The Time of the Infant, Parent-Infant Desynchronization and Attachment Disorganization, or How Long Does it Take for a Preventive Action to be Effective?

The classical version of early development by psychoanalysis has been largely challenged by developmental psychology, and particularly by attachment theory. Psychopathology appears to be much more linked with a sequence of events involving interpersonal relationship disorders rather than with intra psychic conflicts, as hypothesised by drive theory. Establishing synchrony between parent and infant is probably one of the major tasks of the first year of life. Attachment theory appears to be the modern paradigm to understand how the several types of answers from caregivers to stressing situations in the infant give way to different emotional and cognitive regulatory strategies, with impact on the effectiveness of the stress buffer systems. This paper presents what we can figure out about what is time to the infant, the importance of synchronization within infant and caregiver, the key concept of attachment disorganization, the concept of sustained social withdrawal as a defence mechanism and an alarm signal when synchronisation fails, and finally the key issue of conditions for effectiveness of early parent- infant preventive intervention.Parent- infant synchrony, Attachment Disorganization, Parenting, infant social withdrawal behaviour, early prevention and intervention

L'attachement de l'enfant placé en famille d'accueil et en institution

PARIS7-Xavier Bichat (751182101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Les Enfants de mères ayant des troubles du comportement alimentaire (revue de la littérature et réflexion sur le risque de transmission d'un trouble psychopathologique)

LYON1-BU Santé (693882101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Adoption et troubles psychiatriques pendant l'enfance et l'adolescence (une revue de la littérature)

PARIS7-Xavier Bichat (751182101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Apport de la théorie de l'attachement à la compréhension de la relation d'aide (illustration : liens entre le système d'Attachement et l'Alliance de travail, initiale et 4 mois plus tard, sur un échantillon de 130 sujets adultes recourant à une demande d'aide sociale)

PARIS-BIUSJ-Thèses (751052125) / SudocSudocFranceF

Retentissement de la grande prématurité sur le fonctionnement psychique maternel au cours de la période périnatale

PARIS7-Xavier Bichat (751182101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

La théorie de l'attachement, un nouveau modèle de compréhension de la psychopathologie de l'état limite

PARIS7-Xavier Bichat (751182101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

L'attachement insecure ambivalent (facteur de risque à l'émergence de la phobie scolaire à l'adolescence ?)

BESANCON-BU Médecine pharmacie (250562102) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Construction de l'alliance initiale avec les parents dans les prises en charge ambulatoires en pédopsychiatrie d'enfants de 2 à 5 ans

Devant la complexité d'engagement de certains parents dans la prise en charge de leur enfant en pédopsychiatrie, nous avons étudié la question de l'alliance avec les parents dans ce contexte.En considérant les concepts d'alliance avec la patient adulte et les différentes théorisations de l'alliance avec les parents, surtout en psychiatrie du bébé , nous proposons un concept d'alliance avec les parents pour les enfants de 2 à 5 ans, basé sur l'alliance de travail de Bordin : double lien avec le parent et l'enfant dans le parent, partenariat avec accord sur l'objectif et les tâches. Après avoir défini les rôles de l'alliance avec les parents, nous examinons les facteurs entrant en jeu dans la construction de l'alliance initiale, les éléments à évaluer lors du premier entretien et comment le clinicien peut favoriser cette construction. Nous illustrons enfin notre propos par quatre cas cliniques décrivant la co-construction de l'alliance avec les parents en début de prise en charge.Facing the difficult involvement of some parents in their child's infant mental health care, we studied the alliance with the parents in this particular context. Considering the concept of alliance with an adult patient and the different theories on the alliance with parents, especially in infant's psychiatry, we propose a concept of alliance with parents of 2-5 years odl children, baseed on Bordin's working alliance : double link with the parent and the child int the parent, partnership with agreement on goal and tasks. After defining the alliance with parent's roles, we study the factors involved in building the initial alliance, the elements to evaluate during the first session and the ways to propmote this construction of alliance with parents at the biginning of the care process.ST QUENTIN EN YVELINES-BU (782972101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Predictors of Study Attrition in a Randomized Controlled Trial Evaluating a Perinatal Home-Visiting Program with Mothers with Psychosocial Vulnerabilities.

Randomised controlled trials evaluating perinatal home-visiting programs are frequently confronted with the problem of high attrition rates. The aim of the present study is to identify predictors of study attrition in a trial evaluating a perinatal home-visiting program in France.CAPEDP is a French randomized trial comparing a perinatal home-visiting program using psychologists versus usual care (N = 440). The first assessment was at inclusion into the trial at the 27th week of pregnancy and the final assessment when the child reached the age of two. Attrition rates were calculated at 3 and 24 months postpartum. Stepwise logistic regression was used to identify predictors of early (between inclusion and 3 months postpartum) and later (between 3 and 24 months postpartum) attrition among social, psychological and parenting factors.Attrition rates were 17% and 63% at 3 and 24 months respectively. At 24 months, there was significantly more attrition in the control arm (70.6%) compared to the intervention arm (55.2%). Five independent predictors of early attrition were identified: having already had an abortion; having greater attachment insecurity as measured with the Vulnerable Attachment Style Questionnaire (VASQ); having lower global severity of psychiatric symptoms as assessed with the Symptom Check-List (SCL-90) at inclusion, being neither currently employed nor studying; and declaring no tobacco consumption during pregnancy. Being randomized into the control arm, having undergone early parental loss before age 11 and having lower global severity of psychiatric symptoms (SCL-90) at 3 months postpartum were the only variables associated with later attrition.This study provides key information for identifying mothers who may require specific support to avoid study attrition in trials evaluating a home-visiting program