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International audience; Transition to parenthood is considered a developmental crisis and adult attachment has been identified as a key concept for a better understanding of the psychological adjustment of individuals and couples during the transition to parenthood. In the context of transition to parenthood, prenatal diagnostic of a fetal anomaly is a very demanding situation. Regardless of the degree of the illness, this experience incorporates a traumatogenic dimension, due to the impact of the diagnosis of a fetal anomaly on the psychological functioning and well being of expectant parents. It is important to continue to study the factors of psychological adaptation to parenthood in order to guide the clinical interventions protocols focused on individual and dyadic adaptation to parenthood, mainly in pathological contexts.; La transition vers la parentalité représente une crise développementale et l’attachement adulte a été identifié en tant que concept-clé dans la compréhension de l’ajustement psychologique des personnes et des couples pendant cette période. Dans le cadre de la transition vers la parentalité, le diagnostic prénatal d’une pathologie fœtale représente une situation d’extrême exigence. À cause de l’impact de l’annonce du diagnostic sur le fonctionnement psychologique et bien-être des futurs parents, cette expérience peut avoir un caractère traumatogène, indépendamment de la sévérité de la maladie diagnostiquée. L’étude des variables qui déterminent l’adaptation à la parentalité doit se poursuivre de façon à orienter les interventions cliniques qui visent l’adaptation individuelle et dyadique pendant ce parcours développemental, surtout dans les situations pathologiques.

International audience

Avec l’augmentation des accidents vasculaires cérébraux (AVC), améliorer le bien-être des aidants naturels (AN) est devenu une priorité. Quels sont les déterminants psychosociaux de l’estime ressentie par les AN en accomplissant ce rôle ? Méthodologie. Sur une période de 12 mois, les personnes victimes d’un AVC deux ans auparavant, dont le diagnostic a été confirmé, vivant au Luxembourg et ayant donné leur consentement, ont désigné leur AN principal. Etude nationale transversale menée au domicile. Instruments : - Caregiver Reaction Assessment : estime de l’aide, manque de soutien familial, impacts financier, sur l’emploi du temps, sur la santé générale. - Carer Satisfaction of Community Services : services socio-sanitaires et éducatifs - Aides à domicile utilisées : soins corporels, repas, ménage, sorties, courses Résultats. Taux participation 26,5 % ; 48 AN (59,5 ±12,3 ans). Régression multiple (R²ajusté=.230) : une estime élevée est associée à un faible impact de l’aide sur la santé (β=.479***) et un recours important aux aides à domicile (β=.351**). Discussion. Il est possible de valoriser le rôle d’AN en motivant les aidants à utiliser les services disponibles pour les soulager dans leurs tâches quotidiennes. Les soutiens psychologiques peuvent également intégrer le concept de « health capability » pour renforcer l’acquisition de cette estime.

To assess the association between social support and subsequent premature mortality (PM) (15 years, randomly selected in north-eastern France, completed in 1996 a postal questionnaire gathering characteristics, smoking, alcohol abuse, obesity, social support from colleagues/family/friends, and physician-diagnosed diseases. The cohort was followed-up until 2008 (12.5 years). Data were analyzed using Poisson models. Results: There were 165 PM (115 men, 50 women) during the follow-up. For all the cohort, social support was strongly associated with PM: crude relative risk (RR) 2.09 (95%CI 1.53-2.85). It decreased to 1.52 (1.11-2.09) when adjusted for age, 1.46 (1.06-2.00) with further adjustment for occupation, 1.44 (1.04-1.98) with further adjustment for smoking, alcohol abuse and obesity, and 1.28 (0.92-1.78) when diseases (cancer, diabetes, mental, nervous-system, cardiovascular, respiratory, genitourinary and musculoskeletal diseases) were taken into account. Similar results were found for men: crude RR 2.46 decreasing to 1.81, 1.70, 1.60, 1.45 respectively. But not for women: close-to-significant crude RR 1.57 (small number of PM). Conclusions: Social support influenced PM in men but not in women. Occupation, health behaviours, and diseases play a role.

Domestic accidents are a public health problem. This study assessed the disparities between socioeconomic positions and the confounding role of gender, age, education, living alone, income, poor health, obesity, current tobacco use, alcohol abuse, fatigue/sleep disorders, and physical, sensorial and cognitive disabilities. Methods: 6,198 people aged ≥15, randomly selected in north-eastern France completed a post-mailed questionnaire including domestic accident(s) during the last two years. The data were analyzed via logistic models. Findings: Domestic accidents affected 3.1% of subjects. Manual workers and clerks had higher risks (age-gender adjusted OR 1.6, 95%CI 1.1-2.6 and 1.5, 1.0-2.4) compared with the other socioeconomic groups. These differences became non significant when controlling for all covariates of which those significant were: sex, current tobacco use, alcohol abuse, and fatigue/sleep disorders (adjusted odds ratios 1.48-1.88). Discussion: There are social disparities in domestic accidents, and they are confounded by sex, substance use, and fatigue/sleep disorders.

International audience

Objectives. To assess the relationships of multiple deprivation and gender differences towards tobacco, alcohol and psychotropic drug use. Design and methods. The sample included 6,216 subjects, aged 15 years, randomly selected in north-eastern France who completed a mailed questionnaire. Data were analyzed with the logistic model. Results. Multiple deprivation (noted MD, defined by the cumulative number of: low educational level, manual worker, unemployment, living alone, nationality (other than Western Europe), low income, and non-home-ownership) concerned many people: 37.4% for MD1, 21.2% for MD2, 10.0% for MD≥3. Tobacco and excess alcohol use was more frequent in men than in women (30.2% vs. 21.9%, 12.5% vs. 3.3%, p

Objectives. To assess the effects of individual and family characteristics on psychotropic drug use among male and female adolescents. Design and methods. The sample included 2,396 subjects attending two middle schools and two high schools. Respondents completed self-administered questionnaires covering gender, age, body mass index, smoking, alcohol use, illicit drug use, tiredness during the daytime, self-reported personality traits, family conditions, and psychotropic drug use. The data were analyzed using logistic models. Results. The prevalence of frequent psychotropic drug use (for headache, tiredness, nervousness/anxiety, insomnia) was 43.0% overall; twice as high among girls than boys. In girls, frequent psychotropic drug use was associated with frequent tiredness during the daytime (adjusted odds ratio OR 2.03, 95%CI 1.61-2.57), smoking (2.02, 1.50-2.71), alcohol use (1.34, 1.04-1.74), higher body mass index (18 kg/m2, 1.54, 1.16-2.04), poor family atmosphere (1.33, 1.03-1.72), and being worried (1.93, 1.53-2.43) or easily becoming irritable (1.28, 1.01-1.62). In boys the factors with significant ORs were frequent tiredness during the daytime (2.21, 1.67-2.93), alcohol use (1.52, 1.15-2.01), and being worried (1.70, 1.28-2.26) or easily becoming irritable (1.42, 1.06-1.89); univariate analysis revealed a significant relationship with smoking and family atmosphere. An association was also observed for illicit drug in both sexes and for age17 years in girls. Conclusions. Individual and family characteristics have marked influences on psychotropic drug use among both male and female adolescents. This finding may be useful for the psychologists, the physicians, the parents and the school staff to be more aware of the risks and to find remedial measures.

Développer un instrument de qualité de vie (QV) spécifique de l’arthrose du genou et de la hanche (AMIQUAL) et étudier sa validité et sa reproductibilité. Méthodes. – Soixante-dix-neuf patients et 28 professionnels de la santé ont participé à des entretiens individuels ou de groupe. L’analyse de contenu des entretiens a permis d’extraire une liste de 80 items potentiels. Quarante-six de ces 80 items ont été sélectionnés sur leur contenu pour former la version 1.0 de l’AMIQUAL. Les propriétés psychométriques de l’instrument ont été étudiées chez des patients suivis pour coxarthrose ou gonarthrose définies selon les critères d’Altman. Résultats. – L’analyse psychométrique de l’AMIQUAL (1.0) complété par 263 patients a permis d’exclure trois items supplémentaires pour aboutir à une version 2.3 du questionnaire. L’analyse en composantes principales a identifié quatre facteurs : « Activités Physiques », « Santé Mentale », « Activités Sociales » et « Soutien Social ». Une dimension « Douleur » a secondairement été individualisée. L’analyse des dimensions a montré que la reproductibilité, la validité de construction et les capacités discriminantes de l’instrument étaient satisfaisantes. Les réponses moyennes standardisées étaient proches de 1 pour les dimensions « Douleur » et « Activités Physiques » et de 0,7 pour la dimension « Santé Mentale » témoignant d’une bonne validité longitudinale après mise en place d’une prothèse. Conclusions. – L’AMIQUAL est le premier instrument de QV spécifique de l’arthrose des membres inférieurs. Il est capable de capturer les aspects spécifiques de la QV des patients et possède les propriétés psychométriques requises pour être utilisé dans des études longitudinales.

This Article aims to introduce the translation and the validation of a multidimensional measure of coping strategies: the Brief COPE, in a French population. The coping concept comes from psychological studies that were conducted on stress. In the conceptual analysis of stress by Lazarus and Folkman, coping works with two cognitive appraisals performed by the person concerning the perception of a threatening situation and his or her available resources to deal with it. Coping is defined as "cognitive and behavioural efforts to master, reduce, or tolerate the internal and/or external demands that are created by the stressful transaction". The Brief COPE is the abridged version of the COPE inventory and presents fourteen scales all assessing different coping dimensions: 1) active coping, 2) planning, 3) using instrumental support, 4) using emotional support, 5) venting, 6) behavioural disengagement, 7) self-distraction, 8) self-blame, 9) positive reframing, 10) humor, 11) denial, 12) acceptance, 13) religion, and 14) substance use. Each scale contains two items (28 altogether). This inventory has the advantage of being built from acknowledged theoretical models (Lazarus' transactional model of stress, 1984; behavioral self-regulation model, Carver and Scheier, 1981, 1998). It can be used to assess trait coping (the usual way people cope with stress in everyday life) and state coping (the particular way people cope with a specific stressful situation). As is the COPE inventory, the Brief COPE is a measure used for many health-relevant studies: drugs addiction, ageing, breast cancer, depression, AIDS. Both measures are widely used in Anglophone countries and translated in many Languages. Today, the COPE inventory has been validated among Estonian, Croatian, Chinese, and Italian populations and the Brief COPE is also validated among Spanish people. Thus, the worldwide use of this coping inventory should allow a broad comparison of medical and psychological research for coping strategies regarding every kind of pathologies. Thus, we were led to present the translation and the validation of this measure in a French population. Two studies are presented in this Article: the first one describes the validation of the inventory in a dispositional format (trait coping) and the second one the validation of the inventory in a situational format (state coping). The French version of Brief COPE, which was used for both studies, was back-translated and analysed by the Brief COPE Author: Charles S. Carver. For study 1, 834 first Year university students answered the Brief COPE in its dispositional format. To study the factor structure of the Brief COPE, we used structural equation modeling and the LISREL software. Results show that the expected theoretical structure and the observed one fit adequately (c2=606, p0,05, RMSEA=0,04, GFI0,95, AGFI0,92, RMR0,03). In order to study convergent and discriminant validity of Brief COPE, self-esteem (SEI, Rosenberg, 1979), perceived stress (PSS, Cohen et al., 1983), and psychological distress (GHQ-12, Goldberg, 1972) measures were used. Results show that functional coping strategies (eg, active coping) are linked to good self-esteem, to lower perceived stress, and to lower psychological distress, whereas less functional strategies (eg, denial or self-blame) are widely linked to poor self-esteem, to a high perceived stress, and to psychological distress. Study 1 shows also several significant gender differences. Study 2 describes the Brief COPE validation in its situational format. 178 additional students answered this version. The method that was used is the same the one developed by Lazarus and his colleagues for the WCC validation. Participants were asked to recall and think about the most stressful event they had experienced during the past two Months. They were also to give an account of how much that situation mattered to them. They had to evaluate their capacity to control the situation and indicated whether they felt the situation was amenable to change. The study includes only peoples only people who labeled an event as "important" or "very important". Here again LISREL was used to study the factor structure of the Brief COPE. The results emphasise - as in study 1 - that the expected theoretical structure and the observed one fit adequately (c2=391, p0,05, RMSEA0,05, GFI=0,87, AGFI=0,80, RMR0,06). Differences among means showed how the perceived control of the situation and how the perception of its favourable evolution influenced the coping strategies used (eg, humour or denial). Results in both studies indicate good psychometric properties for the Brief COPE in its French version, whatever the format (ie, dispositional or situational). Thus French searchers have a relevant tool on hand to measure as accurately as possible the coping strategies someone used in everyday life (strategies interfering on health, on a long scale), or in distressful situations (eg, serious illness, traumas). The fact that this easy-to-use coping measure is worldwide spread among medical and psychological studies allows a better broadcast and comparison of results whatever the pathology.