Trajectories of medication adherence in patients with Bipolar Disorder along 2 years-follow-up.

BACKGROUND: Bipolar disorder (BD) is a chronic and severe mental illness. It requires a non-discontinued pharmacological treatment to prevent mood recurrences but nonadherence to medication is frequent. To this date, medication adherence in BD has been mostly evaluated in cross-sectional studies and often considered as a stable trait. We aimed to study medication adherence using a prospective person-oriented approach. METHODS: 1627 BD patients were followed on a 2 years period and assessed every 6 months. Medication adherence was evaluated at each visit with the Medication Adherence Rating Scale (MARS). A latent class mixed model (LCMM) was used to identify trajectory classes of adherence over time. Regression analyses and linear mixed model were used to search for predictors and covariables of the trajectories. RESULTS: Three distinct and robust trajectories of medication adherence have been identified: one that starts poorly and keeps deteriorating (4.8%), one that starts poorly but improves (9%) and one that starts well and keeps improving (86.2%). A good tolerance to psychotropic medications, low depressive symptoms, the absence of comorbid eating disorders and anticonvulsant medication were associated to a better prognosis of adherence. Along the follow-up, the lower were the depressive symptoms, the better was the medication adherence (p < .001) LIMITATIONS: The use of a single measure of medication adherence although it is a validated instrument and a possible positive selection bias that might limit the generalization of our findings. CONCLUSIONS: This study demonstrates that medication adherence in BD patients is a heterogeneous and potentially variable phenomenon.

[Psychopathology in adolescents from seven countries: What role does controlling identity development and family relationships play?] / Psychopathologie bei Jugendlichen aus sieben Ländern: Welche Bedeutung hat die Kontrolle von Identitätsentwicklung und Familienbeziehungen?

Psychopathology in adolescents from seven countries: What role does controlling identity development and family relationships play? Abstract. This study analyzed the unique effects of gender and culture on psychopathology in adolescents from seven countries, after controlling for factors that might have contributed to variations in psychopathology. In a sample of 2259 adolescents (M = 15 years; 54 % female) from France, Germany, Turkey, Greece, Peru, Pakistan, and Poland, we assessed identity development, maternal parenting (support, psychological control, anxious rearing), and psychopathology (internalizing, externalizing). Using an analysis of covariance (ANCOVA), we analyzed country, sex, age, and the interaction country x sex as independent variables, while controlling for maternal rearing dimensions and identity development as covariates. This resulted in similar findings for internalizing and externalizing symptoms: Identity rumination and maternal rearing (support, psychological control, anxious rearing) proved to be significant covariates. Further, country, sex, age, and the interaction country x sex were significant. These analyses result in a clearer picture of culture- and gender-specific effects on psychopathology, which is helpful in designing interventions.

How is Civic Engagement Related to Personal Identity and Social Identity in Late Adolescents and Emerging Adults? A Person-Oriented Approach.

Adolescence and emerging adulthood are periods in life when individuals both question and define their place in society and form their identity. Meanwhile, active youth civic engagement represents a challenge for each democracy. The purpose of this study was to analyze the different forms of civic engagement among late adolescents and emerging adults and how they are related to personal identity and social identity, while adopting an integrative perspective through the lens of a person-oriented approach. The participants were 1217 (62.3% female) 16-24 year-old French students (M age = 19.17; SD age = 1.83). First, derived from cluster analyses, the findings emphasized diversity in civic engagement, from strong civic participation (in different formal and informal ways) to various forms of passivity. Diversity was also highlighted for personal identity and social identity profiles. Second, a Configural Frequency Analysis revealed a typical pattern associating passivity in civic engagement, personal carefree diffusion and rejection of social identity. Overall, these findings highlight an absence of general youth disaffection and provide a meaningful specific pattern for the understanding of passivity in political and civic matters in late adolescence and emerging adulthood.

Vocational identity and psychological adjustment: a study in French adolescents and emerging adults.

The aim of the present research was to study vocational identity in French adolescent and emerging adult students by using a French adaptation of the Vocational Identity Status Assessment (VISA), and to analyze the links between vocational identity formation and negative and positive psychological adjustment. Participants were 1077 French students who completed self-report scales about vocational identity, depression and satisfaction with life. The French version of the VISA showed good psychometric properties and six identity statuses were derived by means of cluster analysis: achievement, foreclosure, moratorium, searching moratorium, diffused diffusion and carefree diffusion. The main findings show that diffused diffusion and moratorium represent the dark sides of identity because of their negative psychological adjustment, and that the two processes of reconsideration of commitment were differently associated with psychological adjustment. These findings demonstrate that clinical interventions should be adapted to the individual's identity profile.

New directions for the study of within-individual variability in development: the power of "N = 1".

This article provides an introduction to the idiographic approach ("N = 1" research) in developmental psychology and an overview of methodological and statistical techniques employed to address the study of within-individual variability in development. Through a popularization of the idiographic approach and associated statistical techniques, but also through technical advances in the apparatus used to produce single-case intensive longitudinal data, the "power" of "N = 1" is becoming increasingly tangible and may challenge, or supplement, established paradigms in nomothetic (group-level) developmental psychology.

Adolescents' perceptions of parental practices: a cross-national comparison of Canada, France, and Italy.

This study compares two dimensions of parenting-emotional bonding and control-as perceived by adolescents living in three countries: Canada (province of Québec), France, and Italy. A cross-sectional sample was composed of 1256 adolescents who filled out a self-report questionnaire. Multiple Correspondence Analyses provided a graphic synthesis of cross-cultural results. Results indicate that parents are perceived as highly emotionally bonded, yet the perception of parental control produced two contrasting models. Canadian adolescents perceive less control and disciplinary actions from parents, and more tolerance. Conversely, Italian adolescents perceive more requirements and rules, and stricter disciplinary actions, while French adolescents' perceptions fall between the two. Results also suggested a gradual decrease in the perception of parental control between the ages of 11 and 19 years across all three countries. This reduction in parental constraints is perceived earlier by Canadian adolescents and later by Italian adolescents.