Annales medico-psychologiques最新文献

{"title":"Le partage social des émotions chez 140 psychologues-psychothérapeutes français","authors":"Noémie Sudol , Mathilde Moisseron-Baudé , Charles Martin-Krumm , Christian Heslon , Tristan Hamonniere","doi":"10.1016/j.amp.2024.11.014","DOIUrl":"10.1016/j.amp.2024.11.014","url":null,"abstract":"<div><h3>Context</h3><div>Therapists must manage high emotional demands due to the nature of their work. Emotional regulation is crucial not only for their personal well-being but also for the quality of the therapeutic relationship. Ineffective emotional regulation can compromise the therapeutic relationship and increase the risk of burnout. While many studies have explored emotional regulation by therapists during sessions, few have investigated how these emotions are managed outside of sessions, particularly through the social sharing of emotions (SSE) after an interaction with a patient. SSE allows people to express and share emotions with their social environment, which can help regulate negative emotions and strengthen social bonds.</div></div><div><h3>Materials and methods</h3><div>This study aims to explore the use of SSE among therapists. A sample of 140 French psychologists completed an online questionnaire on the characteristics of emotional sharing outside of therapy following emotions felt during a session. Participants were asked to recall a negative emotional event related to their therapeutic relationship with a patient. Then, they described the intensity and valence of the emotions experienced, and their use of SSE (sharing partner, frequency, and other modalities). Data were analyzed using descriptive statistics and correlations.</div></div><div><h3>Results</h3><div>In total, 98.57% of participants engaged in SSE after emotionally charged events related to their practice, primarily on the same day as the event. The most frequent sharing partners were colleagues (62.3%) and life partners (55.1%), followed by peer therapists and supervisors. On average, SSE was initiated by the participants themselves and occurred shortly after the emotional event. The frequency of sharing was positively correlated with the intensity of the emotions felt (emotional intensity at the time of the event: tau<!--> <!-->=<!--> <!-->0.245; <em>p</em> <!--><<!--> <!-->0.001 and emotional intensity at the time of the study: tau<!--> <!-->=<!--> <!-->0.151; <em>p</em> <!-->=<!--> <!-->0.026). However, there was no significant correlation with the timing of sharing or its exhaustiveness. Higher emotional intensity was associated with more frequent SSE, suggesting an increased need for sharing when facing intense emotions.</div></div><div><h3>Conclusion</h3><div>The results show that therapists widely use SSE as an emotional regulation strategy, primarily with colleagues and life partners. This highlights the importance of this emotional regulation strategy in their professional practice. Sharing plays a crucial role in providing emotional support, strengthening professional bonds, and facilitating the management of difficult emotions. However, sharing can sometimes become repetitive and unresolved, leading to rumination. Furthermore, excessive sharing with close ones raises ethical and professional concerns, as well as emotional repercussions for the surr","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"183 8","pages":"Pages 797-806"},"PeriodicalIF":0.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145242249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Projet, handicap psychique, rétablissement : quelques repères pour l’accompagnement des personnes","authors":"Benoit Brun ,&nbsp;Fabrice Berna ,&nbsp;Jean-Marie Danion","doi":"10.1016/j.amp.2024.09.026","DOIUrl":"10.1016/j.amp.2024.09.026","url":null,"abstract":"<div><div>For some twenty years now, the individual project and, more broadly, life's project, have informed the practices of caregivers and social workers within social and medico-social services. While project-based care has been the subject of considerable interest in the literature, we felt it would be useful to contribute to and clarify the meaning of these different concepts and the way in which projects influence the practice of social and mental health care. We also wanted to discuss more specifically the care of persons with mental disabilities. A psychiatric handicap may indeed appear to be an obstacle for the project methodology. However, these potential obstacles must be weighed against the prospects offered by the concept of recovery in mental health. Finally, we wanted to examine the ethical issues involved in caring for these persons, which seems to be justified by the fact that it enables those patients to achieve a “good life”, which also requires us to question the concept of autonomy.</div></div>","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"183 8","pages":"Pages 847-853"},"PeriodicalIF":0.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145242430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The art of observation: What does Jacques Lacan's mentor have to say?","authors":"Emmanuel Drouin ,&nbsp;Marion Hendrickx","doi":"10.1016/j.amp.2025.05.003","DOIUrl":"10.1016/j.amp.2025.05.003","url":null,"abstract":"<div><div>This article explores the fundamental importance of clinical observation in psychiatry by assessing a case report drafted by Gaëtan Gatian de Clérambault (1872–1934) in 1901, during his internship at the Sainte-Anne Asylum (Paris, France). The detailed observation of patient M.’s complex clinical picture illustrates the method based on questioning and observation developed by de Clérambault under the influence of his mentors [notably Valentin Magnan (1835–1916)]. This approach was characterized by meticulous attention to the details of the patient's behaviour and discourse and had a profound influence on the French school of psychiatry–particularly through its impact on Jacques Lacan (1901–1981). This article highlights the importance of clinical observation in psychiatry training and emphasizes the need to learn how to “look” before making a diagnosis. It argues that an approach based on close observation and apprenticeship is essential for maintaining the richness and depth of psychiatric practice, faced with the current trend towards the rapid categorization of mental disorders. The article closes by emphasizing the importance of preserving this legacy in contemporary psychiatric training and practice.</div></div>","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"183 8","pages":"Pages 859-862"},"PeriodicalIF":0.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145242434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quel rétablissement chez la personne âgée dépressive ? Effets d’un dispositif groupal d’autobiographie guidée","authors":"Ketty Steward ,&nbsp;Arnaud Plagnol ,&nbsp;Renald Asvazadourian","doi":"10.1016/j.amp.2025.04.004","DOIUrl":"10.1016/j.amp.2025.04.004","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Ageing is often presented solely through the lens of loss and bereavement. When mental disorders occur in the elderly, the “deficit” approach results in the overconsumption of psychotropic drugs, implicitly confirming the lack of hope felt by others. The societal proposals for assisting people in death, that sometimes result from this, overshadow the profound experience of the elderly, where a number of studies have confirmed that it is possible to provide them with an outlook for hope. The recovery paradigm has contributed to bringing forth a new perspective for people with “severe” mental disorders, focused on “empowerment” and “connectedness” with the social world. Can this also be relevant for elderly people even though the pending horizon of death is an undeniable reality of their experience? Several studies have confirmed the value of this paradigm for informing interventions in this population, particularly through narrative programs.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;Based on a narrative group proposal of guided autobiography, we wanted to clarify to what extent the central dimensions of recovery such as hope, empowerment and “connection” could be taken into account and highlighted in the care of depressed elderly people.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;A ten-session group guided autobiography program, using written and oral communication, was developed and proposed to 3 groups of from 5 to 8 participants in a psychiatric day hospitalization unit for the elderly. In weekly one-and-a-half hour sessions, participants discussed and wrote about their life experiences in relation to a given theme. The 10 themes – one per session – had been selected through working with depressed elderly people during a pre-study meeting: Time, Family and Relatives, Work and Activity, Money, Sex and Gender, Food, Body and Health, Death, Travel, and Arts. Five participants in each group were able to complete the entire evaluation process. At the beginning and end of the program, their mood was evaluated with the Montgomery-Åsberg Depression Rating Scale, and relation to time was assessed by the Zimbardo Time Perspective Inventory. Observation grids were used to track the changes in people's participation and the characteristics of their texts. At the end of the 10 sessions, an interview was conducted with each person which was subsequently analyzed according to the Interpretative Phenomenological Analysis (IPA) method, in order to reconstitute their experience.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;In addition to the symptomatic improvement measured with the MADRS, the observation grids and The Time Perspective profiles suggest changes indicative of recovery processes in almost all the individuals. The analysis of the interviews also highlights evidence of experiential recovery.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;The therapeutic group proposal would appear to favor several dimensions of recovery, such as hope, connectio","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"183 8","pages":"Pages 807-812"},"PeriodicalIF":0.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145242433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Les stades du burnout selon une perspective temporelle : revue narrative","authors":"Céline Leclercq,&nbsp;Isabelle Hansez","doi":"10.1016/j.amp.2025.03.003","DOIUrl":"10.1016/j.amp.2025.03.003","url":null,"abstract":"&lt;div&gt;&lt;div&gt;Due to the increasing number of burnout cases, prevention and management of burnout have become major concerns, underscoring the importance of further research to better delineate this phenomenon. To provide a contemporary understanding rooted in the experiences of workers, this article introduces a qualitative approach to the experience of burnout as a temporal process. Some authors emphasize burnout as a state, while others identify it as a process integrating symptomatology alone or associating it with changes in the work context. According to a temporal perspective focused on both symptomatology and the professional context, a narrative review of the literature was conducted to investigate the evolution of burnout. The bibliographic databases Medline (Ovid) and Psycinfo (Ovid), as well as Google Scholar, were consulted. Inclusion and exclusion criteria were defined to select relevant studies, including thematic relevance, adult population, qualitative or descriptive methodology while excluding papers lacking full-text availability and irrelevant contexts. A narrative analysis was conducted, involving a thorough examination of the methodologies, findings, and limitations of the chosen studies. Results were synthesized and classified to discern common themes concerning the temporal progression of burnout. This research identified four stages that depict this temporal process: engagement and enthusiasm with a high job ideal (stage 0), weakening of the ideal (stage 1), protective withdrawal (stage 2) and confirmed burnout (stage 3). At stage 0, individuals are fully engaged in their work, driven by idealistic enthusiasm. They invest a lot of energy in their tasks, considering work as a major source of personal accomplishment. At this stage, signs of burnout are rare. In stage 1, professional ideal begins to show signs of weakness. Work hindrance stressors and conflicting events start to diminish initial enthusiasm. Despite efforts exerted to exhaustion, individuals are confronted with obstacles that question their progress and professional fulfillment, resulting in a feeling of stagnation and doubt. At stage 2, a protective withdrawal occurs. What was once a source of work satisfaction is now perceived as a threat. Individuals develop strategies to protect themselves from harmful situations and begin to adopt an increasing cynicism towards organizational values. Work-related issues also start to impact their personal lives. Finally, in stage 3, burnout is confirmed. The ideal of a fulfilling job has completely disappeared, and individuals find themselves unable to maintain their usual functioning. Often triggered by a critical event, burnout manifests as intense emotional and physical distress, potentially leading to sick leave and an increased risk of depression. Doubts arise about their identity and personal worth, marking the beginning of an awareness and a reassessment of their relationship with work. Without being prescriptive or e","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"183 8","pages":"Pages 818-828"},"PeriodicalIF":0.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145242432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Du catégoriel au dimensionnel : description et illustration clinique pour favoriser une transition harmonieuse dans la conceptualisation des troubles de la personnalité","authors":"Dominick Gamache ,&nbsp;Yann le Corff ,&nbsp;Claudia Savard","doi":"10.1016/j.amp.2025.04.009","DOIUrl":"10.1016/j.amp.2025.04.009","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Research and clinical practice in the field of personality disorders (PD) have taken a major and decisive turn in recent years with the publication of the Alternative Model of Personality Disorders (AMPD) in the fifth edition of the &lt;em&gt;Diagnostic and Statistical Manual of Mental Disorders&lt;/em&gt; and with the introduction of a purely dimensional model in the latest edition of the International Classification of Diseases (ICD-11). Along with the general criteria of PD described in the previous versions of the DSM, the AMPD defines personality pathology based on two main dimensional criteria. The first one refers to the severity of personality dysfunction in the spheres of self (including Identity and Self-direction elements) and interpersonal relationships (referring to Empathy and Intimacy elements). Each element can be classified in a severity level ranging from 0 (few or no alteration) to 4 (extreme alteration). The second criterion describes five pathological domains of personality, broken down into 25 pathological facets: Negative affectivity, Detachment, Antagonism, Disinhibition, and Psychoticism. To diagnose a PD in the AMPD model, a person must present a moderate alteration (level 2) in at least two elements and a significant elevation in at least one pathological facet. The AMPD is considered a hybrid model as categorical diagnosis of six PDs (antisocial, avoidant, borderline, narcissistic, obsessive-compulsive, schizotypal) can be made using algorithms including specific pathological facets for each PD. For its part, the model developed in the ICD-11 relies on a general criterion of personality dysfunction to establish the presence and intensity of PD based on a five-point severity continuum: (a) no personality disorder, (b) presence of personality difficulties (without a clear personality disorder), (c) mild personality disorder, (d) moderate personality disorder, or (e) severe personality disorder. Optionally, the clinician can also indicate the presence of five trait domains qualifiers, akin to those found in the AMPD: Negative affectivity, Detachment, Dissociality, Disinhibition, and Anankastia. A specifier for borderline patterns can also be applied. Despite being relatively recent, these models have already generated a lot of interest in the PD research community; however, there are only limited published works devoted to these models intended for French-speaking researchers and clinicians.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;The aim of this article is to provide a guide for French-speaking researchers and clinicians, to promote a smooth transition between the traditional categorical approach and the two emerging dimensional models of PD described above.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;After a brief introduction to the two dimensional models and their respective scoring procedures for the diagnosis of PD, the similarities and distinctions between categorical PD diagnoses and these new dimensiona","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"183 7","pages":"Pages 696-702"},"PeriodicalIF":0.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparaison de caractéristiques sociales et cliniques en fonction du sexe chez des personnes ayant un trouble de la personnalité du groupe B","authors":"Nadine Larivière ,&nbsp;Jacinthe Lavoie-Tremblay ,&nbsp;Lionel Cailhol ,&nbsp;Pierre David","doi":"10.1016/j.amp.2024.08.020","DOIUrl":"10.1016/j.amp.2024.08.020","url":null,"abstract":"<div><h3>Introduction</h3><div>In the field of Cluster B personality disorders (PDs), studies have primarily focused on borderline personality disorder (BPD), predominantly including women. Moreover, studies comparing various Cluster B PDs have examined some clinical features between men and women, particularly symptoms, without considering social characteristics.</div></div><div><h3>Objectives</h3><div>This study aims to compare the social and clinical characteristics of women and men with Cluster B PDs, using a database from a specialized service for persons with a PD.</div></div><div><h3>Methods</h3><div>Clinical variables examined included the severity of psychopathology as assessed by clinicians and perceived PD symptoms. These were measured using validated tools and entered into the service's database. Social variables included for example marital status and social network, and were systematically collected upon entry into the service. Additionally, therapy goals, part of the initial assessment, were qualitatively compared.</div></div><div><h3>Results</h3><div>Socially, there was no statistically significant difference between men (<em>n</em> <!-->=<!--> <!-->103) and women (<em>n</em> <!-->=<!--> <!-->283) regarding marital status, education, source of income, and number of leisure activities. Men had a more limited social network than women (<em>P</em> <!-->&lt;<!--> <!-->0.001). According to the Borderline Personality Questionnaire (BPQ), more women scored in the BPD diagnostic range compared to men (<em>P</em> <!-->&lt;<!--> <!-->0.001). Analysis of BPQ dimensions showed that women exhibited more dissociative symptoms (<em>P</em> <!-->=<!--> <!-->0.04). Also, the proportion of women reporting substance use in the last month was significantly higher (<em>P</em> <!-->=<!--> <!-->0.04). Regarding therapy goals, improving relationships with oneself and others was most common among women, while men's goals mainly focused on managing symptoms and activities of daily life (e.g., finding a job, adopting healthier lifestyle habits).</div></div><div><h3>Conclusion</h3><div>This study contributes to considering sex and gender in service provision for people with Cluster B PDs. While there are several similarities between men and women, some social differences support the addition of interventions targeting everyday life elements, such as lifestyle habits for men.</div></div>","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"183 7","pages":"Pages 715-724"},"PeriodicalIF":0.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cooccurrence de troubles de la personnalité et d’accès hyperphagiques : enjeux cliniques et pistes d’intervention psychothérapeutique","authors":"Élodie Gagné-Pomerleau ,&nbsp;Catherine Bégin ,&nbsp;Marie-Pierre Gagnon-Girouard ,&nbsp;Dominick Gamache ,&nbsp;Claudia Savard","doi":"10.1016/j.amp.2025.01.003","DOIUrl":"10.1016/j.amp.2025.01.003","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Personality disorders (PDs) are often associated with numerous physical and psychological comorbidities, one of which is the recurrent presence of binge eating (BE). While the causes of BE are multiple and complex, well-known triggers of BE include the so-called binge-restrict cycle and the presence of a high negative emotional load (e.g. sadness, anxiety, loneliness), which may sometimes lead to a dissociative state during the BE episode. The prevalence of BE in people with PDs is reported to be up to 15 times greater than in community samples. The presence of PDs is also associated with a greater frequency and severity of BE, as well as a higher preoccupation towards weight and body appearance.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;The aim of this article is to present the current state of knowledge regarding the co-occurrence of PDs and BE, and to explore promising avenues for psychotherapies that could help improve quality of life with this clientele.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The high degree of co-occurrence between PDs and BE may be due to the many characteristics shared by both, such as greater impulsivity, emotional regulation problems, and various difficulties in interpersonal relationships. They are also both associated with a traumatic history (e.g., abuse, neglect, bullying) that transforms into insecure attachment styles in adulthood. The PDs most frequently observed in people with recurrent BE are, in order of importance, avoidant PD, borderline PD and obsessive-compulsive PD. However, PDs and BE are typically treated separately by distinct approaches. Unfortunately, the usual treatments for BE appear less effective when the person also has a PD, leading to more previous treatments, as well as greater residual eating pathology and negative affect at the end of therapy. Instead, it seems preferable to turn to treatments that aim to address the common features of both BE and PDs (i.e. impulsivity, emotional regulation, interpersonal relationships). Fortunately, a growing number of psychotherapies originally developed for PDs (aimed precisely at working those common difficulties) have now been adapted to address eating disorders as well. Schema therapy appears to be a promising treatment, but the small number of studies necessitates cautious interpretation of the results. Mentalization-based therapy (MBT), an evidence-based treatment for PDs, also offers a recent manualised adaptation for eating disorders (MBT-ED) which makes it more easily applicable to treat BE. Dialectical-behavioural therapy (DBT) is well validated and empirically supported, even offering two specific adaptations for BE. The first adaptation, the Stanford Model, was created specifically to treat cases of bulimia and BE. It views BE as an ineffective and inappropriate way to regulate emotions and aims to replace it with less harmful strategies. The second adaptation, the Multidiagnostic Complex Eating Disorders for DBT Model,","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"183 7","pages":"Pages 725-728"},"PeriodicalIF":0.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Développement d’une intervention de remédiation cognitive pour le trouble de personnalité limite","authors":"Frédérique Delisle ,&nbsp;Maude Côté-Ouimet ,&nbsp;Jean Gagnon ,&nbsp;Lionel Cailhol","doi":"10.1016/j.amp.2025.06.008","DOIUrl":"10.1016/j.amp.2025.06.008","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Over the past decade, there has been growing recognition and investigation of neuropsychological impairments in BPD. These impairments have been linked to symptom severity, suicidal behavior, self-harm and treatment adherence. While current therapies for BPD have been linked with symptom reduction, research has shown that psychosocial functioning tends to remain impaired in BPD patients. Although it has not been extensively explored in BPD, research has demonstrated that impairments in psychosocial functioning can be linked to neuropsychological deficits. To our knowledge, there is no specialized intervention addressing these impairments for the BPD population. Therefore, cognitive remediation therapy (CRT) could present itself as a compelling alternative. Given this observation, researchers and clinicians from the Institut Universitaire de Santé Mentale de Montréal (IUSMM) worked on developing a CR intervention that would be specialised for BPD.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;The aim of this article is to describe the conceptual method and to outline the program designed.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methodology&lt;/h3&gt;&lt;div&gt;The development of the program followed phases 0 to 2 of the Medical Research Council (MRC) of the United Kingdom for complex interventions. Phase 0 consisted of a scoping review of the BPD neurocognitive profile and existing CR interventions, Phase 1 involved defining the components of the intervention through consultations with nine mental health professionals (psychiatrists, neuropsychologists and occupational therapists), and Phase 2 involved an exploratory clinical trial with five participants with BPD to assess the feasibility and acceptability of the intervention.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The results demonstrated the feasibility of the intervention for a group of 3 to 5 participants, with necessary adjustments (additions of examples, explanations, discussion questions). Although the dropout rate was high (40%), the intervention was shown to be acceptable with suggestions for improvement (addition of a session on impulsivity). The revised CR program is an 8-week intervention of 2-hour group sessions where participants identify goals, train their cognitive functions, receive psychoeducation, take part in group discussions, and learn coping strategies. Each week, participants put in practice a problem-solving strategy called Goal-Plan-Do-Check. It is a global cognitive strategy. A theme is addressed in each session, and participants are requested to identify a goal regarding the theme. In chronological order, the themes addressed are lifestyle habits, impulsivity, attention, memory, executive functions, motivation, and procrastination.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;The pilot study's positive findings on feasibility and acceptability pave the way for further research. This BPD-specific CR program, with its shorter duration and focus on both cognitive deficits and metacognitive","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"183 7","pages":"Pages 751-756"},"PeriodicalIF":0.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Le narcissisme malin : synthèse intégrative des connaissances conceptuelles, cliniques et empiriques et étude des liens avec la santé physique et psychologique","authors":"Jonathan Faucher ,&nbsp;Claudia Savard ,&nbsp;Dominick Gamache","doi":"10.1016/j.amp.2025.03.010","DOIUrl":"10.1016/j.amp.2025.03.010","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Goal&lt;/h3&gt;&lt;div&gt;Malignant narcissism is a personality disorder that has been extensively discussed in conceptual and clinical literature for decades. The syndrome is postulated to be both severe and extremely difficult to treat. In recent years, the notion of malignant narcissism has gained momentum in the popular discourse, and efforts at empirically studying the syndrome have been undertaken. This paper is organized in two parts. Part I is dedicated to an integrative synthesis of conceptual, clinical, and empirical literature on malignant narcissism, while Part II covers an empirical study on the associations between malignant narcissism, and physical and psychological health.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Part I&lt;/h3&gt;&lt;div&gt;Literature on malignant narcissism originated from the psychodynamic paradigm. Seminal writings on malignant narcissism highlight the underlying role of two intrapsychic structures and related processes: the grandiose self and an unintegrated superego. The observable manifestations of these underlying organizations are distributed across five dimensions: narcissism, psychopathy, aggression, sadism, and paranoia. Three measures relying on the dimensional model of personality disorders have been proposed to assess malignant narcissism. The first measure is the Composite Index of Malignant Narcissism, which relies on the Narcissism and Paranoid Proneness scales from the International Personality Disorder Examination, and the Fearless Dominance and Coldheartedness scales from the Psychopathic Personality Inventory-Revised. The second measure developed is a scoring procedure for malignant narcissism based on 11 of the 25 facets assessed in the Personality Inventory for DSM-5 selected through an expert consensus following a prototype matching approach. The third measure is based on the three scales from the Psychopathic Personality Inventory-Revised, Fearless Dominance, Coldheartedness, and Self-Centered Impulsivity, as well as the two scales of the Pathological Narcissism Inventory, Grandiose and Vulnerable Narcissism. The three measures showed promising results, although the Composite Index of Malignant Narcissism was introduced in a heuristic perspective and has yet to be thoroughly validated, while the index based on the Psychopathic Personality Inventory-Revised and the Pathological Narcissism Inventory was only validated in a small sample. In contrast, the scoring procedure for malignant narcissism based on the Personality Inventory for DSM-5 has been validated in large samples and has showed strong psychometric properties. Measures of malignant narcissism, especially the latter, have been used to empirically document the correlates of malignant narcissism. Research shows that the syndrome is linked to sociodemographic characteristics, personality functioning, and multiple psychological symptoms. Data also support the distinction between malignant narcissism and the closely related narcissistic personality disorder and psychopath","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"183 7","pages":"Pages 734-741"},"PeriodicalIF":0.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145044687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}