Influence of age and self-stigmatization on social eating and drinking issues in French outpatients living with and beyond head and neck cancer: a mixed-method study.

PURPOSE: Social eating (SE) is a corner stone of daily living activities, quality of life (QoL), and aging well. In addition to feeding functional disorders, patients with head and neck cancer (HNC) face individual and social psychological distress. In this aging population, we intended to better assess the influence of age on these challenges, and the role of self-stigmatization limiting SE in patients with and beyond HNC. METHODS: This was an exploratory multicenter cross-sectional mixed method study. Eligibility criteria were adults diagnosed with various non-metastatic HNC, before, during, or until 5 years after treatment. SE disorders were explored with the Performance Status Scale Public Eating rate (PSS-HN PE). In the quantitative part of the study, SE habits, Functional Assessment of Cancer Therapy Body Image Scale (FACT-MBIS) and specific to HNC (FACT-HN35) were also filled in by the patients. In the qualitative study, the semi-structured interview guide was drawn out to explore stigma, especially different dimensions of self-stigmatization. RESULTS: A total of 112 patients were included, mean age 64.7 years, 23.2% of female. One-third (n = 35) of patients had an abnormal PSS-HN PE rate < 100. Younger patients had more often an impaired Normalcy of Diet mean (70.4 vs 82.7, p = .0498) and PE rates (76 vs 86.9, p = .0622), but there was no difference between age subgroups in MBIS nor FACT-HN scores. Seventy patients (72.2%) found SE and drinking « important¼ to « extremely important¼ in their daily life. The qualitative study reported self-stigmatization in two older patients and strategies they have developed to cope with in their behaviors of SE. CONCLUSION: This study confirms that SE remains of high concern in patients with and beyond HNC. Even in older patients experiencing less often functional feeding disorders, body image changes and SE issues are as impaired as in younger patients and need to be addressed.

Is severe alcohol use disorder really associated with increased utilitarian moral judgment? Exploration using the CNI model.

OBJECTIVES: The psychology of moral decision-making classically contrasts utilitarianism (based on consequences) and deontology (based on moral norms). Previous studies capitalizing on this dichotomy have suggested the presence of a utilitarian bias among patients with severe alcohol use disorder (SAUD). We aimed to further disentangle the processes involved in such bias through a more validated approach, the CNI model of moral decision-making. This model allows to go further than the classical approach by distinguishing sensitivity to consequences (C), to moral norms (N), and general preference for inaction over action (I) in response to moral dilemmas. METHODS: Thirty-four recently detoxified patients with SAUD and 34 matched control participants completed a battery of 48 dilemmas derived from the CNI model, as well as social cognition tasks. RESULTS: In contrast with the utilitarian bias suggested in previous studies based on the classical approach, patients with SAUD did not show an increased sensitivity to consequences in comparison with control participants. However, they showed a reduced sensitivity to moral norms, as well as a greater action tendency. These biases were not related to social cognition deficits. CONCLUSIONS: Patients with SAUD are not more utilitarian than healthy controls, this previously reported bias being artificially generated by the methodological limits of the classical approach. Instead, they present a reduced sensitivity to moral norms and an action bias, which might impact their interpersonal relations and contribute to the social isolation frequently reported in this population, thus identifying moral decision-making as a new therapeutic lever in SAUD.

What do we really know about age-related stereotypes and well-being of older adults? A commentary on the state of the art.

There is a considerable body of literature on harmful consequences of age-related stereotypes-including consequences on physical and mental health. However, this commentary critically argues that the current state of the art disregards consequences of these stereotypes specifically for the well-being of older adults (i.e., outcome that is not to be confounded with mental health). To this end, the content of age-related stereotypes and the mechanisms through which they operate on physical and mental health are first outlined. The commentary then focuses on the very scarce evidence documenting how and when the well-being of older adults (as assessed directly and not as inferred from other indicators) is influenced by self-directed stereotypes. After setting out possible ways well-being may be involved in the relationship between self-directed stereotypes and physical and mental health of older adults, the present commentary argues that a better understanding of well-being would benefit strategies targeting the reduction of age-related stereotypes. Overall, this commentary on the state of the art highlights that future research is still needed to better understand both the direct and indirect relationships between age-related stereotypes and well-being that is not reducible to positive experiences of life (or hedonic well-being) but also comprises an eudaimonic component.

Distinct profiles of university students engaged in food and alcohol disturbance behaviors.

The present study aimed at exploring the combined effect of risk of eating disorders (ED), alcohol use, physical activity, and social and psychological traits in Food and Alcohol Disturbance (FAD) behaviors. Nine-hundred and seventy-six college students were included in the study. They were then divided into two groups based on the Compensatory Eating and Behaviors in Response to Alcohol Consumption Scale (CEBRACS): students with a FAD positive score and student with a FAD negative score. Both groups of participants were compared on the risk of ED, alcohol and physical activity variables, as well as social and psychological dimensions. A cluster analysis was performed on the FAD positive group to determine distinct subgroups and to explore the involvement of social and psychological dimensions in FAD behaviors. The comparison between FAD and non-FAD students demonstrated a more severe alcohol use, risk of ED, a higher level of impulsivity, anxiety, depression and more drinking motives as well as a lower self-esteem in students engaged in FAD behaviors compared with non-engaged students. The cluster analysis identified four clusters: the asceticism FAD subgroup, the damage control FAD subgroup, the emotional FAD subgroup and the recreational FAD subgroup. Overall, results reveal that FAD should not be considered as a unitary behavior but rather as a more complex pattern involving distinct psychological profiles.

A prevention program for binge drinking among students based on mindfulness and implementation intention (ALCOMEDIIT): a randomized controlled trial.

BACKGROUND: The emergence of new problematic alcohol consumption practices among young people requires new dynamics in prevention strategies. In this context, the ADUC project (Alcohol and Drugs at the University of Caen) aims to develop a better understanding of alcohol consumption, and in particular the practice of binge drinking (BD) in students, in order to develop relevant and adapted prevention tools. The ALCOMEDIIT study (Rin Normandie and IRESP funding; Agreement 20II31-00 - ADUC part 3) is a randomized controlled trial that focuses on the specific determinant of impulsivity. The main objective of this experiment is to assess a program for the prevention of BD practices based on motivational interviewing (MI) associated with implementation intention (II) and mindfulness meditation (MBM) in a student environment. METHODS: This study will include 170 healthy subjects who will be students at the university, alcohol users, with a BD score > 1 in the month preceding the inclusion but not presenting any specific disorder. The trial will be proposed by e-mail and students who meet the inclusion criteria will join either a control group which will benefit from a MI or an experimental group which will additionally benefit from an initiation to MBM with II (initial visit T0). In order to measure the effectiveness of the prevention program in terms of BD decrease, a follow-up at 1 month (T1) as well as a follow-up at 6 months (T6; exploratory) will be proposed to all participants. The total duration of this research protocol is 21 months. DISCUSSION: The purpose of this study is to evaluate the interest of associating mindfulness meditation practices and implementation of self-regulation strategies to optimize their use, with a motivational interview in an innovative prevention program aiming at reducing alcohol use and BD practice in the student population. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05565989, September 30, 2022. https://clinicaltrials.gov/study/NCT05565989 Protocol version 2.0 (September 2022) No. ID-RCB: 2022-A00983-40.

Only human after all? a pre-registered study on gaze behavior and humanity attributions to people with facial difference.

There is a great deal of indirect evidence suggesting that people with facial difference (FD) may be dehumanized. This research aimed to provide direct evidence of the dehumanization of people with FD based on the stigmatizing reactions they elicit. More precisely, previous findings revealed that the specific way people with FD are looked upon is related to the feelings of disgust they elicit. Since disgust fosters dehumanization, our aim was to confirm the modified pattern of visual attention towards people with FD and to determine whether it was also related to humanness perception. For that purpose, a preregistered eye-tracking study (N = 97) using a former experimental design extended to humanity attributions was conducted. This research replicates findings showing that the face of people with FD is explored differently in comparison with other human faces. However, the hypothesis that people with FD were given fewer humanity attributions was not supported. Therefore, the hypothesis of a "dehumanizing gaze" towards people with FD-beyond humanity-related attributions-is discussed in light of these findings.

When a refusal turns into donation: the moderating effect of the initial position toward blood donation in the door-in-the-face effectiveness.

This research aimed to test the moderating effect of people's initial position to blood donation on the actual acceptance to donate blood in a door-in-the-face situation. This position (attitude, self-importance, normative beliefs) was measured one month prior to the request (Study 1, N = 99) or immediately before (Study 2, N = 80). The results revealed that the door-in-the-face effect is moderated by the importance of blood donation to the self, all the more so when the position is made salient. This highlights the specific character of blood donation in France and the centrality of the importance of donating for the self at the heart of the DITF technique. These results offer new insights into the conditions that must be met to achieve acceptance to donate blood after an initial refusal.

Towards a better understanding of the social stigma of facial difference.

Facial difference (FD) is not only an individual experience; it is inherently social, reflecting interactions between social norms and individual attitudes. Often FD is stigmatized. In this paper, we employ a widely used stigma framework, namely the social stigma framework put forth by Pryor and Reeder (2011), to unpack the stigma of FD. This framework posits that there are four forms of stigma: public stigma, self-stigma, stigma by association, and structural stigma. We first discuss the social and psychological literature on FD as it pertains to these various forms of stigma. We then describe coping approaches for FD stigma. Lastly, we delineate evidence-based methods for addressing the various forms of FD stigma, such that future efforts can more effectively tackle the stigma of facial difference.

Look me in the eyes! A pre-registered eye-tracking study investigating visual attention and affective reactions to faces with a visible difference.

This research aims to determine how disfigurement alters visual attention paid to faces and to examine whether such a potential modified pattern of visual attention to faces with visible difference was associated, in turn, with perceiver's stigmatizing affective reactions. A pilot study (N = 38) and a pre-registered experimental eye-tracking study (N = 89) were conducted. First, the visual explorations of faces with and without disfigurement were compared. The association of these visual explorations with affective reactions were investigated next. Findings suggest that disfigurement impacts visual attention toward faces; attention is not merely attracted to the disfigured area but it is also diverted particularly from the eye area. Disfigurement also eases disgust-related, surprise-related, anxiety-related, and, to a lesser extent, hostility-related affective states. Exploratory interaction effects between attention to the eyes and to the disfigured part of the face revealed a hybrid effect on disgust-related affect and an increase in surprise-related affect when participants fixated more upon the disfigured area and fixated less upon the eyes. Thus, perceiver's attention is captured by disfigurement and also diverted from face internal features which seems to play a role in the affective reactions elicited.

Why should we ask binge drinkers if they smoke cannabis? Additive effect of alcohol and cannabis use on college students' neuropsychological performance.

INTRODUCTION: Binge drinking (BD) and cannabis use are prevalent in European adolescents and students. BD has been shown to have a negative impact on neuropsychological functioning, but little is known about the additive effect when it is combined with cannabis consumption. We therefore investigated the neuropsychological profiles of students who engage in combined BD and cannabis use, in order to explore the potentially harmful additive effects of cannabis use and BD on cognition. MATERIAL AND METHODS: A sample of college students (N = 298) completed questionnaires on alcohol and cannabis use, and were screened for neuropsychological impairments using the Brief Evaluation of Alcohol-Related Neuropsychological Impairments (BEARNI). First, after dividing students into three groups according to their alcohol and cannabis use (i.e., light drinkers, binge drinkers, and binge drinkers consuming cannabis), we ran a linear mixed model based on the BEARNI z scores to test the performances of the three groups. Information yielded by the mixed model was supplemented by individual analyses. Second, to explore the heterogeneity of binge drinkers' profiles, we ran a cluster analysis to characterize the alcohol users at higher risk of more severe neuropsychological impairment. RESULTS: Overall, poorer neuropsychological performances were observed among binge drinkers compared with light drinkers, whether they used cannabis or not. However, flexibility, episodic memory and working memory were particularly affected among binge drinkers who used cannabis. CONCLUSIONS: Results emphasize the importance of asking binge drinkers if they smoke cannabis, in order to adapt care and prevention strategies to their consumption and neuropsychological profile.

What really matters in binge drinking: A dominance analysis of binge drinking psychological determinants among University students.

INTRODUCTION: Binge drinking (BD) is a public health concern, especially in young people. Multiple individual factors referring to different level of analyses - positional, inter-individual and intra-individual - are associated to BD. As they have mainly been explored separately, little is known about the psychological variables most associated with BD. This study, based on an integrative model considering a large number of variables, aims to estimate these associations and possible dominance of some variables in BD. METHODS: A sample of university students (N = 2851) participated in an internet survey-based study. They provided information on alcohol related variables (AUDIT, BD score), positional factors (sex, age), inter-individual factors (subjective norm, social identity, external motivations), and intra-individual factors (internal motivations, meta-cognitions, impulsivity and personality traits). The data were processed via a backward regression analysis including all variables and completed with a dominance analysis on variables that are significantly associated with BD intensity. RESULTS: The strongest variables associated with BD intensity were enhancement motives and drinking identity (average ΔR 2 = 21.81%), followed by alcohol subjective norm and social motives (average ΔR 2 = 13.99%). Other associated variables (average ΔR 2 = 2,84%) were negative metacognition on uncontrollability, sex, coping motives, lack of premeditation, positive metacognition on cognitive self-regulation, positive urgency, lack of perseverance, age, conformity motives and loneliness. CONCLUSION: Results offer new avenues at the empirical level, by spotting particularly inter-individual psychological variables that should be more thoroughly explored, but also at the clinical level, to elaborate new prevention strategies focusing on these specific factors.

What We Talk About When We Talk About Binge Drinking: Towards an Integrated Conceptualization and Evaluation.

RATIONALE: Binge drinking (BD), characterized by recurring alternations between intense intoxication episodes and abstinence periods, is the most frequent alcohol consumption pattern in youth and is growing in prevalence among older adults. Many studies have underlined the specific harmful impact of this habit by showing impaired abilities in a wide range of cognitive functions among binge drinkers, as well as modifications of brain structure and function. AIMS: Several controversies and inconsistencies currently hamper the harmonious development of the field and the recognition of BD as a specific alcohol consumption pattern. The main concern is the absence of consensual BD conceptualization, leading to variability in experimental group selection and alcohol consumption evaluation. The present paper aims at overcoming this key issue through a two-step approach. METHODS AND CONCLUSIONS: First, a literature review allows proposing an integrated BD conceptualization, distinguishing it from other subclinical alcohol consumption patterns. Six specific characteristics of BD are identified, namely, (1) the presence of physiological symptoms related to BD episodes, (2) the presence of psychological symptoms related to BD episodes, (3) the ratio of BD episodes compared to all alcohol drinking occasions, (4) the frequency of BD episodes, (5) the consumption speed and (6) the alternation between BD episodes and soberness periods. Second, capitalizing on this conceptual clarification, we propose an evaluation protocol jointly measuring these six BD characteristics. Finally, several research perspectives are presented to refine the proposed conceptualization.

Distinct psychological profiles among college students with substance use: A cluster analytic approach.

Substance use in youth is a central public health concern, related to deleterious consequences at psychological, social, and cognitive/cerebral levels. Previous research has identified impulsivity and consumption motives as key factors in the emergence of excessive substance use among college students. However, most studies have focused on a specific substance and have considered this population as a unitary group, ignoring the potential heterogeneity in psychological profiles. We used a cluster analytic approach to explore the heterogeneity in a large sample (N = 2741) of substance users (i.e., tobacco, alcohol, cannabis, ecstasy, cocaine, heroin) on impulsivity and consumption motives. We identified four clusters: The first two clusters, associated with good self-esteem, low anxiety, and moderate substance use, were respectively characterized by low impulsivity and consumption motives (Cluster 1) and by high social and enhancement motives without marked impulsivity (Cluster 2). The two other clusters were conversely related to low self-esteem and high anxiety, and characterized by high consumption motives (particularly conformity) together with elevated urgency (Cluster 3) and by globally increased impulsivity and consumption motives (Cluster 4). These two clusters were also associated with higher substance use. These results highlight the existence of distinct psychological profiles of substance users and underline the need to develop targeted prevention and intervention programs (e.g., focusing on the specific impulsivity facets and consumption motives presented by each subgroup). Based on these findings, we also suggest extending the exploration of distinct profiles of substance users by targeting other psychological variables (e.g., self-esteem).

Labeling of previous donation to encourage subsequent donation among experienced blood donors.

OBJECTIVE: This study aims to examine the effects of persuasive messages focused on the labeling of previous blood donation behavior on subsequent donation among experienced blood donors. METHOD: Participants (N = 410) received blood drive invitations by mail that were categorized with the labeling of the previous donation. They were randomly assigned to one of three conditions: functional labeling (which underlines the utility of their donation), social labeling (which underlines their own social value), and no label of previous donation (control condition). Dependent Variable: Number of participants who made a new blood donation. RESULTS: Donors are more likely to make a new blood donation when they have received a message labeling their previous donation (26.7%), whether it be social or functional, compared with a nonlabeled message (17.5%). Moreover, labeling condition interacted with age parameter indicating that the older the donor, the more sensitive the donor to the labeling technique. Labeling condition also interacted with gender, revealing that women were almost three times more likely to come back to give their blood in labeling conditions compared with the no-label condition. CONCLUSION: Our findings highlight the interest in using strategies based on the recall of previous donation, that is a labeling technique, to help blood centers to stimulate repeat donation. Labeling the previous donation increases the likelihood of a new donation among experienced donors, especially among older people and women, the latter being a part of the most reluctant profiles to repeat blood donation.

Gender effect and prejudice: when a salient female norm moderates male negative attitudes toward homosexuals.

Men generally express more negative attitudes than women toward homosexuals. This study aims to determine if social norms saliency can rely on this "gender effect" and influence attitudes toward homosexuals. Gender characteristics (attitudes and lexical markers) concerning homosexuality were identified in Study 1 and used to construct male- (i.e., promoting a prejudice-related norm) and female-marked (i.e., promoting an anti-prejudice-related norm) messages. Social norms saliency was primed using these messages (Studies 2 and 3) and the participant's immediate context (Study 3). Results show that promoting a prejudiced norm eases expression of males' negative attitudes toward homosexuals, whereas the promotion of an anti-prejudice norm inhibits their attitudes. Theoretical elaborations and potential applications for promotion of tolerance are discussed.