Borderline functioning and life trauma: a structural approach

in Archives of Psychiatry and Psychotherapy (2016), 2(2016), 12-21

Aim: The general aim of this multiannual research project was the exploration of the links between traumatizing life events and current functioning. Material and methods: The research project was based on ... [more ▼]

Aim: The general aim of this multiannual research project was the exploration of the links between traumatizing life events and current functioning. Material and methods: The research project was based on a sequential design. It included an exploratory study with 206 persons experiencing exclusion and marginalization, followed by a confirmatory study with 195 persons. We present the confirmatory study results, as well as a meta-analysis of both studies. Both studies were based on an integrated quantitative and qualitative research methodology, combining a semi-structured biographical interview, psychometric scales (Hospital Anxiety and Depression Scale (HADS), Index of Well- Being) and a projective test (Rotter Incomplete Sentences Blank). We developed original rating scales for the semi-structured interview and the answers to the Rotter test, allowing a step from qualitative analysis to inferential and multidimensional statistics. Results: With the help of appropriate multidimensional statistical procedures applied to the semi-structured interview (linear principal components analysis) and the Rotter test (multiple correspondence analysis), we were able to draw out differential types of personality functioning based on the prevalent defense mechanisms and coping strategies, linked either to a succession of traumatic events, such as neglect, maltreatment and multiple losses occurring since childhood, or to recent catastrophes. The comparative study of the answers to the Rotter test in the first and third person pointed to differences in the expression of conscious and unconscious needs. Configural frequency analysis applied to HADS identified specific types that could correspond to variants of borderline functioning. The meta-analysis of the exploratory and confirmatory findings showed convergent results at several fundamental dimensions. Our results supported the traumatogenic hypothesis of borderline functioning and pointed towards a partial overlapping of the concepts of splitting and dissociation. Conclusions: More long-term evaluation studies of appropriate psychotherapeutic measures are needed. From the methodological point of view, the most appropriate strategy might be a mixed-methods design combining data from different sources (semi-structured interviews, psychometric scales, projective tests, etc.) and respecting the person-centered approach. This approach combines objectivity with subjectivity in an optimal manner. [less ▲]

When the Foundations of Life have been Upset… An Integrated Clinical and Experimental Study with Refugees and Asylum Seekers

in Archives of Psychiatry and Psychotherapy (2013), 15(2), 53-62

Aim Recent research results in clinical psychology, health psychology and neurobiology underline the relationship between dissociative states, complex posttraumatic syndromes and borderline functioning ... [more ▼]

Aim Recent research results in clinical psychology, health psychology and neurobiology underline the relationship between dissociative states, complex posttraumatic syndromes and borderline functioning [11]. Our study is meant to investigate the traumatic hypothesis of borderline functioning and to develop appropriate psychotherapeutic measures based on artistic mediations. Material and Methods.To estimate the effect of traumatic events, from the beginning of life up to recent stressors, linked to natural catastrophes, war, political persecution and migration, we undertook an integrated clinical and experimental study with a sample of 73 refugees and asylum seekers. In a second stage, those who suffered from PTSD or complex post-traumatic states were offered to attend arts psychotherapeutic sessions.. To investigate the personality functioning at the structural level, we used a mixed quantitative and qualitative methodology, combining a semi-structured biographical interview, a projective test, i.e. the Sentences Completion Test, for which we developed a new manner of interpretation , and psychometric scales, i.e. the HADS and the Index of Wellbeing . Furthermore, we analysed the artistic production (pictures, stories written under musical induction) with the help of rating scales constructed in the phenomenological and structural tradition. Results. With the help of non parametric multidimensional statistics, we extracted two profiles of personality functioning, linked either to repeated breaks, negligence and maltreatment from the beginning of life, or either to a recent external catastrophe, interrupting a continuous life course. Through the evaluation of the arts therapeutic sessions, we could note the first signs of resumption of the blocked process of subjectivation. Discussion.The results of the study support the traumatogenic hypothesis of borderline functioning, as well as current clinical considerations concerning the defensive role of dissociation in complex posttraumatic states. Conclusion. The study opens tracks for future research concerning an in depth investigation of the arts therapeutic process with traumatized people. [less ▲]

Borderline Functioning and Life Trauma

Scientific Conference (2011, July 03)

Application des méthodes de codage optimal aux valeurs delta: Une stratégie pertinente pour l'exploration du processus thérapeutique.

in Neuropsychiatrie de l'Enfance et de l'Adolescence (2010), 58

Dans le cadre d’une étude intensive sur échantillon restreint, l’application du codage optimal au niveau des valeurs Delta (différences posttest/pré-test) peut permettre de dégager des dimensions latentes ... [more ▼]

Dans le cadre d’une étude intensive sur échantillon restreint, l’application du codage optimal au niveau des valeurs Delta (différences posttest/pré-test) peut permettre de dégager des dimensions latentes faisant sens du point de vue de la théorie et permettant de mieux comprendre le changement manifeste. Celui-ci est mesuré au moyen de différents types d’outils, complémentaires entre eux (échelles psychométriques, tests projectifs, épreuves expressives, schémas d’observation comportementale, critères de validation externe). Nous illustrons l’intérêt de cette stratégie au moyen d’un exemple d’application, tiré d’une étude d’évaluation d’ateliers de musicothérapie offerts à des élèves surdoués en situation d’échec scolaire (n = 20). Nous présentons les changements pré-test/post-test (test signe-rang de Wilcoxon) au niveau des outils suivants : le d2 (Brickenkamp, 1994 [39]), le TSD-Z (Urban et Jellen, 1995 [40]) et le thematic apperception test (TAT) (Murray, 1991 [41]), ainsi que les résultats de l’étude corrélationnelle (Rho de Spearman) et multidimensionnelle (PRINCALS appliquée sur valeurs Delta). Des changements significatifs sont apparus au niveau de la capacité de concentration, de l’élaboration imaginaire et symbolique de l’agressivité, ainsi qu’au niveau de la créativité picturale et littéraire. Les dimensions latentes dégagées à partir du codage optimal font sens du point de vue de la théorie. Nous proposons une modélisation théorique du mode d’action de la musicothérapie dans la levée du blocage, distinguant, d’un côté, les effets stimulants ou équilibrants à court terme, d’un autre côté les effets restructurants à long terme. Au sein d’une démarche exploratoire, la stratégie adoptée peut ouvrir des pistes pour la recherche future. [less ▲]

Applications de l'Art Thérapie. Approche clinique et expérimentale intégrée Tome 1 : Domaine psychopédagogique et développemental

Book published by Saint-Paul (2009)

Analysing the relationship between Biographical Events and the Current Structural Functioning of Personality (en collaboration avec L. Schiltz (CRP-Santé).

in Bulletin de la Société des Sciences Médicales du Grand-Duché de Luxembourg (2008), 1

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 ... [more ▼]

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. [less ▲]

Application de l'art thérapie à quelques problèmes cruciaux de la société luxembourgeoise. Approche clinique et expérimentale. Recherche théorique et méthodologique. 3e partie

Report (2007)

Application de l'art thérapie à quelques problèmes cruciaux de la société luxembourgeoise. Approche clinique et expérimentale. Recherche théorique et méthodologique. 2e partie

Report (2006)

Application de l'art thérapie à quelques problèmes cruciaux de la société luxembourgeoise. Approche clinique et expérimentale. Recherche théorique et méthodologique. 1re partie

Report (2005)