Factors Associated with Increased or Decreased Stress Level in French Children during the First COVID-19 Lockdown.

In spring 2020, governments of many countries implemented lockdown measures to prevent the spread of the COVID-19 pandemic. Worldwide, the pandemic forced about 1.5 billion children to stay at home for several weeks and to experience homeschooling. The objective of this study was to assess the variation in stress levels and associated factors in school-aged children in France during the first COVID-19 lockdown. A cross-sectional study using an online questionnaire was designed by an interdisciplinary team involving hospital child psychiatrists and school doctors. Between 15 June and 15 July 2020, Educational Academy of Lyon (France) invited the parents of school-aged children to participate in this survey. The first part of the questionnaire concerned the children with data on lockdown conditions, socio-demographic data, daily rhythms (eating and sleeping), perceived stress variations, and feelings. The second part assessed parental perspectives on their child's psychological state and use of the mental health care system. Multivariate logistic regression was performed to identify factors associated with stress variation (increased or decreased). A total of 7218 questionnaires were fully completed by children from elementary school to high school with a balanced sex ratio. In summary, 29% of children reported a higher stress level during the lockdown, 34% reported a lower stress level, and 37% reported no stress variation in the usual situation prior to COVID-19. Parents were most often able to identify signs of increased stress levels in their children. The most influential factors in the variation of stress for children were academic pressure, family relationships, and fear of being infected or infecting a family member with SARS-CoV-2. Our study underlines the high impact of school attendance stressors on children in usual conditions and encourages vigilance for children whose stress levels have decreased during the lockdown but who may have increased difficulty re-exposing themselves upon deconfinement.

Explanatory hypotheses of the ecology of new clinical presentations of Dissociative Identity Disorders in youth.

Dissociative Identity Disorders (DIDs) are controversial psychiatric conditions encountered in clinical practice and nosology. DID as described in the international classifications has little similarity with the clinical picture of "DID" met in current youth psychiatry. From this Perspective, we hypothesize that this current clinical presentation does not satisfy the categorical criteria of the international classifications. Based on the two terminological challenges related to the definition of DID (i.e., the notion of dissociative disorders and the different meanings of the term identity), we propose to differentiate two distinct entities from each other. The first is medical and listed in diagnostic criteria of international classifications; the second comes from popular culture and refers to the vast majority of clinical presentations received in daily clinical practice-presented under the term Dissociative Identity Conditions (DIC). Since the status of DIC is a hot topic in current clinical psychiatry, we aim to identify eight possible explanations that can be provided to support its occurrence: (1) impact of iatrogenicity; (2) factors of suggestibility and desire for social acceptability; (3) psychoanalytic explanations; (4) neuropsychological explanations; (5) socio-cognitive explanations; (6) emotional labeling; (7) narrative explanations; (8) and transient illnesses explanations. In conclusion, we sustain that DIC results from a narrative interpretation of medical discourse by popular culture, developing in patients presenting undeniable distress. Such a transient disease fits in an ecological niche, which echoes the values of society, persisting under the action of a need for narrative continuity of the self.

Impairments of humour comprehension in multiple sclerosis.

BACKGROUND: Sociocognition is an important field of neuropsychology involving human interactions. In relapsing-remitting multiple sclerosis, it was recently demonstrated that sociocognition is severely and precociously impaired. Among sociocognitive abilities, humour has not yet been considered in this disease despite its important social functions, including during doctor-patient communication. Its main functions are to reduce stress when interactions become strained and to convey difficult messages in a gentle form. Thus, the inability to perceive this second degree of language is likely to generate a major social handicap. As humour is a higher cognitive process, its assessment requires the control of lower levels according to a serial model. METHODS: The present humour comprehension protocol, based on a serial cognitive model, consisted of a first incongruity detection step (normality identification task) and a second incongruity resolution step (funniness identification task). This protocol was administered using both verbal and visual material (stories and cartoons). For each type of material, the participant had to decide which of three proposed endings was normal (normality identification) and which was funny (funniness identification). A group of 21 relapsing-remitting multiple sclerosis patients was compared to a control group of 38 healthy participants. In view of the severe impairment demonstrated for MS patients in other sociocognitive abilities, we predicted a deficit of humour comprehension in these patients in comparison with healthy participants. In reference to the serial model of humour, and considering the variability of MS lesions, our main goal was to test the hypothesis of a primary deficit in incongruity resolution (selective to funniness identification) in some MS patients whereas others may suffer a non-specific comprehension impairment (affecting both normality and funniness identification). RESULTS: Group analyses (non-parametric tests, Mann-Whitney) revealed lower scores for relapsing-remitting multiple sclerosis patients compared to controls for the visual tasks (normality and funniness). No significant difference was found in the verbal tasks. At the individual level, 62% of relapsing-remitting multiple sclerosis patients showed impairment compared to controls for the funniness tasks. Moreover, 38% presented a selective deficit in the funniness tasks. CONCLUSION: These preliminary results suggest that a high proportion of relapsing-remitting multiple sclerosis patients may be impaired in humour comprehension, some as a primary deficit and others as a secondary deficit to more general comprehension difficulties. On a theoretical level, the dissociations obtained between verbal and visual material do not support an amodal humour comprehension model.