Attachment Style and Mentalization Impact Among Women Victims of Domestic Violence (FEMATAM)

Attachment and mentalization with a population of domestic violence victims Domestic violence is one of the most common forms of domestic violence. Multiform and complex, it affects all backgrounds and all ages. According to a survey instituted by the government of Emmanuel Macron, 219,000 women were recognized as victims of domestic violence in 2017. This phenomenon is not without questioning the scientific scene. Also, this study focus on the quality of the attachment because if this bond is insecure, it can constitute a point of vulnerability in self-construction and impact on future relational modalities.

Study Overview

• Status: Recruiting
• Conditions: Violence, Domestic
• Intervention / Treatment: Behavioral: Semi-structured interviews; Behavioral: Projective methode; Behavioral: Selfreported

Detailed Description

The security of the bond of attachment depends on the capacity of the maternal figure, or her substitute, to understand and respond in an adapted and consistent manner to her baby. In addition, it has also been established that when disruptions occur in the security of attachment bond, the quality of mentalization is impacted. But, mentalization is the quality and quantity of psychic representations available to allow someone understanding and thinking about his links to others and to himself. This is an essential asset in the release of situations of violence and in overcoming trauma because it participates in psychic development. That's why this research focuses on early relationships and the quality of mentalization with a cohort of thirty women victims of domestic violence, consultant within the Legal Medicine department of the CHU of Besançon. This research focuses on two groups of subjects: women who managed to get out of violent relationship (15 subjects) and others who did not (15 subjects). The research methodology includes several tools: two projective tests (Rorschach and TAT), ten self-questionnaires (which assess attachment, stress, social support, relational quality with the main attachment figures, the image of the Self-body, quality of mentalization), a clinical research interview and presentation of the AAI. The observation of this population will highlight the impact of the early environment in the psychic construction of the subject and the victim's destiny. Moreover, this study will look at the role of psychotherapeutic follow-up in the quality of mentalization.

• Study Type: Interventional
• Enrollment (Anticipated): 30
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Rose-Angelique Belot, PhD; Phone Number: 03 81 66 54 70; Email: rose-angelique.belot@univ-fcomte.fr
• Study Contact Backup: Name: Justine CESARI, Student; Phone Number: 06 16 10 28 98; Email: justinecesari53@hotmail.fr

Study Locations

• France
  • Bourgogne Franche-Comté
    • Besançon, Bourgogne Franche-Comté, France, 25000
      • Recruiting
      • CHU Besançon
      • Contact: Justine CESARI, Student; Phone Number: 06 16 10 28 98; Email: justinecesari53@hotmail.fr

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 20 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Female

Description

Inclusion Criteria:

• Women over 20 years old, victims of domestic violence
• With european culture
• Separated from their abusive partner
• Consulting the Legal Medicine Department in Besançon University Hospital

Exclusion Criteria:

• Refusal to participate

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Subjects following a psychotherapy; Domestic violence victims following a psychotherapy 15 subjets Aged from 20 to 55	Behavioral: Semi-structured interviews; Interview; Behavioral: Projective methode; Rorschach + thematic aperception test; Behavioral: Selfreported; RSQ - PBI - RFQ - QSCPGS - SSQ6 - ÉCHELLES DE CUNGI - STAI - PCL-S - IES-R
Experimental: Subjects unfollowing a psychotherapy; Domestic violence victims unfollowing a psychotherapy 15 subjects Aged from 20 to 55	Behavioral: Semi-structured interviews; Interview; Behavioral: Projective methode; Rorschach + thematic aperception test; Behavioral: Selfreported; RSQ - PBI - RFQ - QSCPGS - SSQ6 - ÉCHELLES DE CUNGI - STAI - PCL-S - IES-R

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Security of the current attachment	Relationship Scale Questionary (RSQ) Description : 30 questions Answers : - 5 (not like me at all to) + 5 (very like me) Cotation : self-model scale : - 4 to + 4 model of others : - 4 to + 4 positive self-model and positive model of others = secure positive self-model and negative model of others = insecure detached negative self-model and positive model of others = insecure worried negative self-model and negative model of others = insecure fearful	Month 12
Security of the early attachment	Adult Attachment Interview (AAI : Main, George & Kaplan, 1984 ; Pierrehumbert et al., 1999) Description : 20 questions Free answers Cotation : Edicode, Pierrehumbert Fluidity = 1 to 9 Coherence = 1 to 9 Reflexive = 1 to 9 Authentic = 1 to 9 Scores have to be high	Month 12
Mentalization	The Reflective Functioning Questionnaire (RFQ : Fonagy & al., 2016) The 8-item RFQ Reflective Functioning Questionnaire comprises two subscales each of 6 items (Uncertainty and Certainty about mental states) The two scales operate with a Likert scale of 7 points that evaluate the degree of agreement of the subject with the sentences presented in each item. The items of Uncertainty or RFQ_U correspond to statements such as "Often very strong feelings cloud my thinking", they are recorded to detect extreme levels of uncertainty about mental states, in the following way 0, 0, 0, 0, 1, 2, 3, so that high scores reflect hypomentalization. Scores have to be medium The items corresponding to Certainty of mental states or RFQ_C contemplate statements such as "When I get angry I say things without really knowing why I say them" which are recorded as 3, 2, 1, 0, 0, 0, 0, in such a way that a 6 low degree of agreement reflects Hypermentalization. Scores have to be medium	Month 12
Quality of early relationship	Parental Bonding Instrument (G. Parker, H. Tupling and R.B. Brown) Two scales termed 'care' and 'overprotection' or 'control', measure fundamental parental styles as perceived by the child. 25 item questions, including 12 'care' items and 13 'overprotection' items. Likert scale : "very like" (+3) or very dislike (-3). In addition to generating care and protection scores for each scale, parents can be effectively "assigned" to one of four quadrants: Mothers : care score = 27.0 / protection score = 13.5. Fathers :care score = 24.0 / protection score = 12.5. High care and high protection means "affectionate constraint". High protection and low care means "affectionless control". High care and low protection means "optimal parenting". Low care and low protection means "neglectful parenting".	Month 12

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
PTSD	Cungi's Scale 8 items Subject evaluates the importance for him of each of the items with a rating ranging from 1, very little impact at 6, extremely high impact. Score have to be low State-Trait Anxiety Inventory (STAI : Spielberg, 1983) Measures how the subject feels right now on 40 items with answer choices of 1 = not at all / almost never, 2 = somewhat/sometimes, 3 = moderately so / often, and 4 = very much so / almost always. Item scores are added to obtain subtest total scores. The score range for each subtest is 20-80, the higher score indicating anxiety. The cut point of 39-40 has been suggested to detect clinically significant symptoms. Impact of Event Scale Revisited (IES-R : Horowitz, Wilner, & Alvarez, 1979) 7 additional questions and a scoring range of 0 to 88. Scores that exceed 24 can be quite meaningful 33 and above : PTDS	Month 12

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
The social support	The social support questionnaire SSQ6 (Sarason et al., 1987) 6-item measure of social support. For each of the 6 items, respondents indicate the number of people available to provide support in each of 6 areas and then rate the overall level of satisfaction with the support given in each of the areas. For each item, the respondent makes a list of the people he can count on in the situation described (maximum 9 people) and expresses his degree of satisfaction (from 1 to 6) with this support. We then calculate two total scores, one of availability (N=number of people cited) and the other satisfaction (S), which correspond respectively to the sum of the "number" (N score) and "satisfaction" (S score) scores obtained in each of the six items. N score varies from 0 to 54 and the S score from 6 to 36. Both scores must be as high as possible	Month 12
The self-satisfaction	The self-satisfaction with the body satisfaction and global self-perception questionnaire (QSCPGS) Total score ranges from -100 to +100, each of the 20 items ranging from -5 to +5. The sign of value surrounded is a function of the proposal he has chosen to define himself. The sum of the 20 values gives the total score. If three or more answers lack, the QSCPGS is not valid. For quality analysis, the calculation of the number of hits, negative replies and neutral gives an indication of the perception that the subject of himself. This value is given as a percentage positive, negative and neutral. An item analysis by item, as well as the total and both factors can be considered.	Month 12

Collaborators and Investigators

• Sponsor: Centre Hospitalier Universitaire de Besancon
• Collaborators: University of Franche-Comté
• Investigators: Study Director: Houari Maïdi, PhD, Université de Bourgogne Franche-Comté

Study record dates

Study Major Dates

• Study Start (Actual): October 1, 2020
• Primary Completion (Anticipated): September 30, 2023
• Study Completion (Anticipated): September 30, 2023

Study Registration Dates

• First Submitted: October 4, 2021
• First Submitted That Met QC Criteria: April 8, 2022
• First Posted (Actual): April 15, 2022

Study Record Updates

• Last Update Posted (Actual): April 15, 2022
• Last Update Submitted That Met QC Criteria: April 8, 2022
• Last Verified: April 1, 2022

More Information

Terms related to this study

• Keywords: Victimization; Attachment; Domestic violence; Mentalization; Psychic elaboration of the trauma
• Other Study ID Numbers: 2020/546

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No