Adoptees' experiences of using direct-to-consumer genetic testing and determinants of this use: A mixed study in Quebec.

Adoptees' use of direct-to-consumer genetic testing (DTC-GT) is known to raise both ethical and emotional issues, and it can also challenge their identity. The objective of the present study was to describe the experiences of DTC-GT use among adoptees living in Quebec and to better understand the benefits and disadvantages of use. We adopted a mixed method approach whereby a questionnaire comprising standardized scales was administered to 143 adoptees who had used genetic testing and 40 adoptees who had not. Semi-structured interviews were performed with five respondents from the DTC-GT use group. The quantitative and qualitative data were analyzed and integrated together using the Pillar Integration Process. The results highlighted familial reunion as the primary motivation for the use of DTC-GT among responding adoptees. Reported challenges included needing help with results interpretation, as well as the need for autonomy in the ownership of the results. Participants describe not being particularly concerned by potential ethical issues, describing the benefits of the tests as more important than possible disadvantages. Overall, participants had a good experience of using DTC-GT, and users were less anxious. Various factors associated with the use and experience of use were highlighted (age, psychological distress, community membership, etc.). The results from this study provide much-needed information about adoptees' needs regarding DTC-GT, highlight key risk factors, and introduces best practice recommendations so that adoptees are properly informed and supported when pursuing DTC-GT.

Children's Physical Proximity to Interparental Conflict: Resilient Process and Retrospective Perceptions of Parent-Child Relationships.

This retrospective study sought to determine (a) whether physical proximity to interparental conflict in childhood moderates the link between frequency of exposure to interparental conflict and subsequent levels of resilience in adulthood and (b) whether retrospective perceptions of parent-child relations and insecurity mediate the link between interparental conflict and resilient development. A total of 963 French students aged 18-25 years were assessed. Our study showed that the children's physical proximity to interparental conflict is a major long-term risk factor for their subsequent development and their retrospective perceptions of parent-child relations.

Explaining Differences Between Sibling Relationships in Schizophrenia and Nonclinical Sibling Relationships.

BACKGROUND: Good sibling relationships in adulthood are known to be a protective factor for mental health. The quality of these relationships is influence by the sibship's inherent characteristics (e.g., birth order, number of brothers and sisters, sex composition, age gaps). The present study explored whether these same determinants can help to explain how individuals experience their relationship with a sibling who has been diagnosed with schizophrenia. METHOD: A total of 374 adults completed the Adult Sibling Relationship Questionnaire, a scale that probes the quality of these relationships on three dimensions: warmth, conflict, and rivalry. We also collected sociodemographic data and information about family structure from each of the participants. Participants were divided into two matched groups: nonclinical sibling group (n = 187) or schizophrenia sibling group (n = 187). Regression analyses were conducted to extract possible predictors of sibling relationship quality for each group. Further regression analyses then focused exclusively on relationships with an ill sibling, in order to study the role of disease-related variables in explaining each of the three dimensions. RESULTS: Results showed that sociodemographic and family structure data explained a significant proportion of variance in the sibling relationship, but solely for nonclinical siblings. When participants had a sibling with schizophrenia, we found that disease-related variables (symptom severity, frequency of treatment) also had to be included to predict the conflict dimension. CONCLUSIONS: Our results suggest that feelings of conflict experienced by the schizophrenia sibling group were fueled by the symptoms the ill person displayed. Healthy brothers and sisters probably have only a poor understanding of these symptoms. This could be improved by supporting them and helping them learn more about the disease. Future research will have to prove that providing such support for siblings does indeed improve the quality of their sibling relationships and, by so doing, enhance the wellbeing of both members of a sibling dyad.

Comparison of relationships among French adult siblings with or without schizophrenia using the ASRQ-S: mediating effect on emotional distress.

BACKGROUND: Good sibling relationships in adulthood are known to be a protective factor for mental health. The present study examined and compared the relationships of siblings with either a healthy brother or sister or one experiencing schizophrenia. METHODS: In the first phase, we ran a statistical comparison of the two sibling groups on the quality of their sibling relationships (warmth, conflict, and rivalry), emotional distress, and self-esteem. In the second phase, we looked at whether the quality of the sibling relationship modifies the impact of having a brother or sister with schizophrenia on emotional distress and self-esteem. RESULTS: Results showed that sibling relationships in schizophrenia are less warm and are characterized by heightened rivalry and conflict. In addition, analysis revealed a mediating effect of sibling relationship on the emotional distress of siblings with a brother/sister diagnosed with schizophrenia. CONCLUSION: More needs to be done to enhance the mental health of adults who have a brother or sister with schizophrenia, notably via their sibling relationships.

Return-to-work support in cancer patients: Which methodology?

INTRODUCTION: Return to work after cancer is a determinant of patients quality of life. The aims were to describe return-to-work interventions applied in a French University Hospital and to assess its effectiveness in achieving a successful return to work. METHODS: A return-to-work questionnaire was sent to 153 patients who were accompanied by a multidisciplinary return-to-work after cancer consultation. RESULTS: hundred and twenty-one patients answered the return-to-work questionnaire. Analysis of the questionnaire found an overall rate of return to work of 50% two years after the cancer diagnosis. The rate was significantly higher in patients who had received individual psychological support for returning to work (P=0.04) and higher, but not significantly, in patients who had a consultation with the company physician during their period of sick-leave (P=0.08). Participating in support groups and performing the required actions for the recognition of handicapped worker status were not factors associated with return to work. DISCUSSION: An individual psychological support for returning to work and a consultation with the company physician during the period of sick-leave should be systematically recommended for patients suffering from cancer. Participating in support groups and recognition of handicapped worker status should be recommended on a case-by-case basis.

Involvement of Emotional Intelligence in Resilience and Coping in Mothers of Autistic Children.

In a context described as a challenge in parenting (having an autistic child), we sought to highlight the emotional skills that mothers gain as a result of interacting with their child, and how they then use these skills. Mothers of autistic children (n = 136) and mothers of non-autistic children (n = 139) responded to emotional intelligence, resilience, and coping scales. Comparisons revealed smaller differences between groups than expected. Nevertheless, mothers of autistic children showed greater resilience abilities than mothers of non-autistic children. Moreover, we noted differences between both groups regarding their use of emotional skills. Emotional intelligence is a resource that deserves to be explored in terms of its clinical implications, especially among the parents of autistic children.

Giving up work after cancer: An exploratory qualitative study of three clinical cases.

BACKGROUND: Enabling cancer survivors to resume employment has become a public health issue in France, but not all survivors wish to or would benefit from doing so. OBJECTIVE: This French exploratory qualitative study was designed to identify the psychological factors that influence the decision of some cancer survivors not to return to work, despite their doctor's permission. METHODS: We conducted semi structured interviews with two women and one man. Each interview lasted around 90 minutes. Qualitative analysis of the interviews (clinical case studies) highlighted a number of similarities and differences among these three patients. RESULTS: Comparisons revealed six similarities: 1. the issue of income and its importance had no part in the decision-making process; 2. patients anticipated work return problems; 3. they therefore abandoned their plans to go back; 4. work lost its meaning for them; 5. repressed affects surfaced or they reassessed their career plans; and 6. their life trajectories were disrupted, with the stages being telescoped together. There were also two differences: 1. feelings of social exclusion for two participants, and 2. gendered experiences of quitting employment. CONCLUSIONS: Health professionals and job retention support services need to take this clinical reality into account and acknowledge that not all patients wish to resume work or would benefit from doing so.

[Retiring: a test of resilient capacities]. / Le passage à la retraite: une mise à l'épreuve des capacités de résilience.

This article deals with the question of retiring as a test of the conjunctural resilience capacities. The continuity theory and the rupture theory are developed because their content is related to protective factors and risk factors met by retirees: the first theory advocates the use of familiar strategies in familiar areas to maintain internal and external structures. This continuity would protect mental health. The second one emphasises the gap with the working world and its affiliated status. The loss of the professional status would endanger, in a way more or less important, the subjects' mental health. Retiring, as a life event, can be experienced as a trauma or can even be compared by the subjects themselves to other significant periods of their life which have been more or less well overcome. In order to attempt to figure out the conjunctural resilience capacities requested on the first year of retirement, and at the same time, highlighting the available protective factors, two clinical vignettes of two potentially young resilient retirees are presented.