Développement cognitivo-émotionnel, régulation des émotions et comportements à risques : une étude exploratoire chez l’adolescent

International audienceBut de l'étude. – L'objectif de cette étude était d'explorer les relations entre dysfonctionnement émotionnel, trouble thymique et comportements à risques chez les adolescents.Patients et méthode. – Notre échantillon était constitué de 56 sujets (sex-ratio 31G/25F ; âge moyen = 14,76 ± 0,63), issus de deux collèges de la région Provence-Alpes–Côte d'Azur, répartis en deux groupes grâce à un questionnaire de comportements à risques. Le fonctionnement émotionnel a été évalué avec l'échelle de niveaux de conscience émotionnelle et l'échelle d'alexithymie de Toronto en 20 items, l'intensité dépressive avec l'inventaire de dépression de Beck en 13 items, et le fonctionnement cognitif avec l'échelle d'attitudes dysfonctionnelles forme A.Résultats. – Les adolescents ayant une propension à prendre des risques ont un niveau de conscience émotionnelle inférieur aux autres adolescents, et un score plus élevé d'alexithymie. Ils ont également un niveau d'attitudes dysfonctionnelles supérieur mais ne présentent pas de trouble dépressif. Les troubles de la régulation des émotions associés à des troubles cognitifs semblent présenter des relations significatives avec les prises de risques répétées.Conclusion. – Les comportements à risques pourraient être liés à une incapacité à utiliser les émotions (du fait d'une faible élaboration) pour réguler les comportements, tout en générant des sensations internes pouvant constituer des "prototypes émotionnels"

Rôle du tempérament et de la conscience émotionnelle dans la prise de risque chez des adolescents

International audienceIntroduction. —Risk-taking behaviors among adolescents are now considered as a real public health issue. To investigate for potential vulnerability factors, adolescent risk-taking behavior can be analyzed from several different perspectives, based on biological, social or psychologicalvariables. Risk-taking theories based on temperamental dimensions examine individual differences in propensity for engaging in such behaviors, whereas others focused on emotional processing disorder such as alexithymia or anhedonia with diverse conclusions. The aim of this study was to investigate the relationship between risk taking and two levels of psychological functioning: personality with reference to Cloninger’s model of personality, and emotion with reference to Lane and Schwartz’s level of emotional awareness theory.Method. — The sample consisted in 488 adolescents (mage = 14.93, SD = 1.44) with 257 boys (mage = 15, SD = 1.51) and 231 girls (mage = 14.52, SD = 1.23) who completed a set of three inventories: the Youth Risk Behavior Surveillance Scale (YRBSS), the Tridimensional PersonalityQuestionnaire, and the Level of Emotional Awareness Scale. Risk-taking behaviors were also assessed indirectly with regards to teachers or school educators’ evaluation.Results. — Moderate to weak significant correlations were found between temperament dimensions and risk-taking, and between level of emotional awareness and risk-taking. A positive moderate correlation was observed between novelty and risk-taking, whereas a negative weakcorrelation was observed between harm avoidance and risk-taking. Level of emotional awareness shows moderate negative correlations with risk-taking, as the two self and others dimensions. Finally, a model including the four temperament and the two emotional awarenessdimensions was tested with risk-taking as the outcome variable. It accounted for 33% of the total variance (R2 = 0.33; F = 30.78, p < 0.0001), with novelty seeking (p < 0.0001), self (p < 0.0001) and others (p = 0.0001), and level of emotional awareness as significant criteria.Discussion. — As hypothesized, temperamental dispositions of novelty seeking and harm avoidance, associated with weak emotional awareness, were associated with risk-taking. They may be considered as vulnerability factors for adolescents to engage in risk-taking behaviors. Severalpropositions may explain our results. First, risk-taking might be considered as an attempt to struggle against a sensation of emptiness due to a lack of emotion. Second, it may tend to replace emotion by sensations, which could be more controlled. Third, it could be an attempt — without success — to construct the complexity of subjective emotional experience.Les conduites à risques à l’adolescence constituent un réel enjeu de santé publique, par les conséquences inquiétantes qu’elles entrainent en termes d’accidentologie, de traumatologie ou de leur impact psychosocial et psychopathologique. Différentes travaux ont souligné le rôle de dimensions de tempérament telles que la recherche de sensation ou de nouveauté, ou de dimensions émotionnelles telles que l’alexithymie. Dans ce travail, nous avons testé les relations entre tempérament et développement cognitivo-émotionnel comme facteurs de vulnérabilité à l’engagement dans des conduites à risques, sur un échantillon de 488 adolescents. Les outils utilisés étaient le questionnaire tridimensionnel de personnalité, l’échelle de niveau de conscience émotionnelle, l’échelle de surveillance du risque pour les jeunes. Les analyses statistiques ont permis de dégager un modèle explicatif expliquant 33 % de la variance de la propension à s’engager dans des conduites à risques. Ainsi, une forte recherche de nouveauté et un faible évitement du danger, associés à un faible niveau de conscience émotionnelle, entraîne un risque accru de s’engager dans des conduites à risques. Ces résultats sont comparables à ceux retrouvés dans les études étudiant spécifiquement l’une ou l’autre de ces dimensions, notamment dans des problématiques addictives

Relations entre dimensions émotionnelles et symptômes somatiques : effets médiateurs de la dépression et de l'alexithymie

International audienceObjectives: The aim of the present study was first to complete previous research on negative affectivity, alexithymia, depression and somatic symptoms by testing a theoretical model of their relations. It was second to investigate potential mediating effect on the relations between negative emotionality (i.e. neuroticism) and somatic symptoms.Patients and method: A sample of 309 subjects (77% F et 23% M; mean age = 20, 61 AE 1.55) completed the following questionnaires: the Positive and Negative Emotion questionnaire-31 items (EPN-31), the Toronto Alexithymia Scale 20 items (TAS-20), the Center for Epidemiological Studies Depression scale (CES-D), and the Symptom Check List Revised, 90 items (SCL-90 R). Theoretical model and mediating effects were tested using structural equation modeling, and bootstrapping method.Results: Three measurement models were tested: First, a direct effect model did not fit the data. Second, a partially mediated model fit partially the data for some indices, but not for others, and was rejected for lack of parsimony. Finally, a full mediation model showed the best adjustment with results confirming the good fit of this structural model including (Chi 2 = 10.245, P = 0.069, ns; CFI = 0.989 > 0.95, RMSEA = 0.058 < 0.07 [90% IC = 0.000–0.100], SRMR = 0.026 < 0.08). So as, our resultsshow that alexithymia and depression are full mediators of the negative affectivity–somatic symptoms relation. In other words, when depression and alexithymia are introduced in the relation between negative affectivity and somatic symptoms, the direct effect of negative affectivity becomes non-significant, and turns to an indirect effect. Moreover, depression as a stronger effect on somatic symptoms than alexithymia, which seems to confirm previous research on the distinction between both constructs. These results are compatible with that of previous works on somatic symptoms and negative affectivity, and on somatic symptoms and alexithymia.Conclusion: The propensity to experiment negative emotional states may contribute to develop negative emotion regulation strategies such as alexithymia, which as a direct effect on somatic symptoms. But more precisely, we can hypothesize that alexithymia is not fully efficient as a defense against negative emotions, and that depression remains a strong characteristic of subjective emotional experience for some subjects, constituting a strong contributor to declarative somatic symptoms. Implications for psychotherapy are discussed, supporting the enhancement of negative emotions regulations strategies for subjects showing somatic complaints.Les plaintes somatiques constituent l'un des motifs de consultation les plus courants en médecine générale et sont fréquemment rapportées par les patients dans les prises en charge psychothérapiques. Si plusieurs études ont permis de souligner les relations entre alexithymie et somatisations, peu de travaux se sont cependant intéressés aux relations entre dimensions de personnalité , psychopathologie de l'émotion et symptômes somatiques. Dans cette étude, nous avons testé une modélisation des relations entre dimensions de l'affectivité , alexithymie, dépression et symptômes somatiques autodéclarés, dans un échantillon de 309 sujets. Les instruments d'évaluation étaient le questionnaire d'émotions positives et négatives (EPN-31), l'échelle d'alexithymie de Toronto (TAS-20), l'échelle de dépression du centre d'études épidémiologiques (CES-D) et l'échelle somatisation de la liste de symptômes révisée en 90 items (SCL-90R). Une analyse en pistes causales a permis de confirmer un modèle dans lequel l'alexithymie et la dépression médiatisent totalement les relations entre affectivité et symptômes somatiques. En outre, la contribution de la dé pression au niveau des symptômes somatiques se révèle supérieure à celle de l'alexithymie, soutenant à la fois la pertinence de distinguer les deux dimensions et une interrogation quant aux relations qu'ils entretiennent. Ces résultats sont compatibles avec ceux des travaux antérieurs, mais ils précisent également la fonction possible de l'alexithymie et de la dé pression dans les relations entre affectivité et symptômes somatiques. Les implications pour la prise en charge sont importantes, amenant à prendre en compte les capacités des sujets à élaborer leurs expériences subjectives, voire à mieux tolérer les affects négatifs tout en étant plus à même d'identifier les émotions positives

Fonctionnement cognitivo-émotionnel : le rôle de l’intensité émotionnelle chez les individus anxieux

International audienceAnxiety is an emotional trouble very present in the general population and it seems to be linked to depression symptoms. The aim of this study is to test the relations hypothesis between cognitive-emotional functioning, anxiety and depressive symptoms. The study’s sample was formed from a group of 50 subjects, aged from 18 to 65. Participants completed Hospital Anxiety and Depression Scale (HAD), Affect Intensity Measure (AIM), Emotional Expressivity Scale (EES) and Levels of Emotional Awareness Scale (LEAS). Our results show strong positive correlations between anxiety symptoms, affect intensity, emotional expressivity and level of emotional awareness. In conclusion, this results point out the importance of emotional variables in the study and treatment of subjects suffering of anxiety symptoms.L’anxiété est un trouble émotionnel très répandu dans la population générale et qui semble être souvent en lien avec les symptômes dépressifs. L’objectif de cette étude est de tester l’hypothèse de relations entre fonctionnement cognitivo-émotionnel, symptômes anxieux et dépressifs. Un groupe de 50 sujets âgés de 18 à 65 ans constitue l’échantillon de notre étude. Les participants ont rempli l’échelle d’Anxiété et de Dépression (HAD), les échelles d’intensité et d’expressivité émotionnelle (AIM et EES) et l’échelle de niveau de conscience émotionnelle (LEAS). Les résultats montrent l’existence de corrélations positives significatives entre les symptômes anxieux, l’intensité émotionnelle, l’expressivité émotionnelle et le niveau de conscience émotionnelle. Ces résultats soulignent l’importance des variables émotionnelles dans l’étude et la prise en charge des individus anxieux

Anxiété, dépression et partage social des émotions : Des stratégies de régulation émotionnelle interpersonnelle spécifiques

International audienceDepressed and anxiety states represent respectively 12% of general population. They are associated with alexithymia dimensions like difficulties in verbalization of emotions (Berthoz et coll., 1999). The aim of the research is to identify the relations between anxiety, depression and social sharing of emotions considered as a process of interpersonal emotional regulation (Rimé, 2007). A quantitative method was used. 107 patients of general medicine and control subjects were characterised by the presence or the absence of anxiety and depressed states. We measured depressed and anxiety states with the Hospital Anxiety and Depression Scale (HAD) and le components of social sharing of emotions. Results point out the presence of positives relations between anxiety state and inhibition of social sharing of emotions, and between a part of emotions’ inhibition and depression. In anxiety, it’s about a strategy used in order to avoid emotions reactivation happening despite of, in depression, the subject would try to protect from a negative perception.Les états anxieux et dépressifs représentent respectivement 12% de la population générale. Ils sont associés à des dimensions d'alexithymie et notamment aux difficultés de verbalisation des émotions (Berthoz et coll., 1999). L'objectif de cette recherche est d'identifier les relations pouvant exister entre l'anxiété, la dépression et le partage social des émotions considéré comme un processus de régulation émotionnelle interpersonnelle (Rimé, 2007). La méthodologie quantitative prend appui sur un échantillon de 107 patients de médecine générale et d'individus tout-venant (H/F), caractérisés par la présence ou l'absence d'anxiété état et de dépression état. Nous avons évalué les états anxieux et dépressifs (HAD) et les composantes du partage social des émotions (échelle de PSE). Les résultats montrent l'existence de relations positives entre l'inhibition du partage social émotionnel et l'anxiété état, et entre l'inhibition d'une partie seulement du vécu émotionnel lors du partage et le niveau de dépression. Il semble que dans le premier cas il s'agit d'une stratégie visant à éviter la réactivation du vécu émotionnel alors que dans le deuxième cas, l'individu chercherait davantage à se préserver d'une vision négative de soi

Gut microbiota imbalance and colorectal cancer.

International audienceThe gut microbiota acts as a real organ. The symbiotic interactions between resident micro-organisms and the digestive tract highly contribute to maintain the gut homeostasis. However, alterations to the microbiome caused by environmental changes (e.g., infection, diet and/or lifestyle) can disturb this symbiotic relationship and promote disease, such as inflammatory bowel diseases and cancer. Colorectal cancer is a complex association of tumoral cells, non-neoplastic cells and a large amount of micro-organisms, and the involvement of the microbiota in colorectal carcinogenesis is becoming increasingly clear. Indeed, many changes in the bacterial composition of the gut microbiota have been reported in colorectal cancer, suggesting a major role of dysbiosis in colorectal carcinogenesis. Some bacterial species have been identified and suspected to play a role in colorectal carcinogenesis, such as Streptococcus bovis, Helicobacter pylori, Bacteroides fragilis, Enterococcus faecalis, Clostridium septicum, Fusobacterium spp. and Escherichia coli. The potential pro-carcinogenic effects of these bacteria are now better understood. In this review, we discuss the possible links between the bacterial microbiota and colorectal carcinogenesis, focusing on dysbiosis and the potential pro-carcinogenic properties of bacteria, such as genotoxicity and other virulence factors, inflammation, host defenses modulation, bacterial-derived metabolism, oxidative stress and anti-oxidative defenses modulation. We lastly describe how bacterial microbiota modifications could represent novel prognosis markers and/or targets for innovative therapeutic strategies

Physico-chemical modifications of the interactions between hemp fibres and a lime mineral matrix: impacts on mechanical properties of mortars

International audienceIn order to understand the physico-chemical mechanisms governing interactions between hemp fibres and a lime-based mineral matrix, the consequences of various chemical treatments onto hemp fibres characteristics were measured using scanning electron microscopy, thermal analysis, X-ray diffraction and FTIR spectroscopy. Secondly, effects of these treatments on the mechanical properties of lime mortars incorporating the chemically modified fibres were evaluated using 3 point bending tests. NaOH and EDTA treatments increase the crystallinity index of hemp fibres and increase the experimental rigidity of lime/natural fibres mortars. Treatments with polyethylene imine and a saturated lime solution do not induce any significant changes onto the mechanical properties. These results show that some specific chemical treatments have an impact onto the hemp/lime interfaces quality. The elaborated composite materials exhibit a higher rigidity and an improvement of the matrix /fibre charge transfer. However, the rupture stress is only slightly modified due to a relatively low fibre volumic content (10 %)

Nevirapine versus Efavirenz for patients co-infected with HIV and Tuberculosis: A Randomised Non-Inferiority Trial

BACKGROUND: In countries with a high incidence of HIV and tuberculosis co-infection, nevirapine and efavirenz are widely used as antiretroviral therapy but both interact with antituberculosis drugs. We aimed to compare efficacy and safety of a nevirapine-based antiretroviral therapy (started at full dose) with an efavirenz-based regimen in co-infected patients. METHODS: We did a multicentre, open-label, randomised, non-inferiority trial at three health centres in Maputo, Mozambique. We enrolled adults (≥18 years) with tuberculosis and previously untreated HIV infection (CD4 cell counts <250 cells per μL) and alanine aminotransferase and total bilirubin concentrations of less than five times the upper limit of normal. 4-6 weeks after the start of tuberculosis treatment, we randomly allocated patients (1:1) with central randomisation, block sizes of two to six, and stratified by site and CD4 cell count to nevirapine (200 mg twice daily) or efavirenz (600 mg once daily), plus lamivudine and stavudine. The primary endpoint was virological suppression at 48 weeks (HIV-1 RNA <50 copies per mL) in all patients who received at least one dose of study drug (intention-to-treat population); death and loss to follow-up were recorded as treatment failure. The non-inferiority margin for the difference of efficacy was 10%. We assessed efficacy in intention-to-treat and per-protocol populations and safety in all patients who received study drug. This study is registered with ClinicalTrials.gov, number NCT00495326. FINDINGS: Between October, 2007, and March, 2010, we enrolled 285 patients into each group. 242 (85%) patients in the nevirapine group and 233 (82%) patients in the efavirenz group completed follow-up. In the intention-to-treat population, 184 patients (64·6%, 95% CI 58·7-70·1) allocated nevirapine achieved virological suppression at week 48, as did 199 patients (69·8%, 64·1-75·1) allocated efavirenz (one-sided 95% CI of the difference of efficacy 11·7%). In the per-protocol population, 170 (70·0%, 63·8-75·7) of 243 patients allocated nevirapine achieved virological suppression at week 48, as did 194 (78·9%, 73·2-83·8) of 246 patients allocated efavirenz (one-sided 95% CI 15·4%). The median CD4 cell count at randomisation was 89 cells per μL. 15 patients substituted nevirapine with efavirenz and six patients substituted efavirenz with nevirapine. 20 patients allocated nevirapine (7%) had grade 3-4 increase of alanine aminotransferase compared with 17 patients allocated efavirenz (6%). Three patients had severe rash after receipt of nevirapine (1%) but no patients did after receipt of efavirenz. 18 patients in the nevirapine group died, as did 17 patients in the efavirenz group. INTERPRETATION: Although non-inferiority of the nevirapine-regimen was not shown, nevirapine at full dose could be a safe, acceptable alternative for patients unable to tolerate efavirenz. FUNDING: French Research Agency for HIV/AIDS and hepatitis (ANRS)

Video games in adolescence and emotional functioning: Emotion regulation, emotion intensity, emotion expression, and alexithymia

International audienceVideo-game users represent 40% of the French population and adolescents are the primary users. Yet excessive playing of video games has become a problem in modern society and is manifesting itself in treatment centers for adolescents. Before attempting to gain insight into this problematic use, we must understand video gaming itself and its implications for the gamer. The aim of this research is to propose an understanding of video-game playing based on some dimensions of emotional functioning such as emotion regulation, emotion intensity, emotion expression, and alexithymia. A total of 159 adolescents took part in the study. Regular gamers regulated their emotions more than irregular gamers did. They also felt their emotions more intensely. But regular gamers expressed their emotions less than irregular gamers did. Finally, the regular gamers' alexithymia level was higher than the irregular gamers' level. Especially, they had more difficulty being emotionally reactive. The avatar's evolution in the virtual environment may help mediate adolescents' problematic emotional experiences to give them meaning and enable their appropriation. As such, video games may act as a medium for projecting and experiencing one's emotional life by staging the emotional self, thereby explaining the engagement of adolescents in video gaming