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.

Whether and when disclosing the trauma to one's children in a migratory context? A pilot mixed methods investigation.

BACKGROUND: Disclosing traumatic events experienced by parents to their children is a central issue in the intergenerational trauma transmission. However, little is known about this question among migrant population. The main objective of this study was to examine the choice to disclose the traumatic experiences of migrant women in France to their children. METHODS: This pilot study examined fourteen mother-child dyads in which migrant mothers (M = 30 years; range = 19-42 years) were exposed to traumatic events. A sequential mixed method design was used. In addition to the completion of the Impact Event Scale-Revised, qualitative data were collected through semi-structured interviews. These data were analyzed using thematic and cross-cultural methods. The survey took place from May 2019 to July 2020. RESULTS: Our study revealed three profiles of mothers with regard to the choice to disclose the traumatic story to the child: one group of mothers opted for silence (n = 4), the other for disclosure (n = 7) and the last group who were hesitant (n = 3). The modalities of choice were statistically associated with the severity of the post-traumatic stress symptoms, F (2, 11) = 4,62, p < .05. Specifically, women who made the choice of silence (M = 72.75, SD = 4.99) and those hesitated on the choice to disclosure (M = 71.33, SD = 7.51) reported higher scores on IES-R than those who made the choice to disclosure (M = 59.86, SD = 12.44). Six main themes emerged from the thematic and cross-cultural analysis of participants' narratives: (1) the personalization of the traumatic experience, (2) the child seen as a weapon against collapse, (3) the fear of the child's personal reactions, (4) the possible partial disclosure, (5) the trauma narrative according to the child's age, and (6) the trap of the in-between two cultures. CONCLUSION: Our results suggest that the recovery of these mothers from their trauma, through culturally appropriate therapeutic care, can effectively contribute to the choice to disclose their traumatic experiences to their children. This treatment can support them in developing open and healthy communication strategies to prevent the transmission of traumatic effects to their children.

[Place of the father in the transmission of trauma from mother to baby in a migratory]. / Place du père en contexte migratoire dans la transmission du trauma de la mère au bébé.

Paternal involvement impacts the relationship between mother and child and protects the transmission of the traumatic experience in a migratory context. A study was conducted in France with mother-child dyads in which the women were exposed to traumatic events. It identified three themes around the metatheme of the father's place: the husband's function as moral support during migration, his cultural function as a relay for his wife to the child, and the maintenance of the bond despite his physical absence.

Parental mental illness and their offspring's mental health in Rwanda: neuropsychiatric hospital of Rwanda.

BACKGROUND: Offspring of the parents with mental disorders are at higher risk to have the mental diseases throughout the world. This study examined the association between psychopathology of parents and the mental health of their offspring in Neuropsychiatric Hospital of Rwanda, Butare Branch. METHODS: A cross-sectional study made up of case and control offspring was conducted on the case group made up of 80 offspring born to parents with mental diseases and a control group of 80 offspring from parents without mental disease. Hamilton Rating Scale for Depression (HRSD, α = 0.82), Posttraumatic stress disorders scale (PTSD, α = 0.73) and the Test of Psychological Problems (TPP, α = 0.93) were used. STATISTICA version 8 was used for statistical analysis. RESULTS: Results indicated a significance difference between the two groups on depressive symptoms, psychological problems and PTSD symptomatology. The case group seemed to experience high level symptoms than the control group. Results indicated that, among the offspring born to parents with mental disease, there was a significant correlation between anxiety and depression symptoms (r = 0.71, p < .001), PTSD and eating disorder (r = 0.75, p < .001), domestic violence and PTSD (r = 0.78, p < .001), aggressive behavior and PTSD (r = 0.79, p < .001), somatoform disorders and PTSD (r = 0.98, p < .001). No significant association between the low self-esteem, depression, anxiety, mental disorders induced drug abuse and PTSD was found. CONCLUSION: Offspring of the parents with mental disorders had higher risk to develop mental diseases than the offspring born to the parents without mental diseases. Taking into account the assessment of parents' mental illness when taking care of the offspring's psychological disorders is needed in the neuropsychiatric hospital.

The Role of Food in the Family Relationships of Adolescents With Anorexia Nervosa and Bulimia in Northeastern Brazil: A Qualitative Study Using Photo Elicitation.

Family components can play roles both as protective factors and maintenance mechanisms of eating disorders. We aimed to investigate the role of food in the family relationships of adolescents with anorexia nervosa and bulimia in northeastern Brazil. Using photo elicitation, a visual narrative method that gives insight into the participants' perspective through photograph, we conducted semi-structured interviews with 26 people: four teenage girls with anorexia, four with bulimia, eight mothers, four fathers, five grandmothers, and one sister. Data were analyzed using the principles of Interpretative Phenomenological Analysis, which highlighted the following themes: control of the parent-adolescent relationship through food; food as a mean of experiencing parental presence-absence; food as the focus of conflict in the nuclear family, and food as a source of three-generational conflict. Food seemed to be a means for teens and parents to express physical suffering and psychological violence. Moreover, mourning appeared to influence the girls' relationships with food. Conflict in these families is not focused solely on food, but extends to other subjects, and teenagers' emotional reactivity concerning their relationship with their parents and food during family mealtimes varied. These features reinforced the cultural aspect and influences of eating experiences among adolescent girls with eating disorders. Remarkable disparities exist in the generations' views on what rules and rituals these adolescents must follow at meals. These disparities can obfuscate generational boundaries in these families. Our data reinforce the need to focus on the adolescent's autonomy in the family setting and on family identity as related to food among three generations. These findings necessitate a reorganization of boundaries between these generations.

Case Report: When Does Puberty Become Traumatic?

Puberty provokes physiological upheaval that can be psychologically traumatic and destabilizing for the child. Before the transformations of puberty, the body is a protective vessel that acts as a stable reference for the child. A child's emotional security is derived from a sense of predictability and well-being. However, the nascent sexuality and burgeoning libido experienced during puberty can trigger unsettling changes in the psycho-affective and psycho-dynamic equilibrium of the child as he or she transforms into an adolescent. This article presents puberty as a transformative experience with traumatic impact that needs to be considered in therapy conducted with adolescents. At best, pubescent trauma can cause superficial issues in a child's adaptive abilities; at worse, it can lead to pathological symptoms. This article presents a qualitative study derived from a clinical case of an adolescent girl who expresses her pubescent suffering through social withdrawal and mutism. The study determines several symptomatic and traumatic indicators caused by the sudden physiological transformations of puberty, such as perceived breaches in a child's sense of safety and the child's ability to predict. The study also explores the feelings of helplessness, vulnerability, and aloneness that pubescent adolescents endure, which are then exacerbated by the sensed inability to turn to parents for help or peers for support.

[Developing the educational alliance with migrant minors]. / Travailler l'alliance éducative avec les mineurs migrants.

Over recent years, more and more unaccompanied minors have been arriving on French territory in search of a better future. As a result of their complicated journey before, during and after the migration, these youngsters have specific psychological needs which are not always recognised by the professionals working with them. Research has highlighted the elements weakening the educational alliance between youngsters and the adults surrounding them.

[Welcoming an Afghan in a French family: reactions and analysis]. / Accueil d'un Afghan au sein d'une famille française : réactions et analyse.

The family provides a holding and benevolent environment, allowing the subject to construct himself psychically. Beyond the family, the group of belonging allows an individual to feel that he or she exists. During migration, belonging can be broken: loss of country, language, family, social status, etc. In France, a reception programme for migrants in families helps them to integrate and rebuild their lives. The initial family dynamic is modified. Some important points need to be taken into account during this reception: motivations, consequences on family dynamics and psychological reshuffling.

[Becoming parents in a cross-cultural situation]. / Devenir parents en situation transculturelle.

Being parents is an adventure in itself. Being parents in a cross-cultural situation, in exile, away from family and friends, is a double challenge. Today, we know more about the risks and the potential. Let's explore the key ingredients for early childhood: how to live through pregnancy, welcoming the child, being father and mother, building a family in our own way by blending it with local ways of doing things, a more or less hospitable land of welcome. This is followed by a set of guidelines for all the professionals who intervene at this crucial period to build the parent-child bond.

[Unaccompanied Minors: Individual Trajectories Confronting Politics]. / Les mineurs non accompagnés : des destins individuels qui interrogent le politique.

Objectives The article presents the clinical description and discussion of a 17 years old Moroccan unaccompanied minor who migrated on his own to France. This case illustrates the complexity of the foreign unaccompanied minors' trajectories and the challenges of the clinical and institutional accompaniment provided in France. In the lights of the results of our clinical work and research, we suggest transcultural tools and perspectives that facilitate the construction of a narrative and that reinforce trust with the professionals-care givers working along with this population. Creativity is needed in the care of foreign isolated young people, in the absence of the family. Past traumatic experiences in these youths' lives hinder the process of building trust in the host country's educational accompaniment. Method In the framework of our action research, we describe the transcultural therapy setting created by our team to address the unaccompanied minors' psychological distress. Aiming to encourage the emergence of a life narrative that had been obstructed and ruptured by traumatic experiences, we resort to various tools facilitating the storytelling (objects, circle test, mediators interpreters, transcultural interpretations). Results The discussion follows three stances: the anthropological perspective focusing on the specific situation of the harraga-young people wandering both on the psychic and physical levels-, the political perspective, and the trauma clinic perspective. The enhancement and deepening of the cross-cultural skills of social workers strengthen their resources and provide them with better tools to accompany these young people. Additionally, results highlight the impact of the political discourse and strategies in the social workers' self-perception and the strains it creates in their daily work. Conclusion The transcultural approach addressed to unaccompanied minors relaunches the identity construction process in adolescence, impeded by their traumatic journey in migration. This implies restoring coherence in the life path of young people despite the rupture caused by the migration, often reactivated by new separations during the repetitive changes of foster homes. The unaccompanied minors have the possibility, through this clinical setting to depict an accurate representation of themselves, to develop narratives that can outgrow the preconceptions associated with their status, opening a brighter way for their individual destinies.

[Intercountry adoption, the parents' experience of somatic disorders in children]. / Adoption internationale, le vécu parental des troubles somatiques de l'enfant.

Most children adopted in a foreign country present somatic disorders, which can have an impact on the construction of the bond with the adoptive parents. This potential complication must be taken into account in the adoption procedure and during the post-adoption follow-up, taking on board the trauma of everyone involved.

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.

The Impact of Children's Pre-Adoptive Traumatic Experiences on Parents.

For the last decade, children are adopted increasingly at an older age. Their pre-adoptive past can bare traumatic experiences consequent to abandonment, violence, or deprivation in birth family or orphanage. The objective of this study is to explore the impact of the child's traumatic past on parental representations and subsequent parent-child interactions. The study includes 41 French parents who adopted one or more children internationally. Each parent participated to a semi-structured interview, focused on the choice of country, the trip to the child's native country, the first interactions with the child, the knowledge of the child's pre-adoptive history. The interviews were analyzed according to a qualitative phenomenological method, the Interpretative Phenomenological Analysis. Five themes emerged from this analysis: absence of affects in the narrative; denial of the significance of the child's traumatic experiences; perceptions of the uncanny concerning the child; parental worry about traumatic repetition for the child; specific structure of the narrative. These extracted themes reveal a low parental reflective function when the child's past is discussed. They highlight the impact of the child's traumatic past on parents. Exploring the impact of the child's traumatic experiences on adoptive parents enables professionals involved in adoption to provide an early support to these families and to do preventive work at the level of parental representations and family interactions.

Silence, Rebellion, and Acting-Out of a Silenced Past: Understanding the French Riots From a Postcolonial and Transcultural Perspective.

Context and Objectives: According to a sociological study, the adolescents involved in the "suburban riots" of November 2005 were French nationals with a foreign background, including 55% of North African descent. Numerous attempts to interpret the "riots" have been made, but none of them has discussed the impact of the "silenced" colonial history on their filiation. For this reason, the present research set out to overcome this shortfall. Methods: Using a complementarist, transcultural, qualitative research methodology, 15 interviews with French adolescents of Algerian descent were analysed. Results, Analysis and Discussion: The analysis of these interviews highlighted the impact of the past violence in France's colonial history on family dynamics and intergenerational relationships, which seemed to play a crucial role in the unconscious component of transmission within these families. This discovery led us to a new understanding of the 2005 revolt, envisaging it as a symptom of a disorder situated on several levels: on the level of subjectivity, of trans-generational relationships, and also on the level of social cohesion within French society. The interviews showed how the young interviewees related their current anger to French colonial and post-colonial history. Conclusions: These observations led to a new understanding of the "riots" as a form of acting-out of anger linked to contemporary and past experiences of domination and exclusion.

[Psychological vulnerability of teams working with displaced Syrians in Lebanon]. / Vulnérabilité psychique des équipes, expérience libanaise auprès des déplacés syriens.

In the context of the humanitarian crisis of Syrian refugees in Lebanon, a team of young Lebanese social workers attempted to identify the most economically vulnerable people. These professionals have themselves sometimes been exposed to social and economic difficulties, having in their own past experienced war and deprivation. They were confronted with experiences of war, poverty, inter-community conflicts, the recollection of their own family trauma or guilt. Support in the form of psychological care was provided to them.

[Impact of the trauma of refugees of war on mental health workers]. / Impact du trauma des réfugiés de guerre sur les intervenants en santé mentale.

As part of a research project aiming to measure the psychological impact of humanitarian intervention in the wars affecting the Middle East, 28 humanitarian players working with refugees and displaced people took part in semi-structured qualitative interviews. The material was analysed using the interpretative phenomenological approach. The results show indications of transmission of the trauma when issues of identity and a sense of belonging are involved, psychosomatic manifestations as well as complex transference-countertransference relationships.