Is Problematic Physical Activity (PPA) a Uni- or Multi-Dimensional Concept? A Bifactor Analysis of the Exercise Dependence Scale-Revised (EDS-R).

The study of exercise dependence, or as we prefer, problematic physical activity (PPA), faces both theoretical and methodological challenges. Different factorial solutions were obtained for the widely used Exercise Dependence Scale-Revised (EDS-R), leading us to question both its latent underlying construct and the interpretation of its factor solutions. Through confirmatory factor analysis (CFA) and the use of a bifactor model (BCFA), we assessed the dimensionality of a French version of the EDS-R. We recruited 745 students from Paris Nanterre University, but we removed 88 responses (16.8%) to retain only those who (a) engaged in a moderate to high levels of physical activity, according to the Global Physical Activity Questionnaire (GPAQ; N = 494; 9.5%), and (b) completed the EDS-R. We used a final sample of 435 students (58.4% of the total population) for a factorial analysis of the EDS-R. We conducted a three-step CFA in Mplus, producing three models: (a) unidimensional, (b) second-order, and (c) bi-factor (BCFA). The results of the BCFA indicated that most EDS-R items were better indicators of a general factor than their respective group factors, except for the second factor measuring a withdrawal construct. These results add to an ongoing debate in the field of behavioral addiction as to how to better conceptualize and measure exercise dependence or PPA. Withdrawal appears to have a special position in this debate, since our BCFA suggested that it is the only specific sub-dimension of the EDS-R scale.

Impacts of social restrictions on mental health and health behaviours of individuals with multimorbidity during Covid-19 pandemic.

Background: Social restrictions and their possible impact on lifestyle make people with multimorbidity (≥2 co-existing chronic conditions) more vulnerable to poor perceived mental health and health behaviours modifications during the COVID-19 pandemic. Objective: To understand the mental health status and health behaviour modifications among individuals with multimorbidity during different levels of COVID-19 social restrictions. Methods: Longitudinal multinational cohort study consisting of two online questionnaires with its first wave taken place while social restrictions were imposed (May 2020), and its second wave with less social restrictions in place (November 2020). Including 559 participants (wave 1) and 147 participants from wave 1 (wave 2) with an average age of 34.30±12.35 and 36.21±13.07 years old. Mostly females living in Canada, France, India and Lebanon. Results: The prevalence of multimorbidity was 27.68% (wave 1) and 35.37% (wave 2). While social restrictions were imposed, people with multimorbidity were 2 to 3 times more likely to experience psychological distress, depressive symptoms, increased stress or isolation than those without multimorbidity. Health behaviours were also modified during this period with people with multimorbidity being more likely to reduce their physical activity and increased their fruit and vegetable consumption. In wave 2, regardless of multimorbidity status, sexual desire continuously decreased while stress and psychological distress increased. Conclusion: Mental health and health behaviours modifications occurred while social restrictions were imposed and people with multimorbidity were more severely impacted than those without multimorbidity, indicating a need for a more adapted approach of care during socially restrictive periods for this population.

[Preventing and regulating psychoactive substance use among occasional and regular adolescents]. / Prévenir et réguler la consommation de substances psychoactives chez les adolescents.

The academic success and well-being of young people can be undermined by the use of psychoactive substances (PAS), which is particularly prevalent during adolescence, a period vulnerable to social influences. This article is aimed in particular at school and university preventive medicine nurses. It proposes intervention strategies for adolescents who regularly use such substances. Based on the scientific literature, the aim is to examine how psychological support, coupled with a program of adapted physical activity, could limit the use of APS, a factor in academic failure and health risks.

[Substance use among adolescents: Addiction or self-handicap strategy?] / Consommation de substances psychoactives chez les adolescents : addiction ou stratégie d'auto-handicap ?

Self-handicapping strategies consist of creating or declaring obstacles to oneself before a situation of accomplishment that threatens the self, as might be the case during an academic assessment or a sporting competition, in order to protect oneself from a possible failure or to valorise oneself in the event of success. It turns out that beyond the physiological effects sought and the dependence linked to the product, the consumption of psychoactive substances can serve as an excuse for users in the event of failure, thus protecting their sense of competence or enhancing it in the event of success, for having succeeded in spite of their consumption, which is known to have a negative impact on performance.

[Analysis of the psychological causes of early substance use among adolescents in school and university settings]. / Analyse des causes psychologiques des premières consommations de substances psychoactives chez les adolescents en contexte scolaire et universitaire.

Experimentation with psychoactive substances (PAS), such as alcohol, tobacco or cannabis, is common in adolescence, and continues to pose a public health issue that can lead to failure at school and university. Most of the work on these issues focuses on addiction-related aspects, and little on the underlying causes of addiction. This article sheds psycho-social theoretical light on the causes of first-time use of APS, and cannabis in particular. It is particularly aimed at school nurses and university preventive medicine nurses.

Attention-deficit hyperactivity disorder and addictions (substance and behavioral): Prevalence and characteristics in a multicenter study in France.

AIM: The aim of this study is to determine the possible links between attention-deficit hyperactivity disorder (ADHD) and the presence of concomitant addictions with or without substance use in a French student population. MEASURES: A battery of questionnaire measuring socioeconomic characteristics, university curriculum, ADHD (Wender Utah Rating Scale and Adult ADHD Self-Report Scale), substance consumptions (alcohol, tobacco, and cannabis), and behavioral addictions [(eating disorders (SCOFF)], Internet addiction (Internet Addiction Test), food addiction (Yale Food Addiction Scale), compulsive buying (Echeburua's), and problem gambling (The Canadian Problem Gambling Index)] and measures of physical activity (Godin's Leisure Time Exercise Questionnaire) was filled up by university students in Rouen and Nanterre in France. RESULTS: A total of 1,517 students were included (472 from Paris Nanterre and 1,042 from Rouen). The mean age was 20.6 years (SD = 3.6) and the sex ratio male to female was 0.46. The prevalence of ADHD among the students (current ADHD with a history of ADHD in childhood) was 5.6%. A quarter (25.7%) of students had already repeated their university curriculum, compared to 42.2% among the students with ADHD. Students with possible ADHD had repeated classes more often and believed to have a lower academic level than the students without ADHD. Significant differences were found as students with ADHD were less likely to succeed in their studies (repeated classes more often) than non-ADHD students, and considered their academic level to be lower. They also had significantly higher scores on substance (alcohol, cannabis, and tobacco) as well as behavioral addictions (gambling, compulsive buying disorder, eating disorders, and Internet addiction). CONCLUSION: It seems essential to determine students' problems and propose interventions adapted to students' needs, in order to reduce the negative impact on their future academic and global successes.

Which dimensions of impulsivity are related to problematic practice of physical exercise?

Background and aims Problematic practice of physical exercise (PPPE) has been suggested to be a behavioral addiction. Impulsivity represents a core dimension of behavioral addictions. However, little is known about impulsivity facets in PPPE. The aim of this study was to investigate the role of impulsivity facets in PPPE. Methods A total of 684 students (between 18 and 25 years) took part in this study and filled up a battery of questionnaire, which consisted of following measures - Global Physical Activity Questionnaire, Exercise Dependence Scale - Revised, and the UPPS Impulsive Behavior Scale. Multiple regression analyses were utilized to investigate the predictive role of each impulsivity facet in PPPE. Results Age, the total level of physical activity per day, sex (male), negative urgency, and sensation seeking were found to be significant predictors of PPPE. A categorical analysis of PPPE revealed that negative urgency, positive urgency, and sensation seeking were significantly higher in the dependent category of PPPE. Discussion and conclusions Associations to negative urgency and sensation seeking might indicate that PPPE serves to regulate or alleviate negative affect or aversive emotional states. Thus, PPPE could be conceptualized as a short-term coping strategy dedicated to relieving negative affective states, like other maladaptive behaviors such as binge eating, binge drinking, or compulsive buying.

Patterns of electronic cigarette use in current and ever users among college students in France: a cross-sectional study.

OBJECTIVE: There is sparse information on electronic cigarette use and health behaviours among college student populations. Our objectives were to identify the patterns of electronic cigarette use in current and ever users among college students in France. DESIGN: Cross-sectional study. SETTINGS: A multicentre cross-sectional study was conducted on two major campuses in France. Students filled in an anonymous questionnaire on their use of electronic cigarettes and on targeted behaviours such as smoking, alcohol consumption, binge drinking, use of cannabis, practice of sport and eating disorders. Ever use of electronic cigarettes was defined as use but not during the previous 30 days, and current use of electronic cigarettes as any use in the previous 30 days. The opinions and motivations of electronic cigarette users were also sought and collected. PARTICIPANTS: 1134 college students between October 2014 and February 2015. RESULTS: The 1134 students included had a mean age of 20.8 years. The prevalence of ever use and current use of electronic cigarettes was 23.0% (95% CI (20.5% to 25.3%)) and 5.7% (95% CI (4.4% to 7.1%)), respectively. The prevalence of the combined use of conventional cigarettes and electronic cigarettes was 14.5%. Almost half (45.8%) of the ever users of electronic cigarettes had never smoked conventional cigarettes. Behaviours associated with ever use of electronic cigarettes were current cigarette smoking (adjusted OR (AOR)=3.97, 95% CI 2.71 to 5.83), former smoking (AOR=2.56, 95% CI 1.42 to 4.61), cannabis use (AOR=2.44, 95% CI 1.70 to 3.51) and occasional binge drinking (AOR=1.83, 95% CI 1.28 to 2.64). The only behaviour associated with current use of electronic cigarettes was conventional smoking, either previously (AOR=4.85, 95% CI 1.53 to 15.34) or currently (AOR=14.53, 95% CI 6.81 to 31.02). CONCLUSIONS: The ever users have an experimenter's profile with sensation-seeking while the current users are mostly smokers with intention to quit smoking. Our findings are crucial for the accurate targeting of student populations at risk and to implement appropriate awareness campaigns and health education programmes.

Early substance consumption and problematic use of video games in adolescence.

Substance use as well as use of video games is frequent among young people. The purpose of this research was to study the links between the use of video games and the consumption of various substances such as alcohol, tobacco or cannabis at adolescence. In order to do so, 1423 students from middle and high schools filled an auto-questionnaire that included questions on age, gender, year of study, use of video games and consumptions of alcohol (Alcohol Use Disorders Identification Test Short version, AUDIT-C), tobacco (Heaviness of Smoking Index, HSI), and cannabis (Cannabis Abuse Screening Test, CAST). We found that 92.1% of teens use video games and 17.7% have a problematic use of video games (PUVG). Furthermore, results show that substance consumption seems frequent with 19.8 and 8.3% of participants having hazardous alcohol and cannabis consumptions respectively and 5.2% having a moderate to high tobacco dependence. Video gamers consumed significantly more alcohol and gamers with PUVG started their substance consumption (alcohol, tobacco, and cannabis) earlier. PUVG was found to be negatively correlated to age at first substance consumption, but positively correlated to the time spent playing video games. However, it was not correlated to risks of substance dependence (scores of AUDIT-C, HSI, and CAST). Finally, our results are consistent with the literature, in regard to frequency of substance use and use of video games in adolescence. These data will allow for a better consideration of prevention strategies and future care in this particular field.