[Problematic Internet use, time spent online and personality traits]. / Utilisation problématique d'Internet, temps passé en ligne et traits de personnalité.

BACKGROUND: Internet addiction or problematic Internet use is a recent and increasingly recognized disorder which has been consistently associated with many psychiatric disorders, adding to the documented negative consequences of problematic Internet use. However, very few studies have examined the relationship between problematic Internet use and personality traits and none in a French sample. Moreover, those which have evaluated this relationship have mainly been conducted on small samples. OBJECTIVE: The main goal of our study was to explore the relationship between problematic Internet use, time spent online and personality traits in a French sample, taking into account the presence of depressive symptoms, and gender. METHODS: A sample of 276 participants aged from 18 to 50 (M=28; SD=8.9) completed a questionnaire assessing problematic Internet use, time spent online, the presence of ten personality traits and depressive symptoms. RESULTS: Our results revealed significant differences between genders. Among men, problematic Internet use was associated with personality clusters A and B while in women no cluster or personality traits were associated. Time spent online was predicted by schizoid personality traits among men and avoidant personality traits among women. DISCUSSION: Our results indicate that cluster A (schizoid and schizotypal) and cluster B traits (borderline and antisocial) play a more important role in problematic Internet use than cluster C traits among men. Differences between men and women regarding the relationships between personality traits, time online and problematic Internet use may be related to differences in the activities engaged in by men and women online. We observed that communication websites use was more prevalent among women while erotic, gambling and shopping websites use was more prevalent among men suggesting that the characteristics of problematic Internet use may vary according to gender. CONCLUSION: Few studies have examined the relationship between problematic Internet use, time spent online and personality traits, and none among a French sample. These results suggest the importance of assessing the impact of personality traits on Internet use, particularly on time spent online, by differentiating results in terms of gender and online activities.

[Acculturation orientations and psychosocial adaptation among adolescents with immigrant background]. / Orientations d'acculturation et adaptation psychosociale des adolescents issus de l'immigration.

OBJECTIVE: The aim of the study was to explore the typology of adolescents with immigrant background based on the orientations of acculturation and to estimate the psychosocial adaptation of the various subtypes. METHOD: A sample of 228 French high school students with an immigrant background completed a questionnaire assessing acculturation orientations (Immigrant Acculturation Scale; Barrette et al., 2004), antisocial behaviors, depressive symptoms and self-esteem. Cluster analysis based on acculturation orientations was performed using the k-means method. RESULTS: Cluster analysis produced four distinct acculturation profiles: bicultural (31%), separated (28%), marginalized (21%), and assimilated-individualistic (20%). Adolescents in the separated and marginalized clusters, both characterized by rejection of the host culture, reported higher levels of antisocial behavior. Depressive symptoms and self-esteem did not differ between clusters. DISCUSSION: Several hypotheses may explain the association between separation and delinquency. First, separation and rejection of the host culture may lead to rebellious behavior such as delinquency. Conversely, delinquent behavior may provoke rejection or discrimination by peers or school, or legal sanctions that induce a reciprocal process of rejection of the host culture and separation. The relationship between separation and antisocial behavior may be bidirectional, each one reinforcing the other, resulting in a negative spiral. This study confirms the interest of the study of the orientations of acculturation in the understanding of the antisocial behavior of adolescents with immigrant background.

[Cannabis use and antisocial behaviors in high-school students]. / Consommation de cannabis et comportements antisociaux dans un échantillon d'adolescents scolarisés.

OBJECTIVE: The aim of the study was to evaluate the contribution of cannabis to the prediction of delinquent behaviors. METHOD: Participants were 312 high-school students who completed self-report questionnaires measuring antisocial behaviors, the frequency of cannabis and alcohol use, psychopathic traits using the Youth Psychopathic traits Inventory, borderline traits, depressive symptoms, socio-economic status, life events, attachment to parents, and low academic achievement. Hierarchical multiple regression analyses were conducted to investigate the contribution of cannabis use and potential confounding variables to antisocial behaviors. RESULTS: Boys reported a greater number of delinquent behaviors than girls (10.2±9.2 vs. 5.4±5.3, t=9.2, P<0.001). Thirty-seven percent of boys and 24 % of girls reported having used cannabis at least once during the last six months (P<0.001). Among cannabis users, boys reported a greater frequency of use than girls: average use for boys was 2-3 times per month whereas average use for girls was once a month (3.4±2.3 vs. 2.6±2, t=2.9, P=0.004). Cannabis users reported a greater number of antisocial behaviors than non-users (13.2±9.9 vs. 6.1±6.3, t=13.6, P<0.001). Multiple regression analyses showed that cannabis use was a significant independent predictor of antisocial behaviors in both gender (ß=.35, P<.001 in boys, ß=.29, P<.001 in girls) after adjustment for alcohol use, psychopathological and sociofamilial variables. DISCUSSION: The unique and independent association between frequency of cannabis use and antisocial behaviors does not indicate the causal direction of the relationship. It may be that cannabis use induces antisocial behaviors by enhancing impulsivity or irritability or by the need for money to buy cannabis. Conversely, antisocial behaviors may lead to cannabis use either through becoming used to transgressions or through the influence of delinquent peers using cannabis. This link is probably bidirectional, cannabis use and antisocial behaviors influencing mutually in a negative interactive spiral. This association suggests that these two problems are to be jointly approached when treating adolescents using cannabis or having antisocial behaviors.

[Motivations for cannabis cessation, coping and adaptation strategies, and perceived benefits: impact on cannabis use relapse and abstinence]. / Motivations et stratégies lors d'arrêt spontané de la consommation de cannabis: quel impact sur les rechutes ?

OBJECTIVES: While cannabis has been recognized as the most illicit drug use in the world, few studies focusing on cannabis self-change and cannabis relapse or abstinence in adult non-treatment samples have been conducted. The first aim of this study was to understand cannabis self-change motives, coping and adaptation strategies and evaluating perceived benefits from cannabis cessation. The second aim was to compare, in a convenience sample of non-treatment-seeking adult cannabis smokers, motivations to quit smoking cannabis, coping and adaptive strategies, as well as perceived benefit from cessation between cannabis abstinent and participants who relapse. METHOD: Sixty-three participants (31 men and 32 women) who attempted to quit cannabis in a non-controlled environment without medical help and were enrolled. They completed the Marijuana Quit Questionnaire (MJQQ), a self-report questionnaire collecting information in three areas: sociodemographic characteristics, cannabis use history (including any associated problems), and participants' characteristics regarding their "most difficult" (self-defined) attempt to quit in a non-controlled environment. For this study the index quit attempt was characterized in two areas: reasons for quitting marijuana, coping strategies used while quitting. Two additional questionnaires were added to the MJQQ; the Brief Cope, and a questionnaire assessing perceived benefit of the cannabis quit attempt. The participants were on average 28.5 years old (±5.1), and started using cannabis on average at 15.8 years (±2.8). Seventy-four percent (n=45) of the participants met the DSM-IV criteria for cannabis dependence before cannabis cessation. T-tests were used to compare abstainers and participants who relapsed after the quit attempt. RESULTS: Realizing that cannabis induces disabling cognitive disorders such as affection of memory, concentration and attention were reported by 71% of the participant as a motivation for quitting cannabis use. Then, being more energetic (reported by 68%) and more active during the day (62%), being able to control their life (67%), proving themselves they could quit (60%), saving money (60%), as well being less worried about their health (57%) were also reported as motivations to quit cannabis use. Different coping and adaptation strategies were also reported. First, environmental strategies such as disposing of both cannabis (71%) and equipment to smoke (71%), no longer going to places where cannabis is smoked (33%) or lifestyle changes (68%) were used to cope with cannabis cessation. Then cognitive strategies such as motivation, willingness (71%), self-control and having a positive perception of the situation (68%) were also reported. Regarding coping strategies, participants accepted and learned how to live with the new situation (68%), and social support from family (32%) and friends (30%) were reported. Perceived benefits were linked with motivations for cannabis cessation. Thus, participants reported having more energy (75%), being more active (73%), less tired (70%) and recovering memory (57%) after cannabis cessation. Fifty-two percent of participants relapsed after the quit attempt. Abstainers had significantly higher scores on two subscales: the "negative impact of cannabis use on one's health and on self and social image" (t(61)=-3.84; P<0.001; d=-0.76) and "negative reinforcement (e.g. seeking relief for specific physical symptoms or social problems caused by cannabis)" (t(61)=3.56; P=0.01; d=-0.51) than non-anstainers. Non-abstainers reported significantly less social support from family (t(61)=-3.85; P<0.001, d=-0.76) and friends (t(61)=-2.22; P=00.03, d=-0.51) than abstainers. CONCLUSION: This study underlines different aspects of cannabis cessation, self-change, relapse, and abstinence. Social and family support, as well as social network appears to be of prime importance in relapses and prevention programs for cannabis use. New perspectives for research on cannabis cessation self-change and relapses are thus highlighted, notably regarding factors that could predict relapse or success in cessation of smoking cannabis. Research on cannabis self-change and relapse are warranted for both prevention and therapeutic programs.

[Psychometric properties of the French version of the How I Think Questionnaire]. / Étude des qualités psychométriques de la version française du How I Think Questionnaire dans un échantillon d'adolescents français.

UNLABELLED: Certain research has pointed out the relative importance of cognitive distortions in the development of antisocial behavior. Distortions of social cognitions that facilitate aggression and other types of antisocial behavior have been described as self-serving cognitive distortions (Barriga et al., 2001 [2]). Considering the importance of the assessment of delinquent cognitive distortions, an instrument has been validated to measure self-serving cognitive distortions: the How I Think Questionnaire (HIT-Q, Barriga et al., 2001 [2]). Thus, the aim of the present study was to evaluate the convergent, discriminant and concurrent validity of a French version of the HIT-Q and its four dimensions (self-centered, blaming other, minimizing/mislabeling and assuming the worst). METHOD: A sample of 972 French high-school students completed the Youth Psychopathic traits Inventory (YPI ; Andershed et al., 2002 ; Andershed et al., 2007 [26,27]) used to evaluate the convergent validity of the HIT-Q. To investigate discriminant validity, participants also completed the Sociomoral Reflection Measure-Short Form (SMR-SF ; Gibbs et al., 1992 [28]) and the Interpersonal Reactivity Index (IRI ; Davis, 1983 [29]) used to assess cognitive and affective empathy. To measure antisocial behavior, the French versions of the Self-Reported Delinquency Questionnaire (SRDQ ; Le Blanc and Frechette, 1989 [22]), the Antisocial Behavior Scale (ABS ; Schawb-Stone et al., 1996 [23]), the Self-Reported Delinquency Behavior (SRDB ; Elliott and Menard, 1996 [24]) and three items of the Sexual Experiences Survey (SES ; Koss et al., 2007 [25]) were used. Two samples were composed based on the same socio-demographic (age and gender) and socio-economic characteristics and ethnic background. French males scoring in the upper quartile on the antisocial behavior total score were classified in the antisocial group (n=135) and the rest of the sample in the non-antisocial group (n=306). Convergent and discriminant validity was determined using Pearson coefficients of correlation. One-way analyses of variance were used for mean scores comparisons. Regression analysis was used to evaluate the relative contribution of self-serving cognitive distortions to the prediction of antisocial behavior. RESULTS: The French version of the HIT-Q showed acceptable reliability and validity and also a satisfying convergent and discriminant validity. The HIT-Q and its dimensions were positively and highly correlated to psychopathic traits (r=0.50 to r=0.61, p<0.05) ; these findings suggested a good convergent validity. The correlation between self-serving cognitive distortions and social moral reasoning (r=-0.23 to r=-0.28, p<0.05) and empathy (r=-0.13 to r=-0.20, p<0.05) appeared to be negative and low ; this relationship was conclusive and showed a satisfying discriminant validity. Mean comparison showed that participants in the antisocial group reported higher scores of self-serving cognitive distortions and its dimensions than the non-antisocial group. Self-serving cognitive distortions significantly predicted antisocial behavior (ß=0.58, SE=0.02, p<0.001) and explained 34% of the variance. DISCUSSION: The study of the convergent validity of the HIT-Q with the YPI as external criteria showed they were closely linked, which suggests self-serving cognitive distortion may be the cognitive expression of psychopathic traits. The discriminant validity of the HIT-Q with moral reasoning and empathy was satisfying and similar to previous results (Lardén et al., 2006 [20]). In concordance with previous studies, delinquent cognitive distortions appeared to be a significant predictor of antisocial behavior and moreover, participants in the antisocial group reported higher scores of self-serving cognitive distortions (Capuano, 2007 ; Barriga and Gibbs, 1996 ; Nas et al., 2008 [10-12]). CONCLUSION: The present study showed that the French version of the HIT-Q presents good psychometric properties.

[Evaluation of the characteristics of addiction to online video games among adolescents and young adults]. / Évaluation des caractéristiques sociales, des stratégies de coping, de l'estime de soi et de la symptomatologie dépressive en relation avec la dépendance aux jeux vidéo en ligne chez les adolescents et les jeunes adultes.

OBJECTIVES: The objectives of this study are to assess the social characteristics, coping strategies, self-esteem and depressive symptoms in a population-dependent and not dependent on video games online, in order to investigate the correlations existing between these characteristics. METHOD: The study was conducted among 193 subjects. Data were collected through a global questionnaire constituted of several scales. The global questionnaire consisted of a sociodemographic part (age, sex, social status, most played game, number of hours per week devoted to the game), a questionnaire assessing dependence and abuse according to the DSM -IV-TR, the feeling of social belonging scale (or ESAS which was doubled to collect information about the belonging in real life and virtual life), the Ways of coping check-list (WCCL), the Rosenberg self-esteem scale (EES), the Quality of interpersonal relations scale (EQRI), the UCLA Loneliness scale and the Center for epidemiologic studies depression scale (CES-D). The questionnaire was broadcasted on the Internet, specifically in the forums dedicated to "massively multiplayer online role-playing games" and in young people's forums in specific subject headings. RESULTS: The results show that there are significant differences between the two populations, especially regarding the social characteristics, depressive symptoms, self-esteem and coping strategies. In the entire population, 66 subjects (42%) were considered dependent on online video games and 92 subjects (58%) were not considered dependent. In the dependent population, the number of hours spent playing per week, the score of social belonging in the virtual life, the coping focused on the emotion, the score of loneliness or social isolation and the score obtained on the CES-D appeared more important than the scores obtained by the non-dependent. Moreover, the average age, the scores of social belonging in real life, self-esteem and sub-dimensions "family" and "friends" of the quality of interpersonal relations scale are lower than those obtained by the non-dependent. Furthermore, the number of hours of play per week, the feeling of social belonging, self-esteem, quality of family relationships and loneliness are predictive factors of addiction to video games online. CONCLUSION: These results suggest that one of the crucial issues in dependence is the monitoring of game practice. Indeed, dependence on video games is based on a real hardware that needs to be controlled and managed by a third party before the emergence of a dependency. Therefore the results of this study suggest the establishment of better prevention, especially among parents who are confronted in majority with a world and a technology that is unknown or too complicated. In the case of a proven addiction, the study proposes care therapy focused on the social link, especially the family link, and a particular care to work on self-esteem.

[Influence of cannabis use on suicidal ideations among 491 high-school students]. / Influence de la consommation de cannabis sur les idées suicidaires chez 491 adolescents scolarisés.

OBJECTIVE: The aim of the study was to evaluate the relative contributions of cannabis use and depressive symptoms in the prediction of suicidal ideation. METHOD: A random sample of 491 high-school students from the department of Haute-Garonne, France (290 girls, mean age=16.6+/-1.4; 201 boys, mean age=17.3 years+/-1.6) completed a questionnaire assessing cannabis use, the CES-D (center for epidemiological studies-depression scale) completed by the three-item sub-scale measuring suicidal ideation proposed by Garrison et al. (J Am Acad Child Adolesc Psychiatry 30 (1991) 636-641). RESULTS: In the total sample, 15% of girls (n=44) and 23% of boys (n=46) reported having used cannabis at least once a month during the last three months. The mean CES-D score for girls was significantly higher than for boys (20.6+/-11 versus 18.4+/-10.9, t=2.4, p=0.01). According to the cut-off score of 24, 22% of boys and 36% of girls exhibited a moderate to severe depressive symptomatology (p=0.02). The mean suicidal ideation score was not significantly higher in girls than in boys (1.3+/-2 versus 0.95+/-1.9, t=1.7, p=0.10). At least, the occasional wish to kill oneself was reported by 17% of boys and 20% of girls (p=0.40). The contribution of cannabis use and depressive symptomatology in the prediction of suicidal ideation were tested with a hierarchical multiple regression analysis, to determine whether cannabis use improved prediction of suicidal ideation beyond that afforded by CES-D scores. In the first step, including age and sex as covariates, the model accounted for a significant and important part of the variance of suicidal ideation (41%). Age and sex were not significant predictors. The second step, with cannabis use added to the prediction of suicidal ideation, afforded an increase of 1% in predictable variance. Cannabis use (beta=0.08, t=2.2, p=0.03) was significantly but weakly related to suicidal ideation, while depressive symptoms (beta=0.63, t=17.8, p<0.001) remained the main predictor. In a second regression analysis conducted among cannabis users, frequency of use was almost a significant predictor (beta=0.11, t=1.84, p=0.07). DISCUSSION: This result suggests an association between suicidal ideation, depressive symptoms and cannabis use in adolescents. Cannabis use appeared to be an independent predictor of suicidal ideation after controlling for depressive symptoms. However, the increment of variance accounted for by cannabis use was small. This suggests that cannabis use contributes to suicidal ideation independently from depressive symptoms, but weakly. A limitation to the study was the absence of control for other potential confounding variables. The association between cannabis use and suicidal ideation may be linked to common risk factors such as borderline personality disorder traits, sociodemographic and family factors. In this study, cannabis use does not appear as an important risk factor for suicidal ideation in adolescents.

[Contributions of parental and social influences to cannabis use in a non-clinical sample of adolescents]. / Contribution des influences parentales et sociales à la consommation de cannabis chez des adolescents scolarisés.

OBJECTIVE: The aim of the study was to evaluate the relative contributions of peers and parental influences and adolescents' own beliefs about use, in the prediction of cannabis use. METHOD: Participants were 559 high-school and secondary school students (275 girls, mean age=15.4+/-1; 274 boys, mean age=15.5+/-0.9) who completed questionnaires assessing cannabis use frequency, the number of peers using cannabis, the number of peers opposed to cannabis use, parental attitude toward cannabis use, parental present or past cannabis use and participants' expectations toward use. Parents' opinion of cannabis use was assessed using a ten-point scale ranging from zero (highly opposed to cannabis use) to 10 (highly in favour of cannabis use). The participants' opinion of cannabis use was assessed using a self-report questionnaire which was generated from a preliminary qualitative study on a convenient sample of ten adolescents who agreed to participate in a semistructured interview assessing their perceptions of the effects of cannabis use. Interviewers drew up a list of all the reported perceptions. One rater eliminated redundant responses and combined similar instances into more general terms. Responses were reworded concisely to be appropriate for a close-ended questionnaire. The final questionnaire consisted of 29 items. Items were scored on a 7-point Likert scale, ranging from 1=disagree strongly to 7=agree strongly. RESULTS: In the total sample (n=559), 22% of girls (n=61) and 28% of boys (n=76) reported having used cannabis once during the last six months (p=0.05); 4% of girls and 9% of boys used cannabis at least 3-4 times per week; water pipe or bong was used by 31% of boys and 28% of girls used cannabis. Cannabis users reported that 49% of their fathers were using or had used cannabis versus 10% of non-users. Cannabis users reported that 39% of their mothers were using or had used cannabis versus 22% of non-users. An exploratory factorial analysis of the cannabis use expectations questionnaire was conducted. The eigenvalue curve suggested either a two-factor solution explaining 46% of the variance. These factors were called 'positive expectancies' (eigenvalue=9.0; explained variance=29%, Cronbach's alpha=0.86) and 'negative expectancies' (eigenvalue=4.0; explained variance=17%; Cronbach's alpha=0.93). The correlation of factors was negative and moderate (Pearson's r=-0.29). Cannabis users were characterised by a higher number of peers using cannabis, a lower number of peers opposed to use, a lower level of negative opinion of parents, a higher level of positive expectancies and a lower level of negative expectancies. It is to be noted that both users and non-users tended to perceive their parents as highly opposed to use. A logistic regression analysis predicting cannabis use versus non-use was performed entering sex, the number of peers opposed to cannabis use, the number of peers using cannabis, the opinion of parents, parental present or past cannabis use and positive and negative expectations factor scores. A test of the full model with all predictors against a constant-only model was statistically reliable: the predictors reliably distinguished between users and non-users (chi(2) (8)=153.9; p<0.0001). The variance in cannabis use accounted for was high, with McFadden rho(2)=0.39. Prediction success was satisfactory, with 94% of non-users and 59% of users correctly predicted. The number of peers opposed to cannabis use (B=-0.08; t-ratio=3.9; p=0.04), the number of peers using cannabis (B=0.06; t-ratio=7.9, p=0.01), the positive expectations score (B=0.94; t-ratio=26.6; p<0.0001) and negative expectations scores (B=-0.50; t-ratio=11.8; p=0.0006) and father's present or past cannabis use (B=1.17; t-ratio=8.2; p=0.004) were significant independent predictors of cannabis use. These results indicated that the higher the number of peers using cannabis and the positive expectations, the higher the risk for initiation of cannabis use. The regression coefficient of the number of peers opposed to cannabis use and of the negative expectations score were negative. These results indicated that the less the number of peers opposed to cannabis use and the lower the negative expectations, the higher the risk for initiation of use. Parental attitudes toward use and mother's present or past cannabis use were not significant independent predictors of use. DISCUSSION: As our sample was non-clinical, a first limitation of our findings is that they may not be transposable to patient populations. Another limitation of our study is linked to its cross-sectional design, which prevents the attribution of causal explanations for the associations found. One of the study's strengths is that it assesses potentially important variables not evaluated in previous studies, such as the number of peers opposed to cannabis use and positive and negative expectations of use. The results of the present study suggested that the number of peers using cannabis, father's present or past cannabis use 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 toward use did not appear to influence adolescents' cannabis use. In conclusion, our results may have some implications for prevention interventions. They add weight to the view that normalisation of non-use by peers facilitates abstinence. The absence of influence of parental attitudes toward use suggests that parental disapproval of use is not effective in preventing use, whereas the example of father's use or non-use influences adolescent use. The quite low correlation between positive and negative expectancies suggests that prevention interventions presenting information concerning the effects of cannabis use should focus on both reducing positive expectancies and enhancing negative expectancies.