The process of anxiety reduction during the treatment of social phobia with an interpersonal approach : alone or combined with paroxetine

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal

Is social phobia characterized by a distinct interpersonal pattern?

Traditionnellement, le construit de la phobie sociale a été défini selon une vision intrapersonnelle, en tant que trouble de l’anxiété. Une autre conception se propose de la définir d’un point de vue interpersonnel, comme un pattern global d’autoprotection. L’objectif principal de cette thèse est de tester des hypothèses tirées du modèle interpersonnel de la phobie sociale. Deux études, présentées sous forme d’articles, ont permis d’examiner si des patterns spécifiques d’autoprotection, tels que l’impuissance et la soumission, caractérisent le mode de fonctionnement des phobiques sociaux. Les études ont également évalué si l’autoprotection et l’anxiété sont interreliées. Pour la première étude, les patterns interpersonnels de 132 phobiques sociaux, évalués à l’aide d’une mesure dérivée du Circumplex interpersonnel, ont été comparés à ceux de 85 individus célibataires ayant une dysfonction sexuelle et 105 sujets normaux. La relation entre les patterns d’autoprotection, l’anxiété sociale, la détresse générale et le fonctionnement social a également été examinée chez les phobiques sociaux. La seconde étude a permis d’examiner l’évolution des patterns d’autoprotection ainsi que de l’anxiété sociale, de la détresse générale et du fonctionnement social, chez 85 phobiques sociaux à quatre moments : avant et après un traitement d’approche interpersonnelle, ainsi qu’aux relances de six mois et d’un an. L’étude a également comparé les participants en rémission et ceux satisfaisant les critères de la phobie sociale un an suivant la fin du traitement. Les résultats suggèrent que les patterns d’impuissance et de soumission sont caractéristiques de la phobie sociale. Plus précisément, ces patterns décrivent davantage les comportements des phobiques sociaux plutôt que ceux des groupes de comparaison. De plus, une réduction significative de l’autoprotection a été notée au post-traitement et maintenue jusqu’au suivi d’un an, surtout chez les participants en rémission.En outre, une relation entre l’autoprotection, l’anxiété sociale et la détresse générale a été mise en évidence chez les phobiques sociaux. Une amélioration de l’anxiété, de la détresse subjective et du fonctionnement social cohérente avec la dissolution des patterns d’autoprotection a également été obtenue au post-traitement. En conclusion, les résultats des deux études appuient une conception interpersonnelle de la phobie sociale.

Les effets à long terme d'une approche interpersonnelle pour le traitement de la phobie sociale : un suivi de 8 à 15 ans.

La phobie sociale est le plus souvent décrite comme suivant une trajectoire chronique. Afin de modifier ce cours clinique, plusieurs protocoles de traitement ont été développés, leur efficacité ayant été démontrée dans de nombreuses études. Toutefois, est-ce que les gains rapportés se maintiennent des années suivant la fin du traitement? Cette dissertation avait pour objectif d’examiner cette question. Une recension d’études a d’abord permis d’effectuer une analyse critique des évidences relatives à la durabilité des effets thérapeutiques des traitements contemporains. Cette recension a permis de constater que les études ayant inclus une période de suivi excédant un an sont peu nombreuses. Lorsque de telles études ont été recensées, la réduction de l’anxiété s’est avérée la retombée thérapeutique principalement investiguée. Les évidences demeurent parcellaires concernant la durabilité des gains sur d’autres dimensions de la phobie sociale, en l’occurrence le fonctionnement social, et quant au maintien de la rémission. Pour combler ces lacunes, la durabilité des gains thérapeutiques, 8 à 15 ans suivant la fin d’un traitement d’approche interpersonnelle (AI), a été évaluée. Cette approche vise la dissolution du pattern global d’auto-protection, en améliorant la participation sociale et en facilitant le développement de modes relationnels plus adaptés. Cinquante-huit individus, satisfaisant initialement les critères de la phobie sociale, ont pris part à cette étude. Ces derniers ont rapporté des gains significatifs, jusqu’à une relance d’un an suivant la fin du traitement. L’évolution de l’anxiété sociale, de la détresse générale et du fonctionnement social, de la relance d’un an à la relance de 8 à 15 ans, a donc été évaluée. La signification statistique et clinique des effets obtenus dans le temps, de même que les différences individuelles, ont été examinées. Les résultats révèlent que le protocole de traitement AI a produit des effets durables depuis la relance d’un an sur les variables examinées. La plupart des participants en rémission à la relance d’un an l’étaient encore une dizaine d’années plus tard. Les participants ayant rapporté une réduction cliniquement significative de la détresse sociale un an suivant la fin du traitement ont connu une trajectoire similaire. Une augmentation significative du taux de rémission a également été constatée. Une analyse fonctionnelle a d’ailleurs révélé une amélioration des répertoires de comportements sociaux chez la majorité des participants, suggérant une dynamique de changement reflétant le passage de l’auto-protection à la participation sociale. Par ailleurs, une hypothèse issue de la perspective interpersonnelle de la phobie sociale et de son traitement a été étayée : une convergence des changements relevés sur les dimensions anxieuse et interpersonnelle a été notée. En somme, l’ensemble de ces résultats soutient l’efficacité à long terme du traitement AI.

Adolescent protective behaviour to reduce drug and alcohol use, alcohol-related harm and interpersonal violence

Typically adolescents' friends are considered a risk factor for adolescent engagement in risk-taking. This study took a more novel approach, by examining adolescent friendship as a protective factor. In particular it investigated friends' potential to intervene to reduce risk-taking. 540 adolescents (mean age 13.47 years) were asked about their intention to intervene to reduce friends' alcohol, drug and alcohol-related harms and about psychosocial factors potentially associated with intervening. More than half indicated that they would intervene in friends' alcohol, drug use, alcohol-related harms and interpersonal violence. Intervening was associated with being female, having friends engage in overall less risk-taking and having greater school connectedness. The findings provide an important understanding of increasing adolescent protective behavior as a potential strategy to reduce alcohol and drug related harms.

Interpersonal coupling in rowing : the mediating role of the environment

Evidence currently supports the view that intentional interpersonal coordination (IIC) is a self-organizing phenomenon facilitated by visual perception of co-actors in a coordinative coupling (Schmidt, Richardson, Arsenault, & Galantucci, 2007). The present study examines how apparent IIC is achieved in situations where visual information is limited for co-actors in a rowing boat. In paired rowing boats only one of the actors, [bow seat] gets to see the actions of the other [stroke seat]. Thus IIC appears to be facilitated despite the lack of important visual information for the control of the dyad. Adopting a mimetic approach to expert coordination, the present study qualitatively examined the experiences of expert performers (N=9) and coaches (N=4) with respect to how IIC was achieved in paired rowing boats. Themes were explored using inductive content analysis, which led to layered model of control. Rowers and coaches reported the use of multiple perceptual sources in order to achieve IIC. As expected(Kelso, 1995; Schmidt & O’Brien, 1997; Turvey, 1990), rowers in the bow of a pair boat make use of visual information provided by the partner in front of them [stroke]. However, this perceptual information is subordinate to perception Motor Learning and Control S111 of the relationship between the boat hull and water passing beside it. Stroke seat, in the absence of visual information about his/her partner, achieves coordination by picking up information about the lifting or looming of the boat’s stern along with water passage past the hull. In this case it appears that apparent or desired IIC is supported by the perception of extra-personal variables, in this case boat behavior; as this perceptual information source is used by both actors. To conclude, co-actors in two person rowing boats use multiple sources of perceptual information for apparent IIC that changes according to task constraints. Where visual information is restricted IIC is facilitated via extra-personal perceptual information and apparent IIC switches to intentional extra-personal coordination.

Interpersonal, intrapersonal, extrapersonal? Qualitatively investigating coordinative couplings between rowers in Olympic sculling

Coordinative couplings are commonly classified as interpersonal and intrapersonal. Interpersonal coordination is normally thought of as between organisms but a subset can also be considered where the co-actors movements are coupled to an environmental rhythm. This can be termed extrapersonal coordination. This study explores how coordination is achieved in a situation that demands that at least one actor makes use of extrapersonal sources. In this case multi-seat rowing, where one actor cannot see the other one behind them. A qualitative approach using experiential knowledge from expert rowers (N=9) and coaches (N=4) was used to examine how interpersonal coordination was achieved and maintained in 2 person rowing boats. It was reported that where possible, both rowers coordinated their movements by coupling with an invariant provided by the boat. This invariant is underpinned by perception of water flow past the boat; which is in turn used to determine changes in acceleration - 'rowing with the boat.' Bow seat also identified the rower in front and stroke seat identified the looming of the stern as viable alternative sources for coupling.

Performance analysis in team sports : advances from an ecological dynamics approach

Capacity to produce data for performance analysis in sports has been enhanced in the last decade with substantial technological advances. However, current performance analysis methods have been criticised for the lack of a viable theoretical framework to assist on the development of fundamental principles that regulate performance achievement. Our aim in this paper is to discuss ecological dynamics as an explanatory framework for improving analysis and understanding of competitive performance behaviours. We argue that integration of ideas from ecological dynamics into previous approaches to performance analysis advances current understanding of how sport performance emerges from continuous interactions between individual players and teams. Exemplar data from previous studies in association football are presented to illustrate this novel perspective on performance analysis. Limitations of current ecological dynamics research and challenges for future research are discussed in order to improve the meaningfulness of information presented to coaches and managers.

Interpersonal coordination tendencies supporting the creation/prevention of goal scoring opportunities in futsal

Research on 1vs1 sub-phases in team sports has shown how one player coordinates his/her actions with his/her opponent and the location of a target/goal to attain performance objectives. In this study, we extended this approach to analysis of 5vs5 competitive performance in the team sport of futsal to provide a performance analysis framework that explains how players coordinate their actions to create/prevent opportunities to score goals. For this purpose, we recorded all 10 futsal matches of the 2009 Lusophony Games held in Lisbon. We analysed the displacement trajectories of a shooting attacker and marking defender in plays ending in a goal, a goalkeeper's save, and a defender's interception, at four specific moments during performance: (1) assisting attacker's ball reception; (2) moment of passing; (3) shooter's ball reception, and; (4) shot on goal. Statistical analysis showed that when a goal was scored, the defender's angle to the goal and to the attacker tended to decrease, the attacker was able to move to the same distance to the goal alongside the defender, and the attacker was closer to the defender and moving at the same velocity (at least) as the defender. This study identified emergent patterns of coordination between attackers and defenders under key competitive task constraints, such as the location of the goal, which supported successful performance in futsal.

Fostering interpersonal trust on social media: Physicians' perspectives and experiences

Background The problem of developing and sustaining mutual trust is one of the main barriers to knowledge sharing on social media platforms such as blogs, wikis, micro-blogs and social networking websites. While many studies argue that mutual trust is necessary for online communication and knowledge sharing, few have actually explored and demonstrated how physicians can establish and sustain trusted relationships on social media. Objectives To identify approaches through which physicians establish interpersonal trust on social media. Methods Twenty-four physicians, who were active users of social media, were interviewed using a semi-structured approach between 2013 and 2014. Snowball sampling was employed for participant recruitment. The data were analysed using a thematic analysis approach. Results Physicians trust their peers on social media in a slightly different way than in face-to-face communication. The study found that the majority of participants established trust on social media mainly through previous personal interaction, authenticity and relevancy of voice, professional standing, consistency of communication, peer recommendation, and non-anonymous and moderated sites. Conclusions Healthcare professionals need to approach social media carefully when using it for knowledge sharing, networking and developing trusted relations with like-minded peers.

A Shapley Value-Based Approach to Discover Influential Nodes in Social Networks

Our study concerns an important current problem, that of diffusion of information in social networks. This problem has received significant attention from the Internet research community in the recent times, driven by many potential applications such as viral marketing and sales promotions. In this paper, we focus on the target set selection problem, which involves discovering a small subset of influential players in a given social network, to perform a certain task of information diffusion. The target set selection problem manifests in two forms: 1) top-k nodes problem and 2) lambda-coverage problem. In the top-k nodes problem, we are required to find a set of k key nodes that would maximize the number of nodes being influenced in the network. The lambda-coverage problem is concerned with finding a set of k key nodes having minimal size that can influence a given percentage lambda of the nodes in the entire network. We propose a new way of solving these problems using the concept of Shapley value which is a well known solution concept in cooperative game theory. Our approach leads to algorithms which we call the ShaPley value-based Influential Nodes (SPINs) algorithms for solving the top-k nodes problem and the lambda-coverage problem. We compare the performance of the proposed SPIN algorithms with well known algorithms in the literature. Through extensive experimentation on four synthetically generated random graphs and six real-world data sets (Celegans, Jazz, NIPS coauthorship data set, Netscience data set, High-Energy Physics data set, and Political Books data set), we show that the proposed SPIN approach is more powerful and computationally efficient. Note to Practitioners-In recent times, social networks have received a high level of attention due to their proven ability in improving the performance of web search, recommendations in collaborative filtering systems, spreading a technology in the market using viral marketing techniques, etc. It is well known that the interpersonal relationships (or ties or links) between individuals cause change or improvement in the social system because the decisions made by individuals are influenced heavily by the behavior of their neighbors. An interesting and key problem in social networks is to discover the most influential nodes in the social network which can influence other nodes in the social network in a strong and deep way. This problem is called the target set selection problem and has two variants: 1) the top-k nodes problem, where we are required to identify a set of k influential nodes that maximize the number of nodes being influenced in the network and 2) the lambda-coverage problem which involves finding a set of influential nodes having minimum size that can influence a given percentage lambda of the nodes in the entire network. There are many existing algorithms in the literature for solving these problems. In this paper, we propose a new algorithm which is based on a novel interpretation of information diffusion in a social network as a cooperative game. Using this analogy, we develop an algorithm based on the Shapley value of the underlying cooperative game. The proposed algorithm outperforms the existing algorithms in terms of generality or computational complexity or both. Our results are validated through extensive experimentation on both synthetically generated and real-world data sets.

The body social: an enactive approach to the self

This paper takes a new look at an old question: what is the human self? It offers a proposal for theorizing the self from an enactive perspective as an autonomous system that is constituted through interpersonal relations. It addresses a prevalent issue in the philosophy of cognitive science: the body-social problem. Embodied and social approaches to cognitive identity are in mutual tension. On the one hand, embodied cognitive science risks a new form of methodological individualism, implying a dichotomy not between the outside world of objects and the brain-bound individual but rather between body-bound individuals and the outside social world. On the other hand, approaches that emphasize the constitutive relevance of social interaction processes for cognitive identity run the risk of losing the individual in the interaction dynamics and of downplaying the role of embodiment. This paper adopts a middle way and outlines an enactive approach to individuation that is neither individualistic nor disembodied but integrates both approaches. Elaborating on Jonas' notion of needful freedom it outlines an enactive proposal to understanding the self as co-generated in interactions and relations with others. I argue that the human self is a social existence that is organized in terms of a back and forth between social distinction and participation processes. On this view, the body, rather than being identical with the social self, becomes its mediator

Managing the supply side for product development in China: a Guanxi network approach

Based on the IMP research tradition this paper regards relationships and networks as key issues in the product development and supply management agenda. Within business networks, co-development is only possible to be analysed when emphasis is placed on interdependences and interactive relationships. Co-development usually implies close relationships that allow companies to rely on each other's resources. Close relationships imply interdependences, which may improve companies' technical and product development. By looking at the actual interactions - between a UK company and its Chinese suppliers - that led to an innovative solution and a successful product launch, evolving relationship patterns are identified and analysed in a case study. Both the literature review and case study findings highlight the importance of the 'guanxi' concept (meaning interpersonal relationships in Mandarin) when analysing business-to-business networks in China. Hence, it is suggested that guanxi-based thinking and acting should be incorporated into the interaction model when considering business networking that embrace China. 'Guanxi' broadens the validity of the interaction model, in terms of geographical proximity, and deepens its theoretical base. The case study provides valuable insights for supply management under a product development context in China. In practice, the main point of interest is that Chinese suppliers are important 'resource' providers as well as 'network' providers. Hence, it is suggested that guanxi practice should be reflected into theoretical developments.

De la cooperativa agroalimentaria a la "learning netchain". Hacia un planteamiento teorico interorganizativo e interpersonal

Se propone un planteamiento teórico/conceptual para determinar si las relaciones interorganizativas e interpersonales de la netchain de las cooperativas agroalimentarias evolucionan hacia una learning netchain. Las propuestas del trabajo muestran que el mayor grado de asociacionismo y la mayor cooperación/colaboración vertical a lo largo de la cadena están positivamente relacionados con la posición horizontal de la empresa focal más cercana del consumidor final. Esto requiere una planificación y una resolución de problemas de manera conjunta, lo que está positivamente relacionado con el mayor flujo y diversidad de la información/conocimiento obtenido y diseminado a lo largo de la netchain. Al mismo tiempo se necesita desarrollar un contexto social en el que fluya la información/conocimiento y las nuevas ideas de manera informal y esto se logra con redes personales y, principalmente, profesionales y con redes internas y, principalmente, externas. Todo esto permitirá una mayor satisfacción de los socios de la cooperativa agroalimentaria y de sus distribuidores y una mayor intensidad en I+D, convirtiéndose la netchain de la cooperativa agroalimentaria, así, en una learning netchain.

Experiential learning instruments : an examination of the concept of the instrumental approach in experiential learning

Experiential Learning Instruments (ELls) are employed to modify the leamer's apprehension and / or comprehension in experiential learning situations, thereby improving the efficiency and effectiveness of those modalities in the learning process. They involve the learner in reciprocally interactive and determining transactions with his/her environment. Experiential Learning Instruments are used to keep experiential learning a process rather than an object. Their use is aimed at the continual refinement of the learner's knowledge and skill. Learning happens as the leamer's awareness, directed by the use of Ells, comes to experience, monitor and then use experiential feedback from living situations in a way that facilitates knmvledge/skill acquisition, self-correction and refinement. The thesis examined the literature relevant to the establishing of a theoretical experiential learning framework within which ELls can be understood. This framework included the concept that some learnings have intrinsic value-knowledge of necessary information-while others have instrumental value-knowledge of how to learn. The Kolb Learning Cycle and Kolb's six characteristics of experiential learning were used in analyzing three ELls from different fields of learning-saxophone tone production, body building and interpersonal communications. The ELls were examined to determine their learning objectives and how they work using experiential learning situations. It was noted that ELls do not transmit information but assist the learner in attending to and comprehending aspects of personal experience. Their function is to telescope the experiential learning process.

Does interpersonal behavior of psychotherapy trainees differ in private and professional relationships?

• Aim: The present study aimed to evaluate the effect of trainees’ interpersonal behavior on work involvement (WI) and compared their social behavior within professional and private relationships as well as between different psychotherapeutic orientations. • Methods: The interpersonal scales of the Intrex short-form questionnaire and the Work Involvement Scale (WIS) were used to evaluate two samples of German psychotherapy trainees in psychoanalytic, psychodynamic, and cognitive behavioral therapy training. Trainees from Sample 1 (N = 184) were asked to describe their interpersonal behavior in relation to their patients when filling out the Intrex, whereas trainees from Sample 2 (N = 135) were asked to describe the private relationship with a significant other. • Results: Interpersonal affiliation in professional relationships significantly predicted the level of healing involvement, while stress involvement was predicted by interpersonal affiliation and interdependence in trainees’ relationships with their patients. Social behavior within professional relationships provided higher correlations with WI than private interpersonal behavior. Significant differences were found between private and professional relation settings in trainees’ interpersonal behavior with higher levels of affiliation and interdependence with significant others. Differences between therapeutic orientation and social behavior could only be found when comparing trainees’ level of interdependence with the particular relationship setting. • Conclusion: Trainees’ interpersonal level of affiliation in professional relationships is a predictor for a successful psychotherapeutic development. Vice versa, controlling behavior in professional settings can be understood as a risk factor against psychotherapeutic growth. Both results strengthen an evidence-based approach for competence development during psychotherapy training.