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The aim of the study was to evaluate the influence of dispositional mindfulness on suicidal ideation and its moderating effect on the relationships between depressive symptoms and borderline personality traits, and suicidal ideation.A sample of 1034 students from France (818 women, mean age=20.1±2; 216 men, mean age=20.6±2.2) completed the Five Facets Mindfulness Questionnaire-Short Form (FFMQ-SF), assessing dispositional mindfulness, the Patient Health Questionnaire-9 (PHQ-9) assessing depression symptoms; the borderline personality disorder scale of the Personality Disorder Questionnaire-4th Edition (PDQ-4), and the three-item scale measuring suicidal ideation proposed by Garrison et al. (1991).At least occasional wish to kill oneself was reported by 11% of men and 10% of women. Thirty-eight percent of men and 47% of women had moderate to severe depressive symptoms (P.001). The mean borderline personality traits score for women was higher than for men (33.44±10.56 versus 31.48±10.35; P=.02), and the mean dispositional mindfulness score for men was higher than for women (77.99±12.3 versus 73.4±12.1; P.001). In order to explore the role of mindfulness as a moderator between depressive symptoms/borderline traits and the wish to kill oneself, multiple regression analyses were performed separately by gender according to the method of Hayes (2013). To assess whether the presence of dispositional mindfulness decreased the risk for persons with depressive symptoms/borderline personality traits to have suicidal ideation, the effect of the interaction between these disorders and dispositional mindfulness was tested by introducing in a second regression the cross product of these two variables. To assert moderation we had to observe that the interaction explained an additional part of the variance of suicidal ideation. For men, in the first multiple regression analysis, the FFMQ-SF score and PHQ-9 score both explained 32% of the variance of suicidal ideation (RDispositional mindfulness appeared to be a moderator between depressive symptoms/borderline personality traits and the wish to kill oneself in both genders. This finding is relevant for prevention and therapy and suggests that mindfulness may be important and useful to reduce suicidal ideation and prevent suicidal attempts in young adults.

This study aims to determine the incidence of pain in childbirth and postpartum on depressive and post-traumatic symptomatology 6weeks after delivery.One hundred and nine women who gave birth in maternity hospitals of type 2$participated in the study. Two to four days after delivery they have completed five self-administered questionnaires to assess pain of childbirth (QDSA), dramatization of pain (PCS-CF), satisfaction of childbirth (CEQ), peri-traumatic distress (IDP) and depressive symptoms (EPDS) and visual analogue scales to measure immediate postnatal pain. Six weeks after birth they have again completed questionnaires to measure pain (QDSA and visual analogue scales) and depressive symptoms (EPDS) and a scale measuring posttraumatic symptomatology (IES-R).The pain of childbirth and immediate postpartum was associated with depressive (r=0.27 and r=0.31 respectively) and traumatic symptomatology (r=0.30 and r=0.34 respectively) in postpartum. Regression analysis, however, revealed that only the depressive symptomatology and the affective dimension of postpartum pain at six weeks post-partum was related to post-traumatic stress.The results of this study highlight the importance to support the pain of childbirth but also the pain occurring in the postpartum period.

For the last decades, many researchers have focused on paranormal beliefs. Beliefs in the existence of paranormal phenomena would be common and studies conducted in westernized countries have highlighted a high prevalence of individuals believing in the existence of such phenomena. Tobacyk and Milford (1984) developed the Revised Paranormal Belief Scale (RPBS) for assessing beliefs in paranormal phenomena. This 26-item self-reported questionnaire, measuring beliefs in phenomena such as witchcraft or superstition, is one of the most widely used questionnaires to assess such beliefs. While studies focusing on paranormal beliefs tend to develop, there is no French self-report instrument to assess this construct. Researchers have tried to identify specific variables that might be linked to such beliefs, and some have focused on personalities of individuals who believe in the paranormal. Schizotypy has been reported to be significantly and positively correlated with paranormal beliefs.The aim of this study was a) to validate the French version of the RPBS and b) to explore the relationship between Schizotypal Personality Disorder traits and paranormal beliefs.After being recruited using the Internet and social networks (e.g. facebook), a sample of 313 participants (mean [SD] age=31.12 [11.62]; range 18-58years) completed the Schizotypal Personality Questionnaire (SPQ-B), assessing Schizotypal Personality Disorder traits and the Revised Paranormal Belief Scale assessing paranormal beliefs.Confirmatory factor analysis (CFA) was conducted to test the proposed 7-factor structure of the RPB developed by Tobacyk. Several adjustment indices were used to evaluate the model. As the first model did not fit the original one, others models were tested. Our findings indicated that a seven-factor solution, excluding 2 items, best described the item structure: (1) spiritualism, (2) superstition, (3) witchcraft, (4) precognition, (5) traditional religious belief, (6) psi, (7) and extraordinary life forms. Relationships between paranormal beliefs and Schizotypal Personality Disorder traits were also explored. Correlations between some subscales of the SPQ-B and some dimensions of the RPBS were found. The "cognition-perception" subscale was strongly correlated with the "witchcraft", "spirituality", "precognition" and "psi" subscales. Nevertheless, this subscale was lightly correlated with the "traditional religious belief" and "extraordinary life forms" dimensions. No correlation was found between the others dimensions of schizotypy as "disorganized" and "interpersonal" and dimensions of paranormal beliefs.The initial model developed by Tobacyk and Milford did not fit the data from the French population. The low internal consistencies regarding both superstition and extraordinary life forms dimensions highlighted some cultural differences that have to be acknowledged. This result emphasizes that beliefs in some extraordinary life forms as Loch Ness monster are not an important dimension to take into account in a French population. Our findings also indicate that the RPBS is a valid and reliable instrument for assessing paranormal beliefs in a French population. Our findings also highlight that such beliefs are associated with Schizotypal Personality Disorder traits. Developing research on the association between Schizotypal Personality Disorder traits and such beliefs appears of prime importance. Future studies focusing on features associated with paranormal beliefs are also warranted.

While researches focusing on posttraumatic stress disorder (PTSD) symptoms following childbirth tend to develop, few studies have been conducted on French samples. The aim of the current study was to explore the prevalence rate of women developing postpartum PTSD following preterm birth and highlighting associated features.In the 4weeks following the preterm infant's hospital discharge, a sample of 110 French women (mean age [SD]=29.5 [4.3]years) who delivered prematurely completed questionnaires assessing PTSD symptoms (Impact of Event Scale-Revised) postpartum depressive symptomatology (Edinburgh Postnatal Depression Scale), quality of marital relationship (Dyadic Adjustment Scale) and partner support (Multidimensional Scale of Perceived Social Support). Sociodemographic and gynecologic data were also gathered.Thirty percent of our sample reported a score on the IES-R highlighting a probable posttraumatic stress disorder. Increased postpartum depressive symptoms (β=0.47, P0.05), having undergone a caesarian section (β=0.24, P0.05), and prior traumatic event (β=0.20, P0.05), were independently associated with the intensity of PTSD symptoms.Given the traumatic impact of preterm birth on mothers, further studies focusing on the trauma of premature delivery are warranted.

The therapeutic alliance can be defined as a collaborative relationship between the patient and the practitioner. It represents an essential component of the psychotherapeutic process (Ambresin et al., 2007; Cungi, 2006; Martin et al., 2000). Some authors suggest that a good alliance can have a favorable impact on the therapeutic success (Barber et al., 2000; Hubble, Duncan,Miller 1999; HorvathLuborsky, 1993; HorvathSymonds, 1991). This alliance can be influenced by psychological and behavioral factors (Cungi, 2006) Thus, some defense mechanisms could prevent change or, on the contrary could facilitate adaptation (Ambresin et al., 2007) and have an impact on the therapeutic success (MurisMerckelbach, 1996). However, the relationship between therapeutic alliance and defense mechanisms represents an insufficiently explored field (Ambresin et al., 2007; Cungi, 2006). The aim of the present study was to examine the relationship between therapeutic alliance and twenty defense mechanisms in a sample of French psychiatric patients, by differentiating results in men and women. We also examined the positive and the negative therapeutic alliance.Sixty patients aged from 18 to 58 (M=41.50; SD=11.03) completed the French versions of the Defense Style Questionnaire-40 (DSQ-40) and the Helping Alliance questionnaire-II (HAq-II).Therapeutic alliance was significantly associated with each defense style: mature (0.62), neurotic (0.45) P0.01and immature (0.27) p0.05. The mature defense style was a significant predictor of therapeutic alliance (R(2) adj=36, F=12.39, β=0.65, P0.01) and of positive therapeutic alliance (R(2) adj=36, F=12.34, β=0.62, P0.001). Among women, positive therapeutic alliance was significantly associated with all mature defenses, three neurotic defenses (reaction formation, pseudo-altruism, idealization) and four immature defenses (splitting, denial, somatization, passive aggression). Among men, three mature defenses were associated (anticipation, humor, sublimation), four neurotic (reaction formation, pseudo-altruism, idealization and undoing) and two immature (somatization and denial). The negative therapeutic alliance, in our total sample, was associated with two immature defenses (denial and dissociation). Among men, displacement was the only defense associated with negative alliance, among women no defenses was significant.These results highlight the relationship between therapeutic alliance and some defense mechanisms, like some authors have suggested (Ambresin et al., 2007; BondPerry, 2004; Bond, 2004). Moreover, some defenses appeared to be more associated with a positive or a negative therapeutic alliance, and could depend on the patient gender.The present study confirms the importance of taking into account the gender in the study of defense mechanisms, and to increase our knowledge about the relationship between therapeutic alliance and defense mechanisms.

The aim of the study was to evaluate the contribution of cannabis to the prediction of delinquent behaviors.Participants were 312 high-school students who completed self-report questionnaires measuring antisocial behaviors, the frequency of cannabis and alcohol use, psychopathic traits using the Youth Psychopathic traits Inventory, borderline traits, depressive symptoms, socio-economic status, life events, attachment to parents, and low academic achievement. Hierarchical multiple regression analyses were conducted to investigate the contribution of cannabis use and potential confounding variables to antisocial behaviors.Boys reported a greater number of delinquent behaviors than girls (10.2±9.2 vs. 5.4±5.3, t=9.2, P0.001). Thirty-seven percent of boys and 24 % of girls reported having used cannabis at least once during the last six months (P0.001). Among cannabis users, boys reported a greater frequency of use than girls: average use for boys was 2-3 times per month whereas average use for girls was once a month (3.4±2.3 vs. 2.6±2, t=2.9, P=0.004). Cannabis users reported a greater number of antisocial behaviors than non-users (13.2±9.9 vs. 6.1±6.3, t=13.6, P0.001). Multiple regression analyses showed that cannabis use was a significant independent predictor of antisocial behaviors in both gender (β=.35, P.001 in boys, β=.29, P.001 in girls) after adjustment for alcohol use, psychopathological and sociofamilial variables.The unique and independent association between frequency of cannabis use and antisocial behaviors does not indicate the causal direction of the relationship. It may be that cannabis use induces antisocial behaviors by enhancing impulsivity or irritability or by the need for money to buy cannabis. Conversely, antisocial behaviors may lead to cannabis use either through becoming used to transgressions or through the influence of delinquent peers using cannabis. This link is probably bidirectional, cannabis use and antisocial behaviors influencing mutually in a negative interactive spiral. This association suggests that these two problems are to be jointly approached when treating adolescents using cannabis or having antisocial behaviors.

While cannabis has been recognized as the most illicit drug use in the world, few studies focusing on cannabis self-change and cannabis relapse or abstinence in adult non-treatment samples have been conducted. The first aim of this study was to understand cannabis self-change motives, coping and adaptation strategies and evaluating perceived benefits from cannabis cessation. The second aim was to compare, in a convenience sample of non-treatment-seeking adult cannabis smokers, motivations to quit smoking cannabis, coping and adaptive strategies, as well as perceived benefit from cessation between cannabis abstinent and participants who relapse.Sixty-three participants (31 men and 32 women) who attempted to quit cannabis in a non-controlled environment without medical help and were enrolled. They completed the Marijuana Quit Questionnaire (MJQQ), a self-report questionnaire collecting information in three areas: sociodemographic characteristics, cannabis use history (including any associated problems), and participants' characteristics regarding their "most difficult" (self-defined) attempt to quit in a non-controlled environment. For this study the index quit attempt was characterized in two areas: reasons for quitting marijuana, coping strategies used while quitting. Two additional questionnaires were added to the MJQQ; the Brief Cope, and a questionnaire assessing perceived benefit of the cannabis quit attempt. The participants were on average 28.5 years old (±5.1), and started using cannabis on average at 15.8 years (±2.8). Seventy-four percent (n=45) of the participants met the DSM-IV criteria for cannabis dependence before cannabis cessation. T-tests were used to compare abstainers and participants who relapsed after the quit attempt.Realizing that cannabis induces disabling cognitive disorders such as affection of memory, concentration and attention were reported by 71% of the participant as a motivation for quitting cannabis use. Then, being more energetic (reported by 68%) and more active during the day (62%), being able to control their life (67%), proving themselves they could quit (60%), saving money (60%), as well being less worried about their health (57%) were also reported as motivations to quit cannabis use. Different coping and adaptation strategies were also reported. First, environmental strategies such as disposing of both cannabis (71%) and equipment to smoke (71%), no longer going to places where cannabis is smoked (33%) or lifestyle changes (68%) were used to cope with cannabis cessation. Then cognitive strategies such as motivation, willingness (71%), self-control and having a positive perception of the situation (68%) were also reported. Regarding coping strategies, participants accepted and learned how to live with the new situation (68%), and social support from family (32%) and friends (30%) were reported. Perceived benefits were linked with motivations for cannabis cessation. Thus, participants reported having more energy (75%), being more active (73%), less tired (70%) and recovering memory (57%) after cannabis cessation. Fifty-two percent of participants relapsed after the quit attempt. Abstainers had significantly higher scores on two subscales: the "negative impact of cannabis use on one's health and on self and social image" (t(61)=-3.84; P0.001; d=-0.76) and "negative reinforcement (e.g. seeking relief for specific physical symptoms or social problems caused by cannabis)" (t(61)=3.56; P=0.01; d=-0.51) than non-anstainers. Non-abstainers reported significantly less social support from family (t(61)=-3.85; P0.001, d=-0.76) and friends (t(61)=-2.22; P=00.03, d=-0.51) than abstainers.This study underlines different aspects of cannabis cessation, self-change, relapse, and abstinence. Social and family support, as well as social network appears to be of prime importance in relapses and prevention programs for cannabis use. New perspectives for research on cannabis cessation self-change and relapses are thus highlighted, notably regarding factors that could predict relapse or success in cessation of smoking cannabis. Research on cannabis self-change and relapse are warranted for both prevention and therapeutic programs.

Certain research has pointed out the relative importance of cognitive distortions in the development of antisocial behavior. Distortions of social cognitions that facilitate aggression and other types of antisocial behavior have been described as self-serving cognitive distortions (Barriga et al., 2001 [2]). Considering the importance of the assessment of delinquent cognitive distortions, an instrument has been validated to measure self-serving cognitive distortions: the How I Think Questionnaire (HIT-Q, Barriga et al., 2001 [2]). Thus, the aim of the present study was to evaluate the convergent, discriminant and concurrent validity of a French version of the HIT-Q and its four dimensions (self-centered, blaming other, minimizing/mislabeling and assuming the worst).A sample of 972 French high-school students completed the Youth Psychopathic traits Inventory (YPI ; Andershed et al., 2002 ; Andershed et al., 2007 [26,27]) used to evaluate the convergent validity of the HIT-Q. To investigate discriminant validity, participants also completed the Sociomoral Reflection Measure-Short Form (SMR-SF ; Gibbs et al., 1992 [28]) and the Interpersonal Reactivity Index (IRI ; Davis, 1983 [29]) used to assess cognitive and affective empathy. To measure antisocial behavior, the French versions of the Self-Reported Delinquency Questionnaire (SRDQ ; Le Blanc and Frechette, 1989 [22]), the Antisocial Behavior Scale (ABS ; Schawb-Stone et al., 1996 [23]), the Self-Reported Delinquency Behavior (SRDB ; Elliott and Menard, 1996 [24]) and three items of the Sexual Experiences Survey (SES ; Koss et al., 2007 [25]) were used. Two samples were composed based on the same socio-demographic (age and gender) and socio-economic characteristics and ethnic background. French males scoring in the upper quartile on the antisocial behavior total score were classified in the antisocial group (n=135) and the rest of the sample in the non-antisocial group (n=306). Convergent and discriminant validity was determined using Pearson coefficients of correlation. One-way analyses of variance were used for mean scores comparisons. Regression analysis was used to evaluate the relative contribution of self-serving cognitive distortions to the prediction of antisocial behavior.The French version of the HIT-Q showed acceptable reliability and validity and also a satisfying convergent and discriminant validity. The HIT-Q and its dimensions were positively and highly correlated to psychopathic traits (r=0.50 to r=0.61, p0.05) ; these findings suggested a good convergent validity. The correlation between self-serving cognitive distortions and social moral reasoning (r=-0.23 to r=-0.28, p0.05) and empathy (r=-0.13 to r=-0.20, p0.05) appeared to be negative and low ; this relationship was conclusive and showed a satisfying discriminant validity. Mean comparison showed that participants in the antisocial group reported higher scores of self-serving cognitive distortions and its dimensions than the non-antisocial group. Self-serving cognitive distortions significantly predicted antisocial behavior (β=0.58, SE=0.02, p0.001) and explained 34% of the variance.The study of the convergent validity of the HIT-Q with the YPI as external criteria showed they were closely linked, which suggests self-serving cognitive distortion may be the cognitive expression of psychopathic traits. The discriminant validity of the HIT-Q with moral reasoning and empathy was satisfying and similar to previous results (Lardén et al., 2006 [20]). In concordance with previous studies, delinquent cognitive distortions appeared to be a significant predictor of antisocial behavior and moreover, participants in the antisocial group reported higher scores of self-serving cognitive distortions (Capuano, 2007 ; Barriga and Gibbs, 1996 ; Nas et al., 2008 [10-12]).The present study showed that the French version of the HIT-Q presents good psychometric properties.

A positive link between alexithymia and delinquency, as well as a negative link between alexithymia and emotional intelligence, has already been demonstrated. Previous studies have highlighted that emotional intelligence is associated with antisocial behaviour. Even though the frequency of alexithymia has been explored in non-clinical samples of adolescents, the relationship between alexithymia and delinquency has not been studied in community samples of adolescents. Furthermore, the link between alexithymia, emotional intelligence and interpersonal delinquency has never been explored in such a sample. The aim of the current study was to explore the relationship between alexithymia, emotional intelligence and interpersonal delinquency in a sample of high-school students.A sample of 176 high school students (98 girls and 78 boys; mean age=16.6±0.77) completed self-report questionnaires. Interpersonal delinquency was measured using self-report delinquency questionnaires. The answers are rated on a 5-point scale (from 0 times to 5 or more times) depending on the frequency of the involvement during the past year. Alexithymia was assessed using the Toronto Alexithymia Scale (TAS-20; Bagby et al., 1994 [14]). Three specific dimensions of alexithymia can be assessed: the difficulty to identify feelings, the difficulty to describe feelings, and the externally-oriented cognitive style (α=.71; α=.60, α=.43, respectively). Emotional intelligence was assessed using the French version of the Trait Emotional Intelligence Questionnaire-Adolescent Short Form (TEIQue-ASF).Among participants with a moderate to high level of interpersonal delinquent behaviour, boys presented significantly higher scores on the total TAS score than boys with a lower level of delinquent behaviour. This difference was almost significant among girls. Among boys and girls, only the score on the "difficulty to identify feelings" subscale was significantly higher in the group with a moderate to high level of delinquent behaviour. There was no significant difference in TEIque-ASF total score depending on the gender. As boys reported a higher level of interpersonal delinquency than girls, regression analysis was conducted for males and females separately. Alexithymia and emotional intelligence were entered in both analyses. These variables explained 12% of the variance in interpersonal delinquency among boys (F (7, 110)6.08, P.05), and 6% among girls, (F (7, 110)4.02, P.05). Alexithymia was the only significant predictor of interpersonal delinquency for both genders. A second multiple regression analysis was conducted using the three subscales of the TAS-20 (Difficulty to identify feelings; Difficulty to describe feelings; Externally-oriented cognitive style). These variables explained 7% of the variance in interpersonal delinquency among boys (F (7, 110)2.87, P.05), and 8% among girls, (F (7, 110)3.79, P.05). The difficulty to identify feelings was the only significant predictor of interpersonal delinquency.In line with previous studies, emotional intelligence was linked to delinquent behaviour. The results of the current study show that only alexithymia, especially the difficulty to identify feelings, and to distinguish them from bodily sensations, was significantly linked to interpersonal delinquency among both girls and boys. Difficulty to identify feelings, especially when cognitive treatment is required, could be the root cause of dysfunctional behaviours. As a consequence, individuals are led "to outsource their internal tensions" by dysfunctional behaviours such as delinquency.Our findings suggest the importance of taking into account the emotional dimensions in the care of teenagers presenting antisocial behaviours. It appears of prime importance to lead young people presenting antisocial behaviours to identify their feelings.

The aim of this study was to explore the role of the paternity leave in the appearance of the maternal postpartum depression.Fifty-one couples took part in the whole study. Between the second and the fifth day after the childbirth, the mother completed the Edinburgh Postnatal Depression Scale (EPDS), which measures the symptoms of depression and the Multidimensional Scale of Perceived Social Support (MSPSS) which measures the social support the mother has become. The father completed the EPDS. Two months and then the second time four months after the childbirth, the mother received the EPDS, the MSPSS, and questionnaires measuring the temperament of the baby, the maternal skills, the feeling of being a mother and the quality of life postpartum. In order to evaluate the paternal involvement, the father completed the EPDS and questions about paternal skills and involvement.The paternity leave seemed not to have any consequences on the results at the EPDS or other questionnaires. However, lack of paternal involvement was a significant predictor of the intensity of the depressive symptoms of the mothers.It is not the presence of the father wich seems important to take into account for detection and the traitement of postpatum depression but his participation in the care of the baby.

Desptite medical and scientific advances in the field of obstetrics, psychological trauma following a miscarriage may result in feelings of guilt. The objective of this research was an in-depth examination of the different expressions of feelings of guilt, and the factors, which are associated, and their consequencies.Thirty-one semi-directive interviews were transcribed and analysed to study themes associated with guilt.About one third of women question themselves and interpret some level of personal responsibility for their miscarriage. Many women evoke psychological causes of miscarriage. In all cases, guilt is expressed more or less directly. The lack of medical explanations for miscarriage is particularly difficult for women.The results of the current study underline the importance for careful consideration of any expressed feelings of guilt by women experiencing miscarriage; increasing basic medical information and providing overall psychoeducational support can help women better understand their experience and perhaps avoid excessive feelings of responsibility.

The object of this study is to create and put into place a psychological support intervention including three components (support, educational and cognitive) for women who have suffered a miscarriage.One hundred and thrity-four women participated in the study: 66 composed the "immediate intervention" group (II) and 68 the "differed intervention" (DI) group. All participants completed the Hospital Anxiety and Depression Scale (HADS), the Impact of Events Scale-Revised (IES-R) and the Texas Grief Inventory (TGI) at 3 and 10 weeks as well as 6 months following study enrollment.Results at 3 weeks show a significant difference between the groups for both anxiety and event impact.In terms of prevention, the brief early intervention tested in this study appears to be particularly pertinent following miscarriage.

The objectives of this study are to assess the social characteristics, coping strategies, self-esteem and depressive symptoms in a population-dependent and not dependent on video games online, in order to investigate the correlations existing between these characteristics.The study was conducted among 193 subjects. Data were collected through a global questionnaire constituted of several scales. The global questionnaire consisted of a sociodemographic part (age, sex, social status, most played game, number of hours per week devoted to the game), a questionnaire assessing dependence and abuse according to the DSM -IV-TR, the feeling of social belonging scale (or ESAS which was doubled to collect information about the belonging in real life and virtual life), the Ways of coping check-list (WCCL), the Rosenberg self-esteem scale (EES), the Quality of interpersonal relations scale (EQRI), the UCLA Loneliness scale and the Center for epidemiologic studies depression scale (CES-D). The questionnaire was broadcasted on the Internet, specifically in the forums dedicated to "massively multiplayer online role-playing games" and in young people's forums in specific subject headings.The results show that there are significant differences between the two populations, especially regarding the social characteristics, depressive symptoms, self-esteem and coping strategies. In the entire population, 66 subjects (42%) were considered dependent on online video games and 92 subjects (58%) were not considered dependent. In the dependent population, the number of hours spent playing per week, the score of social belonging in the virtual life, the coping focused on the emotion, the score of loneliness or social isolation and the score obtained on the CES-D appeared more important than the scores obtained by the non-dependent. Moreover, the average age, the scores of social belonging in real life, self-esteem and sub-dimensions "family" and "friends" of the quality of interpersonal relations scale are lower than those obtained by the non-dependent. Furthermore, the number of hours of play per week, the feeling of social belonging, self-esteem, quality of family relationships and loneliness are predictive factors of addiction to video games online.These results suggest that one of the crucial issues in dependence is the monitoring of game practice. Indeed, dependence on video games is based on a real hardware that needs to be controlled and managed by a third party before the emergence of a dependency. Therefore the results of this study suggest the establishment of better prevention, especially among parents who are confronted in majority with a world and a technology that is unknown or too complicated. In the case of a proven addiction, the study proposes care therapy focused on the social link, especially the family link, and a particular care to work on self-esteem.

This qualitative study focuses on feelings of women who receive an anonymous oocyte donation.A heterogeneous group of 12 women who were mothers or pregnant following a oocyte donation or who were waiting for a donation took part in the study. All women participated in a face to face or a telephone semi-directive interview. Questions dealt with desire for children, feelings about difficulties to have a child, place of the oocyte donor and position about revelation of origins.Several key ideas about the experience of oocyte donation can be brought out from the analysis of those interviews, particularly the psychological process implied in losing one's hope for a biological child, ambivalence towards donors, and questionings about this specific mode of conception.Women's satisfaction when the project for having a child is brought to its completion, hides neither complexity nor psychological questionings entailed by the donation process which includes a third during the conception. This study underlines the need for psychological accompaniment.

The aim of this research was to study childbirth experience for the primiparae couple.Thirty-three couples were interviewed two days after the birth in maternities.For mothers, the presence of their husbands is a support whereas men mentioned a feeling of helplessness.These results point out the need to accompany mothers and fathers during birth preparation to make this experience to be the most satisfying for both members of couple.

The aim of this research was to study childbirth experience for the primiparae couple and their emotional state in early post-partum.Thirty-three couples were interviewed 2 days after the birth. A questionnaire on childbirth experience and the EPDS were carried out.According to the results, mothers feel less satisfied, less calm, more useful and suffer more than fathers. Moreover, they consider father's participation more active and more supportive than themselves assess it. Experience of childbirth is linked with parent's emotional state in early postpartum.These results stress the importance to take into account the woman, the men and the couple as three separate and singular units and to create space for dialogue before and after childbirth.

The aim of this study was to highlight a link between childbirth pain and mood disorders in the immediate postpartum.We met 43 women at three days postpartum in a maternity unit in Toulouse (France) between January and April 2004. The mean age of the mothers was 30 years (S.D., 4.8 years; range, 18-39 years). Mothers were excluded if they did not speak French, if they had past psychiatric history, and if their baby was premature, ill, or stillborn. Pain was measured using a French version of the McGill pain questionnaire (Melzack, 1975) [Br J Psychiatry 171 (1997) 550-555]. This questionnaire called questionnaire douleur Saint-Antoine (QDSA) is composed of 58 words and 16 classes (Boureau et at., 1984) [Thérapie 39 (1984) 119-129]. Classes 1-9 provide data on the sensory qualities of pain while Classes 10-16 reflect affective characteristics. Blues symptoms was assessed with the French version of the maternity blues questionnaire of Kennerley and Gath (1989) [Br J Psychiatry 145 (1984) 620-625]. For each 28 items women have to decide how much change there is from their usual self, by ticking one choice out of five, from "much less than usual" to "much more than usual". We used the French version of the EPDS (Cox et al., 1987) [Br J Psychiatry 150 (1987) 782-786]. This scale was used to assess the intensity of depressive mood.The results revealed a significant positive correlation between the pain scores and the "maternity blues" questionnaire scores, and between pain scores and EPDS score at three days postpartum. This study shows a stronger association between intensity of postpartum blues and affective aspect of childbirth pain (r=0.48; p0.05) than between blues and sensorial aspect of pain (r=0.40; p0.05). The level of depressive mood was found to be associated with affective (r=0.32; p0.05) but not with sensory qualities of childbirth pain (r=0.28; p0.05). In a multiple regression analysis predicting intensity of postpartum blues, we entered sensorial and affective scores of QDSA, age, and postpartum blues scores. The subjects to predictors ratio was adequate for multiple regression analysis as it was around the traditional guideline of at least ten participants per predictor [Howell DC. Statistical methods for psychology. Fourth ed. Duxbury press; 1997]. This model accounted for 31% of the variance of intensity of blues (F3,39=5.9, p=0.002). Affective dimension of pain was the only significant predictor (p=0.36, p=0.047). In another multiple regression analysis predicting intensity of depressive mood, we entered the same predictors. This model accounted for 20% of the variance of blues intensity (F3,39=3.26, p=0.03). Age was the only significant predictor (beta=-0.31, p=0.04). These results confirm our hypothesis that intensity of the childbirth pain is associated with mood disorders in the immediate postpartum. Several explications can be advanced. First, maternity blues could be a reaction to stress caused by childbirth pain. Moreover, pain can be felt as a failure for women who prepared themselves to a painless labor. Indeed, the prepared childbirth training pretends to give women the ability to overcome pain through physical and mental training. Thus, their responsibility in coping with the labor is heavy and might make them feel guilty if they fail. In addition, since "the labor itself should be experienced as a positive moment" [Chertock L. Féminité et maternité: étude clinique et expérimentale sur l'accouchement sans douleur. Paris: Desclée de Brouwer; 1996], pain might be at the origin of a great disappointment [Acta Obstet Gynecol Scand 83 (2004) 57-61]. It should be noted that we used the QDSA as a measure of past pain and not as a measure of immediate pain, as Melzack recommended [Pain 1 (1975) 277-299].According to the results of this study, our hypothesis assuming a link between the intensity of labor pain and mood disorders in early postpartum appears to be confirmed. The intensity of postpartum blues is the best predictor of postnatal depression. Hence, knowledge of the risk factors, such as pain, could help to improve the efficiency of detection, and let professionals focus on the psychological impact of labor and especially on post-traumatic stress disorders.

Miscarriage is a frequent but painful event for women. This review aims to underscore psychological morbidity after miscarriage and some characteristics liable to influence women's experience. Then, the last part of the article concerns importance of psychological counselling and different counselling interventions, which have been tested. This review has for objective to provide informations about psychological experience of miscarriage for practitioners and medical teams who take care of women.

Body image literature suggests that the sociocultural environment contributes to the development and maintenance of body dissatisfaction and eating disorders by conveying thin standards of thinness. Three main sources of sociocultural influences were highlighted: family, peers and media. These three sources of pressure can lead to the internalization of messages about the importance of thinness and beauty. Among the various sources of sociocultural influences, media appear to be the most powerful communicator of these standards. Thompson et al. [Intern J Eat Disord 35 (2004) 293-304] developed a multidimensional questionnaire to assess the sociocultural influence of media on appearance: The Sociocultural Attitudes Towards Appearance Scale-3 (SATAQ-3). The SATAQ-3 is a 30-item scale composed of Likert-items in five points (1: completely disagree; 5: completely agree) including four subscales: information, pressures, internalization-general and internalization-athlete. This scale is used in Anglo-Saxon research, notably in clinical populations presenting eating disorder pathologies. People with eating disorders generally show higher scores on these four subscales.The present study is to validate the French version of the SATAQ-3.The sample consisted of 818 teenagers from private and public middle schools aged an average of 16.8 ± 1.2 years old, with an average body mass index (BMI) of 20.7 ± 2.9. Participants completed two questionnaires: the body shape questionnaire (BSQ) assessing body dissatisfaction, in particular worries about weight and body shape, and the SATAQ-3. We carried out the translation of the SATAQ-3 in parallel back-translation. First, two French-speaking people translated the English version into French. Then, two English-speakers translated the French version without the assistance of the original version. Thereafter, the two English-language versions (original version and version obtained by back-translation) were compared in order to ensure that there were no errors of meaning in the French version.A factorial analysis of the SATAQ-3 was conducted on the 818 subjects through extraction of the main components method with the extraction's rule of the curve for the Eigen values; the data was transformed through Varimax rotation. The factorial analysis showed five factors with Eigen values greater than 1 (11.3; 2.6; 2.1; 1.6; 1.07). The factors were then composed of the items presenting substantial saturation, greater than or equal to 0.5. Since only one item (20) presented saturation on factor 5, the four-factor solution was retained. These four factors accounted for 17.7, 16.3, 9.7 and 14.8% of the overall variance, respectively. This four-factor solution explains 58.5% of the total variance. The oblique rotation analysis underlined moderate to strong correlations between the four factors (0.3 to 0.66). The four factors of the factorial analysis correspond to the four subscales of the initial American study: pressures (Cronbach's alpha=0.89), information (Cronbach's alpha=0.87), internalization-athlete (Cronbach's alpha=0.82), internalization-general (Cronbach's alpha=0.92). The four subscales are positively correlated with the BSQ (0.26 to 0.55). The correlation for age and BMI indicates a very low association between these two variables and the SATAQ-3 subscales, with only one significant correlation (SATAQ-3 pressures and BMI=0.14; p0.05). Results of a regression analysis showed that body dissatisfaction (BSQ) was predicted by pressures (β=0.37, t=10.2; p0.0001), internalization-general (β=0.29, t=8.1; p0.0001). This model accounted for 38.1% of the variance of body dissatisfaction.This study shows elements of satisfactory validity for the French version of the SATAQ-3. Indeed, as for the original scale validation, the current factorial analysis revealed four factors corresponding to the four subscales developed by the authors along with similar alpha values. Research relating to the risk factors in the development of body image disturbances and eating disorders are important given their implications for future strategies of intervention and prevention. Anglo-Saxon research identified media as a powerful and influential communicator concerning sociocultural standards of beauty. Because of the lack of French studies on this subject, the newly validated SATAQ-3 could provide a means for exploring new issues related to eating disorders in this population. Implications of the SATAQ-3 are multiple, particularly to detect "risk groups" and to prevent body image disturbance and eating behaviours. The current results provide a means for research on media influence, notably in French clinical samples with eating disorders.

When the antenatal diagnosis reveals a serious anomaly of the fetus, the couple can envisage a therapeutic abortion. This qualitative study aims to bring a better understanding of emotional impact and perinatal grief after a therapeutic abortion.Seven women who have had a therapeutic abortion participated in a semidirective interview.The analysis of the collected data reveals the psychological trauma caused by a therapeutic abortion, the significant distress of the mothers accentuated by omnipresent guilt feelings, persistent symptoms of depression and anxiety. Different reactions within the couple are perceived and can lead to marital conflict.Results show a need for a psychological follow-up of the individual as well as the couple.

The aim of the study was to evaluate the incidence of depressive symptoms and suicidal ideation, and to test the mediating role of hopelessness between depressive symptoms and the wish to kill oneself.A random sample of 1547 high school students from the department of Haute-Garonne, France, (854 girls, mean age=16.9+/-1.5; 693 boys, mean age=17.4+/-1.5) completed a questionnaire assessing cannabis use, the Center for Epidemiological Studies-Depression Scale (CES-D) completed by the three items subscale measuring suicidal ideation proposed by Garrison et al. (1991) ("I felt life was not worth living"; "I felt like hurting myself"; "I felt like killing myself"). The measure of hopelessness was based on a single item, "I felt life was not worth living".At least occasional wish to kill oneself were reported by 13% of boys and 14% of girls (NS). The mean CES-D score for girls was significantly higher than for boys (20.3+/-10.7 versus 16.7+/-9.9; p0.01). According to the cut-off score of 24, 19% of boys and 34% of girls had a moderate to severe depressive symptomatology (p0.0001). The mean suicidal ideation score was significantly higher in participants scoring 24 or above on the CES-D than participants scoring less than 24 (2.4+/-2.7 versus 0.3+/-0.9; p0.0001). Among participants with CES-D greater or equal to 24, 34% reported at least occasional wish to kill oneself versus 6% of participants with CES-D less than 24 (p0.0001). CES-D scores and suicidal ideation scores were moderately correlated in girls (Pearson's r=0.59) and boys (r=0.61) in the total sample. To explore the role of hopelessness as mediator between depressive symptoms and the wish to kill oneself, multiple regression analyses were performed separately by gender. To establish mediation, three regression equations should be estimated and the four following conditions must hold: First, the independent variable (CES-D scores) must affect the mediator in the first equation; second, the independent variable must affect the dependent variable (the wish to kill oneself) in the second equation; third, the mediator must affect the dependent variable in the third equation regressing the dependent variable on both the independent variable and on the mediator; fourth, the effect of the independent variable on the dependent variable must be less in the third equation than in the second. Among girls, in the first equation, CES-D score explained 35% of the variance of hopelessness (beta=0.59, t=21.5, p0.001). In the second equation, CES-D score explained 16% of the variance in the wish to kill oneself (beta=0.40, t=12.7, p0.001). In the third equation, CES-D and hopelessness scores explained 32% of the variance in the wish to kill oneself. Hopelessness was the main predictor (beta=0.50, t=14, p0.001) while the effect of CES-D was markedly reduced (beta=0.10, t=2.9, p0.01). Among boys, in the first equation, CES-D score explained 38% of the variance of hopelessness (beta=0.62, t=20.7, p0.001). In the second equation, CES-D score explained 25% of the variance in the wish to kill oneself (beta=0.50, t=15.1, p0.001). In the third equation, CES-D and hopelessness scores explained 47% of the variance in the wish to kill oneself. Hopelessness was the main predictor (beta=0.60, t=17, p0.001) while the effect of CES-D was substantially weakened (beta=0.13, t=3.6, p0.001).These results showed a strong association between depressive symptoms and suicidal ideation in this nonclinical sample of adolescents. According to Beck's assumption, hopelessness appeared to be a mediator between depressive symptoms and the wish to kill oneself both in boys and girls. These findings are relevant for prevention and therapy. They suggest that targeting hopelessness may be as important in adolescents as in adults to reduce suicidal ideation and prevent suicidal attempts.

This prospective, longitudinal study investigated the contributive role of childbirth pain, perinatal distress and perinatal dissociation to the development of PTSD symptoms following childbirth.One hundred and seventeen women participated at the study. The first day after delivery they completed a questionnaire to evaluate pain, the peritraumatic distress inventory (PDI) and the peritraumatic dissociative experience questionnaire (PDEQ). Six weeks after birth, they completed the impact of event scale-revised (IES-R) to measure posttraumatic stress symptoms and the Edinburgh Postnatal Depression Scale (EPDS) to assess maternal depression.A multiple regression analysis revealed that only both components of perinatal distress, life-threat perception and dysphoric emotions were significant predictors of posttraumatic stress symptoms. In another multiple regression analysis predicting dysphoric emotions, affective dimension of pain was the only significant predictor.Perinatal distress was the best predictor of posttraumatic stress symptoms. Dysphoric emotions were associated with affective dimension of pain, suggesting that women distressed by the childbirth pain would have higher risk to develop posttraumatic stress symptoms.

The thin-ideal of feminine beauty has a strong impact on body image and plays a central part in eating disorders. This ideal is widely promoted by the media images that flood western societies. Although the harmful effects of exposure to thin-ideal media images have been repeatedly demonstrated experimentally in English-speaking western countries, no such studies exist in southern Europe. There is evidence to suggest that the use of average-size models could reduce these negative effects. This study investigates body image amongst French and Italian students following exposure to media images of thin or average-size models, with a neutral or supportive slogan.The data were gathered in three locations: the psychology departments of the Universities of Padua, Italy, and Toulouse, France, and lastly high schools in the Toulouse area. A total of 299 girls took part in the study; their average age was 19.9 years old (S.D.=2.54) In order to investigate the effects of media images, we created three fake advertisements, allegedly promoting body-cream. The first advertisement displayed an ideally-thin model accompanied by a neutral slogan. In the second, the model was average-size with the same neutral slogan. The last advertisement also contained the average-size model, but with a supportive slogan designed to convey acceptance of deviations from the social norms of thinness. The participants first graded themselves on a VAS of body dissatisfaction (0 to 10). On the basis of this score, we created a first group containing girls reporting body dissatisfaction (VASor=5), the second with those reporting no body dissatisfaction (VAS5). Participants were then randomly exposed to one of the three advertisements, after which they filled in the body dissatisfaction sub-scale of the Eating Disorders Inventory (EDI-2).The results showed that girls with initial body dissatisfaction reported higher body dissatisfaction after being exposed to images of ideally thin models than images of average-size models (F(1.32)=4.64, p=0.039). However, there was no significant difference between body dissatisfaction scores reported after exposure to images of average-size models accompanied by neutral or supportive slogans (F(1.39)=0.093, p=0.76).This study illustrates the negative effects of exposure to thin-ideal media images among students with body dissatisfaction. The use of average-size models in the media and advertising might help reduce these effects. No improvement was obtained via the use of a supportive slogan. These results highlight the importance of media literacy campaigns in the prevention of eating disorders.

The aim of the study was to evaluate the relative contributions of cannabis use and depressive symptoms in the prediction of suicidal ideation.A random sample of 491 high-school students from the department of Haute-Garonne, France (290 girls, mean age=16.6+/-1.4; 201 boys, mean age=17.3 years+/-1.6) completed a questionnaire assessing cannabis use, the CES-D (center for epidemiological studies-depression scale) completed by the three-item sub-scale measuring suicidal ideation proposed by Garrison et al. (J Am Acad Child Adolesc Psychiatry 30 (1991) 636-641).In the total sample, 15% of girls (n=44) and 23% of boys (n=46) reported having used cannabis at least once a month during the last three months. The mean CES-D score for girls was significantly higher than for boys (20.6+/-11 versus 18.4+/-10.9, t=2.4, p=0.01). According to the cut-off score of 24, 22% of boys and 36% of girls exhibited a moderate to severe depressive symptomatology (p=0.02). The mean suicidal ideation score was not significantly higher in girls than in boys (1.3+/-2 versus 0.95+/-1.9, t=1.7, p=0.10). At least, the occasional wish to kill oneself was reported by 17% of boys and 20% of girls (p=0.40). The contribution of cannabis use and depressive symptomatology in the prediction of suicidal ideation were tested with a hierarchical multiple regression analysis, to determine whether cannabis use improved prediction of suicidal ideation beyond that afforded by CES-D scores. In the first step, including age and sex as covariates, the model accounted for a significant and important part of the variance of suicidal ideation (41%). Age and sex were not significant predictors. The second step, with cannabis use added to the prediction of suicidal ideation, afforded an increase of 1% in predictable variance. Cannabis use (beta=0.08, t=2.2, p=0.03) was significantly but weakly related to suicidal ideation, while depressive symptoms (beta=0.63, t=17.8, p0.001) remained the main predictor. In a second regression analysis conducted among cannabis users, frequency of use was almost a significant predictor (beta=0.11, t=1.84, p=0.07).This result suggests an association between suicidal ideation, depressive symptoms and cannabis use in adolescents. Cannabis use appeared to be an independent predictor of suicidal ideation after controlling for depressive symptoms. However, the increment of variance accounted for by cannabis use was small. This suggests that cannabis use contributes to suicidal ideation independently from depressive symptoms, but weakly. A limitation to the study was the absence of control for other potential confounding variables. The association between cannabis use and suicidal ideation may be linked to common risk factors such as borderline personality disorder traits, sociodemographic and family factors. In this study, cannabis use does not appear as an important risk factor for suicidal ideation in adolescents.

Within days following birth, most women show signs of mood changes, commonly named baby blues. Baby blues can result in postpartum depression. Hence it appears important to explore in more details the clinical background related to the intensity of postpartum blues. The aim of this study is to investigate the contribution of psychological, psychosocial and obstetrical factors to the intensity of postpartum blues.One hundred and forty-eight women participated in the study and completed questionnaires three days after delivery. A questionnaire was built to collect information on psychosocial and obstetrical factors. The Maternity Blues (Kennerley and Gath, 1989) was used to assess postpartum blues. Psychological factors were measured with the Maternal Self-Report Inventory (Shea et Tronick, 1988), the Perceived Stress Scale (Cohen, Kamarch et Mermelstein, 1983) and the Sarason's Social Support Questionnaire (1983).Four multiple regression analyses were conducted to predict the intensity of postpartum blues by entering psychosocial factors, history of depression, obstetrical factors and psychological and relational factors. Significant predictors (maternal self-esteem, marital status, previous psychotherapeutic treatment, previous antidepressant treatment) were entered in a multiple regression analysis predicting the intensity of postpartum blues. This model accounted for 31% of the variance in the intensity of postpartum blues (F(4, 143)=17.9; P0.001). Maternal self-esteem (beta=-0.37; P0.001), marital situation (beta=-0.16; P=0.02) were significant predictors. Previous antidepressant treatment (beta=0.13; P=0.05) was almost a significant predictor.The preventive implication of this study is important. Some psychological and psychosocial variables predicted the intensity of postpartum blues and may be used in order to detect women who exhibit risk factors.

The link between dissociative disorders and delinquent behavior has been reported in forensic and clinical adolescents. Despite the frequency of dissociative symptoms in nonclinical adolescents, the relation between dissociative disorders and antisocial behavior has not been studied in community samples of adolescents.The aim of this study is to investigate the relative contribution of dissociative symptoms and other psychopathological variables (depressive symptoms, borderline and psychopathic personality traits often reported to be associated with behavioral problems) to antisocial behavior in a sample of high-school students.A sample of 130 participants (84 girls, 46 boys; mean age=16.9+/-1.2) completed self-report questionnaires, the adolescent-dissociative experience scale (A-DES), the center for epidemiological studies-depression scale (CES-D), the Levenson self-report psychopathy scale (LSRP), the scale of the personality disorder questionnaire (PDQ-4+) assessing the borderline personality traits, and the scale of the PDQ-4+ assessing antisocial behavior and antecedent of conduct disorder (aggression to people and animals, destruction of property, deceitfulness or theft, serious violations of rules) for the diagnosis of antisocial personality disorder. In the present study, the internal consistency of these scales was satisfactory or excellent as assessed using Cronbach's alpha. Regarding the A-DES, the CES-D, the borderline traits scale, the antisocial behavior scale, alphas were 0.94, 0.76, 0.78, and 0.91, respectively. The consistency of the LSRP scale assessing callousness (a callous, selfish, and manipulative use of others), which is considered as the core dimension of psychopathy was satisfactory (alpha=0.83), whereas the consistency of the scale assessing impulsivity was poor (alpha=0.49). This scale was not used in the present study.The comparison between boys and girls revealed the differences usually reported in studies on community samples of adolescents. Girls displayed higher scores on dissociative and depressive symptoms, and borderline traits. Boys had higher score on callousness. Among girls, dissociative symptoms were positively and moderately related to depressive symptoms (r=0.62, p0.05), borderline traits [(r=0.62, p.05), callousness (r=0.41, p0.05). Among boys, these associations were weaker (depressive symptoms, (r=0.45, p0.05); borderline traits, (r=0.47, p0.05); callousness, (r=.24, NS)]. A multiple regression analysis predicting antisocial behavior with the psychopathological variables showed that sex was a significant predictor (p0.01). The analysis was repeated for males and females separately. Among boys, the model explained a negligible fraction of the variance in antisocial behaviors (R(2)=0.12). No predictors were significant, perhaps because of the lack of power of this analysis (dissociative symptoms, beta=0.07, p=0.71; CES-D, beta=0.20, p=0.22; borderline traits, beta=0.19, p=0.30; callousness, beta=0.17, p=0.27). Among girls, the model explained a modest part of the variance (R(2)=0.30). Dissociative symptoms were the strongest predictor of antisocial behavior (beta=0.54, p0.001). Depressive symptoms were significantly and negatively related to antisocial predictor (CES-D, beta=-0.36, p=0.006). Borderline traits (beta=0.08, p=0.54) and callousness (beta=0.18, p=0.009) were not significant predictors.As in other studies, antisocial behavior appeared more linked to psychopathological variables in girls than in boys. The most salient result was the influence of dissociative symptoms on antisocial behavior in girls contrary to boys. Three hypotheses may explain this link: dissociative symptoms may facilitate antisocial acting-outs; dissociation may be a defense against anger and affect dysregulation; antisocial behavior and dissociative symptoms may be linked to a third variable such as trauma antecedents. Whereas depressive symptoms were positively linked to antisocial behavior among boys, depressive symptoms were negatively and significantly linked to antisocial behavior among girls. Depressive symptoms may inhibit antisocial behavior in girls. The association between dissociative and depressive symptoms and antisocial behavior in girls warrants further studies.

Medical interventions during the perinatal period are psychologically difficult for women and research has shown this is true as well for in-vitro fertilization procedures (IVF). This study examined the impact of IVF and different medical interventions, common to both non-pathological pregnancies and IVF, through the analysis of both quantitative and qualitative data.Twelve women undergoing IVF evaluated their experience of pregnancy and birth using measures of post-partum depression, maternal self-esteem, and semi-directive interviews.The results showed that the number of medical interventions is correlated with higher scores of post-partum depression as well as lowered scores in maternal self-esteem. Qualitative analyses of interviews showed that IVF has a complex and unique psychological impact.The results of this study underline the need for specific psychological support for women undergoing IVF treatment.

The aim of the study was to evaluate the relative contributions of peers and parental influences and adolescents' own beliefs about use, in the prediction of cannabis use.Participants were 559 high-school and secondary school students (275 girls, mean age=15.4+/-1; 274 boys, mean age=15.5+/-0.9) who completed questionnaires assessing cannabis use frequency, the number of peers using cannabis, the number of peers opposed to cannabis use, parental attitude toward cannabis use, parental present or past cannabis use and participants' expectations toward use. Parents' opinion of cannabis use was assessed using a ten-point scale ranging from zero (highly opposed to cannabis use) to 10 (highly in favour of cannabis use). The participants' opinion of cannabis use was assessed using a self-report questionnaire which was generated from a preliminary qualitative study on a convenient sample of ten adolescents who agreed to participate in a semistructured interview assessing their perceptions of the effects of cannabis use. Interviewers drew up a list of all the reported perceptions. One rater eliminated redundant responses and combined similar instances into more general terms. Responses were reworded concisely to be appropriate for a close-ended questionnaire. The final questionnaire consisted of 29 items. Items were scored on a 7-point Likert scale, ranging from 1=disagree strongly to 7=agree strongly.In the total sample (n=559), 22% of girls (n=61) and 28% of boys (n=76) reported having used cannabis once during the last six months (p=0.05); 4% of girls and 9% of boys used cannabis at least 3-4 times per week; water pipe or bong was used by 31% of boys and 28% of girls used cannabis. Cannabis users reported that 49% of their fathers were using or had used cannabis versus 10% of non-users. Cannabis users reported that 39% of their mothers were using or had used cannabis versus 22% of non-users. An exploratory factorial analysis of the cannabis use expectations questionnaire was conducted. The eigenvalue curve suggested either a two-factor solution explaining 46% of the variance. These factors were called 'positive expectancies' (eigenvalue=9.0; explained variance=29%, Cronbach's alpha=0.86) and 'negative expectancies' (eigenvalue=4.0; explained variance=17%; Cronbach's alpha=0.93). The correlation of factors was negative and moderate (Pearson's r=-0.29). Cannabis users were characterised by a higher number of peers using cannabis, a lower number of peers opposed to use, a lower level of negative opinion of parents, a higher level of positive expectancies and a lower level of negative expectancies. It is to be noted that both users and non-users tended to perceive their parents as highly opposed to use. A logistic regression analysis predicting cannabis use versus non-use was performed entering sex, the number of peers opposed to cannabis use, the number of peers using cannabis, the opinion of parents, parental present or past cannabis use and positive and negative expectations factor scores. A test of the full model with all predictors against a constant-only model was statistically reliable: the predictors reliably distinguished between users and non-users (chi(2) (8)=153.9; p0.0001). The variance in cannabis use accounted for was high, with McFadden rho(2)=0.39. Prediction success was satisfactory, with 94% of non-users and 59% of users correctly predicted. The number of peers opposed to cannabis use (B=-0.08; t-ratio=3.9; p=0.04), the number of peers using cannabis (B=0.06; t-ratio=7.9, p=0.01), the positive expectations score (B=0.94; t-ratio=26.6; p0.0001) and negative expectations scores (B=-0.50; t-ratio=11.8; p=0.0006) and father's present or past cannabis use (B=1.17; t-ratio=8.2; p=0.004) were significant independent predictors of cannabis use. These results indicated that the higher the number of peers using cannabis and the positive expectations, the higher the risk for initiation of cannabis use. The regression coefficient of the number of peers opposed to cannabis use and of the negative expectations score were negative. These results indicated that the less the number of peers opposed to cannabis use and the lower the negative expectations, the higher the risk for initiation of use. Parental attitudes toward use and mother's present or past cannabis use were not significant independent predictors of use.As our sample was non-clinical, a first limitation of our findings is that they may not be transposable to patient populations. Another limitation of our study is linked to its cross-sectional design, which prevents the attribution of causal explanations for the associations found. One of the study's strengths is that it assesses potentially important variables not evaluated in previous studies, such as the number of peers opposed to cannabis use and positive and negative expectations of use. The results of the present study suggested that the number of peers using cannabis, father's present or past cannabis use and participants' positive expectations of cannabis use were risk factors for use, whereas the number of peers opposed to cannabis use and the negative expectations of use were protective factors. Parental attitudes toward use did not appear to influence adolescents' cannabis use. In conclusion, our results may have some implications for prevention interventions. They add weight to the view that normalisation of non-use by peers facilitates abstinence. The absence of influence of parental attitudes toward use suggests that parental disapproval of use is not effective in preventing use, whereas the example of father's use or non-use influences adolescent use. The quite low correlation between positive and negative expectancies suggests that prevention interventions presenting information concerning the effects of cannabis use should focus on both reducing positive expectancies and enhancing negative expectancies.

In vitro fertilization (IVF) is long and difficult. Psychopathologic consequences of IVF have been the object of a great deal of research but few have dealt with women experiences. This study examined women experiences through the analysis of qualitative data.Six women undergoing IVF took part in a semi-directive interview.Qualitative analyses of interviews showed the variety of emotions that women experience during IVF. They experience despair, fear, solitude, unfairness, anxiety, anger, guilt but also hope and determination.The results of this study underline the need for specific support to help women with this emotional alternation.

In today's societies, pressures from the idea of thinness are omnipresent and lead to a corporal dissatisfaction with an excessive preoccupation of the body's image. It seems important to have, in France, a device that can evaluate the corporal dissatisfaction degree, for the reason that the troubles of the body's image is a common diagnostical category to the anorexia and bulimia (DSM IV, 1994). Cooper et al. (1987) have developed one-dimensional questionnaire of 34 items in order to measure the worries towards the weight and the shape of the body, called the "Body Shape Questionnaire" (BSQ). Its concurrent validity has been shown with the using of the corporal dissatisfaction under-scale of the Eating Disorders Inventory (EDI; Garner et Olmsted, 1984) and the using of the diagnostical questionnaire: Eating Attitude Test (EAT; Garner et Garfinkel, 1979). The BSQ gives us a way to explore the role of extreme worries towards the body's apparence in the development, the keeping and the treatment of eating disorders. From this point the BSQ is a tool widely used on an international level in researches on the eating disorders. It has been validited in Spain and in Germany whereas it has not been yet subject to a validation in France. For this reason, we proposed to use the BSQ on the french population.The sample is made of 242 university girl students. The average age is 20.7 years old with an standard deviation of 2.26. The size and the weight helped us to calculate the Body Mass Index (BMI) which is in fact the weight divided by the size squared. The average BMI is 21.06 kg/m2 +/- 2.87. Regarding the evaluating devices, the BSQ is presented as a scale of 34 items marked by 6 different points: 1 never, 2 barely, 3 sometimes, 4 often, 5 very often, 6 always. After getting the authorization form the authors to respect during these kinds of procedures, we have started validation. The corporal dissatisfaction under-scale of Eating Disorder Inventory (EDI, Garner et al., 1991) is made of 9 items and has a scale of 6 points going from "never" to "always". In order to evaluate the accuracy of the Body Shape Questionnaire (BSQ) in France, we made a test/retest. The concurrent validity of the BSQ has been evaluated by the EDI. The 242 subjects have been asked to fill in both questionnaires during the test and the re-test (4 weeks after the test). We have evaluated the accuracy of the BSQ with the calculation of the constancy test/retest (Pearson's r) and the measure of the internal consistency (Cronbach's alpha). Then, we tested the validity regarding an external criteria. The validation procedure is based here on an examination of the correlations between the tests results (BSQ) and another measure taken as criteria (EDI). The solutions proposed by the factorial exploratory analysis have been tested by confirmatory analysis using the 2 index of adjustment: the GFI ("Goodness of Fit Index") and the CFI (Comparative Index of Bentler) which, greater than 0.85, shows a satisfying adjustment and the RMC (redidue) which has to be less than 0.10 for a satisfying adjustment. Finally, inferential statistical analysis have studied the relations between the weight's category and the total result at the BSQ and the results of the factors sprung from factorial analysis.Correlations between the items of test/re-test BSQ are greater than 0.93. The alpha coefficient is high for the test (0.95) and also for the re-test (0.94). This shows a very good internal consistency between the 34 items of the BSQ. Concerning the EDI, the correlation between the test/re-test are greater than 0.98. The alpha coefficient of Cronbach is high: 0.85 for the test and 0.84 for the re-test. The Pearson's r of the BSQ/EDI test and the BSQ/EDI re-test greater than 0.7 point out the concomitant validity of the BSQ with the EDI. We made a factorial analysis of the BSQ (test) on the 242 subjects. We used the extraction of the main components method with the extraction's rule of the curve for the real values. The transformation method used here is the normalised Varimax. The factorial analysis shows four factors with their own value greater or equal to 1 (15.1; 1.77; 1.48; 1.08). This solution concerning these four factors explains 55.2% of the total variance. The oblical rotations analysis of the four factors seems to point out a high correlation between these latters (from 0.54 to 0.77), this suggests a hierarchical pattern with a single factor which is confirmed with an Cronbach's alpha of 0.95. Then, we chose to gather around each selected factors the items presenting a substantial saturation, greater than or equal to 0.5 and which are saturated by only one factor. The first factor obtained by the factorial analysis of the BSQ has been called "social avoidance and shame of the exposure of the body". The internal coherence of this factor is satisfactory (Cronbach's alpha = 0.87). The second factor obtained has been called "body dissatisfaction compared to the lower parts ot the body (Cronbach's alpha = 0.90). The third factor has been called "using laxatives and vomiting in order to reduce body dissatisfaction" The fourth factor has been called "unsuited cognitions and behaviours in order to control the weight (Cronbach's alpha = 0.76). The solution with 1 and 4 factors has been tested by a confirmatory analysis. The adjustment parameters of the unifactorial pattern were not satisfactory (GFI = 0.76, CFI = 0.83, RMC = 0.5). The 4 factors pattern adjusted better to the data (GFI = 0.86, CFI = 0.90, RMC = 0.5). In order to determinate the differences between the weight/score categories to the BSQ) score in comparison to the 4 factors (coming from the factorial analysis), several Anova have been released as well as post-hoc tests (test of Sheffé). There is a significant effect of the weight category on the corporal dissatisfaction (BSQ result), F (2.230) = 11.34; p0.0001. Scheffe's test placed in a prominent position the fact that the subjects having an overweight (99.85 +/- 31.34) have a corporal dissatisfaction significantly greater than the subjects having a normal weight (74.08 +/- 27.94) and presenting a thinness (63.19 +/- 23.61). We pointed out a significant effect of the weight category on factor one "social avoidance and shame of the exposure of the body" [F (2.232) = 20.18; p0.001], on factor 2 "body dissatisfaction compared to the lower parts of the body" [F (2.232) = 6.38; p0.005] and factor 4 "reduce body dissatisfaction and unsuited cognitions and behaviours in order to control the weight" [F (2.232) = 5.67; p0.005]. However, there is no effect in the weight category for factor 3 "using laxatives and cominting in order to reduce the corporal dissatisfaction" [F (2.232) = 5.67; p0.05]. Sheffe's test highlighted the fact that the subjects having overweight have a result more important than the ones having a normal weight and presenting a thinness for factor 1.2 and 4.The BSQ "French version" seems in fact to present the same metrical qualities than its original Anglo-Saxon and Spanish versions. The concluding results invite us to continue our study of the BSQ including in our patients, the bulimic subjects and the ones who are worried about corporal aspect. Its implications on the clinical field could be really interesting especially on people suffering from the eating disorders. Then, the BSQ could provide us a way to explore the role of an extreme worry of the body's appearance in the development, the maintenance and the treatment of the eating disorders.

The postpartum is a high-risk period for the occurrence of anxious and depressive episodes. Indeed, during the first few days after delivery, mothers can present postpartum blues symptomatology: fatigue, anxiety, disordered sleeping and a changing mood. Postpartum depression is characterised by a changing mood, anxiety, irritability, depression, panic and obsessional phenomena. It occurs in approximately 10 to 20% mothers. The exact prevalence depending on the criteria used for detection. The first symptoms usually appear between the fourth and sixth week postpartum. However, postpartum depression can start from the moment of birth, or may result from depression evolving continuously since pregnancy. We can add that the intensity of postpartum blues is a risk factor that can perturb maternal development. So it is important for health professionals to dispose of predictive tools. This study is a validation of the French version of the EPDS. The aims of the study were to evaluate the postpartum depression predictive value at 3 days postpartum and to determine a cut-off score for major depression. Subjects participating in this study were met in 3 obstetrical clinics in, or in the vicinity of, Toulouse. Mothers with psychological problems, under treatment for psychological problems or mothers whose babies present serious health problems were excluded from the study. The EPDS was presented to 859 mothers (mean age=30.3; SD=4.5) met at one of the clinics at 3 days postpartum (period 1). They had an EPDS mean score of 6.4 (SD=4.6); 258 (30%) mothers had an EPDS score 9. 82.6% of these mothers experienced a natural childbirth and 17.3% a caesarean section; 51.5% gave birth to their first child, 36.2% to their second child and 12.3% to their third or more. All subjects were given a second EPDS with written instructions to complete the scale during the period 4 to 6 weeks postpartum and return it for analysis (period 2). Between the 4 to 6 weeks postpartum period, 722 mothers replied again to the EPDS. 131 mothers had an EPDS score 11 (mean age=30.3; SD=4.8). They had an EPDS mean score of 13.6 (SD=3.3). Mothers with probable depression were interviewed and assessed, using the Mini (Mini Neuropsychiatric Interview, Lecrubier et al. 1997), the SIGH-D (Structured Interview Guide for the Hamilton Depression Scale) and the BDI (Beck Depression Inventory) in order to diagnose a major depressive episode. They had a HDRS mean score of 13.7 (SD=5.1) and a BDI mean score of 13.6 (SD=5). At 3 days postpartum, we observed that 258 mothers (30%) had an EPDS scores 9 and 164 mothers (19%) had an EPDS scores 11. Between 4 and 6 weeks postpartum, we observed 18.1% of postpartum depression (EPDS 11) and 16.8% (EPDS 12) of major postpartum depression. The analysis of the sensitivity and the specificity at 3 days postpartum provides a cut-off score of 9 (Sensibility: 0.88) (Specificity: 0.50) as predictive of postpartum depression, for this cut-off score, the type I error is low (5.8%) but the type II error is more higher (18.9%). The analysis of the sensitivity and the specificity between 4 and 6 weeks postpartum provides a cut-off score of 12 (Sensibility: 0.91) (Sensibility: 0.74) for the detection of major postpartum depression. Factor analysis shows at 3 days postpartum that the internal structure of the scale is composed of two subscales. The first factor F1 "anxiety" accounts 28% of the variance and the second factor F2 "depression" accounts 20% of the variance. Between 4 and 6 weeks postpartum, factor analysis suggests an unidimensional model in the evaluation of postpartum depression which is better than a two factor model. This factor accounts 40% of the variance. The scale has a good predictive value, and we can observe a significant correlation with the EPDS periods 1 and 2 (r=0.56; p0.05). This result shows that the depressive mothers mood intensity predicts a future depressive risk. Furthermore, correlations between EPDS and BDI (r=0.68; p0.05) and EPDS and HDRS (r=0.67; p0.05) show a good convergent validity. The reliability study confirms the good internal consistency of the EPDS, at 3 days postpartum and in the postpartum depression -symptomatology evaluation (Cronbach's Alpha0.80). In conclusion, this scale demonstrates good validity and is fast and easy use in obstetrical services, allowing early detection of women who risk to develop postpartum depression and, in the first week of postpartum, of mothers who suffer from a major postpartum depression. The use of the EPDS for an early screening of the risk of postnatal depression which is essential considering the consequences that postnatal depression can have on the development of the infant, on the quality of the relationship within the couple and on other social relationships. Mothers at risk for postnatal depression should be controlled and surveyed by the health professionals in obstetrical clinics.

The aim of the study was to compare perceptions of cannabis use effects and risks of tolerance effect, withdrawal syndrome, dependence and repercussions on school, social, and familial functioning among adolescent cannabis users and non users. Subjects were 210 adolescents (121 boys, 89 girls; mean age=16.3 1.3) from the department of Pyrénées-Orientales, France. Subjects completed a questionnaire assessing the frequency of cannabis use, the method of using cannabis, and including open-ended questions (What are the different methods of cannabis use? What are their pleasant and unpleasant or negative effects? What are their risks? Do you think that cannabis effects decrease in intensity when you are used to it? When someone is used to cannabis and stop using it (or has no more of it), does she experience craving for cannabis and withdrawal symptoms? What do you think of cannabis use?). Among the subjects, 118 (56.2%) were cannabis users and 92 (43.8%) were non-users. Among users, 27% used cannabis once a Month or less than once a Month, 21%, more than once a Month; 24%, more than once a weeks; 6%, every day; 20%, more than once a day. The methods of using cannabis were joints (76%), bong (40%), pipe (23%), and ingestion (18%). Knowledge of methods of using cannabis was higher in users than non-users: joint (87% vs 64%, p0.0001), bong (69% vs 21%, p0.0001), pipe (38% vs 7%, p0.0001), ingestion (41% vs 13%, p0.0001). Fifty-four per cent of users reported that cannabis use induces pleasant affects versus 30% of non-users (p=0.0006). They were exhilaration (47% vs 9%), relaxation (40% vs 23%), cheerfulness (21% vs 10%). Twenty-seven percent of users reported that cannabis use reduces negative feelings versus 14% of non-users (p=0.02). To be more open to social relationships was mentioned by 13% of users versus 1% of non-users (p=0.0001). The negative effects that were reported were attention and cognitive impairment (13% of users vs 5% of non users, p=0.05), irritability (8% vs 8%), loss of control (8% vs 8%) and feeling faint (13% vs 6%, p=0.09). Users reported than bong has much quicker and stronger effects than joints. The effects of bong class cannabis as a hard drug. Physical negative effects or risk were reported by 35% of users versus 30% of non-users (p=0.44). Bong users described specific physical risks such as respiratory problems and fainting. No subjects reported the risk of road accidents. Most users and non-users considered that cannabis use causes dependence (60% vs 74%, p=0.03), tolerance (68% vs 60%, p=0.23), and withdrawal symptoms (76% vs 52%, p0.001). A minority of users and non-users reported that cannabis use causes a deterioration in school functioning (42% vs 20%, p=0.69), in social activities (23% vs 14%, p=0.10) and in family relationships (29% vs 20%, p=0.14). Most of users (56%) had a global positive opinion of cannabis use whereas most non-users (66%) had a global negative opinion of cannabis use. The frequency and methods of use reported in this study compare with the results of a recent study carried out in another town of the south of France. These results suggest that a high proportion of French adolescents are using cannabis and that a high proportion of users utilize bongs. Perception of cannabis effects and risks of tolerance effect, withdrawal syndrome, dependence and repercussions on school, social, and familial functioning differed between users and non-users. Users have more positive beliefs and less negative beliefs about cannabis than non-users. Users reported more frequently pleasant effects and less frequently unpleasant or negative effects, physical risks, risks of dependence, deterioration in school, social, and familial functioning than non-users. However, only a minority of non-users reported negative effects or consequences of cannabis use. None subjects reported a risk of road accident. These results suggest that information on negative effects, risks and repercussions of cannabis use may be a target for prevention intervention.

The aims of this paper is to study the relations between anxious, depressive and borderline symptomatology and cannabis use and dependence in adolescents and young adults. A convenient sample of 212 subjects composed of high-school and college students from Toulouse, France (85 boys, 127 girls; mean age=18.3 1.8 Years) completed questionnaires assessing the patterns of cannabis use, age of first use, the symptoms of dependence using a questionnaire derived from the Mini International Neuropsychiatric Interview, and the anxious, depressive and borderline symptomatology using the STAI-YA (State-Trait Anxiety Inventory; Spielberger et al., 1970), the CES-D (Center for Epidemiological Studies-Depression scale; Radloff, 1977) and the BPI (Borderline Personality Inventory; Leichsenring, 1999), respectively; 54% of subjects reported having used cannabis once during the last 6 Months (45.3% of girls and 66.6% of boys, p=0.002). Frequency of use was higher in boys: eg, 61% of boys used cannabis at least almost daily versus 31% of girls (p0.00001). Age of first use was lower in boys than in girls (14.6 2.6 versus 15.7 2.3, t=- 2.46, p=0.02). Length of use was higher in boys than in girls (3.9 2.2 versus 3 1.6, t=2.2, p=0.03). Among users, near of 64% of boys and 36% of girls met the criteria for cannabis dependence (p=0.003). BPI, CES-D and STAI-YA scores were compared between non-users and users and between non-dependent and dependent users: the only significant differences were that BPI scores were higher in users versus non-users and in dependent users versus non-dependent users; CES-D and STAI-YA scores did not distinguished users from non-users and dependent users from non-dependent users. BPI and CES-D scores were correlated with the length of cannabis use (Pearson r=0.19 and r=0.19, respectively, p0.05). In a multiple regression analysis predicting the frequency of cannabis use, we entered age, sex, CES-D, STAI-YA and BPI scores. This model accounted for 23% of the variance of the frequency of use (F5,206=14.4, p0.0001). Sex, age, and BPI scores were significant predictors (b=- 0.31, t=- 5.03, p0.0001; b=0.29, t=4.87, p0.0001, b=0.27, t=3.80, p0.0001, respectively). CES-D scores were a nearly significant predictor (b=- 0.17, t=- 1.96, p=0.051). STAI-YA scores were not a significant predictor (b=0.11, t=1.29, p=0.20). In a multiple regression analysis predicting the dependence scores, we entered age, sex, frequency of use, CES-D, STAI-YA and BPI scores. This model accounted for 41% of the variance of the dependence score (F6,107=12.6, p=0.005). Frequency of use and BPI scores were significant predictors (b=0.51, t=6.12, p0.0001; b=0.26, t=2.86, p=0.005, respectively). Age, sex, CES-D and STAI-YA scores were not significant predictors (b=- 1.04, t=- 1.32, p=0.19; b=0.008, t=0.09, p=0.92; b=0.16, t=1.53, p=0.12; b=- 0.14, t=- 1.46, p=0.15, respectively). The frequency of use and dependence observed in this study confirm the results obtained in epidemiological studies of use and dependence in France. The high frequency of daily or almost daily users suggests that a high proportion of subjects were "high" while completing the questionnaires. This is a confounding variable now inevitable in epidemiological studies of cannabis use given the high proportion of daily users. The consequence may be that responses to mood questionnaire express both the acute effect of cannabis consumption and the chronic effect that might be different: the acute euphoriant effect of cannabis may mask a chronic depressive symptomatology induced by chronic cannabis consumption. The antidepressant and anti-anxiety acute effect of cannabis may explain that CES-D and STAI-YA scores did not distinguished users from non-users and dependent users from non-dependent users. The correlation between length of use and CES-D scores may reveal the depressant chronic effect of long-term use. The correlation between length of use and BPI scores suggest that long-term cannabis use induces an increase in borderline symptomatology. Results of the regression analyses suggest that the borderline symptomatology is highly linked to frequency of use and cannabis dependence. This may be due to the increase in borderline symptomatology induced by both acute and chronic effects of cannabis. The relation between cannabis use and dependence on one hand and anxious and depressive symptomatology on the other hand may have been obscured by the acute mood effect of cannabis consumption. Borderline symptomatology appeared to be highly linked to cannabis use and dependence in adolescents and young adults. Borderline personality disorder in adolescents is not the only risk factor for cannabis use and dependence in adolescents: borderline symptomatology even at a subclinical level seems to be a higher risk factor than anxious or depressive symptomatology. The frequency of daily or almost daily users may be a confounding variable for the study of relations between anxiety and depressive disorders in adolescents and young adults.

Precise diagnosis of eating disorders has long been problematic. First off, although the DSM IV provides clear criteria, these are applicable to a very narrow range of disorders. Subclinical disorders, although well defined in the literature, are difficult to diagnose as no tool has been previously available. These subclinical disorders are particularly important if one considers that they are often precursors to more serious and life-threatening eating disorders. In addition, choice of diagnostic tool for eating disorders has also long been the cause of difficulty for both researchers and clinicians. Although interviews are favored for their in-depth approach, they are sometimes difficult to implement and often too long and costly to use on a regular basis. Most available questionnaires are limited by their approach to one or two diagnostic categories, and again, until now, no tool has fully addressed the issue of subclinical disorders. The goal of this work was to translate and use a new questionnaire, The Questionnaire for Eating Disorders (Q-EDD), which was developed in the United States and based on both DSM IV criteria as well as carefully developed subclinical disorder criteria. The Q-EDD can identify the major eating disorder categories while at the same time distinguishing between different qualities in each (for example restricting versus compensatory anorexia). Moreover, the Q-EDD can identify several subclinical disorder categories, providing useful insight into potentially dangerous evolution of these disorders. In collaboration with one of the original authors, the questionnaire was translated into French with careful attention to DSM IV criteria in order to preserve its original validity. The questionnaire was read by several professionals in psychology as well as lay people to assure its face validity and ease of use. Once the questionnaire was adequately translated and corrected, it was used for an epidemiological study with a large sample of adolescents and young adults (n=1 001) from several Junior High and High Schools in the greater metropolitan area of Toulouse, France. The schools were located in a variety of neighborhoods and represented a wide range of population, some of them being more academic oriented, others being more oriented towards practical training. The population was composed of 703 females and 298 males, with an average age of 17.06 years. In addition, the population included several different ethnic categories, all of which are similarly represented in the general French population. The results from the Q-EDD showed levels of various clinical disorders to replicate data from previous epidemiological studies with 1.5% of the population suffering from a serious clinical DSM IV disorder; 7.9% suffering from DSM IV disorders NOS; and 20.9% suffering subclinical disorders. In addition to this finding of 30% of the population with an eating disorder, it was noted that a large number of these young people fell into the severe underweight and low weight categories. Indeed, nearly 10% of this group were within the weight criteria for anorexia, despite the fact that they did not meet the other criteria. This finding seemed to warrant additional investigation, and as a result, a different cut-off for severe underweight was established using literature references; this cut-off was set at the 10(th) percentile for BMI based on age. Yet, even with this new cut-off, 6% of this population still met a severe underweight criteria suggestive of anorexic pathology. These results led to the formulation of 2 hypotheses to explain this finding, the first of which examines morphological differences, the second of which suggests cultural differences in terms of eating habits and diet. The French version of the Q-EDD appears to follow the psychometric properties of the original version, moreover it provides useful and rich data regarding eating disorders in a format that is simple and efficient.

To examine the comorbidity of borderline personality disorder and other personality disorders in a nonclinical sample of high-school students.311 high-school students who completed the French version of the CES-D (Center for Epidemiological Studies-Depression Scale), were asked to participate to interviews evaluating personality functioning: 60 subjects (19%) accepted to participate in the study. The mean CES-D score of these 60 subjects (16 boys, 44 girls, mean age=17.7 1.7) was significantly higher than the mean score of the whole sample (23.9 10.4 versus 16.7 9.8). Thus the interviewed sample was not representative of the population of high-school students. Subjects were assessed using the major depressive episode module of the MINI (Mini International Neuropsychiatric Interview) and the SIDP IV (Structured Interview for DSM IV Personality). Inter-rater reliability was determined by comparing the independent ratings of interviewers and an experienced clinician on a random sample of 20 interviews. For DSM IV borderline personality disorder diagnosis, the Cohen's kappa coefficient was 0.85. For personality disorder criteria, kappa ranged from 0.6 to 1.0 (average kappa=0.79).Sixteen of these subjects (26,7%, 4 males, 12 females) received a diagnosis of borderline personality disorder according to DSM IV criteria. The mean CES-D score of borderline subjects (30.6 10.2) was significantly higher than the mean score of nonborderline subjects (21.6 10.5). Of the 16 borderline subjects, 11 (75%) received a diagnosis of major depressive disorder versus 14 (31%) of the non borderline subjects. None of the other personality disorders approached the frequency of borderline personality disorder. The next most frequent diagnoses were depressive and dependent personality disorders which occurred in respectively in 16.6% and 10% of the 60 subjects. All the personality-disorders occurred at higher rates in the group with borderline personality disorder with the exception of obsessive-compulsive personality disorder which was diagnosed only in nonborderline subjects. Of the 16 borderline subjects, 11 (68.7%) met the criteria for another personality disorder which were depressive personality disorder (N=5), paranoid personality disorder (N=4), dependent personality disorder (N=3), antisocial personality disorder (N=2), histrionic personality disorder (N=2), avoidant personality disorder (N=2), negativistic personality disorder (N=2), schizotypal personality disorder (N=1), narcissistic personality disorder (N=1), self-defeating personality disorder (N=1). The optional diagnoses (self-defeating, depressive and negati-vistic personality disorders) accounted for 8 of 23 (34.7%) cases of personality disorders diagnosed among borderline subjects. Among these 11 adolescents, 5 received 2 diagnoses of personality disorders (borderline and paranoid personality disorders, N=1; borderline and dependent personality disorders, N=1; borderline and depressive personality disorders, N=3), 3 received 3 diagnoses (borderline, antisocial and histrionic personality disorders, N=1; borderline, avoidant and negativistic personality disorders, N=1; borderline, depressive and negativistic personality disorders, N=1), 3 received 5 diagnoses (borderline, paranoid, histrionic, narcissistic and dependent personality disorders, N=1; borderline, paranoid, dependent, avoidant and depressive personality disorders, N=1; borderline, paranoid, schizotypal, antisocial and self-defeating personality disorders, N=1). Among the 44 adolescents (12 boys, 32 girls) without borderline personality disorder, 10 (22.7%) (3 boys, 7 girls) met the criteria for another personality disorder which were depressive personality disorder (N=5) or cluster C disorders -obsessive-compulsive personality disorder (N=4), dependent personality disorder (N=2), avoidant personality disorder (N=1) - with the exception of one diagnosis of histrionic personality disorder. Two subjects received 2 diagnoses (obsessive-compulsive and depressive personality disorder). The internal consistency of personality disorders criteria was assessed with Cronbach's alpha coefficient. Borderline personality disorder criteria had high internal consistency (0.82). The factor structure of borderline personality disorder criteria was studied with an exploratory factorial analysis which extracted three factors. The eigenvalues were 3.70, 1.06, and 1.01. Confirmatory factorial analyses were conducted. The correlated two-factor model and the three-factor model fit the data well but the correlation between factors was, however, judged too high, ranging from 0.70 to 0.78. The one-factor model proved to have a good fit (Goodness of Fit Index=0.89, Comparative Fit Index=0.90, Root Mean Square Residual=0.07). As a previous study showed the frequency of two schizotypal personality disorder criteria (odd beliefs/magical thinking experiences and unusual perceptual experiences), an exploratory factorial analysis was performed on the combined set of criteria of borderline and schizotypal personality disorders. It yielded 2 factors: the first factor consisted of all the borderline personality disorder criteria, odd beliefs/magical thinking, and unusual perceptual experiences and could be called the borderline factor; the second factor consisted of the paranoid and the social avoidance criteria and could be called the interpersonal hypersensitivity factor. A confirmatory factor analysis showed that this two-factor model provided a good fit to the data (GFI=0.82, CFI=0,91, RMSR=0.10). The correlation between factors was weak (0.25). These results suggest that odd beliefs/magical thinking and unusual perceptual experiences are a component of borderline symptomatology in adolescents.The high frequency of major depressive disorder and personality disorders in the interviewed sample may be due to the possibility that adolescents with psychological problems have used the interview as a way to obtain attention and support from a psychologist. The interviewed sample, which was characterized by a high intensity of depressive symptomatology and by a high frequency of borderline personality disorder, could thus be seen as intermediate between a clinical and a community sample. Our results may be more generalizable to an outpatients population of adolescents. This study found conflicting results about the construct validity of borderline personality disorder in adolescent. The high internal consistency and the one-factor structure of the borderline personality disorder criteria argue for their validity in adolescents. However, the high rates of comorbidity of borderline personality disorder with depression and other personality disorders, extended to clusters A, B and C and to optional diagnoses, suggest the lack of construct validity of either borderline personality or cluster B disorders in adolescents.Borderline symptomatology in adolescents appears more in adequacy with a dimensional model than with a typological classification. More studies are needed to assess and improve the construct validity of borderline personality disorder in adolescents.

To evaluate the psychometric characteristics of the CES-D (Center for Epidemiological Studies - Depression Scale) in adolescents and to estimate the prevalence of major depression in French high-school students.A random sample of 2 583 high-school students from the departments of Haute-Garonne and Pyrénées-Orientales, France, were asked to complete the CES-D. Of these subjects, 1 953 (75.6%) (966 boys and 987 girls, mean age=17 1.4) completed satisfactorily the questionnaire. A sub-sample of 60 adolescents volunteered for an interview and were assessed using the major depressive episode module of the MINI (Mini International Neuropsychiatric Interview).The internal consistency of the CES-D was satisfactory (Cronbach alpha=0.85). A principal component analysis produced consistent sub-scales. The factor structure was similar to that observed in previous studies in adults. Four factors were extracted which accounted for 49.6% of the variance: a depressive cognition factor (items 1, 9, 10, 15, 19); a positive affect factor (items 4, 8, 12, 16); a factor reflecting slowing of thought and reduction of energy (items 5, 7, 20); and a depressive affect factor (items 2, 3, 6, 11, 14, 17, 18). Among the 1 953 subjects, the mean score for girls was significantly higher than for boys (18,8 10,2 versus 14,4 7,7). Of the 60 subjects who were assessed with the MINI, 28 received the diagnosis of major depressive episode. The mean scores of depressed girls and boys in this sub-sample (respectively 35.5 8.7 and 27.7 9.6) were significantly higher than the mean scores of girls and boys for the total sample. According to the results, the best cut-off score was a score of 24 or higher, providing a sensibility of 0.74 and a specificity of 0.73. According to this cut-off score, 9.9% of boys and 24.2% of girls had a probable major depressive episode.This study showed a high level of depressive symptoms and a high frequency of probable depression in French adolescents. Two findings suggest the reliability of these results: first, the male-female ratio, close to 1:2 for probable depression, is in keeping with current epidemiological data; second, the high internal consistency and the factor structure are indicators of the reliability of CES-D in adolescents. Our study found a higher cut-off score than the previous French study of the CES-D in adolescents by Bailly et al. This discrepancy may be due to our small interview sample. However, the cut-off of 24, identified with our study, provided frequency rates more in agreement with epidemiological data than the cut-off of 21 proposed by Bailly et al. Mean CES-D scores of boys and girls in our study were respectively significantly higher than those obtained in boys (n=439, 12.4 7.5) and girls (n=305, 16.6 9.7) by Bailly et al. eleven years before. Given the similarities of mean age and representativeness of samples in both studies, this discrepancy may be due to an increase in depressive symptoms in French adolescents which may be linked to the parallel increase in substance use and particularly in cannabis use.The high internal consistency and the factor structure of the CES-D suggest its reliability in adolescents. This study found a high frequency of probable major depression in French high-school students.

The term alexithymia is derived from the Greek and means no words for feeling and is used to describe a personality trait characterized by the inability to experience and express emotion. Alexithymia is a relevant feature in subjects with eating disorders. The Toronto Alexithymia Scale (TAS) is the more used scale to assess alexithymia. The TAS 20 represents the latest revised and short version of the TAS, with psychometric properties clearly superior to the other alexithymia scales. The TAS 20 is a 20-items self-administered questionnaire including three subscales: ability to identify feelings, ability to describe feelings and externally oriented thinking. The TAS 20 was sparsely used in obese people and its validity was not studied at the present time in this specific population. The aim of this study was to assess the internal consistency and the factorial structure of the TAS 20 in a group of obese women. Method-The TAS 20 was administered to 192 obese women willing to loose weight, aged from 18 to 60 years. Their body mass index (BMI) was ranged from 27.5 to 55,0 kg/m2. The patients also completed a depression scale (Beck Depression Inventory 13). Cronbach's alpha coefficient was used to investigate the internal consistency of the scale. A confirmatory factorial analysis was performed to examine the validity of the initial three-factor structure in this population. The confirmatory factor analysis was conducted using STATISTICA 5.0((R)). Results-An exploratory factorial analysis using the principal components method was performed to search for a more relevant factorial structure. The global internal consistency value (a) was 0,74 for the full scale. The a coefficients were 0.78 and 0.67 respectively, for the two first subscales, (ability to identify feelings and ability to describe feelings), but was low (a=0.33) for the last subscale (externally oriented thinking). This result questionned the initial three-factor solution and conducted us to perform a exploratory factorial analysis. This analysis yielded a six factors solution, explaining 58.7% of the total variance, with the sole item 3 forming the sixth factor. The factor analysis yielding a five factors solution was retained. This solution explained 53.6% of the total variance. The first factor (22.3% of the variance) was constituted by the majority of the first subscale's items (items 1, 3, 6, 7, 9, 11, 13, 14) and corresponded to the ability to identify feelings. Four items out of five of the second dimension ability to describe feelings (items 2, 4, 12, 17) constituted the fourth factor (7.1% of the variance) of the analysis. The third subscale (externally oriented thinking) was divided in three factors explaining respectively 10.7%, 7.5% and 6.0% of the variance. The first of them included the items 5, 10 and 18, the second one included the items 15, 16 and 20, and the last one included the items 8 and 19. We called these three factors emotional avoidance , lack of interest in psychological comprehension and cognitive avoidance , respectively. The parameter estimates of the confirmatory factorial analysis for this five-factor solution were: c(2) goodness-of-fit=287.50 (df=141; p0.001), goodness-of-fit-index=0.87, adjusted goodness-of-fit index=0.82, root-mean-square-residual=0.08. The different models were compared by testing the differences in the chi-squares. The five-factor solution was better than the other tested models. Discussion-The results of the present study indicate that the use of the TAS 20 to assess alexithymia in obese subjects willing to loose weight, requires a careful interpretation related to the features of this population. Exploratory factorial analysis suggests a five factors solution statistically and clinically more relevant than the three factors solution. The first dimension (ability to identify feelings) is retained. The second dimension (ability to describe feelings) could rather be linked to the common wishes of obese women to keep their own feelings to themselves than to a dimension of alexithymia. Our data suggest to t to divide the last initial dimension externally oriented thinking in three independant factors which we named: emotional avoidance , cognitive avoidance and lack of interest in psychological comprehension . Emotional and cognitive avoidance could be linked to the fact that our subjects wanted to loose weight and exhibited restrain eating. A positive correlation between restrain eating and alexithymia was previously reported. The last factor lack of interest in psychological comprehension would constitute an actual dimension of alexithymia: former studies found a negative correlation between alexithymia and psychologically oriented thinking.

To evaluate the connections between the frequency and patterns of cannabis use and dependence, and the beliefs linked to cannabis use in a sample of adolescents.In 2001, 285 high school students (163 boys, 122 girls; mean age = 17.5 +/- 1.1 years) completed questionnaires assessing the patterns of cannabis use, and the symptoms of dependence and abuse, using a questionnaire derived from the Mini International Neuropsychiatric Interview. Cannabis-related beliefs were assessed using the Beliefs Questionnaire for Drug Addiction.Frequency of subjects who reported having used cannabis during the last year was 65.4% of boys and 42.6% of girls. Among users, 53.6% of boys and 39.3% of girls were regular users, 10.6% of boys and 7.8% of girls being daily users. Almost half of the users reported other means of consumption than "joints", in particular water-pipes or "bongs" (34.5% of boys, 26.4% of girls). Among users, near of 33% of boys and girls met the criteria for cannabis dependence. Dependence was more frequent in users practicing other means of consumption than "joints", increasing to 51% for "bong" users. Expectancies of pleasure or relief, and permissive beliefs reflecting the perception of cannabis use as risk free were higher in users and, particularly, in subjects with cannabis dependence. Regression analysis showed that these beliefs were the strongest predictors of cannabis use and dependence. Predictors of use in the total sample were expectancies of pleasure and permissive beliefs, being a male and the age of the subject. Predictors of dependence among users were expectancies of relief, frequency of use, and use of other means of consumption than "joints".Cannabis use in adolescents appeared to be characterized by the frequency of use, consumption by means other than "joints" and by the frequency of dependence. Cannabis use and dependence are linked to expectancies and permissive beliefs that could be targeted for prevention and treatment.

This study evaluated the clinical effectiveness of a programme aimed at detecting, preventing and treating postpartum depression. The French version of the EPDS was used to measure the intensity of postpartum blues on a sample of 859 women, during their stay at the obstetrical clinic. Subjects under treatment for psychological problems were excluded from the study. Mothers scoring 9 or above on the EPDS, which is predictive of pospartum depression, were randomly assigned to a prevention and a control group. Written informed consent was obtained from the subjects after the study procedure had been explained. The prevention group received a counselling session integrating supportive, educational and cognitive-behavioral components. Therapists included five female Master's Degree level students in psychology. All therapists participated in didactic and clinical training as wells as weekly supervision from the first author. All subjects were given a second EPDS with written instructions to complete the questionnaire during the period 4 to 6 weeks postpartum and return it for analysis. At four to 6 weeks, women in the prevention group had significant reductions in the frequency of probable depression, as defined by a score of 11 or above on the EPDS (30.2% vs 48.2%, chi 2 = 7.36, dl = 1, p = 0.0067) and in the intensity of depressive symptoms measured by the mean score on the EPDS (8.5, SD = 4 vs 10.3, SD = 4.4, t = 3.06, dl = 209, p = 0.0024). Mothers with a probable depression were interviewed at home and assessed using the MINI (Mini Neuropsychiatric Interview, Lecrubier et al., 1997) to diagnose major depressive episode, the SIGH-D (Structured Interview Guide for the Hamilton Depression Rating Scale, Williams, 1988) and the BDI (Beck Depression Inventory, Beck et al., 1988). The baseline depression rating scores, EPDS (mean = 13.6, SD = 4), BDI (mean = 15.7, SD = 5.9), HDRS (mean = 14.8, SD = 6), were consistent with moderate depression. No significant differences in baseline scores were observed between the two groups on all the rating scales (p0.001). Mothers with probable depression in the prevention group were offered a program of 5 to 8 home visits. Most of the mothers in the prevention group (72%) agreed to participate in the program. On the contrary, most of the mothers (83.3%) who scored below 9 on the first EPDS and 11 or above on the second, who so did not received the preventive counselling session, declined to participate. This suggests the importance of the preventive session in establishing therapeutic alliance. The home visits program integrated four components, supportive, educational, cognitive-behavioral and psychodynamic centred on the mother-infant relationship in terms of the mother's personal history. Therapist participated in clinical training and weekly supervision. Fifteen women (71.4%) in the study group demonstrated complete symptom remission, as defined by HDRS score below 7 after the intervention, compared with 4 women (10.5%) in the control group (chi 2 = 23, p0.0001). A clearly therapeutic response to treatment was observed in the treated group with a mean reduction in HDRS score of 9.5 (DS = 6.7) from baseline. The improvement in the women in the treated group, as measured by the mean HDRS scores was statistically greater than that in the control group (m = 5.35, SD = 3.5 vs m = 15.8, SD = 4.6, t = 8.24, dl = 52, p0.0001). Our results indicate that a program based on an intervention at obstetrical clinics and on home visits is efficacious and well accepted for prevention, detection and treatment of postpartum depression.

1,363 high school students were solicited to complete a personality disorder questionnaire and were encouraged to continue in the study by signing up for interviews with Master's level psychology students. 107 students (7.8%, 34 males, 73 females, mean age = 16.7 +/- 1.8) manifested themselves for the interview and were assessed by using structured diagnostic interviews for borderline personality disorder and major depressive disorder (DIB-R, Revised Diagnostic Interview for Borderlines; MINI, Mini International Neuropsychiatric Interview). The interviews were audiotaped. Interrater reliability was determined by independent ratings of 12 borderline subjects and 12 non-borderline subjects (kappa: 0.795). The distribution of the 107 subjects based on the number of DSM IV borderline personality disorder criteria indicated a gradual dispersion suggesting a continuum from normality to borderline personality disorder: 8% of the subjects met none of the criteria; 16% met one criterion; 17% met two; 12.5%, three; 13.7%, four; 8.4%, five; 5.6%, six; 9.3%, seven; 4.6%, eight; 4.6%, nine. Thirty-five of these 107 subjects (32.7%, 6 males, 29 females, mean age = 16.7 +/- 1.7) received a diagnosis of borderline personality disorder according to DSM IV criteria. The most frequent symptoms were paranoid ideation or dissociative symptoms (97.1%), affective instability (88.6%), inappropriate, intense anger (85.6%), suicidal gestures or automutilation (82.9%), followed by frantic efforts to avoid abandonment (77%), impulsivity (65.7%), unstable and intense relationships (62.9%), identity disturbance (60%), and emptiness (57.1%). The comparison between borderline and non-borderline subjects showed that all borderline personality disorder criteria discriminated significantly between the two groups. The high incidence of paranoid ideation (97.1%) and dissociative experiences (65.7%) in the borderline group suggests the pertinence of criterion 9 in the diagnosis of borderline personality disorder in adolescents. Two criteria of schizotypal personality disorder were also frequent in this group: 68.6% of the borderline group reported odd beliefs or magical thinking, in particular beliefs in clairvoyance or telepathy and 88.6% reported unusual perceptual experiences, in particular sensing the presence of a force or person and bodily illusions. Moreover, 31.4% of the borderline group reported transient "quasi" psychotic experiences, mainly "quasi" visual hallucinations. Auditory hallucinations or delusional ideas were not observed. This symptomatology suggests a "quasi" psychotic dimension of adolescent borderline personality disorder. Affective instability was the next most frequent symptom which was usually marked by a cyclothymic appearance. Comorbidity with major depressive disorder was high: 85.7% of the borderline subjects had a concurrent diagnosis of major depression versus 45.8% of the non-borderline subjects. Thus, major depression is more frequent than most of the borderline personality disorder criteria, with the exception of the already noted paranoid ideation and affective instability. Hypomanic symptoms were frequent in the borderline group (65.7%) as well as in the non-borderline group (38.8%). This symptomatology suggests that adolescent borderline personality disorder is linked to an attenuated bipolar spectrum characterised by major depressive episodes and soft signs of bipolarity. However, hypomanic symptoms, which were quite frequent in non-borderline subjects, might also be due to a mechanism of defence, i.e. the denial of depression. Comorbidity with anxiety disorders appeared also to be high: anxiety symptoms were found in 91.4% of the borderline subjects who reported symptoms of generalised anxiety disorder, panic disorder, and somatoform disorders. The overall clinical appearance of these borderline adolescents not referred for treatment seemed to be quite similar to that of borderline adolescents in clinical samples. This study shows that adolescent borderline personality disorder in non-clinical population is a serious disorder characterised by the importance of mental suffering and behavioural disturbances the disorganising power of which may fix the developmental process in a pathological pathway. Adolescent borderline personality disorder appears in this study to be strongly associated with major depressive disorder and at-risk behaviours linked to impulsivity, affective instability, and suicidal ideation. However, this study found an absence of precise cut-off between borderline and non-borderline subjects. Two factors might have contributed to the appearance of a continuum. First, some degree of impulsivity and instability in affectivity, self-images and interpersonal relationships is part of normal adolescence. (ABSTRACT TRUNCATED)

This research evaluated nicotine dependence in adolescent smokers, their motivation to smoke and/or stop smoking, and their knowledge of how to stop smoking as well as the potential difficulties involved.Three hundred forty-two high school students completed questionnaires using two measures of dependence (the Fagerstrom tolerance test and a visual-analog self-evaluation scale), a test to measure motivation to smoke (the Horn test), and a questionnaire exploring motivations to stop smoking, methods used to stop smoking, and the anticipated difficulties.On the Fagerstrom tolerance test, 14.6% of the students indicated strong dependence, whereas 32.3% indicated intermediate dependence. The Fagestrom score was strongly correlated to the self-evaluation test (r = 0.54, P0.001) and negatively correlated with the subjects' ages at the onset of smoking (r = -0.28, P0.001). The Horn test revealed that the main motivation to smoke is the search for relaxation and a decrease of negative emotions, indicating that cigarette smoking is primarily a means to manage stress and anxiety. Eighty-nine percent of the subjects stated that they would like to stop smoking, primarily because of the financial cost and health concerns. Among those subjects wishing to stop, 64.5% had previously tried to stop and had failed and 72% believed that it would be 'difficult' or 'very difficult' to stop. The main anticipated difficulties were an increase in stress and anxiety and, for the girls, weight gain. The anticipation of these difficulties was strongly correlated to dependence scores (r = 0.43, P0.001). Despite awareness of these difficulties, only 19.6% of the subjects wishing to stop smoking expected to seek medical assistance. For most of the measured variables, there was no difference between boys and girls.This study confirms the seriousness of tobacco consumption in adolescence. The results suggest the need for early programs aimed at preventing or delaying onset of use as well as the need to develop programs to aid high school students to stop smoking.

A study of cannabis use in French adolescents was implemented using a questionnaire derived from the French version of the Mini International Psychiatric Interview based on DSM IV criteria for cannabis dependence, among a population of 256 high school students from two high schools with different SES backgrounds. Among the adolescents studied, 41.4% (n = 106) reported using cannabis occasionally or regularly, 51.2% had never used cannabis, and 7.4% had used cannabis and subsequently quit. Incidence of usage appeared to increase as a function of age, 51.4% for those 18 years and over, 44.6% for 17 years-old, and 30.4% for 16 years-old, girls tending to consume less than boys (36.4% to 45.2%). With regards to results of the MINI, of the regular or occasional users (n = 106), 47.2% of the subjects indicated substance dependence while the remaining subjects indicated that they were recreational users only. Among users, data concerning tolerance, withdrawal, and excessive consumption indicated that subjects were significantly affected by their addictive behavior; 33% of users reported having smoked cannabis for one year or less with 10.4% reporting that they have smoked for more than three years. Among those having smoked one year or less, 31.4% reported signs of dependence versus 68.6% who consume on a recreational basis; among those having used cannabis for three years or more, 63.6% reported dependence while 36.4% admitted to recreational usage. This study indicates the seriousness of cannabis usage among high-school students, underlining addictive and dependent behavior and their effects on daily life as well as significant the increase of usage with age and as a function of number of years of smoking.