Is blood still thicker than water? A life-course perspective on the transformation of family and friends' roles in personal networks

This thesis addresses the issue of the moving boundaries between family and friends' roles in personal networks, adopting a life-course perspective and using Switzerland as a case study. In a period of major changes in personal life happening in contemporary Western societies, understanding the organization of personal networks intertwined with the unfolding of individual life courses is of prime importance in facing new challenges with regard to social integration. The data stem from a representative national survey carried out in 2011 named Family tiMes, including 803 individuals born either in 1950-1955 or in 1970-1975. An innovative research design was adopted, combing cross-sectional ego-centered network data and retrospective longitudinal life-course data. The results show continuing boundaries between family and friends' roles and that family keeps a prominent role in personal networks despite the notable importance of friendship ties. One relationship stands out above all, that with the partner, followed quite a few steps behind by those with children. Regarding life courses, de-standardization tendencies were found in family formation and also a persistent gendering of occupational trajectories. Two kinds of life trajectories are particularly intertwined with personal networks, co-residence and partnership trajectories, both related to the unfolding of family life. In particular, transition to parenthood functions as a turning point in individuals' lives, deeply transforming their sociability. Finally, a twofold pluralization process was identified, affecting simultaneously the organization of personal networks and the unfolding of individual life courses. This thesis contributes to the literature on the sociology of family and personal life, and to fruitful interlinkage between the network approach and the life-course perspective.

Interobserver agreement and validity of bedside 'positive signs' for functional weakness, sensory and gait disorders in conversion disorder: a pilot study.

BACKGROUND: Conversion disorder (CD) is no longer a diagnosis of exclusion. The new DSM-V criteria highlight the importance of 'positive signs' on neurological examination. Only few signs have been validated, and little is known about their reliability. OBJECTIVE: The aim was to examine the clinical value of bedside positive signs in the diagnosis of CD presenting with weakness, gait or sensory symptoms by assessing their specificity, sensitivity and their inter-rater reliability. PATIENTS AND METHODS: Standardised video recorded neurological examinations were performed in 20 consecutive patients with CD and 20 'organic' controls. Ten previously validated sensory and motor signs were grouped in a scale. Thirteen additional motor/sensory 'positive signs', 14 gait patterns and 1 general sign were assessed in a pilot validation study. In addition, two blinded independent neurologists rated the video recordings to assess the inter-rater reliability (Cohen's κ) of each sign. RESULTS: A score of ≥4/14 on the sensory motor scale showed a 100% specificity (CI 85 to 100) and a 95% sensitivity (CI 85 to 100). Among the additional tested signs, 10 were significantly more frequent in CD than controls. The interobserver agreement was acceptable for 23/38 signs (2 excellent, 10 good, 11 moderate). CONCLUSIONS: Our study confirms that six bedside 'positive signs' are highly specific for CD with good-excellent inter-rater reliability; we propose to consider them as 'highly reliable signs'. In addition 13 signs could be considered as 'reliable signs' and six further signs as 'suggestive signs' while all others should be used with caution until further validation is available.

Tie Strength and Family Formation : which Personal Relationships are Influential ?

Based on the analysis of qualitative interviews in western Germany, we argue that personal relationships have a strong impact on individuals' family formation processes and fertility intentions. We identify persons who influence individuals' fertility choices. Strong ties, such as those among core family members (i.e., parents and siblings), are an important contributing factor, but we are also able to show that weak ties, such as those among colleagues, and acquaintances need to be considered when examining social influence on family formation processes. Apart from single network partners, we have identified influential groups of persons. Such groups serve as a comparative standard regarding the timing of having one's first child and subsequent children.

Les voix des contes : stratégies narratives et projets discursifs des contes de Perrault, Grimm et Andersen

Les contes de Charles Perrault, des frères Jacob et Wilhelm Grimm, et de Hans Christian Andersen sont parmi les plus connus du genre, mais leur rapprochement masque parfois le fait qu'ils n'ont pas été écrits à la même époque, ni dans la même culture, et qu'ils comportent de nombreuses différences, notamment du point de vue thématique. Il y a cependant aussi des textes extrêmement proches dans leurs recueils : « La belle au bois dormant » raconte comme « Dornröschen » (« Rose d'épine ») l'histoire d'une princesse condamnée à dormir cent ans, puis réveillée par un prince ; « Die sechs Schwäne » (« Les six cygnes ») et « De vilde Svaner » (« Les cygnes sauvages ») relatent tous les deux l'histoire d'une princesse à la recherche de ses frères transformés en cygnes par leur belle-mère. Ces cas-là aident à appréhender les différences essentielles entre les textes, mais aussi à mieux comprendre pourquoi, en dépit des différences, ils sont reconnus comme des parangons du genre. Avec une double approche linguistique et comparatiste, cette thèse s'attache à montrer que les auteurs construisent des manières de raconter particulières. Cela concerne par exemple la place du narrateur dans le récit, la logique selon laquelle s'enchaînent les événements, ou encore l'utilisation du discours représenté. Loin de constituer de simples préférences stylistiques, ces stratégies narratives doivent être mises en relation avec un « projet discursif » : en décidant de publier un recueil de contes, comment les auteurs envisagent-ils le genre, et comment se situent-ils dans le contexte littéraire et culturel de l'époque ? Bien que Perrault, les Grimm et Andersen développent chacun un projet différent, ils exploitent tous trois un mode d'énonciation particulier, à la façon d'un discours rapporté : le conte apparaît comme un enchevêtrement de voix où un conteur relate une histoire déjà racontée auparavant, comme s'il rapportait la voix d'un autre conteur, s'inscrivant ainsi dans une tradition où l'on parle toujours à la suite de quelqu'un. L'analyse des différences entre Perrault, les Grimm et Andersen permet ainsi de construire une poétique du genre : écrire un conte, c'est convoquer une tradition populaire et, d'un point de vue énonciatif, c'est inscrire sa voix dans le concert des voix généré par le conte.

Efficacy of brief interdisciplinary psychotherapeutic intervention for motor conversion disorder and nonepileptic attacks.

OBJECTIVE: The objective was to compare a brief interdisciplinary psychotherapeutic intervention to standard care as treatments for patients recently diagnosed with severe motor conversion disorder or nonepileptic attacks. METHODS: This randomized controlled trial of 23 consecutive patients compared (a) an interdisciplinary psychotherapeutic intervention group receiving four to six sessions by a consultation liaison psychiatrist, the first and last sessions adding a neurological consultation and a joint psychiatric and neurological consultation, and (b) a standard care group. After intervention, patients were assessed at 2, 6 and 12 months with the Somatoform Dissociation Questionnaire (SDQ-20), Clinical Global Impression scale, Rankin scale, use of medical care, global mental health [Montgomery and Asberg Depression Rating Scale, Beck Depression Inventory, mental health component of Short Form (SF)-36] and quality of life (SF-36). We calculated linear mixed models. RESULTS: Our intervention brought a statistically significant improvement of physical symptoms [as measured by the SDQ-20 (P<.02) and the Clinical Global Impression scale (P=.02)] and psychological symptoms [better scores on the mental health component of the SF-36 (P<.05) and on the Beck Depression Inventory (P<.05)] and a reduction in new hospital stays after intervention (P<.05). CONCLUSION: A brief psychotherapeutic intervention taking advantage of a close collaboration with neurology consultants in the setting of consultation liaison psychiatry appears effective.

Differential associations of personal and general just-world beliefs with the Five-Factor and HEXACO models of personality.

Recent literature evidences differential associations of personal and general just-world beliefs with constructs in the interpersonal domain. In line with this research, we examine the respective relationships of each just-world belief with the Five-Factor and the HEXACO models of personality in one representative sample of the working population of Switzerland and one sample of the general US population, respectively. One suppressor effect was observed in both samples: Neuroticism and emotionality was positively associated with general just-world belief, but only after controlling for personal just-world belief. In addition, agreeableness was positively and honesty-humility negatively associated with general just-world belief but unrelated to personal just-world belief. Conscientiousness was consistently unrelated to any of the just-world belief and extraversion and openness to experience revealed unstable coefficients across studies. We discuss these points in light of just-world theory and their implications for future research taking both dimensions into account.

"Efficacy of brief interdisciplinary psychotherapeutic intervention for moto conversion disorder and non-epileptic attacks"

Comparer une intervention psychothérapeutique interdisciplinaire brève à une prise en charge standard comme traitements pour des patients ayant récemment été diagnostiqués comme souffrant d'un trouble de conversion moteur sévère ou d'attaques non-épileptiques. Méthodes Cette étude randomisée contrôlée de 23 patients consécutifs a comparé a) un groupe d'intervention psychothérapeutique interdisciplinaire recevant 4-6 séances par un psychiatre de liaison, la première et dernière séance étant couplée à une consultation neurologique et à une consultation conjointe par le neurologue et le psychiatre; b) un groupe de prise en charge standard. Après l'intervention, les patients ont été évalués à 2, 6 et 12 mois par le questionnaire de dissociation somatoforme SDQ-20, l'échelle d'impression clinique globale, l'échelle de Rankin, l'utilisation des services de santé, la santé mentale en général (MADRS, échelle de dépression de Beck, composante de santé mentale du SF-36), la qualité de vie (SF-36). Nous avons calculé des modèles linéaires mixtes. Résultats Notre intervention a mené à une amélioration statistiquement significative ? des symptômes physiques (par une mesure du SDQ-20 (p<0.02), et par l'échelle de l'impression clinique globale (p=0.02)) ? des symptômes psychologiques (meilleurs scores à la composante de santé mentale du SF-36 (p<0.05) et à l'inventaire de dépression de Beck (p<0.05)) ? et à une réduction des nouvelles hospitalisations après l'intervention (p<0.05). Conclusion Une intervention psychothérapeutique interdisciplinaire brève en étroite collaboration avec des spécialistes en neurologie dans un cadre de psychiatrie de consultation et liaison a un effet statistiquement significatif sur l'amélioration de patients souffrant de trouble de conversion moteur et d'attaques non-épileptiques.

CONVERSION TO AFLIBERCEPT THERAPY VERSUS CONTINUING WITH RANIBIZUMAB THERAPY FOR NEOVASCULAR AGE-RELATED MACULAR DEGENERATION DEPENDENT ON MONTHLY RANIBIZUMAB TREATMENT.

PURPOSE: To compare the effects of converting to aflibercept therapy with continuing ranibizumab therapy in eyes with neovascular age-related macular degeneration requiring monthly ranibizumab treatment. METHODS: Patients were selected from the 104 patients (115 eyes) already enrolled in an "Observe and Plan" prospective case series that included treating neovascular age-related macular degeneration with ranibizumab for 24 months. Patients who still needed monthly retreatment at the end of a 2-year study were randomized to either continue ranibizumab therapy or to convert to aflibercept therapy. Outcome measures included average interval between treatments, resolution of exudative signs, number of retreatments, and change in visual acuity over 12 months (the third treatment year). RESULTS: Nineteen patients (21 eyes) met the inclusion criteria. Ten eyes were randomized to receive aflibercept, and 11 eyes remained on ranibizumab. Groups were balanced for baseline characteristics. Outcomes were similar in the 2 groups over a 12-month study duration, with no statistical difference. CONCLUSION: This comparative pilot study suggests that neovascular age-related macular degeneration requiring monthly retreatment with ranibizumab may respond in similar ways to both ranibizumab and aflibercept treatment. Larger sample sizes would be needed to confirm this observation.

L'expérience sociale de la conversion au bodybuilding

Cette thèse propose d'étudier les carrières des adeptes des salles de musculation afin de comprendre comment certains d'entre eux organisent progressivement leur existence autour du bodybuilding. Nos observations issues d'une ethnographie d'une salle de musculation et de trente entretiens semi-directifs menés avec différents profils d'adeptes en Suisse romande, suggèrent que l'emprise du bodybuilding sur les individus résulte de phénomènes assimilables à des conversions. Deux voies de conversion, « consonante » et « introspective », ont été identifiées. Elles correspondent à des usages distincts de la musculation qui n'ont pas les mêmes conséquences sur les parcours de vie des pratiquant(e)s. Si les conversions consonantes stabilisent les parcours de vie en renforçant un statut professionnel, les conversions introspectives les infléchissent significativement. En outre, cette perspective de recherche offre un nouvel éclairage sur le façonnement des représentations et des pratiques de santé, les processus de normalisation des pharmacopraxis et les rapports sociaux de sexe en présence. -- This thesis aims to study gym-goers' careers in order to understand how some of them progressively organise their lives around bodybuilding. Our observations, drawn from an ethnography of a gym and thirty semi-structured interviews with different profiles of gym enthusiasts in French-speaking Switzerland, suggest that the grip that bodybuilding takes on individuals results from phenomena akin to conversions. Two paths to conversion - consonant and introspective - are identified. They correspond to distinct uses of bodybuilding, which do not have the same consequences in the practitioners' life courses. While consonant conversions stabilise life courses by reinforcing an occupational status, introspective conversions inflect them significantly. Furthermore, this research perspective provides new insights into the shaping of health norms (representations and practices), the process of normalisation of pharmacopraxia and the gender relations identified.