What do child psychiatrists who work with children or adolescents suffering from complex psychotraumatic disorders think about the clinical and socio-political dimensions of their practice? In this article, we discuss some of the questions that clinicians in the field of psychotraumatology may ask themselves, to the point of re-examining the fundamental active principles of healthcare intervention, particularly in the field of mental health.
Although fathers are strongly encouraged to get involved in parenthood since pregnancy, there is still little research on the perinatal experience of fatherhood. In order to better understand and appreciate the experience of fathers during the first months after their child's birth, in this study we investigated the links between perceived social support, sense of parental efficacy and postpartum depression. Similar to studies on mothers, several risk factors may increase the fathers’ vulnerability to the development of postpartum depression symptoms. The objective of this study was to determine whether higher levels of perceived social support and sense of parental efficacy are predictive of lower levels of postpartum depression symptoms in a sample of fathers living in France.
The study population is made up of 376 fathers aged 18 to 59 years old, living in France, and having had a child in the past 6 months. Fathers answered to measures of depression symptoms (Edinburgh Postnatal Depression Scale), perceived social support (Social Provisions Scale), and sense of parental efficacy (Parenting Expectations Survey).
In accordance with our hypotheses, fathers who reported the lowest perceptions of their parental efficacy and the lowest levels of perceived social support are those who reported the highest levels of postpartum depression symptoms. Low levels of perceived social support and of sense of parental efficacy predicted higher postpartum depression symptoms in fathers. Multiple linear regression analyses also showed that the oldest fathers in our sample (30 years and more) had the highest depression scores, as well as lower levels of perceived social support and sense of parental efficacy than younger fathers. Primiparous fathers had higher postpartum depression scores and lower parental efficacy scores than multiparous fathers.
The considerable involvement of fathers in the study and the large size of our sample are strengths of our study that substantiate the interest of fathers in issues related to their parenthood, well-being and mental health. Our results encourage caregivers to give them more attention and well-tailored support to better respond to their specific needs during the transition to parenthood. Couple and individualized care for each parent should be proposed throughout the perinatal period in order to promote parental social support and sense of parental efficacy, particularly for first-time fathers, and to prevent postpartum disorders.
In France, an average of 40% of convicted prisoners are repeat offenders. To prevent disruptions in care that may lead to new offenses, the regional medico-psychological department (SMPR) of the Amiens prison first introduced short-term post-incarceration support (6 months) in 2021. The multidisciplinary team now intends to facilitate the transition to a desistance process for incarcerated men who are undergoing treatment in prison and to, provide support when they are released. The strategy consists of three main components: training, organization, and expanding the range of care. The team has already started training for three tools: HCR20 V3, SAPROF, and CAPP-IRS. The first pertains to the assessment and management of the risk of interpersonal violent relapse, the second focuses on identifying protective factors related to violence, and the third addresses psychopathy, a significant risk factor for violence. In terms of organization, care at the SMPR has been restructured to incorporate the assessment of the level of risk of relapse during detention and its reassessment during post-carceral follow-up. The aim now is to strategically address any identified dynamic risk factors, taking protective factors into account. The expansion of the care provided, begun in 2022, led to the opening of a therapeutic and integration cohabitation unit (TICU) in October 2023, serving as a “gateway” facility accommodating 5 men who have been released from custody supported by the SMPR in post-carceral care, also for a duration of 6 months. The primary objective of this observational, prospective, and single-center study is to measure the effectiveness of intra-carceral and post-carceral support – restructured around risk assessment and management tools – for individuals exiting the Amiens prison after achieving desistance at the end of the follow-up and for a period of 5 years. This effectiveness could be reflected in a reduction in psychopathic traits and in the level of risk of recidivism for those supported in post-carceral care, from the time of incarceration to the end of care. These mental health care professionals also wish to document the implementation of the three tools in their service and assess their predictive validity within their sample. The study also serves to evaluate the effectiveness of the experimental TICU program. The early identification of risk factors should improve the specificity and prioritization of risk prevention actions as part of routine care. Demonstrating the effectiveness of this extended treatment program, tailored to the needs of the outgoing incarcerated population, could lead to the replication of this specialized psychiatric approach in other penal facilities. The project is part of a common effort to break down barriers between the various sectors involved in the care of individuals who are released from prison. Collaborative multidisciplinary teamwork, both within the department and with mainstream psychiatric
Intimate partner violence (IPV) is an international public health problem. Much more than a simple conflict within a couple, it's a process of one partner taking power over the other, through the use of violence (physical, psychological, sexual and/or financial). IPV is rarely an isolated act and generally follows a pattern of chronic abuse. The risks of re-victimization in this context are significantly higher than in other criminal victimization contexts. International recommendations for the management of IPV offenders emphasize the need to establish early assessment processes for recidivism, to prevent violence and guide judicial action and management programs for IPV offenders. Among the structured clinical judgment scales developed for the assessment of IPV, the Spousal Assault Risk Assessment (SARA-V3) is the most widely used tool. While there are several scales for assessing the risk of IPV recidivism, research into their psychometric qualities remains limited, especially for the French-language versions. In addition to the availability of assessment tools, several problems have been identified in the use of IPV recidivism risk assessment instruments by practitioners in real-life situations: frequent recourse to unstructured professional judgment, problems in complying with recommendations for administering assessment instruments, and a lack of training. This article presents a study currently under development whose aim is to translate and validate the SARA-V3 in French. The first part of the study consists of administering the SARA-V3 to suspected or convicted perpetrators of IPV, to measure the psychometric qualities of the French translation. To carry out the assessment of IPV situations, we propose collecting data at several stages in the judicial process. The total sample will be made up of men suspected or convicted of IPV. They will be evaluated in various organizations that deal with perpetrators of IPV and at different stages of the judicial process, namely: in a police department, with expert psychiatrists, and in specific therapeutic care services. After receiving a favorable opinion from the Ethics Committee of the UMONS Faculty of Psychology and Educational Sciences, the SARA-V3 scale was translated into French with the support of the English Unit: Literature, Language, Interpretation and Translation (ELLIT) department of the UMONS Faculty of Translation and Interpretation. The second part of the study analyzes the perceptions of professionals in the field regarding risk assessment scales (particularly SARA-V3). This second stage of the research examines the professionals’ perceptions of the benefits of JPS. The participants in this study are those psychologists who contributed to the first part of the study. They are interviewed in a semi-structured interview. The aim is to evaluate the use of SARA-V3 in a clinical context, its scoring mechanics, validity, training, and perspectives.
Mandatory care is part of court-ordered care. This measure was introduced into French Law on November 23, 1958, at the same time as conditional imprisonment with probation. Rarely used by judges in the beginning, mandatory care appears to be ordered more frequently today. Concerning mainly male individuals with personality or substance abuse disorders, therapists will frequently be asked by their patients to implement this measure. Through a review of the legal and health literature, this paper intends to specify how mandatory care is ordered, implemented, applied and ultimately how it ends.
We conducted a literature review of French legal and health publications between 1958 and 2021. We included sources from several databases such as Science Direct, Persée, Cairn, Dalloz, and Légifrance. We used the keywords “obligation de soin”, “soins pénalement ordonnés”.
Mandatory care is a frequent measure that can be pronounced by French judges at any judicial procedure. No psychiatric expertise is needed contrary to other court-ordered care such as injunction of care. As the magistrate only sets the goals of mandatory care, its organization and extent are determined by the therapist in partnership with the patient. The patient will then have to prove his assiduity to the judge, by asking the therapist to submit certificates of attendance. As the therapist is sworn to respect the professional secrecy towards the magistrate, the judge should transmit all the documents useful for the patient's care. Finally, mandatory care can be terminated at the behest of the patient, the district attorney, or the Executive Magistrate.
It seems essential that healthcare professionals understand what mandatory care is and how it is conducted. Moreover, we invite all those involved, from the judicial to the medical system, to promote meeting venues to better identify the limits of each, while, at the same time, respecting one another's professional secrecy.
If sexual violence perpetrated against children currently seems to be better recognized and treated, there is one type of act and one age category that are totally disregarded: babies and very young children, many of pre-verbal age, (0–3 years) who are victims of rape. However there are adults (and even minors) who are regularly convicted of being perpetrators. Our professional experience has led us for years to treat very young children who are victims of rape without the specificity of this violence being discussed in scientific articles. There is a real taboo concerning the rape of babies, and this unspeakable act leads the interveners to not even imagine that such an act can exist and, therefore, not to consider its reality, even though the resulting disorders are obvious. Admittedly, this is extreme abuse, given the vulnerability of the victims. It is nevertheless very real and the absence of publications on this subject can only make us wonder, because it probably results in a resounding silence about many situations. Perpetrators who rape a baby might kill the child as a result of the acts committed [1], they can continue to abuse the child even when they grow up, but they may also stop the abuse as soon as the child becomes able to speak for fear of being reported. As no quantitative study has ever been carried out on this subject, we can only transmit the reality of the field based on our work as psychotherapists and experts. When a very young child is subjected to rape that is not detected, and when he or she survives, and that violence stops when they begin to speak, it does not mean that the violence suffered will not be expressed in other ways, especially by violence against oneself or others. Rape leaves physical and psychological ramifications and it is often inappropriate sexual behavior that will alert adults (relatives, teachers). But the young child does not have sufficient memory capacity to remember what they have experienced and suffered, and they are unable to denounce their aggressor. Since the expressiveness of post-traumatic stress disorder is not linear, it is common that the child's attitude will be noticed by adults only years after the assaults have been committed. And the consequences of rape suffered in early childhood can be innumerable (multiple post-traumatic disorders, disorders in the construction of childhood sexuality, learning disorders, disorders in the establishment of social bonds, etc.). At a time of full psychosexual, psychoaffective and cognitive development, this extreme violence can have a lasting effect on the child's future. Furthermore, the fact that externalized disorders (which are clearly visible and worrying) can appear on a delayed basis remains largely unknown, including by professionals. This can be a source of all kinds of misunderstandings, particularly due to the lack of training of those involved who believe that if the disorders manifest themselves it is
In this paper, we show that the literature on the prevalence of psychiatric and susbtance use disorders in prisons is substantial. However, there are a number of difficulties one encounters in interpreting this literature: (i) there is considerable heterogeneity between countries’ judicial and mental health care systems, and (ii) the specific features of the prison environment are sometimes overlooked in the methodology used to conduct such studies. With this in mind, we discuss a number of benchmark studies on the prevalence of psychiatric and substance use disorders in French prisons. Finally, we discuss the perspectives for psychiatric epidemiology in prisons.
This exploratory study compares the distinctive characteristics of individuals who have consumed child pornography and those who have committed rape. The study sample consists of 212 men of legal age and who have been convicted of a sexual offence. All were monitored in 2022 for therapeutic guidance by the Centre d’Appui Bruxellois. Of these 212 men, 48 were convicted of child pornography consumption and 100 of rape. Socio-demographic, criminological, victimological and psycho-diagnostic data for all the participants were extracted from the judicial court files. This comparison offers crucial perspectives for the development of prevention strategies and therapeutic guidance specific to these sub-groups of sexual offenders.
Despite being less recognized as a specific subdomain of Psychology in French-speaking countries, forensic psychologists do face the same challenges as their Anglo-Saxon counterparts. Among these, the literature identifies the quality of life in the workplace, which can be divided into Compassion Satisfaction, and Compassion Fatigue, the latter being composed of Burn-out and Secondary Traumatic Stress. Previous research has acknowledged the role of emotional competence, especially the management of emotions, as a central factor of healthcare professionals’ relationship with their work assignments. However, Pirelli and collaborators recently highlighted the lack of empirical research among forensic psychologists. As an answer to their call, this study investigates the association and predictive factors of emotional competence, difficulties in emotional management, and the quality of professional life.
An online survey (Lime Survey) was used to collect data regarding socio-demographic variables such as age, gender, years of experience, and training. The following self-questionnaires were then given to the subjects: Profile of Emotional Competence, Difficulties in Emotion Regulation Scale, and Professional Quality of Life. Descriptive, correlational, and regressive analyses were undertaken to, respectively: (1) describe our sample and compare it to available norms (Student's t), (2) associate (Bravais-Pearson r) the mean scores of the three scales, and (3) evaluate the prediction (simple and multiple linear regression) of emotional competence and emotional dysfunction on the quality of professional life. These predictions were then reversed. Both regression analyses used the backward method.
The sample was composed of 44 French-speaking forensic psychologists (79.50% female), median age 34.20 (SD = 7.96). They were mainly trained in clinical psychology (84.10%), followed by forensic psychology (18.20%). The majority of the sample worked as carceral psychologists (59.10%), and their main missions were support and guidance (78.70%), followed by recidivism risk assessment (52.30%) and crisis management (50.00 %). Descriptive results. The participants exhibited significantly higher emotional dysfunction scores (total score, p ≤ .001; Lack of Emotional Clarity, p = .10; Impulse Control Difficulties,p ≤ .001; Difficulties Engaging in Goal-Directed Behavior,p ≤ .001) when compared to available norms. Regarding their perceived quality of life, all scores were either significantly lower or higher based on the norms used. A similar analysis was not possible for emotional competence as available norms were gender-specific, and the sample gender distribution was clearly unbala
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