Long-term effects of benzodiazepine discontinuation among older adults: potential improvements on depressive symptoms.

OBJECTIVES: To examine how change in benzodiazepine (BZD) use is linked to changes in depressive symptoms intensity, worry intensity, and sleep quality over 16 months. METHOD: Data come from a larger randomised controlled trial (RCT) named the 'Programme d'Aide du Succès au SEvrage (PASSE-60+)' study (NCT02281175). Seventy-three participants age 60 years and older took part in a 4-month discontinuation programme and were assessed four times over 16 months. Change in BZD use was defined as the difference in reported mg/day between two assessments. Control variables were RCT discontinuation group; BZD use at T1; and either depressive symptoms, worry intensity, or sleep quality at T1. Hierarchical multiple regressions were used to analyse data. RESULTS: In the short term, right after the discontinuation programme, sleep quality worsened with lower BZD use. This link was no longer significant at the 3- and 12-month follow-up. In the long term, depressive symptoms lowered with lower BZD use. No change was found in worry intensity in relation to BZD use at all measurement times. CONCLUSION: Discontinuation may improve depressive symptoms. Our study also questions the long-term effectiveness of BZD use, since long-term discontinuation was not linked with change in worry intensity and sleep quality.

Distinguishing Among Symptoms of Posttraumatic Stress Disorder, Complex Posttraumatic Stress Disorder, and Borderline Personality Disorder in a Community Sample of Women.

The diagnosis of complex posttraumatic stress disorder (CPTSD) was included in the ICD-11 in 2018. Debates are still ongoing in the scientific community regarding the conceptual distinction between CPTSD symptoms and those of comorbid PTSD and borderline personality disorder (BPD). The present study aimed to determine whether (a) patterns of symptoms reported by women in a community sample would reveal a CPTSD profile distinct from PTSD and BPD profiles and (b) the resulting profiles could be compared on measures of cumulative childhood trauma exposure, dissociation, and life satisfaction. Women who reported at least one potentially traumatic experience (N = 438) completed questionnaires assessing PTSD, CPTSD, and BPD symptoms. We performed latent profile analyses testing seven models, with the five-profile model emerging as the most appropriate solution. The profiles were characterized as "high PTSD symptoms" (12.0%), "high CPTSD symptoms" (7.6%), "high BPD symptoms" (9.9%), "high CPTSD and BPD symptoms" (3.8%), and "low symptoms" (66.7%). Group comparisons revealed that the profiles characterized by high CPTSD symptoms, high BPD symptoms, and high CPTSD and BPD symptoms tended to include participants with higher levels of cumulative childhood trauma exposure and symptoms of dissociation and lower ratings of life satisfaction compared to the profiles characterized by high PTSD symptoms and low symptoms, ds = 0.55-1.06. These findings support the distinction between ICD-11 CPTSD symptoms and those of PTSD and BPD, promoting an integrative approach to understanding trauma sequelae, diagnosis, and treatment.

Reduction in Costs after Treating Comorbid Panic Disorder with Agoraphobia and Generalized Anxiety Disorder.

BACKGROUND: Panic disorder with agoraphobia (PDA) and generalized anxiety disorder (GAD) are impairing and costly disorders that are often misdiagnosed and left untreated despite multiple consultations. These disorders frequently co-occur, but little is known about the costs associated with their comorbidity and the impact of cognitive-behavioral therapy (CBT) on cost reduction. AIMS OF THE STUDY: The first objective of this study was to assess the mental health-related costs associated with the specific concomitance of PDA and GAD. The second aim was to determine whether there is a reduction in direct and indirect mental health-related costs following conventional CBT for the primary disorder only (PDA or GAD) or combined CBT adapted to the comorbidity (PDA and GAD). METHODS: A total of 123 participants with a double diagnosis of PDA and GAD participated in this study. Direct and indirect mental health-related costs were assessed and calculated from a societal perspective at the pre-test, the post-test, and the three-month, six-month and one-year follow-ups. RESULTS: At the pre-test, PDA-GAD comorbidity was found to generate a mean total cost of CADUSD 2,000.48 (SD = USD 2,069.62) per participant over a three-month period. The indirect costs were much higher than the direct costs. Both treatment modalities led to significant and similar decreases in all cost categories from the pre-test to the post-test. This reduction was maintained until the one-year follow-up. DISCUSSION: Methodological choices may have underestimated cost evaluations. Nonetheless, this study supports the cost offset effects of both conventional CBT for primary PDA or GAD and combined CBT for PDA-GAD comorbidity. IMPLICATIONS FOR HEALTHCARE PROVISION AND USE: Treatment of comorbid and costly disorders with evidence-based treatments such as CBT may lead to considerable economic benefits for society. IMPLICATIONS FOR HEALTH POLICIES: Considering the limited resources of healthcare systems, it is important to make choices that will lead to better accessibility of quality services. The application of CBT for PDA, GAD or both disorders and training mental health professionals in this therapeutic approach should be encouraged. Additionally, it would be favorable for insurance plans to reimburse employees for expenses associated with psychological treatment for anxiety disorders. IMPLICATIONS FOR FURTHER RESEARCH: In addition to symptom reduction, it would be of great pertinence to explore which factors can contribute to reducing direct and indirect mental health-related costs.

The Association between Generalized Anxiety Disorder, Subthreshold Anxiety Symptoms and Fear of Falling among Older Adults: Preliminary Results from a Pilot Study.

OBJECTIVE: A relationship between generalized anxiety disorder (GAD) and fear of falling (FOF) has long been proposed but never specifically studied. This study aimed at analyzing the relationship between FOF and GAD or anxiety symptoms, while controlling for major depressive episodes (MDE), depressive symptoms, fall risk, and sociodemographic variables. METHODS: Twenty-five older adults participated in this pilot study. Assessments included the following: Anxiety Disorder Interview Schedule, Geriatric Anxiety Inventory, Geriatric Depression Scale, Falls-Efficacy Scale-International. A multidisciplinary team evaluated fall risk. RESULTS: FOF was significantly correlated with GAD, MDE, anxiety and depressive symptoms, and fall risk, but not with sociodemographic variables. Multiple regression analyses indicated that GAD and anxiety symptoms were significantly and independently associated with FOF. CONCLUSION: Although the results of this pilot study should be replicated with larger samples, they suggest that FOF is associated with GAD and anxiety symptoms even when considering physical factors that increase the risk of falling. CLINICAL IMPLICATIONS: Treatment of FOF in patients with GAD may present a particular challenge because of the central role of intolerance of uncertainty, which may prevent patients from regaining confidence despite the reduction of fall risk. Clinicians should screen for GAD and anxiety symptoms in patients with FOF to improve detection and treatment.

Insomnia Symptoms Following Treatment for Comorbid Panic Disorder With Agoraphobia and Generalized Anxiety Disorder.

Patients with panic disorder with agoraphobia (PDA) or generalized anxiety disorder (GAD) frequently also suffer from insomnia. However, the impact of cognitive-behavioral therapy (CBT) for anxiety disorders on insomnia has been understudied. Furthermore, comorbidity between anxiety disorders is common. Our main objective was to assess the impact of CBT for PDA or GAD on insomnia. In a quasi-experimental design, 86 participants with PDA and GAD received conventional CBT for their primary disorder or combined CBT for both disorders. Overall, CBTs had a significant impact on reducing insomnia symptoms (η = 0.58). However, among people with insomnia at pretest (67%), 33% still had an insomnia diagnosis, and the majority (63%) had clinically significant residual insomnia following treatment. In conclusion, the CBTs had a positive effect on the reduction of insomnia, but a significant proportion of participants still had insomnia problems following treatment. Clinicians should address insomnia during CBT for PDA and GAD.

Attachment, Sexual Assertiveness, and Sexual Outcomes in Women with Provoked Vestibulodynia and Their Partners: A Mediation Model.

Provoked vestibulodynia (PVD) is a prevalent women's sexual pain disorder, which is associated with sexual function difficulties. Attachment theory has been used to understand adult sexual outcomes, providing a useful framework for examining sexual adaptation in couples confronted with PVD. Research to date indicates that anxious and avoidant attachment dimensions correlate with worse sexual outcomes in community and clinical samples. The present study examined the association between attachment, pain, sexual function, and sexual satisfaction in a sample of 101 couples in which the women presented with PVD. The actor-partner interdependence model was used in order to investigate both actor and partner effects. This study also examined the role of sexual assertiveness as a mediator of these associations via structural equation modeling. Women completed measures of pain intensity and both members of the couple completed measures of romantic attachment, sexual assertiveness, sexual function, and satisfaction. Results indicated that attachment dimensions did not predict pain intensity. Both anxious and avoidant attachment were associated with lower sexual satisfaction. Only attachment avoidance predicted lower sexual function in women. Partner effects indicated that higher sexual assertiveness in women predicted higher sexual satisfaction in men. Finally, women's sexual assertiveness was found to be a significant mediator of the relationship between their attachment dimensions, sexual function, and satisfaction. Findings highlight the importance of examining how anxious and avoidant attachment may lead to difficulties in sexual assertiveness and to less satisfying sexual interactions in couples where women suffer from PVD.

[Perspective of peer helpers regarding their experience animating a self-treatment program for panic disorders]. / Perspective de pairs aidants sur leur expérience d'animation d'un programme d'autotraitement du trouble panique.

OBJECTIVE: Support groups can help to reach individuals with anxiety disorders who are not or are only partly obtaining health services. The present study is based on a program that involves peer helpers as animators of a self-treatment group (Zéro-ATAQ). Their perspective has been documented in order to identify the aspects of the program which can be improved. METHODS: Eleven peer helpers led the 12 sessions of the program, which was dispensed in four regions of Quebec for 32 persons having panic disorders with agoraphobia. The perspectives of ten peer animators were documented based on a semi-structured interview that took place at the end of the program, and a focus group that was held over six months later with peer animators from each of the groups. Their comments were transcribed and a thematic content analysis was conducted. RESULTS: All of the peer helper animators reported that they enjoyed participating in the program, that they appreciated being able to help others having an anxiety disorder, and that the program helped them in their role as animators of these types of activities. Nearly all of the peer helpers emphasized the importance of being able to count on the supervision of a professional when needed. CONCLUSION: This study revealed (1) the feasibility of implementing a program of this kind in partnership with peers, (2) the qualifications necessary to lead this type of program, (3) the requirements in terms of training and available material, and (4) the importance of supervision.

Treatment modality preferences and adherence to group treatment for panic disorder with agoraphobia.

To examine the relationship between preference for group psychotherapy and adherence to group cognitive-behavioral therapy (CBT) for clients with panic disorder with agoraphobia (PDA), 109 participants experiencing PDA completed a questionnaire measuring preference for group treatment (PGTQ) before beginning CBT groups. A t test was used to compare preference scores for group treatment to investigate whether participants who completed treatment differed from those who abandoned treatment. Participants who completed group therapy expressed higher preference for group treatment than participants who dropped out of treatment (t[107] = 1.99; p < 0.05). The PGTQ-4 presented adequate psychometric properties. Reliability analyses of the items retained after factorization demonstrated an acceptable level of internal consistency (Cronbach's alpha of 0.76). Preference for individual or group therapy appears to impact treatment retention for patients with PDA. Matching patients' preferences to the type of treatment modality used appears to be pertinent, especially for the treatment of anxiety disorders. In terms of practical implications, the rationale and benefits of group therapy should be explained to participants reluctant to engage in group therapy. Individual intervention or a combination of group and individual treatment could be considered for clients who are likely to drop out of group therapy.

Development and validation of a questionnaire on musculoskeletal pain in musicians.

Musculoskeletal pain is known to be prevalent among musicians. Unfortunately, there are a lack of standard measures to quantify perceived pain in this population. The principal objective of the present study was to develop a self-reported questionnaire targeting musculoskeletal pain that is specific to musical activity. The Musculoskeletal Pain Questionnaire for Musicians (MPQM) is composed of 10 items investigating diverse areas related to musculoskeletal pain, divided into three components: a set of items related to disability associated with pain (4 items, component 1), a second one related to pain intensity (4 items, component 2), and a third one related to the frequency and duration of pain episodes (2 items, component 3). Thirty-one professional musicians, from the province of Quebec (Canada), entered the study and answered to the MPQM. Data collected from the MPQM was submitted to a principal component analysis. It found that results from the 10 items of the questionnaire were structured around three factors: pain-related disability (32.71% of variance), pain intensity (25.42% of variance), and frequency and duration of pain (18.2% of variance). Convergent validity was also tested, and an adequate correlation was obtained between the MPQM and the Chronic Pain Grade Questionnaire (r = 0.65, p = <0.01). Internal consistency for the whole instrument was measured and supported by a Cronbach's alpha of 0.768. Because the MPQM shows adequate psychometric characteristics, it is believed that it could be helpful in research on the correlates of musculoskeletal pain in musicians.

French translation and validation of the International Trauma Questionnaire in a Canadian community sample.

BACKGROUND: The diagnosis of complex post-traumatic stress disorder (CPTSD) was recently included into the 11th edition of the International Classification of Diseases (ICD-11). Recognizing the need for a brief and specific measure CPTSD symptoms as defined by the ICD-11, Cloitre and her team (2018) developed the original English version of the International Trauma Questionnaire (ITQ). The ITQ is composed of two scales-'post-traumatic stress disorder (PTSD)' and 'disturbances in self-organization' (DSO), respectively subdivided into three subscales. It was found to be psychometrically valid but has yet to be available in French. OBJECTIVE: The purpose of this study was to provide a French version of the ITQ and to examine its factorial validity, internal consistency, and convergent validity in a French-speaking Canadian sample. PARTICIPANTS: The sample included 335 French-Canadian adults from the community. METHODS: The ITQ was translated in French, back translated into English, and deemed equivalent by the original ITQ's author. Participants answered the French version of the ITQ, as well as measures of convergent validity, via phone interview. RESULTS: Confirmatory factorial analyses revealed that the French ITQ presented the same factor structure as the original ITQ. Composite reliability scores revealed good internal consistency for both scales, and all but one subscale. Pearson's correlation and Steiger's Z test revealed good convergent validity. CONCLUSION: This study supports the factorial validity, internal consistency, and convergent validity of the French version of the ITQ, suggesting that it is a psychometrically sound measure of CPTSD.

[Eating disorders (ED) and obsessive-compulsive disorders (OCD): common factors]. / Troubles de l'alimentation et trouble obsessionnel-compulsif: facteurs communs.

Several similarities exist in the phenomenology of obsessive-compulsive disorder (OCD) and eating disorders (ED : anorexia nervosa and bulimia). Both disorders include obsessive thoughts and compulsive or ritualized behaviours. Furthermore, these two disorders frequently present with similar comorbid disorders. In this article, the authors examine similarities between ED and OCD, and whether eating disorders can be conceptualized as a variant of obsessive-compulsive disorders. This raises the possibility that treatments proven effective for OCD could be successfully adapted for ED. The authors consequently further examine both treatments utilized for both disorders.

[Evaluation of inappropriate benzodiazepine use among the elderly: risk factors and impacts]. / Evaluation de l'usage à risque des benzodiazépines chez les personnes âgées: facteurs de risque et impacts.

Inappropriate benzodiazepine use among the elderly is a common and frequently underestimated problem. The present literature revie explores benzodiazepine abuse in this population from a biological, psychological, and environmental perspective. A further objective is the identification of intervention strategies for addressing this problem. The scientific literature reveals a lack of consensus and validity concerning the description of BZD abuse. The prescription practices and somewhat lax attitudes of doctors working with the elderly contribute substantially to the lack of acknowledgement of the magnitude of this problem. Complications specific to the elderly, such as attitudes toward mental illness and differential manifestation of distress, are discussed. Difficulties related to the evaluation of anxiety and depression in elderly patients, have also been identified to contribute too many cases of BZD abuse. In conclusion, it is proposed that research in this area investigate integrative methods for evaluating BZD abuse in the elderly.

Psychological Intimate Partner Violence and Childhood Cumulative Trauma: The Mediating Role of Affect Dysregulation, Maladaptive Personality Traits, and Negative Urgency.

The current study examined the mediating role of affect dysregulation, maladaptive personality traits, and negative urgency in the association between childhood cumulative trauma (CCT) and psychological intimate partner violence (IPV). A total of 241 men and women from the general population answered self-report questionnaires assessing these variables. Results indicated that 70% of participants reported at least two different types of childhood trauma, while, over the past year, 80% indicated having perpetrated or experienced psychological IPV. Path analyses of a sequential mediation model confirmed that the CCT-IPV association is explained by affect dysregulation, maladaptive personality traits, and negative urgency. These findings support the need to assess affect regulation and personality traits in CCT survivors. Psychosocial interventions should aim to increase self-soothing skills and decrease negative urgency to prevent psychological IPV.

A Method for Conducting Preliminary Analysis of the Nature and Context of Sport for Development and Peace Projects in Fieldwork Research: An Illustration With a Malagasy Non-Governmental Organization.

More research on sport for development and peace (SDP) organizations is needed to better understand their actual contributions to the United Nations (UN) Sustainable Development Goals (SDGs). Yet, the unstable, restricted, or even risky contexts in which many non-governmental organizations (NGOs) and SDP agencies sometimes operate often leave researchers to face important challenges to develop effective or feasible methods to work with such organizations. This study aimed to address the ontological and epistemological questions about what should be known about a given context in an organization before setting off on fieldwork. We propose a methodology, based on an actantial model (AM), as a method to analyze the nature and context of a project, to assess the actors involved in the project, and to establish if the global cost (i.e., material, temporal, financial, and physical) for conducting fieldwork is realistic and feasible of all the parties involved in the potential project. To illustrate this process, we analyzed the nature and context of an SDP project in Madagascar as the first step for potential collaborative research. As researchers, we do not want to invest time and energy to build up a fully developed field research project with an NGO in a context where it would not be realistic or feasible to conduct such research. Actually in this context, developing a research protocol without an implementation strategy might not only be detrimental to the researchers, but also to the NGO itself, where resources are often limited. Accordingly, the results from this preliminary field research demonstrate that an AM is a relevant analytical tool for obtaining insights about the context, the actors, and their relationships within an NGO. In conclusion, this model might be a useful instrument for conducting an initial analysis for the preliminary identification of the necessary conditions for the construction of a sustainable empirical research partnership with a given SDP project.

Belief in the obsessional doubt as a real probability and its relation to other obsessive-compulsive beliefs and to the severity of symptomatology.

OBJECTIVES: Despite the important role of doubt in understanding obsessive-compulsive disorder (OCD), current cognitive models of OCD usually do not separate this initial doubt from the anticipated consequence of not ritualizing. The current study evaluates belief in the obsessional doubt as a real probability as an additional cognitive dimension of obsessive-compulsive (OC) beliefs. METHODS: One hundred and fifteen participants with OCD completed four clinical scales measuring different OC beliefs in: (a) the real probability of obsessional doubt; (b) the realism of anticipated consequences; (c) the degree of conviction in the need to perform rituals; and (d) the perceived ability to resist rituals. The severity of symptomatology was also evaluated. DESIGN: Using cross-sectional and longitudinal data, correlational analyses were performed to determine the relationship between OC beliefs as well as to observe how these beliefs may be related to the severity of symptomatology and how they fluctuated over time. Regression analyses were also employed to verify which OC beliefs better predicted the perceived ability to resist rituals. RESULTS: Belief in the obsessional doubt as a real probability was significantly related to other OC beliefs. Also, levels of belief for the same doubt remained stable for a period of two weeks, but different levels of belief were observed for distinct obsessional doubts measured at the same time. Finally, belief in the obsessional doubt as a real probability better predicted the perceived ability to resist rituals than other OC beliefs. CONCLUSIONS: Belief in the obsessional doubt as a real probability may be an important dimension to consider when evaluating OC beliefs in treatment resistant OCD, particularly in people who have low perceived ability to resist rituals.

Determinants of barriers to treatment for anxiety disorders.

The objectives of this study were to evaluate perceived unmet need for mental healthcare, determinants of unmet need, and barriers to care in individuals with social anxiety (SA) or panic disorder with agoraphobia (PDA) in Quebec. Data from 206 participants diagnosed with SA or PDA were collected using an online questionnaire. Correlational analyses and binary stepwise logistic regressions were conducted to explore determinants of perceived unmet need. Of the 206 participants, 144 (69.9%) reported instances of unmet need for treatment. Perceived unmet need was correlated with variables related to the severity of the disorder, such as comorbid depression, avoidance, duration of worry, interference with functioning, and time lapsed between the appearance of first symptoms and first consultation. Depression and avoidance emerged as predictors for perceived unmet need in the regression analysis. The most common barriers to treatment reported were concern about the cost of services (63.9%), not knowing where to go to get help (63.2%), lack of health insurance coverage (52.4%), and appointment wait times (52.1%). The results of this study demonstrate the need to overcome barriers to treatment engendered by avoidance behaviors associated with anxiety. Potential methods for achieving this objective include Internet outreach, support groups, and increased accessibility to public services.

A Dyadic Analysis of the Associations Between Cumulative Childhood Trauma and Psychological Intimate Partner Violence: The Mediating Roles of Negative Urgency and Communication Patterns.

Prior research has suggested associations between cumulative childhood trauma (CCT), negative urgency, communication patterns, and psychological intimate partner violence (P-IPV), but no study has examined these links using a dyadic approach. This study examined the sequential mediation of negative urgency and communication patterns in the link uniting CCT and P-IPV in a sample of 501 heterosexual couples. Results suggest that more CCT events are associated with higher levels of negative urgency, which in turn are associated with a higher tendency to endorse a demand/withdraw and/or demand/demand communication pattern, and to perpetrate P-IPV. Findings support the need to assess CCT, emotional self-control, dyadic and communication patterns, and P-IPV perpetration and victimization in couples seeking help in order to select interventions that will take into account the individual and dyadic nature of P-IPV.

Cumulative Childhood Trauma and Couple Satisfaction: Examining the Mediating Role of Mindfulness.

OBJECTIVES: Cumulative childhood trauma (CCT) survivors are at a higher risk of suffering from interpersonal problems including couple dissatisfaction. Dispositional mindfulness is increasingly proposed as a potential explanatory mechanism of post-traumatic symptomatology and has been documented as a predictor of couple satisfaction. Most authors operationalize mindfulness as a multidimensional disposition comprised of five facets (i.e., Describing, Observing, Non-judgment of inner experiences, Non-reactivity, and Acting with awareness), but the role of these facets in the link between CCT and couple satisfaction has yet to be understood. This study aimed to assess mindfulness as a potential mediator in the relationship between CCT and couple satisfaction and to examine the distinctive contributions of mindfulness facets in this mediation. METHODS: A sample of 330 participants from the community completed measures of couple satisfaction, mindfulness, and exposure to eight types of childhood maltreatment experiences. RESULTS: Path analysis results revealed that mindfulness mediated the relationship between CCT and couple satisfaction. More precisely, two mindfulness facets acted as specific mediators, namely, Describing and Non-judgment of inner experiences. The final integrative model explained 14% (p < .001) of the variance in couple satisfaction. CONCLUSIONS: Findings suggest that mindfulness may be a meaningful mechanism in the link between CCT and couple satisfaction. They also highlight that description of inner experiences and a non-judgmental attitude of these experiences may act as key components to understand the influence of CCT on adults' lower couple satisfaction.

Spousal Support and Relationship Happiness in Adults With Type 2 Diabetes and Their Spouses.

OBJECTIVES: The purpose of this study was to examine the association between the perceptions of spousal support self-efficacy in terms of dietary self-care and relationship happiness. METHODS: Forty-six couples, in which only one spouse has type 2 diabetes, completed questionnaires on perceptions of spousal support self-efficacy and relationship happiness. RESULTS: Using an actor‒partner interdependence model, we found that, when persons with type 2 diabetes were more confident in their spouse's ability to provide them with support regarding their dietary self-care, they reported more relationship happiness. We also found that, when their spouse without diabetes was more confident in their own abilities to provide such support to their partner, they reported more relationship happiness. However, the person with diabetes' confidence in their spouse's support abilities and the spouse's confidence in their own support abilities were not associated with the other partner's relationship happiness. CONCLUSIONS: This study offers a unique dyadic perspective on the determinants of happiness for couples in which one spouse has type 2 diabetes. The perceived quality of spousal support appears to be associated with relationship happiness in committed couples managing diabetes, regardless of the actual support received or provided.

Psychological predictors of benzodiazepine discontinuation among older adults: Results from the PASSE 60.

BACKGROUND: Long-term benzodiazepine (BZD) use among seniors is mostly inappropriate and associated with adverse health outcomes. To prevent these consequences, withdrawal is crucial, yet knowledge is limited about what predicts BZD discontinuation. Until now, most studies have focused on sociodemographic and BZD intake factors as predictors while neglecting psychological factors. This research addresses this issue by studying how the intensity of depressive symptoms, social support satisfaction, self-perceived competence in the ability to withdraw, and overall quality of sleep predict discontinuation in long-term older consumers. METHOD: Seventy-three participants aged 60 years and older were enrolled in this study. There were four time measures: before discontinuation (T1), after (T2), 3 months after (T3), and 12 months after (T4). Data were collected in the "Programme d'Aide du Succès au SEvrage" (PASSE-60+) study. RESULTS: Social support satisfaction predicted discontinuation at T2 and T4. Self-perceived competence in the ability to withdraw and depressive symptoms predicted discontinuation at T4. This later prediction was counterintuitive; higher depressive symptoms at T1 were linked with higher discontinuation success. BZD intake factors (length of use and dose) were good predictors for short term discontinuation. Psychological factors were moderate predictors for short term and good predictors for long term discontinuation. CONCLUSION: Psychological factors are good predictors of discontinuation and are better predictors than BZD intake factors of long-term discontinuation. Discontinuation programs should focus on social support and self-perceived competence to improve their efficacy. Further studies are needed to acquire a more complete picture of the psychological predictors of discontinuation success. ClinicalTrials.gov Identifier: NCT02281175.