Orthorexic eating behaviors are not all pathological: a French validation of the Teruel Orthorexia Scale (TOS).

As no French validated measurement tool distinguishing healthy orthorexia (HeOr) from orthorexia nervosa (OrNe) currently exists, this study aimed at examining psychometric properties of the French version of the Teruel Orthorexia Scale (TOS). A sample of 799 participants (Mean [SD] age: 28.5 [12.1] years-old) completed the French versions of the TOS, the Düsseldorfer Orthorexia Skala, the Eating Disorder Examination-Questionnaire, and the Obsessive-Compulsive Inventory-Revised. Confirmatory factor analysis and exploratory structural equation modeling (ESEM) were used. Although the bidimensional model, with OrNe and HeOr, of the original 17-item version showed an adequate fit, we suggest excluding items 9 and 15. The bidimensional model for the shortened version provided a satisfactory fit (ESEM model: CFI = .963, TLI = .949, RMSEA = .068). The mean loading was .65 for HeOr and .70 for OrNe. The internal consistency of both dimensions was adequate (αHeOr = .83 and αOrNe = .81). Partial correlations showed that eating disorders and obsessive-compulsive symptomatology measures were positively related to OrNe and unrelated or negatively related to HeOr. The scores from the 15-item French version of the TOS in the current sample appears to present an adequate internal consistency, pattern of associations in line with what was theoretically expected, and promising for differentiating both types of orthorexia in a French population. We discuss why both dimensions of orthorexia should be considered in this area of research.

Orthorexia ('right appetite', from the Greek) covers two dimensions: (1) orthorexia nervosa (OrNe), a strong preoccupation with healthy diet with negative emotional, cognitive, and/or social consequences while trying to approach this goal and when the eating behavior deviates from it, and (2) healthy orthorexia (HeOr), which can be defined as a healthy interest in diet, (self-assessed) healthy behavior with regard to diet and eating healthily as part of one's identity. OrNe is not yet indexed into mental disorder classifications. Some prominent measurement tools in the area of orthorexia present important limitations: it is unclear if they validly assess OrNe and they do not tap HeOr by design. To overcome these limitations, a promising self-reported instrument was developed: the Teruel Orthorexia Scale (TOS), a bidimensional questionnaire whose structure has been replicated in different samples. Our research based on 799 participants aimed to adapt this instrument in a French speaking population. The results revealed that the French version of the TOS is an empirically supported tool allowing to differentiate both forms of orthorexia (healthy and nervosa). It also suggests that OrNe is associated with psychopathological symptoms while opposite patterns were found with HeOr. We discuss the importance of measuring both orthorexia dimensions.

Childbirth as an anticipated trauma during pregnancy: pretraumatic stress symptoms in primiparous women.

INTRODUCTION: Women can develop anticipated traumatic reactions related to the forthcoming delivery through "pretraumatic stress" symptoms. The present study aims at: a) exploring the frequency of probable pretraumatic stress disorder in primiparous pregnant women, b) evidencing associated features of pretraumatic stress symptoms and c) exploring which specific components of antenatal anxiety are associated with pretraumatic stress symptoms. METHODS: A sample of 100 primiparous pregnant women completed an online questionnaire assessing pretraumatic stress, fear of childbirth, depressive and anxiety symptoms. Socio-demographic and pregnancy-related data were also gathered. RESULTS: 8 % of women met all criteria for probable pretraumatic stress disorder. Increased depressive symptoms (ß = 0.48, p< .05), childbirth concerns (ß = 0.47, p< .05) and worry about self (ß = 0.74; p< .05) were associated with the intensity of pretraumatic stress disorder symptoms. CONCLUSION: This study contributes to the very limited literature on pretraumatic stress symptoms. Thus, it is noteworthy that pretraumatic stress is not a reactivation of a former postpartum PTSD or associated with a prior negative experience of childbirth. Future studies conducted on primiparous women with no history of traumatic exposure could allow to provide additional evidences of the existence of anticipated traumatic reactions of childbirth.

Posttraumatic growth and depreciation in people with chronic pain: A profile analysis.

OBJECTIVE: Chronic pain can disrupt everyday life and shatter beliefs about the world. Shattered beliefs may be rebuilt, either positively or negatively, leading to posttraumatic growth (PTG) or posttraumatic depreciation (PTD). According to a transdiagnostic emotion regulation perspective, these phenomena are associated with coping strategies and emotions related to the body, self, others, and the world. Because PTG and PTD can coexist, this study aims to compare different profiles of rebuilt beliefs based on emotions, emotion regulation, and psychopathology. METHOD: People with chronic pain (N = 1,577) completed online self-report questionnaires evaluating PTG and PTD, trauma-related emotions, and reactions regarding pain (guilt, shame, mental defeat, injustice, feeling discounted, sensitivity to pain traumatization, sense of body-self unity), difficulties in emotion regulation, coping strategies, and psychopathological symptoms. RESULTS: Profiles illustrate four ways to experience potentially traumatic and life-challenging circumstances: no disruption, ambivalence, growth, and distress. Differences were found regarding trauma-related emotions and reactions, levels of comorbid psychopathologies, and emotion regulation. CONCLUSIONS: Considering trauma as a genuine dimension of chronic pain experience could provide an important framework to better address the resources and trajectories of people with chronic pain. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Beyond Clinical Outcomes: Posttraumatic Stress Symptoms Favor Attentional and Memory Control Abilities for Trauma-Related Words.

Memory alterations and biases are core features of posttraumatic stress symptoms (PTSS). Although a large number of studies have investigated memory biases associated with PTSS, some inconsistencies remain regarding the nature of the mechanisms behind the threat-related biases observed in prior findings. The present study explored the extent to which inhibitory deficits, both for automatic and controlled processes, can account for these biases. Participants (N = 64) took part in a remember/know recognition procedure for positive, neutral, negative, and trauma-related words associated with negative priming and directed forgetting encoding. Half of the participants had high levels of PTSS (i.e., PCL-5 score > 40) and half had low levels (i.e., total PCL-5 score < 20). As both negative priming and directed forgetting effects are posited to depend on inhibitory abilities, we expected these effects to be absent for trauma-related words in participants with more severe PTSS. Replicating classic memory biases, participants with high levels of PTSS produced more "remember" recognition responses for trauma-related words, ηp 2 = .10. However, contrary to our expectations, directed forgetting, ηp 2 = .26; and negative priming effects were observed for trauma-related words but not for words of other valences, ηp 2 = .07 and .06, respectively. Hence, rather than the expected inhibitory deficits, our results suggest that PTSS preserve the ability to inhibit trauma-related information in both attentional and memory processes. As it appears to occur at the expense of other information, this preserved cognitive functioning for trauma-related stimuli is discussed with regard to resource reallocation theories.

Traumatic anticipation of childbirth and disordered eating during pregnancy.

BACKGROUND: While research on Fear Of Childbirth (FOC) during pregnancy is on the rise, research regarding pretraumatic stress reactions is lacking. Moreover, less is known regarding negative anticipation of childbirth and Eating Disorders (ED). This study aims at identifying typologies of women in the prepartum period based on FOC and pretraumatic stress symptoms and investigating whether or not the identified profiles differ on levels of bulimic symptoms and Drive for Thinness (DT). PARTICIPANTS AND METHODS: a sample of 213 pregnant women completed questionnaires assessing FOC, pretraumatic stress, DT and bulimic symptoms. RESULTS: four clusters based on pretraumatic stress and FOC symptoms were identified: one characterised by traumatic symptoms, one showing moderated FOC symptoms, one with high symptomatology and one with low symptoms. Higher ED symptoms were found in women with both FOC and pretraumatic stress symptoms, and in the cluster showing elevated pretraumatic stress symptomatology. CONCLUSIONS: To our knowledge, this is the first study focusing on anticipated traumatic reactions and ED in pregnant women. While some women evidenced FOC and pretraumatic stress symptoms, two different clusters, one with FOC and one with pretraumatic stress, were found. These findings suggest that, while sharing similarities, these constructs are different.

[Othorexia: A new type of Eating Disorder?] / L'orthorexie : une nouvelle forme de trouble des conduites alimentaires ?

Othorexia Nevrosa is defined as an obsessive though regarding healthy food consumption, food properties and cooking tools. Orthorexia Nevrosa is not mentioned in the psychiatric nosography and is not considered as a disorder. While no formal diagnostic criteria currently exist, screening tools have been developed to explore characteristics of Orthorexia Nevrosa. While Orthorexia Nevrosa has specific characteristics, an overlapping exists with Eating Disorders (ED) and Obsessive Compulsive Disorder (OCD) symptoms.

Inhibitory control of threat remembering in PTSD.

Intrusive traumatic recollections suggest an inability in Posttraumatic Stress Disorder (PTSD) to control and notably to inhibit memories for trauma-related information. Supported by inhibitory deficits found on experimental settings in PTSD, memory functioning and memory biases in the disorder were usually explained through inhibitory and control deficits in the processing of trauma-related information. The present study aimed to directly assess this hypothesis by investigating memory control abilities for emotional information in PTSD. For this purpose, 34 patients diagnosed with PTSD were compared to 37 non-PTSD controls on an item-cued directed forgetting paradigm for emotional words combined with a Remember/Know recognition procedure. Results revealed enhanced amounts of Remember recognitions for trauma-related words in PTSD. Moreover, we replicated findings of memory control impairments in the disorder. However, such impairments only occurred for non-trauma-related words. Accordingly, it appeared that PTSD patients presented preserved memory control abilities for trauma-related words, at the expenses of other emotional valences. Surprisingly, PTSD patients presented a preserved ability to control and notably to inhibit their memory functioning for trauma-related material. In addition to potential theoretical and clinical relevance, these results are discussed in the light of resource reallocation hypotheses and vigilant-avoidant theories of information processing in PTSD.

[Influence of post-traumatic stress disorder on asthma]. / Influence du trouble stress post-traumatique sur l'asthme.

INTRODUCTION: Exposure to a traumatic event may not only lead to a large variety of mental disorders, such as post-traumatic stress disorder (PTSD) but also respiratory symptoms and/or respiratory diseases, as asthma. OBJECTIVES: Systematic literature review of data on the impact of post-traumatic stress disorder on asthma. DOCUMENTARY SOURCES: Medline, on the period 1980-2018 with the following keywords: "PTSD" or "post-traumatic stress disorder" or "post-traumatic stress disorder" and "asthma", limits "title/abstract"; the selected languages were English or French. Among 141 articles, 23 abstracts have given use to a dual reading to select 14 studies. RESULTS: While PTSD may develop 4 weeks after being exposed to a traumatic event during which the physical integrity of the person has been threatened, it might also develop several months or years later. PTSD has been reported to be a risk factor for asthma and also a factor that might enhance a preexisting asthma. It is also important to note that this relation has been highlighted among several populations, traumatic events and regardless the gender and/or cultural factors. Despite its impact on the development of asthma, in asthmatic patients, PTSD may be responsible for poor asthma control, increased rates of healthcare use (visit in the emergency department and/or hospitalization for asthma) and poor asthma-related quality of life. The study of the association between PTSD and asthma have to take into account some potentially confounding factors, such as smoking status and dust exposure (e.g.: asthma following the terrorist attacks of the World Trade Center). Less is known regarding the potential mechanisms involved in the association between PTSD and asthma. Several factors including the nervous system, the hypothalamo-pituitary-adrenal axis, the inflammatory response and the immune system may explain the association. CONCLUSION: PTSD is a risk factor for the development of asthma and for the worsening of preexisting asthma. In asthmatic patients, it is of primary importance to systematically screen potential PTSD that might be developed after a traumatic event or a preexisting traumatic condition. Moreover, after exposure to a traumatic event, a special attention needs to be paid to somatic reactions such as asthma. The majority of studies having been conducted on American samples, replicating studies among European samples appears of prime importance in order to add a body of knowledge on the association between somatic and psychiatric conditions.

Childbirth as a forthcoming traumatic event: pretraumatic stress disorder during pregnancy and its psychological correlates.

BACKGROUND: Recent research has suggested that pretraumatic stress related to a forthcoming predictable traumatic event might exist and that such stress reactions would be a key, 'but largely ignored', aspect of the etiology of Posttraumatic Stress Disorder (PTSD). While it is now acknowledged that childbirth may lead to PTSD, less is known regarding pretraumatic reactions in pregnancy. This study aims to (a) explore the frequency of PTSD, Fear of Childbirth and tokophobia associated with the forthcoming delivery and (b) highlight associated features of pre-traumatic stress symptoms. METHODS: At 34 weeks' gestation, a sample of 102 women completed questionnaires assessing anticipated labour pain, fear of childbirth, fear of pain, pretraumatic stress symptoms, perceived social support and depressive and anxiety symptoms. RESULTS: 8.8% of women met DSM-IV-TR criteria for PTSD related to the threatening forthcoming delivery. Fear of childbirth, anticipated labour pain, anxiety, and depressive symptoms were significant predictors of pretraumatic stress intensity. CONCLUSION: Our results extend prior findings on postpartum PTSD by showing that fear of labour pain is a specific construct, clearly independent from the experience of general pain. Our results suggest that childbirth may be experienced as threatening and traumatic and that this traumatic impact might develop way before the delivery. As a potential traumatic continuum from pre- to posttraumatic stress might exist, further longitudinal studies assessing pre-, peri- and posttraumatic reactions is needed to provide support for this hypothesis.

When Fear of Childbirth is Pathological: The Fear Continuum.

OBJECTIVES: Given that prepartum psychiatric symptoms have been reported to be associated with postpartum disorders, focusing on the prepartum period appears of prime importance. The aim of the current study was threefold: (a) to identify the prevalence rates of women suffering from fear of childbirth (FOC) and tokophobia (b) to explore the association between FOC, obstetrical and psychopathological variables and (c) to identify the independent predictors of the intensity of FOC symptoms, FOC and tokophobia. METHODS: at 36 weeks' gestation, 98 women completed questionnaires assessing FOC, pretraumatic stress, fear of pain, depressive and anxiety symptomatology as well as perceived social support. Socio-demographic and gynecological data were also gathered. RESULTS: 22.45% of women reported a probable FOC and 20.41% suffered from a potential tokophobia. Epidural anesthesia (ß = 5.62, p < 0.05), and the intensity of pretraumatic stress symptoms (ß= 0.69, p < 0.05), were independently associated with the intensity of FOC symptoms. Planning a c-section was significantly related to FOC (ß = 0.09, p = 0.03). Planning an epidural anesthesia was also an independent predictor of both FOC and tokophobia (ß = 1.33, p = 0.03; ß = 1.26, p = 0.04, respectively). CONCLUSIONS: Given the high rates of FOC and tokophobia highlighted, developing an appropriate preparation to childbirth is of great relevance. Longitudinal studies should be developed in order to provide an in-depth examination of the course of prepartum psychiatric disorders, maintenance of symptoms and their impact on subsequent infant development.

When traumatic event exposure characteristics matter: Impact of traumatic event exposure characteristics on posttraumatic and dissociative symptoms.

OBJECTIVE: Traumatic events can lead to posttraumatic (posttraumatic stress disorder [PTSD] specific symptoms) and dissociative symptoms (PTSD nonspecific symptoms). However, the trauma exposure characteristics (type of exposure, categorical form, number of exposures and the age of the exposure) are rarely studied. We hypothesized that the characteristics of a traumatic event are the only predictors of specific posttraumatic symptoms (intrusion, avoidance, negative cognitive impairment) and nonspecific symptoms (dissociation). We also hypothesized that some characteristics of a traumatic event are specific predictors of posttraumatic symptoms, whereas other characteristics are predictors of nonspecific symptoms. METHOD: Three hundred nine university students participated in the study (201 men, 108 women; mean age : 19.32 years). Students completed questionnaires assessing trauma exposure characteristics, PTSD, dissociation, and burnout. Multiple linear regressions were conducted to identify predictive factors for elevated specific PTSD symptoms and elevated nonspecific PTSD symptoms. RESULTS: A different impact of the characteristics of 1 or more traumatic events was observed on specific posttraumatic symptoms. In men, the model was significant, with 6 predictors explaining 14% to 23% of the variance of specific posttraumatic symptoms. In women, 2 predictors explaining 15% to 28% of the variance of posttraumatic symptoms were found. The characteristics of the traumatic event were not the only predictors of posttraumatic symptoms (specific and nonspecific), with emotional exhaustion playing an unexpected predictive role. CONCLUSIONS: Burnout and PTSD might share emotional exhaustion as a common risk factor for PTSD. Further studies in this area are warranted, noteworthy focusing on clinical populations. (PsycINFO Database Record

Typology of schizotypy in non-clinical young adults: Psychopathological and personality disorder traits correlates.

Few typological studies address schizotypy in young adults. Schizotypal traits were assessed on 466 college students using the Schizotypal Personality Questionnaire-Brief (SPQ-B). Other measures evaluated personality traits previously associated with schizotypy (borderline, obsessionnal, and autistic traits), psychopathological symptoms (suicidal ideations, depressive and obsessive-compulsive symptoms) and psychosocial functioning. A factor analysis was first performed on SPQ-B results, leading to four factors: negative schizotypy, positive schizotypy, social anxiety, and reference ideas. Based on these factors, a cluster analysis was conducted, which yielded four clearly distinct groups characterized by "Low" (non schizotypy), "High schizotypy" (mixed positive and negative), "Positive schizotypy", and "Social impairment". Regarding personality disorder traits and psychopathological symptoms, the "High schizotypy" cluster scored higher than the "Positive" and the "Social impairment" groups, which scored higher than the "Low" cluster. The "Positive" group had higher levels of interpersonal relationships than in the "High" and the "Social impairment" clusters, suggesting that positive schizotypy was associated to benefits such as perceived social relationships. Nevertheless the "Positive" cluster was also linked to high levels of personality disorder traits and psychopathological symptoms, and to low academic achievement, at levels similar those observed in the "Social impairment" cluster, confirming an unhealthy side to positive schizotypy.

Somatic Symptoms Mediate the Relationship Between Trauma During the Arab Spring and Quality of Life Among Tunisians.

This study examined the relationship between peritraumatic reactions, posttraumatic stress disorder (PTSD) symptoms, somatic complaints, and quality of life in Tunisians exposed to the events of the Arab Spring. Participants (n = 60) completed an online survey 1 year after the events, assessing peritraumatic distress, peritraumatic dissociation, PTSD symptoms, somatic complaints, and physical and mental quality of life. Results showed that peritraumatic dissociation was independently associated with increased PTSD symptoms and somatic complaints 12 months after the events. Multiple mediator mediation analyses revealed that somatic complaints (not PTSD symptoms) were the only independent mediators of the relationships between peritraumatic dissociation and both physical and mental quality of life. Assessing peritraumatic dissociation soon after trauma exposure among the North African population might help identify individuals at risk for PTSD. Furthermore, the impact of trauma on quality of life may be better explained by somatic complaints than PTSD symptoms among North Africans.

Psychopathological traits in college students from top-ranking french schools: Do autistic features impair success in science when associated with schizotypal traits?

The link between personality and the interest of individuals for science has not been thoroughly explored. In this report, we studied psychopathological traits in students studying science in French top-ranking institutions. Three hundred and forty seven individuals answered questionnaires assessing autistic and schizotypal dimensions, as well as anxiety, depression symptomatology and attachment quality. A cluster analysis based on autistic and schizotypal traits led to the identification of 4 distinct profiles: a "low trait cluster", a "moderate autistic trait cluster", a "moderate schizotypal trait cluster" and a "high trait cluster" (HTC) composed of individuals with high scores on both autistic and schizotypal scales. Each cluster represented 20.1-27.1% of participants and was clearly different from the three others, both on autistic and on schizotypal dimensions. These groups could be also typified by their level of anxiety, depression or degraded attachment, which are proportional to the extent of psychopathological traits. Moreover, students from the HTC cluster displayed lower academic results, thus implying that autistic traits might impair success in science when they are associated with moderate schizotypal personality features. This study also suggests that depression and anxiety might mediate performance inhibition in the HTC group.

Psychiatric outcomes after childbirth: can posttraumatic growth protect me from disordered eating symptoms?

PURPOSE: While many studies on mood disorder and posttraumatic stress disorder (PTSD) following childbirth have been conducted, little is known regarding posttraumatic growth (PTG) and disordered eating in the postpartum period. This study aims to (a) identify the typology of women following childbirth based on anxiety, depressive, PTSD symptoms and level of PTG and (b) evaluate whether these profiles differ on disordered eating symptoms. METHODS: Up to 2 years after childbirth, 306 French-speaking mothers [mean age (SD) = 29.4 (4.6) years] completed questionnaires assessing PTSD, depressive, anxiety and disordered-eating symptoms and level of posttraumatic growth. RESULTS: Four profiles were highlighted: a first one labeled growing cluster (22.2 % of the sample, n = 68), a second one labeled low level of symptoms cluster (37.6 % of the sample, n = 115), a third one labeled vulnerable cluster (21.6 % of the sample, n = 66) and a last one labeled anxious-depressed-traumatized cluster (18.6 % of the sample, n = 57). Our findings also highlight an impact of these profiles on disordered eating symptoms, suggesting that disordered eating in postpartum would not be the result of pregnancy. CONCLUSION: Consistent with our expectation, our findings suggest a potential protective role of posttraumatic growth on the development of disordered eating symptoms. Further researches focusing on traumatic experience, disordered eating and posttraumatic growth in postpartum are warranted.

Validation of the French version of the marijuana craving questionnaire (MCQ) generates a two-factor model.

BACKGROUND: Craving is a major issue in drug addiction, and a target for drug treatment. The Marijuana Craving Questionnaire-Short Form (MCQ-SF) is a useful tool for assessing cannabis craving in clinical and research settings. OBJECTIVE: To validate the French version of the MCQ-SF (FMCQ-SF). METHODS: Young adult cannabis users not seeking treatment (n = 679) completed the FMCQ-SF and questionnaires assessing their frequency of cannabis use and craving, cannabis use disorder criteria, and alcohol use. RESULTS: Confirmatory factor analysis of the four-factor FMCQ-SF model did not fit the data well. Exploratory factor analysis suggested a two-factor solution ("pleasure", characterized by planning and expectation of positive effects, and "release of tension", characterized by relief from anxiety, nervousness, or tension) with good psychometric properties. This two-factor model showed good internal and convergent validity and correlated with cannabis abuse and dependence and with frequency of cannabis use and craving. CONCLUSION: Validation of the FMCQ-SF generated a two-factor model, different from the four-factor solution generated in English language studies. Considering that craving plays an important role in withdrawal and relapse, this questionnaire should be useful for French-language addiction professionals.

Association between personality disorders traits and problematic cannabis use in adolescents.

BACKGROUND: There are few studies on the contribution of personality disorder traits to cannabis use disorders in adolescents. OBJECTIVES: The aim of the study was to evaluate the association of personality disorder traits to problematic cannabis use. METHODS: Participants were 111 high school students who completed self-report questionnaires, mainly the Cannabis Use Disorders Identification Test, assessing problematic cannabis use, and the Personality Diagnostic Questionnaire using the scales evaluating personality disorders most often linked to adolescent cannabis use. RESULTS: A multiple regression analysis showed that personality disorder traits explained a high part of the variance in problematic cannabis use symptoms. Schizotypal and borderline personality traits were positively associated to problematic cannabis use symptoms after adjustment for anxious and depressive symptoms. CONCLUSIONS: This study suggests the importance of evaluating personality disorder traits in studies of risk factors or consequences of problematic cannabis use.

Impact of antisocial behavior on psychopathic traits in a community sample of adolescents.

The objective of this study was to cross-sectionally explore the mediating role of self-serving cognitions in the relationship between antisocial behavior and psychopathic traits. A sample of 970 high school students completed self-report questionnaires assessing antisocial behavior, cognitive distortions, and psychopathic traits. Cognitive distortions partially mediated (and gender moderated) the relationship between antisocial behavior and psychopathic traits. Gender was found to moderate this relationship. Longitudinal studies would permit a fuller understanding of how these relationships interrelate-an understanding that may have important implications for clinical intervention.

Cannabis use and suicidal ideations in high-school students.

BACKGROUND: The association of cannabis use and suicidal ideations in adolescents has been inconsistent. This discrepancy may reflect differences in controlled confounders. In particular, no study has controlled for personality disorder traits linked to both cannabis use and suicidality such as borderline and psychopathic personality traits. METHOD: Participants were 972 high-school students who completed questionnaires assessing cannabis use, suicidal ideations, depressive symptoms, social anxiety symptoms, and borderline and psychopathic personality traits. RESULTS: Cannabis use was not a significant independent predictor of suicidal ideations after adjustment for confounding personality traits in the total sample and in the subsample of cannabis users.