The Pregnant Smoker Stigma Scale - Self Stigma (P3S-SS): development and validation in pregnant smoking women in France.

Pregnancy smoking self-stigma may be associated with mental health and smoking cessation. This study aims to validate the Pregnant Smoker Stigma Scale - Self-Stigma (P3S-SS) assessing perceived and internalized stigma. Between May 2021 and May 2022, French pregnant smokers recruited online (n = 143) took the P3S-SS and other scales assessing depressive symptoms (EPDS), social inclusion (SIS), dissimulation, dependence (CDS-5), cessation self-efficacy (SEQ), and intention. The two versions of the scale include four dimensions: derogatory cognitions ("People think/I feel I am selfish"), negative emotions and behaviors ("People make me feel/smoking makes me feel guilty"), personal distress ("People/I feel sorry for me/myself"), and information provision ("People tell me/I think about the risks of smoking"). Confirmatory factor analyses and multiple regressions have been computed. Model fit was good for perceived stigma and internalized stigma (X2/df = 3.06, RMSEA = .124, AGFI = .982, SRMR = .068, CFI = .986, NNFI = .985; X2/df = 3.31, RMSEA = .14, AGFI = .977, SRMR = .087, CFI = .981, NNFI = .979). Controlling for dependence, cessation intention was positively predicted by perceived and internalized personal distress and negatively predicted by perceived negative emotions and behaviors (Adj R2 = .143, F(8,115) = 3.567, p = .001). Controlling for dependence, dissimulation was positively predicted by internalized negative cognitions and perceived personal distress and negatively predicted by internalized personal distress (Adj R2 = .19, F(9,98) = 3.785, p = .000). The P3S-SS opens up exciting avenues for further research. Stigma does not motivate women to stop smoking but increases distress and dissimulation.

Workplace bullying: is there a difference by enterprise size?

OBJECTIVE: While relationships between working conditions, bullying and health issues have been proven, most studies have investigated these relationships in large enterprises (> 250 employees). Indeed, only a few studies have analyzed this issue in small firms, despite the fact that the latter differ from the former at multiple levels. Therefore, our objective was twofold: to assess whether the size of a firm had an impact on the frequency of workplace bullying and to identify whether the effects of bullying on workers' health differed according to the size of the company. METHOD: Data from the 2010 SUMER French periodical cross-sectional survey were analyzed (N = 31,420 for the present study). Bullying at work was measured based on nine possible hostile attitudes derived from the French version of the Leymann Inventory of Psychological Terror. Two other questions measured colleague-to-colleague verbal violence and sexual or physical assaults. Anxious or depressive episodes were measured using the Hospital Anxiety and Depression scale (HAD). Other health issues were: perceived health status, sickness absence (at least one absence lasting more than eight days), and work injuries. RESULTS: Our findings show that bullying at work was less frequent in micro enterprises (< 10 employees). Anxiety/depression, perceived health status, sickness absence (at least one lasting more than eight days) were significantly associated with workplace bullying, but the effects of bullying were significantly higher in micro enterprises (statistical interaction). CONCLUSION: This study highlights how a firm's size influences workplace bullying and, in particular, the prevalence and consequences of bullying in micro enterprises. The implication and guidelines for practice are discussed.

Validity of the Measure of Intensive Mothering Ideology (MIMI).

OBJECTIVE: The aim of this study was to test the validity of the Measure of Intensive Mothering Ideology (MIMI), a French scale assessing beliefs about mothering and childcare. METHOD: The MIMI was submitted online to Mothers/mothers-to-be (n=249) and Childless women (n=231). To test structural validity, confirmatory factor analyses were conducted in both groups. Then, to test known-groups validity, means comparisons were conducted according to parity (mothers/mothers-to-be and childless women) and employment status (full-time, part-time and housewives). It was also hypothesized that MIMI scores would be negatively correlated with education. RESULTS: Model fit was satisfactory for Mothers/mothers-to-be (X2/df=2.52, AGFI=.957, NFI=.937 RMR=.087) and, to a lesser extent, for Childless women (X2/df=3.31, AGFI=.948, NFI=.907, RMR=.104). In both groups, most dimensions were moderately correlated (.22-.70). As hypothesized, Mothers/mothers-to-be and Housewives had higher score than Childless women and Employed women. MIMI scores were also negatively and moderately correlated with education. CONCLUSION: The MIMI shows good structural validity and known-groups validity. This scale offers interesting research avenues notably regarding perinatal parental adaptation.

Screening Beyond Postpartum Depression: Occluded Anxiety Component in the EPDS (EPDS-3A) in French Mothers.

INTRODUCTION: According to many studies, anxiety in the perinatal period is widespread and has many detrimental effects. Thus, screening measures should not be limited to assessing depression symptoms. The widely used Edinburgh Postnatal Depression Scale (EPDS) might assess depression but also anxiety symptoms. This study explores whether an anxiety dimension (EPDS-3A) was found and valid in French women during pregnancy and the postpartum period. METHODS: French women were followed-up at late pregnancy and 2 and 4 months postpartum (N = 144, 138 and 129). They completed the EPDS and the Hospital Anxiety and Depression Scale (HADS-A). Exploratory factor analyses were performed. Then to test its validity, the EPDS-3A was correlated with anxiety (HADS-A) and depression (EPDS-D) scores. Finally, prevalence estimates were computed according to recommended cut off. RESULTS: The anxiety dimension assessed through the EPDS-3A was observed during the postpartum period but not during pregnancy. A two-factor structure (depression and anxiety) increases the variance explained at 2 and 4 months postpartum (respectively 6 and 12%). The EPDS-3A shows good internal consistency (≥ .70) and was more strongly associated with anxiety scores (HADS-A) (.48-.57) than with depression scores (EPDS-D) (.30-.39). Nearly 28% of mothers had scores that exceeded the EPDS-3A cut off (≥ 4) but not the full EPDS cut off (≥ 13 or more). DISCUSSION: The EPDS contains an anxiety component (EPDS-3A) that can be found in French women during the postnatal period but not during pregnancy. It shows signs of internal consistency and validity. The EPDS-3A could be considered when screening for postpartum anxiety.

Intensive mothering ideology in France: A pilot study.

OBJECTIVE: The aim of this pilot study was to adapt the intensive mothering ideology concept in a French sample and to get an assessment tool. METHOD: First, the Intensive Parenting Attitudes Questionnaire (IPAQ), a U.S. scale comprising 25 items, was translated and submitted online to French mothers and mothers-to-be (n=250). Structural validity was tested through confirmatory factor analysis with poor results. Secondly, to increase the cultural validity of a new tool, new items were derived from French women speech. French mothers and mothers-to-be (n=22) were asked about their views regarding motherhood and childcare (semi-structured interviews). A thematic content analysis was performed with good inter-judge agreement (0.53-0.86) and 27 items were created. Finally, the total set of 52 items was submitted online to French mothers and mothers-to-be (n=474). The structure was tested through exploratory factor analysis. RESULTS: A new tool called the Measure of Intensive Mothering Ideology (MIMI) was obtained. This 21 items scale with 6 dimensions (Essentialism, Consuming Fulfillment, Child-centrism, Challenge, Sacrifice and Stimulation) explains 59.75% of variance. Internal consistencies were satisfactory (0.61-0.83) and most dimensions were positively and moderately correlated (0.17-0.38). CONCLUSION: The MIMI is the first French-language scale assessing IMI and offers interesting research avenues notably regarding perinatal parental adaptation.

A video-based intervention to overcome pregnancy smoking stigma among healthcare students: a randomised controlled trial.

OBJECTIVES: This study tests a video intervention to reduce pregnancy smoking stigma among French healthcare students. DESIGN: The participants were randomly selected to watch online either an experimental video (presenting educational content regarding stigma and contact with pregnant smokers) or a control video (presenting standard educational content about the risks of smoking). The students completed scales assessing stigma, intention to address smoking cessation and self-efficacy to do so, before the intervention (T0, n = 252), one week after the intervention (T1, n = 187), and one month after the intervention (T2, n = 131). RESULTS: Compared to the medical students, especially men, the midwifery students reported lower derogative cognitions (η2p = .18), negative behaviours (η2p = .07) and personal distress (η2p = .06). However, the midwifery students also reported lower levels of intention to address smoking (η2p = .02) than the medical students. The experimental video decreased derogative cognitions to a greater extent than the control video (η2p = .23) in both the short and medium term. This study is the first intervention designed to reduce the stigmatisation of pregnant smokers by healthcare students. We recommend that the issue of stigma should receive more attention in the medical curriculum.

[Psychometric properties of the French adaptation of the Family Relationship Index (FRI)]. / Qualités psychométriques de l'adaptation française du Family Relationship Index (FRI).

OBJECTIVE: The aim of the present study was to investigate the psychometric properties of the French adaptation of the Family Relationship Index (FRI) from Moos and Moos. The FRI is a self-report inventory which consists of 27 items assessing family relations. It is composed of three dimensions: family cohesion, family expressiveness (of feelings and emotions) and family conflict. METHOD: The FRI was translated and adapted into French according to published recommendations. After appropriate cultural adaptations, the scale was administered to a sample of 976 students with a mean age of 21.9 years and 43.5% of men. The participants completed the FRI and three other questionnaires: the Family Adaptability and Cohesion Scale (FACES), the Satisfaction with Life Scale and the General Health Questionnaire. Confirmatory factor analyses were used to test different models with one and three factors. The psychometric properties of the short version of the FRI, proposed by Kissane and Bloch (2002) and composed of 12 items, were also studied. RESULTS: Confirmatory factor analyses showed that the three factors solution was more relevant that the one factor solution (for Khi(2)/ddl, Root mean square error of approximation [RMSEA], Root mean square residual [RMR], Goodness of fit index [GFI], Adjusted goodness of fit [AGFI] and Comparative fit index [CFI]). However, three items belonging to family expression explained a small variance. Therefore, a version consisting of 24 items seemed more appropriate than the 27 items version proposed by Moos and Moos. Cultural differences may explain these results. Internal consistency was satisfactory for cohesion (0.79) and conflict (0.71) but weak for expression (0.55 for 27 items version and 0.62 for 24 items version). One month test-retest reliability showed high correlations for the three dimensions (from 0.77 to 0.85). Correlation between the cohesion subscale of the FRI and the cohesion subscale of the FACES was high (0.77), showing a good convergent validity. The correlations between the three FRI dimensions and the Satisfaction with Life Scale and the General Health Questionnaire were quite low (from -0.31 to 0.41). High family cohesion and high family expression were associated with high life satisfaction and good mental health. Conversely, high family conflict was associated with low life satisfaction and weak mental health. These results support the criterion validity of the FRI. Concerning the 12 items version of the FRI, the factor analysis results showed very good psychometric qualities. However, this short version had lower internal consistency (which ranged between 0.50 and 0.71), test-retest reliability (which ranged 0.68 and 0.81), convergent (0.69 for cohesion) and criterion validity (from -0.21 to 0.37 for the Satisfaction with Life Scale and from -0.28 to 0.19 for the General Health Questionnaire) than the longer versions. CONCLUSION: The results of the present study show that the FRI's 24 items version seems to be the more relevant. Nevertheless, the 12 items version shows interesting qualities. Further studies should confirm these results on other samples. Given the lack of French-language surveys assessing family relations, the FRI will be a useful tool for research and clinical practice.

Older People Facing the Crisis of COVID-19: Between Fragility and Resilience.

The health crisis we are facing is challenging seniors' resources and capacities for adaptation and resilience. The PACOVID survey, set up a few days after containment, investigates their psychological and social experiences with regard to the COVID-19 crisis and to what extent these characteristics, representations and attitudes have an impact on health and mortality. A telephone survey is being carried out on 935 people already followed up in the framework of ongoing epidemiological studies. As we are writing this article, the interviews conducted during the containment have just ended. Even though we will have to wait for the analysis of the results to draw conclusions, words collected by the psychologists during the interviews already illustrate a great heterogeneity in the way older adults lived this experience: social isolation, anxiety, the importance of family and the difficulty of being deprived of it, but also remarkable coping skills and resilience capacities.

[Pain coping strategies: French adaptation of the coping strategies questionnaire (CSQ-F)]. / Stratégies de coping des patients douloureux: adaptation française du coping strategies questionnaire (CSQ-F).

BACKGROUND: Many studies have shown that the strategies used to cope with chronic pain play a very important role in the adjustment to the pathology and to its effects (emotional distress, physical and psychosocial impairment, and quality of life). Among the methods assessing coping with pain, the most widely used instrument at present is the coping strategies questionnaire (CSQ) developed by Rosenstiel and Keefe, [Pain 17 (1983) 33-44]. This questionnaire is composed of 48 items distributed in eight subscales each including six items: diverting attention, reinterpreting pain sensations, coping self-statements, ignoring pain sensations, praying and hoping, catastrophizing, increasing activity level, and increasing pain behaviour. Most studies examining the factor structure of the CSQ have used the scores of its eight prior theoretically derived scales rather than the 48 items. Three studies, Tuttle et al. [Rehab Psychol 36 (1991) 179-187], Swartzmann et al. [Pain 54 (1994) 311-316; Robinson et al. [Clin J Pain 13 (1997) 43-49] have examined the factor structure of the CSQ from the 48 original items on the questionnaire and have yielded five or six factors. A structural confirmatory analysis showed the superiority of the six-factor model [Clin J Pain 13 (1997) 156-162]: distraction, catastrophizing, ignoring pain sensations, distancing from pain, coping self-statements and praying. The present study aimed at measuring the internal consistency and the construct validity of the French version of the CSQ. METHOD: The CSQ was translated into French with the forward and backward translation procedure. To evaluate internal consistency, Cronbach's alphas were computed. Construct validity of the questionnaire was estimated through confirmatory factor analysis (CFA) in a sample of 330 chronic pain patients (71% of women): 40.3% suffered from low back pain, 33.6% from headaches and 26.1% from neuropathic pain. The three factor structures previously proposed in the literature were tested using the LISREL 8.3 structural equation-modelling program developed by Jöreskog and Sörbom, [Lisrel 8: user's reference guide, Chicago: Scientific Software International, 1993]. RESULTS: The CFA performed on the three models of factor structures of the CSQ previously reported confirms the best fit of the six-factor model by Robinson et al. [Clin J Pain 13 (1997) 43-49] in our sample. However, the coping self-statements factor, whose internal consistency was too weak in our analysis (Cronbach's alpha=0.57), was eliminated. We therefore retained only five factors in our sample. The French version of the CSQ (CSQ-F) is composed of 21 items belonging to five factors: distraction, catastrophizing, ignoring pain sensations, reinterpreting pain sensations, and praying. CONCLUSIONS: The present study indicates that the internal consistency and the construct validity of the French version of the CSQ were adequate, and contributes to demonstrate the stability of the factor structure of the CSQ across samples. The 21-item French adaptation of the CSQ (CSQ-F) appears to be a very interesting tool because it facilitates the use of this questionnaire, not only for research but also in the clinical assessment of the patients suffering from chronic pain.

French adaptation of the Ways of Coping Checklist.

A short form (42 items) of the Ways of Coping Checklist was administered to 468 French men and women. A factor analysis of the responses yielded three factors, accounting for about 35% of the total variance, and named Problem-focused Coping, Emotion-focused Coping, and Social Support seeking. The first two dimensions are close to those generally described in the literature. Some interesting relationships of scores appeared between personality and coping, notably, between anxiety and emotion-focused coping.

Evolution of perinatal depressive symptoms from pregnancy to two years postpartum in a low-risk sample: the MATQUID cohort.

BACKGROUND: Few studies have explored the evolution of perinatal depressive symptoms (PNDS) throughout the perinatal period. AIMS: To evaluate in a low-risk sample, whether different evolutive profiles of PNDS exist from pregnancy to 2-years postpartum, and whether the subgroups differ regarding psychopathological and demographic characteristics. METHODS: In a prospective, longitudinal study from 8 months pregnancy to 2 years postpartum, repeated measures of PNDS using the CES-D were performed on a sample of 579 women at low-risk for PNDS. First, semiparametric mixture models were used to identify groups of women with distinct trajectories of PNDS. Second, multinomial logistic regressions were used to identify risk factors for each group. RESULTS: Four distinct trajectories of PNDS evolution were found: (i) 72% of the women never presented with clinically significant depressive symptoms; (ii) 4% presented with depressive symptoms only during the postnatal period; (iii) 21% presented with depressive symptoms throughout the follow-up period, with a higher intensity during pregnancy; (iv) 3% presented with stable highly intense symptoms throughout the follow-up period. Psychosocial risk factors for PNDS were mainly identified in the patients of the third group, with an influence of socio-economical variables and anxiety traits. LIMITATIONS: The main limitations of the present study are the small size of the sample and the low level of risk for PNDS, so the results cannot be extrapolated to all types of populations. CONCLUSION: Different subtypes of evolutionary profiles of PNDS are found in a low-risk sample, and are associated with different profiles of risk factors.