Treating the emotional and motivational inhibition of highly gifted underachievers with music psychotherapy: Meta-analysis of an evaluation study based on a sequential design.

The psychological and neuropsychological characteristics of gifted children and adolescents are analysed, as well as the emotional and behavioural risks linked to this condition. A prospective follow-up study of N=93 highly gifted students suffering from school failure at the beginning of adolescence was implemented. They were treated with an integrated form of music psychotherapy and verbal psychotherapy in 5 separate groups. The methodology of treatment combined active musical improvisation with the writing of stories or the production of drawings under musical induction, followed by verbal elaboration in the cognitive-psychodynamic psychotherapeutic tradition. The evaluation was based on a mixed-methods design, combining psychometric scales, projective tests and expressive tests. Comparative pretest-posttest, correlational and multidimensional analyses were computed, using non-parametric statistical procedures adapted to small samples and data belonging to a mixed level of measurement. We present a meta-analysis of the confirmatory results in 5 subgroups. There was a significant increase in the capacity of concentration, the capacity of imaginary and symbolic elaboration, the pictorial and literary creativity, self-esteem, the quality of coping strategies, as well as in school marks. There was a significant decrease in defensive functioning and in embitterment and resignation. The latent dimensions extracted with Optimal Scaling procedures from the correlational matrixes of the Delta values of TAT and TSD-Z were meaningful at the light of the state-of-the-arts. The results of the study confirm a prior theoretical modelization coming out of the preparatory stage of the research project. They are interpreted at the light of recent findings in developmental and clinical psychology of adolescence and they open many tracks for future research.

[The elaboration of aggressiveness in adolescence: Comparative structural study based on the Rorschach test]. / L'élaboration de l'agressivité à l'adolescence: étude structurale comparée basée sur le test de Rorschach.

BACKGROUND: In adolescence, a component of a successful identity quest consists in elaborating the aggressiveness, be it endured or acted out, in an imaginary and symbolic manner. We will present a comparative study between anxious and violent adolescents, based on the Rorschach test. As the handling of aggressiveness by means of various defense mechanisms and coping strategies contributes to the construction of a sense of reality and of coherent representations of oneself and the others, the Rorschach test is a pertinent tool to study the vicissitudes of the identity quest of medium adolescence. On the other hand, many studies demonstrate that it is also a precious tool allowing diagnosis of the risks of evolution towards character pathology and personality disorders belonging to cluster B of the DSM, or towards emotional disorders and suicidal tendencies. Thus, it can help initiating appropriate therapeutic measures in a spirit of tertiary prevention. METHODS: We present a comparative study between a sample of 20 adolescents suffering from anxiety and inhibition of aggressiveness (subgroup anxiety) and a second sample of 20 adolescents suffering from exteriorized aggressiveness and violent behavior (subgroup violence). The inclusion into the subgroups was based on clinical interviews and a thorough psychological assessment, using the criteria of categorical psychopathology. The comparative study between the two subgroups is based on an original rating scale constructed in the phenomenological and structural tradition, reflecting the global judgment of the experienced clinical psychologist. It permits using the Rorschach test as a research tool by making the step from qualitative analysis towards quantification and the use of inferential and multidimensional statistics. It also allows computing correlations between the Rorschach test and psychometric scales or other projective tests, using specific rating scales of the same type. RESULTS: After showing the descriptive demographic data, we present the results of the comparative between groups study (computed by means of Mann-Whitney's U test) and those of the multidimensional study (computed by means of the optimal scaling procedure HOMALS). The comparative study indicates that, with adolescents suffering from anxiety and inhibition, the emotional and relational needs are much greater, as is the tendency to direct one's aggressiveness against one self. Mentalization, documented by the richness, the originality, the level of integration and the maturity of associations is better developed in this subgroup. In the subgroup of adolescents characterized by exteriorized aggressiveness and violent behavior, the ambiguity of the stimulus causes perplexity, slowing down executive functions. The latent dimensions, extracted with the help of optimal scaling procedures, are meaningful at the light of current clinical psychology and create a typology of the adjustment to aggressive drives. They tend to illustrate the pertinence of the rating scale as a research tool and contribute in demonstrating its construct validity. DISCUSSION AND CONCLUSION: The data of the comparative and multidimensional study are discussed in relationship with open questions in developmental and clinical psychology of adolescence. They highlight the role of the Rorschach test as a means to differentiate between temporary and long-term difficulties related to aggressiveness, as well as to show similarities and differences at the structural level of personality functioning between subgroups with interiorized and exteriorized aggressiveness. The psychological meaning of the latent dimensions, extracted with the help of optimal scaling techniques, are discussed in light of the recent research literature. Rorschach profiles can help indicate risks of evolution towards personality pathology at adult age. Let us stress that our latent dimensions are not focused on aggressiveness itself but rather on control functions liable to modulate its expression. Using the Rorschach test in pretest and posttest situation and exploring the change occurring during the psychotherapeutic interventions with the help of the rating scale (application of optimal scaling on Delta values) could open interesting tracks for future research in the realm of outcome and process evaluation of psychotherapies.

[Using arts therapies in psycho-oncology: evaluation of an exploratory study implemented in an out-patient setting]. / Application de l'art thérapie en psycho-oncologie: evaluation d'une étude exploratoire en milieu extrahospitalier.

According to the state-of-the-art in health psychology and psycho-oncology, a cancerous disease, as well as the accompanying medical treatments, is a source ofintense emotional stress. As feelings of insecurity and anxiety are likely to induce negative effects on immune defences, those effects may overlap with the cancerous disease and complicate its evolution. As arts therapies tend to favour the imaginary and symbolic elaboration of the tensions of daily life, as well as the re appropriation of one's body and personal history, different artistic mediations may occupy an important function in the psychological follow-up of the patient. Following an exploratory study in a hospital, we carried out an action-research in an out-patient setting during six moths. The arts therapeutic treatment comprehended alternatively drawing and writing sessions while listening to music, opening tracks for a thorough verbal elaboration. The evaluation was based on psychometric scales (HADS and MDBF), rating scales for the pictorial and literary production and a semi-structured interview. According to the results of the quantitative analyses, based on non parametric statistical procedures for small groups and non metric data, as well as to the qualitative content analyses, arts therapies could become a valuable treating measure within a multidisciplinary bio-psycho-social approach.

[Defence mechanisms and coping strategies in men and women: a comparative and structural study based on the artistic production of people suffering from a break-up of their life project]. / Mécanismes de défense et stratégies d'ajustement au masculin et au féminin: etude structurale comparée basée sur la production artistique de personnes en rupture de projet de vie.

A comparative study of men and women suffering from a break-up of their life project allowed us examining the typically female and male manners to cope with trauma, anxiety, guilt, depression and internal destructivity. In a first stage, an exploratory study was focussed on 206 subjects, belonging to several clinical subgroups: people living in great precarity and long-term unemployed people, asylum seekers and refugees, drug addicts, prisoners and people coming out of prison. Secondly, arts therapeutic sessions were proposed with the aim of helping the participants finding an outlet to their situation. The artistic production (drawings and stories induced by music) was analysed with the help of original rating scales, constructed in a phenomenological and structural perspective. We will present a synthesis of our qualitative observations, as well as some results of typological and structural studies, computed with the help of non parametric statistical procedures on the data of N = 93 participants. The results allow us pointing to gender differences and defining typically male and female coping styles. Differential indications for psychotherapy can be extracted from these analyses.

[The influence of music on pictorial expression of young women--a comparative study of different music styles]. / L'influence de la musique sur l'expression picturale d'adolescentes--une étude comparative entre différents styles de la musique.

Questing one's personal identity and developing a coherent representation of oneself, the other and the world are major tasks in adolescence. Research showed that a satisfactory resolution of the crisis of adolescence can be favoured by psychological counselling based on artistic mediations. The objective of this study consisted in exploring the effect of music on the pictorial expression of a non clinical sample of female adolescents (N=157) aged from 17 to 28 years. We analysed free drawings realised by the test group with the help of a rating scale constructed in a phenomenological and structural perspective (Schiltz, 2006). The adolescents painted under musical induction. We proposed three different styles of music, i.e. baroque music (Georg Friedrich Händel and Johann Sebastian Bach), classical music (Wolfgang Amadeus Mozart and Ludwig van Beethoven) and polish ethnical music (Kapela ze Wsi Warszawa-Warsaw Village Band). By using non parametric inferential and multi dimensional statistics, we could show that structural characteristics of music styles lead to differences in formal and content variables on the rating scales for the pictures. The results of our exploratory study open some tracks for future research. It would be pertinent to enlarge the population to other categories of age and to investigate the influence of gender.

[Evaluation in the interest in arts psychotherapy treatment of alcoholics hospitalized for a weaning process--presentation of two clinical examples]. / Evaluation de l'intérêt de la prise en charge par l'art thérapie de personnes alcooliques hospitalisées pour un sevrage--presentation de deux études de cas.

The aim of our study is to show the relevance of art therapeutic treatment with an alcoholic population met in the weaning department of a general hospital. A current tendency of research in psychology consists in using an integrated quantitative and qualitative methodology. This approach is especially suited to the study of the therapeutic intervention. In arts therapeutic research the investigation of the artistic production and the application of a projective test (Rotter) may complete the psychometric tools: SVF 78 Stressverarbeitungsfragebogen by Janke W., Erdmann G., Kallus W.; MDBF Mehrdimensionalen Befindlichkeitsfragebogens by Steyer R., Schwenkmezger P., Notz P., Eid M.. The results of the study show the relevance of our art therapeutic treatment. We are going to illustrate the multidimensional reality of the therapeutic process by two clinical examples.

[Extracting specific profiles in two clinical subgroups of patients suffering from addiction]. / Dégagement de profils spécifiques dans deux sous-groupes de personnes dépendantes.

According to research literature, people suffering from addiction to alcohol or illegal drugs are presenting well defined troubles of identity. The aim of this study consists in showing structural similarities and differences between those two clinical subgroups, with the help of the Rorschach test which we have interpreted in an integrated quantitative and qualitative manner. We constructed a rating scale for the test of Rorschach, following the phenomenological and structural tradition of Mucchielli. This rating scale is considering as well the special phenomena as the global judgment of the experienced clinical psychologist. It is differing from the classical psychogramme by its holistic perspective, as it takes into account the interaction of different factors in a specific context. In an exploratory perspective we applied this rating scale to the Rorschach protocols of two small samples of people suffering from alcoholism and of people suffering from drug addiction. The patients belonging to both subgroups were in a state of abstinence at the period of the test. Thus their answers are reflecting an interaction of their basic personality and long term effects of the toxic products, but not the immediate effects of alcohol or illegal drugs. We have compared the answers of the two subgroups of dependent people with the help of non parametric statistics. Their specific profiles have been extracted with optimal scaling techniques. The results are discussed in relationship with structural psychopathology.

Analysing the relationship between traumatic biographical events and the current structural functioning of personality.

We present the general structure of a multi-annual research project. Our general expectancy concerns the possibilities of arts psychotherapy as a means of launching the blocked process of subjectivation with people suffering from exclusion, precarity and marginalization. The research project follows a complex research design with a sequential strategy, the first part consisting in an integrated psychosocial and clinical study using a mixed methodology. We constructed special rating scales for the analysis of the data of a semi-structured biographical interview and also for the holistic interpretation of the Rotter Blank Sentences Test, separating the associations to sentences beginning with the third and first person. The correlations between two sets of variables (biographical interview and Rotter test) were computed for the total experimental group (N=206), and for clinical subgroups. We shall analyse the matrices of correlations (Spearman's Rho) with the help of optimal scaling procedures (OVERALS). The links between traumatic biographical events and responses to the 3rd, respectively 1st person items of the Rotter test are interpreted in terms of unconscious versus conscious psychological processes and allow us analysing the expression of defence mechanisms and coping strategies. The results of the study are discussed in the light of the recent traumatogenic hypothesis of borderline functioning.

[Identification of types in small samples with the help of bootstrap simulation (illustrated with the help of the anxiety/depression subscales of the HAD)]. / Bootstrapsimulierte Typenidentifikation in kleinen Stichproben (dargestellt am Beispiel der Angst/Depression-Subskalen - HAD).

Using a HAD-file as an illustration, we could show that small files (n = 50) can provide statistically significant results if we apply bootstrap simulation. First the subscales "anxiety" and "depression" are computed and afterwards classified (in three categories). Both classified subscales are cross tabled and submitted to a configurational cluster analysis. One type can be clearly identified. To test the stability of the one-type solution, a bootstrap simulation (Lautsch/von Weber: BOOTSTRAP) is applied. The simulation confirms the one-type solution.

[Socio-demographic identification of anxiety-depression types (socio-demographic specification and prediction of types)]. / Soziodemographische Identifikation von Angst-Depressions-Typen (Soziodemographische Erklärung und Prognose von Typen).

In the article "Identification of Types in Small Samples with the help of Bootstrap Simulation" we could show how anxiety-depression types could be explored in small samples. We used the two sub-scales (anxiety and depression) in accordance with the indications of the HAD manual of Zigmond, A.S. & Snaith R.P. . The extraction of types will be repeated with the data of n=168 homeless people. Then the socio-demographic homogeneity of the extracted types will be tested. With this procedure we want to answer the question, whether in the sub-group of homeless people, the knowledge the degree of expression of some significant socio-demographic traits will allow us assigning them to specific anxiety-depression types.

[Rating scales based on the phenomenological and structural approach]. / Grilles d'analyse de contenu basées sur l'approche phénoménologico-structurale.

A current tendency of research in clinical psychology consists in using an integrated quantitative and qualitative methodology. This approach is especially suited to the study of the therapeutic intervention where the researcher is himself part of the situation he is investigating. As to the tools of research, the combination of the semi-structured clinical interview, of psychometric scales and projective tests has proved to be pertinent to describe the multidimensional and fluctuating reality of the therapeutic relationship and the changes induced by it in the two partners. In arts therapeutic research the investigation of the artistic production or of the free expression of people may complete the psychometric and projective tools. The concept of "expressive test" is currently being used to characterise this method. In this context, the development of rating scales, based on the phenomenological and structural or holistic approach allows us making the link between qualitative analysis and quantification, leading to the use of inferential statistics, providing that we remain at the nominal or ordinal level of measurement. We are explaining the principle of construction of these rating scales and we are illustrating our practice with some examples drawn from studies we realized in clinical psychology.

[Multidimensional homogeneity analysis with small samples: comparison of different subgroups of people suffering from exclusion]. / Analyse multidimensionnelle d'homogénéité sur échantillons restreints: comparaison entre différents sous-groupes d'individus en situation d'exclusion.

With the aim of studying the relationship between harmful biographical events and exclusion we have developed a rating scale for semi-structured biographical interviews. The rating scale was constructed in accordance with the phenomenological and structural approach and allows us gathering some clinically pertinent indicators concerning the course of life, the nature of the trauma, the composition of the original family, the life period of emotional pain and the current familiar and social support. The homogeneity or multiple correspondence analysis (HOMALS) led to the extraction of the fundamental dimensions underlying the data of three clinical subgroups of people suffering from exclusion and marginalization: homeless and long term unemployed people, immigrants, political refugees and asylum seekers, drug addicts. The results demonstrate the relevance of the multidimensional homogeneity analysis applied to this kind of data. On one hand they suggest a theoretical model of the relationship between harmful biographical events, vulnerability, exclusion and psychopathological complications. On the other hand they show that we are facing differential psychological profiles which will be studied thoroughly during the next stages of our research.

Paradoxical effects of trichostatin A: inhibition of NF-Y-associated histone acetyltransferase activity, phosphorylation of hGCN5 and downregulation of cyclin A and B1 mRNA.

Trichostatin A (TSA), an inhibitor of histone deacetylase (HDAC), is widely used to study the role of histone acetylation in gene expression, since genes that use histone acetylation as a means of regulating expression may be up regulated when TSA is added. In this study, however, we show that TSA has an unexpected paradoxical effect leading to inhibition of NF-Y-associated histone acetyl transferase (HAT) activity and phosphorylation of the HAT, hGCN5. TSA treatment of cells resulted in diminished levels of NF-Y-associated HAT activity without changes in NF-Y(A) amount. hGCN5 is one of the HATs known to associate with NF-Y. The association of hGCN5 with NF-Y was not altered by TSA treatment. The enzymatic activity of hGCN5 is known to be inhibited by phosphorylation. TSA treatment of Hela cells resulted in phosphorylation of hGCN5. Exposure of the NF-Y immunoprecipitates from TSA-treated cells to a phosphatase resulted in enhanced HAT activity. We have also shown that the mRNA levels of several genes, cyclin B1 and cyclin A, are downregulated by TSA; these effects do not require protein synthesis and the downregulation of cyclin B1 by TSA occurs through transcription. These results suggest that TSA can have contradictory effects, on one hand stimulating HAT activity in general by inhibition of HDACs, but also resulting in inhibition of NF-Y-associated HAT activity and phosphorylation of hGCN5.

ATF-2 has intrinsic histone acetyltransferase activity which is modulated by phosphorylation.

Transcription factors carry functional domains, which are often physically distinct, for sequence-specific DNA binding, transcriptional activation and regulatory functions. The transcription factor ATF-2 is a DNA-binding protein that binds to cyclic AMP-response elements (CREs), forms a homodimer or heterodimer with c-Jun, and stimulates CRE-dependent transcription. Here we report that ATF-2 is a histone acetyltransferase (HAT), which specifically acetylates histones H2B and H4 in vitro. Motif A, which is located in the HAT domain, is responsible for the stimulation of CRE-dependent transcription; moreover, in response to ultraviolet irradiation, phosphorylation of ATF-2 is accompanied by enhanced HAT activity of ATF-2 and CRE-dependent transcription. These results indicate that phosphorylation of ATF-2 controls its intrinsic HAT activity and its action on CRE-dependent transcription. ATF-2 may represent a new class of sequence-specific factors, which are able to activate transcription by direct effects on chromatin components.

HIV-1 tat transcriptional activity is regulated by acetylation.

The human immunodeficiency virus (HIV) trans- activator protein, Tat, stimulates transcription from the viral long-terminal repeats (LTR) through an RNA hairpin element, trans-activation responsive region (TAR). We and others have shown that trans-activator protein (Tat)-associated histone acetyltransferases (TAHs), p300 and p300/CBP-associating factor (PCAF), assist functionally in the activation of chromosomally integrated HIV-1 LTR. Here, we show that p300 and PCAF also directly acetylate Tat. We defined two sites of acetylation located in different functional domains of Tat. p300 acetylated Lys50 in the TAR RNA binding domain, while PCAF acetylated Lys28 in the activation domain of Tat. In support of a functional role for acetylation in vivo, histone deacetylase inhibitor (trichostatin A) synergized with Tat in transcriptional activation of the HIV-1 LTR. Synergism was TAR-dependent and required the intact presence of both Lys28 and Lys50. Mechanistically, acetylation at Lys28 by PCAF enhanced Tat binding to the Tat-associated kinase, CDK9/P-TEFb, while acetylation by p300 at Lys50 of Tat promoted the dissociation of Tat from TAR RNA that occurs during early transcription elongation. These data suggest that acetylation of Tat regulates two discrete and functionally critical steps in transcription, binding to an RNAP II CTD-kinase and release of Tat from TAR RNA.

HIV-1 tat binds TAFII250 and represses TAFII250-dependent transcription of major histocompatibility class I genes.

HIV Tat, a transactivator of viral transcription, represses transcription of major histocompatibility (MHC) class I genes. Repression depends exclusively on the C-terminal domain of Tat, although the mechanism of this repression has not been known. We now show that repression results from the interaction of Tat with the TAFII250 component of the general transcription factor, TFIID. The C-terminal domain of Tat binds to a site on TAFII250 that overlaps the histone acetyl transferase domain, inhibiting TAFII250 histone acetyl transferase activity. Furthermore, promoters repressed by Tat, including the MHC class I promoter, are dependent on TAFII250 whereas those that are not repressed by Tat, such as SV40 and MuLV promoters, are independent of functional TAFII250. Thus, Tat repression of MHC class I transcription would be one mechanism by which HIV avoids immune surveillance.