The number of single people is increasing in the Western world. Despite this and a trend towards individualisation, women are still stigmatised for being single. Quantitative studies have shown that physical appearance and romantic relationships are two interconnected areas by demonstrating that single women who seek a partner are more sensitive to their appearance. This can have adverse psychological implications, such as body image concerns or low self-esteem. How physical appearance is experienced in the context of partner seeking remains however understudied. To address this gap, this study explores qualitatively how women feel about themselves and their appearance when seeking a partner. Eight women, who had been single for at least one year, were interviewed. Data gathered from the semistructured interviews were transcribed and analysed using Interpretative Phenomenological Analysis (IPA), chosen due to its in-depth exploration of the participants’ experiences. Four master themes were identified: I) The intrusive Other: Experiencing a sense of restriction when seeking a partner; II) Self-rejection when seeking a partner; III) Appearance as a means of control when seeking a partner; and IV) Feeling overwhelmed: The emotional intensity of seeking a partner. The results revealed that women who seek a partner experience several tensions regarding their appearance, their singleness and their social interactions. They are left excessively outer-focused, which is self-silencing and disconnecting. The implication for clinical practice is that counselling psychologists should acknowledge public and private aspects of distress when working with women who seek a partner. It is advised to stay with different tensions and to explore their underlying anxiety phenomenologically instead of either glamourising or pathologising women’s experiences of partner seeking. Limitations are discussed, including that this study does not consider the experiences of women who wish to remain single, which can be addressed in future research.

This thesis used FIT Science (Fletcher & Stead, 2000) as a framework to study different aspects of family functioning. FIT variables measure the cognitive and behavioural characteristics of a person that mediate interpretations of events and attempts at coping with constraints. The research sought to examine whether scores on FIT variables explain differences in perceptions of family functioning and outcomes such as individual stress levels. In the first questionnaire study, members of the general population (N=235) completed The FIT Profiler (Fletcher, 1999), which measures scores on FIT variables, and the Family Assessment Device (Epstein, Baldwin & Bishop, 1983), which measures family functioning across six dimensions. The study found that higher scores on FIT variables were associated with more positive experiences of the family. A similar pattern of results was observed in study two involving participants (N=52) with Autistic Spectrum Conditions (ASCs). The results of the studies suggested that FIT Science is a useful framework to study family functioning in diverse contexts. Study three compared the stress and perceptions of family functioning of mothers of typically developing children (n=55), and children with ASCs (n=33). Mothers scoring high on FIT variables had better perceptions of family functioning, were less anxious and depressed, and also coped better with the demands of parenting. Studies four and five explored whether FIT Science also offers a useful framework for promoting changes in family functioning and individual well being. Study four reported a randomized control trial of a FIT-­‐Do Something Different (FIT-­‐DSD) intervention, which was administered to mothers (n=13) of children with ASCs. The FIT-­‐DSD intervention aimed at expanding behavioural flexibility and disrupting constraining habits. Study five reported a qualitative follow-­‐up of the intervention group in study four. 17 The results of studies four and five suggested that the FIT-­‐DSD intervention was a useful and novel tool to help mothers across a number of domains of family life. Relative to a wait-­‐list control group (n=11), the intervention group reported moderate to large improvements in their levels of parenting stress, depression, relationship satisfaction and scores on the cognitive FIT variable Self-­‐responsibility. Qualitative investigation also suggested that the intervention helped mothers develop feelings of control, self-­‐esteem and self-­‐efficacy. The thesis suggests that FIT Science offers a fruitful framework with which to study and intervene with family functioning. Further research seeking to explore the use of FIT Science as a vehicle for family change is recommended. This may help promote better physical and psychological health for individuals struggling with their environmental and self-­‐generated constraints.

Les candidats à la chirurgie bariatrique ont une trajectoire biopsychosociale singulière : obésité très sévère ou compliquée, psychopathologies fréquentes et histoires de vie difficiles et traumatiques. Considérant le traitement médical comme un échec, ils voient la chirurgie comme l’ultime solution. Le concept de résilience permet d’aborder la fragilité psychique et sociale de ces personnes. Les objectifs principaux de l’étude visent à mieux cerner leurs fonctionnements psychiques et à identifier leurs évolutions au cours d’un parcours de préparation à la chirurgie bariatrique, selon une approche semi-quantitative d’inspiration psychodynamique. Deux cents sujets candidats à la chirurgie bariatrique (153 femmes et 47 hommes ; âge : 43,5 ± 11,74 ans ; IMC : 45,54 ± 7,19 kg/m²) ont été recrutés au début de leurs parcours de préparation au CHRU de Nancy. Ce parcours qui dure un an est basé sur un abord cognitivo-comportemental et propose des ateliers collectifs d’éducation thérapeutique.Trois méthodologies ont été utilisées au début et à la fin de ce parcours pour explorer les différentes dimensions de la résilience dans le contexte de l’obésité sévère : des entretiens cliniques de recherche, des données projectives (102 protocoles Rorschach) et des auto-questionnaires permettant d’apprécier la qualité de vie (EQVOD et SF-36), les Troubles des Conduites Alimentaires (TCA) (DEBQ et BES), les psychopathologies (HAD et MINI), les mécanismes de coping (Briefcope), l’alexithymie (TAS), et la résilience (RSA). Le processus de résilience est inexistant en début de parcours. Les résultats indiquent que les sujets présentent une faible qualité de vie ainsi que de nombreuses psychopathologies : compulsions alimentaires (62,89 %, dont 56,6 % de Binge Eating Disorder (BED)), dépressions (15 %), anxiétés (34,5 %) ou encore addictions (29,5 %). Un nombre important d’événements de vie difficiles et traumatiques est relevé : 86 % des sujets ont un vécu polytraumatique remontant majoritairement à l’enfance et l’adolescence. Les réponses paradoxales données par certains sujets aux auto-questionnaires permettent de les classer selon un profil comportemental dit "discordant" (sous-évaluation du binge eating à la BES et surévaluation de la résilience à la RSA) qui se caractérise par un défaut de mentalisation relevé à l’entretien clinique et au Rorschach. Une nette amélioration de l’ensemble des indicateurs est constatée à la fin du parcours. La qualité de vie des sujets, notamment psychique, augmente. La prévalence des psychopathologies, elle, diminue fortement, avec des réductions significatives des TCA en termes de fréquence (64,78 %) et d’intensité (13,21 % avec forte compulsivité), des dépressions (3,14 %), de l’anxiété (8,18 %) et des comportements addictifs (13,84 %). Enfin, les difficultés de mentalisation ont régressé, bien que la majorité des sujets présente toujours une absence de processus résilient juste avant la chirurgie. Les sujets présentant un profil "concordant" d’après les auto-questionnaires, connaissent une amélioration significativement plus importante à la plupart des indicateurs, par rapport aux sujets "discordants" / Candidates for bariatric surgery have a singular biopsychosocial trajectory: very severe or complicated obesity, frequent psychopathologies and difficult and traumatic life histories. Considering medical treatment as a failure, they see surgery as the ultimate solution. Resilience’s concept enables to come closer the psychic and social fragility of these people. The main objectives of the study are to pinpoint their psychic functioning and to identify their evolution during a healthcare pathway of preparation for bariatric surgery, using a semi-quantitative approach of psychodynamic inspiration. Two hundred subjects who are candidates for bariatric surgery (153 women and 47 men, age: 43.5 ± 11.74 years, BMI: 45.54 ± 7.19 kg/m2) were recruited at the beginning of their healthcare pathway of preparation at CHRU of Nancy. This one-year circuit is based on a cognitive-behavioral access and offers collective therapeutic education working group.Three methodologies were used at the beginning and end of this circuit in order to explore the different dimensions of resilience in severe obesity context: clinical research interviews, projective data (102 Rorschach protocols) and self-questionnaires enabling the quality of life (EQVOD and SF-36), eating disorders (ED) (DEBQ and BES), psychopathologies (HAD and MINI), coping mechanisms (Briefcope), alexithymia (TAS), and resilience (RSA) to be assessed.The resilience process is nonexistent at the beginning of the circuit. Results indicate that the subjects have a poor quality of life as well as many psychopathologies: food compulsions (62.89%, including 56.6% of Binge Eating Disorder (BED)), depressions (15%), anxieties (34, 5%) or addictions (29.5%). A significant number of difficult and traumatic life events is noted: 86% of the subjects have polytraumatic past life experiences mostly going back to childhood and adolescence periods.Paradoxical responses given by some subjects at self-questionnaires authorize them to be classified according to a behavioral profile known as "discordant" (underestimate of binge eating at BES and overvaluation of resilience at RSA) which is characterized by a deficit of mentalization identified at the clinical interview and at Rorschach.A clear improvement of all these indicators is certified at the end of this circuit. The quality of life of subjects, especially psychic, increase. The prevalence of psychopathologies, it, strongly decreases, with significant reductions in eating behavior disorders in terms of frequency (64.78%) and intensity (13.21% with sizable compulsivity), depressions (3.14%), anxiety (8.18%) and addictive behaviors (13.84%). Lastly, mentalization’s difficulties decreased, although the majority of subjects still have an absence of resilient process just before surgery. Subjects with a "consistent" profile according to the self-questionnaires, know a significant improvement in the majority of indicators, compared to "discordant" subjects

Nous proposons à travers ce travail de thèse une analyse théorico-clinique en contexte écologique de la problématique des personnes adultes, sujettes au syndrome de l'autisme avec retard mental profond associé, accompagnées en structure médico-sociale, qui constituent une population spécifique du fait de la sévérité particulière de leur handicap et de la grande difficulté pour autrui à accéder à leur subjectivité. Suivant une double démarche éthique et épistémologique, nous avons élaboré de manière complémentaire une modélisation théorique compréhensive de la cognition de ces sujets, basé sur leur singularité développementale, et une méthode d'investigation de leur vécu et fonctionnement sur plusieurs niveaux, adaptée à la complexité de leur problématique et de leur cadre de vie. Suite à cinq études de cas et l'exemple d'une intervention systémique psycho-éducative, nous présentons une synthèse des facteurs susceptibles de contribuer à la situation de handicap de ces sujets. / We propose through this work of thesis a theoretical and clinical analysis in ecological context of the issue of the adult people, prone to the syndrome of autism with severe mental retardation, cared for within medico-social structures. These subjects constitute a specific population, because of the particular severity of their disabilities and of the great difficulty for others of reaching their subjectivity. According to a double ethical and epistemological approach, we worked out in a complementary way an understanding theoretical modeling of the cognition of these subjects, based on their developmental singularity, and a method of investigation of their experience and functioning, on several levels, adapted to the complexity of their issue and to their living environment. Following five case studies and an example of a psycho-educational systemic intervention, we present a synthesis of the factors likely to contribute to the disability situation of these subjects.

L’objectif majeur de cette thèse a été d’appréhender les conséquences de la comparaison sociale sur l’auto-évaluation implicite et explicite en termes de prudence, les affects et les comportements à risque. Les participants ont été exposés à un standard de comparaison prudent (standard haut) ou imprudent (standard bas) en matière d’alcool. Les résultats montrent que les sujets confrontés au standard haut se perçoivent implicitement plus imprudents et ressentent plus d’anxiété que les sujets exposés au standard bas. En revanche, le standard de comparaison n’influence pas l’auto-évaluation explicite et les comportements contrôlés. Ces résultats témoignent en faveur d’une dissociation entre les processus automatiques (implicites) et contrôlés (explicites) en jeu dans la comparaison sociale. Au niveau appliqué, nos données suggèrent que dans une campagne de prévention il serait potentiellement plus efficace de mettre en scène un standard prudent plutôt que de montrer un preneur de risque. / The main goal of this PhD research was to study the consequences of social comparison on implicit and explicit self-evaluation in terms of cautiousness, on affect and on risk-taking behavior. In a series of studies, participants were exposed to a comparison standard who displayed either cautious (high standard) or reckless (low standard) drinking behavior. Results show that participants confronted with the high standard implicitly perceive themselves as more reckless and experience higher levels of anxiety than participants exposed to the low standard. On the other hand, the comparison standard does not influence explicit self-evaluation and controlled behaviors. These results indicate that there might be a dissociation between automatic (implicit) and controlled (explicit) processes involved in social comparison. On an applied level, regarding alcohol prevention campaigns, our findings suggest that it could be more effective to show a cautious standard rather than a reckless one.