interest in children has diminished as he got more mature and developed better relational and sexual abilities with adults. Considerations about therapy for paedophiles are developed as a conclusion.     

Perception de la maladie et adhérence thérapeutique chez des enfants asthmatiques

This study had two objectives. The first one was to adapt and validate the Revised-Illness Perception Questionnaire (IPQ-R) for children and their parents. The second one was to assess the influence of parent's and children's asthma perception and parent's involvement in treatment on adherence among children suffering asthma. One hundred and forty-six asthmatic children (8–12 years old) and ninety-two parents completed the Revised-Illness Perception Questionnaire and a therapeutic adherence scale. Children who have a good understanding of their illness and who think that their treatment control their asthma, have a better therapeutic adherence. The originality of this research lies in the use of the Illness Perception Questionnaire among children; this could be used in other chronic pediatric diseases.     

La médiation des groupes face aux situations limites du travail thérapeutique en pédopsychiatrie

When we are confronted with children presenting of the behavioural problems in the consultations in child psychiatry, therapeutic work in-group becomes often an alternative. The device of group of psychodrama can allow conflicting the violence of the excitations for children latency. We must however pay attention to the range of the regressions, which it induces in the installation of the group, in the activation of the groups' processes and the reactions to our interventions. In order to preserve phenomena of influence being able to cause the failure of these orientations, it is necessary to think these approaches in reference to intersubjective dimensions and in a plurifocal step compared to the colleagues of the institution.     

Le clinicien face à la crise hystérique : enjeux théoricocliniques de l'épreuve du féminin

Hysterical crisis shows unexpected hallucinations and delirium happening into hysterical structure. Although subject of many psycho-analytical works, hysterical crisis is always matter of debate. That kind of crisis happens when hysterical women and their lover have fallen out. Analysing the case of madam M., we will propose a reflexion about the real raison of those love-affairs to reconsider hysteria in relation to feminity. We will propose a new conception of feminine climax in connection with hallucinations and delirium happening into hysteria. We will debate about position of psycho-clinician, precisely the transference-using face to hysterical subject in state of emergency. Finally, we will propose to think over singularity of subjective structure using the supply concept.     

L’évaluation thérapeutique et collaborative : preuves empiriques

This paper covers the empirical research that addressed utility and effectiveness of therapeutic assessment or of its components (i.e., providing individualize feedback to clients). Studies vary in terms of methods and problems addressed but provide the consistent picture of therapeutic assessment as a brief approach which increases process variables related to subsequent treatment and has direct effects of symptoms reduction for a variety of psychological problems. Future directions of studies in this are finally provided.     

Quelle place pour les médiations thérapeutiques dans la « psychothérapie par l'institution » ?

Therapeutic mediations are an essential part of the communautary treatment offered by our Clinic (Clinique Dupre de Sceaux). They contribute to the adaptation of our therapeutic program to the psychopathological characteristics of our adolescents and young adults patients. We see this therapeutic mediations as a tool to allow a bounding between the treating team and patients whose central psychopathological feature is the fear of bounding and relationship with significative others seen as potential threat of dependency and/or seduction. Through therapeutic mediations, the treating staff is able to deal with repetitive symptomatic situations, using the empathic capacity of each member of the team included in the “psychic enlarged space” of the patient. Therapeutic mediations are the contributing to regulate the bounding process in this type of patient. Through a clinical presentation this paper will present the use of therapeutic mediations in our Clinic. We will then discuss more widely the concept of “psychotherapy through the institution” we use in this type of therapeutic setting.     

L’évaluation thérapeutique : description de quatre modèles

Since its development, therapeutic assessment (TA) has been used in many different settings and adapted accordingly. There are four different TA models: adult, couple, child and adolescent. This article presents the steps of each model and addresses the specific similarities and differences between them.     

La notion de rapport au savoir : convergences et débats théoriques

During the last 20 years in France, the notion of relation to knowledge was very successful in the fields of education research and teachers training, and in the social debate about school. This kind of success should not hide or play down the importance of theoretical or social questions and debates this notion gives rise to, specially when some terms (as relation to knowledge or school experience) are used by different researchers or research teams in different theoretical frames and perspectives. This paper aims to clarify these debates and their theoretical, empirical and social stakes.     

Période périnatale et Rorschach : normes,indicateurs, mentalisation et perspectives théorico-cliniques

ObjectiveThe perinatal period is a maturation phase characterised by the appearance of a radical psychological and identity crisis, little studied by projective methods, in particular the Rorschach inkblot test. The objective of this article is to offer a list of Rorschach norms and indicators adapted to the perinatal population. This is to comprehend the psychological modifications occurring during pregnancy.Materials and methodThe projective Rorschach inkblot test was presented to a representative sample of 54 pregnant primiparous French women. Based on the scoring and analysis methods of the Parisian School, the quantitative norms from the analysis of the psychogram, the chosen cards, and the mentalization indicators were compared to those of the general population.ResultsWith the exception of F +% and H%, all the normative data for the perinatal population are significantly different from those related to the general population (p .005). On a qualitative level, the interpretation of the data highlights the presence of major inhibition mechanisms, associated with a preconscious functioning stasis.ConclusionThe normative data in Rorschach of the perinatal population should be specifically used for the study and psychological support devoted to this population. It also allows a better understanding of the feminine psychologic modifications during pregnancy.     

Logique et théorie physique

Conclusion On s'occupe de la logique quantique depuis 1935 et pendant cette période beaucoup de résultats ont été obtenus, encore me suis-je abstenu de mentionner les résultats obtenus ces dernières années par les logiciens dans ce domaine. Certains de ces résultats ont un intérêt direct pour les théories physiques. En particulier on voit de quelles conditions impératives on doit tenir compte quand on effectue un changement de théorie pour passer à une théorie meilleure. L'exemple de la théorie fonctionnelle des corpuscules est significatif.     

Les théories implicites de l’intelligence : une question de perspectives ?

IntroductionImplicit theories of intelligence are beliefs that people form regarding the malleability of intelligence. The so-called “growth” and “fixed” mindsets respectively view intelligence as a characteristic that can or cannot be changed. Psychology, as a science, also offers diverging responses. The developmental and differential traditions in the study of intelligence merely provide different answers because they do not focus on the same sources of variability nor on the same dimensions of intelligence.ObjectivesThe research question that guided the present studies was: Are people's naïve theories influenced by the same factors that drive developmental and differential psychologists to different conclusions?MethodIn Study 1, we first assessed participants’ (n = 509) reference norm orientation (i.e. whether they tend to focus on individual or social comparison), using a task in which they had to predict the school results of an hypothetical child. Then we administered a French version of Dweck's (2007) mindset scale. In study 2, we first asked participants (n = 530) to choose between two definitions of intelligence focusing either on its fluid or crystalized dimensions. Then we administered the French Mindset Scale and asked participants to justify their conclusion.ResultsBoth variables of interest (reference norm orientation and preferred definition of intelligence) had a significant effect on the participant's incremental beliefs.ConclusionThe results of the two studies as well as the qualitative analysis of participants’ arguments suggest that mindsets, like scientific theories, partly stem from the fact that the same question regarding intelligence malleability can be approached with two different perspectives.     

Modèle systémique de l'alliance thérapeutique

This article presents Pinsof's (1995) systemic model of therapeutic alliance. Pinsof's systemic model of alliance sees the therapy as an interaction between the systems of the client and those of the therapist. This model is composed of two primary dimensions: an interpersonal system dimension and a content dimension. The first focus on four levels of the alliance between and within the therapist and patient systems. The dimension of content includes three qualities of alliance that cut across the four interpersonal dimensions. We studied the notion of alliance profiles, institutional alliance and the notion of split alliance because the alliance is born and evolutes inside the interaction between the systems of the client and those of the therapist. Thus clients develop an alliance not only with their own therapist but also with the systems in which the therapist operate.     

Révéler son humanité ? L’autorévélation du thérapeute à la lumière de la recherche empirique

Self-disclosure, which consists in revealing personal information about oneself to one's client, could be a beneficial therapeutic technique. There are yet many definitions of this concept. However, empirical research shows that self-disclosure may be favourably perceived by clients and that it could influence how they perceive their therapist. Moreover, it could positively influence treatment outcome. Self-disclosure about immediate feelings in the therapy and about the therapist–client relationship would be particularly effective in resolving problematic events by enabling feelings to be expressed and accepted and by providing clients with interpersonnal learning. Several authors finally advise using this technique infrequently, about moderately intimate but relevant themes in relation to the therapy, examining each client's specific needs, and always with the intention of helping them or improving the therapeutic relationship.     

« La malléabilité du cadre thérapeutique comme support d’élaboration sur les terrains de l’aide internationale »

IntroductionIn the field of international aid, the projects set up, including psychological care systems, must respond to international and local requirements regarding their financing and sustainability. In these contexts, clinical questions intersect with those of the systems and culture. The traumatic dimension remains prevalent, and these contexts often must deal with multiple local and international requirements. These dimensions can influence the devices set up and their evolution.ObjectivesThrough feedback from an action-research conducted in Cambodia, we question the evolutions and adaptations of a therapeutic device with abused children.MethodFor one year, a device based on mediation was proposed for 10 children hosted within a local child protection NGO. We describe here its implementation and its evolution in the field.ResultsThe setting up of the system was a vector of different meetings. The adjustments were made in relation to the institutional context, the meetings with the local actors and the specificities of the clinic.ConclusionThe evolutions of the therapeutic device seem to signify the processes at play, both on the institutional and intersubjective scene. Regarding these field returns, the malleability of the therapeutic devices in these contexts seems to support the expression and the processual evolution, allowing a work of psychic elaboration.     

Quelques réflexions sur l'évaluation de l'intelligence générale : un retour à Binet ?

At this centennial of the Binet-Simon test (1905), the edition of the WISC-IV (Wechsler, 2005) raises some questions about general intelligence. After outlining the different approaches of its evaluation, especially global versus factorial approaches, and its evolution, the objective is to show how that contributes to understand the changes presented in the WISC-IV. The scale is built on four factorial homogeneous indices corresponding to dimensions which are the most studied today: fluid intelligence, crystallized intelligence, working memory and fast processing abilities. Nevertheless, this multidimensionality is accompanied by certain redundancies and the reduction of some aspects, especially knowledge, visual-spatial intelligence and social intelligence. In conclusion, some fundamental principles are noted, which were defined by Binet, yielding a “flash-back to the source”.     

Remarques sur la théorie intuitionniste des espaces linéaires

Sans résumé     

Travailler l’acceptation de la maladie en éducation thérapeutique : exemple d’une intervention « ateliers théâtre » pour des personnes porteuses d’un lupus

In this article, a reflection concerning the acceptance of chronic illness in patient education (PE) is proposed. The research focuses on a therapeutic theatre intervention, inspired by theatre of lived experience as proposed to people with lupus. The aim of the intervention is to enable a putting into words and a staging of events that are identified by the patient as disabling. The framework and the process of the intervention are being presented. The results of an exploratory analysis followed by a clinical case will shed light on the contribution of these workshops on the improvement of life satisfaction and illness perception as well as the understanding and the acceptance of illness by the patients and their families. The article will be concluded by the interest of this project in proposing optimized support in PE.     

Utilisation d'une analyse de discours dans l'étude d'un cas de dédoublement de personnalité

The object of this article is to study the contribution of a discourse analysis software in comprehension of a case of dissociate personality disorder. Results obtained inform about the psychopathology of this case and give certain elements useful for the diagnostic discussion.