Risques de violences externes au travail et facteurs de protection

Violence external to work is a risk that is difficult to reduce for professionals in certain business sectors. This study (N = 447) assessed two conflict management resources never studied to our knowledge (social support and professional training). The study showed that the search for social or emotional support is linked to exposure to external-to-work violence. Additionally, training moderated the perception of individual capacities to manage certain component of external violence at work, with some gender differences. This research highlights the importance of the availability of these resources in collective strategies to combat the stress generated by external-to-work violence risks.     

Les métamorphoses du système de santé

The normative framework intervened in recent years to renovate and establish a coherent framework to the hospital system questions the bipartite division between private medicine and public medicine. The state supervision, consolidated by the Law of 26 January 2016 on the modernization of the health system, blurs the boundaries and involves renewing the qualification of our health system.     

Le rôle de la mémoire de travail dans la production écrite de textes

Integration of capacity (Just and Carpenter, 1992) and componentiel (Baddeley, 1986) conceptions of working memory in models of text composition (Hayes, 1996 ; Kellogg, 1996 ; McCutchen, 1996) has allowed studying several facets of the role of working memory in writing acquisition and in expert management of the writing processes. This article presents these two conceptions and examines their respective contribution in the field of writing research from two perspectives: The demands of the writing processes (in terms of processing and transient storage) and the influence of working memory capacity on the control of production. The conclusion underlines the importance of investigating the on-line management of text production, the role of the visuo-spatial sketchpad, and to link strategies for allocating the working memory resources with text quality.     

Efficacy of neurostimulation to treat symptoms of Mal de Debarquement Syndrome. A preliminary study using repetitive transcranial magnetic stimulation

Mal de debarquement syndrome (MdDS) is a rare and poorly understood condition of perceived continual motion. Using a multiple‐case design (n = 13; 8 f; 63.5 ± 12.6 years), this study investigated the efficacy of eight 20‐min sessions, over 4 weeks, of repetitive transcranial magnetic stimulation (rTMS) of the dorsolateral pre‐frontal cortex. Compared to sham, rTMS demonstrated improvement in balance and confidence in daily living activities. rTMS shows promise for the treatment of MdDS. However, larger trials with longer intervention periods are required.     

Neurocognitive functioning in patients with conversion disorder/functional neurological disorder

Neurocognitive symptoms are common in individuals with somatic symptom and related disorders (SSRD), but little is known about the specific impairments in neurocognitive domains in patients with conversion disorder (CD)/functional neurological disorder (FND). This study examines neurocognitive functioning in patients with CD/FND compared to patients with other SSRD. The sample consisted of 318 patients. Twenty-nine patients were diagnosed with CD/FND, mean age 42.4, standard deviation (SD) = 13.8 years, 79.3% women, and 289 patients had other SSRD (mean age 42.1, SD = 13.3, 60.2% women). Patients completed a neuropsychological test battery that addressed a broad range of neurocognitive domains, including information processing speed, attention and executive functioning. Patients with CD/FND had clinically significant neurocognitive deficits in all neurocognitive domains based on normative data comparison. Patients with CD/FND also performed significantly worse than patients with other SSRD on information processing speed (Digit Symbol Substitution Test (V = .115, p = .035), Stroop Color–Word Test (SCWT) card 1 (V = .190, p = .006), and SCWT card 2 (V = .244, p < .001). No CD/FND vs. other SSRD differences were observed in other neurocognitive domains. These findings indicate the patients with CD/FND perform worse on information processing speed tests compared to patients with other SSRD.     

CBT/DBT-Informed Intensive Outpatient Treatment for Anxiety and Depression: A Naturalistic Treatment Outcomes Study

Anxiety and depression are highly prevalent and disabling mental health disorders, with comorbidity often posing as a barrier to successful treatment outcomes, thus creating a need for more intensive treatment options. Outpatient clinicians are more likely to refer patients with severe symptoms of anxiety and depression to inpatient hospitalizations rather than partial hospital programs (PHPs) or intensive outpatient programs (IOPs), despite evidence that inpatient hospitalization is associated with high costs and other risks following discharge. The present study reviews two case studies of patients who received cognitive-behavioral therapy/dialectical behavior therapy (CBT/DBT)-based IOP treatment in a private New York clinic. We evaluated treatment outcomes for 73 adult patients (50.7% female) with a mean age of 29.10 years (SD = 10.30). At intake, patients averaged 2.15 diagnoses (SD = 0.94, range = 4) and the majority (80.8%) were prescribed psychotropic medication. Treatment was structured and individually tailored, with patients receiving an average of 21.77 hours (SD = 15.06) of psychotherapy over 12.63 treatment sessions (SD = 9.76), across 12.21 days (SD = 9.61). We observed a clinically and statistically significant change in symptoms of anxiety (t = 6.24, p < .001), depression (t = 5.55, p < .001), and suicidality (t = 2.32, p < .05) over the course of the IOP. After completing treatment, 68.1% of participants tapered down to once-weekly treatment. The present study highlights the clinical utility of an IOP and suggests that this approach can be effective for adult patients presenting with severe symptoms of anxiety and/or depression.     

Happiness and Personal Growth are Attainable in Interferon-Beta-1a Treated Multiple Sclerosis Patients

Multiple sclerosis (MS) is a chronic debilitating disease. MS is associated with high rates of depression and dissatisfaction with life. “Positive psychology,” (PoP) has endeavored to better understand happiness, meaning in life and how these can be developed. There is a growing interest amongst clinicians and consumers in happiness and personal growth as indicators of patients’ well-being. To evaluate happiness and personal growth in treated relapsing-remitting (RR) MS patients compared with age and gender matched healthy subjects. The Oxford Happiness Inventory (OHI), the Satisfaction with Life Scale (SLS) and the Personal Growth Initiative Scale (PGIS) were completed by 105 RR-MS patients [70 females, mean age 44.4 ± 13.3 years, Expanded Disability Status Scale (EDSS) 3.6 ± 2.3] and 87 healthy subjects (66 females, mean age 39.7 ± 11.5 years). Scores were correlated with disease and treatment related parameters. All patients were treated for at least 6 months with interferon-beta-1a (Rebif). Mean happiness scores in MS patients for the OHI (103.1 ± 17.0), the SLS (23.9 ± 6.8) and the PGIS (40.1 ± 7.6) were not statistically different from those of healthy subjects. Categorical analysis of the SLS demonstrated a different distribution wherein more MS patients were in the “dissatisfied” subgroup (SLS score < 20) as compared to healthy subjects (24.8% vs. 12.6%, p = 0.045), while rates were similar in the extremely satisfied subgroup (SLS ≥ 30). Happiness was scored similarly in treated RR-MS patients and healthy subjects despite a greater percentage of patients reporting being dissatisfied with their lives. These findings may reflect positive treatment effects, hedonic adaptation or their combination.     

The cerebellum and language: Evidence from patients with cerebellar degeneration

Clinical and imaging studies suggest that the cerebellum is involved in language tasks, but the extent to which slowed language production in cerebellar patients contributes to their poor performance on these tasks is not clear. We explored this relationship in 18 patients with cerebellar degeneration and 16 healthy controls who completed measures of verbal fluency (phonemic and semantic), word stem completion, and oral naming speed. Cerebellar patients showed significantly slower response times when naming common nouns, which correlated with their degree of motor impairment. Patients were significantly impaired on both phonemic and semantic fluency measures compared to controls (p < 0.001), even when naming speed was entered as a covariate (p = 0.03). On the word stem completion task, patients were significantly less accurate (p < 0.001), had more errors due to non-responses (p = 0.008), and were slower to respond (p = 0.036) than controls; group effects were significant for overall accuracy, but not response time, when the effects of naming speed were covaried (p = 0.014). These findings suggest that cerebellar patients’ poorer performance on language tasks cannot be explained solely by slower language production, and that the integrity of cerebellar-prefrontal loops might underlie poorer performance on measures of executive function in cerebellar patients.     

Analyse d’un modèle théorique de la conception dimensionnelle du narcissisme pathologique : incidences probables sur le leadership organisationnel

The purpose of this case study is to examine the appropriateness of the dimensional model of pathological narcissism developed by Roche, Pincus, Lukowitsky, Ménard and Conroy (2013). The exploration was essentially focused on decompensatory segment (failure of maladaptive self-enhancement strategies) of this model. By using a longitudinal research design, the results, although fragmentary, isolated a positive relationship between the two dimensions – grandiosity and vulnerability – of pathological narcissism. This positive relationship exists both in compensatory segment (use of maladaptive self-enhancement strategies) and in decompensatory segment of the model.     

Sleeping beauty and the dynamics of de se beliefs

This paper examines three accounts of the sleeping beauty case: an account proposed by Adam Elga, an account proposed by David Lewis, and a third account defended in this paper. It provides two reasons for preferring the third account. First, this account does a good job of capturing the temporal continuity of our beliefs, while the accounts favored by Elga and Lewis do not. Second, Elga’s and Lewis’ treatments of the sleeping beauty case lead to highly counterintuitive consequences. The proposed account also leads to counterintuitive consequences, but they’re not as bad as those of Elga’s account, and no worse than those of Lewis’ account.

Les modes de scolarisation des enfants à haut potentiel et leurs effets

Many modes of schooling of gifted children have been tested and each one has its partisans. These various modes of schooling are presented and the studies relating to their effects are reviewed. The results show that the effects do not depend on the mode of grouping of the children but depend on the modifications introduced into the content of teaching programs or the rhythm to which they are teached (compacting, accelerating, etc.). Children being both gifted and motivated to progress more quickly seem able to complete their courses in 1 or 2 years less, without apparent disadvantage. However, there are few longitudinal studies that indicate the long-term effects of these various modes of schooling.     

Le rôle de l’implication et des systèmes de croyances au sein des représentations sociales

The study presented in this article concerns the functioning of representational mechanisms in social thought. More specifically, its objective is to identify the role of variables covering psychosocial involvement and systems of belief within social representations. At the interface between the individual and the group, these variables are considered here because of their status as explanatory variables of social thought. By analyzing the representation of human rights, we hypothesize that the level of involvement and the type of beliefs developed toward the state (concepts of a democratic state versus a safe state) impact on the expression of this representation and the standpoints it creates. The survey was conducted by questionnaire with a student population (315 participants). The main results, which are consistent with our hypotheses, provide evidence of an influence of the variables tested on the expressiveness of the representation of human rights. On the one hand, they reveal how an involvement developed in this subject and the social beliefs attached to the role of the state come to particularize the meaning of this representation, especially concerning its principles of equality. On the other hand, the results demonstrate the activity of ideological processes – political in content – which intervene in the realization of the representation. Through these processes, the results show a stronger influence of social beliefs than of psychosocial involvement on the representation studied.     

Twice daily low frequency rTMS for treatment-resistant auditory hallucinations

BackgroundRepetitive transcranial magnetic stimulation (rTMS) has emerged as a therapeutic solution in patients with treatment-resistant auditory verbal hallucinations. However, the optimal stimulation parameters remain unclear, especially for patients with clozapine-resistant symptoms.MethodIn an open label retrospective study, we investigated whether parameters of stimulation that were useful in patients with major depressive disorder would help schizophrenia patients with treatment-resistant auditory verbal hallucinations. Fourteen participants, including 9 under clozapine, received 30 sessions of 1 Hz rTMS over 3 weeks (360 pulses per sessions delivered with 60 s ‘on’ and 30 s ‘off’ at 110% of the resting motor threshold, 2 sessions per day). Stimulations were applied over the left temporoparietal junction (T3-P3 according to 10/20 system).ResultsAfter rTMS, a significant decrease of auditory verbal hallucinations was observed (?38.7% ± 31.8, p = 0.003) on the Auditory Hallucination Rating Scale. The beneficial effects were also significant in the 9 patients who were also receiving clozapine (?34.9% ± 28.4, p = 0.01).ConclusionsLow frequency rTMS, 30 sessions over 3 weeks, appears to be a suitable approach to decrease treatment-resistant auditory verbal hallucinations, including in patients with clozapine-resistant symptoms. Results from the current retrospective study in the clinical settings need to be confirmed by large-scale randomized sham-controlled trials.     

Pronostic de l’intention de départ chez les sapeurs-pompiers volontaires en France

The fire departments in France currently experience a growing need in volunteer stuff. At the same time the turnover rate among volunteers remains high. Intention to leave was mainly examined on the population of permanent workers, while the antecedents of intention to leave among volunteers are still undervalued. We suggest the existence of specific effects different from those previously coined out in standard organisational settings. Thus, the present study seeks to identify first- and second-order factors of intention to leave among volunteer fire-fighters. The literature review leads us to the proposition of three conceptual models that vary in terms of main mediators. Either job satisfaction, or organisational commitment, or both of them are envisaged as having the main mediating effect in the model. One hundred and thirty-nine volunteer fire-fighters returned completed questionnaires. The data was further analysed via path analysis in LISREL 8.80. The results partly confirm the model, according to which job satisfaction mediates the effects of organisational commitment, job involvement, perceived organisational support and motivation. Two variables – satisfaction with supervisors and length of service – are identified as main predictors of intention to leave. Job involvement and perceived organisational support are confirmed as second-order mediators of the effects exercised onto turnover intention by affective and normative commitment, satisfaction with colleagues and work, as well as intrinsic and extrinsic motivation. The results also indicate the necessity to examine the role of different dimensions of organisational attitudinal variables independently. Thus, the most salient dimension of satisfaction refers to the relationship with supervisors. As regards organisational commitment, its calculate dimension appears to have no significant effects at all; while affective one is characterised by a weak effect on intention to leave contrary to the results previously reported. The only individual variable having a significant effect on intention to leave is the volunteer fire-fighter's length of service. We conclude that instead of seeking to identify the appropriate selection criteria helping to reduce the existing turnover rate among volunteer fire-fighters, it is time to focus further research on the practices of organisational socialisation in order to reduce the current level of turnover. The main conclusion of the study emphasises the role the attitudes towards organisation plays in the decision of a volunteer fire-fighter to resign.     

The piloting of a brief relational psychodynamic protocol (psychodynamic addiction model) for problem gambling and other compulsive addictions: A retrospective analysis

The paper describes a treatment pilot for gambling and compulsive addiction within an NHS problem gambling clinic. The pilot study used a brief relational psychodynamic treatment protocol specifically designed to meet the needs of a group of patients who had not responded to CBT and who had other addictions or co‐morbidities. Seventy‐two (n = 72) patients were offered 12 sessions of therapy by four psychodynamic counsellors. Results were assessed using scores from a pre‐ and post‐treatment patient health questionnaire, the generalised anxiety disorder—7 (GAD‐7) and the Problem Gambling Severity Index (PGSI). Weekly feedback and supervision from counsellors and patients were used to assess the treatment model. The results highlighted that the psychodynamic addiction model was associated with reduced depression (Mean = 14.9; SD: 6.7), anxiety (Mean = 11.5; SD: 5.9), and gambling severity (p < .001), suggesting that a relational psychodynamic treatment is needed for complex patients with compulsive addiction, where CBT had not been successful. These results also highlight the importance of the therapeutic relationship as a critical factor in the treatment of patients with compulsive addiction problems.     

Depression screening and treatment among uninsured populations in Primary Care

Uninsured populations have poor treatment engagement and are less likely to receive evidence-based interventions for depression. The objective of the current study was to retrospectively examine depression screening, diagnosis, and treatment patterns among uninsured patients in primary care. Study sample included all patients (N = 11,803) seen in nine community-based clinics. Key variables included depression screener and/or a depression diagnosis, anti-depressant initiation, behavioral health visits, and patient follow up measures. Treatment patterns from the subsample of patients diagnosed with depression were analyzed by collecting the number of behavioral health visits and antidepressant use six months (180 days) following the diagnosis. Utilization of the depression screening tool was high (67%, n = 7,935) and 24% (n = 2,789) of the patients had a diagnosis of depression, however, more than half of the patients with a depression diagnosis did not have a recorded treatment plan (n = 1,474). The odds of anti-depressant use and behavioral visits for Hispanic patients were significantly greater than for Non-Hispanic patients. Universal screening with brief measures in primary care is improving, however, guideline-concordant depression treatment remains elusive for uninsured populations.     

Sense of body ownership in patients affected by functional motor symptoms (conversion disorder)

Background and aimPatients with functional neurological symptoms are commonly seen in neurological practice. Nevertheless their aetiopathology remains unclear. We have recently shown that patients affected by functional motor symptoms (FMS) present lower interoceptive awareness and higher alexithymia levels than healthy controls. Nevertheless sense of body ownership has never been studied in FMS patients.The aim of the present study was to systematically investigate the sense of body ownership, with the rubber hand illusion (RHI) paradigm, in patients with FMS and healthy controls.Materials and methodsWe included in the study 16 patients with FMS and 18 healthy controls (HC). Patients and HC were asked to complete the Toronto Alexithymia Scale (TAS-20) and the self-consciousness scale (self-objectification questionnaire). All participants underwent the RHI paradigm: illusionary experience was measured by self-report and by proprioceptive alteration.ResultsA Mann–Whitney U test performed revealed that FMS (median = 2.11) participants embodied the rubber hand to the same extent than HC participants (median = 2.0, Z = −0.86, p > 0.05, r = −0.15). The same test revealed no significant difference in the Proprioceptive Drift experience between FMS (median = 0.0) and HC participants (median = −0.5, Z = −0.96, p > 0.05, r = −0.16).ConclusionsOur study revealed that sense of body ownership is not impaired in patients affected by FMS. This, together with the results from our previous experiment (studying the interoceptive awareness), supports the hypothesis that interoceptive awareness and sense of body ownership may be dissociated in patients with FMS.     

The Effect of Holy Qur’an Recitation on Depressive Symptoms in Hemodialysis Patients: A Randomized Clinical Trial

Patients with advanced renal failure often face considerable sociopsychological stress as a result of lifestyle changes due to the disease and its treatment. The aim of the present study is to examine the effect of the Holy Qur’an recitation on depressive symptoms in hemodialysis patients. In this clinical trial, 54 hemodialysis patients were randomized to either an experimental (n = 27) or a control (n = 27) group. Patients completed the Beck Depression Inventory-II (BDI-II) at baseline and at 1 month after the intervention. Participants in the experimental group listened to recitation of the Holy Qur’an, while those in the control group received no intervention. The mean BDI-II score at baseline was 33.6 (±6.7) for the experimental group and 29.3 (±9.0) for the control group; at the end of treatment, BDI-II scores in the experimental and control groups were 14.5 (±4.8) and 31.6 (±9.2), respectively. Results from the repeated-measures general linear model controlling for baseline differences indicated a significant treatment effect (F = 9.30, p = 0.004, Cohen’s d = 0.85). Holy Qur’an recitation has a significant effect on lowering depressive symptoms in hemodialysis patients. Holy Qur’an recitation is an easy-to-implement and cost-effective strategy that may be used to supplement the treatment of depression in this setting in Iran.

     

Effects of Mindfulness-Based Therapy for Cancer Patients: A Systematic Review and Meta-analysis

This meta-analysis was a systematic review of evidence on the effects of mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) on quality of life (QOL), pain, fatigue, anxiety, and depression in cancer patients. Until July 2020, PubMed, Cochrane Library, and Embase were searched for randomized controlled trials (RCTs). The study included 18 RCTs. The MBSR/MBCT intervention resulted in a significant effect on QOL (SMD 0.80, CI 0.28, 1.32, I²?=?94%). In subgroup analysis, MBSR/MBCT interventions had a significant effect in the early cancer stage on anxiety (SMD ? 3.48, CI ? 4.07, ? 2.88), and QOL (SMD 4.30, CI 3.62, 4.99); in alleviating decreasing pain (SMD ? 0.42, CI ? 0.70, ? 0.14) within 4 weeks after the end of intervention, and alleviating fatigue in younger participants (SMD ? 0.64, CI ? 1.09, ? 0.19). MBSR/MBCT has short-term effects on cancer patients, especially in younger patients and early cancer stages.

     

Cognitive-Behavioral Therapy for Insomnia Co-Morbid with Hearing Impairment: A Randomized Controlled Trial

The purpose of the current study was to examine the effects of cognitive behavior therapy (CBT-I) for insomnia on patients with insomnia co-morbid with hearing impairment. A randomized controlled design was used with a 3-month follow-up. Thirty-two patients with insomnia co-morbid with hearing impairment were randomized to either CBT-I or a waitlist condition (WLC). The primary outcome was insomnia severity. Secondary outcomes were sleep diary parameters, dysfunction, anxiety, and depression. Compared to WLC, CBT-I resulted in lower insomnia severity at post-treatment and at follow-up (d = 1.18–1.56). Relative to WLC, CBT-I also led, at both assessment points, to reduced total wake time (d = 1.39) and increased sleep restoration (d = 1.03–1.07) and sleep quality (d = 0.91–1.16). Both groups increased their total sleep time, but no significant group difference emerged. Compared to WLC, CBT-I resulted in higher function (d = 0.81–0.96) and lower anxiety (d = 1.29–1.30) at both assessment points. Neither CBT-I nor WLC led to improvement on depression. Based on the Insomnia Severity Index, more CBT-I (53–77%) than WLC participants (0–7%) were treatment responders. Also, more CBT-I (24%) than WLC participants (0%) remitted. In patients with insomnia co-morbid with hearing impairment, CBT-I was effective in decreasing insomnia severity, subjective sleep parameters, dysfunction, and anxiety. These findings are in line with previous results on the effects of CBT-I in other medical conditions.