Neuroendocrine mechanisms involved in the physiological effects caused by skin-to-skin contact – With a particular focus on the oxytocinergic system

The positive clinical effects caused by skin-to-skin contact immediately after birth or after repeated skin-to-skin contact of premature infants (kangaroo care) or fullterm infants are well documented in the literature. However, information regarding the physiological mechanisms mediating these effects are surprisingly scarce and incomplete. In this article the oxytocinergic system and the cutaneous sensory pathways by which the oxytocinergic system is activated in response to skin-to-skin contact are presented in more detail. In addition, we discuss how the effects of skin-to-skin treatment can be attributed to different aspects of the effect spectrum of the oxytocinergic or calm and connection system.The structure of the oxytocinergic system, comprising the peripheral (circulating, hormonal) and the central (neurotransmitter) components, as well as, the pathways and mechanisms by which these functions are coordinated are described. Also the various effects induced by the oxytocinergic system (the calm and connection system) are reviewed.The sensory pathways, which include visual, auditory, olfactory and tactile stimuli, given and received by both mother and newborn and which activate the oxytocinergic system in response to skin-to-skin contact, are reviewed. A special emphasis is placed on the role of cutaneous sensory nerves and their activation by touch, light pressure and in particular warmth. The important role of the rise and the pulsatility of maternal temperature in mediating the positive effects of skin-to-skin contact in the newborn is highlighted. The concept of maternal giving of warmth and its possible link to the experience of trust and safety in the newborn is discussed from an evolutionary perspective.The effects induced by skin-to-skin contact can be attributed to the different functions of the oxytocinergic system. Ameliorated social interaction (e.g., more tactile and auditory interaction, more sensitive and synchronous interaction between mother and baby, the baby’s crawling behavior) are expressions of oxytocin’s ability to stimulate social interaction. The decreased levels of fear and stress are expressions of oxytocin’s ability to reduce the activity of the amygdala and of the stress system, e.g. the activity in the HPA-axis and the sympathetic nervous system. Increased HRV, increased activity in endocrine system of the gastrointestinal tract as well as stimulation of growth and maturation are examples of oxytocin’s ability to stimulate the activity of the parasympathetic nervous system and other peripheral and central mechanisms related to restoration and growth.The propensity of different types of treatment with skin-to-skin contact to induce long-term effects is also highlighted. We propose that the sustained effects caused by skin-to-skin contact are induced by an enduring shift in the balance between the oxytocinergic system (the calm and connection system) and the stress system (fight flight reaction) in favor of the oxytocinergic system. This shift leads to a sustained decrease in the HPA-axis and the sympathetic nervous system probably involving alpha 2-adrenoceptors.It is of clinical importance to be aware of the mechanisms by which skin-to-skin contact induces short and longterm positive effects in parents and newborns. If ward routines are adapted to ascertain a maximal stimulation of these mechanisms, the function of the oxytocinergic system will be optimized, which will be linked to a better clinical outcome for parents and newborns.     

Utilisation de l’engagement pour limiter la valorisation des fumeurs chez les adolescents

IntroductionSocial psychology research about commitment has demonstrated that it is possible to change one people's cognition and behavior.ObjectiveThe aim of the present article is to show that commitment can be used as a reduction strategy of smokers’ valorization and smoking normativity in order to reduce smoking.MethodStudents have been followed into a longitudinal study from end of elementary school to 8th grade class. They have been divided into different groups representing the smoking prevention's degree of commitment.ResultsRsults suggest that the sooner they are engaged in schooling, the better is the prevention. Commitment intervention made later in schooling has no influence on students smoking valorization.ConclusionResults will be discussed in terms of commitment theory by highlighting that an intervention using commitment is efficient only if the target is not already committed in an opposite behavior.     

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.