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Résumé Première femme médecin-psychiatre à avoir eu, bien avant les années 1920, une expérience et un contact direct avec l’institution psychiatrique à Vienne, puis à Berlin, Helene Deutsch a ensuite entrepris une formation psychanalytique suivie de fonctions psychanalytiques institutionnelles à Vienne, puis – à partir des années 1934 – à Boston. Elle a produit une œuvre riche et controversée qui anime encore les débats sur le féminin, la personnalité, la maternité, l’érotisme dans la psychanalyse et la sociologie contemporaines. First woman who as psychiatric practitioner before 1920, Helene Deutsch began her career in psychiatric institution in Vienne and Berlin. She trained further in psychoanalysis first in Vienne, and in Boston. She also developed formal training for therapists and analysts. She also wrote several famous papers on female sexuality and about women's psychology. [ABSTRACT FROM AUTHOR]

Résumé Objectifs En venant compléter deux publications relatives à l’enquête Hepaig-quali, l’une consacrée à la sexualité et l’autre à l’usage de drogues, cet article s’intéresse à la dimension psychodynamique des récits recueillis auprès d’homosexuels masculins séropositifs pour le VIH. L’enquête Hepaig-quali constitue l’un des volets de l’étude épidémiologique Hepaig, portant sur les « hépatites aiguës C chez des homosexuels atteints par le VIH », coordonnée par l’Institut de veille sanitaire (France). En complément de résultats recueillis par questionnaire, et à partir du point focal de « l’événement hépatite C », l’objectif de ce volet qualitatif visait à recueillir des récits de pratiques relatifs à la sexualité et à l’usage de drogues, à connaître les motivations de tels choix et à les replacer dans la trame biographique des sujets, à détailler les événements survenus dans leurs parcours de soins et à explorer les représentations relatives à leur santé physique et psychique. Méthode L’enquête repose sur la réalisation de deux entretiens successifs réalisés auprès de 31 hommes, initialement inclus dans l’étude Hepaig. Ces entretiens, intégralement retranscrits, ont fait l’objet d’une double lecture, psychodynamique et sociologique, selon une posture épistémologique se référant à une approche compréhensive des comportements. Résultats Cet article s’intéresse spécifiquement à la santé psychique des enquêtés et à la dimension psychodynamique de leurs récits. Bien que les entretiens, réalisés par le sociologue, ne soient pas l’équivalent de « cas cliniques », les enjeux psychiques y sont très présents. Les répondants évoquent, avec leurs mots, leurs expériences du stress, de la « déprime » et évoquent pour certains leurs idées suicidaires. Ils abordent en majorité leurs pratiques, et les motivent selon un discours de recherche de jouissance et de maîtrise rationnelle des risques. Discussion À bien des égards, les enquêtés apparaissent comme des « hommes ordinaires », notamment du point de vue de leur socialisation sexuée et de leur représentation du risque. Leur spécificité du point de vue de la santé psychique tiendrait à leur expérience des discriminations et à leur vécu d’une maladie chronique. En exprimant une tension permanente entre pulsion et raison, entre recherche de jouissance et besoin de maîtrise de leur vie, ils présentent les caractéristiques de l’individu hypermoderne dont les contradictions se révèlent dans le rapport à l’autre. Conclusion Les enquêtés, bien informés, adhèrent au discours médical positif des soignants, qui les soutient psychiquement face au poids de morbidité des infections par le VIH et le VHC. L’évolution des cultures sexuelles se traduit, pour ces hommes, par un rejet de la norme du préservatif et par l’adoption de pratiques décrites comme plus satisfaisantes, mais pouvant comporter des risques accrus. Leurs comportements sont toutefois régis par d’autres dimensions que la connaissance et la rationalité. La recherche de jouissance ne s’embarrasse pas toujours des freins et des empêchements que la raison imposerait. Cela devrait conduire les soignants à mieux entendre et accompagner les efforts de réduction des risques de leurs patients. Objectives This paper focuses on the psychodynamic dimension of narratives collected in interviews carried out with HIV-positive gay men, and completes two previous publications concerning the Hepaig-quali study, one centred on sexuality and the other on drug use. The Hepaig-quali study was part of the Hepaig epidemiological survey on acute hepatitis C among HIV-infected gay men, coordinated by the Institut de Veille Sanitaire (InVS, France). In addition to the results gathered from questionnaires, and with a focus on the “hepatitis C event”, the present study aimed to describe sexual practices and drug use among HCV-infected gay men, to assess the motivations of these choices, to position them in relation to their life histories and healthcare experiences, and to explore how they viewed their physical and mental health. Methodology Our study was based on two successive in-depth interviews with 31 men previously included in the Hepaig survey. These interviews, conducted by a sociologist, were fully transcribed, and analysed from a dual psychodynamic and sociological viewpoint, an epistemological stance related to the comprehensive approach to behaviours. Results Thirty-one men were included in this qualitative study. We focused specifically on the mental health of the respondents and the psychodynamic dimension of their narratives. Despite the fact that these interviews were not equivalent to “clinical cases”, psychic issues were very much present. In their own words, the respondents talked of their experiences of stress and depression, and some mentioned suicidal ideations. Most talked readily about their practices and explained them via discourse on achieving pleasure, alongside the rational control of risks. Discussion In many respects, the respondents appeared as “ordinary men”, in particular with respect to their gendered socialisation and their representations of the risks. From a mental health perspective, some specificities were linked to the experiences of discrimination and chronic illness. With the permanent tension between impulse and reason, between the search for pleasure and the need to control their lives, they present the characteristics of the hypermodern individual whose contradictions are revealed in their relationship with the other. Conclusion Accurately informed, the respondents also embraced the positivist medical discourse of their caregivers, which provides them with support and helps them to face the burden of HIV and HCV infections. The evolution of gay sexual culture leads these men, via the rejection of the “condom norm”, to choose practices described as more satisfying, but entailing greater risks. Nevertheless, as with any topic, their behaviours are regulated by other dimensions than knowledge and rationality. The search for pleasure is not always restrained by the hindrance and impediments of reason. This should lead caregivers to better understand and support the efforts that their patients make to reduce risks. [ABSTRACT FROM AUTHOR]

Résumé La fin du xix e siècle a été marquée à Paris par de nombreux suicides, dont une série de suicides familiaux (parents + enfants) attribués à la misère. Il s’agissait soit d’un dénuement total, soit de revers de fortune, soit de situations plus complexes. Depuis 1836, la catégorie « misère/revers de fortune » était répertoriée par la Justice comme l’un des motifs présumés du suicide. Malgré la réalité de la misère de masse qui sévissait à Paris, le phénomène suicide ne saurait s’y résoudre et, sauf à accepter un sociologisme primaire, des facteurs de psychopathologie individuelle et un état dépressif au moment de l’acte étaient, et restent, nécessairement présents. Late Nineteenth-Century Paris saw a spate of suicides, including a series of family suicides, i.e. suicides of parents and children, which have been attributed to poverty. “Poverty” in this context can refer to utter destitution, a reversal of fortune, or, in some cases, a more complex set of economic factors. In 1836, the authorities had introduced “poverty/reversal of fortune” as one of the categories of motives used to classify individual cases of suicide. In spite of the fact that poverty was indeed widespread in Paris, reducing suicide to poverty makes for crude sociologizing and ignores constants such as individual psychopathology and the occurrence of a depressed mood at the time of suicidal acts. [ABSTRACT FROM AUTHOR]

Résumé L’épidémiologie, les facteurs de risque et la base biologique de comportements suicidaires ont été l’objet d’une recherche croissante au cours des trois dernières décennies. Pendant cette période, les chercheurs du monde entier ont identifié des biomarqueurs potentiels de risque et développé plusieurs théories sur les mécanismes conduisant à un comportement suicidaire. Cependant, l’absence d’une terminologie commune, d’instruments valides et de coopération plus intensive a été un obstacle au progrès. Aujourd’hui, la communauté a établi les bases de cette collaboration, et des données provenant d’études neuroscientifiques peuvent déjà être appliquées au domaine de la suicidologie. Nous présentons ici une sémiologie basée sur les données actuelles provenant des études biologiques, cliniques et de neuroimagerie. Au-delà de l’idéation et des signes et de menace suicidaires, les caractéristiques cliniques liées au risque de suicide et révélées par des études neuroscientifiques comprennent : l’impulsivité agressive, le désespoir, des signes « silencieux » comme la consommation élevée d’Internet, les comportements sédentaires et le temps de sommeil réduit, la sensibilité accrue à l’exclusion sociale, la diminution de la sensibilité pour détecter le soutien social, les problèmes interpersonnels liés aux déficits de prise de décision, les difficultés à réguler les états émotionnels négatifs, la propension à percevoir la douleur psychique et physique et également la consommation de traitements opiacés. Améliorer l’évaluation permettra également de proposer de nouvelles cibles pour la prévention du suicide. Les protocoles standardisés d’évaluation, la continuité des soins, l’implication de la famille/aidants, l’atténuation de la douleur psychologique et sociale : à court terme, ces objectifs nous attendent pour le bien de nos patients. The epidemiology, risk factors and biological basis of suicidal behaviors have been the object of an ever-increasing research in the last three decades. During this period, researchers all over the world have identified potential biomarkers of risk and developed several theories about the mechanisms leading to suicidal behavior. However, the lack of common terminology, instruments and cooperation has been a major deterrent. Today, the community has established the bases for this collaboration and evidence coming from neuroscientific studies can already be applied to the field of suicidology. We present here a potential semiology based on current evidence coming from biological, clinical and neuroimaging studies. Besides suicidal ideation and warning signs, the clinical features related to suicide risk and revealed by neuroscientific studies include notably: impulsive-aggression and hopelessness as well as high web consumption, sedentary behaviors and reduced sleep time, an enhanced sensibility to social exclusion and loneliness, a decreased sensitivity to detect social support, interpersonal problems related to decision making impairments, difficulties to regulate negative emotional states, a propensity to perceive psychic and also physical pain and to receive opiates treatments. Improving the assessment will also open new targets for suicide prevention. In the short term some of these targets await us: standard protocols for evaluation of risk, healthcare continuity, implication of the family/caregivers, mitigation of social or psychological pain. [ABSTRACT FROM AUTHOR]

Résumé L’accroissement des actes de terrorisme commis en Europe par l’« État islamique » entraîne la communauté des sciences humaines à contribuer à la connaissance psychologique et à la réflexion sur la prise en charge des personnes parties combattre en Syrie. Cette publication a pour objectif d’illustrer des apports de la littérature scientifique internationale par une analyse thématique (biographie, relation à la religion, motivations du départ en Syrie…) de 12 cas de jeunes djihadistes français partis combattre en Syrie. Ces réflexions permettent de dégager des pistes en matière d’élaboration de profils cliniques et d’évaluation de leur risque de passage à l’acte et de violence. Objectives The growth of terrorism of the Islamic State in Europe leads the Human Sciences community to contribute to the psychological knowledge and the reconsideration of management of individuals who went to fight in Syria. This publication aims to illustrate the contributions of the international scientific literature by a thematic analysis (biography, the relation to the religion, the motivations of the departure in Syria) of 12 cases of young French jihadists who went to fight in Syria. Patients The French jihadists were encountered in psychological expertise while they were in custody for criminal association made for the commission of offenses of a terrorist nature. Materials and methods Two separate interviews were conducted with each young man, combining active listening techniques to confrontation techniques speech to the evidence collected in the investigation files. Results One can speculate that these young people who face a lack of transmission of cultural and religious values have chosen to over-invest in the religious sphere in a movement of omnipotence. For some, adolescence was also a period of entry into delinquency, consisting of robberies, fights and trafficking, including drugs. These delinquent behaviors can also be trivialized by some. If they all manifest the wish to structure their love life, they seem to have experienced setbacks, some already divorced, most already have two young children. For most people interviewed, schooling was marked by difficulties and failures. We observed an early school leaving. None of the people interviewed seem to have actually invested their professional live. We observed high variability criminal record but also for religious motives. Some showed only partial perception and utility of religion, while others adhered to the rigoristic religious beliefs. In all interviewees, the desire to fight in Syria was, according to them, motivated by the need of helping the Syrian people victim of Bashar al-Assad regime. For most of them, the lack of safe everyday anchor would germinate the decision to go to Syria as part of a headlong rush of a disappointment in love or feeling empty. Internet played a fundamental role in the decision to go to Syria. Belief in obtaining recognition and a special status, due to support for the Syrian population, have also played an important role. They said that all derive from their experience in Syria, frustration and disappointment, in view of their hope to contribute to the fight for the benefit of the Syrian people. They would each be trained in weapons handlings. It is also important to note that most young people met were able to present an ability to adapt to the expectations of his interlocutor, to hide an emotional state and rationalize motivations. The elements obtained through clinical interviews with persons accused in connection with a “criminal association for the commission of a terrorist related offense” have allowed to highlight three specific “profiles” which we can describe the salient aspects of their personality: The “ambitious offender”, the “converted preacher” and the “connected criminal”. These clinical descriptions also allow to propose reflections on the assessment of the risk of violence and acting out among jihadists returning from Syria. Conclusions Specific questions on their ability to concealment are the major issue for psychological evaluation. The aim is to identify the authentic “repentant” one (already involved in a deradicalization process) from the “sleeping agent” (who is still committed in islamist networks and can provide a possible reactivation in a violent action). [ABSTRACT FROM AUTHOR]

Résumé Objectif La création à la fin des années 1990 de la catégorie d’état mental à risque pour caractériser des présentations cliniques susceptibles d’évoluer à échéance de quelques mois vers la psychose est à l’origine d’une nouvelle psychiatrie du jeune adulte, organisée notamment autour du dépistage et de la prise en charge de ces états. Cet article analyse les attentes et les promesses de cette nouvelle psychiatrie. Méthode L’article mobilise une approche de sociologie de la connaissance mettant en évidence les intérêts, les contextes institutionnels et les pratiques qui contribuent à façonner les savoirs et catégories psychiatriques ainsi que les débats que ces savoirs et catégories font naître. Résultats Les débats et recherches sur les états mentaux à risque au cours des vingt dernières années ont considérablement fait évoluer la vision des cliniciens sur cette catégorie. Les difficultés à stabiliser le risque de transition psychotique chez les patients concernés ont amené les promoteurs de cette catégorie à en proposer une interprétation nouvelle : sans être le signe nécessairement d’une évolution vers la psychose, les états mentaux à risque seraient indicatifs d’un devenir pathologique à la fois ouvert dans ses développements et certain dans son accomplissement. La communauté psychiatrique est divisée entre deux façons d’aborder ces résultats : affiner la catégorie pour la rendre réellement prédictive ou en faire le point de départ d’une nouvelle stratégie de santé publique orientée vers la santé mentale du jeune adulte. Discussion Les états mentaux à risque sont à l’origine d’une clinique de l’attente paradoxale caractérisée par l’indétermination des perspectives et des promesses qui y sont attachées. C’est cette indétermination qui pourrait expliquer son succès auprès d’un large ensemble d’acteurs issus de la clinique, de la recherche et de la politique aux intérêts divers. Conclusion Une meilleure compréhension des dynamiques d’innovation et de réforme en psychiatrie devrait prêter attention aux conditions sociales des promesses psychiatriques. Objective The category of “at-risk” mental states was created during the second half of the 1990s to characterize clinical presentations that were liable to evolve into psychosis within months. At-risk mental states are at the center of a new psychiatry among young adults. This article examines the expectations and promises of this form of psychiatry. Methods This article uses an approach based on the sociology of knowledge, highlighting the interests, the institutional contexts and the practices that contribute to shaping psychiatric knowledge and categories, as well as the debates generated by this knowledge and these categories. Results Over the last twenty years, debates on at-risk mental states have resulted in a shift in the way clinicians understand this category. The difficulty in stabilizing the risk of transition to psychosis among patients concerned has led proponents of this category to argue for a new interpretation: without being necessarily the sign of a transition towards psychosis, at-risk mental states could point to a pathological outcome that remains open as to its development, and certain as to its endpoint. Two different approaches towards these issues have emerged within the psychiatric community: the first seeks to refine the at-risk category to make it a truly predictive category, the second to use it as the starting-point for a new public health strategy aiming to improve mental health among young adults. Discussion At-risk mental states create a paradoxical clinical area of expectation, characterized by the indeterminacy of its perspectives and promises. This indeterminacy could explain its success among a wide array of people with diverse interests from clinical, research and public policy circles. Conclusion A better understanding of the dynamics of innovation and reform in psychiatry could be gained from paying more attention to the social underpinnings of psychiatric promise. [ABSTRACT FROM AUTHOR]

Résumé Dans une précédente communication (Luauté, 2014), nous avons montré qu’une conception dominante en France soutenait l’existence d’un lien direct entre conditions actuelles de travail et suicide au travail. Outre le choix du lieu, des mises en accusations précises de la part des suicidés tendent à confirmer la signification protestataire de ces actes. Ceux-ci sont à rapprocher des modèles de « suicide vengeance » et de « suicide sacrifice » issus d’une tradition extrême-orientale de la mort volontaire. L’absence de tout facteur de psychopathologie individuelle est chaque fois subsumée. Récupéré comme un mode majeur d’expression politique, le suicide au travail mérite aussi d’être questionné comme une forme insidieuse de terrorisme. En tant que phénomènes spectaculaires, les suicides au travail et le terrorisme actuel ne se conçoivent pas sans le rôle des médias. In a previous paper (Luauté, 2014), we have shown that a prevailing view in France advocates the existence of a direct link between the current conditions of work and work-related suicide. In addition to the choice of the whereabouts, specific accusations by those who commit suicide, tend sometimes to confirm the protesting signification of their action. Therefore, they can be regarded as modes of revenge and sacrifice closely patterned on far-eastern traditions of voluntary death. In each time, the lack of an individual psychopathological factor is subsumed. Having recourse to suicide is now viewed as a major mode of political expression which deserves to be considered as an insidious form of terrorism. At-work suicides as spectacular phenomena, as well as present days’ acts of terrorism, are inconceivable without the role of mass media in our societies. [ABSTRACT FROM AUTHOR]

Résumé Parmi les traits de personnalité, les traits de personnalité narcissique semblent devenir plus fréquents ; ceci est renforcé par des caractères mis en valeur par les médias ou les émissions de téléréalité. L’étude des traits narcissiques des étudiants qui intègrent les grandes universités américaines montre une majoration des aspects narcissiques au fil des ans. Objectif Il vise à étudier les différences intergénérationnelles des traits narcissiques en utilisant l’inventaire de personnalité narcissique à 16 items : NPI 16. Méthode Il s’agit d’une étude « boule de neige » ; elle utilise les réseaux sociaux ; le NPI 16 est envoyé à une population de sujets de 20 à 30 ans ; ils doivent le compléter et proposer ce questionnaire à au moins un de leurs proches de la génération supérieure, c’est-à-dire âgé de 55 à 70 ans. Résultats Cent vingt et un sujets, d’âge moyen 26 ans, composent la génération des sujets jeunes, 74 sujets, d’âge moyen 60 ans, composent la génération supérieure. Ce sont les hommes de plus de 60 ans ayant un niveau d’étude supérieur de type « doctorat » qui ont les scores traits narcissiques les plus élevés. Discussion Outre le biais de recrutement qui privilégie un milieu universitaire et des sujets familiarisés avec l’outil informatique, cette étude montre que les traits narcissiques peuvent être différents selon les générations. Le fait que les hommes soient plus exposés peut témoigner d’une forme de sélection des traits de personnalité utiles à la progression dans l’échelle des carrières. Les études ultérieures sur des échantillons plus larges et d’origine sociale plus diversifiée permettront de mieux approfondir ce phénomène. Among the traits of personality, narcissistic personality traits appear to become more frequent, this is reinforced by characters highlighted by the media or TV reality shows. The study of narcissistic traits of students who integrate the large universities of the United States shows an increase of narcissistic aspects over the years. Objective It aims to study the inter-generational differences of the narcissistic traits using 16 items narcissistic personality inventory: NPI 16. Method It is a study “snowball”; it uses social networks; NPI 16 is sent to a population of subjects of 20 to 30 years and they must complete and propose this questionnaire to at least one of their relatives of the higher generation or age 55 to 70 years. Results One hundred and twenty-one subjects, average age 26 years, make up the generation of young subjects, 74 topics, and average age 60, composed the greater generation. These are men over 60 years with a higher level of study of type “PhD” who has narcissistic traits scores the higher. Discussion In addition to recruitment bias, which promotes an academic environment and familiar subjects with computer tools, this study shows that the narcissistic traits can be different according to generations. The fact that men are more exposed may reflect a form of selection of personality traits relevant to the progression in the career ladder. Subsequent studies on larger samples and more diversified social origin will allow better to deepen this phenomenon. [ABSTRACT FROM AUTHOR]

Résumé: Le but de cette étude, rappelons-le, n’a pas été de formuler une opinion sur la validité des classifications psychiatriques existantes, mais d’attirer l’attention sur diverses causes d’erreur qui ont pu influencer les efforts des classificateurs. Certains, partis d’une notion incomplète de la nature de la classification, ont voulu la faire exclusivement d’après les besoins pratiques immédiats, ou d’après des conceptions abstraites. D’autres y ont projeté inconsciemment des contenus schématiques d’ordre numérique, linguistique, sociologue, ou empruntés à des courants intellectuels contemporains. D’autres enfin ont peut-être suivi un dynamisme personnel inconscient qui les a amenés à satisfaire des tendances affectives inconscientes ou à résoudre leurs problèmes par procuration. [ABSTRACT FROM AUTHOR]

Résumé: En Tunisie, le don de sang est volontaire, anonyme et bénévole. L’objectif de notre travail est d’étudier les motivations et la sociologie des donneurs de sang (DDS). L’étude a concerné 903 DDS tunisiens ayant donné leur sang au CRTS de Sfax (entre 14 mai 2007 et 23 juin 2007). Les DDS ont été interrogés selon un modèle de questionnaire rempli lors de l’entretien médical prédon. Les donneurs étaient de sexe masculin dans 81,8 % et avaient un âge moyen de 34,2ans avec une prédominance de la tranche 18–29ans. La classe sociale moyenne était majoritaire (77,8 %) ainsi que la profession libérale (65,1 %). Les niveaux d’instruction primaire et secondaire étaient prédominants (79,3 %). Parmi les donneurs de sang, 41,6 % étaient des nouveaux donneurs et 28,6 % avaient un historique d’un seul don, 50,3 % étaient volontaires et 49,7 % de compensation. Les raisons motivant le don volontaire ont été la solidarité (69,9 %), la religion (21,2 %), le bénéfice pour la santé (3,6 %) et l’assurance pour la famille (5,2 %). Les donneurs de compensation refusent le don volontaire pour des raisons non évidentes (51 %), par manque de disponibilité (13,3 %), pour difficultés d’accessibilité des sites de collecte (7,6 %), par phobie du sang et des piqûres (4,02 %) ou par refus du don de sang (1,79 %). L’information et la sensibilisation des donneurs de sang de compensation pourraient changer dans un avenir proche leurs attitudes pour devenir des donneurs volontaires et réguliers. L’implication des associations des DDS dans l’organisation des collectes et la promotion du don de sang seraient d’un apport considérable. [ABSTRACT FROM AUTHOR]

Résumé: Dans un premier temps, l’article a pour objectif d’exposer et de critiquer les recherches internationales en sociologie et en psychologie portant sur le problème des prises de risque sexuel liées au VIH chez les homosexuels masculins. Partant du cas de la France, les chiffres de l’épidémiologie indiquent en effet qu’en dépit de l’information dont ils disposent sur les modalités de contamination par le VIH et les règles de prévention, certains homosexuels ne se protègent pas systématiquement de cette maladie sexuellement transmissible. Le taux de prévalence du VIH étant chez les gays près de 120 fois plus élevé que chez les hétérosexuels, cet échec relatif de la prévention est un enjeu majeur du domaine de la santé publique. L’article distingue dans les recherches qui tentent d’expliquer ces prises de risque celles qui fondent leurs méthodologies sur des questionnaires préétablis passés à des cohortes d’individus et traités par la statistique, de celles qui a contrario permettent aux répondants des enquêtes de détailler leurs vécus subjectifs de manière plus particularisée. Du point de vue de l’article, c’est ce second type d’études qui semble le plus à même de fournir des données heuristiques à la recherche en psychopathologie clinique. Pour affiner et compléter ces études, l’article présente quelques résultats de recherche du dispositif clinique mis en place par les deux auteurs sur le sujet étudié. À partir d’un cas clinique atypique, ils montrent la pertinence d’une analyse psychopathologique des prises de risque sexuel chez les homosexuels masculins qui prend en compte la dimension inconsciente du fait psychique. [ABSTRACT FROM AUTHOR]

Résumé: Le champ de la psychiatrie s’est ouvert autour de la question du traitement de l’aliénation mentale. Au milieu du xx e siècle, c’est à partir de l’idée de lutter contre les mécanismes d’aliénation qu’est apparu le renouveau de la psychiatrie française sous les traits de la psychothérapie institutionnelle. Ce mouvement, dont la vocation est de ű désaliéner Ƈ, a postulé dès 1948, avec Jean Oury, que l’aliénation de l’homme est double : sociale et psychopathologique. À partir, toujours, de cette notion d’aliénation, et particulièrement des modalités théoriques et cliniques de sa prise en charge, ce mouvement s’est divisé en différents courants, chacun porteur de pratiques désaliénistes différentes. À notre époque où le terme d’ű aliénation Ƈ a pratiquement disparu du champ psychiatrique, il semble nécessaire de resituer épistémologiquement ce concept fondateur de notre pratique. Nous repérons cinq époques dans l’histoire du concept d’aliénation. L’aliénation juridique comme cession de sa propriété, issue de la tradition latine. Le xviii e siècle avec Rousseau qui, reprenant Hobbes et la thématique du contrat, définit l’aliénation comme le moment socialement structurant qui permet le passage de l’état de nature à l’état de société. L’époque pinélienne de l’aliénation mentale comme possibilité, réversible, de perdre la capacité à être soi-même. La quatrième, par la philosophie allemande du xix e siècle, est celle de l’aliénation comme extériorisation. Extériorisation de la conscience de soi dans ses objets de représentation avec Hegel et Feuerbach, extériorisation de soi dans la pratique sociale avec Marx. Enfin, dans la deuxième moitié du xx e siècle, le cinquième temps de l’aliénation n’est plus celui de l’extériorisation mais de l’intériorisation. L’aliénation devient avec la psychanalyse, notamment chez Lacan, une étape fondamentale de la structuration du monde interne du sujet. Dans le champ sociologique, il est aussi possible d’entendre, avec les travaux de Bourdieu, que l’aliénation devient ce qui de la domination de l’espace social s’inscrit dans le corps et dans les structures mentales du sujet. Il est dès lors, avec cette cinquième époque, moins question de l’extériorisation sociale de l’intériorité que de l’intériorisation psychique de l’extériorité. Nous verrons, pour conclure, que sous les traits de la dialectique du Dehors et du Dedans, cette construction de l’intériorité par l’enfermement de l’extériorité introduit la dimension de l’antériorité dans le psychisme. [ABSTRACT FROM AUTHOR]

Abstract: Contrarily to M. Klein and D.W. Winnicott, who, generally speaking, look favorably on play in the cure, for us it appears impossible to talk about play in general without considering that there exist several types of play. Also, following the examples of J. Piaget for developmental psychology and R. Caillois for sociology, we propose a Freudian “structural classification of play,” and we distinguish three types of plays: play based on the mechanism of negation (Verneinung), play based on the mechanism of disavowal (Verleugnung), and play based on the mechanism of foreclosure (Verwerfung). This article develops the first type of play based on the mechanism of negation – which is what studies of play typically allude to – that we will call “trompe-l’œil” play. In order to illustrate this category, we will study the horse game played by “Little Hans” in Freud''s famous analysis, which immediately follows the young patient''s phobia. We maintain that the transition from phobic symptom to play is the result of an intervention of the Law. Play based on the mechanism of negation veils the reality of castration, and succeeds the child to move beyond merely being played upon by his fantasy – as in the case of the phobic symptom – allowing him instead to play with his fantasy. Here, the “trompe-l’œil” game can be considered therapeutic, or, at least, its emergence can be considered the effect of the analyst''s therapeutic intervention. [Copyright &y& Elsevier]

Abstract: Sectorization has been set up to allow the practice of psychiatry closer to people by opening community mental health centers in most cities. Since this advent, the sociology of cities has changed and this response to mental health issues is no longer fully appropriate. Time is accelerating and the waiting list for an appointment has extended. In addition, the “village” has disappeared; families are often single parents because of divorces. The main socializing area is now the company. Also, in these work environments, many human tragedies such as suicides are increasing. These tragedies are not always directly related to the company''s issues and internal functioning''s. Psychiatrists have a duty to invest the social fields more. This new area of expertise in psychiatry is called upon most often as a preventive measure when faced with potential psychological vulnerabilities. It implies risk assessment of psychosocial origins, accompaniment of a social transition, maintaining human capital, psychological support following difficult and/or brutal events (such as suicides, accidents, etc.). Often, this type of exercise requires adjustment of our practices (ethics, limits of intervention). In these new fields, the objective is to take care of people in order to avoid the appearance of psychiatric disorders (adjustment disorders, etc.) that are not easily absorbed by the current health institutions. Hence these potential disorders may lead to the exclusion of individuals due to their inability to work. [Copyright &y& Elsevier]

Summary: Children placements in educative living-in are determined by parenthood failures. Many recent works have pointed out several parameters in parenthood: psychoanalysis has shown real, symbolical and imaginary dimensions; developmental psychology has described successive steps; attachment theory has defined different caregiving kinds; and sociology has emphasized the role of social, economical and cultural contexts. In residential placement situation, children profit by daily educational action. One parenthood guidance setting seeks to mobilize parents about their parental functions. Parents are invited to participate to encounters on the very place where the child is living in. To bring out all the elements of plural parenthood, guidance is managed by a professional partnership: an educator, a social worker and a psychiatrist. [ABSTRACT FROM AUTHOR]

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Copyright of Pratiques Psychologiques is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Psychologie Française is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The only proper solution to confusion is clarification. Rather than take sides in a heated and confusing polemic, this article aims first to clarify the issues involved, and second, to show how sociology can contribute to public health expertise. In the first part, I analyze the triple context of the ideological rigidification of the field of mental health. In the second, epistemological part, I shed light on two underlying and unseen problems: the interconnection of facts and values, and the distinction between wholes and ensembles. The comparison of two reports, one by the "Haute Autorité de santé" (HAS) and the other by Inserm, illustrates these two problems. The HAS report was written from the perspective of wholeness, whereas the one by Inserm is based on the notion of “ensemblism”. The consequence is that the HAS report can be used as a basis for establishing policies, whereas the Inserm report can not, because it provides only a list of decontextualized measures. A public health report should clarify possible choices to allow for informed decision-making. [Copyright &y& Elsevier]

The following article aims at a better theoretical understanding of the organizational communication concept. By questioning the link between "communication" and "organization", we try to circumscribe the emergence of this concept along with its current and future directions. The first part of the article refers to the history of organizational communication; its role and place as a field of study among Social Sciences is discussed from a North American perspective. The second part reflects on the classical views of organizational communication, mainly through a functionalist approach. Finally, the third part opposes these views through a discussion on "organizing communication" (la communication organisante), where the future of organizational communication lies in the interactionist approach and in code-centred models. [ABSTRACT FROM AUTHOR]

Sciences of communication can bring much to the necessary critical reflection on current journalistic practices. By adopting the viewpoint of an understanding sociology and by identifying the logic of manufacturing news, we can better understand the practices of journalists that they themselves would not question. We will thus see which lessons ensue from a critical sociology of journalists' practices. [ABSTRACT FROM AUTHOR]

Abstract: Psychiatry is now confronting a critical movement, which predicts not only its « collapse », but also its « end » and even its « death ». After a reminder of the facts, this problem is approached by an analysis of the components and of the structure of psychiatry. First all the domains constituting psychiatry, their internal and external links, and their general coherence are reviewed. An analysis of psychiatry''s diverse components shows that the nature of mental trouble is not restricted to mental suffering only; it is also necessary to consider the role of biological factors, of representations, of the milieu, and of the tools for thinking, as well as that of the institutions and of the treatments which have evolved over time. Psychiatry is subsequently considered as a structure which has evolved from its roots, its conceptual evolution, and the crises it has overcome. It is thus possible to show the limits of present assertions and to deny the exclusive role of neurosciences or of sociology. The actual forms of psychiatry are certainly open to criticism, but this does not imply the disappearance of this discipline, the specificity of which rests not only on its objects of study, but also and especially on the nature of its procedures aiming at precising them more precisely. [Copyright &y& Elsevier]

Abstract: Starting from a sociological research on late parenthood, the article shows quantitative and qualitative lessons on the subject – in particular concerning the fathers'' perspective. Late parenthood has declined over the 20th Century, to increase again since 1980. The further exploitation of the survey EHF 99 shows the processes and the socio-demographic of late fatherhood, over three generations. This phenomenon is tightly related to the multiple descents and family recombinings. We also observe in these configurations major age differences between spouses and late relationship. The social bipolarity of this phenomenon appears clearly as far as late motherhood is concerned, but is less clear concerning fatherhood, since more blue collars and non qualified men are concerned. This difference is due to the important role played by migrants in this phenomenon. A qualitative survey conducted on the basis of biographic interviews has underlined the gendered logics of late family founding. These logics are linked to the discrepancies due to man/woman differences regarding their respective calendar of fertility and to their attitude towards work. The interviews which provide an analysis of the biographical processes of late parenthood are organised according to postponement or renewal logics, in the form of refoundation or repetition. They are linked to self-introspection and to the negotiations at work within a couple. [Copyright &y& Elsevier]

Abstract: France has a population of about 60 million peoples and each ten years data about the standard of living are collected by the central bureau of statistics, we considered the collection of data on 5000 households in 1999 in our geographical area would afford a unique opportunity to compare the equivalent status of French adults with repaired cleft of the lip and palate (CLP). Aspects of social adjustment were investigated in a sample of 82 French adults 18–35 years old with repaired complete unilateral cleft of the lip and palate (CLP). All subjects received a standardized regimen of care from the Burgundy cleft palate team of Dijon. The investigation, based on response to a questionnaire, partly replicated a national survey of social and economic life in the population (Standard of living survey Burgundy, INSEE France 1999), so that adults with complete clefts could be compared with a large control sample of the same age. The control group was constituted by subjects between 18 and 35 years in the standard of living survey Burgundy 1999, INSEE France, they were taken from a regional probability sample of households. This report covers education, employment, and marriage. The significant difference between groups was assessed by: Student’s t-test or analysis of variance for continuous variables and χ2 test for categorical variables. The results demonstrated that there are significant differences in educational attainment and employment between adults with cleft of the lip and palate and other people. Fewer with cleft of the lip and palate marry, and when they marry they do so later in life, scholarship history showed significant delay in the cleft of the lip and palate group, independence regarding housing was lower in the cleft of the lip and palate group. If cleft of the lip and palate adults functioned within normal limits with regard to employment. However, levels of income were substantively lower than control groups. It would appear that cleft subjects experience some limitation in their ability to secure vocational and economic rewards from society. As a conclusion we can say regarding our results that the cleft of the lip and palate group, even with the smallest degree of malformation (unilateral without associated malformation), showed a significant delay in the independence process. [Copyright &y& Elsevier]

The adolescent is pushed toward the outside world, both in search of himself and in search of an encounter with the other. The adolescent is fascinated by the world outside. The street is the symbol of the new space that he alone can occupy. From the time that he leaves the intimate space of the family unit until he has been able to create another space, the street personifies the intermediary state between the two. It is there, in the course of his sexual development, that he encounters the sexual and carnal aspect of the other. It is also there that he exhibits his intimacy: his public display of the personal, ‘extimacy’, is also expressed through his use of the portable telephone. Violence is continually present both at a sexual level and in the adolescent’s relations with others, in an outside environment that he has to make a continual attempt to conquer. The world outside, i.e. the street, is the place where an encounter takes place with the opposite sex, but also with violence at a symbolic level. It is a necessary passage and training ground adulthood, and which requires complete commitment on the part of the individual concerned. [Copyright &y& Elsevier]

Patterns of social integration and exclusion differ from one society to the other. By focusing on the identifications of the Ego with the objects which surround it, and taking some particular socio-relational contexts into account, we shall consider the adolescent subject through the aspect of his need to have an enhancing self-image. Twelve interviews of 15–18-year-old subjects presenting behavioural disorders seem to confirm the following hypothesis: the more narcissistically enhancing the self-image reflected by the introduced object might be, the closer to it should the subject draw, through some adapted social behaviour. However, when overwhelmed by identity and narcissism conflicts, some adolescents happen to confuse fantasy and reality. The splitting up between self and object perceptions, which proceeds from projection and introjection mechanisms, may reinforce the behavioural disorders. Theoretically, these apparently asocial behaviour patterns reveal the subject’s psychological attempt to adapt to his surroundings, and could be considered as a concrete way to approach adolescents at odds with society. In practice, we shall assess the relevance of institutional help facilities. To examine a starting insertion process, we shall base our reflection upon the example of a practice of mediation: a radio program aiming to introduce a third party to young users of an educational support organisation, and widen the range of their narcissistic and identity supports. [Copyright &y& Elsevier]

Abstract: Children suffering from ADHD, need special care and a proper diagnosis, taking into consideration biological factors from which the disorder originated. However, parents do not wish to have a prediction formulated on the future destiny of their child. Obviously, there is a need to establish a preventive program as well as a children''s evaluation''s program. This will create a positive influence on the quality of life for people suffering from this disorder, and implement actions, in the social, educational, and family environment, avoiding any measures leading to their isolation from society. [Copyright &y& Elsevier]