Corrigendum: Paradoxes in borderline emotional dysregulation in adolescence: influence of parenting, stressful life events, and attachment.

[This corrects the article DOI: 10.3389/fpsyt.2021.735615.].

Alcohol and psychoactive substance use in a cohort of children followed by child protection in France.

Background and aim: Many studies have investigated the association between maltreatment and substance use in adulthood.In this study, we sought to explore the association between substance use during adolescence, diverse forms of child maltreatment, and psychological symptoms within a cohort of individuals under the purview of child protection services in France. Method: The dataset was culled from a retrospective, population-based study encompassing minors and young adults aged 0 to 21, who were under the care of child protection services. Specifically, we conducted a comparative analysis between minors exhibiting substance use (N = 72) and those without such use (N = 776). Result: The odds ratios predominantly illuminated a significant correlation between Substance Use and the manifestation of self-destructive behavior (OR = 4.35; CI 2.02-9.59), as well as aggressive behavior (OR = 5.75; CI 2.87-11.84). Univariate analysis also hinted at an association between SUD and suicidal ideation (OR = 3.52; CI 2.1-5.90). Conclusion: Children in France who are in the care of child protection services and who use psychoactive substances are at greater risk of dropping out of school and of having other psychological symptoms. It is important that the public authorities take account of these results in order to adjust the care given to these minors, who often do not receive psychological support.

Precarious Young Adults' Mental Health during the Pandemic: The Major Impact of Food Insecurity Independently of COVID-19 Diagnosis.

The COVID-19 pandemic had a major impact on mental health across populations, especially young and precarious people. Furthermore, COVID-19 diagnosis itself has been associated with psychiatric symptoms. However, only a few studies have assessed the mental health of precarious youth, and examined a possible association with food insecurity, while including COVID-19 diagnosis in their analyses. We aimed to determine the prevalence of poor mental health in precarious youth during the COVID-19 pandemic, and to investigate its possible association with food insecurity, independently of COVID-19 diagnosis. In a cross-sectional study conducted in the context of an employment program for precarious youth (18-25 years) living in Paris, France, 823 individuals were assessed for depression, anxiety, subjective distress and food insecurity during the second lockdown of 2020. A directed acyclic graph (DAG)-based approach was used to identify confounders for inclusion in a multivariate regression model. Of the 823 precarious youth, 45.93% reported significant symptoms of depression, 36.69% anxiety, 39% distress and 25.39% suicidal ideation. In the multivariate analysis based on DAG, food insecurity (less than one meal per day) was associated with depression (OR = 2.30; CI%: 1.19-4.51), anxiety (OR = 2.51; CI%: 1.29-4.88), distress (OR = 2.36; CI%: 1.23-4.57) and suicidal ideation (OR = 4.81; CI%: 2.46-9.44), independently of age, gender, education, COVID-19 contact and COVID-19 diagnosis. This study highlights the importance of food insecurity on mental health among young precarious people during the COVID-19 pandemic. Reducing food insecurity is essential to help reduce psychological distress.

Male Victims of Sexual Abuse: Impact and Resilience Processes, a Qualitative Study.

The increasing prevalence of sexual abuse calls for exceptional awareness of its multidimensional impact on the mental, sexual, and social wellbeing of male adults. This study aims to deepen the overall understanding of sexual abuse consequences; to highlight some common resilience factors; and to strengthen therapeutic and social support. In this qualitative research, we conducted seven semi-structured interviews with male victims of sexual violence. The data were analysed with the interpretative phenomenological analysis. They shed light on the great suffering linked to sexual violence, and on seven themes which are seemingly pillars of resilience: bond to others, bond to the body, making sense of things, expression, rediscovering oneself, institutions, and finally, learning and commitment. The exploration of these themes reveals several avenues for adjusting care, most of which imply the importance of raising awareness so that spaces receiving the victims' word can emerge.

Clinical Stakes of Sexual Abuse in Adolescent Psychiatry.

BACKGROUND: The extent and nature of sexual abuse (SA) and its consequences in psychiatry are still poorly described in adolescence. OBJECTIVE: This article describes the frequency of SA reported in an adolescent population hospitalized in psychiatry, and assesses its links with the severity of mental disorders and the medical issues of these adolescents. METHODS: The study includes 100 patients for whom SA has been mentioned, among all patients aged 13 to 17 years old hospitalized for about 4 years. The characteristics of sexual abuse were correlated with the medical severity of the patients, as well as the number, the duration of their hospitalization(s), and the time until disclosure. RESULTS: The results show the central place of SA in adolescent psychiatry, with a prevalence of 28.5% and a cumulative hospital stay which is five times longer than average. Correlations have been observed between the number of suicide attempts and the number of abuses reported. The medical severity of patients is significantly increased when the named aggressor is an adult. The number of hospitalizations is positively correlated with the number of reported abuses, as well as with the intrafamilial and adult status of the perpetrator. Finally, an early age of onset, repeated abuse, and the intrafamilial nature of the abuse are associated with a longer time to disclosure. CONCLUSIONS: The severity of adolescent psychiatric situation is statistically in favor of a history of SA, which should therefore be actively explored during care.

Adversity, attachment and emotion recognition in BPD adolescents: the distinct roles of disengaged and controlling environment.

BACKGROUND: Literature data about emotion perception in patients with borderline personality disorders (BPD) revealed some discrepancies between some patients that are vigilant and accurate to detect their emotional environment and others that are impaired at identifying emotions of others. Even if some links between childhood adversity and facial affect recognition have been established, there is a need to understand the heterogeneous psychobiological mechanisms underlying this association. The aim is to distinguish in a BPD sample, the links between facial emotion recognition (FER) and adversity types (maltreatment and parental bonding), by evaluating two dimensions of disengaged and controlling environment. METHOD: The study includes BPD adolescents (n = 45) and healthy controls (HC, n = 44): two scores of disengaged environment (parental low care; emotional and physical neglect) and controlling environment (high level of parenting control; emotional, physical and sexual abuse) were established and correlated to FER, as well as to attachment dimensions. Multiple linear regression analyzes were conducted to evaluate the effect of disengaged and controlling dimensions, on FER scores of sensitivity and accuracy, including anxious and avoidant attachment as covariables. RESULTS: Analyzes revealed that a disengaged environment was positively correlated to sensitivity in BPD patients, and the correlation was negative in the HC group. Controlling environment was negatively associated to accuracy of emotion in BPD. Avoidant and anxious attachment did not influence these associations. CONCLUSIONS: These results suggest that distinct adverse experiences account for the heterogeneity observed in emotion regulation in BPD patients.

Mental health of medical students during the COVID19: Impact of studies years.

BACKGROUND: The COVID-19 pandemic had led to severe education disruption in many countries, including for medical students (MS). We aimed to evaluate MS mental health in France and search for a difference depending on studies' years and clinical activities. METHODS: In a cross-sectional, survey-based study during the first confinement, 668 (8.35%) MS were compared to 7 336 non-medical students (non-MS) (91.65%). The PHQ-9 (≥ 10), the GAD-7 (≥ 8), and the IES-R (≥ 26) were collected to assess depressive, anxiety, and distress symptoms. Multivariable logistic regression analyses were performed. RESULTS: MS reported significant psychological distress (depressive symptoms: 38.17%, anxiety: 38.77% and distress: 36.83%). Compared to non-MS, they reported less significant depressive (OR, 0.80; 95% CI, 0.67-0.91; P = .007) and distress symptoms (OR, 0.73; 95% CI, 0.62-0.87; P < .001), after taking into account potential confounding variables including COVID-19 diagnosis. First year-MS reported higher rates of significant psychological distress than MS with clinical activities. Moreover, depressive symptoms' rates were higher among MS with COVID-19 diagnosis (OR, 2.61; 95% CI, 1.21-6.13; P = .016). CONCLUSIONS: Special attention should be offered to first year-MS and MS with COVID-19 diagnosis. Systematic companionship could be implemented for first year MS, and systematic psychiatric/psychological consultations for students with COVID-19 diagnosis.

Facteurs D'adversité Chez des Adolescents Issus de Milieu Aisé Hospitalisés en Psychiatrie.

Malgré l'enjeu majeur de santé publique qu'elles représentent, les maltraitances infantiles, et particulièrement les négligences, restent sous-estimées en psychiatrie, tant dans leur prévalence que leur impact sur la santé. De plus, le phénomène de maltraitance reste habituellement associé à un fort déterminisme socio-culturel et est très peu évalué dans les catégories sociales aisées. Cette étude mesure la prévalence et l'impact sur l'état médical des facteurs d'adversité précoce - maltraitances (abus et négligences) et événements de vie (divorce, séparations précoces, antécédents familiaux de maladie psychiatrique) - dans une population d'adolescents hospitalisés en psychiatrie et issus de milieux aisés, afin d'en évaluer l'ampleur et l'impact. Les résultats montrent l'ampleur et le cumul des facteurs d'adversité, incluant des fréquences élevées de maltraitances (64.8%), d'événements de vie difficile (dont 29.7% de séparations précoces et 36.4% de troubles psychiatriques familiaux). Ils soutiennent ainsi l'idée d'une sous-estimation importante de ces phénomènes en population générale et en psychiatrie, et ce, notamment dans les catégories sociales aisées. Les maltraitances sont associées à la gravité médicale (niveau de fonctionnement global, nombre et durée d'hospitalisation). Les abus sont particulièrement corrélés au nombre d'hospitalisations, alors que les négligences semblent également impacter leur durée et le niveau de gravité médicale de l'adolescent. Cette étude invite à une évaluation systématique des phénomènes d'adversité en pédopsychiatrie, quel que soit le contexte environnemental du patient, et à renforcer les prises en charge familiales ainsi que la prévention des abus et négligences.

Paradoxes in Borderline Emotional Dysregulation in Adolescence: Influence of Parenting, Stressful Life Events, and Attachment.

Introduction: Borderline personality disorder (BPD) in adolescents is characterized by emotional dysregulation, insecure attachment, a history of stressful life events (SLEs) as well as dysfunctional parent-child interactions. The respective contribution of each of these factors on BPD affective symptoms is not yet clear. The purpose of this study is to assess the distinct impact of parental adversity and SLEs on BPD affective symptoms and the role of attachment and alexithymia in such emotional processes. Method: This study explored parental dysfunction and SLEs as predictors of affective symptoms of BPD and of attachment insecurity in BPD adolescents (n = 85) and healthy controls (n = 84) aged 13-19 years from the European Research Network on BPD. The links between adversity and BPD symptoms were also investigated by emotional dysregulation assessment, as measured by alexithymia and hopelessness. Results: Dysfunctional parental interactions were linked to affective symptoms, hopelessness, and anxious attachment in healthy controls but not in BPD. Cumulative SLEs were positively correlated with affective symptoms and avoidant attachment in the control group but negatively correlated with both these variables in BPD. Multivariate regression analysis revealed that, in BPD, affective symptoms were independent of dysfunctional parenting but depended on attachment, whereas in controls, a maternal affectionless control style directly predicted affective symptoms. Moreover, increasing numbers of SLEs reduced affective symptoms in BPD, independently of parental interactions or attachment, and were associated with growing use of operative thinking. Discussion: BPD patients showed paradoxical emotional reactions: there was no increase of hopelessness and affective symptoms with an increased parental dysfunction, but a decrease in affective symptoms and hopelessness with cumulative SLE. Two pathways arose, one involving attachment as an emotional dysregulation process for parent-child interactions and a second one for SLE, with a more direct pathway to affective symptoms, independent of attachment but dependent on early interactions, and involving alexithymia. In summary, adversity factors have distinct effects in BPD, and attachment is partly accountable for affective symptoms independently of adversity. Our results suggest that in highly insecure conditions, cumulative adversity may produce paradoxical effects, including a lesser expression of affective symptoms and hopelessness.

High-risk sexual behaviours, from the neurotica to complex trauma: Psychopathologies of repetition.

In adolescent psychiatry, when patients present high-risk sexual behaviours, analysing the symptoms usually leads back to a traumatic sexual event in childhood. These clinical situations include a first stage in which the trauma is constituted and a second adolescent stage in which the mnemic trace can lead to the traumatic experience being reproduced within a destructured psychic apparatus that is seeking restructuration through actions. These two psychopathological stages are examined in the light of the connection between Freud's two paradigms of the neurotica and the theory of fantasy, focusing therapeutically either on the primacy of sexual abuse or on the psychic representation of a traumatic sexuality, respectively. Here, the elaboration of these behaviours relates either to the individual traumatic history or the transgenerational history, or to both histories, intermingled or even undifferentiated. The repetition processes and the temporary loss of reality-testing in these clinical situations are analysed there, including by the yardstick of the psychopathology of complex trauma, as well as by that of containment in the familial and therapeutic environment, from which the subject will benefit in the context of the revelation processes.

The Impact of Classroom Chatter Noise on Comprehension: A Systematic Review.

Communication through discussion and conversations is fundamental to human life; but when such discourse escapes the control of a teacher in the classroom, it becomes little more than chatter. This noise challenges teaching methods and the teaching stance with students. Yet, its impact on comprehension has rarely been studied. The aim of this literature review was to examine the research on the impact of classroom noise generated by chatter on students' comprehension performance. We adopted the PRISMA (Preferred Reporting Items for Systematic Reviews and Metanalysis) guidelines to examine this literature. This review covered a 10-year period (papers written between 2009 and 2019), with nine experimental studies selected from the 2,954 papers screened. In 89% of these nine studies, there were significant comprehension differences on all tests, revealed when comprehension took place in a noisy environment due to chatter. This review indicated an essential need for a field survey to better understand the impact of chatter on comprehension. Other studies are recommended to highlight any correlation between measured chatter and student comprehension in a real classroom environment.