Comme réponse à la précarité du lien mère–bébé, les « Petits Pas » : un réseau en périnatalité…

The “Baby Steps” network includes a multi-disciplinary team and aims to accompany parents-to-be and young parents as they meet their newborns. The exchange and development relationships that professionals develop among themselves help to support the notion of parenthood and circumscribe any potential risk. The professionals in the network hail from a variety of backgrounds but they are all involved in perinatal care and by grouping their skills can adapt and optimise the assistance and care they offer to parents. The “Parent Island” reception area and the mother-baby therapy group with a separate father oriented structure are the truly original aspects of the network. Prevention is vital, as is providing therapeutic care for disturbances related to early parent-child relationships. With a strong “group psychology focus” the network creates a sufficiently solid structure to receive any unconscious negative projections from momentarily or deeply distressed parents.     

« Mon enfant est-il surdoué ? » Que demande-t-on ?

Is it possible to identify the specific characteristics as well as the scope of the phenomenon of demands concerning giftedness? The author presents and comments a set of data reflecting the activity of a Parisian consultation center over two separate years: 2004 (12% of the demands concern giftedness) and 2006 (11% of the demands concern giftedness). The psychometrical investigations are based on the Wechsler Scales (WISC-III; WISC-IV). The percentage of demands related to giftedness is quite high as compared to other motives. It mainly concerns children who do not show what are called “very superior” intellectual abilities. The development of certain social stereotypes could be an explanation.     

Usage légal du titre de « psychothérapeute » : stratégies des acteurs concernés

The law proposal of the deputy Bernard Accoyer adopted by the National Assembly the 13th of March 1999, after many debates, finally led to a law article on use of psychotherapist title. Several consultation meetings with professional organizations in the Health Ministry took place about its future application decree, nevertheless without a consensus because of the contradictory interests for people practising psychotherapy. Are concerned two regulated professions — psychologists and physicians — and two types of non-regulated activities, psychoanalysts and “psychotherapists” which are not physicians and not psychologists. These last ones defend in France, as it's the fact in some other european countries, the creation of the independant profession of “psychotherapist”; a minority part of psychoanalysts societies support them, leant upon the principle of practice liberty. The opinion differences are focused on the training criteria in psychopathology required by the law, some organizations disputing that this training be a university monopoly. Another ambiguity deals with the law gives a miss about the actual psychotherapy training, the Senate having chosen for the minimum requirement of a psychopathology training. The subject of this paper is to come back on the strategies and the identity stakes of actors mobilized during the different drafts of this law proposal and to prepare the ground about the ideological positions underlying by these strategies.     

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.     

Les capacités d'inhibition : une fonction « frontale » ?

It has been strongly suggested that one important function related to frontal lobes is inhibition. However, a review of the literature on classical tests of inhibition (Stroop test, WCST, and AB-AC learning) suggests that this hypothesis is not well established. We further examined this hypothesis using short-term and long-term directed forgetting tasks (Reed, 1970, Zacks et al., 1996), the Stroop test and the Hayling test (Burgess and Shallice, 1996) in 13 patients with focal frontal lesions. The results revealed short-term and long-term memory deficits and a slowing down, but no inhibition deficit compared with control subjects. These results question the relevance of the hypothesis of the frontal lobe as the unique substrate of inhibitory mechanisms. More generally, they address the issue of executive functions: are these sustained by the frontal cortex or by a cortical and subcortical diffuse neural network?     

« Te dire comment je me suis sentie insultée ! » – Instruments, émotions et transformation de l’activité

This article examines the place of emotions in mediated activity. The literature has shown that management tools produce emotions for users. However, this literature mainly analyses users in isolation and without taking into account their work context. Building on the work of Rabardel and 15 interviews with managers, this article shows how the emotions produced by the use of management tools transform the relationship to the activity, the relationship to oneself and the relationship to others and contribute to the transformation of the mediated activity. These results allow to underline the place of emotions in the mediated activity but also to discuss the relevance of the usual distinction between positive and negative emotions.     

La fin de l'adolescence pour un état adulte : mythe ou réalité ?

Research in philosophy, sociology, psychiatry, psychology and psychoanalysis converge on the one hand to describe modernism as an approach to ignoring subjectivity, as a consequence of the power of the economy, and on the other hand the identification of the word as an instrument of the advent of subjective autonomy, the only real “maturity” which exists. By its words, the individual becomes autonomous from this economic matter as it does from its fantasies. There are many, of all ages, who never reach this position. Consequently, does the postulate of adolescence being limited to an age bracket have any sense? And doesn't all that has been said referring to this concept apply in fact to all social suffering?     

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”.     

Compétences communicatives dans la relation avec l'adulte et aptitude à interagir avec leurs pairs chez des enfants âgés de 20 à 30 mois

These research deals with the existence of a link between level of communication with adults and interactions between peers according to the observation of a group of twelve children. The level of communication with adults is evaluated with the Early Social Communication Evaluation Scale. The children are observed during an object exploration activity which is analysed from the point of view of the interactions between peers. The results show that more thehigher the level obtained by the children got a high level on the ECSP is, the more they set interactions. There is a link between the level obtained on the ECSP and the functions of communication set when peers interact (social interaction and behaviour regulation). The link exists also with the centration of interactions (on action or on object). These differences depend of one's capacity in conceiving someone else's intention.     

La rétention de sûreté : punir,prévenir et guérir des troubles de la personnalité ?

The law of February 25, 2008 introduced security detention. This is a post-sentence measure intended for offenders who have served their sentence. This may apply to people with personality disorders. Because of these disorders, they are considered too dangerous to be left in society but the importance of the disorders was not sufficient to benefit from the mechanism of criminal irresponsibility. Is the real objective of preventive detention, as indicated in the law, to treat disorders or, more pernicious, to eliminate ex-convicts from society?     

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.     

Le déclenchement « sans indication médicale » : regard étonné du juriste

Delivery trigger may question obstetrician liability.     

Optimisme et pessimisme comparatifs consécutifs à l'exposition à plusieurs messages menaçants

The aim was to investigate whether comparative optimism or CO (i.e. general tendency to believe that negative events are less likely to others than for self) is a compatible clue or not with adoption of preventive behaviours. Sixty-three smokers have read one and five prevention messages followed by recommendations. Presence or non-appearance of pictures (vividness) and positive or negative framing were manipulated. Five illustrated (high vividness) messages and positively framed messages showed CP (health risks were more likely for self than for others), whereas the same messages without pictures (low vividness) generated CO. Presenting five messages strengthened the relationship between CO (or CP), and behavioural intention. Presenting a single message triggered negative affects whereas five messages elicited coping response highly correlated to CO (or CP). It is valuable to present positively framed messages five times to enhance their efficacy. The role of CO within tobacco prevention is discussed.     

La qualité de vie d'enfants asthmatiques participant à un programme d'éducation à la maladie

Our purpose is here to study the quality of life of asthmatic children involved in a program of education. Regarding this, we used the “OK. ado” of Manificat and Dazord, the Trait-Anxiety inventory for children of Spielberger, the questionnaires of educative diagnostic “Ce que tu sais” and “À toi de jouer” and our observations during the different sessions of the program of education. The analysis of the results we obtained for the questionnaires of educative diagnostic, and for the Trait-Anxiety inventory, combined with our observations confirmed the elements of the literature: asthma badly affects quality of life among children. It also shows the importance not to neglect the experience of asthmatic children in their treatment. Nevertheless, results obtained for the quality of life questionnaire (“OK. ado”) doesn't reveal the same dissatisfaction of children regarding their quality of life. This contradiction leads us to wonder about the influence of a group into the educational program and about the opposition between assessment of the quality of life and experience of the disease.     

Le malade génétique responsable « La loi des suspects »

A patient suffers of a genetical disease. He does not wish to inform his family. Is he responsible for a lost of chances of his parents, chances to prevent the disease, or to receive care? Is there a second class of patients?     

« Conciliation vie privée vie professionnelle » : plusieurs termes pour une même réalité ? Proposition de modélisation à travers l’usage français

The aim of this paper is to define the vocabulary used about interactions between people's work and their private lives. Several terms exist and are used as synonyms despite of their slightly different meanings are different: balance, conflict, interaction, enrichment; personal life, family life… Based on an analysis of 45 French articles in psychology, management and human resources, we notice that the terms used are rarely defined. In a thematic analysis of these articles, we suggest a model which defines all words usually used.     

La loi no 2016-87 du 2 février 2016 créant de nouveaux droits en faveur des malades et des personnes en fin de vie : un nouvel équilibre décisionnel ?

Adopted after a tumultuous legislative process, the Act of 2 February 2016 complete the “Leonetti” law of April 22, 2005. Without going to legalize active help to die, this law does include some notable developments. It increases patient autonomy, including the consecration of mandatory advance directives and extends the right to refuse care. It specifies the role of the support person in the decision process and extends the scope of the collegiate procedure. Finally, it recognizes a right to care for the suffering and diversified palliative care modalities, particularly through the introduction of continuous deep sedation until death. Some aspects of the law relating to the mandatory advance directives or the process of sedation are however asked to be specified by regulation.     

Éléments contextuels associés à l'émission de comportements d'agitation verbale présentés par des personnes âgées institutionnalisées atteintes de démence

This research examines the contexts in which verbal agitation (VA) behaviours occur. The study was conducted with 15 participants suffering from dementia who live in an institution and display agitated behaviours. Participants were subject to observation assisted by a hand-held computer. The frequency and duration of agitation episodes were calculated. The time of day, the location, and the activity engaged in, the presence of other persons and use of physical restraint were noted. A total of 180 observation hours were conducted, with each participant being observed for 12 hours, from 8 a.m. to 8 p.m. The results show that the participants are verbally agitated 10% of the time. VA is manifested when participants are in their rooms (94%), not engaged in a specific activity (81%), alone (80%) and physically restrained (78%). VA occurs mainly after 2 p.m. (73%). Certain contextual characteristics rather than others are associated with greater VA concentrations.