Some thoughts about thought disturbance in adolescence

One of the principal aims of adolescence is the development of the capacity to think for oneself. The authors explore the difficulties caused by disturbances of thinking in borderline adolescents, pointing out the role that the analyst can take in promoting better functioning of their patients' mental processes. Two cases are explored, one through a supervision and the other through direct clinical experience. Both illustrate the efforts of the analyst to carry out 'management in the area of thinking' with those borderline patients who have not received help from their parents to think, and still need to be shown how mentation takes place. The authors propose some changes in technique in order to implement this improvement, including sharing with the patient the way in which the analyst thinks about him. Thinking itself can be an important integrating factor for these patients.

Une des tâches principales de l'adolescence est de développer la capacité à penser par soi-même. Les auteurs explorent les difficultés occasionnées par des troubles de la pensée chez des adolescents borderline et soulignent le rôle que peut jouer l'analyste pour favoriser un meilleur fonctionnement des processus psychiques chez ces patients. Deux cas sont étudiés dans cet article ; dans l'un, le matériel est extrait de séances de supervision, dans l'autre, il est tiré directement de la situation thérapeutique. Ces cas mettent en évidence les efforts de l'analyste pour aider le patient à mieux fonder ses processus de pensée ; dans les états limites, le patient bien souvent n'a jamais pu bénéficier de l'aide de ses parents dans ce domaine et devra encore apprendre comment mettre en ?uvre l'idéation. Les auteurs proposent quelques modifications techniques afin de faciliter l'activité mentale chez ce type de patient, visant notamment à lui faire part de la manière dont son analyste pense à lui. La pensée en elle-même peut être un facteur important qui favorise l'intégration psychique chez ces patients.

Uno degli scopi principali dell'adolescenza e' lo sviluppo della capacita' di pensare per se stessi. Le autrici esplorano le difficolta' causate dai disturbi del pensiero in adolescenti borderline, sottolineando il ruolo che l'analista puo' avere nel promuovere un miglior funzionamento dei processi mentali dei loro pazienti. Vengono riportati due casi, uno attraverso l'esperienza di supervisione e l'altro attraverso l'esperienza diretta del lavoro clinico. In entrambi i casi viene illustrato lo sforzo dell'analista di portare avanti il 'management nell'area del pensare' con quei pazienti bordeline che non sono stati aiutati dai loro genitori a pensare, e che ancora hanno bisogno di capire come prende luogo il processo del pensare. Le autrici propongono dei cambiamenti nella tecnica per poter implementare tale miglioramento, compreso il condividere con il paziente il modo in cui l'analista pensa a lui. Il pensare puo' essere di per se' un importante fattore di integrazione per questi pazienti.

Eines der Hauptziele der Adoleszenz ist die Entwicklung der Fähigkeit, für sich selber zu denken. Die Autorinnen betrachten die Schwierigkeiten, die durch Denkstörungen bei Borderline- Jugendlichen verursacht werden, und stellen die Rolle heraus, die Analytiker einnehmen können, um ein besseres Funktionieren der mentalen Prozesse ihrer Patienten zu fördern. Es werden zwei Fälle betrachtet, einer durch Supervision und der andere durch direkte klinische Erfahrung. Beide illustrieren die Bemühungen der Analytikerin, 'Management im Bereich des Denkens' auszuführen mit diesen Borderline-Patienten, die von ihren Eltern keine Unterstützung zu denken erlangt hatten, und denen noch gezeigt werden muss, wie Denkprozesse stattfinden. Die Autorinnen schlagen einige Veränderungen in der Technik vor, um diese Verbesserung zu implementieren, einschliesslich dem, dass man dem Patienten mitteilt, wie die Analytikerin über ihn denkt. Denken selbst kann ein wichtiger integrierender Faktor für diese Patienten sein.     

The influence of social instructions on the effectiveness of a cognitive interview used with very young child witnesses

IntroductionThe modified cognitive interview (MCI) is an investigative interview method used to help child eyewitnesses to enhance the quality of their testimonies (Memon et al., 2010). Composed of cognitive (mnemonics) and social instructions, it indeed supports young witnesses to retrieve and to accurately report all their memories. If the benefits of the mnemonics on the MCI efficiency have been now established (e.g., Holliday & Albon, 2004; Verkampt & Ginet, 2010), the contribution of its social components has however not been deeply explored to date. This is notably the case of two main social instructions presented at the right beginning of an interview: the “Child can say ‘I don’t know”’ and the “Interviewer knows nothing about the facts” instructions.ObjectiveThis study aimed at evaluating the influence of these two social instructions on the effectiveness of MCI mnemonics, designed to be used by police officers to gather very young children's testimonies.MethodTo this end, 59 children aged 4 to 5.9 participated in a painting session and were interviewed two days later with a full modified cognitive interview (MCI), a MCI minus the “Child can say I don’t know” instruction, a MCI minus the “Interviewer knows nothing about the event” instruction, or a structured (control) interview that was solely composed of social instructions.ResultsThe results indicated an increase of 42% more correct information recollected with a full MCI relative to a structured interview during the free recall phase. However, the withdrawal of the “Interviewer knows nothing about the event” instruction from the MCI led the children to report 21% less information. This drop reached 3% with the MCI minus the “Child can say I don’t know” instruction.ConclusionChildren testimonies are therefore more informative when the mnemonics of the MCI are presented to the children along with social instructions.     

Methods and aims of investigative interviewing of adult witnesses: An analysis of professional practices

Eyewitnesses provide crucial evidence for the investigation of criminal cases. We analysed professional police interviewers’ behaviour by conducting a literature review. Our results indicate that the interviewing techniques used by untrained and trained investigators are predominantly inappropriate and harmful to memory recall. The way investigators curtail and select witnesses’ responses suggests that they look for specific information. As a subsequent step, we analysed investigative interviewing in terms of professional objectives, identifying the types of information that the police inquire about during the interview. Based on our results, we conclude future research should perform a fine-grained analysis of professional interviewing procedures with the aim of producing effective interviewing techniques that meet investigators’ real-world objectives.     

Attachment representations in school-age children: the development of the child attachment interview (CAI)

This paper introduces a new measure of attachment in middle childhood (8?-?13 years), an interview extensively adapted from the AAI and with a new coding system. We report data from a series of studies with clinical and normal populations, in which the psychometric properties of reliability, stability and validity are tested and found to be satisfactory. Although work remains to be done, we see the Child Attachment Interview as a promising new attachment measure. Ce texte présente un nouvel instrument d'évaluation de l'"attachement" chez les enfants entre 8 et 13 ans. Adaptation considérablement remaniée de l'Entretien d'Attachement chez l'Adulte, cet "Entretien" est doté d'un système de codage entièrement nouveau. Les auteurs rapportent les données de plusieurs études portant sur des échantillons cliniques et normaux, dans lesquelles les propriétés psychométriques de fiabilité, de stabilité et de validité ont été testées et trouvées satisfaisantes. S'il est encore à amèliorer, l'Entretien d'Attachement chez l'Enfant s'avère déjà être un nouvel instrument d'évaluation à perspectives fort intéressantes. Questo articolo presenta un nuovo strumento di misurazione dell'attaccamento per il periodo dell'infanzia dagli 8 ai 13 anni, un metodo di intervista in gran parte preso dal AAI con un nuovo sistema di decodifica. Vengono riportati i dati derivati da una serie di studi su una popolazione normale ed una clinica, nei quali le variabili psicometriche di affidabilita', stabilita' e validita' sono state testate e ritenute soddisfacenti. Sebbene resti del lavoro da fare, gli autori ritengono che lo strumento del Child Attachment Interview sia promettente per misurare l'attaccamento. Dieser Artikel gibt eine Einfährung zu einer neuen Messung von Bindung in der mittleren Kindheit (8?-?13 Jahren), ein Interview, das ausgiebig vom AAI (Erwachsenen Bindungsinterview) angepasst und mit einem neuen Kodierungssystem versehen wurde. Wir berichten von einer Reihe von Studien mit klinischen und normalen Populationen, in denen die psychometrischen Eigenheiten von Verlässlichkeit, Stabilität und Validität getestet wurden und sich als befriedigend erwiesen. Auch wenn noch viel Arbeit geleistet werden muss, sehen wir doch das Kindbindungsinterview als eine vielversprechende neue Messung von Bindung.     

Attachment representations and adoption: associations between maternal states of mind and emotion narratives in previously maltreated children

This paper reports on associations observed between Adult Attachment Interviews (AAIs) obtained from adoptive mothers, and emotional themes appearing in doll play narratives obtained from their recently adopted children. The children, aged 4?-?8 years, carried into their adoptive placements a history of consistently serious maltreatment, including neglect and abuse. Results reveal strong and significant influences of maternal state of mind regarding attachment upon their adopted children's story-completions. Mothers whose AAIs were judged insecure (either dismissing or preoccupied) were likely to have adopted children who, three months after placement, provided story-completions with higher levels of aggressiveness as compared to the stories provided by children adopted by mothers with secure-autonomous AAIs. Children whose adoptive mothers provided AAIs indicative of unresolved (as opposed to resolved) mourning regarding past loss or trauma provided story completions with higher scores for emotional themes such as 'parent appearing child-like' and 'throwing out or throwing away'. Results also include a qualitative section that provides narrative excerpts of maternal AAIs and children's story-completions. Discussion concerns the contribution these findings make to the literature on intergenerational transmission of attachment patterns, and the implications these findings have for child clinical work and social policy. Cet article rend compte des rapports observés entre, d'une part, les Entretiens d'Attachement chez l'Adulte auxquels participaient des mères adoptives et, d'autre part, la thématique émotionnelle évoquée lors des récits de jeux de poupée fournis par leurs enfants, adoptés depuis peu. Ces enfants, âgés de 4 à 7 ans, reportent dans leur placement adoptif leur histoire antérieure de maltraitance; constante et sévère, celle-ci englobe carences graves et abus. Les résultats montrent l'influence considérable et significative, sur la manière dont les enfants adoptés terminent leurs récits, des états psychiques maternels par rapport à l'attachement. En ce qui concerne les méres dont le type d'attachement, évalué lors de l'Entretien, est jugé précaire (peu attentionné ou préoccupé), on constate, après trois mois de placement, que l'enfant adopté tend à fournir des fins de récit dont le niveau d'agressivité est plus élevé que celui donné par des enfants adoptés par des mères chez qui le type d'attachement est jugé sûr et autonome. Si l'évaluation de l'attachement chez la mère renvoie à l'existence de deuils non élaborés et de traumatismes, la thématique émotionnelle présentée par son enfant dans ces récits est de type "parent infantile" ou "jeter/rejeter". Les données rapportées comportent une dimension qualitative qui met en parallèle des extraits des Entretiens d'Attachement maternels et les fins de récit proposées par leurs enfants respectifs. Les auteurs discutent ensuite de la contribution que ces résultats pourraient apporter aux travaux concernant la transmission intergénérationnelle des modèles d'attachement. Les implications de cette étude pour le travail clinique auprès des enfants et pour la politique sociale au sens large sont également débattues. Questo articolo presenta le associazioni osservate tra l'Adult Attachment Interviews (AAIs) sottoposto a madri adottive e tematiche emotive emerse nelle narrative di gioco con le bambole espresse dai loro bambini recentemente adottati. I bambini di eta' dai 4 ai 7 anni portano nelle loro famiglie adottive storie di severo maltrattamento, che includono l'abuso e negligenza. I risultati rivelano che lo stato mentale materno in relazione all'attaccamento ha un' influenza forte e significativa sul completamento delle storie dei bambini adottati. Madri che all'AAI risultavano insicure (sia superficiali che troppo preoccupate) avevano alta probabilita' di aver adottato bambini che, tre mesi dopo l'arrivo, fornivano storie con un maggior livello di aggressivita' paragonato alle storie fornite da bambini adottati da madri con attaccamento all'AAI classificato come sicuro-autonomo. Bambini le cui madri adottive risultano all'AAI avere dei lutti non elaborati (invece che elaborati) riguardanti perdite del passato o traumi producono storie che danno un punteggio piu' alto nelle tematiche emotive come per esempio 'il genitore e' infantile' e 'che respinge o rifiuta'. I risultati comprendono anche una sezione qualitativa che riporta parti delle narrative delle madri al AAI e delle storie raccontate dai bambini. La discussione si sofferma sul contributo che questi risultati portano alla letteratura sulla trasmissione intergenerazionale di modelli di attaccamento e sulle implicazioni che tali risultati hanno per il lavoro clinico con bambini e per le politiche sociali. Dieser Artikel berichtet von Verbindugen zwischen Erwachsenen-Bindungsinterviews (AAIs), die von Adoptivmüttern erhalten wurden und emotionalen Themen, die inm Puppenspielnarrativen bei Kindern, die vor kurzem adoptiert worden waren, auftraten. Die Kinder zwischen 4 und 7 Jahren brachten in ihre Adoptionsplätze eine Geschichte von durchgehend ernster Misshandlung, einschliesslich Vernachlässigung und Missbrauch, mit. Die Ergebnisse zeigten starke und signifikante Einflüsse des mütterlichen Gemütszustands bezüglich Bindung auf die Fertigstellung der Geschichten der Adoptivkinder. Mütter, deren AAI als unsicher ( entweder abwehrend oder besorgt) eingeschätzt wurden, hatten eher Adoptivkinder, die drei Monate nach ihrer Plazierung Geschichten mit einem höherem Grad an Aggressivität herstellten, verglichen mit Geschichten, die von Kindern produziert wurden, die von Müttern mit sicherer-autonomer Bindung adoptiert worden waren. Kinder, deren Adoptivmütter AAIs zeigten, die indikativ für unverarbeitetes (im Gegensatz zu verarbeitetem) Trauern bezüglich vergangener Verluste oder Trauma waren, produzierten Geschichten mit höherem Zahlen von emotionalen Themen wie etwa 'Elternteil, das wie ein Kind erscheint' und 'hinauswerfen und wegwerfen'. Die Ergebnisse schliessen auch einen qualitative Abschnitt ein, in dem Exzerpte der Narrative der mütterlichen Interviews und der Geschichten der Kinder dargestellt werden. Die Diskussion dreht sich um den Beitrag, den diese Ergebnisse zur Literatur der Intergenerationsweitergabe von Bindungsmustern leistet und den Implikationen, die diese Ergebnisse für die klinische Arbeit mit Kindern und für die Sozialpolitik haben.     

Impact of the telephone motivational interviewing on the colorectal cancer screening participation. A randomized controlled study

IntroductionWhile high participation rates ensure the cost-effectiveness of colorectal cancer screening programs, it is well known that postal requests do not achieve acceptable levels of participation.ObjectiveThis randomized controlled study aimed to test the impact of individualized phone counseling to prompt people aged 50 to 74 to take a colorectal cancer test.MethodTwo phone strategies were compared. The first involved computer-aided individualized counseling while the second was based on motivational interviewing. A total of 49,972 people were randomly assigned to a control group (CG) and to the individualized counseling (IC) and motivational interviewing (MI) telephone groups.ResultsA simple call doubled the participation rate per protocol (19.2% > 9.2%; p < .001; r = .131; OR = 2.374), and tripled it when the interview was conducted (30.4% > 9.2%; p < .001; r = .219; OR = 4.321). In an intention-to-treat analysis, the benefit of calling by phone remained even higher than postal requests (10% > 9.2%; p < .01; r = .014; OR = 1.103). However, there was no impact of the type of interview on participation rates.ConclusionThe results are discussed for future research.