Support groups for parents with an adult child suffering from bipolar disorder

Confronted with the disconcerting behaviour exhibited by their children, parents of bipolar patients are in severe distress. Research focuses on the study of the ‘burden’ that the pathology puts on caregivers, owing to their experience of depression, sometimes combined with the presence of hostile attitudes and negative affects. In France, parents of adult patients encounter an initial specific difficulty: they are not systematically included in the care management system. Thanks to the initiative of an association of psychiatrists and psychoanalysts, the authors set up a psychoanalytic support group for the parents of ‘bipolar’ adults. The diagnosis of a bipolar disorder is established by a psychiatrist within a medical structure. Support groups for parents do exist in France, but their experiences have not led to scientific publications on this specific topic. Existing publications focus on other types of pathology and other therapeutic approaches. In this article, we will highlight how this type of psychoanalytic support group, with operating rules based on the theoretical work of Anzieu, can help parents of patients with bipolar disorders. Group participants accepted the principle of a research study that maintained their anonymity. We collected and analysed qualitative data from the first year of the group, so we highlight the specific difficulties of these parents, faced with chronic disease. The relevance of our qualitative study also resides in the data collected over a period of time, enabling us to see the progress made, and encouraging us to reflect on the place of psychoanalytic groups for parents, as well as on the care management of this pathology.     

Vulnerability of Individuals With Mental Disorders to Epistemic Injustice in Both Clinical and Social Domains

Many individuals who have mental disorders often report negative experiences of a distinctively epistemic sort, such as not being listened to, not being taken seriously, or not being considered credible because of their psychiatric conditions. In an attempt to articulate and interpret these reports we present Fricker’s concepts of epistemic injustice (Fricker, 2007, p. 1) and then focus on testimonial injustice and hermeneutic injustice as it applies to individuals with mental disorders. The clinical impact of these concepts on quality of care is discussed. Within the clinical domain, we contrast epistemic injustice with epistemic privilege and authority. We then argue that testimonial and hermeneutic injustices also affect individuals with mental disorders not only when communicating with their caregivers but also in the social context as they attempt to reintegrate into the general society and assume responsibilities as productive citizens. Following the trend of the movement of mental health care to the community, the testimonies of people with mental disorders should not be restricted to issues involving their own personal mental states.     

The effect of self‐identity alongside perceived importance within the theory of planned behaviour

Self‐identity often predicts behavioural intentions after standard theory of planned behaviour (TPB) components are accounted for. However, it has been claimed this is due to conceptual similarity between self‐identity and perceived importance of the behaviour. We examined this claim within the context of recycling food waste. Participants (N = 113) completed questionnaires assessing intentions, attitude, perceived behavioural control, perceived norms, perceived importance, self‐identity, and past behaviour. Confirmatory factor analysis indicated that self‐identity and perceived importance were distinct constructs. Further, after accounting for TPB components and perceived importance, self‐identity explained a significant amount of additional variance in intentions. The present findings therefore do not support this particular argument against the predictive utility of self‐identity.     

Safety Behavior After Extinction Triggers a Return of Threat Expectancy

Safety behavior is involved in the maintenance of anxiety disorders, presumably because it prevents the violation of negative expectancies. Recent research showed that safety behavior is resistant to fear extinction. This fear conditioning study investigated whether safety behavior after fear extinction triggers a return of fear in healthy participants. Participants learned that two stimuli (A and C) were followed by an aversive loud noise (“threat”), and one stimulus (B) was not. Participants then learned to use safety behavior that prevented the loud noise. Next, A and C were no longer followed by the loud noise, which typically led to extinction of threat expectancy. Safety behavior then became available again for C, but not for A and B. All participants used safety behavior on these C trials. In a final test phase, A, B, and C were presented once without the availability to use safety behavior. At each stimulus presentation, participants rated threat expectancy by indicating to what extent they expected that the loud noise would follow. Compared with the last extinction trial, threat expectancy increased for C in the test phase, whereas it did not increase for A and B. Hence, safety behavior after the extinction of classically conditioned fear caused a partial return of fear. The findings suggest that safety behavior may be involved in relapse after exposure-based therapy for anxiety disorders.     

Protecting Women from the Negative Effects of Body Dissatisfaction: The Role of Differentiation of Self

ABSTRACT

Body dissatisfaction is a prevalent and concerning issue among college age women. Due to its strong association with eating pathology, identification of moderating variables is a crucial line of inquiry. The present study investigated the ability for an intrapersonal differentiation-of-self variable (“I” position) to attenuate the impact of body dissatisfaction on anorexia and bulimia symptoms among college women participants. Study findings indicated that an “I” position moderated the body dissatisfaction-bulimia relationship and the body dissatisfaction-anorexia relationship. These findings signified the protective influence of a high “I” position for women with high levels of body dissatisfaction. Research and therapeutic implications are discussed.     

Patient preference as a predictor of outcomes in a pilot trial of person-centred counselling versus low-intensity cognitive behavioural therapy for persistent sub-threshold and mild depression

The aim of this analysis was to explore whether pre-treatment intervention preferences were related to outcomes for patients with persistent sub-threshold and mild depression who received one of two treatment types. Thirty-six patients took part in a two-arm, parallel group, pilot randomized controlled trial that compared short term (3 month and 6 month) outcomes of person-centred counselling (PCC) compared with low-intensity, CBT-based guided self-help (LICBT). Patient preferences for the two interventions were assessed at baseline assessment, and analysed as two independent linear variables (pro-PCC, pro-LICBT). Eight out of 30 interactions between baseline treatment preferences and treatment type were found to be significant at the p < .05 level. All were in the predicted direction, with patients who showed a stronger preference for a treatment achieving better outcomes in that treatment compared with the alternative. However, pro-LICBT was a stronger predictor of outcomes than pro-PCC. The findings provide preliminary support that treatment preferences should be taken into account when providing interventions for patients with persistent sub-threshold and mild depression. It is recommended that further research analyses preferences for different treatment types as independent variables, and examines preferences for format of treatment (e.g. guided self-help vs. face-to-face).     

Understanding the prevalence and correlates of implicit theories of weight in the United States: Insights from a nationally representative sample

Objectives: The primary aim of this research is to understand how mindsets about weight controllability in the United States relate to population health. We examined the distribution of people’s implicit theories of weight, from an incremental (controllable) to an entity (not controllable) mindset, in a nationally representative sample, as well as their relation to: sociodemographic factors, beliefs about behaviour and genetics as causes of obesity and engagement in weight management-relevant behaviours.

Methods: We report data from the National Cancer Institute’s Health Information National Trends Survey 4.

Results: A majority of respondents endorsed an incremental mindset of body weight, but endorsement of this mindset was stronger among younger, white respondents, and those with a higher income and more educational attainment. A stronger incremental mindset was related to stronger behaviour and weaker genetic causal beliefs about obesity, as well as a tendency to report increased engagement in weight management-relevant behaviours.

Conclusions: Our research provides evidence that although incremental mindsets are more common overall and associated with engagement in health behaviours that can contribute to or detract from population health, incremental mindsets are less common among individuals from more marginalised groups.     

Équivalence de la version en français pour le Canada et de la version originale états-unienne de l’Adult Self-Report

The aim of the present study was to evaluate the equivalence of the French-Canadian version of the Adult Self-Report (ASR; Achenbach & Rescorla, 2003) to its original English (USA) version. Both the original English version and the newly translated French-Canadian version were administered to 251 bilingual students from four Canadian provinces (Manitoba, New-Brunswick, Ontario, and Quebec), with a one to two weeks interval. Correlations varying from 0.72 to 0.87 indicated a high degree of correspondence between the scales of the two versions. Cohen's d calculated using Morris and DeShon's (2002) formula for within-subjects designs indicate that differences between mean scores varied from near-zero (d = 0.01) to small (d = 0.19), and suggest that they are not clinically significant. Ordinal alpha coefficients for the scales of the French-Canadian version varied from 0.66 to 0.96 but are inferior to those of the English version in seven of the eleven scales. Globally, results indicate that the equivalence of the French-Canadian version to the original English version of the ASR is sufficient to recommend its use.