An examination of relationships between transdiagnostic psychological processes and mental health disorders in athletes.

INTRODUCTION: The aims of this study were (a) to identify links between transdiagnostic psychological processes and mental health disorder (MHD) symptoms, and (b) to examine differences in MHD and transdiagnostic psychological processes as a function of demographic variables, including, gender, status as an athlete (elite vs. non-elite), number of training sessions per week, previous severe injuries, and use of medical care following severe injuries. METHODS: A total of 159 competitive athletes aged between 18 and 40 years old (44 % female; mean age = 24.20 ± 4.88 years) participated in this cross-sectional study. Participants completed a demographic questionnaire along with validated questionnaires evaluating MHD symptoms and transdiagnostic processes including: motivation to practice sport, emotional competencies, self-efficacy, repetitive negative thinking, meta-cognitive beliefs, and impulsive and perfectionist behaviors. RESULTS: MHD symptoms were positively correlated with controlled forms of motivation, repetitive negative thinking, meta-cognitive beliefs, and impulsive and perfectionistic behaviors; and negatively correlated with emotional competencies and self-efficacy. Gender differences showed that women were more likely to experience MHD, higher levels of repetitive negative thinking, meta-cognitive beliefs, and lower levels of emotional competencies and self-efficacy than men. Finally, elite athletes showed higher personal standards than their non-elite counterparts and those training more than four times per week showed significantly higher perfectionistic behaviors. DISCUSSION: These results are in line with previous findings in clinical psychology and shed light on the role of transdiagnostic processes and the risk of MHD in a sample of French athletes. Further research on the identification of key risk factors for MHD in competitive athletes is needed.

Role of Worry in Addiction: Implication of Metacognitive Beliefs and Type 2 Worry.

INTRODUCTION: According to the self-medication hypothesis, worriers use substances to cope with their symptoms; however, some published results have challenged this hypothesis. The aim of this study is to show if worry increases the risk of SUD when it is negatively appraised by negative metacognitive beliefs. METHOD: We recruited three samples: 68 patients with a severe AUD, 27 patients dependent on eating and 42 control participants. We used the Yale Food Addiction Scale-2, the Metacognitions Questionnaire-65, the UPPS-P Impulsive Behaviour Scale and the Anxiety Thoughts Inventory. RESULTS: We confirmed a direct effect of worries and metaworry on alcohol (AUD) and eating addiction (EA), but our multivariate analyses revealed that metacognitive beliefs and metaworry are the most robust predictors of alcohol and eating addiction. DISCUSSION: We reported substance-related differences in the relationship between worry and addiction. AUD is related to the metacognitive activity set in motion by worries while EA is associated with a maladaptive form of worry (meta-worry) where worries are negatively interpreted.

The PEERCARE peer led programme for college students: A qualitative evaluation of a "chill-out" harm reduction space.

Aims: Harmful patterns of alcohol consumption, such as binge drinking, are prevalent among the student population at universities. Despite the risks of this behaviour, few secondary prevention programmes have been created to meet the specific needs of this population. The PEERCARE programme is a peer-based prevention programme that seeks harm reduction for alcohol overuse in party environments, among other goals. To do so, a "chill-out" space is created by peer educators in party environments to limit the risks associated with alcohol overuse. This study sought to examine peer educators' experience with a chill-out space to identify their specific actions, difficulties and needs, and to consider possibilities for improvement. Methods: Nine engineering students from one French grandes écoles campus trained as peer educators (six men and three women; mean age 21 years) participated. Semi-structured interviews were used for data collection. Results: The thematic analysis showed that the peer educators were highly engaged with this programme in response to alcohol overuse on their campus. The chill-out space was lauded for its non-judgemental and non-moralising nature. In addition, the numerous risk reduction activities that were enacted confirmed the benefits of these spaces during parties. The peer educators' experience was positive, and acting as managers of the chill-out space seemed to answer to a sense of competence recognitiontion. Conclusion: This study confirms the relevance of utilising chill-out spaces during parties and provides preliminary data on the deployment and management of peer-led chill-out space approaches. Expanding the implementation of such spaces to more educational institutions is recommended.

Mobile app measuring sleep and behaviors: A trial in adolescents with addiction.

INTRODUCTION: The smartphones generalisation allows the development of attractive "real-life" monitoring tools for care and research enabling the measurement of addictive behaviours and comorbidities such as sleep disorders. The study objective was to assess the interest of a mobile app collecting such information among adolescents with addictive behaviours in order to enhance the availability of behavioural data in consultation. METHODS: An open label randomised pilot study was held along two parallel arms. The patients randomised to the intervention group (n=18) used a mobile app to provide daily data for 15 days relating to their sleep and their behaviour (addictive behaviours with or without substances). The patients in the control group (n=18) used a paper diary allowing the collection of the same data, only the medium differed. RESULTS: The patients' median age was 16 years [15.0-16.5]. A median of 67% and 10% of the expected information was completed respectively in the intervention and control groups during the 15 days of follow-up and could be used in consultation (P=0.08). The patient's knowledge, attitudes, intentions to change, behaviour change and seeking help related to the use of the diaries appeared higher in the intervention group (20.5/30) than in the control group (11/20). CONCLUSION: This study described the high patient compliance with the data collection by means of the app. The diary app seems to have been more impactful for patients than the paper diary. This app could represent an important tool to improve the therapeutic alliance and care due to a better knowledge of the behaviours on the part of the clinician but also a better awareness of the patients themselves.

Alcohol Use, Anxiety and Depression among French Grandes Écoles Engineering Students during the COVID-19 Pandemic.

In French Grandes Écoles, heavy alcohol consumption seems to be generalized and largely tolerated, leading to particular concerns about Alcohol Use Disorder and harmful alcohol practices among students. The COVID-19 pandemic led to increased psychological difficulties, and two coexisting scenarios seemed to emerge regarding alcohol consumption: A decrease in alcohol consumption linked to the absence of festive events, and an increase in solitary alcohol consumption to cope with lockdowns. The aim of this exploratory study is to investigate the evolution of alcohol consumption, consumption motives and the relationship of these factors to the anxiety and the depression of French Grandes Écoles students during the COVID-19 pandemic, depending on their residential status. After the last lockdown, 353 students completed a questionnaire measuring alcohol consumption, motivation to drink, anxiety and depression during and after the COVID-19 period. Although students confined to campus were more likely to increase their alcohol use, they also presented higher well-being scores than those who lived off campus. A significant proportion of students were aware of their increased alcohol use due to the COVID-19 pandemic, and the motives attributed to their increased consumption highlight the need for vigilance and specialized support facilities.

Individually delivered mindfulness-based cognitive therapy in concomitant problematic substance use and emotional symptoms: A process-based case study.

The process-based approach assumes that transdiagnostic psychological processes are involved in the onset and maintenance of mental disorders. Case conceptualization is used to identify such psychological processes and to individualize the intervention accordingly. This approach is fundamentally different from syndrome-based approaches in which standardized treatments are administered for psychiatric diagnoses or symptoms. In the current case, we proposed a process-based conceptualization and treatment for a woman with concomitant problematic substance use and emotional symptoms. Our idiosyncratic process-based conceptualization showed that for this person, substance abuse consisted in a maladaptive coping strategy to deal with repetitive negative thinking and poor emotion regulation skills, for which we decided to use a mindfulness-based intervention. Treatment comprised 8 weeks of individually delivered mindfulness-based cognitive therapy sessions. A comprehensive assessment of psychiatric symptoms and psychological processes was conducted at baseline, post-intervention and 3-month follow-up. The post-treatment assessment revealed that psychological processes targeted by the intervention were improved, together with the mindfulness trait. At the symptom-based level, we observed a significant reduction in substance abuse and emotional symptoms. Treatment gains were maintained at follow-up. From a process-based perspective, this result implies that the intervention successfully targeted the psychological processes underlying the presenting symptoms. Adopting a process-based approach rather than symptom- or syndrome-based approaches is a valuable alternative in the conceptualization and treatment of complex cases presenting with multiple comorbidities.

Guilt in alcohol use: A systematic review.

For decades, alcohol use disorder has been investigated in an attempt to understand its processes and implications. However, among all of the factors involved in alcohol use disorder, the role of guilt in alcohol use remains poorly explained, with many contradictory results. Therefore, the purpose of this review is to conduct a systematic analysis of the literature from 1990 to 2022 to review the studies investigating the link between guilt and alcohol consumption. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method, 31 studies were included in this review. The results of this work enable to highlight the plurality of guilt that has been studied in the literature. Grouped in two categories: state guilt and trait guilt, they seem to have diverse implications towards alcohol use or misuse. Guilt proneness seems to act as a protective factor towards alcohol use, except for the few studies conducted on a clinical population. Numerous studies indicated that state guilt is deleterious toward alcohol use, even if some results are contradictory. Furthermore, this work allows us to shed light on the limits of the studies currently carried out, and thus to propose new directions for future studies.

Repetitive negative thinking, metacognitive beliefs, and their interaction as possible predictors for problematic cannabis use.

The metacognitive formulation of addictive behaviours considers repetitive negative thinking (RNT) and metacognitive beliefs as two important processes involved in the development and maintenance of addictive behaviours. To date, very limited research has investigated the implication of these processes in problematic cannabis use. The present study was aimed at exploring the association between RNT, metacognitive beliefs, and cannabis use in a sample of 157 problematic cannabis users. Participants were administered measures of cannabis use severity, RNT, metacognitive beliefs, anxiety, and depression. Multiple regression analysis showed that metacognitive beliefs (cognitive confidence, beliefs about the need to control thought, and cognitive self-consciousness) were independent predictors of problematic cannabis use and related problem severity when controlling for RNT and negative affect (anxiety and depression). Furthermore, RNT predicted problematic cannabis use severity only for users with low levels of negative beliefs about thoughts concerning uncontrollability and danger. These data suggest that metacognitive beliefs and RNT may be two relevant cognitive processes for understanding problematic cannabis use. More generally, it enables the consideration of cannabis use from the perspective of self-regulation theories, and more specifically cognitive regulation, thus offering several theoretical and clinical implications.

Toward a better understanding of the influence of repetitive negative thinking in alcohol use disorder: An examination of moderation effect of metacognitive beliefs and gender.

Repetitive negative thinking (RNT), the most studied forms of which are depressive ruminations and anxious worry, is a unique transdiagnostic process responsible for the development and maintenance of many mental disorders. Over the past decade, studies have shown that RNT could be involved in the development and maintenance of alcohol use disorder (AUD). However, to date, little is known about the factors that can influence this relationship, even though some theoretical and empirical arguments suggest that variables such as gender or metacognitive beliefs may determine the role of RNT in the onset of symptoms. The aim of the present study was to test the moderation effect of metacognitive beliefs and gender in the relationship between RNT and AUD. Eighty-one AUD patients were administered measures of AUD severity, RNT, metacognitive beliefs about thinking and alcohol use, anxiety, and depression. Results indicated that the 'capture mental resources' factor of RNT is a significant predictor of AUD severity, independent from anxiety and depression, and that this effect is moderated by metacognitive beliefs and gender. RNT is a significant predictor of AUD severity only for people with high negative beliefs about thoughts regarding uncontrollability and danger. Furthermore, RNT was found to predict AUD severity only for men with high beliefs about the need to control thoughts and for men with high positive beliefs about emotional self-regulation. Treatments that reduce attentional impairments caused by RNT and modify dysfunctional metacognitive beliefs could be promising for some patients with AUD.

Metacognitive beliefs in addictive behaviours: A systematic review.

A wide research base has shown the link between metacognitive beliefs and psychopathology and there is currently evidence that elevated levels of maladaptive metacognitive beliefs are present in the majority of psychological disorders. An increasing body of evidence also suggests that metacognitive beliefs may play a role in alcohol use, nicotine use, gambling, online gaming and problematic internet use. This article provides a systematic review of empirical studies that have examined metacognitive beliefs and addictive behaviours. Thirty-eight studies were included, with results showing a significant positive association between metacognitive beliefs and addictive behaviours. These results are consistent with the metacognitive model of addictive behaviour that supports the central role of metacognitive beliefs in the development and maintenance of addictive behaviours. However, our review highlights the paucity of longitudinal and experimental studies, preventing the determination of the causal status of metacognitive beliefs in addictive behaviours. Despite this limitation, the current evidence has important treatment implications because it suggests that interventions that target metacognitive beliefs could be beneficial for people presenting with addictive behaviours.