Social determinants of antidepressant continuation during pregnancy in the USA: findings from the ABCD cohort study.

PURPOSE: Patients and healthcare professionals overestimate the risks of using antidepressants during pregnancy. According to current literature, approximately half of people stop taking an anti-depressant medication when they become pregnant. Discontinuing antidepressants during pregnancy increases risks of postnatal relapses. Factors like socioeconomic status, education, and planned pregnancies play a role in the decision to continue antidepressant medication, which can worsen disparities in maternal and child health. Our aim was to identify the sociodemographic factors associated with antidepressant continuation after awareness of pregnancy. METHODS: We used representative data from the Adolescent Brain Cognitive Development (ABCD) study that captures maternal medication during pregnancy. We identified women who used antidepressants before awareness of their pregnancy. We calculated crude and adjusted associations between sociodemographic factors and continuation of antidepressant medication during pregnancy. Our model included age, education, ethnicity, first language, household income, living with a partner, having planned the pregnancy, pregnancy duration and smoking during pregnancy. RESULTS: In total, 199 women continued antidepressants and 100 discontinued. The logistic regressions resulted in only one significant factor: first language. Native English speakers were more likely to continue medication than other mothers (adjusted OR = 14.94, 95% CI = [2.40; 291.45], p = .015). CONCLUSIONS: Language differences were associated with continuation of antidepressants. Non-native English speakers were more likely to discontinue antidepressants, which may lead to health inequities. This finding should be taken into account to reinforce information about the limited risks of antidepressants among people with non-English speaking backgrounds in the USA.

Swiss cohort on Traumatic Childbirth and Health (SwiTCH): protocol for a prospective, population-based cohort study on parents' mental health from pregnancy to one year postpartum.

INTRODUCTION: Approximately 4%-5% of mothers develop childbirth-related post-traumatic stress disorder (CB-PTSD) and approximately 12.3% of mothers develop some CB-PTSD symptoms (CB-PTSS). To date, there is a dearth of studies on fathers and other coparents. Parental CB-PTSD and CB-PTSS may have a negative impact not only on the parents but also on the infant. Understanding risk and protective factors of CB-PTSD for both parents and its consequences on the family is key to detecting or anticipating it, to developing interventions aimed at reducing its detrimental effects and to supporting parents. METHODS AND ANALYSIS: This study protocol describes an observational, population-based study, consisting of a longitudinal prospective cohort with online surveys at four time points. The population of interest consist of women, in the third trimester of pregnancy or at 6-12 weeks postpartum, and their partner/coparent, who will give birth or gave birth in the French-speaking part of Switzerland. The target sample size is 300-500 women and a proportional number of partners. The primary outcome of this study is the prevalence of CB-PTSD and CB-PTSS. The secondary outcomes focus on: (1) the impact of CB-PTSD and CB-PTSS on the marital and coparental relationships, the bonding with the infant, parental burnout and healthcare seeking behaviours, (2) the role of the childbirth experience in the development of CB-PTSD and CB-PTSS and (3) the social and economic determinants of CB-PTSD and CB-PTSS. ETHICS AND DISSEMINATION: Ethical approval was granted by the human research ethics committee of the Canton de Vaud (study number 2022-00284). All study participants signed an informed consent form. Dissemination of results will occur via national and international conferences, in peer-reviewed journals, public conferences and social media. TRIAL REGISTRATION NUMBER: NCT05865704.

Implementation and Evaluation of a Training Program for Traditional Healers to Improve Knowledge of Noma (Cancrum Oris) in Burkina Faso.

Noma (cancrum oris) is an orofacial gangrene affecting young children living in extreme poverty. The acute morbidity is high, and survivors suffer from physical and social sequelae. When diagnosed early, noma can be cured. Noma is especially prevalent in sub-Saharan Africa, where traditional medicine is the norm. The aim of this work was to provide 1-day training to traditional healers in Burkina Faso and to evaluate change in knowledge of noma across time. A sample of 78 healers who attended the training were asked to complete the same questionnaire before, immediately after, and 8 months after the training. A total of 66 healers completed the entire study. Before training, more than 40% of the participants did not know any of its key messages. Most of the key messages were acquired and still present after 8 months by a large proportion of the participants. Systematic intraoral examination was practiced by 7 (9.0%) of the traditional healers before training, and 43 (65.2%) reported doing so 8 months after training. The key messages aiming to improve early diagnosis as well as rapid and adequate treatment (the recognition of facilitating factors and the need to perform a systematic oral examination and to advise hospital transfer) have been well integrated. The study suggests that organizing a self-managed training program is feasible when done within an association, as was the case here, and owing to the willingness to collaborate shown by the traditional healers who participated in our study.

Was retrospective change measurement conducted with Covid-19 containment inconsistent? Comparing prospective and retrospective change measures using data from a national survey on substance use and addictive behaviors.

Single-measurement-point data collection to assess change has increased with studies assessing the impact of the Covid-19 pandemic and of its containment, despite evidence of its lack of validity. Retrospective change is not equivalent to change in repeated self-reported measures giving raise to questions about the validity of the former. This paper purports to investigate inconsistencies between change measures by confronting retrospective change to information from longitudinally self-reported measures from the C-SURF cohort study. The study sample consists of 2,279 young men who participated in C-SURF between 2020 and 2021, and completed between May and June 2021 a survey covering change in alcohol, cigarette, cannabis and other addictive behaviors related to the pandemic. The aforementioned behaviors were assessed longitudinally at two time points using self-reports, and retrospective change since the onset of the Covid-19 crisis was also assessed at the second measurement time. Information from both prospective and retrospective change measures were confronted to identify inconsistent information for each behavior. Additionally, multiple logistic regressions were performed to assess associations between socioeconomic status, impulsivity, depression, and different indicators of motivation to complete the study and inconsistency between both measures for each behavior of interest. Importantly, inconsistent information in at least one of the investigated behaviors was found in about 90% of the participants. Small associations were found between inconsistency and different factors with a consistent effect of impulsivity. In the absence of evidence of the validity of retrospective change measures, studies relying on retrospective change should be interpreted with caution.

Associations of binge gaming (5 or more consecutive hours played) with gaming disorder and mental health in young men.

Background: Video gaming is a popular activity among young people. Time spent with gaming was found to be only moderately associated with gaming disorder. However, patterns of binge gaming (playing more than 5 h consecutively) were rarely considered in research on gaming. This study explores how binge gaming frequency is related with gaming disorder and mental health. Methods: The sample came from the Cohort study on substance use risk factors (C-SURF) and comprised 5,358 young men aged 28.26 years (SD = 1.27). ANCOVA was conducted to estimate the association between binge gaming frequency (gaming at least 5 h consecutively) and gaming disorder (measured with the Game Addiction Scale) as well as indicators of mental health. Results: A total of 33.3% of the sample engaged in binge gaming at least once in the previous year, and 6.1% at least weekly. Frequency of binge gaming was associated with gaming disorder score in a linear dose-response relationship (linear trend = 2.30 [2.14, 2.46]) even if adjusted for time spent gaming (linear trend = 1.24 [1.03, 1.45). More frequent binge gaming was associated with lower life satisfaction and sleep quality, and with more major depression and social anxiety disorder symptoms. Conclusions: Binge gaming patterns, especially daily or almost daily binge gaming, are important to consider with regard to gaming disorder and mental health. Asking about binge gaming may be a promising screening question for gaming related problems. Encouraging regular breaks from gaming may be a valuable prevention strategy to reduce negative outcomes of gaming.

Nurses and the doctorate: A mixed study in French health care organizations.

AIM: This research aims to understand the place and role of nurses holding a PhD or PhD students (nurse doctor [ND]/nurse doctoral students [NDS]) in health care organizations in France. CONTEXT: Worldwide, many nurses are undertaking doctoral studies. France is no exception. However, in France, there is no doctorate dedicated to nursing. The question of ND/NDS integration into health organizations is thus raised in a specific manner. METHODS: We used a two-stage mixed methodology. The first stage used data from questionnaires that were sent to 165 ND/NDS in France. To contextualize issues raised by these data, we used qualitative methods which comprised 45 semi-structured interviews with nurses, 10 interviews with health managers and chief nurses and 27 h of in situ observations with research coordinators. RESULTS: Seventy-nine participants (47.9% response rate) completed questionnaires. The data showed that work organization in some departments-intensive care units (ICUs), oncology and psychiatry-favoured the development of scientific expertise among nurses. Favourable elements promoting the professional and academic development of ND/NDS included the potential for medical teaching in healthcare services, participation in research projects and, most importantly, medical proximity. Conversely, our data also identified poor visibility and recognition of nursing doctoral courses in French health organizations: A lack of task missions, a lack of suitable posts and poor integration into the nursing profession. Currently, French nurses define their profession as providing direct care to patients and their families-yet this definition fails to consider other important professional elements, such as research. CONCLUSIONS: Our study identified how proper ND/NDS integration is important to health care organizations. We identified key organization factors facilitating the integration of ND/NDS, such as participating in research teams and providing research support management. IMPLICATIONS FOR NURSING MANAGEMENT: In recent years, the nursing profession has significantly evolved. We are interested in the impact of these changes in work organizations following the development of new scientific skills. Our study investigates all aspects of the nursing profession (teaching, practice, research and organizations). Our study advocates managerial roles, among others, to improve ND and NDS integration into work organizations. We directly observed work organizations that helped develop nursing research. Our study is also aimed at managers who have roles as decision-makers in promoting and facilitating research and nurse researchers.

Economic and Social Costs of Noma: Design and Application of an Estimation Model to Niger and Burkina Faso.

BACKGROUND: While noma affects hundreds of thousands of children every year, taking their lives, disfiguring them and leaving them permanently disabled, the economic and social costs of the disease have not been previously estimated. An understanding of the nature and levels of these costs is much needed to formulate and implement strategies for the prevention and control of this disease, or to mitigate its burden. The objectives of our study were to develop a model for estimating the economic and social costs of noma and to provide estimates by applying this model to the specific contexts of two countries in the "noma belt", namely Burkina Faso and Niger. METHODS: Three main approaches were used. The estimation of prevalence levels of potential noma cases and of cases that should receive and actually do receive medical care was carried out using a literature review. The documentary approach made it possible to estimate the direct costs of noma by analyzing the database of a non-governmental organization operating in this field and present in both countries. Indirect costs were estimated using the human capital method and the cost component analysis technique. RESULTS: The direct costs of care and management of noma survivors amount to approximately USD 30 million per year in Burkina Faso, compared to approximately USD 31 million in Niger. They mainly include costs for medical treatment, surgery, hospital stays, physiological care, psychological care, social assistance, schooling, vocational training and care abroad. Indirect costs are estimated at around 20 million in lost production costs in Burkina and around 16 million in Niger. Costs related to premature deaths are estimated at more than USD 3.5 billion in Burkina Faso and USD 3 billion in Niger. Finally, the costs to survivors who are unable to marry are around USD 13.4 million in Burkina and around USD 15 million in Niger. Intangible costs were not calculated. CONCLUSIONS: The neglect of noma and inaction in terms of prevention and control of the disease have enormous economic and social costs for households, communities and states. Future studies of this kind are necessary and useful to raise awareness and eradicate this disease, which impacts the health and well-being of children and results in lifelong suffering and severe economic and social costs to survivors and their families.

Noma: Experiences of Survivors, Opinion Leaders and Healthcare Professionals in Burkina Faso.

The scientific literature on noma (Cancrum Oris) has clearly increased in recent decades, but there seems to have been limited analysis of issues around the psycho-social impacts of this disease. Even when these issues have been addressed, the focus has tended to be on patient experiences, whereas the community dimension of the disease and the role of healthcare professionals and community leaders in mitigating these impacts remain largely unexplored. A study in the form of semi-directed interviews with 20 noma survivors and 10 healthcare professionals and community leaders was conducted between January and March 2021 in Burkina Faso with the aim of describing the experiences of noma survivors, generating knowledge about living with the burden of the disease and understanding the attitudes of community leaders towards the disease. The results reveal that noma is a disease that affects economically vulnerable populations and leads to extreme household poverty. As far as treatment is concerned, patients tend to turn to practitioners of both traditional and modern medicine. Within communities, noma survivors face discrimination and stigma. The study highlighted a lack of information and knowledge about noma. However, surgical operations lead to patient satisfaction and these remain one of the coping strategies used to tackle the stigma and discrimination. The recommendations set out in this article are aimed firstly at stepping up research into the psycho-social impacts of noma, and secondly at considering these impacts in regional programmes and national plans to combat the disease.

Validity of the older people quality of life-7 domains (OQoL-7) scale.

BACKGROUND: The Older people Quality of Life-7 domains (OQoL-7) is a 28-item multidimensional questionnaire developed to measure community-dwelling older people's QoL. The OQoL-7 assesses both importance of and satisfaction in seven QoL domains (Material resources; Close entourage; Social and cultural life; Esteem and recognition; Health and mobility; Feeling of safety; and Autonomy). This study aimed to investigate concurrent and construct validity of the OQoL-7. A secondary aim was to compare different methods of weighting participants' ratings of satisfaction according to their individual ratings of importance, as compared to the OQoL-7 total score (unweighted). METHODS: Data came from the first and second samples of the Lausanne cohort 65+ study, assessed at the same age of 72-77 years in 2011 (N = 1117) and 2016 (N = 1091), respectively. To assess concurrent validity, the OQoL-7 was compared to other measures of the same concept (single QoL item) or related concepts (self-rated health, SF-12). Construct validity was tested by comparing subscores in the seven QoL domains in the presence and absence of two stressful events during the preceding year (financial difficulties and relationship difficulties). The effect of importance weighting was assessed using moderated regression analysis. RESULTS: The OQoL-7 total score was significantly associated with the single QoL item (Spearman's rho 0.46), self-rated health (Spearman's rho 0.34), SF-12 physical (Spearman's rho 0.22) and mental (Spearman's rho 0.28) component scores. Large differences (Cohen's d > 0.8) were observed in the presence or absence of stressful events in the expected QoL domains: "Material resources" in the presence or absence of "Financial difficulties" (Cohen's d 1.34), and "Close entourage" in the presence or absence of "Relationship difficulties" (Cohen's d 0.84). Importance weighting resulted in a very small improvement in the prediction of the single QoL item (ΔR2 0.018). All results were highly consistent across 2011 and 2016 samples. CONCLUSIONS: The OQoL-7 showed adequate concurrent and construct validity in two samples of older people. In future studies, the decision to use weighted or unweighted scores will depend on the priority given to either optimizing the prediction of QoL or limiting the burden on respondents and the amount of missing data.

Mental disorders, attrition at follow-up, and questionnaire non-completion in epidemiologic research. Illustrations from the CoLaus|PsyCoLaus study.

OBJECTIVE: This study aimed to investigate the associations between mental disorders recorded at baseline and participation in the subsequent follow-up interview (vs. attrition) or baseline questionnaire completion (vs. non-response) within the psychiatric arm of a population-based study. METHODS: Participants of a physical health survey were initially invited to also participate in a semi-structured interview covering mental disorders and were reassessed approximately 5.5 years later. They were also asked to complete self-rating questionnaires at baseline. Associations between the presence of lifetime mental disorders assessed at baseline and attrition at follow-up as well as non-completion of self-rating questionnaires at baseline were established. RESULTS: After controlling for sociodemographic variables, a significant negative association was found between anxiety disorders at baseline and attrition at follow-up (Adjusted odds ratio (AOR) = 0.84; 95% confidence interval (CI) = 0.71-1.00) and a positive association between major depressive disorders (MDD) and non-response to the self-rating questionnaires at baseline (AOR = 1.24; 95% CI = 1.05-1.45). CONCLUSIONS: The associations of anxiety disorders during lifetime with a higher participation rate in interviews at follow-up and of MDD during lifetime with the non-completion of self-rating questionnaires are potential sources of bias and should be taken into account in future longitudinal research.

Detecting computer-generated random responding in questionnaire-based data: A comparison of seven indices.

With the development of online data collection and instruments such as Amazon's Mechanical Turk (MTurk), the appearance of malicious software that generates responses to surveys in order to earn money represents a major issue, for both economic and scientific reasons. Indeed, even if paying one respondent to complete one questionnaire represents a very small cost, the multiplication of botnets providing invalid response sets may ultimately reduce study validity while increasing research costs. Several techniques have been proposed thus far to detect problematic human response sets, but little research has been undertaken to test the extent to which they actually detect nonhuman response sets. Thus, we proposed to conduct an empirical comparison of these indices. Assuming that most botnet programs are based on random uniform distributions of responses, we present and compare seven indices in this study to detect nonhuman response sets. A sample of 1,967 human respondents was mixed with different percentages (i.e., from 5% to 50%) of simulated random response sets. Three of the seven indices (i.e., response coherence, Mahalanobis distance, and person-total correlation) appear to be the best estimators for detecting nonhuman response sets. Given that two of those indices-Mahalanobis distance and person-total correlation-are calculated easily, every researcher working with online questionnaires could use them to screen for the presence of such invalid data.

Associations of lack of voluntary private insurance and out-of-pocket expenditures with health inequalities. Evidence from an international longitudinal survey in countries with universal health coverage.

OBJECTIVES: In countries with universal health coverage (UHC), national public health insurances cover 70% of health expenditures on average, but health care user fees and out-of-pocket expenditures have been neglected in empirical patient-centered health inequality research. This study is the first to investigate how health care-related factors are associated with health status among middle-aged and elderly people-vulnerable groups for the burden of illness-in countries with UHC. DESIGN: Longitudinal observational cohort study. SETTING: Population-based cohort Survey of Health, Ageing and Retirement in Europe (SHARE) in twelve countries with UHC. PARTICIPANTS: Non-institutionalized people aged 50 and older (n = 29,260). Two subsamples were also used: participants without global activity limitation at baseline (n = 16,879) and participants without depression at baseline (n = 21,178). MAIN OUTCOME MEASURES: Risk of death, risk of global activity limitations, and risk of depression. We used mixed-effects Cox proportional hazards regressions to estimate hazard ratios (HR) for all-cause mortality, physical limitations, and depression. RESULTS: Having a voluntary private insurance to cover health expenses not included in the public health care system (44.1% of the total sample) was a protective factor for all outcomes (HR≤0.91), controlling for a large range of socio-economic variables. On the contrary, having out-of-pocket expenditures (62.4%) was a risk factor (HR≥1.12). CONCLUSIONS: UHC systems are not free from health inequalities: there is a potential effect of lack of voluntary private insurance and out-of-pocket expenditures on mortality and health. Health care-related factors should be at focus in future researches designed to understand and address health inequalities. Reducing out-of-pocket expenditures and developing voluntary private insurance may protect against premature illness and death.

Addictive behaviors and healthcare renunciation for economic reasons in a French population-based sample.

BACKGROUND: Healthcare renunciation for economic reasons is a major health concern, but it has been scarcely investigated among drug users, even if drug users constitute a vulnerable population in need of medical care. This study investigated associations of healthcare renunciation for economic reasons and addictive behaviors (alcohol, tobacco, cannabis, illicit drug use, and gambling) in a population-based sample of adults living in France, a country with universal health coverage. METHODS: Data were collected using the 2014 Health Barometer, a French cross-sectional survey conducted among a random representative sample of the general population aged 18-64 (n=12,852). Measures included healthcare renunciation, substance use (alcohol, tobacco, cannabis, and other illicit drugs) and gambling. Experimental/recreational and heavy/chronic use were assessed. Logistic regressions were used to test the relationship between healthcare renunciation and addictive behaviors, controlling for relevant covariates. RESULTS: A total of 25% of the participants had renounced care at least once in the previous twelve months. Most variables of drug use were significantly associated with increased healthcare renunciation. This was the case for heavy/hazardous use and experimental/recreational use. Regular gambling was not associated with healthcare renunciation, but disordered gambling was. CONCLUSION: This study showed that addictive behaviors, including substance use and gambling, were part of the burden of vulnerability of people who forgo care. Therefore, drug use and gambling patterns should be a focus in the development of policies to reduce health inequalities, not only for heavy and chronic drug users.

Substance Use in Young Swiss Men: The Interplay of Perceived Social Support and Dispositional Characteristics.

BACKGROUND: Social environment plays a central role in substance use behaviors. However, it is not clear whether its role varies as a function of individual dispositional characteristics. OBJECTIVES: To investigate the interaction between dispositional characteristics (i.e. sensation seeking, anxiety/neuroticism) and social environment (i.e. perceived social support [PSS]) in association with substance use. METHODS: A representative sample of 5,377 young Swiss males completed a questionnaire assessing substance use, sensation seeking, anxiety/neuroticism, and PSS from friends and from a significant other. RESULTS: Sensation seeking and anxiety/neuroticism were positively related to most substance use outcomes. PSS from friends was significantly and positively related to most alcohol and cannabis use outcomes, and significantly and negatively associated with the use of hard drugs. PSS from a significant other was significantly and negatively associated with most alcohol and cannabis use outcomes. The associations of sensation seeking with drinking volume, alcohol use disorder and the use of illicit drugs other than cannabis were stronger in individuals reporting high levels of PSS from friends than those with low levels. The associations of sensation seeking with risky single-occasion drinking and the use of hard drugs were weaker in participants reporting high levels of PSS from a significant other than in those with low levels. CONCLUSIONS: Sensation seeking and anxiety/neuroticism may constitute risk factors for substance use and misuse. PSS from friends may amplify the risk for alcohol and illicit drug use (other than cannabis) associated with high sensation seeking, whereas the PSS from a significant other may reduce it.

Psychiatric symptoms and response quality to self-rated personality tests: Evidence from the PsyCoLaus study.

Despite the fact that research has demonstrated consistent associations between self-rated measures of personality dimensions and mental disorders, little has been undertaken to investigate the relation between psychiatric symptoms and response patterns to self-rated tests. The aim of this study was to investigate the association between psychiatric symptoms and response quality using indices from our functional method. A sample of 1,784 participants from a Swiss population-based cohort completed a personality inventory (NEO-FFI) and a symptom checklist of 90 items (SCL-90-R). Different indices of response quality were calculated based on the responses given to the NEO-FFI. Associations among the responses to indices of response quality, sociodemographic characteristics and the SCL-90-R dimensions were then established. Psychiatric symptoms were associated with several important differences in response quality, questioning subjects' ability to provide valid information using self-rated instruments. As suggested by authors, psychiatric symptoms seem associated with differences in personality scores. Nonetheless, our study shows that symptoms are also related to differences in terms of response patterns as sources of differences in personality scores. This could constitute a bias for clinical assessment. Future studies could still determine whether certain subpopulations of subjects are more unable to provide valid information to self-rated questionnaires than others.

Validation of a brief form of the Perceived Neighborhood Social Cohesion questionnaire.

The aim of this study was the validation of a brief form of the Perceived Neighborhood Social Cohesion questionnaire using data from 5065 men from the "Cohort Study on Substance-Use Risk Factors." A 9-item scale covering three factors was proposed. Excellent indices of internal consistency were measured (α = .93). The confirmatory factor analyses resulted in acceptable fit indices supporting measurement invariance across French and German forms. Significant correlations were found between the brief form of the Perceived Neighborhood Social Cohesion questionnaire, and satisfaction and self-reported health, providing evidence of the concurrent validity of the scale. Perceived neighborhood social cohesion, and depression and suicide attempts were negatively associated, sustaining the protective effect of perceived social cohesion.

Subthreshold problem drinkers in DSM-5 alcohol use disorder classification.

BACKGROUND AND OBJECTIVES: The DSM-5 defined alcohol use disorder (AUD) to better cover undiagnosed subthreshold alcohol users, but few studies have investigated this topic. This study aimed to test whether subthreshold problem drinkers were a distinct subgroup of undiagnosed drinkers according to the DSM-5 AUD classification by investigating drinking patterns and longitudinal trajectories. METHODS: Data were collected in the Cohort Study on Substance Use Risk Factors from young Swiss men in their early twenties (n = 4,630) at two time points. Participants responded to the 11 criteria of the DSM-5 AUD and to variables related to drinking patterns. RESULTS: Among drinkers, 23.2% and 23.5% of the participants were subthreshold problem drinkers at baseline and follow-up, respectively. The trends showed that 29.4% of them remained subthreshold problem drinkers over time. Those who remained subthreshold problem drinkers or progressed to AUD status were likely to meet the same criterion/add a new one. Subthreshold problem drinkers showed concurrent and later drinking patterns that were in between those of symptom-free drinkers and AUD drinkers. DISCUSSION AND CONCLUSION: Subthreshold problem drinkers were an important subgroup of drinkers with risky drinking patterns, but they did not necessarily progress to later AUD status and did not appear to be a consistent subgroup over time. SCIENTIFIC SIGNIFICANCE: Subthreshold problem drinkers did not seem to be a subgroup of undiagnosed problem drinkers in the current DSM-5 classification. The results showed that AUD appeared to be a dimensional construct, in which one additional criterion was associated with worse alcohol-related outcomes. (Am J Addict 2016;25:408-415).

Drinking Motives As Mediators of the Associations between Reinforcement Sensitivity and Alcohol Misuse and Problems.

Alcohol may be used and misused for different reasons, i.e., to enhance positive affect and to cope with negative affect. These to pathways are thought to depend on two distinct and relatively stable neurobiological systems: the behavioral activation (BAS; i.e., fun seeking, drive, reward responsiveness) and behavioral inhibition (BIS) systems. This study investigates the associations of BAS and BIS sensitivity with risky single-occasion drinking and alcohol use disorder in a representative sample of 5362 young Swiss men. In order to better understand the contribution of more proximal motivational factors in the associations of BIS and BAS with alcohol outcomes, mediations via drinking motives (i.e., enhancement, social, coping, conformity) was also tested. Risky single-occasion drinking and alcohol use disorder were positively associated with fun seeking and negatively with reward responsiveness. Drive was negatively associated with risky single-occasion drinking. BIS was positively associated with alcohol use disorder and negatively with risky single-occasion drinking. Positive associations of fun seeking with risky single-occasion drinking and alcohol use disorder were partially mediated mainly by enhancement motives. Negative association of drive with risky single-occasion drinking was partially mediated by conformity motives. The negative reward responsiveness-alcohol use disorder association was partially mediated, whereas the negative reward responsiveness-risky single-occasion drinking association was fully mediated, mainly by coping and enhancement motives. The positive BIS-alcohol use disorder association was fully mediated mainly by coping motives. Fun seeking constitutes a risk factor, whereas drive and reward responsiveness constitute protective factors against alcohol misuse and disorder. BIS constitutes a protective factor against risky single-occasion drinking and a risk factor for alcohol use disorder. The results of the mediation analysis suggest that prevention strategies targeting coping and enhancement motives may reduce the risk associated with high BIS and with high fun seeking, respectively.

Do bipolar subjects' responses to personality questionnaires lack reliability? Evidence from the PsyCoLaus study.

Differences in personality scores between subjects with and without mood disorders might result from response biases rather than specific personality traits per se. The aim of this study was to compare subjects with bipolar disorders (BPD) to non-bipolar subjects in terms of response quality to the NEO-FFI. Using data from the population-based cohort study PsyCoLaus, subjects were compared in terms of responses to the NEO-FFI, and indices of response quality were calculated. Hierarchical regression analyses were performed and controlled for sociodemographic factors, depressive episodes, dysthymia, anxiety disorders and substance use disorders. Consistent with the literature, subjects with BPD had higher scores in neuroticism and openness, and lower scores in conscientiousness. However, significant differences were measured for response reliability and validity. In particular, the indices of response quality including response reliability were lower in subjects with BPD suggesting that bipolar subjects might have more difficulty in providing consistent answers throughout questionnaires. However, regression models resulted in small associations between mania/hypomania and response quality, and showed that differences in response quality were mainly attributable to correlates of BPD instead of the presence of mania/hypomania itself. The current findings suggest that bipolar subjects' responses to questionnaires are biased, making them less reliable.

Reframing video gaming and internet use addiction: empirical cross-national comparison of heavy use over time and addiction scales among young users.

BACKGROUND AND AIMS: Evidence-based and reliable measures of addictive disorders are needed in general population-based assessments. One study suggested that heavy use over time (UOT) should be used instead of self-reported addiction scales (AS). This study compared UOT and AS regarding video gaming and internet use empirically, using associations with comorbid factors. DESIGN: Cross-sectional data from the 2011 French Survey on Health and Consumption on Call-up and Preparation for Defence-Day (ESCAPAD), cross-sectional data from the 2012 Swiss ado@internet.ch study and two waves of longitudinal data (2010-13) of the Swiss Longitudinal Cohort Study on Substance Use Risk Factors (C-SURF). SETTING: Three representative samples from the general population of French and Swiss adolescents and young Swiss men, aged approximately 17, 14 and 20 years, respectively. PARTICIPANTS: ESCAPAD: n =22 945 (47.4% men); ado@internet.ch: n =3049 (50% men); C-SURF: n =4813 (baseline + follow-up, 100% men). MEASUREMENTS: We assessed video gaming/internet UOT ESCAPAD and ado@internet.ch: number of hours spent online per week, C-SURF: latent score of time spent gaming/using internet] and AS (ESCAPAD: Problematic Internet Use Questionnaire, ado@internet.ch: Internet Addiction Test, C-SURF: Gaming AS). Comorbidities were assessed with health outcomes (ESCAPAD: physical health evaluation with a single item, suicidal thoughts, and appointment with a psychiatrist; ado@internet.ch: WHO-5 and somatic health problems; C-SURF: Short Form 12 (SF-12 Health Survey) and Major Depression Inventory (MDI). FINDINGS: UOT and AS were correlated moderately (ESCAPAD: r = 0.40, ado@internet.ch: r = 0.53 and C-SURF: r = 0.51). Associations of AS with comorbidity factors were higher than those of UOT in cross-sectional (AS: .005 ≤ |b| ≤ 2.500, UOT: 0.001 ≤ |b| ≤ 1.000) and longitudinal analyses (AS: 0.093 ≤ |b| ≤ 1.079, UOT: 0.020 ≤ |b| ≤ 0.329). The results were similar across gender in ESCAPAD and ado@internet.ch (men: AS: 0.006 ≤ |b| ≤ 0.211, UOT: 0.001 ≤ |b| ≤ 0.061; women: AS: 0.004 ≤ |b| ≤ 0.155, UOT: 0.001 ≤ |b| ≤ 0.094). CONCLUSIONS: The measurement of heavy use over time captures part of addictive video gaming/internet use without overlapping to a large extent with the results of measuring by self-reported addiction scales (AS). Measuring addictive video gaming/internet use via self-reported addiction scales relates more strongly to comorbidity factors than heavy use over time.