Le développement d’une grille d’évaluation du risque d’agression physique en communauté. L’implantation de G.E.R.A.C. à l’Urgence-Psychosociale-Justice.

Rapport de stage présenté à la Faculté des arts et des sciences en vue de l’obtention du grade de maîtrise en criminologie (option intervention).

Habileté de mentalisation chez les mères présentant un trouble de personnalité limite : orientation mentale maternelle lors d’interactions mère-bébé.

Contexte : Les personnes atteintes de trouble de personnalité limite (TPL) présenteraient un déficit de mentalisation, soit la capacité de percevoir et interpréter les états mentaux chez soi et chez l’autre. Dans le cadre de la relation mère-bébé, un tel déficit est susceptible d’entraîner des perturbations relationnelles ayant des conséquences néfastes sur le développement de l’enfant. L’orientation mentale se mesure par le biais des verbalisations du parent au sujet des états mentaux de son enfant et constitue donc un reflet de la mentalisation du parent durant cette interaction. Toutefois, aucune étude n’a encore investigué l’orientation mentale chez des mères avec TPL durant l’interaction avec leur bébé. Objectif : Le but de cette étude était d’évaluer l’orientation mentale de 38 mères en interaction avec leur enfant âgé de 12 mois, incluant 10 mères atteintes de TPL et 28 sans diagnostic psychiatrique. Méthode: L’orientation mentale maternelle fut évaluée à partir de vidéos d’interaction mère-enfant dans un contexte de jeu libre. Le TPL a été identifié à l’aide du Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II). Résultats: Les mères atteintes de TPL ne se sont pas distingué concernant la fréquence de commentaires faisant référence aux états mentaux de leur bébé. Toutefois, les commentaires mentaux des mères souffrant de TPL se sont avérés être 4.7 fois plus fréquemment jugés non-appropriés à l’état mental de l’enfant comparés à ceux des mères sans diagnostic psychiatrique. Conclusions : Les commentaires mentaux des mères atteintes de TPL semblent plus fréquemment empreints d’erreurs d’interprétation des états mentaux de leur enfant, ce qui pourrait poser un risque pour le développement de l’enfant.

Modélisation de l’engagement et de la charge mentale de travail dans les Systèmes Tutoriels Intelligents

Les récents avancements en sciences cognitives, psychologie et neurosciences, ont démontré que les émotions et les processus cognitifs sont intimement reliés. Ce constat a donné lieu à une nouvelle génération de Systèmes Tutoriels Intelligents (STI) dont la logique d’adaptation repose sur une considération de la dimension émotionnelle et affective de l’apprenant. Ces systèmes, connus sous le nom de Systèmes Tutoriels Émotionnellement Intelligents (STEI), cherchent à se doter des facultés des tuteurs humains dans leurs capacités à détecter, comprendre et s’adapter intuitivement en fonction de l’état émotionnel des apprenants. Toutefois, en dépit du nombre important de travaux portant sur la modélisation émotionnelle, les différents résultats empiriques ont démontré que les STEI actuels n’arrivent pas à avoir un impact significatif sur les performances et les réactions émotionnelles des apprenants. Ces limites sont principalement dues à la complexité du concept émotionnel qui rend sa modélisation difficile et son interprétation ambiguë. Dans cette thèse, nous proposons d’augmenter les STEI des indicateurs d’états mentaux d’engagement et de charge mentale de travail. Ces états mentaux ont l’avantage d’englober à la fois une dimension affective et cognitive. Pour cela, nous allons, dans une première partie, présenter une approche de modélisation de ces indicateurs à partir des données de l’activité cérébrale des apprenants. Dans une seconde partie, nous allons intégrer ces modèles dans un STEI capable d’adapter en temps réel le processus d’apprentissage en fonction de ces indicateurs.

La notion de bonne foi dans les immunités législatives au Québec : entre imprécision et redondance

Les immunités législatives pour bonne foi sont une composante importante des règles spécifiques s’appliquant à la responsabilité civile des administrations publiques. Apparues dans les années 1940 au Québec, elles visent à insuffler à la responsabilité civile les considérations propres à l’action étatique (difficulté des tâches, pouvoir discrétionnaire, liberté d’action, etc.). Or, la notion principale de ces immunités, la bonne foi, est d’une nature fragile. Tiraillée entre une vision subjective et objective, elle souffre de nombreuses lacunes. Originalement fondée sur l’évaluation de l’état d’esprit d’une personne, la bonne foi reproduit dorénavant le concept de faute lourde présent en responsabilité civile. Il en résulte un système qui crée de la confusion sur l’état mental nécessaire pour entrainer la responsabilité d’une administration publique. Au surplus, le régime de la bonne foi est variable et change selon les fonctions exercées par les administrations publiques. Ces attributs mettent en exergue le peu d’utilité de cette notion : la bonne foi dédouble plusieurs éléments déjà présents en responsabilité civile québécoise et partant de là, affaiblit sa place comme règle particulière applicable aux administrations publiques. Bref, par son caractère adaptable, la bonne foi est un calque de la responsabilité civile québécoise et son faible apport embrouille le régime de cette dernière.

Le corps “mort-vivant” et la ville “détruite” dans le cinéma libanais d’après guerre.

"ENTRE DEUX", le film que j'ai écrit et réalisé pour cette recherche-création, a été filmé avec les caméras Canon 5D et 7D et monté en utilisant le logiciel final cut pro 7

Medidas de sintomas depressivos em idosos: relações com variáveis sociodemográficas

Fundamentação: Considerando a prevalência da depressão em pessoas idosas, torna-se importante conhecer mais sobre as manifestações de sintomas depressivos nessa fase da vida. Objetivo: Este estudo se propôs a verificar possíveis relações entre medidas de sintomas depressivos, considerando as variáveis sexo e idade em idosos. Método: Fizeram parte do estudo 183 idosos, divididos em dois grupos, G1 - asilares, e G2- nãoasilares praticantes de atividades físicas. Após eliminar os participantes com indicador de demência por meio do Exame Mental Mini-Mental- MMSE e outros critérios de inclusão da amostra, restaram 69 participantes, nos quais foram aplicadas a Escala de Depressão Geriátrica – GDS e a Escala Baptista de Depressão em Idosos - EBADEP -I. Resultados: Os resultados demonstraram um índice de correlação excelente entre as duas medidas e pouca variação quando controlados sexo e idade. Na amostra pesquisada os homens apresentaram escores maiores nas duas medidas, bem como os idosos asilados e os acima de 75 anos.

Treatment response in child anxiety is differentially related to the form of maternal anxiety disorder

An examination was made of the extent to which maternal anxiety predicted response to treatment of children presenting with an anxiety disorder. In a sample of 55 children referred to a local NHS CAMH service for treatment of an anxiety disorder, systematic mental state interview assessment was made of both mothers and children, and both completed self-report questionnaires to assess aspects of anxiety, both immediately before the children received treatment and following treatment. Children of mothers with anxiety disorder overall responded less well to treatment than children of mothers with no anxiety disorder. There was some diagnostic specificity in this in that children of mothers with GAD did as well in treatment as children whose mothers had no anxiety, whereas children of mothers with social phobia did poorly. The outcome for children with anxiety appears to be related to the presence and nature of maternal anxiety. It would seem prudent that treatment of children with anxiety involves assessment of maternal anxiety. It is important to establish in systematic investigation whether treatment of maternal anxiety improves the outcome for child anxiety.

Affective disorder in the parents of a clinic sample of children with anxiety disorders

Background: Family history studies in adults reveal strong familiality for the anxiety disorders with some specificity. The aim of the current study was to establish whether there was an elevated rate of anxiety disorders in the parents of children with anxiety disorders, and whether there was intergenerational specificity in the form of disorder. Methods: The mental state of a clinic sample of 85 children with anxiety disorder and their parents was systematically assessed, together with a comparison sample of 45 children with no current disorder and their parents. Results: Compared to the rate of anxiety disorder amongst parents of comparison children, the rate of current anxiety disorder in mothers of anxious children was significantly raised, as was the lifetime rate of anxiety disorder for both mothers and fathers. The mothers of children with generalised anxiety disorder, social phobia, specific phobia and separation anxiety disorder all had raised lifetime rates of the corresponding disorder, but also raised rates of others disorders. Limitations: Only 60% of the fathers of the anxious children were assessed. Conclusions: Strong familiality of anxiety disorders was confirmed, especially between child and maternal anxiety disorder. All child anxiety disorders were associated with several forms of anxiety disorder in the mother. Some specificity in the form of anxiety disorder in the child and the mother was apparent for social phobia and separation anxiety disorder. The findings have implications for the management of child anxiety. (c) 2006 Elsevier B.V. All rights reserved.

Individual differences in brain structure underpin empathizing–systemizing cognitive styles in male adults

Individual differences in cognitive style can be characterized along two dimensions: ‘systemizing’ (S, the drive to analyze or build ‘rule-based’ systems) and ‘empathizing’ (E, the drive to identify another's mental state and respond to this with an appropriate emotion). Discrepancies between these two dimensions in one direction (S > E) or the other (E > S) are associated with sex differences in cognition: on average more males show an S > E cognitive style, while on average more females show an E > S profile. The neurobiological basis of these different profiles remains unknown. Since individuals may be typical or atypical for their sex, it is important to move away from the study of sex differences and towards the study of differences in cognitive style. Using structural magnetic resonance imaging we examined how neuroanatomy varies as a function of the discrepancy between E and S in 88 adult males from the general population. Selecting just males allows us to study discrepant E-S profiles in a pure way, unconfounded by other factors related to sex and gender. An increasing S > E profile was associated with increased gray matter volume in cingulate and dorsal medial prefrontal areas which have been implicated in processes related to cognitive control, monitoring, error detection, and probabilistic inference. An increasing E > S profile was associated with larger hypothalamic and ventral basal ganglia regions which have been implicated in neuroendocrine control, motivation and reward. These results suggest an underlying neuroanatomical basis linked to the discrepancy between these two important dimensions of individual differences in cognitive style.

Pragmatic abilities of high-functioning Greek-speaking children with autism

This paper reports on the findings of the pragmatic abilities of Greek-speaking children with autism spectrum disorders (ASD). Twenty high functioning children with ASD and their typically developing age and vocabulary controls were administered a pragmatics task. The task was based on the Diagnostic Evaluation of Language Variation (DELV) in the context of a larger study targeting the grammar of Greek-speaking children with autism, and assessed the children’s abilities in communicative role taking, narrative, and question asking. The children with ASD showed an uneven profile in their pragmatic abilities. The two groups did not differ in communicative role taking and question asking. However, the children with ASD had difficulties on the narrative task, and more specifically, on the items assessing reference contrast and temporal links. Yet, they performed similarly on the mental state representations and the false beliefs items. Despite their good performance on mental states and false beliefs, the ASD children’s lower performance on reference contrast can be interpreted via Theory of Mind deficits if we assume that the former involve an additional level of complexity; namely, quantifying the amount of information available to the listener. Lower performance on temporal links is in line with the ASD children’s attested difficulties in organizing events into a coherent gist. Their overall profile, and, in particular, the dissociation between the different sections of the task, does not support single deficit accounts. It rather indicates that the deficits of individuals with ASD stem from distinct deficits in core cognitive processes (Happé & Frith, 2006).

Adaptação da bateria montreal de avaliação da comunicação : habilidades lingüísticas de ativação do hemisfério direito durante o envelhecimento

Esta investigação foi realizada através de dois estudos. O Estudo 1 teve por objetivo adaptar as tarefas que compõem a Bateria MEC ao Português Brasileiro (PB). O Estudo 2 visou verificar a influência do envelhecimento nas habilidades lingüísticas verbais e não-verbais de grande ativação do hemisfério direito (HD), testadas neste teste neuropsicológico. Para a adaptação da Bateria MEC, no primeiro estudo, três procedimentos gerais foram promovidos: tradução, análise de critérios lingüísticos por juízes e aplicação do instrumento em um estudo piloto. As tarefas intituladas Compreensão de metáforas, Discurso narrativo e Julgamento semântico exigiram um processo de adaptação mais complexo e rigoroso do que as outras provas. Com base em critérios psicolingüísticos, realizaram-se algumas mudanças nos estímulos. Participaram do segundo estudo 40 adultos jovens e 40 idosos, de ambos os sexos, com escolaridade superior a oito anos de estudo, sem relato de quaisquer patologias sensoriais, neurológicas ou psiquiátricas. Quatro instrumentos foram utilizados: Questionário de dados sócio-culturais e aspectos da saúde, Mini-mental, Escala de depressão geriátrica Yesavage e a Bateria MEC, já adaptada. Os três primeiros caracterizaram a amostra e possibilitaram a observação dos critérios de inclusão. O último examinou habilidades de compreensão de metáforas, evocação lexical, prosódias lingüística e emocional, atos de fala indiretos e julgamento semântico. Os idosos apresentaram um desempenho inferior ao dos jovens em todas estas tarefas, com exceção da prosódia lingüística – repetição, dos atos de fala indiretos e do julgamento semântico. A maior dificuldade de processamento comunicativo observada nos idosos não representou um déficit lingüístico, mas sim um efeito de idade no seu estilo cognitivo.

Aspectos epidemiológicos, cognitivo-comportamentais e neurofisiológicos do sonho lúcido

Lucid dreaming (LD) is a mental state in which the subject is aware of being dreaming while dreaming. The prevalence of LD among Europeans, North Americans and Asians is quite variable (between 26 and 92%) (Stepansky et al., 1998; Schredl & Erlacher, 2011; Yu, 2008); in Latin Americans it is yet to be investigated. Furthermore, the neural bases of LD remain controversial. Different studies have observed that LD presents power increases in the alpha frequency band (Tyson et al., 1984), in beta oscillations recorded from the parietal cortex (Holzinger et al., 2006) and in gamma rhythm recorded from the frontal cortex (Voss et al., 2009), in comparison with non-lucid dreaming. In this thesis we report epidemiological and neurophysiological investigations of LD. To investigate the epidemiology of LD (Study 1), we developed an online questionnaire about dreams that was answered by 3,427 volunteers. In this sample, 56% were women, 24% were men and 20% did not inform their gender (the median age was 25 years). A total of 76.5% of the subjects reported recalling dreams at least once a week, and about two-thirds of them reported dreaming always in the first person, i.e. when the dreamer observes the dream from within itself, not as another dream character. Dream reports typically depicted actions (93.3%), known people (92.9%), sounds/voices (78.5%), and colored images (76.3%). The oneiric content was related to plans for upcoming days (37.8%), and memories of the previous day (13.8%). Nightmares were characterized by general anxiety/fear (65.5%), feeling of being chased (48.5%), and non-painful unpleasant sensations (47.6%). With regard to LD, 77.2% of the subjects reported having experienced LD at least once in their lifetime (44.9% reported up to 10 episodes ever). LD frequency was weakly correlated with dream recall frequency (r = 0.20, p <0.001) and was higher in men (χ2=10.2, p=0.001). The control of LD was rare (29.7%) and inversely correlated with LD duration (r=-0.38, p <0.001), which is usually short: to 48.5% of the subjects, LD takes less than 1 minute. LD occurrence is mainly associated with having sleep without a fixed time to wake up (38.3%), which increases the chance of having REM sleep (REMS). LD is also associated with stress (30.1%), which increases REMS transitions into wakefulness. Overall, the data suggest that dreams and nightmares can be evolutionarily understood as a simulation of the common situations that happen in life, and that are related to our social, psychological and biological integrity. The results also indicate that LD is a relatively common experience (but not recurrent), often elusive and difficult to control, suggesting that LD is an incomplete stationary stage (or phase transition) between REMS and wake state. Moreover, despite the variability of LD prevalence among North Americans, Europeans and Asians, our data from Latin Americans strengthens the notion that LD is a general phenomenon of the human species. To further investigate the neural bases of LD (Study 2), we performed sleep recordings of 32 non-frequent lucid dreamers (sample 1) and 6 frequent lucid dreamers (sample 2). In sample 1, we applied two cognitive-behavioral techniques to induce LD: presleep LD suggestion (n=8) and light pulses applied during REMS (n=8); in a control group we made no attempt to influence dreaming (n=16). The results indicate that it is quite difficult but still possible to induce LD, since we could induce LD in a single subject, using the suggestion technique. EEG signals from this one subject exhibited alpha (7-14 Hz) bursts prior to LD. These bursts were brief (about 3s), without significant change in muscle tone, and independent of the presence of rapid eye movements. No such bursts were observed in the remaining 31 subjects. In addition, LD exhibited significantly higher occipital alpha and right temporo-parietal gamma (30-50 Hz) power, in comparison with non-lucid REMS. In sample 2, LD presented increased frontal high-gamma (50-100 Hz) power on average, in comparison with non-lucid REMS; however, this was not consistent across all subjects, being a clear phenomenon in just one subject. We also observed that four of these volunteers showed an increase in alpha rhythm power over the occipital region, immediately before or during LD. Altogether, our preliminary results suggest that LD presents neurophysiological characteristics that make it different from both waking and the typical REMS. To the extent that the right temporo-parietal and frontal regions are related to the formation of selfconsciousness and body internal image, we suggest that an increased activity in these regions during sleep may be the neurobiological mechanism underlying LD. The alpha rhythm bursts, as well as the alpha power increase over the occipital region, may represent micro-arousals, which facilitate the contact of the brain during sleep with the external environment, favoring the occurrence of LD. This also strengthens the notion that LD is an intermediary state between sleep and wakefulness

Anemia and dementia among the elderly: the Sao Paulo Ageing & Health Study

Background: Anemia and dementia are common diseases among the elderly, but conflicting data are available regarding an association between these two conditions. We analyzed data from the Sao Paulo Ageing & Health Study to address the relationship between anemia and dementia. Methods: This cross-sectional observational study included participants aged 65 years and older from a deprived area of the borough of Butantan, Sao Paulo, Brazil. Data about demographics, education, income, and cognitive and daily life function were collected, as well as blood samples. Anemia and dementia were defined according to WHO and DSM-IV criteria, respectively. Results: Of the 2267 subjects meeting the inclusion criteria, 2072 agreed to participate in the study; of whom 1948 had a valid total blood count and were included in the analysis. Anemia was diagnosed in 203 (10.2%) participants and dementia in 99 (5.1%). The frequency of anemia was higher in patients with dementia according to univariate analysis (odds ratio (OR) = 2.00, 95% confidence interval (CI) = 1.17-3.41, p = 0.01), but this association was not present after adjusting for age (OR = 1.33, 95% CI = 0.76-2.33, p = 0.32). Further multivariate adjustment did not change the results. Conclusion: Although anemia and dementia are frequent disorders in older people, we found their relationship to be mediated exclusively by aging in this low-income population from Sao Paulo.

The near babylonian speech confusion in early detection of psychosis

It is barely 15 years since, in 1996, the issue theme of Schizophrenia Bulletin (Vol 22, 2) “Early Detection, and Intervention in Schizophrenia” signified the commencement of this field of research. Since that time the field of early detection research has developed rapidly and it may be translated into clinical practice by the introduction of an Attenuated Psychosis Syndrome in Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, (DSM-5) (www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=412#). Attenuated psychotic symptoms (APS) had first been suggested as a clinical predictor of first-episode psychosis by the Personal Assessment and Crisis Evaluation (PACE) Clinic group as part of the ultrahigh risk (UHR) criteria.1 The term ultrahigh risk became broadly accepted for this set of criteria for imminent risk of developing psychosis in the late 1990s. The use of the term “prodrome” for a state characterized by at-risk (AR) criteria was criticized as a retrospective concept inevitably followed by the full-blown disorder.1 Although alternative terms have been suggested, prodrome is still used in prospective studies (eg, prodromally symptomatic, potentially or putatively prodromal, prodrome-like state/symptoms). Some alternative suggestions such as prepsychotic state/symptoms, subthreshold psychotic symptoms, early psychosis, subsyndromal psychosis, hypopsychosis, or subpsychosis were short-lived. Other terms still in use include UHR, at-risk mental state (ARMS), AR, high risk, clinical high risk (CHR), or early and late AR state. Further, the term psychotic-like experiences (PLEs) has recently (re-)entered early detection research. …

Insular volume abnormalities associated with different transition probabilities to psychosis

Background Although individuals vulnerable to psychosis show brain volumetric abnormalities, structural alterations underlying different probabilities for later transition are unknown. The present study addresses this issue by means of voxel-based morphometry (VBM). Method We investigated grey matter volume (GMV) abnormalities by comparing four neuroleptic-free groups: individuals with first episode of psychosis (FEP) and with at-risk mental state (ARMS), with either long-term (ARMS-LT) or short-term ARMS (ARMS-ST), compared to the healthy control (HC) group. Using three-dimensional (3D) magnetic resonance imaging (MRI), we examined 16 FEP, 31 ARMS, clinically followed up for on average 3 months (ARMS-ST, n=18) and 4.5 years (ARMS-LT, n=13), and 19 HC. Results The ARMS-ST group showed less GMV in the right and left insula compared to the ARMS-LT (Cohen's d 1.67) and FEP groups (Cohen's d 1.81) respectively. These GMV differences were correlated positively with global functioning in the whole ARMS group. Insular alterations were associated with negative symptomatology in the whole ARMS group, and also with hallucinations in the ARMS-ST and ARMS-LT subgroups. We found a significant effect of previous antipsychotic medication use on GMV abnormalities in the FEP group. Conclusions GMV abnormalities in subjects at high clinical risk for psychosis are associated with negative and positive psychotic symptoms, and global functioning. Alterations in the right insula are associated with a higher risk for transition to psychosis, and thus may be related to different transition probabilities.