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Auteurs de violence sexuelle sur enfants : développement de lignes directrices d’évaluation clinique avant prise en charge par thérapie comportementale et cognitive

Abstract : There is an important gap between the number of people forced to get treatment and the number of psychotherapists specialized in this coverage. The objective of the law is very clear : incite to care in order to avoid a second offense. To be successful, the static and dynamic risk factors should be considered and it requires a specialist training in criminology. The objective of this research is to highlight, on one hand the main elements to be estimated before a cognitive behavioral therapy (CBT), and on the other hand to select tools which allow a better evaluation of child sexual abusers.Method: a semi-structured interview was developed to obtain a general conceptualization and a contextualization of the sexual violence on the children. This interview, associated with an evaluation of the mental illness and personality disorder was estimated with 19 men condemned by the French justice for crimes and offence against minors of less than fifteen years old. In a second study, we studied the social desirability (SD) and three dimensions of the personality (neuroticism, extraversion and psychoticism) in the same group of child sexual abusers. As we didn’t get the French standards on the scale of SD, we studied this variable in a group of 418 subjects stemming from the general population. We compared the results of 19 child sexual abusers with those of two control groups : violent people ( n=19 ) and not violent ( n=19 ). Our third study allowed us to analyze the activation of early maladaptive schema in our clinical sample and to compare these results with our two control groups.Results: the first study allowed us to define important elements to be estimated by every professional trained in behavioral and cognitive therapy : the experiments of adversity lived during the childhood, the self-esteem, the emotional sphere, the assertiveness, the normal sexuality, the negative vision of the spouses and the woman from the past, the relationship with others, the implicit theory and the cognitive schema. The study of SD in the general population gave us reference values of the French-speaking version of the tool. Our first hypothesis (the scores of the child sexual abusers on the scale of SD are superior to those of the not violent people) is validated. Our second hypothesis (the scores of the child sexual abusers are higher on the scale of SD than those of violent subjects) is not validated. Concerning the early maladaptive schemas, our first hypothesis (child sexual abusers have higher scores than non violents people) is validated. Our second hypothesis (child sexual abusers get higher scores than non-violent people to early maladaptive schemas  : emotional inhibition, social isolation, mistrust/abuse, abandonment/instability, subjugation and defectiveness/shame is partly validated.Discussion: the conceptualization of the problem of child sexual abusers before a CBT includes nine elements that we chose to keep when we analysed the interviews. Our three studies also allowed us to recommend the evaluation of the fundamental needs, the goals, the associated values and the strategies of resolution of problem. Measuring the quality of life would be an advantage. Associated to these variables, several evaluation tools were efficient : the structured interview MINI International Neuropsychiatric Interview to estimate the mental disorders, the Personnality Disorder Test 4 + to estimate the personality disorders, the shortened scale of social desirability C and the Young Schema Test-Short form 3 to study maladaptive schemas. We recommend the Eysenck Personality Questionnaire Revised to estimate the three personality dimensions and the Self-Report Psychopathy Scale-III to estimate the four facets of psychopathy.
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Submitted on : Wednesday, December 2, 2020 - 11:38:07 AM
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Marie Thomas. Auteurs de violence sexuelle sur enfants : développement de lignes directrices d’évaluation clinique avant prise en charge par thérapie comportementale et cognitive. Psychologie. Université Grenoble Alpes, 2018. Français. ⟨NNT : 2018GREAS035⟩. ⟨tel-03035568⟩



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