Neuropsychiatrie de l''Enfance et de l''Adolescence最新文献

Psychoanalytic family therapy and infant observation according to the Esther Bick method differ a priori in their aims. One is a psychotherapeutic device while the other is a training course for psychotherapists. Both approaches have psychoanalytic theory, its epistemology and ethics, as their common basis. The clinicians are guided by the families they meet, whether they are suffering or “normally well”. Thinking jointly about these two systems makes it possible to overcome the debate that opposes the “real baby”, of direct and developmental observation, and the “true baby”, reconstructed on the couch. In fact, the observer in training is witness to the narration of fantasmatic and transgenerational elements, weaving a psychic cradle that welcomes the “real baby” and where the construction of the “true baby” begins. Family therapists are naturally attentive to these plural constructions and imaginaries, and to the claims of these eternal babies that families still carry within them. Both approaches involve attention to the archaic, to affective and sensory experiences, and both rely on the group: the observer witnesses the birth or remodeling of the family group, while the support group participates in the transformation of the observed material in search of elaboration. In the same way, the neo-group, composed of the family therapists and the families, supports a space of containing reverie, which facilitates the re-establishment of a new form of fantasmatic circulation. The observer, by his presence, modifies the family system in which he is in fact included, families testify to the benefit they derive from these meetings, and therapeutic applications at home have thus been set up to support families in difficulty, while at the same time, practitioners defend the interest of psychoanalytical family work in perinatal care. The articulation of these two systems gives us a glimpse of fruitful perspectives for training, prevention and psychotherapeutic support.

In child psychiatry services we are seeing more and more adolescents reporting “dissociative” symptoms, and it is no longer rare for the diagnosis of dissociative identity disorder to be evoked. The increased visibility of certain psychiatric symptoms may be related to better identification and increased training of clinicians, but it may also be related to changes in societal contexts that may favor the emergence or maintenance of certain forms of expression of psychological suffering. Adolescence also contains its own identity reorganizations and dialectics which necessarily color the disorders and their significance, and which sometimes must be deciphered beyond the act or the inaugural syndromic form. We propose here to discuss our interrogations in relation to dissociative identity disorder in adolescence and some of the psychopathological issues that are raised.

Background

In recent years, psychological factors, including anxiety and post-traumatic stress disorder, have emerged as possible background factors for obesity and its comorbidities. Post-traumatic stress disorder (PTSD) has been associated with higher body mass index (BMI) and metabolic syndrome (MetS) compared to other psychiatric disorders, but this association remains partly mysterious and intriguing, especially considering the effect of childhood trauma.

Method

We decided to conduct a review in order to obtain the most recent information on this association with a focus on developmental elements.

Results

The studies considered were very heterogeneous, in terms of sample size and results, and do not lend themselves to meta-analysis but rather to discursive synthesis.

Conclusion

There are many different and complex planes of interrelationship between PTSD and obesity which offer different therapeutic clues for the clinician. Integrated psychotherapies and interventions focusing on exercise and mindfulness can be used in different settings to promote recovery from both disorders.

Objectives

The first objective of this study was to describe and compare the intensity of inappropriate behaviors and attitudes toward food and body image (BAFBI) and the degree of internalization of athletic identity in a group of adolescent female athletes to those assessed in a control group. The second objective was to examine the contribution of sport-specific pressures on the variability in the intensity of BAFBI among the group of athletes. The third objective was to test whether the internalization of athletic identity acts as a moderating variable in the relationship between sport environment pressures and BAFBI.

Method

The sample consisted of 197 adolescent girls , 122 non-athletes and 75 athletes participating in high performance aesthetic sports. The Eating Disorder Inventory-3 (EDI-3) and the Body Shape Questionnaire (BSQ) were used to assess the intensity of BAFBI. Pressures from the sport environment were measured by the Weight Pressures in Sport for Female questionnaire (WPS-F) and the degree of internalization to athletic identity was assessed using the Athletic Identity Questionnaire (AIQ).

Results

The results indicated that there is no significant difference between the two groups in the intensity of the BAFBI. The athlete group differed in their perception of the degree of internalization to athletic appearance. The results revealed that certain pressures in the sport environment contribute to the explanation of the variability of BAFBI among the group of athletes. Internalization of athletic identity was not a moderating variable between sport environment pressures and BAFBI among the participating athletes.

Conclusions

The results of this study highlight the influence of certain pressures in the sport environment on the adoption of various BAFBI in adolescent athletes.

Background

The Early Start Denver model is one of the interventions recommended by the French High Authority on Health since 2012 for the very early care of children with Autism Spectrum Disorders. This program, developed in the United States, has shown the best evidence of effectiveness in an intensive form of delivery that is difficult to generalize to other culturally different contexts. Consequently, its implementation in the French health care system has required some adaptations that have not yet been evaluated. After a summary of the method's features and the results of studies of its effectiveness, this first retrospective descriptive observational study aims to characterize the implementation and practice of this intervention in France. In doing so, it also aims to better understand the potential obstacles to the implementation of early intervention and thus propose avenues for improvement.

Material and method

A census of French units offering the Denver model was conducted from June to October 2020. A questionnaire sent to the participating units made it possible to explore different dimensions: first, the characteristics of these units, including their composition. Secondly, their integration into the care network and the children's care pathway. Practice and delivery modalities were also assessed. Finally, the objective was to highlight the difficulties that the teams may have faced when implementing the model. The data were collected in Microsoft Excel® software in order to perform a descriptive statistical analysis.

Results

In total, 92% of the units surveyed participated in the study and returned the questionnaire. Our results highlight a significant heterogeneity in the deployment of the Denver method at the national level and underline the limit of resources available in the territory, particularly in its intensive delivery form.

Conclusion

Further research is still needed to study the feasibility and effectiveness of ESDM interventions deployed in the specific context of the French healthcare system. In addition, significant work remains to be done to establish rapid and identifiable pathways for early intervention in young children with ASD.

Objectives

The primary aim of this study was to explore the influence of antenatal class attendance on paternal security and bonding in the postpartum period, while the secondary aim was to investigate fathers’ interest in attending antenatal classes.

Methods

A total of 375 fathers living in France answered several questions online about their participation in prenatal classes as well as questionnaires assessing the sense of postnatal security and bonding quality.

Results

In general, the results showed a non-significant difference in terms of bonding and sense of security between fathers who attended multiple sessions and those who attended fewer or no sessions of antenatal classes. Nevertheless, participation in prenatal classes and socio-demographic factors explain together a significant part of the paternal feeling of postnatal security and bonding. In addition, a majority of the participants stated that they would be interested in participating or increasing their participation in birth/childbirth preparation and parenting classes.

Conclusions

These results highlight the importance of further exploring the effect of prenatal classes on the paternal postpartum experience in order to propose adapted and inclusive prenatal accompaniments for future fathers.

We report the case of a 12-year-old boy with nonverbal autism, intellectual disability, and hypermobility spectrum disorder. The patient was hospitalized in a French multidisciplinary neurobehavioral inpatient unit due to extreme self-harming behaviors. This major self-aggression led to a multi-fractured nose and to a growing risk of life-threatening traumatic injuries (risk of cervical fracture and spinal cord injury caused by forceful headbanging). These challenging behaviors required for a time the day-to-day skills of at least four caregivers and resulted in a rare escalation of restraint measures and in exceptional adaptations by our psychoeducational team. Clinical improvement was obtained after managing all causes of somatic pain and discomfort, as well as stabilizing the patient's mood and anxiety. We offered both sensorimotor developmental approaches with proprioceptive compressive garment and therapeutic body wrap, as well as protective equipment and specific psychoeducational interventions adapted to his severe self-injurious behaviors and to his developmental abilities.

Aim

The child's place in our society has largely evolved over the past few decades. This has led to numerous public policies to tackle social inequalities in health care from an early age. Parenting support is one of the enhanced strategy actions and aims put in place, in particular, to strengthen the bonds of attachment and promote a child's development. The quality of attachment and parent–child interactions is correlated with parents’ representations of their children. The objective of the study is to report current parental representations of newborn children in the French population in general.

Method

As part of the PERL study, an ancillary study was conducted on parental representations. The interviews were conducted with the control families. The analysis was based on the method of conceptual categories in order to bring out the salient elements relating to parental representations and feelings associated with parenthood.

Results

Among the analyzed discourses, parents have constructed the representations of their child, from the child's age of 4 months. These representations identify the 4-month-old child as being capable of making choices, having preferences, acting in the environment, and communicating with others. In addition, parents’ representations of themselves highlighted various feelings experienced concerning parenthood, the exercise of this new role, and the new parental behaviors towards the child, as a result of the disruption of being a parent. Parents also experienced a variety of feelings associated with parenting, parenthood, and their new role.