Implementation of a Primary Prevention Program for Posttraumatic Stress Disorder in a Cohort of Professional Soldiers (PREPAR): Protocol for a Randomized Controlled Trial.

BACKGROUND: Posttraumatic stress disorder (PTSD) is a psychiatric disorder that can manifest after a traumatic event where the individual perceives a threat to his or her life or that of others. Its estimated prevalence in the European population is 0.7% to 1.9%. According to the "dose-response" model, individuals who are most exposed to traumatic events are most at risk of developing PTSD. Hence, it is unsurprising that studies have observed a higher prevalence among the military population, ranging from 10% to 18%, or even up to 45%. This project's overall goal is to evaluate the primary prevention actions that can strengthen the resilience of at-risk professionals, notably military personnel, in the short term, with the medium- to long-term aim of preventing the occurrence of PTSD and improving the patient's prognosis. OBJECTIVE: This study's objectives are (1) to design a primary prevention program for PTSD, tailored to the studied military population and compatible with operational constraints; and (2) to implement and validate the Primary Prevention of Posttraumatic Stress Disorder in Military Professionals (PREPARE) program in the short term with operational personnel belonging to the French Mountain Infantry Brigade. METHODS: This is a single-center, prospective, randomized, parallel-group controlled cohort study. The cohort is divided into 2 groups: the nonintervention group receives no training, and the intervention group follows a dedicated prevention program (structured into 8 workshops and 2 debriefing and practice reinforcement workshops). Each participant is evaluated 4 times (at inclusion, +4 months, +6 months, and +12 months). During each visit, participants complete several psychosocial questionnaires (which take 15-80 minutes to complete). Samples (a 30-mL blood sample and three 5-mL saliva samples) are collected on 3 occasions: at inclusion, +4 months, and +12 months. Emotional reactivity (electrocardiogram and electrodermal activity) is measured before, during, and after the classic and the emotional Stroop task. RESULTS: The project is currently ongoing, and results are expected to be published by the end of 2024. CONCLUSIONS: The study adopts an integrative approach to the processes that play a role in the risk of developing PTSD. Our biopsychosocial perspective makes it possible to target levers related to factors specific to the individual and socio-professional factors. The following dimensions are addressed: (1) biophysiology (by studying markers of the neurobiological stress response, wear and tear, and vulnerability phenomena and reinforcing the flexibility of the autonomic nervous system), (2) psychology (by facilitating and measuring the development of flexible coping strategies to deal with stress and evaluating the moderating role of the individual's sense of duty in the development of PTSD), and (3) social (by facilitating community strategies aimed at reducing stigmatization and supporting the use of care by professionals in difficulty, in the institutional context). TRIAL REGISTRATION: ClinicalTrials.gov NCT05094531; https://clinicaltrials.gov/study/NCT05094531. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/47175.

Why do students in psychological distress not use psychological care?

It is well established that some students face psychological difficulties, such as feelings of distress, major depressive episodes, and/or suicidal risk. This study aimed to shed light on students' use of psychological care and the reasons for nonuse among students facing these troubles and, by controlling the socionormative context in which students were interviewed, the role of knowledge about these psychopathologies and the severity and comorbidity of their disorders. In total, 316 students previously diagnosed for distress, major depression, or suicidal thoughts or behaviors were interviewed by peers in a door-to-door procedure about their use of psychological care and the reasons for their nonuse. The results confirmed the low use rate of psychological care in this clinical population (i.e., 8.23%). Students' knowledge about these psychological troubles improved the use of psychological care, as well as the perception of a need for use if care was not used. However, better knowledge was also associated with greater perceptions of structural barriers (e.g., not knowing where to go). These results support the need for psychoeducational programs that deepen knowledge about psychopathologies and also facilitate access to psychological care services. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Self-compassion and resistance to persuasion.

OBJECTIVE: Persuasive health messages sometimes induce resistance. This article explores the link between self-compassion and resistance to health messages that threaten autonomy. DESIGN: A pilot study (N = 100) tested whether threatening health messages versus non-threatening messages damage needs for autonomy, which translates into emotional resistance and behavioural intentions of resistance. The main study (N = 83) tested self-compassion and reactant traits as moderators of observable health-behaviour (soft drink consumption) faced with threatening messages versus non-threatening messages. OUTCOME MEASURES: The pilot study tested whether threatening health messages create resistance using self-reports of anger and resistant behavioural intentions. Observable health-behaviour (soft drink vs. water consumption) was measured in the main study. RESULTS: The pilot study showed that the perceived threat to autonomy, which was induced by threatening health messages about soft drink consumption, creates resistance (self-reports of anger and resistant behavioural intentions). The main study shows that the most self-compassionate people act in favour of the arguments of the threatening messages (drinking water rather than soft drinks), whereas the least self-compassionate do not. CONCLUSION: These innovative results are discussed in regard to the compliance role of self-compassion through self-regulatory functions.

Perceived trajectory of psychological and physical states after breast cancer: An optimistic perception.

BACKGROUND: In cancer research, studying the quality of life trajectory helps us understand the complaints but also the cognitive, physical, and emotional aspects that can evolve positively. Examining both the suffering and the improvements expressed by the patients facilitates their care and their recovery knowing that an optimistic perception of the future is important for adaptative functioning after cancer. Through retrospective, present and prospective measures, we sought to characterize the subjective trajectory perceived by women with breast cancer about their cognitive, emotional and physical states, as it relates to quality of life. METHODS: Nine hundred ninety women survivors of breast cancer (after curative treatments) described, on the appropriate scales, their perceived cognitive, emotional and physical states over three periods of time: from past care (i.e., retrospective analysis) to the future (i.e., projective analysis), including the present period, as a function of their treatment (chemotherapy vs. no chemotherapy) and surgery (lumpectomy vs. mastectomy) using ANCOVA. RESULTS: The 732 women who had received chemotherapy perceived the most significant consequences, regardless of the type of surgery (η2= .01). Moreover, all survivors expressed an optimistic perception of the change in their states in the anticipated future as a normative optimistic perception. CONCLUSIONS: Results are discussed in terms of the benefits of specific and early interventions that enable patients to cope better with the disease and its treatments by taking into account their more or less optimistic perception of the future.

Comparative Pessimism or Optimism: Depressed Mood, Risk-Taking, Social Utility and Desirability.

Comparative optimism can be defined as a self-serving, asymmetric judgment of the future. It is often thought to be beneficial and socially accepted, whereas comparative pessimism is correlated with depression and socially rejected. Our goal was to examine the social acceptance of comparative optimism and the social rejection of comparative pessimism in two dimensions of social judgment, social desirability and social utility, considering the attributions of dysphoria and risk-taking potential (studies 2 and 3) on outlooks on the future. In three experiments, the participants assessed either one (study 1) or several (studies 2 and 3) fictional targets in two dimensions, social utility and social desirability. Targets exhibiting comparatively optimistic or pessimistic outlooks on the future were presented as non-depressed, depressed, or neither (control condition) (study 1); non-depressed or depressed (study 2); and non-depressed or in control condition (study 3). Two significant results were obtained: (1) social rejection of comparative pessimism in the social desirability dimension, which can be explained by its depressive feature; and (2) comparative optimism was socially accepted on the social utility dimension, which can be explained by the perception that comparatively optimistic individuals are potential risk-takers.