Endometriosis diagnosis buffers reciprocal effects of emotional distress on pain experience.

OBJECTIVES: Emotional profile is involved in the experience of chronic pain related to endometriosis. Following the Örebro Model of Behavioral Emotion Regulation of Pain, the aim of this study was to understand the processes involved in the psychological adaptation to pain experienced during menstruations in women either diagnosed or not diagnosed with endometriosis. METHODS: The study was conducted on a sample of 545 women, either diagnosed with endometriosis or not, during their menstruations. Functional repercussions and intensity of pain, catastrophic thinking, difficulties in emotional regulation and emotional distress were assessed through an online questionnaire. Structural equation modeling (SEM) was carried out. RESULTS: Women diagnosed with endometriosis experience more suffering than women who have not had such a diagnosis. The model we adapted from Örebro's model fits the data well. A differential effect is observed regarding the retroactive effect of depression on pain. Although emotional distress increases functional repercussions among women both with and without the diagnosis, growing pain intensity only occurs among those without. CONCLUSIONS: A woman presenting pain during menstruation faces emotional regulation issues that make her more vulnerable to the development of emotional distress. Pain impacts emotional distress, but emotional distress does not impact pain among women for whom the origin of the pain was known (i.e., a diagnosis of endometriosis). Having a diagnosis allows women to externalize the origin of their pain, attributing it to the disease and not to their psychological state.

Buying-Shopping Disorder among Women: The Role of Vulnerability to Marketing, Buying Motives, Impulsivity, and Self-Esteem.

INTRODUCTION: The influence of marketing on addictive behaviours has been studied among tobacco and alcohol users. Although the fashion industry is highly influenced by marketing, research has poorly studied vulnerability to fashion marketing as a factor related to buying-shopping disorder (BSD) while considering psychological characteristics (buying motives, impulsivity, and self-esteem). OBJECTIVE: The objective of the present work is to investigate the relationship between vulnerability to marketing and BSD. METHODS: Women (n = 242) were exclusively recruited through social networking. They completed an online survey exploring the severity of BSD using the Compulsive Buying Scale (CBS) and the psychological factors associated with BSD (impulsivity, self-esteem, and buying motives) and an experimental task designed to investigate the intention to purchase in several situations, where marketing modalities such as price, brand, and packaging fluctuate. RESULTS: Among the 242 participants in the study, 34 were identified as compulsive buyers (14%). Income level was considered, and compulsive buyers displayed a higher level of vulnerability to marketing, except for the packaging modality. High levels of positive urgency, lack of premeditation, and coping motivation were found to be significant predictors of the CBS score, but vulnerability to marketing was not. DISCUSSION AND CONCLUSIONS: Compulsive buyers seem to be more sensitive to marketing strategies, although vulnerability to marketing was not identified as a predictor of the severity of BSD. Given the enormous literature on the role of marketing in other addictive behaviours, further studies are needed to better understand the role of marketing in BSD to develop appropriate public health policies.

Tilt in Online Poker: Loss of Control and Gambling Disorder.

Online poker is a form of gambling where an element of skill may influence the outcome of the game. 'Tilt' in poker describes an episode during which the player can no longer control their game by rational decisions. It leads to a loss of control over the game, a loss of emotional regulation, higher cognitive distortion, and a loss of money. This phenomenon, experienced by most players, could be the gateway to excessive gambling. The aim of this study was to assess the links between the frequency of tilt episodes, cognitive distortion, anxiety, depression, sensation seeking and excessive online poker gambling. Our sample is composed of 291 online poker players, with a mean age of 33.8 years (SD = 10.6). Participants completed an online self-assessment questionnaire, measuring the frequency of tilt episodes, cognitive distortion, anxiety, depression and impulsivity. The findings indicated that the frequency of tilt episodes and cognitive distortion were the only significant predictors of excessive online gambling (respectively, r = 0.49 and r = 0.20). Tilt frequency and cognitive distortion were strongly correlated (GRCS, r = 0.60), moderate to low correlations were found for tilt and anxiety (HADS, r = 0.40), and positive and negative urgency (UPPS, r = 0.27). To date, tilt has seldom been studied, and could improve our understanding of online poker gamblers. It could be a new means of identifying at risk gamblers, and thus facilitating preventive measures specifically adapted to this population.

A Typology of Buyers Grounded in Psychological Risk Factors for Compulsive Buying (Impulsivity, Self-Esteem, and Buying Motives): Latent Class Analysis Approach ina Community Sample.

Our objective was to identify meaningful subgroups of buyers based on psychological risk factors for compulsive buying. A community sample of 242 adult women fulfilled an online survey exploring buying habits and motives, impulsivity, self-esteem, and severity of compulsive buying. A latent class cluster analysis was performed. A nonproblematic cluster (28%) was characterized by low levels of impulsivity and buying motives. An intermediary cluster (51%) was characterized by higher levels of positive and negative reinforcement-related buying motives. Both clusters were characterized by a low frequency of compulsive buying (2 and 8%, respectively), but the severity of compulsive buying was higher for the intermediary cluster. A third cluster (21%) was characterized by a higher frequency of compulsive buying (43%), a higher severity of compulsive buying, a stronger feeling of losing control, and higher levels of negative urgency and coping motive. These results present similarities with the Interaction of Person-Affect-Cognition-Execution (I-PACE) model of addiction and the negative reinforcement model of drug addiction, which both postulate that negative feelings play a central role in motivating and maintaining addiction. These results also echo other typologies performed in problem gamblers and problematic videogame users. These similarities of psychological profiles with other addictive behaviors, and with common symptoms and clinical expressions, are supplementary arguments to consider conceptualizing compulsive buying as an addictive disorder.

Ability to Discriminate Online Poker Tilt Episodes: A New Way to Prevent Excessive Gambling?

Tilt is a very common term in online poker players' vocabulary, it describes a state where the player is no longer able to make rational decisions because they are overwhelmed by strong emotions. This study aims to explore the relation existing between the frequency of Tilt episodes, the player's perception of these episodes and excessive gambling in online poker. The sample is composed of 291 adult French-speaking online poker players. All participants completed an online self-assessment questionnaire. The results of the classification analysis showed that the sample could be divided into three groups. The first group, named ''players in control'' included low excessive gambling tendencies with low perceived and measured Tilt frequencies. The two other groups showed high measured tilt levels, with perceived tilt levels that were different from the measured levels. Furthermore, these two groups present a moderate usage risk of developing an excessive gambling tendency in a money-based game of chance. These results show the existence of a relation between the player's capacity to perceive tilt and the online poker player's behavior.

Cannabis Withdrawal in Adults With Attention-Deficit/Hyperactivity Disorder.

OBJECTIVE: Cannabis withdrawal has not been studied in adults with attention-deficit/hyperactivity disorder (ADHD) who have high rates of cannabis use. We aimed to describe cannabis withdrawal, motivations to quit, and strategies to quit cannabis use in cannabis-dependent adults with ADHD. METHODS: Twenty-three adults with ADHD enrolled in a controlled clinical trial of pharmacotherapy (atomoxetine) for cannabis dependence (DSM-IV criteria) completed the Marijuana Quit Questionnaire (MJQQ) to provide information on their "most serious" quit attempt made without formal treatment. The study was conducted between November 2005 and June 2008. RESULTS: Participants were predominantly male (82.6%, n = 19), with a mean (SD) age of 27.4 (8.5) years (range, 18-53) at the start of their index quit attempt. The most common motive for quitting cannabis was "to save money" (87%, n = 20); the most common strategy to maintain abstinence was "stopped associating with people who smoke marijuana" (43%, n = 10). Almost all (96%, n = 22) subjects reported ≥ 1 cannabis withdrawal symptom; 7 (30%) met DSM-5 diagnostic criteria for cannabis withdrawal syndrome. CONCLUSIONS: Participants with comorbid ADHD and cannabis dependence reported withdrawal symptoms similar to other samples of non-treatment-seeking cannabis-dependent adults with no psychiatric comorbidity. These findings suggest that ADHD does not influence cannabis withdrawal in the way that it does tobacco (nicotine) withdrawal. TRIAL REGISTRATION: Data used in this secondary analysis came from ClinicalTrials.gov identifier: NCT00360269.

Psychopathology of Online Poker Players: Review of Literature.

Background and aims Online Texas Hold'em poker has become a spectacular form of entertainment in our society, and the number of people who use this form of gambling is increasing. It seems that online poker activity challenges existing theoretical concepts about problem gambling behaviors. The purpose of this literature review is to provide a current overview about the population of online poker players. Methods To be selected, articles had to focus on psychopathology in a sample of online poker players, be written in English or French, and be published before November 2015. A total of 17 relevant studies were identified. Results In this population, the proportion of problematic gamblers was higher than in other forms of gambling. Several factors predicting excessive gambling were identified such as stress, internal attribution, dissociation, boredom, negative emotions, irrational beliefs, anxiety, and impulsivity. The population of online poker players is largely heterogeneous, with experimental players forming a specific group. Finally, the validity of the tools used to measure excessive or problematic gambling and irrational beliefs are not suitable for assessing online poker activity. Discussion and conclusions Future studies need to confirm previous findings in the literature of online poker games. Given that skills are important in poker playing, skill development in the frames of excessive use of online poker should be explored more in depth, particularly regarding poker experience and loss chasing. Future research should focus on skills, self-regulation, and psychopathology of online poker players.

Smoked cannabis' psychomotor and neurocognitive effects in occasional and frequent smokers.

Δ9-Tetrahydrocannabinol (THC), the primary psychoactive constituent in cannabis, impairs psychomotor performance, cognition and driving ability; thus, driving under the influence of cannabis is a public safety concern. We documented cannabis' psychomotor, neurocognitive, subjective and physiological effects in occasional and frequent smokers to investigate potential differences between these smokers. Fourteen frequent (≥4x/week) and 11 occasional (<2x/week) cannabis smokers entered a secure research unit ∼19 h prior to smoking one 6.8% THC cigarette. Cognitive and psychomotor performance was evaluated with the critical tracking (CTT), divided attention (DAT), n-back (working memory) and Balloon Analog Risk (BART) (risk-taking) tasks at -1.75, 1.5, 3.5, 5.5 and 22.5 h after starting smoking. GLM (General Linear Model) repeated measures ANOVA was utilized to compare scores. Occasional smokers had significantly more difficulty compensating for CTT tracking error compared with frequent smokers 1.5 h after smoking. Divided attention performance declined significantly especially in occasional smokers, with session × group effects for tracking error, hits, false alarms and reaction time. Cannabis smoking did not elicit session × group effects on the n-back or BART. Controlled cannabis smoking impaired psychomotor function, more so in occasional smokers, suggesting some tolerance to psychomotor impairment in frequent users. These data have implications for cannabis-associated impairment in driving under the influence of cannabis cases.

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.

Cannabis withdrawal in patients with and without opioid dependence.

BACKGROUND: Cannabis use is common among opioid-dependent individuals, but little is known about cannabis withdrawal in this population. METHODS: Thirty inpatients (57% men) completed the Marijuana Quit Questionnaire (MJQQ) after completing acute heroin detoxification treatment in Saint Petersburg, Russia. The MJQQ collected data on motivations for quitting, withdrawal symptoms, and coping strategies used to help maintain abstinence during their most "serious" (self-defined) quit attempt made without formal treatment outside a controlled environment. RESULTS: At the start of their quit attempt, 70% of participants smoked cannabis at least weekly (40% daily), averaging [SD] 2.73 [1.95] joints daily; 60% were heroin dependent. Subjects with heroin dependence were significantly older at the start of their quit attempt (22.9 [3.6] vs. 19.1 [2.9] years), were significantly less likely to report withdrawal irritability/anger/aggression (22% vs. 58%), restlessness (0% vs. 25%), or physical symptoms (6% vs. 33%), or to meet diagnostic criteria for DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th edition) cannabis withdrawal syndrome (6% vs. 33%), and had shorter duration of abstinence (29.6 [28.7] vs 73.7 [44.1] months) than those without heroin dependence. CONCLUSION: Cannabis users with opioid dependence are less likely to experience cannabis withdrawal, suggesting that opiate use may prevent or mask the experience of cannabis withdrawal. RESULTS should be considered preliminary due to small convenience sample and retrospective data.

Motivations to quit cannabis use in an adult non-treatment sample: are they related to relapse?

BACKGROUND: The majority of cannabis smokers who quit do so without formal treatment, suggesting that motivations to quit are an important part of cessation process. However, little is known about how motivations relate to successful quitting. METHOD: A convenience sample of 385 non-treatment-seeking adult cannabis smokers (58% male, age 16-64years at start of quit attempt) who made a "serious" (self-defined) quit attempt without formal treatment while not in a controlled environment were administered the 176-item Marijuana Quit Questionnaire (MJQQ) to assess their motivations to quit and outcome of the quit attempt. Exploratory factor analysis was performed to identify significant motivational factors. Subgroup comparisons used t-tests and ANOVA. Cox proportional hazard regression and the General Linear Model were performed to evaluate the influence of motivational factors, gender, and age on relapse status at time of interview and risk of relapse over time, with time between quit attempt and interview as a covariate. RESULTS: Exploratory factor analysis identified 6 motivational factors with eigenvalues >1 which accounted for 58.4% of the total variance: self-image and self-control, health concerns, interpersonal relationship concerns, legal concerns, social acceptability concerns, and self-efficacy. Women were more likely than men to be motivated by self-image/self-control, health concerns, and social acceptability concerns. Older individuals were more likely to be motivated by health concerns. At the time of interview, 339 subjects had relapsed. Self-image and self-control, health concerns, interpersonal relationship concerns, and social acceptability concerns were associated with greater likelihood of abstinence at the study interview. Legal concerns and social acceptability concerns were associated with significantly lower hazard ratios (0.88, 0.83) for relapse during the abstinent period. CONCLUSION: These findings show gender and age differences in motivations to quit cannabis smoking and that adult cannabis smokers have motivations to quite similar to those of adolescent cannabis smokers and of adults who quit alcohol and tobacco use without formal treatment. The findings suggest areas of focus to improve secondary prevention and psychosocial treatment efforts.

Exploratory study of the psychopathological profiles of adolescent cannabis users.

Although adolescent cannabis users have been reported not to be a homogeneous group, they are few typological studies and only one based on psychopathological variables. A better knowledge of the typology of cannabis users might contribute to the identification of specific needs concerning prevention or treatment. Among 199 adolescents using cannabis at least monthly during the last six month, cluster analysis yielded three clusters based on depressive symptoms, social anxiety, borderline personality traits, and psychopathic traits (impulsivity and callous-unemotional traits). The largest cluster, called 'ordinary' was well below the mean on all measures. Another cluster, labeled 'borderline' was distinguished by high levels of borderline traits, depressed mood, and social anxiety. The smallest cluster, called 'impulsive' was well above the mean in impulsivity and callous traits but low on all other measures. Frequency of cannabis use was higher in the borderline and impulsive clusters than in the ordinary cluster. Multiple regression analyses suggested that the contributions of psychopathological variables to cannabis use varied across clusters.

Relative contributions of acculturation and psychopathological factors to cannabis use among adolescents from migrant parents.

Immigrant adolescents and adolescents born of immigrant parents are at increased risk of substance use which has been linked to difficulties in acculturation processes. However very few studies have examined the role of the different acculturation strategies and none of them have controlled for relevant psychopathological and socio-familial factors. The aim of this study was to investigate the role of acculturation in cannabis use in a sample of adolescents born of immigrant parents taking into account potential confounding variables. A sample of 292 high school students born in France from at least one foreign parent completed a questionnaire assessing cannabis use, acculturation orientations, ethnic identity and the most relevant potential confounders (depressive symptoms, sensation seeking, borderline and psychopathic traits, alcohol and tobacco use, parental attachment, life events, socioeconomic status and academic achievement). A regression analysis showed that acculturation orientations and ethnic identity explained a significant part of the variance in the frequency of cannabis use. Individualism, integration and assimilation were negatively associated with the frequency of cannabis use suggesting they might serve as protective factors.

Cannabis use and suicidal behaviours in high-school students.

The aim of the study was to evaluate the relative contributions of cannabis use, depressive and anxious symptoms in the prediction of suicidal behaviors. Participants were 248 high-school students who completed questionnaires assessing cannabis use, suicidal behaviors, depressive and anxious symptoms. Cannabis use was a significant independent predictor of suicidal behaviors after adjustment for depressive and anxious symptoms.

Contributions of social influences and expectations of use to cannabis use in high-school students.

The aim of the study was to evaluate the relative contributions of peers cannabis use or non-use, parental approval of such use, adolescents' own beliefs about use, to the prediction of cannabis use. The participants were 559 high-school students who completed questionnaires assessing the frequency of cannabis use, the number of peers using cannabis, the number of peers opposed to cannabis use, parental attitude toward cannabis use, and participants' expectations towards use. The number of peers using cannabis and participants' positive expectations of cannabis use were risk factors for use whereas the number of peers opposed to cannabis use and the negative expectations of use were protective factors. Parental attitudes towards use were not a significant independent predictor of use.