Validation française du Caregiving Strain Questionnaire sur une population de parents d’enfants avec troubles du spectre de l’autisme

The Caregiving Strain Questionnaire (CGSQ-21) allows the assessment of the burden of family caregivers. The objective of this study is to present a validation of a French translation of this questionnaire (FCGSQ-21) to parents of children with autism spectrum disorder (ASD). A literature review from 2002 to 2012 highlighted that five scales measured caregivers’ burden regarding children and only one English scale examined parents of children with ASD's burden. The CGSQ-21 was chosen for this study and has been validated with 167 French parents who completed an online survey. Those parents filled out a total of six questionnaires measuring optimism, perceived social support, care satisfaction, anxiety, depression and perceived burden. The factorial and convergent validities as well as the internal consistency of the FCGSQ-21 have been tested with an exploratory and confirmatory factor analysis (CFA). A three factors model was found to best fit the structure of this scale, those include the objective burden as well as the internalized and externalized subjective burdens. The convergent validity brings to light significant correlations between many scales of the protocol. In the present study, the FCGSQ-21's homogeneity is excellent with a Cronbach's alpha of 0.90. The FCGSQ-21 is a valid and useful tool to measure the burden perceived by parents of children with ASD. This study's objective was to confirm the tool's validity in order to improve clinical practice with children and their parents. This scale evaluates parents’ levels of burden perceived for the purpose of adapting interventions given to the children while taking into account parental well-being's specificities highlighted by the FCGSQ-21.     

The acceptability of prophylactic mastectomy among lay people and health professionals: A pilot study

IntroductionWomen with certain genetic mutations have a risk of up to 85% of developing breast cancer. Bilateral prophylactic mastectomy is the most effective way to reduce risk of cancer.ObjectiveThis pilot study focuses on the acceptability of prophylactic breast surgery and examines, in a series of concrete cases, the cognitive processes by which health professionals and lay people make their judgments. This research also aims to identify the factors involved in these judgments. An additional objective is to determine whether there are groups with different patterns of responses.MethodWe recruited two samples in France, one comprising 90 lay people and the other 30 health professionals (n = 120) and asked them how acceptable it would be for a woman at a high risk of breast cancer to undergo a prophylactic surgery (mastectomy), in each of the 64 scenarios presented to them. The scenarios were all combinations of two levels of age, of marital status, of parenting status, of body appearance investment, of reconstructive surgery and also two levels of the person suggesting oncogenetic diagnosis.ResultsWe found that lay people and health professionals structured the factors in the scenarios in nearly the same way. They assigned importance to three factors: the most important one was reconstructive surgery, and then the age of the woman. The least important factor was the person who requested the genetic test. Furthermore, the age of the participants, and knowing a person who had cancer impacted the degree of acceptability assigned by participants. Being a lay person or a health professional did not have a direct impact on acceptability but influenced the integration of factors. In addition, cluster analysis showed that only a small group was opposed to mastectomy.ConclusionThis pilot study demonstrated that three factors have to be considered when judging the acceptability of prophylactic mastectomy and showed a common cognitive foundation for future discussion, at the levels of both clinical care and health policy, of the conditions under which prophylactic surgery might be acceptable.     

OBSERVATION AND COMPARISON OF MEALTIME BEHAVIORS IN A SAMPLE OF CHILDREN WITH AVOIDANT/RESTRICTIVE FOOD INTAKE DISORDERS AND A CONTROL SAMPLE OF CHILDREN WITH TYPICAL DEVELOPMENT

Despite widespread use of behavioral observations to evaluate child feeding behaviors in research and clinical practice, few studies have comprehensively characterized mealtimes or identified features that differentiate children with and without disordered feeding; these were the aims of the current study. Mealtime observations were conducted for 18 children with avoidant restrictive food intake disorder (ARFID) and 21 typically developing children. Observations were coded inductively, and associations between disorder and observed mealtime actions were examined. Most behaviors were observed across both clinical and nonclinical mealtimes, and many did not differ in frequency between children with and without ARFID. However, significant group differences were observed in the frequencies of behaviors relating to food intake, visual and physical engagement with feeding, and movement during mealtimes. The comparability of behaviors across clinical and nonclinical groups suggests that eating behaviors exist on a continuum from “normal” to “abnormal,” with group differences relating to frequency rather than type of behavior. The behavioral differences observed in this study suggest that identification of children with ARFID should focus on child engagement with food and restlessness during mealtimes. Reliance on emotional and escape‐maintained behaviors will lead to underrecognition of families in need of clinical support.     

CULTURAL MODELS OF INFANT EMOTIONS AND NEEDS AMONG THE GAMO PEOPLE OF SOUTHERN ETHIOPIA

How mothers perceive their infants’ emotions and their subsequent responses are influenced by cultural values and beliefs. Mothers who live in particularly harsh environments may have perceptions about their infants’ emotions that reflect not only cultural values but also constraints of the environment. In this qualitative study, 29 Gamo mothers living in rural Ethiopia were interviewed about perceptions of their infants’ emotions, how they felt about these emotions, and what they believed their infants needed in response. Through constant comparative analysis and thematic coding, several patterns emerged in mothers’ perceptions about their infants’ emotions and what constituted appropriate responses. Mothers said that their infants’ negative emotions were possibly related to illness and that appropriate responses were focused mostly on breastfeeding, complementary food, and needing to be held. Mothers also discussed their work demands and how they conflicted with their desire to respond to their infants; however, many mothers said that they relied on their older children to help. Mothers’ responses were centered on a parenting strategy aimed at promoting infant health and survival, which is consistent with research on parents living in rural environments who subsist by farming and have relatively high risk for infant mortality.     

Evaluation of a French parent-training program in young children with autism spectrum disorder

Parent training programs (PTs) in young children with autism spectrum disorders (ASDs) are known to reduce parenting stress and improve child's behavior and parent-child interactions. Few PTs are available to French speaking families. In order to provide them with this type of intervention, we developed a French parent-training program of 12 bimonthly sessions and three individual home visits based on applied behavior analysis. The purpose of this study is to evaluate the social validity and efficacy of this new PT on eighteen parents who have a child with ASD and developmental delay. For 16 parents, the PT was considered effective, the objectives targeted important and the strategies learned acceptable for use with children. They have significantly improved their knowledge in ASD and behavioral intervention strategies and their children's socialization skills, and reduce their parental stress. This new French PT program seems to be a promising intervention.     

Juger la recrutabilité des candidats : quels effets de l’apparence et des aptitudes en fonction des types de postes ?

Scientific research has shown the influence of norms and of gender and beauty stereotypes on evaluations and hiring decisions. Recent studies (Desrumaux, 2005; Jawahar & Mattson, 2005) have shown an evolution of the lack of Fit model (Heilman, 1983). The objective of this research is to test the effects of physical appearance, GMA and normative pieces of information (internality/externality) related to the candidate on the candidates’ recrutabilty. This study has also taken into account hierarchy level and sexual connotation of the job. We have tested its effects on medical jobs, of higher level (surgeon, doctor nutritionist) or subordinate (ambulance man and dental assistant). The results indicate that an attractive candidate is judged more recrutable for a subordinate job than a superior one. Moreover, for a subordinate job, the effect of the attractiveness was more important for male target than for feminine target. Results show also that men are judged less hirable than the women for female type jobs. Moreover, the effect of the aptitude is more discriminating for the external ones than for the internals. Results were discussed on the line of the lack of fit correspondence model.     

EARLY REGULATION IN CHILDREN WHO ARE LATER DIAGNOSED WITH AUTISM SPECTRUM DISORDER. A LONGITUDINAL STUDY WITHIN THE DANISH NATIONAL BIRTH COHORT

Studies have shown that children later diagnosed with autism spectrum disorders (ASD) in their first years of life might show symptoms in main developmental areas and that these signs might be sensed by the parents. The present study investigated in a large birth cohort if children later diagnosed with ASD had deviations at 6 and 18 months in areas such as the ability to self‐regulate emotions, feeding, and sleeping. The study was based on prospective information collected from 76,322 mothers who participated in the Danish National Birth Cohort. When the children reached an average age of 11 years, 973 children with ASD and a control group of 300 children with intellectual disability (IDnoASD) were identified via Danish health registries. Associations were found between short periods of breast‐feeding and the children later diagnosed with ASD and IDnoASD as well as associations at 18 months to deviations in regulation of emotions and activity. The similarities in these associations emphasize how difficult it is to distinguish between diagnoses early in life.     

The influence of motivational and emotional factors in mathematical learning in secondary education

IntroductionWhile motivation has, for decades, been investigated as a key component of academic learning and performance, academic emotions have often been left out of the scope of investigation. According to several researchers, mathematics learning seems to be particularly affected by students’ emotions.ObjectiveThis paper is aimed at characterizing the emotions and motivation of eighth grade students in a mathematical setting and highlighting the cluster of emotions–activity emotions vs outcome emotions–which best predict math value, math self-concept, behavioral engagement and math performance.MethodData were collected through questionnaires from 115 students and analyzed through means comparisons and linear regressions.ResultsResults indicated that eighth grade students give a relatively high value to mathematics have a positive mathematics self-concept and are moderately engaged in mathematical tasks. Regression analysis showed that mathematics value and behavioral engagement are better explained by activity emotions while mathematics self-concept and performance are better predicted by outcome emotions.ConclusionThe implications of these findings in terms of educational practices are discussed at the end of this study.     

Working with chronic and relentless self‐hatred,self‐harm,and existential shame: a clinical study and reflections (Paper 2 of 2)

This second of two papers focuses on the shame which emerged in the first 14 years of analysis of a woman who was bulimic, self‐harmed, and repeatedly described herself as ‘feeling like a piece of shit’. To explore this intense and pervasive shame I draw on Jung's and Laplanche's emphasis on experiences of unresolvable, non‐pathological ‘foreignness’ or ‘otherness’ at the heart of the psyche. Images, metaphors, elements of clinical experience, and working hypotheses from a number of analytic traditions are used to flesh out this exploration. These include Kilborne's use of Pirandello's image of shame as like a ‘hole in the paper sky’ which, I suggest, points to a crack in subjectivity, and reveals our belief in the efficacy of the self to be illusory. Hultberg's observations on shame as having an existential mode (function) are also explored, as is the nature of analytic truth. Using these ideas I describe my patient's process of finding some small but freeing space in relation to her shame and self‐hatred. Through enduring and learning from her shame in analysis she realized that it was part of a desperate unconscious attempt to draw close to her troubled father and so to ‘love him better’.