The purpose of my dissertation is to further our understanding of why some states restricted immigrant access to welfare in the 1990s while other states granted immigrants access to social programs. With the passage of the Personal Responsibility Work Opportunity Reconciliation Act (PRWORA), many states diverged from equal access to welfare programs, such as Temporary Assistance to Needy Families (TANF), for immigrants arriving after 1996. Very little scholarly work examines the variance in immigrants’ access to welfare programs. Current research studying welfare attitudes and policy has largely failed to investigate whether and how the influx of immigrants over the last three to four decades has decreased public support for welfare programs and resulted in policies that both decrease benefit levels and restrict access to programs based on citizenship. This is a serious shortcoming because immigration since the 1970s represents the largest population shift since the early 20th century, a change that has increased the size of the underclass and transformed the cultural and racial makeup of theUnited States. Accordingly, in my dissertation, I will examine how changes to the American political environment, immigration levels and the increasing number of immigration media stories, trigger authoritarian attitudes that in turn form a breeding ground supporting restrictive welfare programs. The results from the individual-level analysis provide strong evidence that authoritarians prefer less welfare spending, fewer immigrants, and a waiting period before immigrants can access welfare programs. In addition, authoritarians view immigrants as a threat due to their perceived failure to socially conform to American society. Building on these individual-level results, I find that states with large authoritarian populations are more likely to adopt restrictive welfare policies.

Hemodializuojamų ligonių skaičius pasaulyje kasmet auga, dializuojama vis daugiau vyresnio amžiaus ligonių, turinčių sunkią gretutinę patologiją. Todėl tenka dažniau juos stacionarizuoti, didėja finansinė šių ligonių gydymo našta visuomenei. Daugelis pasaulyje atliekamų hemodializuojamų ligonių stacionarizavimą vertinančių tyrimų apima atskiras būkles, kaip anemijos, kaulų ir mineralų metabolizmo sutrikimų reikšmę, gretutines ligas ir kitus veiksnius. Mes savo tyrime sujungėme dažniausias hemodializuojamiems ligoniams aprašomas komplikacijas, kad įvertintume bendrą suminę jų reikšmę stacionarizavimui. Tai pirmasis tyrimas, nagrinėjantis Lietuvos hemodializuojamų ligonių stacionarizavimo priežastis ir sąlygojančius veiksnius. Taip pat pirmą kartą nustatytos Lietuvos hemodializuojamų ligonių gydymo išlaidos. Perspektyvusis tyrimas atliktas Kauno Medicinos universiteto Nefrologijos klinikoje. Į tyrimą įtraukti visi galutinės stadijos inkstų nepakankamumu sergantys ligoniai, kurie buvo hemodializuoti visuose Kauno krašto hemodializės centruose 5 metų laikotarpiu (2002-2006 metais). Nustatėme, kad hospitalizavimui svarbūs tiek demografiniai veiksniai, tiek gretutinės ligos, tiek kai kurių laboratorinių rodiklių pokyčiai, tiek ir režimo pažeidimai. / Increasing numbers of hemodialysis patients is influenced by growing life expectancy. increasing burden of diabetes and hypertension. Dialysis population becomes older with heavy comorbidities and high risk for hospitalization. Treatment of those patients is a big financial burden for society. So it is necessary to evaluate the predisposing factors for hospitalization and to assess possibilities of ambulatory treatment optimization and reduction of hospitalization rates in hemodialysis patients. Most of the studies in hemodialysis patients investigate hospitalization risk according to separate conditions, like influence of anemia, bone-mineral metabolism, comorbidities and other factors. In our study we tested together most common complications of end stage renal disease in order to evaluate a combined value of various different factors on hospitalization risk and to discriminate the most important ones. This is the first study which examined hospitalizations rates and factors related to hospitalization in Lithuanian hemodialysis population. Also for the first time treatment expenditures of Lithuanian hemodialysis patients were estimated. Prospective study was performed in the Nephrology department of Kaunas University of Medicine. We enrolled all end stage renal disease patients dialysed in the years 2002-2006 in all centers in Kaunas region. In order to reduce hospitalization risk, a contribution of the doctor and the patient is needed as both treatment failure and... [to full text]

Necrotic enteritis (NE), a devastating enteric disease caused by Clostridium perfringens type A, contributes to the losses of 6 billion dollars worldwide per year and is currently being considered as a major global threat to the poultry industry. In past decades, it has been well-controlled by ineed antimicrobial growth promoters (AGPs). The withdrawal of AGPs due to antibiotic-resistance concerns resulted in a spike in NE incidence and led to the re-emergence of NE in the modern broiler production system. To unveil the association of toxin genes of C. perfringens, particularly for netB, with clinical NE, a self-designed qPCR primer set targeting netB was developed to qualify and quantify netB in NE-producing and non-NE-producing isolates. The netB was demonstrated to exist in the majority of C. perfringens type A isolates. The presence and the amount of netB were not significantly different between two types of isolate, indicating that those indicators are insufficient to predict an association with the pathogenicity of NE. The virulence of netB is suggested to be expressed or triggered under certain conditions, further promoting NE. A side by side trial was implemented with different combinations of netB-positive C. perfringens (CP1) and two predisposing factors to assess their role in NE development. Both CP1 and predisposing factor(s) are required for consistent NE reproduction, and particularly, Eimeria exerts significant effects on NE induction. The use of CP1 without a predisposing factor failed to induce NE. The severity and incidence of NE were positively correlated with the number of predisposing factors given in the NE induction. Analyzing gut microbiota in chickens challenged with CP1 and/or Eimeria by metagenomic sequencing, significant overgrowth of Clostridium sensu stricto 1, the genus contains C. perfringens, was associated with NE. Eimeria infection precedent to CP1 challenge had a synergistic effect on the overrepresentation. In addition to C. perfringens, the other member under Clostridium sensu stricto 1 was found to participate in NE development. Given supplementary dose of 0.4 kg/ton in feed, lauric acid neither exerted the inhibitory effect against proliferation of Clostridium sensu stricto 1 and C. perfringens nor reduced the incidence and severity of NE.

A retrospective study of invasive pneumococcal disease in patients from Greater Göteborg in 1964- 1980 identified 125 cases of meningitis, 305 of pneumonia, 61 of septicemia with unknown focus, and 17 with other manifestations, all verified by cultures from normally sterile body fluids. The incidence was several times higher in infants and in the elderly than in any other age-group. A wide variety of underlying conditions were present in 23% of the infants, 34% of the children, and 81% of the adults. In adults alcoholism was known in one third of the cases. The case fatality rate was 24% among patients with underlying conditions and 9% among previously healthy individuals. The case fatality rate was 50% in patients with hospital-acquired infection. Twohundred-fifteen pneumococcal strains, isolated from blood or CSF from 1971 to 1983 at the laboratories of clinical bacteriology of Göteborg, Malmö, and Umeå were serotyped by coagglutination (COA). Of all isolates, 89% belonged to serotypes represented in the 23-valent vaccine. In a separate study COA was compared with counterimmunoelectrophoresis (CIE). COA was found to have several advantages; rapidity, lower cost, and ability to disclose serotypes with neutral charge, which constituted 19% of all strains. In a prospective study the etiology was determined in 196 hospitalized patients with pneumonia, most of them community-acquired. Culture of specimens from blood, transtracheal aspirate (TTA), sputum, and nasopharynx, assays of antigen in sputum, urine, and TTA, and assays of pneumococcal antibodies to capsular polysaccharide, C-polysaccharide, and pneumolysin in paired sera were performed. The etiology was established in 64% of the patients. Streptococcus pneumoniae was the most common agent (32%). In a serological study of patients with pneumococcal infection, diagnosed by culture of CSF, TTA, or blood, IgG antibodies against C-polysaccharide and pneumolysin were determined by ELISA. The diagnostic sensitivity was only 51% and 60%, respectively. In conclusion, invasive pneumococcal disease is strongly overrepresented at tender and high age and in patients with concomitant conditions, notably alcoholism. S. pneumoniae remains a predominant causative agent of community-acquired pneumonia in adults needing hospitalization. Due to the low sensitivity and/or specificity of individual microbiological techniques, a combined use of several techniques is necessary when trying to assess the relative importance of pneumococci and other agents in pneumonia. Extended use of the currently available pneumococcal vaccine and development of improved pneumococcal vaccines seem highly warranted. / <p>Diss. (sammanfattning) Umeå : Umeå universitet, 1993, härtill 5 uppsatser.</p> / digitalisering@umu.se

Background: The aim of this study was to explore the experience and sense making oftherapists working with clients who present with a PTSD diagnosis. The study engaged with therapists experience and understanding of predisposing factors to PTSD and how they incorporate this understanding into the therapy process. Further to this the experience of the therapists understanding of the influence of predisposing factors on the expression of PTSD was explored. Literature Review: A literature review is presented identifying core research relating to PTSD, predisposing factors to the development of PTSD and the treatments used when working with PTSD as a presenting issue. Methodology: To address the aims of the study 9 therapist participants were interviewed. Semi-structured, one to one, in-depth interviews were utilised to elicit participant’s experience of the issues outlined within the aims. Interpretative Phenomenological Analysis (IPA) was used to identify re-current themes across the interviews and analyse the data, which emerged. Findings: The main findings present thirteen sub-ordinate themes that reflect the essence of the participant’s experience of the phenomenon under investigation. These were based around eight Super-ordinate (master) themes of Previous history, Therapy relationship, Psychoeducation and Normalisation, Identity, Culture, Attachment, Presenting Therapy Themes, and Support Systems. Discussion and Conclusion: The study identified the participant’s experience of predisposing factors on the expression of PTSD. There was consensus from the participant’s in relation to the significant impact of client’s previous life experience on their expression of PTSD. The participants further identified that the client’s previous life experience influenced their formulation and treatment of PTSD. Significant issues that were described by all of the participants regardless of their theoretical or therapeutic perspective were (1) the central importance of the therapeutic relationship, (without a strong, trusting and safe relationship the participants would not engage the therapy work), (2) the importance of in-depth history taking (identification of previous life experience and its impact on the current response to the trauma), (3) the impact of previous trauma(s), and (4) the impact of support systems, environment and identity. These issues are discussed alongside the existing literature around this topic. Additionally, suggestions for future directions of research and recommendations for practice are presented.

Les crues – telles que les laves torrentielles – engendrées dans les torrents lors de fortes précipitations peuvent mobiliser de grande quantité de sédiments. Lorsqu'elles atteignent les zones urbanisées, elles peuvent mettre en dangers à la fois les personnes et les biens. Les approches visant à réduire le risque torrentiel se basent largement sur des seuils intensité-durée de pluie qui déterminent les conditions minimum de déclenchement d’une lave torrentielle. Pourtant, ces seuils sont sujets à une forte variabilité liée, non seulement aux différences inter-sites, mais aussi à la méthode appliquée lors de leur établissement. De plus, ils peuvent entraîner des fausses prédictions, l’intensité et la durée de l’épisode de pluie n’étant pas les seules variables explicatives. Ce travail de thèse vise (i) à fournir un cadre méthodologique rigoureux pour l’établissement des seuils de pluie afin de limiter les sources de variabilité, et (ii) à améliorer leurs performances en considérant à la fois les facteurs de déclenchement et de prédisposition. Il s’appuie sur les données d’un observatoire des crues torrentielles, mis en place dans les Alpes françaises en 2011 sur les torrents très actifs du Manival et du Réal. Dans un premier temps, les images et mesures hautes-fréquences collectées entre 2011 et 2016 ont été analysées afin de détecter et de caractériser les crues torrentielles. Pour appréhender la diversité des écoulements observés, une classification phénoménologique a été proposée. Dans un second temps, la condition minimum intensité-durée de pluie requise pour déclencher une lave torrentielle a été établie. La sensibilité du seuil à la définition d’un épisode de pluie a été évaluée. Dans un troisième temps, un modèle de régression logistique a été implémenté pour discriminer les épisodes de pluies critiques qui n’ont pas engendré de lave torrentielle. Il a permis de sélectionner les variables explicatives les plus pertinentes. Finalement, des pistes de travail ont été avancées pour (i) passer de conditions critiques établies à une échelle locale vers une échelle régionale, en perspective d’une application au sein d’un système d’alerte dédié aux risques hydrométéorologiques, et (ii) passer des conditions de déclenchement d’une lave torrentielle dans la zone de production sédimentaire aux conditions de propagation jusqu'aux zones à enjeux. / Flows – such as debris flows – caused by heavy rainfalls in torrents can mobilise a huge amount of sediments. When they reach the urbanised areas, they may endanger the people’s safety or cause damages. Approaches aimed at mitigating torrential risk widely rely on rainfall intensity-duration thresholds which determine the minimum debris-flow triggering conditions. However, these thresholds suffer from a high variability related not only to inter-site differences but also to the method applied to design them. In addition, they are likely to cause false prediction because the intensity and the duration of the rainfall event are not the only explanatory variables. This PhD research work aim (i) to provide a rigorous methodological framework for designing rainfall threshold in order to limit the variability sources, and (ii) to improve their performances by including both the triggering and the predisposing factors. It is supported by field observations stemming from high-frequency monitoring stations installed since 2011 on two very active debris flow-prone torrents in the French Alps: the Manival and the Réal. First, the images and data gathered between 2011 and 2016 were analysed in order to detect and characterise the sediment laden-flows. To deal with the variety of recorded flows, a phenomenological classification was performed. Second, the minimum intensity-duration threshold for debris-flow triggering was assessed. The threshold sensitivity to the rainfall event definition was estimated. Third, a logistic regression model was used to discriminate the critical rainfall events which do not lead to a debris flow. It makes it possible to select the most relevant explanatory variables. At last, several avenues of work were proposed (i) to move the knowledge of debris-flow initiation conditions from a local to a regional level, with a view to application in a warning system dedicated to hydrometeorological risks, and (ii) to improve the ability to predict, not the debris-flow triggering in the production zone, but the debris-flow propagation up to the area concerned.

Objetivo: describir y analizar la percepción sobre factores predisponentes a Infecciones Respiratorias Agudas en madres de preescolares de una comunidad de Pomalca. Método: Investigación cualitativa, descriptiva, en una muestra de 12 madres de preescolares de la comunidad el Combo, determinada por saturación y redundancia de datos, el muestreo fue no probabilístico por conveniencia. Los datos se recolectaron a través de la entrevista semiestructurada, la cual fue validada por juicio de expertos y por una prueba piloto en 2 madres que cumplían con los criterios de inclusión. Los datos fueron procesados por el método de análisis de contenido temático. Resultados: Se obtuvieron 4 categorías: identificación de factores individuales, reconocimiento de factores en la vivienda, asimismo, identificación de los factores familiares y reconocimiento de factores ambientales como factor predisponente. Conclusión: En su mayoría, las madres de familia tienen una percepción adecuada y reconocen los diversos factores que predisponen a presentar una IRA en los menores de 5 años. Reconocen de manera correcta dentro de los factores familiares, la presencia de algún familiar fumador debido a las sustancias tóxicas que pueden inhalar los preescolares; pero existe una percepción incorrecta sobre la asociación del fumador pasivo (inhala el humo del cigarrillo) con presentar TBC. / Objective: to describe and analyze the perception of predisposing factors to Acute Respiratory Infections in mothers of preschoolers in a community of Pomalca. Method: Qualitative, descriptive research, in a sample of 12 mothers of preschoolers from the Combo community, determined by data saturation and redundancy, sampling was non-probabilistic for convenience. The data were collected through a semi-structured interview, which was validated by expert judgment and by a pilot test on 2 mothers who met the inclusion criteria. The data were processed by the thematic content analysis method. Results: 4 categories were obtained: identification of individual factors, recognition of factors in the home, also, identification of family factors and recognition of environmental factors as a predisposing factor. Conclusion: For the most part, mothers have an adequate perception and recognize the various factors that predispose children under 5 years of age to having an ARI. They correctly recognize within family factors, the presence of a family member who smokes due to the toxic substances that preschoolers can inhale; But there is an incorrect perception about the association of passive smoking (inhaling cigarette smoke) with developing TB.

Text in Afrikaans / Selfmoord is 'n kontroversiele aangeleentheid wat beide omstanders en agterblywendes met onsekerheid vervul. 'n Belangrike rede hiervoor is dat dit 'n onnatuurlike afsterwe is wat teen baie mense se norme en waardes indruis. ldiografiese navorsing is onderneem om die belewenisse van agterblywende gesinslede te ondersoek aangesien hulle die eintlike slagoffers van 'n selfmoord is wat met 'n komplekse realiteit gelaat word. Die doel van die navorsing was om riglyne daar te stel vir die hantering en ondersteuning van hierdie mense. Vanuit 'n in-diepte literatuurstudie, het dit geblyk dat die grootste probleme waarmee agterblywendes gekonfronteer word, wentel random problematiese emosies, veroordeling deur omstanders en belewings van persoonlike onvermoe om te midde van intense rousmart selfaktualisering optimaal te volvoer. 'n Vraelys wat aspekte (socs dit uit die literatuurstudie geblyk het) inkorporeer, is opgestel en aan agterblywendes gegee om te beantwoord. Van die belangrikste elemente wat na vore gekom het, is dat intense verhoudingskomplikasies na 'n selfmoord figureer, dat agterblywendes 'n behoefte het om rouverwerking teen hul eie tempo te doen, dat agterblywendes verkies dat omstanders nie voortdurend die gebeure sal ontleed en soek na oorsake in die teenwoordigheid van agterblywendes nie en dat elke agterblywende persoon se roubelewing persoonlik en uniek is. 'n Hoofstuk is gewy aan 'n wye verskeidenheid terapeutiese tegnieke wat geimplementeer kan word tydens hulpverlening aan agterblywendes. Die studie beskryf ook 'n gevallestudie en die verloop van sestien individuele terapeutiese sessies. In die terapeutiese insette is daar hoofsaaklik gebruik gemaak van hipnoterapie as 'n vorm van ontspanningsterapie waartydens daar gelokus word op problematiese emosies en persepsies wat voortgesette kwalitatiewe selfaktualisering belemmer. In die studie word Opvoedkundige Sielkundige riglyne vir hulpverlening aan agterblywendes, wat benut kan word deur hulpverleners (soos sielkundiges, onderwysers en ander ondersteuningsisteme). verskaf. Die studie bevestig dat die agterblywendes as die werklike slagoffers na 'n selfmoord agtergelaat word, maar dat sinvolle intervensie hierdie persone in staat kan stel om ten spyte van die gebeure weer optimaal te selfaktualiseer. / Suicide is a controversial topic. It causes both bystanders and survivors to feel insecure. An important reason for this is that it is an unnatural death which directly opposes the norms and values of the majority of people. ldiografic research has been undertaken to closely examine the experiences of suicide survivors as they are the real victims who are left to cope with a complex reality after a suicide. The objective of this study was to provide guidelines to effectively manage and render assistance to survivors. From an in depth review of available literature it appeared that troubled emotions, being denounced by bystanders and the inability to proceed with continued qualitative self-actualization are some of the most important problems survivors have to cope with. A questionnaire, incorporating significant aspects reported in literature, was compiled and given to survivors to complete. From their responses certain facets seemed to be problematic. Among the more problematic aspects were complicated interpersonal relations, the basic need to grieve at their own pace, the preference that bystanders avoid analysing the suicide and possible contributing factors (especially in the presence of survivors) and the recognition that each survivor's grief is personal and unique. A chapter has been devoted to a wide range of therapeutic techniques that can be implemented to facilitate the support given to survivors. The study also describes a case study as well as the progression of sixteen individual therapy sessions. Therapeutic intervention was mainly based on hypnotherapy as a form of relaxation therapy during which the focus is placed on problematic emotions and perceptions which prevent continued qualitative self-actualization. Educational Psychological guidelines along which assistance can be rendered by psychologists, teachers as well as other support services are given. This study not only confirms that the survivors are the actual victims of a suicide, but also that it is possible to assist these people to achieve optimal self-actualization through meaningful intervention. / Psychology of Education / D. Ed. (Sielkundige Opvoedkunde)

Text in Afrikaans / Selfmoord is 'n kontroversiele aangeleentheid wat beide omstanders en agterblywendes met onsekerheid vervul. 'n Belangrike rede hiervoor is dat dit 'n onnatuurlike afsterwe is wat teen baie mense se norme en waardes indruis. ldiografiese navorsing is onderneem om die belewenisse van agterblywende gesinslede te ondersoek aangesien hulle die eintlike slagoffers van 'n selfmoord is wat met 'n komplekse realiteit gelaat word. Die doel van die navorsing was om riglyne daar te stel vir die hantering en ondersteuning van hierdie mense. Vanuit 'n in-diepte literatuurstudie, het dit geblyk dat die grootste probleme waarmee agterblywendes gekonfronteer word, wentel random problematiese emosies, veroordeling deur omstanders en belewings van persoonlike onvermoe om te midde van intense rousmart selfaktualisering optimaal te volvoer. 'n Vraelys wat aspekte (socs dit uit die literatuurstudie geblyk het) inkorporeer, is opgestel en aan agterblywendes gegee om te beantwoord. Van die belangrikste elemente wat na vore gekom het, is dat intense verhoudingskomplikasies na 'n selfmoord figureer, dat agterblywendes 'n behoefte het om rouverwerking teen hul eie tempo te doen, dat agterblywendes verkies dat omstanders nie voortdurend die gebeure sal ontleed en soek na oorsake in die teenwoordigheid van agterblywendes nie en dat elke agterblywende persoon se roubelewing persoonlik en uniek is. 'n Hoofstuk is gewy aan 'n wye verskeidenheid terapeutiese tegnieke wat geimplementeer kan word tydens hulpverlening aan agterblywendes. Die studie beskryf ook 'n gevallestudie en die verloop van sestien individuele terapeutiese sessies. In die terapeutiese insette is daar hoofsaaklik gebruik gemaak van hipnoterapie as 'n vorm van ontspanningsterapie waartydens daar gelokus word op problematiese emosies en persepsies wat voortgesette kwalitatiewe selfaktualisering belemmer. In die studie word Opvoedkundige Sielkundige riglyne vir hulpverlening aan agterblywendes, wat benut kan word deur hulpverleners (soos sielkundiges, onderwysers en ander ondersteuningsisteme). verskaf. Die studie bevestig dat die agterblywendes as die werklike slagoffers na 'n selfmoord agtergelaat word, maar dat sinvolle intervensie hierdie persone in staat kan stel om ten spyte van die gebeure weer optimaal te selfaktualiseer. / Suicide is a controversial topic. It causes both bystanders and survivors to feel insecure. An important reason for this is that it is an unnatural death which directly opposes the norms and values of the majority of people. ldiografic research has been undertaken to closely examine the experiences of suicide survivors as they are the real victims who are left to cope with a complex reality after a suicide. The objective of this study was to provide guidelines to effectively manage and render assistance to survivors. From an in depth review of available literature it appeared that troubled emotions, being denounced by bystanders and the inability to proceed with continued qualitative self-actualization are some of the most important problems survivors have to cope with. A questionnaire, incorporating significant aspects reported in literature, was compiled and given to survivors to complete. From their responses certain facets seemed to be problematic. Among the more problematic aspects were complicated interpersonal relations, the basic need to grieve at their own pace, the preference that bystanders avoid analysing the suicide and possible contributing factors (especially in the presence of survivors) and the recognition that each survivor's grief is personal and unique. A chapter has been devoted to a wide range of therapeutic techniques that can be implemented to facilitate the support given to survivors. The study also describes a case study as well as the progression of sixteen individual therapy sessions. Therapeutic intervention was mainly based on hypnotherapy as a form of relaxation therapy during which the focus is placed on problematic emotions and perceptions which prevent continued qualitative self-actualization. Educational Psychological guidelines along which assistance can be rendered by psychologists, teachers as well as other support services are given. This study not only confirms that the survivors are the actual victims of a suicide, but also that it is possible to assist these people to achieve optimal self-actualization through meaningful intervention. / Psychology of Education / D. Ed. (Sielkundige Opvoedkunde)

L’aliénation parentale (AP) est un phénomène connu des intervenants sociolégaux œuvrant auprès des familles éclatées chez lesquelles on retrouve un haut niveau de conflits parentaux. Ce phénomène est peu étudié empiriquement et sa définition et les balises l’entourant demeurent à ce jour non circonscrites et suscitent confusion et controverse. Cette recherche n’a pas comme objectif de trancher sur ce qui est ou n’est pas de l’aliénation parentale, mais porte plutôt sur l’étude du phénomène de Détérioration du lien parent-enfant (DLPE), qui inclut une rupture complète du lien comme dans les cas d’AP, lors de séparations conjugales litigieuses. Cette thèse doctorale a pour objectif principal d’élargir notre compréhension sur les différents facteurs qui interagissent et qui mettent en place une situation familiale de DLPE. Le présent ouvrage est composé de quatre articles, dont trois sont empiriques. Le premier article est une synthèse critique des écrits théoriques et empiriques permettant de dégager les différents facteurs, conduites ou contextes individuels et relationnels associés à une DLPE. Il ressort que la plupart des écrits proviennent de comptes rendus cliniques. De plus, peu d’auteurs abordent ce phénomène dans une perspective systémique incluant une vision multifactorielle de cette situation. Plusieurs aspects demandent à être étudiés davantage : les caractéristiques individuelles, les comportements inappropriés des acteurs et les dynamiques familiales. En définitive, il importe d’établir les facteurs de résilience. Les articles 2, 3 et 4 ont été réalisés suite à une analyse qualitative de 17 dossiers d’expertise psychosociale de familles séparées en litige autour des accès des enfants. Le second article a pour objectif d’apporter un éclairage fouillé sur les structures de personnalité des parents impliqués dans de tels litiges. Il se dégage de cette analyse que les parents contribuent différemment à la dynamique familiale en fonction de leur profil de personnalité. Quatre profils parentaux ont émergé et permettent de discerner en quoi les parents aux conduites aliénantes se distinguent des parents dénigrés au niveau des profils de personnalité et en quoi la personnalité de ces parents est respectivement différente selon qu’ils maintiennent ou pas la relation avec leur enfant. L’analyse approfondie des profils parentaux a permis de formuler certains facteurs de risque et de protection relatifs à la structure de la personnalité des parents à risque d’une DLPE. Le troisième article a pour objectif d’évaluer par une lecture psychodynamique les différentes caractéristiques individuelles des enfants dans l’optique d’établir des pistes pouvant élucider pourquoi un enfant est résistant à une DLPE ou, au contraire, ne l’est pas. L’analyse qualitative fouillée des dossiers d’expertise a permis d’extraire différents facteurs de risque et de protection d’une DLPE chez ces enfants. Le quatrième article cherche à modéliser les différents facteurs de risque ou, au contraire, qui atténuent le risque de DLPE. Trois trajectoires dénotant une dynamique de DLPE ont émergé. Une modélisation systémique reprend l’ensemble des facteurs (dynamiques personnelles et relationnelles, contexte familial, système sociojuridique, personnes tierces et temps) émergeant de l’analyse et leur déploiement spécifique à chaque trajectoire. / Parental Alienation (PA) is a widespread phenomenon among socio-legal professionals working with conflictual separated families. This phenomenon is rarely studied empirically and its definition and markers remain poorly circumscribed and arouse confusion and controversy. We will attempt to stay away from this controversy by focusing on the phenomenon of Deterioration of the Parent-Child Relationship (DPCR), including PA. This thesis main objective is to expand our understanding of the various factors that interact and set in place a family situation of a DPCR. This work consists of four articles, three of which are empirical. The first article is a critical review of the literature that identifies various factors, conduct or individual and relational context associated with DPCR. It appears that very few papers have address this phenomenon in a systemic perspective who could bring an in-depth and comprehensive understanding of this multifactorial phenomenon. Several aspects need to be further investigated: individual characteristics, inappropriate behaviors and family dynamics. Finally, resilience factors need to be addressed. Articles 2, 3 and 4 present the results of a qualitative analysis of 17 psychosocial expertise performed on separated families in litigation around the custody and access to children. The second article intends to provide a refined psychoanalytic insight on the personality profiles of the parents and how it contributes distinctively to the family dynamics. Four parental profiles emerged and helped differentiate parents with alienating behaviors from denigrated ones and, those who maintained a relationship with their child or those who did not. Risk and protective factors associated with the personality profile are formulated. The third paper intends to analyse through a psychodynamic lens, the individual characteristics of children with the aim to understand why a child is resistant to a DPCR or is not. Various risk and protective factors of a DPCR associated with the characteristics of the children are provided. The fourth article seeks to model the different contributing or mitigating variables to a DPCR. Three trajectories denoting a DPCR emerged. A systemic model is proposed and incorporates different factors (personal and relational dynamics, family background, socio-legal system, third parties and time) and their specific deployment to each trajectory.