Resilience and vulnerability of northern regions to social and environmental change.

The arctic tundra and boreal forest were once considered the last frontiers on earth because of their vast expanses remote from agricultural land-use change and industrial development. These regions are now, however, experiencing environmental and social changes that are as rapid as those occurring anywhere on earth. This paper summarizes the role of northern regions in the global system and provides a blueprint for assessing the factors that govern their sensitivity to social and environmental change.

[Antenatal diagnosis. A psychological study. I. The intervention of doctors in pregnancy (author's transl)]. / Le diagnostic prénatal. étude psychologique. I. L'intervention des médecins dans la grossesse.

Antenatal diagnosis enables certain fetal abnormalities to be detected "in utero", and in particular mongolism. This examination is often undertaken in the process of medical attention in pregnancy. This explains why interviews with pregnant women about this far from ordinary act have become so superficial. Men and women react differently to this take-over. The former take part in a scientific discussion, the latter, who are more closely involved, which is to say with their whole bodies, set themselves against both good and bad doctors and often try to resist this test. We have attempted to understand the meaning of wanting to or not wanting to know the sex of the child in this context before its birth, and what happens to the wish to have a child after this kind of medical care.

[Prenatal diagnosis. A psychological study. II. Pregnancy after the age of 40 (author's transl)]. / Le diagnostic prénatal. Etude psychologique. II. les grossesses après 40 ans.

This article, which is the second installment of a study of the psychological aspects of antenatal diagnosis, presents the analysis of interviews with women (and with some of their partners) who were examined because of their age. The characteristics of these "late" pregnancies seem to be the following: 1. The question of a abnormality shifts the emphasis from the child to the pregnancy itself, which is often lived through as something abnormal; 2. knowing the sex of the child before its birth emphasizes the abnormality of the pregnancy and therefore draws attention to the problem of the age of the mother; 3. this last chance of pregnancy emphasizes the question, which is near in time for these women, of the menopause, of getting old and of death; 4. it also emphasizes in a most emphatic way the question of mourning, of loss, of the place of the future child in the history of the woman and in a more general way the question of the desire to have a baby.

[Psychological repercussion of hereditary diseases and of their detection (author's transl)]. / Retentissement psychologique des maladies héréditaires et de leur détection.

In an investigation concerning the psychological aspects of prenatal diagnosis, the repercussions of hereditary disease as well as their detection were studied. Analysis of the contents of interviews with the 30 involved couples pointed out the prevalence of imaginary elaborations regarding heredity and its affections and allowed us to examine the function of the secret, which was always present, regardless of the hereditary disease and its means of transmission.

Asking for a prenatal diagnosis after the birth of a child with Down's syndrome.

Three years ago we undertook, in collaboration with André and Joëlle Boue (Inserm U 73), a research project investigating the psychological aspects of prenatal diagnosis following the earlier birth (and sometimes death) of a child with Down's syndrome. For this study we selected 20 couples who had requested such an examination. These couples present some particularities which justified, in our opinion, a specific study. In a few cases, one of the parents happened to be a carrier of a balanced chromosome translocation, but usually the trisomy was free. Moreover, the mother's age did not increase the risk factor. Our investigation was carried out on the basis of a series of one or several interviews, the man and the woman being seen separately. These unstructured interviews, with the fewest possible questions and interventions on our part, were tape-recorded with the permission of our subjects. We then analyzed the precise content of the typed texts of the these interviews. Two main topics emerged from this analysis: 1) The extreme impact of the birth of a child with Down's syndrome and the place and role of such a child in the family's life, and 2) The relationship between the parents and physician before and after the birth, including the request for a prenatal diagnosis.