Disentangling the Link Between Mindfulness and Dissociation in PTSD: The Mediating Role of Attention and Emotional Acceptance.

INTRODUCTION: A number of studies have investigated the relationship between mindfulness and dissociation and suggested that mindfulness-based interventions could be effective in the treatment of dissociative symptoms. A recent study in healthy volunteers found that attention and emotional acceptance mediates this relationship. However, no study has yet been performed among a clinical sample to assess this association. METHOD: We recruited 90 patients (76 women) suffering from Posttraumatic Stress Disorder (PTSD). They completed self-report questionnaires to measure PTSD, dissociation, emotion regulation difficulties, childhood trauma, mindfulness abilities and cognitive abilities. RESULTS: We found that mindfulness abilities, emotional difficulties, dissociation and attention-concentration were all related to each other. Using a step-by-step approach and bootstrapping techniques, we found a significant indirect effect of mindfulness abilities on dissociation through non-acceptance (confidence interval 95%=-.14 to -.01) and attentional difficulties (confidence interval 95%=-.23 to -.05). CONCLUSION: Patients with higher levels of dissociative symptoms have less capacity for mindfulness. Our results support Bishop et al.'s model proposing that attention and emotional acceptance are the two active components of mindfulness. To extend our findings, clinical trials are required to evaluate a causal relationship and the effectiveness of mindfulness-based interventions for patients suffering from dissociation.

Validation of the French version of the Emotion and Regulation Beliefs Scale (ERBS) and Dissociation Belief Scale (DBS).

INTRODUCTION: Dissociation is a recurrent symptom of post-traumatic stress disorder (PTSD) and is associated with emotional dysregulation. Beliefs about emotions seem to be involved in emotional dysregulation but have not been studied in relation to dissociation. Likewise, there is currently little empirical evidence of beliefs about dissociation. The aims of the study were to validate psychometric tools assessing these beliefs, to assess their role in dissociation, and to explore the mediating role of emotional dysregulation and beliefs about dissociation in the relationship between beliefs about emotion and dissociation. METHOD: We recruited a sample from the general population (n=1009) and a sample of patients with PTSD (n=90). All participants completed self-report questionnaires to evaluate symptoms of PTSD (PTSD Checklist/Impact of Event Scale, PCL-5/IES-6), dissociation (Dissociative Experiences Scale, DES), difficulties in emotion regulation (Difficulties in Emotion Regulation Scale, DERS), beliefs about dissociation (Dissociation Beliefs Scale, DBS), and beliefs about emotion (Emotion and Regulation Beliefs Scale, ERBS). RESULTS: The questionnaires used to assess the beliefs about emotion (ERBS) and dissociation (DBS) had good psychometric properties. Dissociation was positively associated with positive and negative beliefs about dissociation and with negative beliefs about emotions in both the clinical and non-clinical groups. The relationship between beliefs about emotions and dissociation was mediated by emotional dysregulation and positive beliefs about dissociation in both groups. CONCLUSION: The ERBS and DBS are effective tools to assess beliefs. Beliefs about emotion and dissociation seem to be involved in dissociative manifestations in both clinical and non-clinical individuals.

Interaction of mediation and moderation effects of positivity, cognitive fusion, brooding and mindfulness.

INTRODUCTION: Currently, cognitive behavior therapy (CBT) targets multiple cognitive processes. However, only a few studies have focused on the interaction among these processes. Preliminary studies have identified a moderation effect of rumination on the link between thought content and emotional difficulties, and a mediation effect of ruminations on the link between mindfulness and emotional difficulties. METHOD: We recruited 236 participants (185 women) who consented online to participate by choosing to either continue with the study or decline to proceed. They completed a battery of questionnaires online, namely Positivity scale, General Health Questionnaire, Rumination Response Scale, Five Facet Mindfulness Questionnaire and Cognitive Fusion Questionnaire. RESULTS: All cognitive processes were significantly correlated with emotional distress. Step-by-step linear regression analysis revealed that positivity, cognitive fusion and brooding were significant independent predictors of emotional difficulties. Bootstrapping analysis confirmed that cognitive fusion and brooding mediate the link between mindfulness and depression and anxiety-insomnia. They also demonstrated that cognitive fusion moderates the link between positivity and depression but not anxiety-insomnia. CONCLUSION: Cognitive processes interact with each other. Taken together, these results suggest that combining cognitive interventions is not useful and that different cognitive interventions may be selected depending on the patient's profile.

Psychological consequences of the COVID-19 pandemic: A qualitative study.

Multiple psychological health problems related to the COVID-19 pandemic among both the general public and health-care workers have been identified in the scientific literature. However, most studies used quantitative methods with scales selected on the basis of the researchers' pre-established knowledge derived from the experience of other situations and which can therefore induce biases. The dual aim of the present study was to explore qualitatively the perceived psychological consequences of lockdown on members of the general public and the perceived psychological consequences of COVID-19 on health-care workers. We recruited 241 participants from the general public and 120 health-care workers. They consented online to participate and completed open-ended questions evaluating the consequence of the health crisis on their life as a couple, on their friendships, family life, work, studies, psychological health, stress, and vision of the future. Finally, participants were asked to add any further consequences that had not been mentioned. We used double coding to process the data. We identified five main themes among the participants from the general public: improved and maintained social relationships, deterioration of health, improved health, personal growth, and lack of direct social contact. We also identified five main issues among the health-care workers: psychological and emotional impact, adjusting, negative impact on work, worries, and uncertainty about the future. The results confirmed the existence of psychological health problems related to the COVID-19 pandemic. They also highlighted positive consequences. Health-care workers tended to perceive more negative consequences than the participants from the general public.

An investigation of reliability and validity of the LS/CMI with French offenders.

INTRODUCTION: The Level of Service/Case Management Inventory (LS/CMI) is one of the best-known recidivism risk instruments. In France, this scale is rarely used because no study had yet been carried out to confirm its psychometric properties on samples of French offenders. The aim of this study was to test the psychometric properties of the LS/CMI on samples of violent French prisoners. METHOD: The Level of Service/Case Management Inventory, the BARR-2002R, Historical Clinic Risk-Scale 20 and the Risk for Sexual Violence Protocol were administered to 128 violent offenders. RESULTS-DISCUSSION: The results showed good internal consistency, reliability and convergent validity of the LS/CMI. Assault, robbery and sexual assault were correlated with the LS/CMI. All of these results are discussed and analysed using the international reference literature. CONCLUSION: Confirmation of the psychometric properties of the LS/CMI among French offenders to allow it to be used to assess the risk of recidivism of offenders.

[Is the use of patient records necessary to assess the risk of sexual, violent and general recidivism?] / Le recours aux dossiers des patients est-il nécessaire pour l'évaluation du risque de récidive sexuelle, violente et générale ?

INTRODUCTION: Sexual, violent and general recidivism risk scales are widely used in a number of countries. Their psychometric qualities are generally considered to be good. However, in practice they may vary in the quality of prediction of risk of sexual, violent and general recidivism, in particular because of the sources of the information collected. In France, the medical records of incarcerated patients are kept by health-care professionals. Although regulated, the content and quality of these records vary widely from one patient to another. The criminal justice system holds the criminal records of convicted and imprisoned persons. There is no set list of documents contained in these records. For caregivers and researchers, access to criminal records is difficult because of the confidentiality to which legal professionals are subject. The aim of our study was to investigate whether using medical files in addition to structured interviews can improve the assessment and management of the risks of sexual, violent and general recidivism. MATERIAL AND METHOD: A total of 128 perpetrators of violence were assessed using three scales of risk of sexual, violent and general recidivism. Scores for the items of the scales were compared between (a) those that were based on medical records and an interview, and (b) those based only on an interview. RESULTS AND DISCUSSION: First, differences in scores between the two groups (assessed through interview only, and assessed through interview and use of medical records) were observed on the RSVP, HCR-20 and LS/CMI scales. Secondly, most of the results indicate that the overall level of risk was perceived as lower when medical records were used, which would, indirectly, lead to a reduction in false positives when evaluating perpetrators of sexual violence. Thirdly, the point-by-point analysis shows that the use of information contained in the medical records reduces the weight of present and future factors (e.g. the physical and psychological stress of recent events), increases the weight of past factors (e.g. history of sexual violence), and can increase the weight of certain factors that can lead to more negative emotions in the assessor (e.g. deviance). These results can be explained by (i) the emotional functioning of the persons assessed (particularly defensive processes or memory difficulties), (ii) the attitude of the aggressor (particularly the presence of emotional and cognitive biases), (iii) the nature of the information (particularly "hot" cognitions or those leading to greater social desirability). The limitations of the study concern the relatively small number of participants, the environment in which the file was transmitted and the very heterogeneous and sometimes relatively incomplete composition of the files. CONCLUSION: The use of information contained in medical files impacts the results of recidivism risk scales and restores a balance to the factors. In France, risk scales are currently being introduced, although their use is still limited in the health field. However, ethical use of these scales raises the issue of the homogenisation of the content of medical records and access to criminal records in order to enable future research to confirm whether the use of information provided in medical and criminal records can improve the quality of assessment and treatment of offenders.

Validation of the French ADNM-20 in the assessment of emotional difficulties resulting from COVID-19 quarantine and outbreak.

BACKGROUND: Multiple psychological consequences of the COVID-19 outbreak and quarantine have been described. However, there is a lack of global conceptualization. We argue that the stressful aspects of the situation, the multiple environmental consequences of the outbreak, and the diversity of symptoms observed in such a situation, suggest that Adjustment disorder (AD) is a promising way to conceptualize the psychological consequences of the outbreak and quarantine. The first aim of the study was to validate the French version of the ADNM. The second aim was to set out adjustment difficulties resulting from COVID-19 outbreak and quarantine. METHOD: We recruited 1010 (840 women, 170 men) who consented online to participate. They filled out the French ADNM, visual analogic scales, HADS, IES, and the COPE, to evaluate coping strategies. RESULTS: We confirmed the factor structure of the ADNM and we found good psychometric properties. We found that 61.3% of participants presented an adjustment disorder related to COVID-19 outbreak. We found multiple risk factors and protective factors to AD due to quarantine and outbreak. We also identified the coping strategies negatively and positively associated with AD. CONCLUSION: Adjustment disorder is a relevant concept to understand psychological manifestations caused by quarantine and outbreak. The French ANDM has good psychometric properties to evaluate such manifestations. The association between coping strategies and AD symptoms suggest that CBT may be the best intervention to help people suffering from AD.

[Validation of the French version of the 10-item Big Five Inventory]. / Validation française du Big Five Inventory à 10 items (BFI-10).

OBJECTIVE: Our primary objective was to validate the French version of the BFI-10, an ultra-short ten-item version of the Big Five Inventory (BFI; John et al., 1991), which allows for a reasonably accurate assessment of personality in circumstances in which more in-depth assessment is not possible. In order to reach a thorough evaluation of the external validity, we also aimed to examine the bandwidth of the BFI-10 scales with reference to the study by De Young, Quilty and Peterson (2007) who distinguished between two aspects in each of the Big Five: Assertiveness and Enthusiasm for Extraversion; Compassion and Politeness for Agreeability; Orderliness and Productiveness for Conscientiousness; Withdrawal and Volatility for Negative Emotionality, and finally Openness to Aesthetics and Openness to Ideas for Open-Mindedness. Our concern with regard to bandwidth was to examine whether the BFI-10 scales have strong enough correlations with both aspects of each domain. METHODS: Participants. Data from four samples were analysed: Sample 1 comprised 2499 undergraduate students (1654 women) who completed the full BFI in university classes; Sample 2 comprised 13,306 participants (8471 women) who filled out the BFI-10 ten items online via Internet; Sample 3 comprised 143 undergraduate students (115 women) who completed the full BFI twice with a two-week interval; Sample 4 comprised 360 undergraduate students (183 women) who filled out the BFI and NEO PI-R. INSTRUMENTS: The French version of the Big Five Inventory is a 45-item inventory, which measures the five broader domains of personality. The ultrashort Ten-item Big Five Inventory (BFI-10) was developed simultaneously in German and English by Rammstedt and John (2007); it comprises five two-item scales measuring the big five domains. The Neuroticism-Extraversion-Openness Personality Inventory Revised (NEO PI-R; Costa et McCrae, 1992) is a 240-item questionnaire which assesses the big five domains and 30 lower-order facets, i.e. six facets per domain. STATISTICAL ANALYSES: Factor structure and reliability of the five two-item scales were first investigated on samples 1 and 3. Confirmatory factor analyses (CFAs) were conducted on samples 1 and 2, and discriminant validity was assessed via comparison with the NEO PI-R (sample 4). In order to examine the bandwidth of the BFI-10 two-item scales, we studied their correlation not only with the NEO PI-R domains but also with the 30 facets. RESULTS: The CFAs showed the good fit of the five-factor structure, with RMSEA=.077 (.072), CFI=.974 (.956), and SRMR=.029 (.027) in samples 1 and 2 respectively. Multigroup CFA conducted in groups 1 and 2 showed invariance across gender of factor loadings and item intercepts. Test-retest reliability was satisfactory with rs ranging from .68 (Open-Mindedness) to .86 (Extraversion and Negative Emotionality). The comparison of the two-item scales with the NEO PI-R scales showed high correlations not only with the NEO domain scales, but also with several facets: Four BFI-10 two-item scales (Extraversion, Conscientiousness, Negative Emotionality, and Open-Mindedness) were highly correlated with at least three of the six NEO facet scales in each domain. For Agreeableness, the magnitude of correlations was smaller, but the pattern of correlations was the same. All BFI-10 scales had at least moderate correlations with both aspects of each domain, with the exception of Negative Emotionality, which measured the NEO Withdrawal aspect better than Volatility. CONCLUSION: The French version of the BFI-10 demonstrated the expected five-factor structure, satisfactory reliability, and broad bandwidth. It could be a valuable tool for the assessment of personality in circumstances in which it is not possible to use a longer and more in-depth instrument, especially when personality is not the main focus of research but one of the variables to be controlled.

[French validation of the Sexual Addiction Screening Test (SAST-Fr)]. / Validation de la version française du Sexual Addiction Screening Test (SAST-Fr).

INTRODUCTION: The Sexual Addiction Screening Test (SAST) is one of the most frequently used tools on the international level for assessing sexual addiction. This study aimed to translate the English version of the SAST, and adapt and test the psychometric properties of its French version (the SAST-Fr) by establishing its factor structure, internal consistency and convergent validity. METHODS: Three hundred ninety eight voluntary participants were recruited online through specialized forums. Participants completed a sociodemographic questionnaire, the SAST-Fr and the diagnostic criteria of sexual addiction proposed by Goodman. We tested the psychometric properties of SAST-Fr through an exploratory factorial analysis, especially its internal consistency, using the Kuder-Richardson alpha (KR-20) given that the items were dichotomous. We also performed correlation analyses of Bravais-Pearson on numerical variables. Finally, we studied the predictive validity of Goodman's score in predicting SAST-Fr criteria using a ROC (Receiver Operating Characteristics) analysis. RESULTS: Mean age of participants was 29.08 years (±11.30) and included 54% of women (n=215). Statistical analysis had shown that SAST-Fr had a one-factor structure explaining 31% of the variance, an excellent internal consistency (KR-20=0.90). We found significant correlation between SAST-Fr item scores and PEACCE scores (r=0.87; P<0.001) and Goodman's criteria (r=0.79; P<0.001). CONCLUSION: Our results indicate that the psychometric properties of the French version of the SAST are comparable to its original English version with a one-factor structure. The SAST-Fr is a reliable and valid questionnaire to assess symptoms of sexual addiction.

[Smartphone addiction: French validation of the Internet Addiction Test-Smartphone version (IAT-smartphone) and associated psychopathological features]. / L'addiction aux smartphones : validation française de l'échelle Internet Addiction Test-version smartphone (IAT-smartphone) et caractéristiques psychopathologiques associées.

INTRODUCTION: Since their first appearance in 1992 smartphones have improved constantly, and their use, combined with the rapid spread of the Internet, has increased dramatically. The recent emergence of this technology raises new issues, at both individual and societal levels. Several studies have investigated the physical and psychological harm that may be caused by smartphones. The issue of excessive smartphone use as an addictive disorder is frequently raised and debated, although it is not acknowledged in international classifications. In France, there is no validated assessment tool for smartphone addiction. Therefore, the aims of this research were: to validate a French translation of the Internet Addiction Test-smartphone version (IAT-smartphone); to study the links between smartphone addiction, Internet addiction, depression, anxiety and impulsivity. METHOD: Two hundred and sixteen participants from the general population were included in the study (January to February 2016), which was available online using Sphinx software. We assessed smartphone addiction (French version of the Internet Addiction Scale - smartphone version, IAT-smartphone), specificity of smartphone use (time spent, types of activity), Internet addiction (Internet Addiction Test, IAT), impulsivity (UPPS Impulsiveness Behavior Scale), and anxiety and depression (Hospital Anxiety and Depression scale, HAD). We tested the construct validity of the IAT-smartphone (exploratory factor analysis, internal consistency, non-parametric correlation tests for convergent validity). We also carried out multiple linear regressions to determine the factors associated with IAT-smartphone. RESULTS: Mean age was 32.4±12.2 years; 75.5% of the participants were women. The IAT-smartphone had a one-factor structure (explaining 42 % of the variance), excellent internal consistency (α=0.93) and satisfactory convergent validity. Smartphone addiction was associated with Internet addiction (ρ=0.85), depression (ρ=0.31), anxiety (ρ=0.14), and some impulsivity subscales, including "negative urgency" (ρ=0.20; P<0.01), "positive urgency" (ρ=0.20; P<0.01), and "lack of perseverance" (ρ=0.16; P<0.05). Age was negatively associated with the IAT-S total score (ρ=-0.25; P<0.001), and there was a non-significant difference between the IAT-S total scores of men and women (29.3±10.2 vs. 32.7±12.4; P=0.06). Multiple linear regression showed that age, anxiety, depression, average time spent on the smartphone, impulsivity and Internet addiction explained 71.4 % of the variance of IAT-smartphone scores. However, this score dropped to 13.2 % when Internet addiction was removed from the model. This variable alone explained 70.8 % of the IAT-smartphone scores. CONCLUSION: The French version of the IAT-smartphone is a reliable and valid questionnaire to assess smartphone addiction. This addiction appears to be strongly linked to anxiety, depression and impulsivity. The strong association between smartphone addiction and Internet addiction suggests that smartphone addiction is one of the many forms of Internet addiction. In fact, smartphones may not be the object of the addiction but rather a medium facilitating Internet access as it makes it possible to connect anywhere anytime. This raises the issue of the potential role of smartphones in speeding up and facilitating the development of Internet addiction.

[Personality profiles of students at risk of dropping out: Resilients, Overcontrollers and Undercontrollers]. / Étudiants à risque de décrochage selon le profil de personnalité : Resilients, Overcontrollers et Undercontrollers.

INTRODUCTION: Preventing students from dropping out of higher education, and particularly university, requires understanding the different factors that can lead to individuals failing to complete their studies. The role of personality in academic success or failure remains poorly understood. Block's personality profile model (Resilients, Overcontrollers, Undercontrollers) has been used to link personality traits to academic performance. The objective of this study is to apply this model to the risk factors of dropping out of higher education courses, including psychological vulnerability, level of autonomy, and the feeling of not being able to keep up. This involved validating Block's profiles in relation to the Big Five personality traits (Extraversion, Agreeableness, Conscientiousness, Neuroticism and Openness), and their links with the risk factors for dropping out. METHODS: This study is based on a quantitative survey of 196 students (mean age 21.32 years±3.11 years, with 63% females) taking higher education courses in France. Three measuring instruments were used: a French scale of Autonomy-situnomy, the French version of the Big Five Inventory (BFI-Fr) for personality traits, and the French version of the General Health Questionnaire (GHQ-28) for psychiatric morbidity. One item empirically evaluated the feeling of not being able to keep up. Data was processed using a k-average cluster analysis to establish the personality profiles, then by analysis of variance measures to evaluate the differences between them, and Bravais-Pearson correlation coefficient to identify links between risk factors and profiles. RESULTS: Conscientiousness (Control) was the trait most strongly associated with high autonomy and a low feeling of not being able to keep up. There was also a positive influence of Extraversion and Agreeableness on autonomy. On the other hand, Neuroticism scores were related to greater psychiatric morbidity, a greater feeling of not keeping up, and lower autonomy. The results for personality profiles confirm the stability of Block's profiles (Resilients, Overcontrollers and Undercontrollers) and their relevance in higher education contexts. Resilients and Overcontrollers had greater autonomy and a lower feeling of not keeping up, but Resilients had the lowest psychiatric morbidity. Undercontrollers were associated with the greatest risk factors: lowest autonomy, the highest psychiatric morbidity and the strongest feeling of not keeping up. Gender comparisons indicated that women were more affected by psychiatric morbidity, but had higher Conscientiousness and autonomy.

[Validation of the French version of the Binge Eating Scale: Examination of its factor structure, internal consistency and construct validity in a non-clinical and a clinical population]. / Validation de la version française de la Binge Eating Scale : étude de sa structure factorielle, de sa consistance interne et de sa validité de construit en population clinique et non clinique.

OBJECTIVE: The Binge Eating Scale is a widely used scale to assess binge eating disorder in obese patients. Until now, this scale has not been validated on a French population, and no psychometrically sound tool assesses binge eating disorder in the French. This study aimed to test the psychometric properties of a French version of the Binge Eating Scale by establishing its factor structure, internal consistency, and construct validity in both a non-clinical population and a clinical population (obese patients who are candidates for bariatric surgery). METHODS: A total of 553 non-clinical subjects and 63 morbidly obese patients who were candidates for bariatric surgery were assessed with the BES and the Bulimic Investigatory Test, Edinburgh or BITE (which assesses both binge eating behaviours and use of inappropriate compensatory behaviours). We tested the factor structure of the instrument, its internal consistency, its construct validity with measures of binge eating, and its construct validity with measures of inappropriate compensatory behaviours to avoid weight gain. In 47 out of the 63 obese patients, we assessed binge eating disorder (SCID). RESULTS: In the non-clinical population, the BES had a one-factor structure (which accounted for 61% of the variance), excellent internal consistency (α=0.93), and high construct validity with measures of binge eating. In this population, construct validity with measures of inappropriate compensatory behaviours was confirmed in overweight and obese subjects (P=0.42), but not in underweight and optimal weight subjects (P<0.001). In obese patients candidates for bariatric surgery, we demonstrated that the BES had a one-factor structure (which accounted for 46% of the variance), had high internal consistency (α=0.88) and high construct validity with measures of binge eating and good construct validity with measures of inappropriate compensatory behaviours to avoid weight gain. In the subpopulation of 47 obese patients, sensitivity, specificity, positive predictive value and negative predictive value were respectively 75%, 88.4%, 37.5% and 97.4% (BES threshold=18). DISCUSSION: In this study, we validated a psychometrically sound French version of the Binge Eating Scale, both in a non-clinical and a clinical sample. The psychometric properties of the French version of the BES are comparable to its original version with a one-factor structure. The BES is a useful tool to assess binge eating disorder in obese patients (e.g., bariatric surgery candidates), but might not differentiate between binge eating disorder and bulimia nervosa in underweight and optimal weight subjects.

[Pubertal maturation, physical self-esteem and sexuality in a sample of French adolescents]. / Influence de la maturation pubertaire et de l'estime de soi corporelle sur la sexualité à l'adolescence.

AIM: The aim of this study was to explore the links between pubertal maturation, physical self-esteem and sexuality in adolescence, differentiating between boys and girls. METHOD: The sample was comprised of 312 French secondary school children (seventh and ninth grades); 52.6 % (n=164) of whom were girls. Participants answered three self-evaluation questionnaires: the scale of sexuality (interests, emotions, relationships: IERS) in prime adolescence (12 to 15 years); (b) the self-administered rating scale for pubertal development and (c) the Physical Self-Description Questionnaire (PSDQ). RESULTS: Pubertal maturation was associated with higher scores on "Flirting with the aim of having sexual relations" and "Going out with someone", and a drop in overall and physical self-esteem, mainly in socially valued domains, namely "Body fat" for girls, and "Strength" and "Health" for boys. Overall physical self-esteem was associated with "Going out with someone" and "Flirting with the aim of having sexual relations" in boys. DISCUSSION: Physical changes at puberty induce two distinct trends in adolescents: sexual exploration and discovery (genitalized body), and self-depreciation (social body).

Orthognathic surgery improves quality of life and depression, but not anxiety, and patients with higher preoperative depression scores improve less.

This study assessed quality of life (QoL), depression, and anxiety before and after orthognathic surgery and identified risk factors for poorer postoperative outcome. This multicentre prospective study included 140 patients from five French medical centres. We assessed patients before surgery (T1), 3 months after surgery (T2), and 12 months after surgery (T3). We assessed the severity of the orofacial deformity, physical, psychological, social, and environmental QoL (WHOQOL-BREF), and depression and anxiety (GHQ-28). Risk factors for poorer outcome were identified using linear mixed models. Between baseline and 12 months, there was significant improvement in psychological and social QoL and in depression (although below the norms reported in the general population), but not in anxiety. Physical QoL was poorer in patients who were younger, who had a mild orofacial deformity, and who were depressed. Psychological QoL was poorer in younger patients and in depressed patients. Social QoL was poorer in patients who were single, who had a mild orofacial deformity, and who were depressed. Although orthognathic surgery provides a moderate improvement in psychological and social QoL, the systematic screening and treatment of depression could further improve QoL after surgery because it is a major predictor of poor QoL in this population.

Exploratory study toward development of the French version of the questionnaire on personality traits (QPT/VKP-4) in an elderly population in comparison to young adults.

This research is an exploratory study toward development of the French version of the Questionnaire on Personality Traits (QPT/VKP-4). The goal was to assess its association with the Big Five Inventory (BIG-5) and to explore the personality characteristics of the elderly compared to young adults. The 241 participants included 83 elderly people and 158 young adults. Borderline and anxious personality disorders were less frequent in elderly women than in young women, and depressive personality disorder was less frequent in elderly men. Dimension scores were higher for Conscientiousness in the elderly, Agreeableness in elderly women, and Extraversion in elderly men. Statistically significant correlations were found between personality dimension scores using the VKP-4 and the BIG-5.

[Psychological effects of orthognatic surgery and postoperative dissatisfaction: presentation of a research protocol]. / Effets psychologiques de la chirurgie orthognatique et insatisfaction postopératoire : présentation d'un protocole de recherche.

INTRODUCTION: The causes of postoperative dissatisfaction in orthognathic surgery are difficult to grasp. The aims of our study are to analyze the effects of orthognathic surgery on self-esteem, body image, psychological morbidity, and quality of life. We also want to assess the combined effects of these factors on postoperative dissatisfaction, and to study the interest of personality assessment (especially neuroticism) as a predictive factor of dissatisfaction. METHOD: Three hundred patients candidates for maxillo-mandibular osteotomy will be included in the study. They will answer a questionnaire assessing self-esteem, body image, psychological morbidity, quality of life, and personality. The evaluation will be conducted preoperatively and postoperatively at 3 months and at 1 year. The degree of satisfaction will be measured postoperatively. EXPECTED RESULTS: The results should help evaluate the psychological effects of orthognathic surgery and identify predictors of postoperative dissatisfaction, and especially the role of neuroticism.

[The Paris cell for collecting preoccupying information (la CRIP 75): an organization at the heart of child protection]. / La cellule de recueil des informations préoccupantes de Paris, la CRIP 75 : un dispositif au cœur de la protection de l'enfance.

Within the objective of coordinating actions of the different partners whose mission involves childhood protection measures, and to allow convergence of preoccupying information toward a centralized unit, law n(o) 2007-293 of 5 March 2007 reforming child protection requires the creation of a departmental cell for the collection, processing, and assessment of preoccupying information (cellule départementale, de recueil, de traitement, et d'évaluation des informations préoccupantes, CRIP) on the circumstances of a minor in danger or at risk of being so. The CRIP 75 is a multidisciplinary cell comprising an administrative pole, a socio-educational pole, and a medical health officer. Its mission is to participate in assessing preoccupying information and directing it appropriately, with a preference toward treating situations within an administrative framework and in accordance with the parents. The public prosecutor is only called in when the recommended measures have not provided an adequate response to the danger. Situations that are a matter for prosecution as a criminal offence are transmitted directly to the public prosecutor's office, as are situations for which the social or medico social services are unable to make an assessment.

[Validation of a scale of sexuality (interests, emotions, relationships: IERS) in prime adolescence (12 to 15 years)]. / Validation d'une échelle de sexualité (intérêts, émotions, relations : IERS) à la prime adolescence (12 à 15ans).

BACKGROUND: Early adolescence, which we also call prime adolescence, is marked by the transformations of puberty and the sexualisation of the body, changes in cognition and the progressive involvement in sexuality. This study is the continuation of an earlier work dealing with the construction and validation of a questionnaire on sexuality during adolescence (Courtois et al., 1998) [8]. METHODS: Population. The sample was composed of 312 middle-school students (7 to 9(th) grade) from four middle-schools in Tours and its suburbs (Indre-et-Loire, France): 164 girls (52.6%) and 148 boys (47.4%); with a mean age of 13.8 (S.D.=1.02; from 10.7 to 16.9) (without significant differences between boys and girls). Material. The material was composed of 22 items calling for true or false answers and including 13 items from the initial questionnaire by Courtois et al. (1998) [7,8] structured in three dimensions ("Behavioral engagement in sexuality", "Love and fidelity" and "Taste for flirting"). Procedure. The study was carried out in 2008 in the classroom (anonymity guaranteed). RESULTS: The results of the factorial analysis (as the main component and by the method which maximizes variance, Varimax) made it possible to find three factors which explain 41% of total variance: "Going out with someone" (value of 4.6, explaining 21% of the total variance); "Giving priority to love" (value of 2.8 explaining 13% of the variance); "Flirting with the aim of having sexual relations" (value of 1.6 explaining 7% of variance). The Cronbach alphas are 0.79, 0.70 and 0.66 respectively. The first and third factors are correlated. In order to obtain a shorter final instrument and to favor the orthogonality between factors, we only retained the items which are strongly saturated by the factors (>0.50). A confirmatory analysis revealed the good adequation of the model retained (Chi(2): 162, 87 dof, P<0.001; Goodness of fitness index [GFI] of Joreskog: 0.91; Root mean square error of approximation [RMSEA]=0.05). Following these analyses, we are able to propose a shorter questionnaire (15 items), structured in three dimensions of sexuality significant in prime adolescence (in accordance with interests, emotions and relationships). The analyses were conducted according to gender and age. There is no significant difference for "Going out with someone" between boys and girls. On the other hand, there is a difference between "Giving priority to love", which is more important for girls (P<0.05) and for "Flirting with the aim of having sexual relations", more important for boys (P<0.001). However, as ages increase, we notice a rise in scores for "Going out with someone" for girls as well as for boys (P<0.05); a drop in scores for "Giving priority to love" (for girls, (P<0.05) and an increase in the scores for "Flirting with the aim of having sexual relations" (only for boys (p<0.05). DISCUSSION: This study allowed us to validate a scale of sexuality in prime adolescence that presents good psychometric qualities. It was carried out on a larger and more representative sample of this period than the initial study, although essentially finding the same results as previously. Thus, the use of this scale, coupled or not with the individual analysis of the items which make it up, could allow us to understand sexuality in prime adolescence in three significant dimensions of psychosexual development, as well as regarding risky sexuality, i.e., an excessive interest in genital sexuality, behavioral involvement and precocious sexual relations or an absence of feelings.

[Psychopathy and associated personality disorders: searching for a particular effect of the borderline personality disorder?]. / Psychopathie et troubles de la personnalité associés : recherche d'un effet particulier au trouble borderline ?

INTRODUCTION: Recent clinical and empirical works are based on Cleckley's clinical observations in which psychopathy is viewed as a personality disorder, characterised by a lack of emotions, callousness, unreliability and superficiality. Hare operationalised Cleckley's concept of psychopathy by developing the Psychopathy Checklist-Revised composed of 20 items that load on two factors in majority: factor 1 (personality aspects of psychopathy) and factor 2 (behavioural manifestations), close to the antisocial personality disorder (DSM-IV criteria). Comorbidity is strong with antisocial personality disorder but also with histrionic, narcissistic and borderline disorders. OBJECTIVES: As results of categorical studies relative to comorbidity suggest a strong comorbidity between psychopathy and other personality disorders, and particularly cluster B disorders (axis II, DSM-IV), this study assesses the relationships between psychopathy (dimensional approach) and personality disorders (categorical approach) and particularly with the borderline personality disorder. The aim of this study is also to underline the complementarity of categorical (SCID-II) and dimensional approaches (PCL-R), and the utility of the standardised clinical examination. DESIGN OF THE STUDY: We hypothesised positive associations between psychopathy and other personality disorders, mainly with the cluster B axis II (narcissistic, antisocial, histrionic, and borderline). Among those disorders, a particular link exists with the borderline personality disorder, considering that their association may attenuate the pathological level of the psychopathy. The sample included 80 male inmates from French prisons (age: M=31.48; SD=11.06). Each participant was evaluated with the PCL-R to assess the level of psychopathy and the SCID-II to assess the possible presence of personality disorders. The MINI and the WAIS-III were used to exclude respectively those who presented an axis I comorbidity (mood disorders and psychotic disorders established at the moment of the testing), or a backwardness (IQ<70). Correlations and multiple linear regressions analysis (with the Stepwise procedure) were used to analyse the data. RESULTS: As expected, the results suggested positive correlations between narcissistic, antisocial personalities and scores of psychopathy (from 0.36 to 0.63); paranoid personality was less expected (from 0.32 to 0.47). Borderline personality was associated with both the total score of psychopathy (0.24) and the score of factor 2 (0.30). Linear regression analysis revealed that the antisocial and paranoid personalities predicted the total score (R(2)=38%) and the factor 2 (R(2)=45%) of the PCL-R. Antisocial and narcissistic personalities predicted factor 1 (R(2)=22%). However, in the different models, contrary as predicted, the borderline personality was not a significant predictor. CONCLUSION: First, these results underline the importance of impulsivity above all for the cluster B personality disorders and secondly, the importance of considering impulsivity with antisocial (factor 2), narcissistic and paranoid characteristics. Moreover, because of the transversality of impulsivity, the literature outlined the cross-over between cluster B disorders and psychopathy. These different studies could have important clinical consequences (risk of violence, therapeutic indications and forecast). These results also emphasize the necessity of standardised examinations. Implications for treatment are outlined: the treatment may be adapted according to the comorbidities having an effect on psychopathy that is antisocial with paranoid personalities, and antisocial with narcissistic personalities.

[Links between stress factors, mental health and initial consumption of tobacco and alcohol during pre-adolescence]. / Liens entre stresseurs, santé psychique et premières consommations de tabac et d'alcool à la préadolescence.

BACKGROUND: We know the effects of stress hassles and life events on mental health at pre-adolescence and the impact of the first experiences with alcoholic beverages and tobacco, where the precocity of the initiation tends to encourage abuse and later dependence on these substances. The goal of this study was to look into the related effect of environmental factors (daily hassles, life events, and social support) on perceived mental health and on the initiation and consumption of tobacco and alcohol by preadolescents. POPULATION: The study was carried out in 12 institutions in a French department ("Indre-et-Loire") in the "Région Centre", including students from the last year of primary school (fifth grade) and the first two years of middle school (sixth and seventh grades): all nine elementary schools in Joué-lès-Tours, the second largest city of the department, and three middle schools in Tours and surrounding areas (urban, semi-rural and inner city). The sample was made up of 476 preadolescents attending school, 234 girls (49%) and 242 boys (51%), 267 primary school and 209 middle school students, with an average age of 11 years and 7 months. MATERIAL: Standardized questionnaires, specific to this population: with a scale of daily hassles, life events, mental health, and social support, were used. They proved to be adapted to each of them (Cronbach alpha coefficient>0.70) and the types of hassles and life events corresponded to the psycho developmental knowledge specific of this period. For the middle school students, dependence on tobacco was defined according to the "Hooked on nicotine checklist". PROCEDURE: In April 2004 in class (anonymity guaranteed). RESULTS: The results show that the hassles (considered in terms of occurrence or intensity, that is, the perceived stress) and life events (occurrence and negative perception) have a negative effect on mental health. In particular, pressure due to family problems has the greatest influence on mental health. For primary school students, this is followed by problems linked to self-perception; for middle school students, those linked to school. The consequences of hassles and life events on mental health allowed us to verify the solidity of the model used in previous studies [the Lausanne pediatric psychiatry team ], even with a younger preadolescent population. The effect of daily hassles is greater than that of life events, but they are not independent of one another (mediational model). Social support plays a modulating and protective role in mental health and the effects of daily hassles and life events. The prevalence of preadolescent smokers (simple experimentation or more or less regular use) is 5.7% (n=26). The prevalence of alcohol use is greater, encompassing more than one-third of subjects (33.4%; n=153). The influence of daily hassles can be seen both on the age of initiation to alcoholic beverages and to use of alcohol and intoxications. It is also observed on the age of initiation to tobacco and nicotine dependence (only taken into account for middle school students). That is to say that they promote precocity in the consumption of these products and increase their use. The absence of links with tobacco consumption may be due to the low number of preadolescent tobacco users. Life events also show an effect on tobacco and alcohol consumption, but it is lesser and should be moderated. Mental health is also correlated (but weakly) to the use of alcoholic beverages and intoxications. This applies more specifically to middle school students. Finally, the role of social support cannot be distinguished. CONCLUSIONS: This study shows the degree that daily hassles impact mental health and the recourse to psychoactive substances during preadolescence. Precocious use of tobacco and alcohol, the abuse of these substances and occasionally the beginning of dependence should be considered, at the very least, as warning signs for states of tension on individual, familial and environmental levels, or even as signs of established problems which could be revealed through a thorough clinical.