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.     

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.     

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.     

A psychoanalytically informed hospitalization‐based treatment of personality disorders

This study presents a model of psychic change in personality disorders focusing on three dimensions: felt safety, mentalization and self‐object relations. Based upon this model a hospitalization‐based therapy program was created. Four scales to measure these three dimensions on the Object Relation Interview are discussed: the Felt Safety Scale, the Reflective Functioning Scale and the Bion Grid Scale and the Differentiation‐Relatedness Scale. A naturalistic symptom outcome study of the program showed a large effect on both symptoms and personality functioning. Furthermore, trajectory based on pre‐treatment patient characteristics (i.e., anaclitic versus introjective personality styles). Importantly, we also found a relation between symptomatic and personality change and change in felt safety and object relations. At 5‐year follow‐up, patients showed sustained improvement in symptomatic distress and further improvement in terms of personality and interpersonal functioning.     

Can we fight stigma with science? The effect of aetiological framing on attitudes towards anorexia nervosa and the impact on volitional stigma

The present study experimentally investigated the way in which exposure to various aetiological explanations of anorexia nervosa (AN) differentially affected stigmatisation and behavioural intention outcomes. University students (N = 161) were randomly assigned to read one of four aetiological vignettes presenting the causes of AN as biological/genetic, socio‐cultural, environmental, or multifactorial. Results indicate that those who received a socio‐cultural explanation made stronger socio‐cultural causal attributions, fewer biological/genetic causal attributions, and were significantly less willing to sign a health insurance petition for AN. Unexpectedly, the multifactorial group considered individuals with AN as more responsible and blameworthy for their condition. Overall, findings were comparative with previous research and partially support the propositions of attribution theory. Results also suggest that by conceptualising the aetiology of AN as biological or genetic, or at least increasing one's knowledge of these contributing factors, it may be possible to decrease the level of blame‐based stigma associated with AN.