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Cette étude examine dans quelle mesure l'organisation de la personnalité et les pathologies du narcissisme prédisent la discontinuation de la psychothérapie pour 50 hommes reconnus coupables d'abus sexuels commis à l'endroit d'enfants. Les participants ont été recrutés dans une clinique externe du Centre Hospitalier Robert-Giffard (CHRG), où un programme de thérapie d'orientation cognitive/comportementale est offert. Vingt participants (40%) n'ont pas complété le programme. Les mesures utilisées incluent la version francophone du Personality Organization Diagnostic Form (PODF; Diguer et al, 2001), les échelles de Blatt et de ses collègues (1988; 1993) destinées à évaluer les représentations de soi et des autres, le Structured Clinical Interview for DSM-IV axis II disorders (SCID-II First et al., 1997) et une version française du State-Trait Anger Expression Inventory (STAXI; Spielberger, …

Anorexia is an eating disorder that often begins during adolescence. Most researchers and clinicians recognize the multifactorial etiology of this disorder and highlight the challenges related to its treatment. Individual psychotherapy remains the preferred mode of intervention with persons suffering from anorexia. The objective of this paper is to discuss various aspects of psychological assessment and intervention with teenage girls struggling with anorexia nervosa. Specifically, the article presents the diagnostic criteria, factors possibly associated with the development and maintenance of the disorder, the impact of anorexia on health, important issues to consider in psychological assessment and parents role in the process. Issues regarding the therapeutic relationship and clinical framework as well as guiding principles for intervention are discussed.

Keywords: anorexie, psychothérapie, évaluation, intervention, adolescentes, anorexia, psychotherapy, assessment, intervention, teenage girls

Children who have experienced early relational traumas present many challenges to interdisciplinary intervention, particularly because of their tendency to act-out their difficulties and their relational problems. The concept of mentalization, which refers to the ability to identify mental states in oneself and others, enriches the thinking of clinicians concerning these complex cases. Based on a clinical example, this article describes the general principles of mentalization-based interventions and their contribution to four treatment approaches: dyadic interventions, parental support meetings, individual psychotherapy and educational interventions.

Keywords: traumas relationnels précoces, interdisciplinarité, mentalisation, enfant, early relational traumas, interdisciplinarity, mentalization, children

SummaryBy means of a certain number of social issues relating to intervention in mental health, the author has elaborated a framework for analyzing the links between individual change and social change. These issues - the proliferation in the number of interventions, the social and ideological functions of the agents of intervention, professionalization, the market relationship, alternatives, and social classes - when applied to a work of critical analysis in mental health, Psychothérapies, attention1., permit us to isolate a social model of mental health/illness. In this model a predominantly social aetiology of mental health/ illness requires of necessity a type of intervention which is directed both at the individual and his environment. The author questions the applicability of such a model by proposing three working hypotheses on individual responsibility versus social responsibility in relation to mental health problems, on the links between theory and practice in mental health, and on the distinction between immediate and intermediary causes of mental health/illness.

AbstractThe prevalence of patients with borderline personality disorder in outpatient psychiatric clinics, the severity of their presenting symptoms including potential mortality and the difficulty to treat these poorly collaborative healthseekers are sufficient arguments to justify the need for a practice guideline about their treatment. Supported by a strong experience in the creation of many practice guidelines, the American Psychiatric Association has produced a guide that answers quite well to the scientific criteria of a treatment guide and respects most of the specified requirements emitted by the Canadian Medical Association and the Advisory Committee to Public Health Services of the American Institute of Medicine. A review of the suggested recommendations on psychotherapeutic and pharmacological treatments and their scientific evidence is given followed by comments and a critical discussion.

AbstractThis article examines the links between anxiety and early maladaptive schemas as elaborated by Young. These schemas have been divided in three categories : schemas that already include anxiety in their definition ; schemas that refer to a relational loss or crisis ; schemas linked to a potential loss of self-integrity. These three categories influence the expression of anxiety. The link between anxiety and schemas is not always clear and often require further clinical judgment. Finally, the schema focused approach appear to favor a better understanding of symptoms in the context of the individual's structural organization.

AbstractIn this paper, the authors present an overview of a range of psychoanalytic understandings of narcissistic pathology with an emphasis on the model and system of classification described by Kernberg. They discuss how the concept of a fundamental split between object relations dyads can contribute to major pathology of superego development and functioning and to the defensive establishment of the false grandiose self that are central to pathological narcissism. The authors also review therapeutic modifications that can help clinicians effectively treat patients with narcissistic pathology and describe distinctions in levels of narcissism that influence both how to approach treatment and prognosis.