Bullying on Adolescence: Psychological Assessment with Projective Methods (Paris School) / Bullying na Adolescência: Avaliação Psicológica com Métodos Projetivos (Escola de Paris)

ABSTRACT This work aims to assess the psychological impact of school bullying on adolescents. This study is about an exploratory clinical-qualitative research with multiple case studies of four teenagers, who had been victimized by bullying acts aged between 15 and 17 years old. This study applied the following instruments: Semi-structured interview; SCL-90-R scale; Rorschach Method and Thematic Apperception Test (Parisian School). The results show depression, anxiety, non-suicidal self-injury and suicidal attempts. On the SCL-90-R Scale, five out of nine psychopathological factors stood out in two cases. On Rorschach, the coercion and extroversion predominate as a Type of Intimate Resonance. Thematic Apperception Test results points lability and rigidity. The presence of bullying points to an own psychological dynamic in each case.

RESUMO Analisa-se o impacto psicológico do bullying escolar em adolescentes. Trata-se de pesquisa exploratória clínico-qualitativo com estudo de casos múltiplos de quatro adolescentes que sofreram bullying, com idade entre 15 e 17 anos. Utiliza-se como instrumentos: Entrevista Semiestruturada; Escala SCL-90-R; Método de Rorschach e Teste de Apercepção Temática (Escola de Paris). Resultados mostraram sinais de depressão, ansiedade, comportamentos autolesivos e tentativas de suicídio. Na Escala SCL-90-R sobressaíram em dois casos, cinco dos nove fatores psicopatológicos. No Rorschach predomina Tipo de Ressonância Íntima coartado e extroversivo, com reatividade afetiva e capacidade de relacionamentos interpessoais afetadas em alguns casos. No Teste de Apercepção Temática destacam-se procedimentos que indicam labilidade e rigidez. A presença do bullying aponta para dinamismo psíquico próprio em cada caso.

The experience of bullying among adolescents receiving mental health care: an interpretative phenomenological analysis.

BACKGROUND: Bullying, the most prevalent form of abuse among adolescents, is associated with emotional and behavioural problems as well as psychiatric morbidity. Moreover, it has been shown that adolescents with previous mental health problems are at increased risk of being bullied and that the psychopathological repercussions of bullying are greatest among them. However, little is known about the experience of bullying in adolescents receiving treatment from mental health services. The aim of this study was to explore the subjective experience of bullying in adolescents receiving mental health care. METHODS: The study was developed in the context of a French multicentre research program and employed an exploratory phenomenological approach. A purposeful sampling strategy was used to select adolescents who had experienced bullying (according to the Olweus criteria) and who were able to relate their experiences clearly. In-depth, semistructured interviews with participants were conducted; written transcriptions of these interviews were analysed using thematic analysis. RESULTS: Twenty-one adolescents (age range: 12-17 years; 13 girls) participated in the study. The analysis indicated a three-axis structure: (1) negative emotions and violent feelings, describing adolescents' fear, sadness, aggression against themselves, and generalized mistrust; (2) isolation and loneliness, underlining the need to take refuge within oneself and the experiences of rejection, helplessness, and secret-keeping; and (3) self and identity repercussions, including experiences of shame and lowered self-esteem, identity questions, and a vision of bullying as a life experience. CONCLUSIONS: The results of this study may have practical implications for clinicians: (1) a situation of bullying should be sought when an adolescent is seen for unexplained externalized behavioural misconduct; (2) low levels of emotional expression in a bullied adolescent may warn about associated self-harm; (3) a bullied adolescent's tendency to hide this situation from his or her parents may reflect underlying family-related vulnerability; and (4) the phenomenological analysis showed potential particularities in the assumptive world of these adolescents and suggested that relationality may play a crucial role in their experiences. These results suggest incentives to design specific individual and group therapeutic interventions for bullied adolescents with significant levels of social withdrawal, including family support. Additional research is necessary to improve our understanding of the psychopathological and intersubjective aspects of bullying in adolescents.

Destino dos Afetos no Rorschach de Mulheres Vítimas de Incesto / The Fate of Affections in the Rorschach of Women Victims of Incest

Resumo Este estudo tem como objetivo analisar o destino e a dinâmica dos afetos em mulheres adultas que sofreram incesto paterno na infância e adolescência. Apoiando-nos nos conceitos de afeto e trauma da psicanálise, levantamos a hipótese de que o incesto desorganiza as capacidades psíquicas das vítimas e suas vivências afetivas. Realizamos um estudo descritivo-exploratório de casos múltiplos com mulheres francesas utilizando entrevistas e o Método Projetivo de Rorschach (Escola de Paris). Essas mulheres apresentam um modo particular de expressar afetos, nem sempre sintônico com a representação devido à gravidade da clivagem. Assim, há uma distorção do afeto com perda da sua qualidade psíquica. Concluímos pela necessidade de acompanhamento terapêutico baseado nas capacidades de identificar, reconhecer e manejar os afetos.

Abstract This article aims to analyze the fate and dynamics of affections in adult women who suffered paternal incest during their childhood and adolescence. Based on the concept of affection and trauma in psychoanalysis, we hypothesized that incest disorganizes psychological capacities and affective experiences of the victims. We conducted an exploratory-descriptive study of multiple cases with French women using interviews and the Rorschach Projective Method (Parisian School). These women have a particular way of expressing affections, not always in sync with representation, due to the severity of the splitting. Therefore, there is a distortion of affection with the loss of its psychic quality. We conclude that therapeutic follow-up, based on the ability to identify, recognize and manage affections is deemed necessary.

Using a Mixed-Methods Approach to Analyze Traumatic Experiences and Factors of Vulnerability Among Adolescent Victims of Bullying.

A number of studies have analyzed the bullying phenomenon among adolescent victims. Relatively few studies, however, have specifically addressed the associated post-traumatic stress disorder (PTSD). Our clinical practice and therapeutic encounters with adolescents reveal that the majority of bullied adolescents suffer from high levels of PTSD. The objective of this study is to further explore bullied adolescents' traumatic experiences. In an attempt to analyze these experiences, this article presents a mixed-methods approach. Such an approach will allow to analyze the PTSD that results from bullying as well as subjects' psychic and family-relevant vulnerabilities. First, bullying will be defined in the context of adolescence. Then the main studies on bullying will be presented. The objectives, tools and methods of analysis will be presented. The interviews will be analyzed according to the Interpretative Phenomenological Analysis (IPA) method. Projective tools, family drawings, Rorschach and Thematic Apperception Test (TAT), will be analyzed using a psychoanalytic interpretation method. Each qualitative tool will be used alongside a validated quantitative tool. The Clinical Administered PTSD Scale (CAPS-CA-5 questionnaire) and the interviews conducted will thus allow to analyze PTSD and traumatic experiences. The Family Assessment Device (FAD) and the family drawing test will enable to assess family functioning; lastly, the Symptom Check List (SCL-90) that will be used alongside Rorschach and TAT tests will allow to analyze individual psychological vulnerabilities. This approach will increase data validity. The originality of this research study is based on a mixed-methods approach, our methodology which is based on clinical psychology, and the choice of certain research tools which have received little attention to date. Ultimately, this study may help improve how bullying is identified and could contribute toward the reinforcement or revision of the criteria that characterize bullying. Lastly, it may help us explore various unexamined dimensions of bullying. A possible limitation is the complexity associated with such a protocol.

Evolution of procalcitonin, C-reactive protein and fibrinogen levels in neutropenic leukaemia patients with invasive pulmonary aspergillosis or mucormycosis.

Unlike bacterial infections, the value of procalcitonin (PCT) in detecting fungal infections in leukaemia patients is not clear. To determine whether the monitoring of PCT coupled with C-reactive protein (CRP) and fibrinogen (Fib) could be helpful in the management of pulmonary aspergillosis (IPA) or mucormycosis (PM), we retrospectively analysed the evolution of PCT, CRP and Fib levels in 94 leukaemia patients with proven/probable IPA (n = 77) or PM (n = 17) from D-12 to D12 relative to IFI onset defined as D0. Overall, 2140 assays were performed. From D-12 to D0, 12%, 5% and 1.4% of patients had PCT >0.5, 1 and 1.5 µg l(-1) , respectively, while CRP was >50, 75 and 100 mg l(-1) in 84%, 70% and 57% and Fib was >4, 5 and 6 g l(-1) in 96%, 80% and 61% of cases respectively (P < 10(-7) ). The same trends were observed from D1 to D12. Overall, between D-12 and D12, only 6.4% of patients had PCT >1.5 µg l(-1) , while CRP >100 mg l(-1) and Fib >6 g l(-1) were observed in 80% and 75% of cases respectively (P < 10(-7) ). In leukaemia patients, IPA or PM was accompanied by a significant increase in CRP and Fib while PCT remained low.

[Between the creation of the arteriovenous shunt and the dialysis: a convenient moment for patient education?]. / Dans l'entre deux de la création de la fistule et de la mise en dialyse : un moment propice pour l'accompagnement du patient ?

The majority of the researchers having worked on the psychology-nephrology agree to say that the stake in dialysis patient is lived as a major traumatism. Do we consequently have to understand that the announcement of the renal insufficiency accompanied with a medical follow-up indeed upstream to the stake in dialysis cannot require a preventive value? To arrest various stages in the progress of the person reached by a renal pathology helps us to understand in what way the psychic temporality is different from the real time. Doctors, nursing, psychologists seem sometimes amazed to notice that the patient did not integrate certain elements of reality, cannot hear, accept his condition to be sick whereas he has a crowd of information or what it was "warned". In supporting us of clinical examples, we advance the hypothesis according to which the fistula arterio-venous as first physical burglary seems too to be traumatic. We wonder if between two of the creation of the arterio-venous fistula and the stake in dialysis is a convenient moment to inform the patient and watch that he welcomes as good as possible the treatment.