Contribution aux recherches sur l'alcoolodépendance : étude comparative entre alcoolisme chronique et alcoolisme intermittent, réalité externe perçue, réalité interne

Abstract : 1. Objectives: Alcoholism, a major public health, includes a set of behaviors, and several theorical approaches (classical typologies, cognitive-behavioural approach, psychoanalytic,?). The alcohol-dependence concept, However, doesn't seems to consider precisely the common denominators and specificities of these behaviors. The objective of this research is to compare two types of alcohol dependence, chronic alcoholism and intermittent alcoholism regarding two levels: external perceived reality (attributions, alcohol expectancies, coping, locus of control, life events) and internal reality (psychic organization and functioning). Do these behaviors belong to the same psychopathologic unit, either two different registers? This questioning allows to view an approach of alcoholism which would be less standard than underlined by alcohol-dependence concept. 2. Method: Two groups of alcohol dependents were established (7 chronic alcoholics, and 6 intermittent alcoholics), and compared from the point of view of external reality and internal reality by following method: - external perceived reality : semi-structured interview, life events questionnaire, coping scale (Brief Cope of Carver), locus of control scales (IPC et ARS), - intrapsychic reality : projectives tests : TAT and Rorschach (classic and psychoanalytic application) to investigate personality organization (body image and self representation, objectal relation, anxiety, defense mechanisms), and mental functioning (imaginary space, mentalization, defense efficacy). The importance of variables, and the limited number of subjects set this study on a comparative qualitative research through contrasted clinical cases, in exploratory aim. Hypothesis focus on commun denominators and differences between chronic alcoholic subjects and intermittents concerning these dimensions. 3. Results: Collected data lead us to deduct both common and differential elements in chronic and intermittent alcoholism, as much in external perceived reality level as in internal reality level. Intermittent alcoholics (who present globally less fragility), in particular, tend to fluctuate between different registers, allowing to suggest hypothesis of functioning by ?eclipse?. 4. Conclusion: Results would be reproduced in a more large population, but supporting differences observed between chronic and intermittent alcoholism, it is possible to conceive alcoholic problem as organized by strata, including a common general level, and particular modalities according to consumption behavior. These differences seem interesting to consider in a preventive and therapeutic way, to propose adapted care to needs and expectancies of alcoholic people.
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Barbara Smaniotto. Contribution aux recherches sur l'alcoolodépendance : étude comparative entre alcoolisme chronique et alcoolisme intermittent, réalité externe perçue, réalité interne. Psychologie. Université Nancy 2, 2008. Français. ⟨NNT : 2008NAN21011⟩. ⟨tel-01777315⟩

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