Annales medico-psychologiques最新文献

{"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 , Yann le Corff , Claudia Savard","doi":"10.1016/j.amp.2025.04.009","DOIUrl":"10.1016/j.amp.2025.04.009","url":null,"abstract":"<div><h3>Introduction</h3><div>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 <em>Diagnostic and Statistical Manual of Mental Disorders</em> 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.</div></div><div><h3>Objective</h3><div>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.</div></div><div><h3>Method</h3><div>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":"Impact d’une formation francophone, internationale et en ligne sur le trouble de la personnalité","authors":"Lionel Cailhol ,&nbsp;Amaury Durpoix ,&nbsp;Simon Poirier ,&nbsp;Paco Prada ,&nbsp;Juliette Salles ,&nbsp;Sophie Slovak ,&nbsp;Antoine Yrondi","doi":"10.1016/j.amp.2024.12.003","DOIUrl":"10.1016/j.amp.2024.12.003","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Context&lt;/h3&gt;&lt;div&gt;While the prevalence of Borderline Personality Disorder (BPD) is high and it is characterized by significant severity, individuals affected often encounter obstacles to accessing effective care due to stigma in healthcare services. Training on the subject plays a crucial role in improving the competence of caregivers and changing their perception of individuals living with BPD. In this context, a team of professors developed an autonomous online training integrating testimonials from patient partners.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;To evaluate the satisfaction of participants in this training, as well as its impact on various domains (perception and understanding of BPD, impact on their practice).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and methods&lt;/h3&gt;&lt;div&gt;A cross-sectional study was conducted using two surveys among all students enrolled in an online course from January to September 2023. The first survey, conducted after the course, was gradually administered before the allocation of training credits, while the second, anonymous survey was distributed via the student forum, accessible to all enrolled students in September 2023, regardless of their stage of course completion. Sample 1, consisting of 32 respondents predominantly female (F/H ratio&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;3.3), mainly comprised physicians (42.8%) working in a hospital setting (39.0%) and frequently exposed to individuals living with BPD. Sample 2, with 44 respondents, mainly included participants who had partially completed the course (61.4%) and had not participated in synchronous sessions (70.4%), with no data on socio-demographic characteristics.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Sample 1, mainly composed of physicians working in hospital settings and frequently exposed to patients with BPD, reported an increase in their comfort with these patients after completing the online course, with high satisfaction both for the online format and the course length. Qualitative responses highlighted the integration of new therapeutic approaches, a better understanding of BPD, increased confidence in patient care, concrete changes in clinical practice, as well as improved emotional management and counter transference. Improvement suggestions included more in-depth content on comorbidities and therapies, aspects related to professional practice and external management, as well as particular attention to prevention and pharmacology. As for Sample 2, respondents’ satisfaction was high, emphasizing the expertise of the trainers, the variety of educational materials, the relevance and updating of the content, as well as the flexibility and accessibility of the course. Areas for improvement included lack of diversity of viewpoints, length and density of content, lack of associated resources and the ability to download course materials, as well as issues with audiovisual quality and use of sophisticated terms.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion and conclusion&lt;/h3&gt;&lt;div&gt;Partic","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"183 7","pages":"Pages 703-708"},"PeriodicalIF":0.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048029","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":"Contribution des formes de tristesse aux symptômes du trouble de personnalité borderline","authors":"Serge Lecours,&nbsp;Gabrielle Riopel","doi":"10.1016/j.amp.2025.02.010","DOIUrl":"10.1016/j.amp.2025.02.010","url":null,"abstract":"&lt;div&gt;&lt;div&gt;Painful dysphoric affects are an important part of the phenomenology of individuals suffering from borderline personality disorder (BPD). Previous research has distinguished this dysphoria from major depression, underlining its relational, hostility-laden, and undifferentiated nature. We have previously noted that the processing of loss was absent from BPD individuals’ discussion of sadness-laden interactions and that lower levels of mentalization of sadness were strongly associated with BPD traits.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;We wish to pursue our exploration of painful depressive affects in BPD by framing the definition of dysphoria in terms of differing qualities of sadness or, in other words, differing levels of mentalization of sadness. We conceptualize BPD as presenting both high levels of poorly mentalized sadness and low levels of well-mentalized sadness. Stated differently, a greater experience of psychic pain at a psychic equivalence level, combined with a lack of mentalized or mentalizing sadness (or a lack of adaptive sadness, or the capacity to mourn).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;To test this hypothesis, 208 undergraduate students (mean age: 22.4; 87.5% female) completed two online questionnaires: the Forms of Sadness Questionnaire (FSQ) and the McLean Screening Instrument for BPD (MSI-BPD). The FSQ assesses two forms/qualities, or levels of mentalization, of sadness: pathological sadness (here, self-critical sadness) and adaptive sadness (here, tolerated sadness). Correlations and hierarchical regression analysis were conducted.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Correlations indicate that the number of self-reported BPD criteria is more strongly associated with self-critical sadness (pathological or less mentalized sadness: &lt;em&gt;r&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.51**, large effect size) and also, but less strongly, with tolerated sadness (adaptive or mentalized sadness: &lt;em&gt;r&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;–0.35**, medium effect size). A hierarchical regression analysis was computed in order to assess the unique contribution of pathological and adaptive sadness on the prediction of BPD traits, over and above the contribution of the potential confounding variables of sex and age. Results indicate that both forms of sadness, as well as age, predict self-reported BPD traits. The strongest predictor is pathological, or less mentalized, sadness.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;The findings give an indirect indication that BPD dysphoria is composed of at least two types of subjective “depressive” or dysphoric experiences: mostly a type of suffering or sadness that is subjectively recognized through the perception of difficult to tolerate forms of mental pain; and also, a lack of a form of subjectively tolerable sadness, felt as productive. Since adaptive sadness contributes to BPD traits while the contribution of pathological sadness is statistically removed, the findings indicate that adaptive sadness is not reduc","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"183 7","pages":"Pages 729-733"},"PeriodicalIF":0.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048141","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":"« Good Psychiatric Management » pour le trouble de la personnalité borderline dans le cadre du soutien à l’emploi : étude de cas multiples sur l’expérience des clients","authors":"Noëllie Dunand ,&nbsp;Philippe Golay ,&nbsp;Charles Bonsack ,&nbsp;Danièle Spagnoli ,&nbsp;Valentino Pomini","doi":"10.1016/j.amp.2025.03.007","DOIUrl":"10.1016/j.amp.2025.03.007","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Context&lt;/h3&gt;&lt;div&gt;People with borderline personality disorder (BPD) often present occupational issues, such as impulsivity, conflicts in the workplace, dismissals and unemployment. Several psychosocial programs have been recently developed to tackle this issue but need more evidence for their value, and require rather a lot of resources for implementation. The Individual Placement and Support (IPS) model of supported employment has shown its international effectiveness in professionally reintegrating people with severe mental illness, and is well established throughout the world. This model responds to a principle of zero exclusion regarding any kind of disorders if they are being treated. However, its value for individuals with BPD remains largely understudied. IPS job coaches find it difficult to deal with people with this disorder and could benefit from an additional feature to help them in this sense. Good Psychiatric Management (GPM) for BPD, an evidence-based therapeutic method, applicable in any psychiatric setting, could be a solution for easing job coaches’ practices and reaching more satisfying results for clients. A one-day training is enough to show a change in healthcare attitudes towards BPD. In a previous study, IPS teams seemed to find this additional feature valuable and feasible.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;The aim of this multiple case study was to explore clients’ experiences of the IPS intervention with GPM-trained job coaches.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Material and Methods&lt;/h3&gt;&lt;div&gt;IPS practitioners of the RESSORT unit of the Community Psychiatry Ward of Lausanne University Hospital and the Nant Foundation, Vaud, Switzerland, were trained in GPM in January 2022. Six of their BPD clients took part in research interviews, around 9 months later, addressing their experience and opinion about the intervention. An abductive content analysis was conducted, using the characteristics of an efficient GPM intervention as a theoretical background to classify elements that were or were not fitting GPM success. In parallel, quantitative data from these clients, including their professional path during the intervention, and questionnaires for non-vocational outcomes, were collected at three time points, when they entered the study, 3 months and 9 months later. Their evolution through time was analysed descriptively and linked to their discourse.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Service users were globally satisfied with the intervention, built a certain level of stability and an alliance with their job coach, and would recommend participating in the program. Job coaches seem to have adopted the main GPM principles. Judging by the discourse and evolution of the participants, the intervention seemed to help them in their recovery and professional goals. Most of them had a stable or improving symptoms level and found an activity at post-test.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;These results also suggest some additional ","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"183 7","pages":"Pages 742-750"},"PeriodicalIF":0.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048142","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}

{"title":"Fonctionnement conjugal et sexuel des personnes souffrant de troubles de la personnalité : survol des connaissances actuelles impliquant le Modèle alternatif pour les troubles de la personnalité","authors":"Mélissa Deschênes ,&nbsp;Charlotte Bouchard Asselin ,&nbsp;Élodie Gagné-Pomerleau ,&nbsp;Dominick Gamache ,&nbsp;Marie-Chloé Nolin ,&nbsp;Marie-Pier Vaillancourt-Morel ,&nbsp;Claudia Savard","doi":"10.1016/j.amp.2025.03.011","DOIUrl":"10.1016/j.amp.2025.03.011","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Individuals with personality disorder (PD) face numerous challenges, particularly in their interpersonal relationships. Issues frequently encountered include difficulties in establishing lasting intimate relationships, rapid cycles of breakup and reconciliation, infidelity, intimate partner violence, sexual distress, and risky sexual behaviors. Introduced in 2013 in the DSM-5, the Alternative Model for Personality Disorders (AMPD) provides a theoretical framework that combines dimensional and categorical approaches, based on growing empirical and clinical support. This model considers the severity of personality difficulties (Criterion A), describing self (including Identity and Self-direction elements) and interpersonal (including the elements of Empathy and Intimacy) impairment. Criterion B of the AMPD details 25 specific pathological personality facets regrouped into five domains: Negative Affectivity, Detachment, Antagonism, Disinhibition, and Psychoticism. The PD conceptualization of this model makes it a promising perspective to improve our understanding of the intimate and sexual issues of people with PD.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;This brief review aims to describe the contribution of the AMPD to the understanding of relationship functioning (including relationship satisfaction and intimate partner violence), as well as sexual functioning (including sexual distress, sexual satisfaction, and sexual function). A literature review involving the aforementioned areas of functioning and the AMPD across various samples was conducted.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Various personality components appeared to be involved in relationship and sexual functioning. Personality pathology, regardless of its nature, seems negatively associated with relationship satisfaction, but pathology of the Detachment domain seems particularly consistent across studies. As for intimate partner violence, in addition to an elevation of the Hostility facet (Negative affectivity) and the Detachment domain, a more disinhibited profile appears to be particularly associated with violence perpetration in men, while women may have a profile of traits that is more antagonistic. For sexual health, a single listed study showed that personality, as conceptualized by the AMPD, predicts sexual health beyond factors such as distress and relationship satisfaction, with specific personality domains and facets contributing to sexual satisfaction or distress across genders. Women with an elevation in the Detachment domain suffer more from sexual functioning issues, while for men, several facets from different AMPD domains contributed to lower sexual functioning, namely Separation Insecurity, Intimacy avoidance, and Anhedonia. Additionally, unexpected positive effects of personality pathology were found in men. In fact, it seems that Intimacy impairment, Rigid perfectionism, and Irresponsibility are related positively to particular aspects of","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"183 7","pages":"Pages 709-714"},"PeriodicalIF":0.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048043","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":"Thérapie cognitivo-comportementale pour l’insomnie chez des adultes souffrant d’un trouble de la personnalité du groupe B et d’insomnie : une étude de faisabilité (étude INSOPERSO)","authors":"Laurent St-Pierre ,&nbsp;Ann Julie Huberdeau ,&nbsp;Félix-Antoine Bérubé ,&nbsp;Annie Vallières ,&nbsp;Célyne Bastien ,&nbsp;Laurie-Anne Côté ,&nbsp;Alexandre Hudon ,&nbsp;Annabelle Bissonnette ,&nbsp;Lionel Cailhol","doi":"10.1016/j.amp.2025.06.005","DOIUrl":"10.1016/j.amp.2025.06.005","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Insomnia is highly prevalent among individuals with Group B personality disorders (GBPD). Cognitive-behavioral therapy for insomnia (CBT-I) is the most recommended treatment for chronic insomnia; however, no study has examined this approach in patients with GBPD. This study aimed to assess the feasibility of a CBT-I program for this patient population, focusing on acceptability, gathering preliminary measures of effectiveness, and collecting participant experiences to enhance treatment.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;This pilot study employs a mixed methods design without a control group. Twenty-two adult participants diagnosed with GBPD and experiencing insomnia were recruited from a specialized program for personality disorders. The four-session CBT-I program was specifically designed for patients with GBPD to enhance treatment retention and therapeutic response. Quantitative measures included recruitment and retention rates and self-administered questionnaires assessing insomnia and comorbidities, collected before, during and three months after treatment. &lt;em&gt;Per protocol&lt;/em&gt; and intention-to-treat analyses were conducted on data from these questionnaires. Qualitative data were gathered through group discussions and semi-structured interviews, and the qualitative data were analyzed using thematic content analysis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Twenty-two participants were recruited, with an initial goal of 24. The treatment retention rate was 45%. Among the eight participants who completed the study &lt;em&gt;as intended&lt;/em&gt;, a significant reduction in insomnia (−9 points on the ISI), depression (−6 points on the PHQ-9), and anxiety (−3.6 on the GAD-7) was observed from the time of inclusion to three months post-therapy. In discussions about the collection of qualitative data, six main themes were identified among four participants: content, functioning, therapist, group format, therapy effect, and factors influencing motivation,&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;The retention rate achieved is lower than what is found in the literature. Factors impacting motivation, such as momentum, external influences on therapy, and group dynamics, are identified. The initial measures of therapy effectiveness align with the literature, indicating a reduction of about 50% in the ISI at three months. The ISI score declined after therapy concluded, in line with participants’ perception of having the tools to enhance their sleep further.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;This is the first pilot project evaluating a CBT-I program for Group B personality disorder patients. It has shown that a short-duration group CBT-I protocol for this clientele is feasible but not entirely acceptable. The low retention rate observed suggests a need for reflection to enhance acceptability, particularly regarding the recruitment process and individual support. Moreover, the preliminary results regarding clinical outcomes are prom","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"183 7","pages":"Pages 757-764"},"PeriodicalIF":0.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048616","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}