Search

Objectives: 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., Patients and Methods: Thirty-one semi-directive interviews were transcribed and analysed to study themes associated with guilt., Results: 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., Conclusion: 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., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)

The aim of the authors' study was to explore a model of suicidal ideation among adolescents in which environmental risk factors were mediated by both depression and defensive psychopathology. Suicidal ideation, depression, defensive psychopathology (substance use, borderline traits or symptoms, dissociative symptoms), parental attachment, and stressful life events were assessed among 615 adolescents (62% male). Despite gender differences, the proposed model received support. Findings suggest a psychodynamic relationship linking suicidal ideation to defensive mechanisms, aiming to alleviate depressive affects.

The aim of the study was to compare levels of body dissatisfaction, disordered eating and risk factors, and to examine the tripartite influence model of body image and eating disturbance among French and Australian young adult females. Participants were 188 Australian (mean age=19.6 years, SD=1.0) and 190 French (mean age=20.7 years, SD=2.6) students. Media, peer and family influences, internalisation of media ideals, appearance comparison, body dissatisfaction, drive for thinness, bulimia and self-esteem were assessed. Australian participants reported perceiving more peer and media influence, and higher levels of appearance comparison, internalisation of media ideals and bulimic symptoms than French participants (p<.001). Path analyses revealed that the tripartite model was a good fit in both samples, with similarities and differences. Findings suggest the importance of identifying cultural specificities, and developing a global framework of body image and eating disturbance with a view to prevention., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Objectives: 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., Method: 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., Results: 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., Conclusion: 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., (Copyright © 2010 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.)

Unwanted sexual experiences occurring only in young adulthood have rarely been explored. A sample of 122 college women completed a questionnaire survey assessing previous unwanted sexual experiences, sexual satisfaction, depressive symptoms and disordered eating. Seventeen percent reported unwanted sexual experiences. Results indicated that unwanted sexual experiences were associated with disordered eating and depressive symptoms, but that sexual satisfaction was not. Furthermore, the relationship between unwanted sexual experiences and disordered eating was mediated by depressive symptoms. These findings emphasize the high rates of unwanted sexual experiences in student populations, and suggest that victims of these experiences should be screened for depression., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

This study explored the contributions of sociocultural and psychopathological factors to suicidal ideation among adolescents. A sample of 292 French high school students with an immigrant background completed a questionnaire assessing suicidal ideation, borderline personality traits, depressive symptoms, parental attachment, life events, acculturation orientations, ethnic identity, cannabis and alcohol consumption, socioeconomic status and academic failure. Although stressful life events, depressive symptoms, and individualism were risk factors, and attachment to parents a protective factor for both boys and girls, some gender differences emerged. Borderline traits (risk factor), assimilation and marginalization (both protective factors) were significant predictors only among girls.

Introduction: The therapeutic alliance in psychotherapy refers to the quality of the relationship between therapist and patient, as well as their agreement upon the aims and tasks of the treatment. This concept is widely used in clinical settings and, since the validation of a number of instruments, has become the focus of much research. However, the quantity of experimental evidence now available impedes the dissemination of these findings among clinicians in a concise manner., Literature Findings: The present paper aimed to provide a review of the literature reporting experimental evidence focusing on the therapeutic alliance. In order to do this, findings were organized around four main issues: the relationship between the therapeutic alliance and clinical outcome; the evolution of the therapeutic alliance over time; the mechanism of action by which the therapeutic alliance encourages change, and finally the factors that have been shown to influence the creation and evolution of the alliance., Discussion: This review reveals that the therapeutic alliance is to this day one of the most investigated factors of psychotherapy. The therapeutic alliance enables change to take place during psychotherapy and, along with a number of specific factors, appears to be important for clinical outcome. Over time, the therapeutic alliance has been seen to evolve and several patterns have been identified. A number of characteristics inherent to the patient, the therapist, and even their interaction have been reported to influence the development and strength of the therapeutic alliance. Several hypotheses have been put forward to account for the mechanism by which the therapeutic alliance encourages change., Conclusion: The area of research regarding the therapeutic alliance remains dynamic. Despite the present body of knowledge surrounding this concept, a number of research questions await further investigation., (Copyright © 2010 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.)

Introduction: 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., Objective: The present study is to validate the French version of the SATAQ-3., Method: 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., Results: 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; p<0.05). Results of a regression analysis showed that body dissatisfaction (BSQ) was predicted by pressures (β=0.37, t=10.2; p<0.0001), internalization-general (β=0.29, t=8.1; p<0.0001). This model accounted for 38.1% of the variance of body dissatisfaction., Discussion: 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., (Copyright © 2009 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.)

This study aimed to explore the role of depression as a moderator of sociocultural influences on eating disorder symptoms. A sample of 509 adolescents (56% female) completed self-report questionnaires assessing depression, body dissatisfaction, drive for thinness, bulimic symptoms and sociocultural influences on appearance from family, peers and the media. Both girls and boys displaying high levels of depressive symptoms perceived stronger media and peer influences on appearance. Among girls, eating disorder symptoms were directly affected by sociocultural influences, in particular media influences, as well as by depression. However, depression played only a limited role as a moderator of these relationships. Among boys, sociocultural influences and depression revealed fewer direct effects on eating disorder symptoms. However, depression had a greater moderating effect on these relationships. Future research into the role of depression may increase the understanding of gender differences in body dissatisfaction, drive for thinness and bulimic symptoms.

Unlabelled: The aim of this study was to evaluate the contribution of psychopathic personality traits to delinquent behaviour after controlling for borderline personality traits, depressive symptomatology, dissociation and cannabis use in male adolescent delinquent behaviour., Method: A sample of 155 young male participants (mean age=17+/-1.5) completed self-report questionnaires. Delinquent behaviour was assessed with the Antisocial behavior scales (ABS, Schawb-Stone et al., 1999) which include three subscales assessing behavior problems of different severity: conduct problems, assessing relatively mild behavior problems; less severe delinquency, assessing non-violent antisocial behavior; severe antisocial behavior, exploring relatively serious aggressive and antisocial behavior. The respondents were asked to report on a 5-point scale how many times (ranging from "0 times" to "5 or more times") they were involved in the described behaviors during the past year. In this study, only the two subscales assessing less severe delinquency and severe antisocial behavior were used. Personality psychopathic traits were assessed with the Youth psychopathic traits inventory (YPI; Andershed et al., 2002). It consists in three scales assessing interpersonal, affective (with callousness, which is considered as the core dimension of a psychopathy) and lifestyle traits of the psychopathic personality (alpha=0.90, alpha=0.81 and alpha=0.77, respectively). Other questionnaires assessed borderline personality traits (Borderline personality features scale for children), depression (Center for epidemiological studies-depression scale), dissociation (Adolescent dissociative experience scale) (alpha=0.83, 0.88 and 0.92 respectively) and cannabis use., Results: In the present study, the frequency of antisocial behaviour was important (55%): 7% of the adolescents had stolen a bike or a car at least once, 11% had committed a theft at least once, 36% had started a fight at least once, and 25% had threatened someone seriously or beaten up somebody at least once, 15% had had hurt someone badly in a physical fight so they had to be treated by a doctor or a nurse at least once, 21% had carried a blade, knife or gun at least once, 9% had been involved in a gang fight at least once, and 12% had carried a blade, knife or gun in school. A multiple regression analysis predicting antisocial behaviour in the total sample with the psychopathic and borderline traits, depressive and dissociative symptoms, alcohol and cannabis use, showed that delinquent behaviours were only predicted by alcohol and cannabis use and the psychopathic trait "callousness"., Discussion: This study suggests the importance of callousness in explaining adolescent delinquent behaviour. Other psychopathological variables did not appear to influence delinquent behaviour in this sample., (2009 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.)

The aim of the study was to evaluate the contribution of cannabis to the prediction of delinquent behaviors. Participants were 615 high-school students who completed self-report questionnaires. Hierarchical multiple regression analyses showed that cannabis use was a significant independent predictor of delinquent behaviors after adjustment for alcohol use, psychopathological and socio-familial variables. Cannabis use was associated with greater numbers of delinquent behaviors among adolescents with higher scores on psychopathic traits or depressive symptoms., (Copyright 2009 Elsevier Ltd. All rights reserved.)

Background: approximately 56% of babies in France are breast fed at birth compared with approximately 91% in Germany. Few studies have compared these neighbouring countries despite the similarities in their social systems., Objectives: to compare breast-feeding initiation and duration from birth to 3 months post partum between French and German mothers, as well as reasons for breast-feeding cessation in the first 3 months., Design: mothers were contacted twice during the study: immediately after childbirth and at 3 months post partum., Participants: 126 French mothers were recruited during their maternity stay in hospital, and 80 German women were recruited by their midwives and contacted via regular mail. All women were primiparous., Methods: breast-feeding rates at birth and 3 months post partum were collected and compared. In addition, reasons for breast-feeding cessation in the first 3 months were explored and analysed., Results: 96% of German women initiated breast feeding at birth and 83% were still breast feeding at 3 months post partum. In comparison, 67% of French women initiated breast feeding at birth and 34% were still breast feeding at 3 months post partum., Conclusion: there is a need for postnatal follow-up care for French mothers who breast feed. Follow-up care available for German mothers shows encouraging results., (Copyright 2008 Elsevier Ltd. All rights reserved.)

Immigrant adolescents and adolescents born of immigrant parents are at increased risk of substance use which has been linked to difficulties in acculturation processes. However very few studies have examined the role of the different acculturation strategies and none of them have controlled for relevant psychopathological and socio-familial factors. The aim of this study was to investigate the role of acculturation in cannabis use in a sample of adolescents born of immigrant parents taking into account potential confounding variables. A sample of 292 high school students born in France from at least one foreign parent completed a questionnaire assessing cannabis use, acculturation orientations, ethnic identity and the most relevant potential confounders (depressive symptoms, sensation seeking, borderline and psychopathic traits, alcohol and tobacco use, parental attachment, life events, socioeconomic status and academic achievement). A regression analysis showed that acculturation orientations and ethnic identity explained a significant part of the variance in the frequency of cannabis use. Individualism, integration and assimilation were negatively associated with the frequency of cannabis use suggesting they might serve as protective factors.

Objectives: 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., Method: 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"., Results: 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; p<0.01). According to the cut-off score of 24, 19% of boys and 34% of girls had a moderate to severe depressive symptomatology (p<0.0001). 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; p<0.0001). 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 (p<0.0001). 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, p<0.001). In the second equation, CES-D score explained 16% of the variance in the wish to kill oneself (beta=0.40, t=12.7, p<0.001). 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, p<0.001) while the effect of CES-D was markedly reduced (beta=0.10, t=2.9, p<0.01). Among boys, in the first equation, CES-D score explained 38% of the variance of hopelessness (beta=0.62, t=20.7, p<0.001). In the second equation, CES-D score explained 25% of the variance in the wish to kill oneself (beta=0.50, t=15.1, p<0.001). 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, p<0.001) while the effect of CES-D was substantially weakened (beta=0.13, t=3.6, p<0.001)., Discussion: 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 study examined a sociocultural model of the influence of parental comments on body shape and eating concerns among males and females. Questionnaires were completed by 338 undergraduates. Participants reported levels of perceived parental comments, internalization of media ideals, appearance comparison, body dissatisfaction, drive for thinness and bulimia. Results revealed that, regardless of gender, internalization and appearance comparison only partially mediated the relationship between parental comments and the outcome variables. The final model for females explained a larger proportion of the variability in body shape and eating concerns than in males, with positive and negative parental comments directly related to body dissatisfaction and through it to eating outcomes. In males, only negative comments were directly related to body dissatisfaction. These findings highlight the role of parental influences in sociocultural models of the development of body dissatisfaction and eating concerns, and the gender-specific patterns of sociocultural influence.

Aims: 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., Methods: 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 (VAS>or=5), the second with those reporting no body dissatisfaction (VAS<5). 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)., Results: 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)., Conclusions: 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.

Objectives: This qualitative study focuses on feelings of women who receive an anonymous oocyte donation., Patients and Methods: 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., Results: 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., Discussion and Conclusion: 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.

Objective: The purpose of this paper was to review the existing literature regarding the contribution of parental influences to the sociocultural pressures on body image disturbance and disordered eating so as to highlight principal findings so that parents can be given practical information and identify areas that require further research., Methods: Relevant articles were located through Pubmed, Sciencedirect and PsychInfo, as well as the screening of bibliographies., Results: The available data suggest that parents are strong communicators of sociocultural pressures. Parental influences via verbal messages and active encouragement have been shown to have more impact on offspring's body concerns and eating behaviours than modelling effects. Both mothers and fathers are important sources of influence for their offspring., Conclusion: Considering the role of parents could help improve public health management. Futher exploration of the way adolescents and young adults interpret and perceive parental attitudes and of potential protective factors is necessary.

Objective: The aim of this research was to study childbirth experience for the primiparae couple and their emotional state in early post-partum., Patients and Methods: Thirty-three couples were interviewed 2 days after the birth. A questionnaire on childbirth experience and the EPDS were carried out., Results: 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., Discussion and Conclusion: 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.

Introduction: 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., Aim of the Study: 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., Method: 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., Results: 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, p<0.05), borderline traits [(r=0.62, p<.05), callousness (r=0.41, p<0.05). Among boys, these associations were weaker (depressive symptoms, (r=0.45, p<0.05); borderline traits, (r=0.47, p<0.05); callousness, (r=.24, NS)]. A multiple regression analysis predicting antisocial behavior with the psychopathological variables showed that sex was a significant predictor (p<0.01). 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, p<0.001). 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., Discussion: 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.

The aim of the study was to evaluate the relative contributions of cannabis use, alcohol use, psychopathic and borderline personality traits, and depressive symptoms in the prediction of delinquent behaviors. Participants were 312 high-school students who completed self-report questionnaires. Hierarchical multiple regression analyses were conducted to investigate the contribution of cannabis use and potential confounding variables to delinquent behaviors in the total sample and in cannabis users. Cannabis use was no more a significant independent predictor of delinquent behaviors after adjustment for alcohol use and psychopathological variables. However, among users, frequency of use remained a significant predictor of delinquency after adjustment for those confounders.

The aim of the study was to evaluate the contribution of psychopathic traits in the prediction of suicidal ideation among non-clinical non-forensic adolescents. A sample of 312 high-school students completed questionnaires assessing suicidal ideation, depressive symptoms, borderline personality traits, and cannabis use and the Youth Psychopathic traits Inventory (YPI, Andershed, Kerr, Stattin et al., 2002), which consists of three dimensions, the Interpersonal subscale (grandiosity, manipulation), the Affective subscale (callousness, unemotionality), and the Behavioral subscale (impulsiveness, irresponsibility). A multiple regression analysis showed that the affective component of psychopathic traits was an independent predictor of suicidal ideation. Our results suggest that clinicians should not assume that the presence of psychopathic traits in adolescent is a protection against suicidal ideation.

Objective: The aim of this research was to study childbirth experience for the primiparae couple., Patients and Methods: Thirty-three couples were interviewed two days after the birth in maternities., Results: For mothers, the presence of their husbands is a support whereas men mentioned a feeling of helplessness., Discussion and Conclusion: 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.

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.

Objective: The aim of the study was to evaluate the relative contributions of cannabis use and depressive symptoms in the prediction of suicidal ideation., Method: 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)., Results: 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, p<0.001) 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)., Discussion: 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.

Objective: 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., Patients and Methods: Seven women who have had a therapeutic abortion participated in a semidirective interview., Results: 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., Discussion and Conclusion: Results show a need for a psychological follow-up of the individual as well as the couple.

Aim: 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., Method: 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)., Results: 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; P<0.001). Maternal self-esteem (beta=-0.37; P<0.001), 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., Conclusion: 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 aim of the study was to evaluate the relative contributions of cannabis use, depressive and anxious symptoms in the prediction of suicidal behaviors. Participants were 248 high-school students who completed questionnaires assessing cannabis use, suicidal behaviors, depressive and anxious symptoms. Cannabis use was a significant independent predictor of suicidal behaviors after adjustment for depressive and anxious symptoms.

Objective: 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., Method: 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., Results: 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; p<0.0001). 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; p<0.0001) 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., Discussion: 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.

Objective: To evaluate the effect of providing information on postpartum blues during pregnancy on the intensity of the blues., Patients and Methods: A convenient sample of 37 women agreed to participate in the study during the third trimester of pregnancy and were randomly assigned to one of three groups. The first group received a short text of information, the second group received the text which was read and discussed and the third group was the control group. All the participants completed the Edinburgh postnatal depression scale (EPDS) questionnaire during the period three to five days postpartum., Results: Given the small number of participants in the three groups and the subsequent lack of power of the study, the magnitude of the differences between the means scores of the EPDS of the three groups was estimated using effect size (ES) and indicated a small to medium effect of providing information on the blues., Discussion and Conclusion: Despite the limitations of the study mainly linked to the small sample, this study suggests that providing information on postpartum blues during the third trimester of pregnancy may reduce the intensity of the depressive dimension of the blues symptomatology.

Objective: This prospective, longitudinal study investigated the contributive role of childbirth pain, perinatal distress and perinatal dissociation to the development of PTSD symptoms following childbirth., Patients and Methods: 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., Results: 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., Discussion and Conclusion: 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.

Aim: The aim of this study was to highlight a link between childbirth pain and mood disorders in the immediate postpartum., Method: 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., Results: 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; p<0.05) than between blues and sensorial aspect of pain (r=0.40; p<0.05). The level of depressive mood was found to be associated with affective (r=0.32; p<0.05) but not with sensory qualities of childbirth pain (r=0.28; p<0.05). 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]., Conclusion: 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.

Objective: 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., Patients and Methods: Six women undergoing IVF took part in a semi-directive interview., Results: 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., Discussion and Conclusion: The results of this study underline the need for specific support to help women with this emotional alternation.

The aim of the study was to evaluate the link between the different dimensions of depressive symptoms and suicidal ideation in adolescents. A sample of 1057 adolescents completed the CES-D (Center for Epidemiological Studies Depression Scale) and three additional items measuring suicidal ideation. The four dimensions of depressive symptoms on the CES-D (Depressed Affect, Loss of Positive Affect, Somatic and Retarded Activity, Interpersonal) were entered into regression analyses predicting the presence of any suicidal ideation and of the wish to kill oneself among participants with moderate/severe depressive symptoms (n=271). For both boys and girls Depressed Affect was the main significant predictor of the presence of any suicidal ideation and of the wish to kill oneself. There were two additional significant predictors for boys: Loss of Positive Affect positively predicted the presence of any suicidal ideation; Somatic and Retarded Activity negatively predicted the presence of the wish to kill oneself.

Postnatal depression is a common condition that may have a significant negative impact on both infant and mother, often remaining undiagnosed and untreated. Development of effective means of detection, prevention and treatment of postnatal depression is a major health challenge. The objective of this article is to critically review pharmacological, psychological and psychosocial approaches of prevention and treatment for postnatal depression. There is little evidence of short-term success for preventive interventions and some evidence of short-term success for treatment interventions. No preventive or therapeutic studies, however, have provided evidence for long-term success. There is a need for future research into the prevention and treatment of postnatal depression including the assessment of long-term effects on the child's development as well as feasibility in relation to cost-effectiveness.

The aim of the study was to evaluate the relative contributions of peers cannabis use or non-use, parental approval of such use, adolescents' own beliefs about use, to the prediction of cannabis use. The participants were 559 high-school students who completed questionnaires assessing the frequency of cannabis use, the number of peers using cannabis, the number of peers opposed to cannabis use, parental attitude toward cannabis use, and participants' expectations towards use. The number of peers using cannabis 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 towards use were not a significant independent predictor of use.

Objective: 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., Patients and Methods: Twelve women undergoing IVF evaluated their experience of pregnancy and birth using measures of post-partum depression, maternal self-esteem, and semi-directive interviews., Results: 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., Discussion and Conclusion: The results of this study underline the need for specific psychological support for women undergoing IVF treatment.

Although psychotherapeutic observation and empirical data suggest a link between borderline and antisocial personality disorder or traits in adolescents, there is no study on the relationships of borderline personality organization (BPO) and psychopathic traits in adolescents. The aim of this study was to explore the relationship of structural criteria of (BPO) as assessed by the French version of the Borderline Personality Inventory (BPI), with psychopathic traits, as assessed by the French version of the Levenson Self-Report Psychopathy Scale (LSRP), in a nonclinical sample of 243 adolescents. Significant correlations were found between the BPI scales of identity diffusion, primitive defense mechanisms, impaired reality testing, and psychopathic traits of callousness and impulsivity, suggesting that BPO may contribute to psychopathic traits in nonforensic, nonclinical adolescents.

There are few studies examining the face validity of the 40-item version of the Defense Style Questionnaire (DSQ-40). Moreover, the existing studies have provided conflicting results. The present study provides an in-depth examination of the face validity of the DSQ-40. Eight clinicians independently attributed each item of the DSQ-40 to a defense mechanism. The defense mechanisms listed in the DSM-IV Defensive Functioning Scale and their definitions were provided as a guide, along with the definition of those defense mechanisms investigated by the DSQ that are not included. It was further specified that the raters could attribute the items to defense mechanisms other than those listed or coping mechanisms. Twelve items out of 40 (30%) were attributed to the defense mechanisms they were supposed to investigate by fewer than four out of the eight raters. This result suggests that a substantial part of the DSQ-40 is lacking in face validity.

Defence mechanisms are mental operations that are involuntary and unconscious and contribute to reduce internal and external stresses. The concept of defensive organisation or style, defined as a set of defence mechanisms relatively stable and characteristic of personality appears to be a major dimension of personality, from normal to pathology. Studies on defence mechanisms have gained the interest of clinicians, largely outside the psychoanalytical field. However, the lack of reliability and validity of the assessment instruments still limits the empirical studies of the relation between defence mechanisms and psychological health as well as of their therapeutic implications.

Nicotine Dependence (FTND) was administered to a sample of 749 adult smokers. The Heavy Smoking Index (HSI) which combines two items of the FTND (the number of cigarettes per day and the time of the first cigarette of the day) was compared to the FTND. A cut-off score equal or greater than 4 on the HSI detected a similar rate of nicotine dependence as a cut-off score equal or greater than 6 on the FTND. HSI had good sensitivity (79.5%) and specificity (96.5%). The concordance between the two instruments was high (Cohen's kappa=0.74). The HSI performed as well on men as on women. The HSI provides a good measure of high nicotine dependence, particularly appropriate for epidemiological surveys.

Objectives: To evaluate the relative contributions of peers cannabis use or non use, parental approval of such use, adolescents' own beliefs about use, self-esteem, and depressive and symptoms of borderline personality disorder, in the prediction of cannabis use and dependence., Method: Participants were 257 high-school students who completed questionnaires assessing cannabis use frequency, cannabis dependence, the number of peers using cannabis, the number of peers opposed to cannabis use, parental attitude toward cannabis use, participants' attitude toward use, self-esteem, depressive and borderline symptomatology. Logistic regression analyses were conducted to predict cannabis use, daily use and dependence., Results: The number of peers using cannabis, participants' approval of cannabis use, and the intensity of symptoms of borderline personality disorder were risk factors for use whereas the number of peers opposed to cannabis use was a protective factor. Parental attitudes toward use and participants' depressive symptomatology were not significant independent predictors of use. There were no significant predictors of probable cannabis dependence., Conclusion: To inform adolescents that a significant proportion of them disapprove of cannabis use may be an effective component of prevention of use. Symptoms of borderline personality disorder may account for the association between depression and cannabis use. The social influences and psychopathological factors evaluated in this study did not appear to play a major role in the development of cannabis dependence.

This study investigated the relations between anxious, depressive and borderline symptomatology, motivations for cannabis use, and cannabis use and dependence among 212 adolescents and young adults, 114 of whom were cannabis users. Motives for cannabis use were assessed using the Marijuana Motives Measure (Simons, J., Correia, C. J., Carey, K. B., & Borsari, B. E. (1998). Validating a Five-Factor Motives Measure: Relations with use, problems and alcohol motives. Journal of Counseling Psychology, 45, 265-273.). In three sets of regression analyses, motives, cannabis use frequency, and cannabis dependence served as criterion variables. First, when motives were regressed on psychopathological measures, borderline symptomatology predicted expansion motives in both boys and girls. Second, when frequency of use was regressed on motives and psychopathological measures, enhancement motives were the only significant predictor among boys and expansion motives were the only significant predictor among girls. Finally, when cannabis dependence was regressed on motives and psychopathological measures, borderline symptomatology was the only significant predictor in boys and expansion motives were the only significant predictor in girls. This study suggests the importance of motives and borderline symptomatology in the understanding of cannabis use and dependence among adolescents and young adults.