Foster children avoidance-related interactive behaviors with caregivers.

BACKGROUND: A lot of the research concerning foster children - often children who have suffered maltreatment in the family home - has focused on internalized and externalized symptoms. Few studies, however, have looked at the interactions between such children and caregivers. PURPOSE: The purpose of this study is to explore the Emotion Regulation Strategies (ERS) of children in foster care and to highlight those most commonly employed in family or placement contexts. The parents' and foster carers' ERS are also analyzed in order to understand the co-regulatory processes at work. METHOD: An in-depth analysis of observation sequences was performed. Three data collection times, spaced across a period of 6 months (t1, t2 and t3), were included in the observation protocol. Each observation, recorded using a video camera, comprised 45 min of free time and 15 min of structured tasks. Transcription and coding of ERS were performed for each sequence using a microanalytical method. Both children's and adults' ERS were coded. RESULTS: Children tended to be readily distracted when interacting with adults, and more particularly so with their parents. While they tended to display relatively normative processes with a foster carer, they turned to pathological avoidance mechanisms with their parents such as physical venting or self-stimulation. Interactions during structured tasks showed a significant reduction in distraction processes. CONCLUSION: This study highlights the prevalence of distraction behavior in foster children during their interactions with caregivers, and offers an insight into how structured interactions provide a framework that mitigates children's avoidance behaviors and so enhances adult-child collaboration.

Interaction microanalysis of foster care research using THEME.

Environmental stress is a key element to the understanding of the psychopathology of children in foster care. Such children often present a wide range of symptoms from anxiety to depression, including abnormal behaviors in their interactions with adults that can be related to experience suffered in their family of origin (e.g., abandonment, abuse, etc.). Foster care should provide a safe environment, both to protect children from abuse and to help them build a well-adjusted developmental trajectory. The relationships with the family of origin may also be maintained. How do children in foster care behave in relation to caregivers given the differences between the families they grow up in? This study focuses on three adult-child relationships: those with a foster carer, a mother and a father. Each adult-child interaction was recorded several times in a day-to-day environment. On each occasion the instruction was given to behave naturally while interacting with a child. No additional material was supplied. Our observations concern the verbal and non-verbal comportment of a 4-year-old foster child named Julia when entering the study, with her caregivers. Once the principal elements had been coded (behaviors, verbalizations), a sequential behavioral patterns analysis was performed using the THEME© program. For this purpose, a 2-min interaction was chosen from the third video of an event which appeared particularly representative of the relationship between Julia and her different caregivers. According to whom Julia was with, the results reveal very different interactive processes. We observe, for example, that with the foster carer the interaction patterns were primarily focused on play objects, whereas they involved more collaborative activity with the father and distraction/avoidance behaviors with the mother. The study identifies the use of disengaging and self-exciting behaviors in all types of interaction. Those emotion regulation strategies are particularly developed during parent-child sessions, showing pathological processes of relationship.

Is the Snoezelen method a non-pharmacological alternative for patients with neurocognitive disorders? / La méthode Snoezelen : une alternative thérapeutique chez les patients ayant des troubles cognitifs ?

Neuropsychiatric disorders are one of the frequent complications of neurocognitive disease, and have an impact on the quality of life of patients and caregivers. Non-phamacologic interventions are recommended as first-line treatment. The Snoezelen method is a multisensory stimulation method based on the assumption that acting on sensoriality can improve neuropsychiatric symptoms and thus quality of life, but its level of evidence is controversial. To explore this, we performed a systematic literature review of randomized controlled articles focusing on the use of the Snoezelen method in patients with cognitive disorders. Eighteen studies were included. The clinical outcomes studied were multiple (behavior, mood, cognition, functional capacities and biomedical parameters). When the Snoezelen method was compared to the "standard activities" group, it appears to be effective on short-term behavior. This was more negligible when the method was compared to others non-pharmacological interventions. Although the Snoezelen method could be effective on mood, cognition, and functional abilities, its level of evidence remains low. Furthers mixed studies (quantitative and qualitative) would be an interesting approach to delve into this topic in the most holistic way by integrating the patients, the caregivers and the cost of the method.

La prise en soin des symptômes neuropsychiatriques de patients ayant des troubles neurocognitifs est basée sur des traitements non médicamenteux. Certains auteurs suggèrent que la méthode Snoezelen pourrait être une alternative thérapeutique. L'objectif de cette revue de littérature était de faire une recherche systématique des essais contrôlés et randomisés ayant analysé l'effet de la méthode Snoezelen sur les patients âgés ayant des troubles cognitifs. Le processus de sélection a permis d'inclure 18 études, ayant des méthodologies hétérogènes. Dans plusieurs études, la méthode Snoezelen pourrait avoir un effet bénéfique, à court terme, sur les troubles du comportement, sur l'humeur, la cognition, ou les capacités fonctionnelles. Cependant, la méthode Snoezelen ne semblait pas être supérieure à d'autres interventions non médicamenteuses et certaines études montraient des résultats discordants. Finalement, le niveau de preuve d'efficacité de la méthode Snoezelen reste faible et des études mixtes (quantitatives et qualitatives) seraient intéressantes à mener pour évaluer l'intérêt de la méthode Snoezelen sur des profils spécifiques de patients ayant des troubles neurocognitifs.

Left but not right hemisphere semantic processing abnormalities in language comprehension in subjects with schizotypy traits.

Thought and language disorders in schizophrenia and schizotypy are thought to result from hemispheric dysfunction during semantic processing. Left hemisphere (LH) abnormalities are well established, but little is known about right hemisphere (RH) semantic processes. We explored hemispheric processing in 50 healthy volunteers assigned to high (h-SZT) or low schizotypy (l-SZT) group using the Schizotypal Personality Questionnaire (SPQ). Subjects were asked to make semantic judgments on sentence pair ending with a target that was either expected word (EW) or an unexpected word from the same (related violation, RV) or a different category (unrelated violation, URV). Targets were presented in a dichotic manner to the left or right ear. Analyses of reaction times in the l-SZT group showed semantic compatibility effect (URV-EW) in the LH and semantic memory activation effect (RV-URV) as well as semantic compatibility effect in the RH. The h-SZT group showed semantic memory activation but no semantic compatibility effect in the LH, the RH pattern resembling that of the l-SZT group. The magnitude of the LH semantic compatibility effect was inversely correlated with SPQ total scores and SPQ Cognitive-perceptual factor. Thus, RH semantic processes are effective and there is a deficit in LH focused activation in schizotypy.

An Event Related Potentials Study of Semantic Coherence Effect during Episodic Encoding in Schizophrenia Patients.

The objective of this electrophysiological study was to investigate the processing of semantic coherence during encoding in relation to episodic memory processes promoted at test, in schizophrenia patients, by using the N400 paradigm. Eighteen schizophrenia patients and 15 healthy participants undertook a recognition memory task. The stimuli consisted of pairs of words either semantically related or unrelated to a given category name (context). During encoding, both groups exhibited an N400 external semantic coherence effect. Healthy controls also showed an N400 internal semantic coherence effect, but this effect was not present in patients. At test, related stimuli were accompanied by an FN400 old/new effect in both groups and by a parietal old/new effect in the control group alone. In the patient group, external semantic coherence effect was associated with FN400, while, in the control group, it was correlated to the parietal old/new effect. Our results indicate that schizophrenia patients can process the contextual information at encoding to enhance familiarity process for related stimuli at test. Therefore, cognitive rehabilitation therapies targeting the implementation of semantic encoding strategies can mobilize familiarity which in turn can overcome the recollection deficit, promoting successful episodic memory performance in schizophrenia patients.

Impaired context processing during irony comprehension in schizotypy: An ERPs study.

Mentalizing deficits are a core manifestation of schizophrenia spectrum disorders. They contribute to the social handicap associated with the pathology, leading to disruption in autonomy, professional achievement, and interpersonal relationships. However, the underlying mechanisms of these deficits remain poorly understood. The aim of the present study was to test the hypothesis that context processing deficits would be responsible for mentalizing difficulties in schizotypy (personality traits considered as attenuated manifestations of schizophrenic symptoms) by using an irony comprehension task. Irony processing is a mentalizing exercise that requires the ability to take into account the semantic context to understand the literal meaning of the utterance, and to integrate the pragmatic context to infer the speaker's intention. These two steps of processing can be indexed by the N400 and P600 components, respectively, of event-related brain potentials (ERPs). Forty participants were assigned to high or low schizotypy groups according to their Schizotypal Personality Questionnaire (SPQ) score, and ERPs were recorded while they read short stories ending with a literal, ironic, or incompatible statement. In the low-SPQ group, there was a significant N400 semantic context effect (literal targets elicited less negative N400 amplitudes compared to incompatible targets) followed by a P600 pragmatic context effect (ironic targets evoked greater positive P600 amplitudes than literal targets). In contrast, there was neither a N400 nor P600 effect in the high-SPQ group. These abnormalities were associated with high interpersonal SPQ factor scores. These results show a strong association between context processing, mentalizing abilities, and interpersonal functioning in schizophrenia spectrum.

Event-related brain potential study of expectancy and semantic matching in schizotypy.

Priming studies have revealed semantic processing abnormalities in subjects that display high schizotypal traits. The objective of the present study was to further elucidate the contribution of predictive (expectancy) and integrative (semantic matching) context processing to the semantic deficit described in schizotypy. Thirty-six participants were assigned into high or low schizotypy groups according to their score on the Schizotypal Personality Questionnaire (SPQ), and event-related brain potentials were recorded while these individuals performed semantic judgments based on asymmetrically associated word pairs. Viewed in one direction (forward), the target was highly predictable from the prime, whereas in the backward direction, the prime-to-target association was weak. It was assumed that the forward condition would be dependent on expectancy generation, while the backward condition would rely on semantic matching. In the low-SPQ group, forward and backward related words evoked a reduced (less negative) N400 amplitude compared to unrelated words, resulting in a significant forward and backward N400 priming effect, respectively. By contrast, only forward related words were facilitated in the high-SPQ group, resulting in significant forward priming and a lack of backward priming. Furthermore, the N400 amplitude for forward related words was less negative within the high-SPQ group in comparison to the low-SPQ group, which indicated easier semantic access to predictable words for high-SPQ individuals. Therefore, schizotypy may be associated with an imbalance in the use of predictive and integrative context processing strategies, namely preserved, if not over allocated, expectancy generation along with altered integration of unpredictable words due to semantic matching deficit.

Effect of semantic coherence on episodic memory processes in schizophrenia.

Schizophrenia is associated with severe episodic retrieval impairment. The aim of this study was to investigate the possibility that schizophrenia patients could improve their familiarity and/or recollection processes by manipulating the semantic coherence of to-be-learned stimuli and using deep encoding. Twelve schizophrenia patients and 12 healthy controls of comparable age, gender, and educational level undertook an associative recognition memory task. The stimuli consisted of pairs of words that were either related or unrelated to a given semantic category. The process dissociation procedure was used to calculate the estimates of familiarity and recollection processes. Both groups showed enhanced memory performances for semantically related words. However, in healthy controls, semantic relatedness led to enhanced recollection, while in schizophrenia patients, it induced enhanced familiarity. The familiarity estimates for related words were comparable in both groups, indicating that familiarity could be used as a compensatory mechanism in schizophrenia patients.

An event-related potential study of predictive and integrative semantic context processing in subjects with schizotypal traits.

Context processing abnormalities may explain thought disorder in schizophrenia/schizotypy. This study aimed to assess predictive and integrative context processing in subjects with high or low scores on the Schizotypal Personality Questionnaire (SPQ). The N400 amplitude was recorded during semantic judgment of sentence pairs ending with a lateralized expected or unexpected word from the same or a different category (related and unrelated violation). In both groups, the N400 amplitude was less negative for expected words versus unrelated violations, regardless of which hemisphere received the stimulus, and for related versus unrelated violations, but only for left-hemisphere stimuli. The N400 amplitude for unrelated violations was less negative in subjects with high SPQ scores for both hemispheres. These results indicate that subjects with schizotypal traits use context to predict or integrate congruent words, but fail to inhibit incongruent words.

Validation of a French adaptation of the Harvard Trauma Questionnaire among torture survivors from sub-Saharan African countries.

BACKGROUND: To date no validated instrument in the French language exists to screen for posttraumatic stress disorder (PTSD) in survivors of torture and organized violence. OBJECTIVE: The aim of this study is to adapt and validate the Harvard Trauma Questionnaire (HTQ) to this population. METHOD: The adapted version was administered to 52 French-speaking torture survivors, originally from sub-Saharan African countries, receiving psychological treatment in specialized treatment centers. A structured clinical interview for DSM was also conducted in order to assess if they met criteria for PTSD. RESULTS: Cronbach's alpha coefficient for the HTQ Part 4 was adequate (0.95). Criterion validity was evaluated using receiver operating characteristic curve analysis that generated good classification accuracy for PTSD (0.83). At the original cut-off score of 2.5, the HTQ demonstrated high sensitivity and specificity (0.87 and 0.73, respectively). CONCLUSION: Results support the reliability and validity of the French version of the HTQ.

Effects of weight-related literal and metaphorical suggestions about the forearms during hypnosis.

During hypnosis, the authors tested repeated weight-related, literal and metaphorical suggestions about the heaviness of the subjects' arms. The purpose was to determine if linguistically varied hypnotic suggestions produced significantly different motor reactions--involuntary pressure forces of the forearms--as assessed by a linguistic biomechanical system. Classic, literal (L) suggestions such as "your right arm is heavy" were used, as well as metaphorical (M) suggestions, such as "your right arm is made of lead." A specific effect on the progressive increase of pressure forces only in the temporal sequence L-M for each forearm (literal suggestions followed by metaphorical suggestions) was found. This effect, termed crescendo image metaphor effect, conceptualized within context-limited simulation theory, explains the findings.