Annales medico-psychologiques最新文献

Many studies have highlighted the psychological impact and resulting vulnerability inherent in being second-generation immigrant (SGI) children. Some studies have also demonstrated that the symptoms of SGI adolescents can be the manifestations of traumas that have been unconsciously transmitted from one generation to another. The purpose of the research presented in this article is to investigate the different therapeutic processes and tools used by therapists during transcultural therapy to support conscious intergenerational and transgenerational transmission in their care of SGI adolescents and their participating family members. The monitoring of three patients, SGI adolescents, of different ages and origins, provided data that were analyzed using a clinical and transcultural qualitative method. The analysis of 10 sessions of transcultural psychotherapy with each SGI adolescent patient reveals, first of all, that this therapeutic device is illustrative in the care of SGI children suffering from the symptoms of inter- and transcultural transmissions of trauma. It also highlights various therapeutic levers and approaches to transcultural counseling that can enable families to consciously unveil their family and cultural histories. This research project also proposes a methodology where the inter- and transgenerational transmissions can be adapted to favor the healthy development of SGI adolescents’ identity and that can also be applied in other group or individual therapeutic devices.

Objective

The study proposes the analysis of the relationship between body image, self-esteem and body shame (dependent variables) in HIV patients according to their age, gender, level of education, HIV status and year of their HIV screening. We also wanted to see how independent variables (gender and age) affect self-esteem, body image and body shame.

Methods

Participants included 158 HIV patients (men and women) who completed a battery of self-report measures: the Rosenberg Self-Esteem Scale (1965), the Bruchon-Schweitzer Body Image Scale (BIS) (1990), and the body shame subscale from the Shame Experience Scale (ESS) by Andrews et al. (2002).

Results

The first hypothesis, which tests the link between self-esteem, body image and body shame and the sociodemographic variables (age, gender, level of education, HIV status and year of screening), showed a significant relationship among Gabonese HIV patients. The second hypothesis, which evaluates the influence of age and gender on all our dependent variables (self-esteem, body image and body shame), indicated that women are no more likely to express more body dissatisfaction and shame about their bodies and their level of self-esteem is no lower than that of men. Finally, an intergroup comparison demonstrated that self-esteem is lower among youth in certain age groups.

Conclusion

There are significant links between self-esteem, body image and body shame with a lower level of self-esteem in young HIV patients. For clinicians involved in the management of HIV patients, knowledge of the level of self-esteem, body dissatisfaction and body shame would allow for the development of appropriate care and therapeutic intervention goals (therapeutic group, self-efficacy group).

Exiles have often experienced multiple traumas, and when they arrive in France, they generally find themselves in precarious social situations, often with a certain level of nomadism and significant isolation. Unfortunately, the existing mental health care services available for exiles are currently inadequate, and more resources and innovative approaches to providing care would help alleviate the pressure of demand. The presentation of Post-Traumatic Stress Disorder (PTSD) in this population is often somatic, with frequent initial misdiagnoses. Through the study of three clinical vignettes, we are able to substantiate that a trained general practitioner, as the primary care physician, can readily establish a bond of trust that has often been broken, restore a sense of security, and provide support, which is at the core of trauma care for these patients who are often dehumanized and isolated, far from their supportive cultural environment. The general practitioner can screen, refer, and manage these psycho-traumas according to their competence, serving as a resource person and using a complementary approach while taking into account all the symptoms presented by the patients. Addressing PTSD in a transcultural context requires essential decentralization and comprehensive patient care to establish a therapeutic alliance necessary for quality care. This approach is increasingly being used in general medical practice. Additionally, the continuity of care over time helps prevent breaks in treatment, which can be traumatic for these patients. The treatment provided by the general practitioner will help to improve access to mental healthcare for refugees and to develop structures specialized in treating psychotrauma in migrant populations, while at the same time being innovative in patient care.

Objective

Incest among siblings is a topic that is not often discussed despite its frequency. The objective of this study is to explore the subjective experience of the disclosure of brother/sister incest by the adolescent victim and their parents in the context of child psychiatric care.

Method

This is a qualitative study based on semi-structured interviews with three adolescent victims who were under child psychiatric care and who had revealed the brother/sister incest to their caregivers for the first time, as well as with two mothers of adolescent victims. The analysis of the data was conducted using the interpretative phenomenological analysis method.

Results

The results include eleven themes grouped into three meta-themes: (1) pre-disclosure: a state of unease that leads to the initiation of care; (2) the experience of disclosure to a health professional; (3) post-disclosure and its consequences. The different themes highlight the specificities of the experience of the disclosure of incest during the teenage years and the consequences for the parent–child relationship and also for the victim's relationship to the family depending on the adolescent's perspective, parental support, and the medical and legal support.

Conclusion

The vulnerability of the adolescent population in a context of disclosure of intrafamilial sexual abuse between brothers and sisters makes it essential that we conceive of care in a specific way and take into account family and transcultural approaches. This study allows us to identify research perspectives in the field of child psychiatry as well as to formulate concrete clinical proposals, in particular a multidisciplinary support protocol on three different levels: individual, parental and familial.

The legal implications of abortion worldwide do not confer the same rights or conditions on women. Although abortion has been practiced for centuries in all societies, it remains highly unequal in legislative terms throughout the world. This article traces the historical, socio-cultural and political contexts in which decisions to criminalize and decriminalize abortion have been made, particularly in Argentina. Representations of the status of the fetus and of women's social condition that have been developed by each society, provide additional insight into the issues surrounding this universal and transcultural practice. The female body, and its procreative function, correspond to the interests of state policies. The fight by Argentinian women to legalize abortion is an example of rebellion against the weight of patriarchal traditions.

Introduction

Cognitive and Behavioral Therapies (CBT) explore thought patterns related to psychological disorders, acting on the cognitive, behavioral, and emotional levels, according to structured and validated protocols. The patient's cultural representations can be questioned as early as the initial stage of Functional Analysis (FA), enabling CBT models to be adapted to transcultural situations.

Context

FA examines the disorder and its context. Synchrony, based on Cottraux's SECCA model, addresses the cognitions, emotions and beliefs associated with the problematic situation. Diachrony collects structural and anamnestic data related to the disorder. A model of FA can be proposed in a transcultural context, taking into account the social and cultural construction of the symptom, illness, disorder or crisis.

Methodology

By adapting the SECCA model and the diachronic reading grid, FA is adjusted to the transcultural situation, considering aspects relating to culture, exile, migration, the etiological model, the therapeutic itinerary, the traditional treatment of the illness, and the patient's representations and beliefs. It also questions the notion of family and affiliations, transmission, and what, for some patients, is the “invisible world”.

Discussion

The adjustment of FA in a transcultural context raises questions about representations, belief systems and the individual, and the collective history of the patient. Raising the clinicians’ awareness of the cultural issue in CBT helps them to better understand its influence on the clinical expression of psychiatric disorders and their conceptualization by patients, over and above stereotypes and the therapist's own representations.

Conclusion

The theoretical model of FA conceptualized in this way takes into account the subjectivity of the patient, combining the transcultural approach with cognitive-behavioral methodology; and thus making it possible to adapt to our global patients and their singularities.

Context

There is a gap in the literature that qualitatively explores the effects of psychoeducation on siblings who serve as caregivers for persons with schizophrenia. Therefore, this study aims to investigate the qualitative effects of brief need-based psychoeducation on sibling family caregivers of persons with schizophrenia from southern India.

Methods

Ten sibling family caregivers of persons with schizophrenia were recruited for the study, with five in each group receiving either brief need-based psychoeducation or standard care. The participants were interviewed and their responses were recorded. Qualitative data analysis was performed using a combination of thematic and summative content analysis.

Results

The study found that both the intervention and standard care groups of sibling family caregivers of persons with schizophrenia reported similar themes. However, the frequency and prominence of the themes were greater among those in the intervention group, as shown by the summative content analysis. The thematic analysis revealed four major themes: 1) personal experiences with the treatment process, including reduced stigma, active caregiving involvement, bonding, reduced criticality, and coping; 2) improved understanding and management of illness; 3) service satisfaction, and 4) indirect effects on symptomatic and functional recovery.

Conclusion

Brief need-based psychoeducation was found to be more beneficial for sibling family caregivers of persons with schizophrenia, as evidenced by the greater prominence of themes in the intervention group. This study adds to the limited literature on psychoeducation for sibling family caregivers of persons with schizophrenia. Further studies utilizing rigorous qualitative methods are needed to explore the full scope of the intervention's effects.

In at least 67 countries, LGBTQ+ individuals face discrimination and persecution due to their sexual and gender identity. For this reason, some decide to leave their countries of origin to escape violence and to seek better living conditions. Regardless of their reasons for migration, it significantly impacts the expression of their sexual orientation and gender identity. Once they arrive in the host country, they often experience other forms of hardship or violence due to socio-cultural differences, the perception of otherness, and hosting conditions. These factors can have either a positive or a negative impact on their identities. In this context, migration leads to a process of questioning and reconstruction of identity, which needs to be understood in all its complexity if we are to adequately meet their needs for psychosocial support. To gain a better understanding of the impact of migration on the identities of LGBTQ+ migrants, we have based our study on the concepts of the Dialogical Self proposed by H. Hermans, and those of Intersectionality developed by K. Crenshaw. On the one hand, the Dialogical Self depicts identity as a dynamic ensemble of relational Self “voices” that can change, be challenged or reinforced based on time and context, allowing for the development of a complex and harmonious perception of the Self. On the other hand, Intersectionality underscores how different systems of oppression operate to create novel experiences for individuals with multiple marginalized identities. Taking into account the complex and multiple identities that engage in dialogue and that intersect with each other seems to us to be essential for the elaboration of a more decentralized and well-founded clinical and psychosocial approach.