Analyse narrative du récit de la maladie : intérêts méthodologiques et réflexion sur la prise en charge thérapeutique des patients en oncologie

The narrative approach is an emerging disciplinary field, which considers the narrative to be a therapeutic, a methodological and an object of study in its own right. The objective of our contribution is twofold: (a) to present the context of emergence of the narrative approach and the notion of narrative in the field of psychology, and (b) to question the theoretical-methodological relevance of this approach in order to explore the expression of social knowledge with regard to the lived experience of cancer. After presenting some methods of collection and analysis of the narrative, we will suggest an application of this approach by analyzing narrative interviews of people with cancer. We will build on the results obtained to develop a reflection on the applied perspectives of the narrative approach, particularly with regard to the psychological therapy of cancer patients.     

Statistical learning of multiple speech streams: A challenge for monolingual infants

Language acquisition depends on the ability to detect and track the distributional properties of speech. Successful acquisition also necessitates detecting changes in those properties, which can occur when the learner encounters different speakers, topics, dialects, or languages. When encountering multiple speech streams with different underlying statistics but overlapping features, how do infants keep track of the properties of each speech stream separately? In four experiments, we tested whether 8‐month‐old monolingual infants (N = 144) can track the underlying statistics of two artificial speech streams that share a portion of their syllables. We first presented each stream individually. We then presented the two speech streams in sequence, without contextual cues signaling the different speech streams, and subsequently added pitch and accent cues to help learners track each stream separately. The results reveal that monolingual infants experience difficulty tracking the statistical regularities in two speech streams presented sequentially, even when provided with contextual cues intended to facilitate separation of the speech streams. We discuss the implications of our findings for understanding how infants learn and separate the input when confronted with multiple statistical structures.     

Conceiving of entities as objects and as stuff

What is the difference between conceiving of an entity as an object of some kind and conceiving of it as an amount of solid stuff? We propose that the difference lies in how one thinks about the entity's structure. Object construals require thinking of the structure as being nonarbitrary, whereas substance construals require thinking of the structure as being arbitrary. We report six experiments that provide empirical support for this proposal. Regularity of structure, repetition of structure, and the existence of structure-dependent functions, all of which provide reasons to consider the structure of an entity to be nonarbitrary, were shown to bias participants towards object construals. We also discuss how the proposed account of what it means to construe an entity as an object or as some stuff can account for a range of findings in the literature on lexical development. These include the relation between cohesiveness and ontological category, shape and ontological category, and complexity of shape and ontological category. Finally, we discuss the nature of construals and the relation of object and substance construals to the physical, design, and intentional stances.     

Infants' formation and use of categories to segregate objects

Four- and-a-half-month-old infants' (N = 100) category formation and use was studied in a series of five experiments. For each experiment, the test events featured a display composed of a cylinder and a box. Previous research showed that this display is not clearly parsed as a single unit or as two separate units by infants of this age. Immediately prior to testing, infants were shown a set of category exemplars. Knowledge about this category could help infants disambiguate the test display, which contained a novel exemplar of this category. Clear interpretation of the test display as composed of two separate units (as indicated by infants' longer looking at the move-together than at the move-apart test event) was taken as evidence of category formation and use. In Experiments 1 and 5, infants' prior experience with a set of three different boxes that were similar to the test box facilitated their segregation of the test display. Experiment 2 showed that three different exemplars are necessary: prior experience with any two of the three boxes used in Experiment 1 did not facilitate infants' segregation of the test display. Experiment 3 showed that variability in the exemplar set is necessary: prior experience with three identical boxes did not facilitate infants' segregation of the test display. Experiment 4 showed that under these conditions of very brief prior exposure, similarity between the exemplar set and test box is necessary: prior experience with three different boxes that were not very similar to the test box did not facilitate infants' segregation of the test display. Together, these findings suggest that: (a) number of exemplars, variability, and similarity in the exemplar set are important for infants' category formation, and (b) infants use their category knowledge to determine the boundaries of the objects in a display.     

Young infants' expectations about hidden objects

Infants aged 3-5 months (mean of approximately 4 months) were given a novel anticipatory looking task to test object permanence understanding. They were trained to expect an experimenter to retrieve an object from behind a transparent screen upon hearing a cue ("Doors up, here comes the hand"). The experimenter then hid the object behind one of two opaque screens and after either 2 or 8s gave the "doors up" cue. Infants looked to the correct location after the two-second delay, but not after the eight-second delay. This indicates a brief memory that the object is present behind the occluder. The study provides converging evidence that infants grasp object permanence by a young age. The novel anticipatory looking paradigm helps rule out counter-explanations applied to violation-of-expectation tasks.     

A secret agent? How infants learn about the identity of objects in a causal scene

Four experiments examined the role of correlations between dynamic and static parts on 12- to 16-month-olds' ability to learn the identity of agents and recipients in a simple causal event. Infants were habituated to events in which objects with a dynamic or static part acted as an agent or a recipient and then were tested with an event in which the part-causal role relations were switched. Experiment 1 revealed that 16-month-olds, but not 12-month-olds, associate a dynamic part with the role of agent and a static part with the role of recipient. Experiment 2 showed that 12- and 16-month-olds do not associate a static part with the role of agent or a dynamic part with the role of recipient. Experiment 3 demonstrated that 14-month-olds will learn the relations presented in Experiment 1 and Experiment 2. Experiment 4 revealed that 12-month-olds were able to discriminate the two geometric figures in the events. The results are discussed with respect to infants' developing ability to attend to correlations between dynamic and static cues and the mechanism underlying early object concept acquisition.     

Predictive Genetic Testing for Hereditary Breast and Ovarian Cancer: Psychological Distress and Illness Representations 1 Year Following Disclosure

This prospective study evaluates emotional functioning and illness representations in 68 unaffected women (34 carriers/34 noncarriers) 1 year after predictive testing for BRCA1/2 mutations when offered within a multidisciplinary approach. Carriers had higher subjective risk perception of breast cancer than noncarriers. Carriers who did not have prophylactic oophorectomy had the highest risk perception of ovarian cancer. No differences were found between carriers and noncarriers regarding perceived seriousness and perceived control of breast and ovarian cancer. Mean levels of distress were within normal ranges. Only few women showed an overall pattern of clinically elevated distress. Cancer-specific distress and state-anxiety significantly decreased in noncarriers from pre- to posttest while general distress remained about the same. There were no significant changes in distress in the group of carriers except for ovarian cancer distress which significantly decreased from pre- to posttest. Our study did not reveal adverse effects of predictive testing when offered in the context of a multidisciplinary approach.     

Category specificity in normal episodic learning: applications to object recognition and category-specific agnosia

Studies of patients with category-specific agnosia (CSA) have given rise to multiple theories of object recognition, most of which assume the existence of a stable, abstract semantic memory system. We applied an episodic view of memory to questions raised by CSA in a series of studies examining normal observers' recall of newly learned attributes of familiar objects. Subjects first learned to associate arbitrarily assigned colors or textures to objects in a training phase, and then attempted to report the newly learned attribute of each object in a recall task. Our subjects' pattern of recall errors was similar both quantitatively and qualitatively to the identification deficits among patients with CSA for biological objects. Furthermore, errors tended to reflect conceptually and structurally based confusions. We suggest that object identification involves recruitment and integration of information across distributed episodic memories and that this process is susceptible to interference from objects that are structurally similar and conceptually related.     

Representation of two geometric features of the environment in the domestic chick (<Emphasis Type="Italic">Gallus gallus</Emphasis>)

We report experiments based on a novel test in domestic chicks (Gallus gallus), designed to examine the encoding of two different geometric features of an enclosed environment: relative lengths of the walls and amplitude of the corners. Chicks were trained to search for a food reward located in one corner of a parallelogram-shaped enclosure. Between trials, chicks were passively disoriented and the enclosure was rotated, making reorientation possible only on the basis of the internal spatial structure of the enclosure. In order to reorient, chicks could rely on two sources of information: the relative lengths of the walls of the enclosure (associated to their left-right sense order) and the angles subtended by walls at corners. Chicks learned the task choosing equally often the reinforced corner and its rotational equivalent. Results of tests carried out in novel enclosures, the shapes of which were chosen ad hoc (1) to induce reorientation based only on the ratio of walls lengths plus sense (rectangular enclosure), or (2) to induce reorientation based only on corner angles (rhombus-shaped enclosure), suggested that chicks encoded both features of the environment. In a third test, in which chicks faced a conflict between these geometric features (mirror parallelogram-shaped enclosure), reorientation seemed to depend on the salience of corner angles. These results shed light on the elements of the environmental geometry which control spatial reorientation, and broaden the knowledge on the geometric representation of space in animals.