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Les distorsions cognitives sont des processus mentaux qui agissent sur l'individu et qui régissent en partie son rapport au monde. Elles s'installent de manière très précoce et dépendent directement des premières expériences de vie desquelles un apprentissage implicite sur le monde et sur soi va avoir lieu. Ces apprentissages sont personnels et biaisés. De ces derniers vont dépendre les filtres cognitifs que l'individu va renforcer à la manière d'un cercle vicieux. Les informations sélectionnées dépendent de ces filtres, et les processus de traitement de ces informations vont dépendre des distorsions du sujet. Ces processus mentaux se retrouvent chez tout un chacun ; néanmoins, certaines populations présentent des spécificités de par leur expérience de vie. C'est le cas des patients ayant une symptomatologie anxio-dépressive, des victimes ou des personnes souffrant de Trouble Stress Post-Traumatique. À la lumière des différentes approches thérapeutiques et des différents traitements qui sont accordés à la dimension cognitive, nous proposons une modélisation sous forme de syllogisme du mode de penser le monde et de s'y confronter des patients ayant un statut de victime. Deux vignettes cliniques permettent d'illustrer cette modélisation. Cette dernière s'enracine dans la philosophie, la psychopathologie cognitive, mais se veut transthéorique et peut être utilisée, peu importe l'obédience du thérapeute. Cognitive distortions are mental processes that affect individuals and partially govern their relationship with the world. They manifest themselves at a very early age and are directly influenced by an individual's early life experiences, from which implicit learning about the world and oneself occurs. This acquisition is personal and biased, leading to the formation of cognitive filters that individuals reinforce in a self-perpetuating cycle. The information selected depends on these filters, and the processing of this information depends on the subject's distortions. These mental processes are present in everyone; however, certain populations, such as individuals with anxiety or depressive symptoms, victims, or those with post-traumatic stress disorder, exhibit specificities based on their life experiences. In light of the various therapeutic approaches and treatments related to the cognitive dimension, we propose a syllogistic model for understanding how victims from different social backgrounds and with a victim status perceive and confront the world. Two clinical vignettes are provided to illustrate this model. This approach is rooted in philosophy and cognitive psychopathology but is intended to be trans-theoretical and applicable regardless of the therapist's orientation. [ABSTRACT FROM AUTHOR]

L'opposition entre psychanalyse et thérapies cognitivo-comportementales semble s'être irréductiblement installée dans les esprits, au point d'apparaître et de fonctionner de nos jours comme un lieu commun. Le présent article montre que des praticiens français des deux bords ont pourtant cherché, par le passé, à dépasser leurs antagonismes en travaillant ensemble au sein de la toute première association française dédiée à l'étude des thérapies comportementales. Tout en mettant en lumière un chapitre méconnu de l'histoire de la psychiatrie hexagonale et de l'éclectisme en psychothérapie, cette enquête incite à penser à nouveaux frais les enjeux des divergences contemporaines entre psychanalystes et praticiens des thérapies comportementales et cognitives. La méthode employée est celle de l'histoire sociale et culturelle des sciences. Notre étude s'est nourrie des publications des principaux acteurs de ce dialogue, des archives de l'Association Française de Thérapie Comportementale et Cognitive, ainsi que d'une série d'entretiens avec plusieurs figures majeures de l'histoire du comportementalisme français. Le psychiatre et psychanalyste Daniel Widlöcher fut le principal artisan de cette « improbable rencontre ». En tant que membre fondateur, puis président de l'Association Française de Thérapie Comportementale (AFTC), le professeur Widlöcher s'est en effet employé à comparer les méthodes, indications et opportunités de ces deux approches thérapeutiques, a publié à cet effet, et contribué à la création d'un institut de formation au sein de ladite association. En s'appropriant au tournant des années 1990 les méthodes cognitives, la deuxième génération de thérapeutes évoluant au sein de l'AFTC s'est davantage employée à se démarquer du paradigme psychanalytique que leurs prédécesseurs. La publication du rapport de l'INSERM sur l'efficacité des psychothérapies (2004), puis du Livre noir de la psychanalyse (2005) mit définitivement à mal les efforts entretenus par le passé pour conjuguer les deux approches. Bien avant qu'une polarisation extrême ne s'instaure au milieu des années 2000, des praticiens de la psychanalyse et des thérapies comportementales se sont employés à dépasser leurs différences en vue de trouver un terrain d'entente, propice à la mise en œuvre de cothérapies. Le nœud de la discorde entre psychanalystes et praticiens des thérapies comportementales dépasse de simples enjeux et débats d'ordre théorique et pratique. L'article conclut que cette controverse est indéniablement liée à des questions de pouvoir au sein des instances académiques, de reconnaissance ou de visibilité sociale, de même qu'à des enjeux économiques. The opposition between psychoanalysis and cognitive-behavioral therapies seems to have become irreducibly entrenched in people's minds, to the point of appearing and functioning today as a commonplace. The present article shows that French practitioners from both sides have, in the past, tried to overcome their antagonisms by working together within the very first French association dedicated to the study of behavioral therapies. While shedding light on a little-known chapter in the history of French psychiatry and of eclecticism in psychotherapy, this investigation encourages us to think afresh about the issues at stake in the contemporary divergences between psychoanalysts and practitioners of behavioral and cognitive therapies. The method used is that of the social and cultural history of science. Our study was based on the publications of the main actors in this dialogue, the archives of the Association Française de Thérapie Comportementale et Cognitive, and a series of interviews with several major figures in the history of French behaviorism. The psychiatrist and psychoanalyst Daniel Widlöcher was the main architect of this "unlikely encounter." As a founding member and later president of the Association Française de Thérapie Comportementale (AFTC), Professor Widlöcher worked to compare the methods, indications, and opportunities of these two therapeutic approaches; published about his findings; and contributed to the creation of a training institute within the AFTC. By appropriating cognitive methods at the turn of the 1990s, the second generation of therapists evolving within the AFTC made a greater effort to distance themselves from the psychoanalytical paradigm than their predecessors. The publication of the INSERM report on the effectiveness of psychotherapy (2004), followed by the Livre noir de la psychanalyse (2005), definitively undermined the efforts made in the past to combine the two approaches. Long before the extreme polarization of the mid-2000s, practitioners of psychoanalysis and behavioral therapies worked to overcome their differences in order to find common ground for the implementation of cotherapies. The crux of the discord between psychoanalysts and behavioral therapy practitioners goes beyond mere theoretical and practical issues and debates. The article concludes that this controversy is undeniably linked to questions of power within academic bodies, recognition or social visibility, as well as to economic issues. [ABSTRACT FROM AUTHOR]

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Parmi les moyens thérapeutiques proposés pour les troubles anxieux, les thérapies cognitives et comportementales ont un effet anxiolytique prouvé. L'objectif de notre travail était d'illustrer la prise en charge cognitive et comportementale d'une patiente souffrant d'un trouble d'anxiété généralisée sévère comorbide d'une sclérose en plaques. Nous présentons le cas d'une patiente âgée de 42 ans, suivie depuis 2007 à la consultation externe de l'Institut National de Neurologie pour une sclérose en plaques rémittente-récurrente sévère sous immunosuppresseurs. Le diagnostic de Trouble Anxiété Généralisé sévère a été établi chez elle. La thérapie cognitivo-comportementale de ce trouble s'est déroulée sur quinze séances. Les évaluations initiales, intermédiaires et finales comprenaient les échelles « Penn State Worry Questionnaire » et « Hamilton Anxiety Scale ». Après une phase d'analyse fonctionnelle et d'évaluation initiale, les différentes parties de la prise en charge étaient comme suit : psychoéducation, identification de ses sujets d'inquiétude, recherche des comportements d'évitement et de réassurance, exposition à l'inquiétude, exposition aux situations redoutées et prévention des comportements d'évitement et de réassurances, identification des émotions évitées ou vécues en situation anxieuse, et une exposition à ses émotions. Nous avons pu constater assez rapidement une amélioration clinique avec diminution de l'intensité de l'inquiétude, de la fréquence de ses sujets d'inquiétude ainsi que l'amélioration des plaintes somatiques. L'évaluation finale a montré que les objectifs formulés avec la patiente ont été atteints et qu'il y a eu une amélioration de plus de 50 % pour les différentes échelles d'évaluation. Conformément aux données de la littérature, le suivi de notre patiente montre que la thérapie cognitive et comportementale constitue une option intéressante dans le traitement de l'anxiété généralisée, y compris dans la forme sévère et comorbide d'une maladie neurologique invalidante telle que la sclérose en plaques. The social, personal and financial costs of anxiety disorders in multiple sclerosis patients are considerable. A properly managed anxiety disorder in these patients can reduce the morbidity associated with this debilitating disease. Among the therapeutic means proposed for anxiety disorders, cognitive and behavioral therapies have a proven anxiolytic effect. The current study aimed to describe the cognitive and behavioral management of a female patient with severe generalized anxiety disorder comorbid with multiple sclerosis. The clinical case presented in this study concerned a 42-year-old woman followed since 2007 at the Outpatient clinic department, National Institute of Neurology of Tunis, for a severe relapsing-remitting multiple sclerosis. In March 2018 she was diagnosed with generalized anxiety disorder. The therapy took place over fifteen 45-minute weekly sessions (From February 8th to May 24th, 2018). Initial, intermediate and final evaluations included the "Penn State Worry Questionnaire" and the "Hamilton Anxiety Scale". During the course of the therapy, we observed a clinical improvement in the patient's symptoms such a decreased of anxiety intensity and frequency of worries and an improvement in somatic complaints. The final evaluation showed that the objectives formulated with the patient were achieved and that there was an important improvement of the different scales of evaluation. According to the available data, the follow-up of our patient showed that cognitive and behavioral therapy is an interesting option in the treatment of generalized anxiety disorder, including its severe and comorbid form with a disabling neurological disease such as multiple sclerosis. [ABSTRACT FROM AUTHOR]

Résumé: Le trouble dépressif met en échec le rappel de souvenirs positifs, mécanisme mis en place par les sujets sains pour contrer les affects négatifs. Une adaptation de cette stratégie, via la création d'un carnet de souvenirs définissant le Soi, pourrait permettre de diminuer la fréquence des ruminations et d'améliorer l'état dépressif des sujets. L'échantillon, composé de 14 femmes dépressives de plus de 65 ans, a été divisé en deux groupes selon la sévérité du trouble dépressif. Les participantes ont créé puis utilisé un carnet de souvenirs positifs définissant le Soi. Les résultats montrent une diminution significative des ruminations dans les deux groupes. Cependant, si l'amélioration de l'état dépressif est significative et constante pour les dépressions modérées, elle stagne après la phase d'accompagnement pour les dépressions sévères. Ces résultats mettent en lumière la pertinence de ce protocole thérapeutique sur les ruminations et la dépression modérée des femmes âgées. D'autres recherches sont nécessaires pour ajuster cette thérapie aux sujets atteints de dépression sévère.è Depressive disorders overthrow the recovery of positive memories, this mechanism being strategically used by healthy subjects to cope with negative feelings. An adjustment to this strategy to deal with depression affecting elderly women showing ruminative responses could be obtained through the materialization of a number of positive self-defining memories. This innovative cognitive therapeutic method should allow a decrease in the rumination rate and an improvement of depressive disorders for aging women. Our study, including 14 depressed women over 65 years old showing ruminative responses, was divided into two groups according to the severity of their depressive disorder (moderate or severe). Positive self-defining memories were collected in a book during three sessions by each participant, which was autonomously used during the three following weeks. The results show a significant decrease in rumination, regardless of the disorder severity. A significant improvement of the depressive disorder was observed in the elderly women with moderate depressive disorder, but stagnated after the support phase. These data point out the interest of this therapeutic method for the treatment of patients suffering from moderate depression, while further studies will be required to adjust it for severely affected patients. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Community Mental Health is the property of Canadian Periodical for Community Studies Inc. 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.)

Résumé Objectif Notre objectif a été de démontrer le modèle biopsychosocial dans la lombalgie commune chronique. Matériel et méthode Il s'agit d'une étude transversale réalisée sur des sujets adultes recrutés aléatoirement sans tenir compte de la lombalgie. Nous avons étudié les paramètres anthropométriques, les antécédents de lombalgies, l'endurance des muscles spinaux, le niveau d'étude, l'EVA douleur lombaire et handicap, l'antécédent et durée de lombalgie, l'anxiété et dépression. Nous avons utilisé l'Hospital Anxiety and Depression Scale, et la version arabe du Québec. Nous avons étudié les paramètres en corrélation et utilisé la régression logistique des facteurs liés à la lombalgie. Résultats Cent vingt-cinq sujets ont été recrutés, 89 lombalgiques et 36 non lombalgiques. Les médianes d'âge étaient de 36 et 24 ans respectivement. La douleur lombaire était faiblement corrélée à la durée d'évolution (r = 0,66), au test de Sorensen (r = −0,45), au Québec (r = 0,69), au HAD (r = 0,24) et à l'anxiété (r = 0,32), mais corrélée à la dépression de façon non significative (r = 0,069, p = 0,49). En analyse univariée, le HAD (OR = 1,074, IC95 % [1,01–1,13]), l'âge (OR = 1,103, IC95 % [1,04–1,16]) et IMC (OR = 1,340, IC95 % [1,15–1,54]) étaient des facteurs de risque de lombalgie commune (p = < 0,01) ; le niveau universitaire et l'endurance des spinaux ont été identifiés comme facteurs protecteurs. Seule l'endurance des spinaux (OR = 0,97, IC95 % [0,95–0,99]), p < 0,01 et le niveau universitaire (OR = 0,76, IC95 % [0,58–0,98], p < 0,041) sont restés significatifs en analyse multivariée. Conclusion Le traitement du lombalgique passe par la prise de compte du modèle biopsychosocial. Abstract Objective As defined by the International Association for the Study of Pain, pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. The phenomenon is subjective and multifactorial (Affective-motivational and sensori-discriminative component). Chronic low back pain is a disability with significant socio-economic repercussions. To avoid such repercussions, the treatment of the low back pain requires global care taking into account all the factors involved, including those psychic. Any treatment based on pain alone would be insufficient. Our goal was to demonstrate the biopsychosocial model in low back pain. Material and method This is a cross-sectional study conducted on randomly recruited adult subjects regardless of low back pain. We studied anthropometric parameters, history of low back pain, endurance of spinal muscles, level of study, EVA low back pain and disability, antecedent and duration of low back pain, anxiety and depression. We used the Hospital Anxiety and Depression Scale, and the Arabic version of Quebec. We studied parameters in correlation and used the logistic regression of factors related to low back pain. Results One hundred and twenty-five subjects were recruited, 89 were low back pain but 36 were not. The median age was 36 and 24 years, respectively. Lumbar pain was weakly correlated with duration of the evolution of pain (R = 0.69), Sorensen (r = −0.45), Quebec (r = 0.69), HAD (r = 0.24) and anxiety (r = 0.32), but correlated with depression in a non-significant way (r = 0.069, p = 0.49). In a single-variant analysis, HAD [OR = 1.074, 95% CI (1.01–1.13)], age [OR = 1.103, 95% CI (1.04–1.16)] and BMI [OR = 1.340, 95% CI (1.15–1.54)] were the risk factors for low back pain (p = < 0.01); university level and spinal endurance were identified as protective factors. Only spinal endurance [OR = 0.97, 95% CI (0.95–0.99), p < 0.01] and the university level [OR = 0.76, 95% CI (0.58–0.98), p < 0.041] remained significant in multivariate analysis. Conclusion Most studies show a reciprocal link between chronic pain and depression. Consequently, we must have been interested in the pain as in the psychic symptoms. We have the impression that is two mechanisms are involved. On the one hand, the patients express their psychic problems by pain as low back pain; on the other hand, pain triggers psychiatric processes. This causality has been well explained by the transactional stress model of Lazarus and Folkman. According to our results, protective factors such as level of study (university level) and the endurance of spinal muscles were the factors that would counteract risk factors such as psychic factors. The action on the beliefs and/or the cognition of the patients, whatever the level of culture, could constitute a therapeutic part, it is the cognitive therapy. By using non-medicated means like changing one's own behavior, the chronic pain patient can bring effective remedies against his or her condition. Although some patients are ignorant or have a low level of culture, action on information or sensitization could relieve patients. To improve the endurance of spinal muscles, we insist on the promotion of non-drug treatments by sensitization such as physical activity. Exercise can have specific benefits in reducing the severity of chronic pain, as well as improving overall physical and mental health and physical functioning. The final goal of our reflection is to insist, in these chronic pain patients, on a global multidisciplinary approach integrating physical, cognitive and behavioral therapies. [ABSTRACT FROM AUTHOR]

Three clinicians of different sensitivity comment on a clinical situation, proposing clinical exploration and some therapeutic perspectives. A philosopher concludes this work from a phenomenological point of view. [ABSTRACT FROM AUTHOR]

Résumé La recherche a montré que pour différents troubles anxieux, une seule session d’entraînement attentionnel permet la modification du biais ainsi qu’une diminution de la vulnérabilité émotionnelle. Les méta-analyses révèlent cependant que la taille d’effet pour les symptômes reste faible, même si l’on augmente le nombre des sessions d’entraînement. En ce qui concerne la dépression, les résultats semblent indiquer que l’entraînement attentionnel serait efficace pour des individus ayant un faible niveau de dépression. Finalement, quel que soit le trouble émotionnel traité, les faiblesses psychométriques du paradigme de détection de sonde ainsi que les problèmes de compliance au traitement manifestés par certains patients incitent les chercheurs à proposer d’autres paradigmes qui pourraient être mieux acceptés par les patients dans le contexte d’une intervention thérapeutique. Introduction According to the theoretical models in cognitive psychopathology, the susceptibility to develop an emotional disorder is causally related to the presence of cognitive biases in the information treatment process such as attention, memory and interpretation biases. Researchers are collecting data supporting the idea that it is possible to modify the cognitive biases and the clinical symptoms as well. The present paper focuses on the modification of attentional bias and symptoms in both anxiety disorders and depression. Method After a brief recall about the nature of attentional biases in anxiety and depression disorders, the article offers a synthetic review of the recent literature on attentional bias modification (ABM) in these mental disorders. First, it explains and debates the methodology mostly employed in this domain. Secondly, it presents the main results with a critical viewpoint especially on the therapeutic interests of these findings by answering a series of questions relevant for the clinical practice. Results In anxiety disorders, the attentional bias selectively favors information that is the most threatening for the trouble. The attentional bias in depression is characterized by a preference toward negative information and is also likely to have an absence of bias for positive information compared to healthy subjects. The attentional bias is most often modified using the so-called dot probe task. However, poor psychometric properties have been now repetitively reported. What are the effects of attentional bias modification on anxiety disorders? The research showed that only one session of ABM is sufficient to modify the bias toward threat and to reduce the emotional vulnerability when people are exposed to stressful situations. These findings have been reported for different anxiety disorders and in adults, adolescents and children. Can the attentional bias modification be envisaged as a therapeutic intervention of anxiety disorders? To answer to this question, patients have been exposed to several ABM sessions. Furthermore, a variety of outcomes measures (subjective, behavioural and physiological) have been taken. The researchers reported a modification of the attentional bias and an improvement of a variety of clinical symptoms. The results of one meta-analysis revealed that more ABM sessions lead to a more extended bias modification. However, another meta-analysis failed to show that a more extended bias modification leads to a greater improvement of the clinical symptoms. This report puts forward the need to enhance our knowledge on the causal relationship between the attentional bias and clinical symptoms. More recently, researchers have developed ABM training at home or via smartphone but the results are mitigated. Is it useful to combine the modification of attentional bias to another clinical intervention to treat anxiety disorders? A few studies have been conducted and even if some of them reported positive findings, overall, the results are reserved. Further, given the number of dropout reported, the effectiveness of the current ABM paradigm in a real-world setting is questionable. What are the effects of attentional bias modification on depression? A few small studies on ABM for depression have been published. Researchers found that ABM sessions lead to a reduced bias for negative stimuli but it is likely that this is only for individuals suffering from a low level of depression. The research on ABM in depression seems to be more successful in the use of ABM as a means to prevent the depressive relapse. Conclusion The ABM paradigm seems to be efficient to treat anxiety disorders even if its capacity to improve the clinical symptoms remains small. In depression, its efficiency remains to be established. So, researchers are now trying to alleviate the use of the current ABM paradigm or to innovate new paradigms to make ABM more exploitable in the context of a therapeutic treatment. [ABSTRACT FROM AUTHOR]

The aim of this article is to give three different points of view on the same case report. [ABSTRACT FROM AUTHOR]

In this study we describe some of the reasons that lead Aaron T Beck to move away from psychoanalysis and participate in the creation of cognitive therapy. With this aim in view, we describe the research developed by Beck between 1959 and 1962. In these studies the data that promotes the fall of the psychoanalytic explanatory hypothesis for depression began to be processed. Within this analysis we include some elements that we consider essential to understand this process of change: From Beck's obtaining a grant to investigate depression and his starting to work with collaborators like Marvin Hurvich and Sigmour Feshbach, whose new tools and methodologies helped Beck to test a psychoanalytic hypothesis of depression. Finally, we will include questions related to the research policies of the National Institute of Mental Health, and some commentaries about personal and institutional policy reasons that influenced Beck's work. [ABSTRACT FROM AUTHOR]

Résumé Objectif La consommation de benzodiazépines en France est un problème de santé publique qui a fait, ces dernières années, l’objet de nombreux rapports nationaux (HAS, INPES, OPEPS, ANSM…). Depuis les années 1990, de nombreux travaux ont signalé le niveau excessivement élevé de la consommation de benzodiazépines en France. En 2009, la France était le deuxième pays européen consommateur d’anxiolytiques et d’hypnotiques. Chaque année, un Français sur cinq consomme au moins une benzodiazépine ou une molécule apparentée. Cette consommation des anxiolytiques est majoritairement féminine et augmente avec l’âge. On sait également que l’introduction d’un traitement par benzodiazépines entraîne une consommation moyenne continue de sept mois et, pour 52 % de ces patients, une exposition moyenne de deux ans consécutifs. Le rapport de la HAS d’octobre 2007 rappelle que la prise de benzodiazépines expose plus spécifiquement à des risques de chutes (grade B), à des altérations cognitives (grade C) et à des accidents de la voie publique (grade C), alors que l’arrêt progressif et encadré des benzodiazépines peut améliorer certaines fonctions cognitives. Matériel et méthode Face à ce problème, il existe peu de stratégies thérapeutiques efficaces pour le sevrage et le maintien de l’arrêt de cette consommation de médicaments. Dans des études récentes, la balnéothérapie a montré son efficacité dans le traitement du trouble anxieux généralisé. Par ailleurs, des programmes de psychoéducation se sont montrés efficaces en addictologie dans la prévention de la rechute. Ainsi, est apparu crédible le projet d’associer une cure thermale de trois semaines, un programme psycho-éducatif de type thérapie cognitive et comportementale validé par un groupe d’experts. Ce programme a été constitué et mis en place dans quatre des cinq stations thermales psychiatriques françaises. Le programme consistait en l’association de techniques à base de thérapie cognitive et comportementale, d’entretien motivationnel et de séances de relaxation. Chaque équipe a été formée par un psychologue clinicien, spécialiste en thérapie cognitive et comportementale. Soixante-dix patients, d’un âge moyen de 54 ans et 9 mois, ont intégré ce protocole. Ils ont été répartis en 9 groupes de 6 à 12 patients sur les quatre centres. L’objectif de l’étude consistait à assurer le sevrage durable des benzodiazépines. Résultats À l’issue de la cure, un suivi longitudinal sur six mois était assuré à J5, J30, J60, J100 et J180. L’évaluation méthodologique de l’étude a été réalisée par l’ISPED de Bordeaux II. Les résultats sont en cours d’analyse, mais il est permis dès à présent de conclure en la faisabilité de la mise en place d’un tel programme en station thermale et en l’obtention de résultats très encourageants dans l’objectif d’un sevrage à six mois des benzodiazépines. Conclusions La médecine thermale, qui peut s’associer à une prise en charge en thérapie cognitive et comportementale, pourrait se révéler être une solution thérapeutique adaptée pour la prise en charge de la consommation chronique et stable de benzodiazépines. Cette étude est le premier essai clinique évaluant l’efficacité de la balnéothérapie associée à un modèle psycho-éducatif spécifique sevrage de benzodiazépines. Objective The consumption of benzodiazepines in France has become a public health issue, which has been the subject of many a national report over these last years (HAS, INPES, OPEPS, ANSM…). Since the 1990s, numerous works have pointed out the excessively high level of consumption in psychotropic medication. In 2009, France came second as a European country after Portugal in anxiolytic consumption, and second after Sweden in consumption of hypnotics. Every year, 1 French person out of 5 consumes at least one benzodiazepines or one related molecule. This consumption of anxiolytics is in majority feminine and increases with age. It is also known that the introduction of a treatment by benzodiazepines leads to an average of 7-month continual consumption and for 52 % of those patients an average exposure for a further 2 consecutive years. The HAS Autumn 2007 report reminds people that benzodiazepines intake endangers the risks of falls (grade B), cognitive alteration (grade C) and accidents on the public highway (grade C), whereas when stopping progressively and supervising use of benzodiazepines, it may improve certain cognitive functions. Facing up to this problem, there are very few efficient therapeutic strategies for withdrawal or maintenance in stopping the medicinal consumption. Materials and methods In recent studies, balneotherapy has shown its efficacy in treating generalised anxiety disorder. Furthermore, psycho-educative programmes have proved to be efficient in addiction studies to prevent relapse. In this way, the project associating a psycho-educative programme of cognitive and behavioural type with a 3-week spa treatment, validated by experts appeared to be credible. The programme was constituted and set up in 4 out of 5 of the French psychiatric spa resorts. The programme consisted in associating behavioural and cognitive-based therapy, motivational support and relaxation sessions. A psychologist clinician specializing in behavioural and cognitive therapy trained each team. Seventy patients with an average age of 54 years and 9 months took part in the protocol. They were divided up into 9 groups of 6 to 12 patients over the 4 centres. The aim of the study consisted in ensuring a lasting withdrawal from benzodiazepines. At the outcome of the treatment, a longitudinal follow-up was carried out on Day 5, day 30, day 60, day 100, day 180. The methodological assessment of this study was implemented by the ISPED of Bordeaux II. Results The results are still being analysed, but it can already be concluded that the feasibility of setting up such a programme in a spa resort has been shown from the very encouraging incoming results in terms of the objective of withdrawal in 6 months of benzodiazepines. Conclusions Thermal medicine, which may be associated with an undertaking in behavioural and cognitive therapy can well be a therapeutic solution adapted to the taking-in of those with stable chronic dependency to benzodiazepines in particular. This study is the first clinical trial assessing the efficacy of balneotherapy associated with a psycho-educative treatment in withdrawal from benzodiazepines. [ABSTRACT FROM AUTHOR]

Résumé Le trouble bipolaire est déterminé par un ensemble de facteurs, à la fois psychologiques, génétiques et environnementaux. Les patients atteints de ce trouble présentent un risque très élevé de récurrence, une hyper-réactivité aux situations de stress, des perturbations des rythmes de vie, une mauvaise observance au traitement, un manque d’insight, des perturbations majeures des relations interpersonnelles. D’autres mesures thérapeutiques ont été proposées afin d’optimiser le traitement médicamenteux et d’agir en amont sur les éléments déclenchants ou précipitants. Les mesures psychoéducatives, dont l’efficacité a longtemps été sous-évaluée, sont aujourd’hui les traitements psychologiques les mieux documentés et pour lesquels le niveau de preuve est élevé. Ils figurent en première ligne dans la plupart des guidelines. Les bénéfices de cette approche complémentaires se situent à différents niveaux : reconnaissance précoce des symptômes qui annoncent une récidive, optimisation de l’observance, acceptation du trouble, amélioration de la qualité de vie, meilleure gestion de la vie sociale, professionnelle et affective, consolidation de l’alliance thérapeutique, contrôle des facteurs déclenchants et précipitants… Les études publiées rapportent une diminution du nombre de récidives et de rechutes, une réduction de la durée d’hospitalisation, un meilleur équilibre de la vie familiale, une amélioration de l’observance et de la qualité de vie. Les mesures psychoéducatives présentent des points communs avec d’autres approches psychothérapiques (TCC, IPSRT, FFT) tant en ce qui concerne les objectifs que le déroulement des séances. Les résultats de ces différentes approches sont comparables en termes d’efficacité. The bipolar disorder is determined by several factors, be they psychological, genetic and environmental. Patients suffering from this disorder present high risks of recurrence, a hyper activity to stressful situations, disruptions in their daily lives, a bad observance to treatment, lack of insight, major disruptions in their interpersonal relationships. Other therapeutic measures have been proposed to optimize the medical treatments and act as early as possible on trigger elements or elements that precipitate symptom resurgences. Psychoeducational measures that have long been underestimated in their efficiency are now the best-documented psychological treatments, for which evidence is high. It figures as a front-line patient care in most of the guidelines. The benefits of this complementary approach is located at different levels: Recognition of preliminary symptoms that announce a recurrence of the illness, an optimization of medical observance, acceptance of the disorder, a better quality of life, a better emotional, professional and social life interaction, a consolidation of the therapeutic alliance, a control over trigger and precipitating factors. Studies show a decrease in relapses and recurrences, a reduction in length of hospitalization, greater equilibrium in family life, better medical observance and quality of life. Psychoeducal methods are comparable to other psychotherapeutic methods (such as TCC, IPSRT, FFT) in their objectives and in the way they conduct sessions. The results of these approaches are similar in terms of efficiency. [ABSTRACT FROM AUTHOR]

Résumé Cette communication a pour but de tester la faisabilité de la thérapie de résolution de problèmes pour des patients ayant fait une tentative de suicide. En général les patients restent hospitalisés en moyenne trois semaines. Malgré leur réticence initiale à décrire le geste suicidaire en termes émotionnels, comportementaux et cognitifs, ils adhèrent bien à cette base de travail psychologique. Cette technique s’avère donc acceptée et surtout très informative sur les différents facteurs présents au moment suicidaire. L’évaluation clinique montre une corrélation significative entre basse estime de soi sociale et intentionnalité suicidaire. This is a feasibility study of problem-solving therapy for adults attending a psychiatric hospital following self-harm. Feasibility objectives are as follows: to establish and field test procedures for implementing the problem-solving intervention; to determine the feasibility and best method of participant recruitment and follow up; to assess therapeutic delivery; to assess the feasibility of obtaining the definitive trial's primary and secondary outcomes; to assess the perceived burden and acceptability of obtaining the trial's self-reported outcome data. The results of this feasibility study determine the appropriateness of proceeding to a definitive trial and will allow us to design an achievable trial of problem-solving therapy for adults who self-harm. [ABSTRACT FROM AUTHOR]

Résumé Dernièrement, de nombreuses études se sont intéressées à la notion de pleine conscience, incluse dans la troisième vague des thérapies comportementales et cognitives. Notre objectif est de déterminer l’existence de ses bénéfices et leurs liens avec les spécifiés de cette vague émotionnelle, comme le développement de la pleine conscience. Pour cela, 38 patients souffrant de troubles anxiodépressifs ont suivi 15 séances d’un groupe utilisant la mindfulness. Leur niveau de pleine conscience (MAAS), d’anxiété (STAI-B), de dépression (BDI-13), d’alexithymie (TAS-20) et d’affectivités (PANAS) ont été évalués en pré- et post-thérapie. Nos résultats indiquent une évolution positive des sujets au niveau de la dépression, de l’anxiété et de l’affectivité positive ainsi qu’une augmentation de la pleine conscience. Il existait un lien assez fort entre la pleine conscience et les variables cliniques mais on ne peut affirmer un lien de causalité. Objectives Mindfulness-based interventions are part of the third wave of behavioral and cognitive therapies and have resulted in many research studies. Mindfulness can be considered as a state of open attention on the present where people observe theirs thoughts and feelings from a distance without judging them. In this study, we considered mindfulness as a metacognitive competence. This psychotherapeutic approach has proved positives effects in a wide range of mental disorders (recurrent depression, Generalized Anxiety Disorder , bulimia…). However, questions remain about benefits of the third wave of CBT in comparison with behavioral and cognitive waves. Are they of additional benefits and correlated to development of mindfulness? This study aims to test these problems. The following hypotheses were made: Anxious-depressed patients, included in this study, will decrease theirs scores to clinical variables (depression anxiety, affectivity) between pre and post treatment, and this evolution will be linked to the increase in the capacity of mindfulness. Patients and methods Thirty-eight patients (including 10 men and 28 women) from 24 to 63 years ( m = 42.89 ; σ = 11.89) with a diagnosis of depressive disorder and/or anxious disorder (CIM-10), have followed fifteen group sessions including mindfulness-based intervention (Mindfulness-Based Cognitive Therapy, Acceptance and Commitment Therapy, Unified Protocol of Barlow). In this protocol, the patient's level of mindfulness (MAAS), anxiety (STAI-B), depression (BDI-13), alexithymia (TAS-20) and positive affectivity and negativity affectivity (PANAS) are evaluated at pre- and post treatment (four months of times). Results In pre-test, patients have a low capacity of mindfulness, a moderated depression and anxiety, affectivity negative and they are on the limit alexithymia threshold. After, statistical processing, the results show a positive and significant evolution of protocol on some of the indicators (depression, d = –0.6; anxiety, d = –1.02; positive affectivity, d = –0.47). However, there are not significant evolution for alexithymia and negative affectivity. Furthermore, this research has enabled to show mindfulness is negatively and significantly correlated ( P < 0.001) with depression, anxiety and alexithymia, but less with negative affectivity ( P < 0.10). Others results indicate that evolution of mindfulness is proportional to evolution of clinical variables (except for anxiety). Conclusions These data don’t enable to conclude a causal link, but the results show that improves capacity of mindfulness could improve clinical variables (depression, anxiety, alexithymia). Limits: lack of control group, and absence of follow up test. Mindfulness-based interventions seem to be a useful adjunct treatment. Other studies would be useful to study specific effects of mindfulness. [ABSTRACT FROM AUTHOR]

Résumé La psychoéducation occupe aujourd’hui une place essentielle dans le champ des approches psychosociales. Initialement proposée aux patients psychotiques chroniques, elle s’est peu à peu étendue à d’autres types de pathologies chroniques, tels que les troubles bipolaires. Dès les années 1970, des cliniciens spécialisés dans les démarches thérapeutiques comportementales et cognitives enrichissent les programmes de psychoéducation avec des composantes propres aux thérapies comportementales et cognitives (TCC) pour devenir des programmes de réhabilitation du psychotique chronique. Il faudra attendre les années 1990 pour voir apparaître la même combinaison d’intervention psychoéducation plus TCC pour des patients souffrant d’addictions, de troubles de l’humeur récurrents tels que les troubles bipolaires. Depuis 1996, au moins cinq programmes psychoéducatifs TCC ont été développés pour ces patients. Parmi eux, le programme de Lam et al. (1999) constitue la référence internationale, de par le nombre important de publications concernant son efficacité. Nous présentons ici, d’une part, la démarche psychoéducative TCC dans sa mise en place historique, en insistant sur les différences de pratiques qu’il existe entre psychoéducation, approche TCC et éducation thérapeutique du patient qui voit aujourd’hui son développement se généraliser. Nous décrirons notre expérience depuis dix ans au centre de psychothérapie universitaire CMME, du Centre Hospitalier Sainte-Anne de Paris. Nous décrirons les résultats cliniques et psychologiques d’un programme de psychoéducation TCC pour patients bipolaires I partiellement améliorés par leurs traitements pharmacologiques cependant bien conduits (patients réfractaires). Les résultats principaux constatés chez 139 sujets sont une amélioration du fonctionnement psychologique associé à la dépression (c.-à-d., croyances dysfonctionnelles, estime de soi) et de la qualité de vie (c.-à-d., relations sociales, santé psychologique) pour des patients bipolaires qui ont connu en moyenne plus de 13 épisodes thymiques et qui, malgré les traitements pharmacologiques thymorégulateurs, connaissent encore des récurrences aux fortes répercussions psychosociales. In recent years, psychoeducation is largely used in the field of psychosocial approaches. Originally proposed for chronic psychotic patients it is gradually extended to other types of chronic diseases such as bipolar disorder. Since the 1970s, Cognitive Behavioral Therapy (CBT) is associated with psychoeducation to become rehabilitation programs for chronic psychotic patients. In the 1990s appears the combination CBT + psychoeducation intervention for patients with substance abused, mood disorders in particular bipolar disorder. Since 1996, five psychoeducational CBT programs have been developed to patients with bipolar disorder. Among them, the Lam et al. program is the international reference, from the large number of publications concerning its effectiveness. We present here the psychoeducational + CBT in theses different aspects: historical developments, definition of terms, differences with other approaches as educational training developed recently in medical setting. We describe in this paper the program proposed by Lam et al. (1999), as conducted in our academic department of psychotherapies in Sainte-Anne's hospital in Paris with 139 refractory bipolar I outpatients. The main results show an improvement in psychological functioning associated with depression (i.e., dysfunctional beliefs, self-esteem) and quality of life (i.e., social relationships, psychological health) for bipolar patients significantly weakened by the duration of illness, the number of recurrence (average of 13 thymic episodes) and the burden psychosocial consequences. [ABSTRACT FROM AUTHOR]

The article presents a study on an occupational video feedback intervention for people with traumatic brain injury (TBI). It states that the intervention aims at improving self awareness of people with TBI by using video feedback for their occupational performance. It mentions key procedures of the intervention which includes planning a meaningful activity for the participant of the therapy, monitoring of participant by the therapist and self evaluation of participant.

The aim of this article is to give three different points of view on the same case report. [ABSTRACT FROM AUTHOR]

Résumé Sujet et problématique Les délires de persécution et de préjudice sont les thèmes délirants les plus fréquents. Ils induisent chez les sujets psychotiques (schizophrènes ou paranoïaques) qui en souffrent un climat émotionnel fait d’angoisse et de peur qui suscite la plupart du temps des réactions pathologiques de défense et/ou de vengeance. Ces réactions sont faites de comportements d’évitement ou de fuite, voire quelquefois d’agressions contre les persécuteurs. Dans ce cas, ces passages à l’acte violents sont destinés à maîtriser ou à anéantir la source de la persécution ou des préjudices éprouvés. De nombreux exemples l’attestent régulièrement. Certaines de ces réactions pathologiques peuvent même donner lieu à des homicides uniques ou multiples. Les thérapies cognitives et comportementales sont un vecteur thérapeutique utilisable pour traiter certaines de ces croyances délirantes. Patient et méthode Nous présentons dans cet article une thérapie cognitive et comportementale de ce type de croyance délirante criminogène. Nous avons réalisé cette thérapie avec un schizophrène dangereux auteur d’un double homicide par vengeance pathologique. Ce patient était convaincu depuis quatre ans que la mère de sa petite amie lui avait volontairement transmis le virus du sida en lui faisant boire un café et qu’il allait de ce fait mourir dans d’atroces souffrances. Résultat Rémission de la conviction délirante criminogène en fin de thérapie. Discussion/conclusion Après l’échec des thérapies psychiatriques traditionnelles à résoudre ou à abraser le délire de ce patient et la symptomatologie réactionnelle à ce délire, nous constatons le résultat positif de l’approche cognitiviste et regrettons qu’elle n’ait pas eu lieu avant les passages à l’acte criminel. Ce résultat a certainement été facilité par la relative récence de la conviction délirante, par l’investissement total du patient dans la psychothérapie pour « échapper à la mort », par sa suggestibilité de ce fait accrue et par l’existence d’un psychisme majoritairement sain. Il faut également remarquer chez ce sujet la disproportion existant entre l’extrême sectorisation (une seule croyance maîtresse erronée), voire la banalité du délire et sa puissance criminogène (deux homicides précédés et suivis d’une velléité suicidaire et vindicative importante et récurrente). De la même façon, la relative facilité à résoudre le problème cible paraît disproportionnée par rapport à sa puissance émotionnelle et psychodynamique. La dissolution non confrontative et progressive des composantes du délire avec participation très active de ce patient chimiorésistant a constitué l’axe central et efficace de cette thérapie réalisée en 1994. Depuis, la littérature scientifique a régulièrement confirmé l’intérêt des thérapies cognitives et comportementales dans le traitement de certaines croyances délirantes schizophréniques. Associées à des stratégies traditionnelles (hospitalisations, chimiothérapie psychotrope, etc.) ou à des techniques plus nouvelles et complémentaires (modules de réhabilitation des habiletés sociales, modules neuroleptiques, psychoéducation, etc.), ces thérapies semblent d’autant plus efficaces qu’elles sont réalisées tôt da Subject and problematic Delusions of persecution and prejudice are the most common delusional themes. Psychotic subjects (schizophrenics or paranoiacs) who suffer from delirium are therefore liable to defensive behavioural characteristics and mechanisms, often leading to the pathological reactions of defence and/or vengeance. These reactions come from behaviour that compels one towards avoidance or escape, sometimes even aggression towards the perceived persecutors. In such cases, violent acts are committed in an effort to control or destroy the source of perceived suffering and persecution. Several examples regularly attest this claim. Some of these pathological reactions can even give rise to unique or multiple homicides. Cognitive and behavioural therapies are a therapeutic method that can be used to treat some of these delusional beliefs. Patient and method In this article, we present a cognitive and behavioural therapy for this type of criminogenic delusional belief. We carried out this therapy with the dangerous schizophrenic perpetrator of a double homicide that was driven by a pathological need for vengeance. This patient was convinced for four years that his girlfriend's mother had deliberately transmitted the AIDS virus to him by making him drink a coffee, and that as a result he was going to die in terrible agony. “She contaminated me because I wanted to leave her daughter and she was not happy about this”, he thought. Following the manifestation of this mistaken conviction, the patient developed a reactive depression: a social retreat and a significant isolation, during which he constantly nourished his delusional thoughts. As a way of anticipating this “death by AIDS”, he eventually wished first to eliminate the person whom he held responsible for his contamination, then to commit suicide. In the latter stages, his thoughts came to him “as voices” which he heard repeatedly in his head: “ I have AIDS! I’m going to die! I must kill her! I absolutely must kill her! There's nothing to do, I must kill her! ”. As a result, using a hunting rifle he killed a couple, having mistook his target. The aim of the therapy was to induce a doubt in the delusional conviction of his contamination. This increasingly significant doubt and the gradual alleviation of the delirium were mainly researched using the socratic method of modifying belief(s). This technique enabled progressive critical analysis of the “proofs” which had lead the subject to construct and furnish his erroneous conviction while wrongly processing extra psychic or infra information. While still respecting the pathological belief of the patient, this method allowed him to find alternative and substitutional explanations for his false ideas. The reinforcement of the delusional belief by direct confrontation was thus avoided, and the patient grew to realise and understand the dysfunctional dimension of his cognition, his emotions and his behaviour. The therapeutic care carried out in a unit devoted to dangerous patients was composed of five sessions of functional analysis, followed by twelve sessions of therapy at a rate of one session a week. Between each session, the patient was required to complete some exercises. Result Disappearance of the delusional criminogenic conviction by the end of therapy. The depressed state of mind, like his suicidal tendencies, decreased step-by-step as the conviction of having AIDS extinguished, the disappearance of the cause naturally leading to the dissipation of its effects. Discussion/conclusion After the failure of traditional psychiatric therapies to resolve or to ease the patient's delirium and the reactional symptomatology to this delusion, we note the success of the cognitivist approach and regret that it did not take place before the transition of this delusion into criminal acts. Obtaining this result was certainly facilitated by the relative recen [ABSTRACT FROM AUTHOR]

Résumé Dans l’optique d’asseoir la légitimité du neurofeedback comme thérapeutique et de mieux informer les patients sur cette thérapeutique, les études classiques d’efficacité (études contrôlées randomisées en double insu) sont indispensables mais ne représentent qu’un aspect parmi d’autres. Nous avons donc proposé d’appliquer les critères de Duruz au cas emblématique du neurofeedback pour la prise en charge du trouble déficit de l’attention avec hyperactivité (TDAH). Nous avons, d’une part, rendu compte du modèle du neurofeedback selon les cinq critères scientifiques de pertinence et de preuve. Nous avons, d’autre part, analysé l’épistémologie engagée par le modèle du neurofeedback et une perspective neuro-phénoménologique a été proposée. Enfin, nous soulignons, qu’en France, la création d’une communauté scientifique, rattachée aux sociétés savantes internationales existantes sur le neurofeedback, devient nécessaire. In order to establish the legitimacy of neurofeedback as a treatment and to better inform patients about this therapeutic, classical efficacy studies (double-blind randomized controlled trials) are essential but are only one aspect among many. We therefore proposed to apply the Duruz's criteria to the emblematic case of neurofeedback for the treatment of attention-deficit/hyperactivity disorder (ADHD). On the one hand, we applied five scientific criteria of relevance and evidence to the neurofeedback. On the other hand, we analysed the epistemology initiated by the model of neurofeedback according to a neurophenomenological perspective. Finally, we note that, in France, the creation of a scientific community, attached to the existing international scholarly societies on neurofeedback, is needed. [ABSTRACT FROM AUTHOR]

Psychophysiological insomnia is characterized by acquired sleep difficulties and/or a state of hypervigilance when going to bed. This mental and physiological condition prevents sleep onset regardless of the presence of anxious or depressive disorders. Despite the fact that cognitive behavioural therapies have been shown to be effective for this disorder, some people are not responding to this treatment. It is therefore important to explore new ways of increasing the effectiveness of current treatments. Approaches based on mindfulness, which promote a non-judgemental acceptance of the living experience, are increasingly reported in the literature to be effective in the treatment of various physical and psychological health conditions, being particularly efficient in reducing the stress and discomfort associated with these problems. This article focuses on some cognitive factors associated with maintaining insomnia and suggests that approaches based on mindfulness, through certain action mechanisms, may help to improve sleep. A review of recent studies on the application of mindfulness-based approaches to treat insomnia is hereby presented. Avenues for future research to improve insomnia treatment protocols based on mindfulness are suggested. [ABSTRACT FROM AUTHOR]

Tinnitus is frequently a motive for consultation in audiological services, which is generally a tolerated symptom according to epidemiological studies. However clinicians must also give counselling to some distressed patients, for whom the ringing in the ear are unbearable, leading to significant emotional disorders. The clinical contrast between suffering and non-suffering tinnitus patients has suggested comparative researches in order to enlighten this minor lack of tolerance to tinnitus compared to an epidemiological normal response. Studies have supported an habituation model to tinnitus which stands that habituation is the normal state of perception of tinnitus, and inhabitation is the result of a psychiatric co-morbidity. Referring to the neurophysiological principle of a natural inhibition of the orienting reflex with repeated stimulations, the habituation model states that tinnitus is a meaningless stimulus for the perception. Several psychopathological roadblocks (related to anxiety and depression) would prevent this natural inhibition to occur, leading to individual annoyance. In this article we analysed the epistemological foundations of the habituation model framework, regarding to experimental results in the psychoacoustics of tinnitus, and the concept of habituation in its neurophysiological framework. The process of habituation to tinnitus is discussed from these experimental references and recent progress in magnetic resonance imaging (MRI) from the neuroscience of tinnitus. Clinical implications of this analysis are suggested in conclusion, opening the discussion to the opportunity of another clinical approach of patients suffering from tinnitus. [ABSTRACT FROM AUTHOR]

Résumé: L’évaluation et la prise en charge de la douleur chronique nécessitent de se référer au modèle bio-psychosocial. Ce modèle prend en compte la diversité du patient et permet de proposer une stratégie globale de traitement. Les Thérapies Comportementales et Cognitives (TCC) s’inscrivent dans cette démarche pluridisciplinaire qui prend en compte les facteurs somatiques mais aussi les aspects psychosocioprofessionnels. Elles s’intègrent dans le cadre d’une démarche scientifique expérimentale, basée sur les théories de l’apprentissage. La douleur chronique est considérée comme un comportement conditionné et le travail thérapeutique se centre sur le « comment faire face » au comportement actuel qui pose problème. Ces thérapies s’aident de plusieurs stratégies de traitement de manière concomitante et présentent moins de clivage entre le modèle médical et le modèle « psy ». De ce fait, elles sont bien acceptées par les patients. Cette approche a montré son efficacité et est bien documentée dans la littérature. Les Anglo-Saxons utilisent le terme de « psychoeducation ». [ABSTRACT FROM AUTHOR]

Abstract: Social cognition, which refers to how people think about themselves and others in the social world, is a core component for social, professional and interpersonal functioning and is commonly impaired in schizophrenia. This cognitive domain has strong associations with daily activities and could act as a link between social functioning and neurocognition. Two primary domains of social cognition: theory of mind and emotions perception have been studied for long and many arguments highlighted the direct relationship between impairments of these processes and the alteration of functional outcomes in schizophrenia. During the past 15years, researchers are interested in social cognition and developed, in the field of cognitive remediation, some therapeutic approaches with the aim of reducing difficulties and handicaps. The first programs were supported by the assumption that the improvement of neurocognition was necessary before enhancing social cognition. At the same time, other authors hypothesized that it is possible to improve the performance of people with schizophrenia by directly targeting impaired functions, and so developed specific programs. More recently, researchers intend to develop global programs that take into account all components of social cognition impaired in schizophrenia in order to improve functional outcomes. [Copyright &y& Elsevier]

Abstract: Rooted in the psychotherapies of the third wave which point up the mindfulness concept and the acceptance of life experiences, the MBCT was applied for the first time in 2000 by Teasdale within the framework of a clinical trial designed to explore the key factors of the cognitive vulnerability to recurrent depression. If this princeps study has been replicated on several occasions and is still being deepened at this time, the exploration of the MBCT effects has also been broadened to a plurality of other therapeutic fields. After a brief presentation of its background and basic procedure, we submit an overview of the present state of research based on thirty-seven studies in accordance with the original group format delivery while expressing the main empirical results relating to the efficiency issue of the therapy. The outcomes show evidence of both a proven action in the depression field and a real applicability potential in the other fields explored despite an obvious need of methodological refinement and replication to complement the existing accounts. The outcome analysis will lead us to reflect on the psychotherapeutic drives of the MBCT and to mark the area of its most efficient clinical application modes out. [Copyright &y& Elsevier]

Abstract: The objective of this article is to investigate the effects of Eye Movement Desensitization Reprocessing treatment for victims of domestic violence. Five women were offered treatment with between three and nine 60-minute EMDR sessions. Assessments were completed at pre-treatment, post-treatment, and at the 6-month follow-up, with the purpose of demonstrating the ability of EMDR psychotherapy to reduce Posttraumatic Stress Disorder (PTSD), anxiety, and depressive symptoms. Results showed a significant reduction in PTSD scores (intrusion, avoidance symptoms), anxiety, and depression, and were maintained after 6months. This study opens up original perspectives for the treatment of domestic violence victims. The question of EMDR therapy''s adequacy and pertinence for the treatment of domestic violence will be discussed. In any case, EMDR therapy seems to offer a promising therapeutic, social, and clinical response for this population, which is often difficult to treat. [Copyright &y& Elsevier]

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Abstract: Obsessive-compulsive disorder (OCD) is a chronic, recurrent, and often disabling disorder. Comorbid emotional and personality disorder are common and can serve to complicate both course of illness and treatment outcome. Controlled trials with adults have shown cognitive-behavior therapy (CBT) that includes exposure and response prevention (ERP) to be highly effective for treating the disorder. It means exposing the patient to the very thing that causes fear and anxiety, and using all his strength to simply accept the experience instead of relying on compulsions to counteract it. The basic concept of CBT is: by changing the behavior, the patient eventually changes how he thinks and feels. CBT usually works fairly quickly, and it relies mostly on action, not insight. In this article we describe a cognitive-behavioral group treatment for both OCD symptoms and comorbid personality disorder. By an evaluable patient analysis; statistically and clinically significant pretreatment to posttreatment change occurred in OCD diagnostic status and severity. Some personality traits also changed. The results of this study, the first to evaluate this dimension of the personality disorders comorbidities in the OCD and their evolution with a behavioural and cognitive psychotherapy, are very encouraging. Indeed, evolution of the fields and facets of the personality changed positively. [Copyright &y& Elsevier]

Abstract: This paper reviews the cognitive-behavioural strategies of psychotherapy applied to hypochondria. Cognitive mechanisms of hypochondria are the tendency to amplify body manifestations (pain, fatigue…) and to interpret them in a catastrophic manner. The persistence of anxiety is due to a confirmatory bias, which increases the importance given to information congruent with anxiety. The exposure–response prevention model is an important technique in the treatment of hypochondria. This model has been validated in patients presenting obsessive compulsive disorders. Patients are invited to confront ideas or thoughts that induce fear. This confrontation is repeated or prolonged in order to induce the extinction of anxiety. Another cognitive approach is the step-by-step cognitive “modelling”. During the first step the patient assesses his stress-inducing thoughts concerning his health, he also has to assess the frequency of inadequate medical treatments. During the next step, the therapist helps the patient correct automatic thoughts and false beliefs concerning his illness. The last step is a phase of consolidation. The therapist identifies factors triggering anxiety and excessive medical care. All these behavioural cognitive therapies can be performed in individual or in-group processes. Therapies proposed to patients presenting generalized anxiety disorders can be adapted to hypochondriacs. Lastly, hypochondria can be understood and treated as a form of addiction to medicine characterised by a craving for medical care, for biological exams and for different forms of medication. According to this conception, the treatment can be conducted as a form of detoxification: patients identify the frequency of their pathological behaviour and find strategies to reduce and/or control them. [Copyright &y& Elsevier]

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Copyright of European Review of Applied Psychology 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.)