Over approximately the past 20 years, posttraumatic stress disorder (PTSD) has been increasingly
... more Over approximately the past 20 years, posttraumatic stress disorder (PTSD) has been increasingly recognized as a significant personal and societal problem (Alonso et al., 2004; Kessler, 2000).With this recognition has come a burgeoning amount of research examining the neurobiological and cognitive characteristics of the disorder. Much of the early research on PTSD focused on military veterans, in particular those who served in World War II and the Vietnam War (Card, 1987; Foy & Card, 1987). More recently, considerable emphasis has been placed on understanding the etiology and consequences of PTSD in military personnel returning from operations in the Middle East termed ‘‘Operation Enduring Freedom’’ and ‘‘Operation Iraqi Freedom’’(OEF/OIF; Vasterling, Verfaellie,& Sullivan, 2009). Research has also involved individuals with PTSD secondary to a variety of other common causes including rape, criminal victimization, motor vehicle accidents, and physical abuse in childhood or adulthood (Darves-Bornoz et al., 2008; Kessler, 2000). In this chapter, we first provide an overview of the diagnostic criteria for PTSD and common assessment measures, as well as the epidemiology and course of the disorder. We then review the neuropsychological correlates of PTSD, including variables that may contribute to the heterogeneity of findings. We briefly address current treatment approaches to PTSD and what is known about their impact on neuropsychological functioning, as well as the potential role of neuropsychological assessment in treatment planning. Finally, we conclude with a discussion of brain imaging research that has informed our understanding of neural substrates and its associated cognitive limitations
Contexte: Les relations avec les proches jouent un rôle dans le développement, l'évolution et... more Contexte: Les relations avec les proches jouent un rôle dans le développement, l'évolution et le traitement des troubles anxieux. L'objectif de cette recherche est d'étudier les facteurs spécifiques de soutien qui sont offerts aux patients ayant un trouble anxieux. Méthode : Des participants diagnostiqués avec un TPA ou un TOC ont été recrutés à l'IUSMM et une interaction filmée entre la personne atteinte du trouble et un proche a été complétée. Une analyse lexicale de type thématique (verbal) et conversationnel (non-verbal) a été réalisée à partir des transcriptions des discussions actives (interactions filmées). Plus précisément, des mesures de spécificité ont été effectuées en fonction de cinq variables: le type et la durée de la relation, le trouble, le sexe et le rôle. Résultats : Les résultats préliminaires obtenus à partir des transcriptions de 17 discussions actives ont montré que les pleurs sont spécifiques aux couples dont la femme a un TPA, alors que les r...
Contexte: Le soutien social est un des facteurs qui influencent le développement, la sévérité et ... more Contexte: Le soutien social est un des facteurs qui influencent le développement, la sévérité et l'évolution de l'état de stress post-traumatique (ÉSPT). Quand il est positif, il est généralement considéré comme bénéfique, mais quand il est négatif (e.x. critique), il corrèle positivement avec la détresse psychologique. L'objectif de cette étude vise à explorer, au-delà des mesures autorapportées, les facteurs de nature interactive (conjugaux ou non) du soutien social chez les gens avec un ÉSPT. Méthode: Des participants avec un ÉSPT ont été recrutés à l'IUSMM et une interaction filmée entre la personne atteinte du trouble et un proche a été complétée. Seize discussions actives (interactions filmées) ont été transcrites et une analyse lexicale de type thématique et conversationnel a été réalisée. Plus précisément, des analyses de spécificité (Brunet, 2003) ont été faites en fonction de cinq variables: l'apparition du trouble, le type de relation, la durée de la r...
Compassion fatigue is currently the dominant model in work-related stress studies that explain th... more Compassion fatigue is currently the dominant model in work-related stress studies that explain the consequences of caring for others on child-protection workers. Based on a deterministic approach, this model excludes the role of cognition a priori and a posteriori in the understanding of the impact of caregiving or providing social support. By integrating the notion of professional identity, this article adds a subjective perspective to the compassion fatigue model allowing for the consideration of positive outcomes and takes into account the influence of stress caused by accountability. Mainly, it is argued that meanings derived from identity and given to situations may protect or accelerate the development of compassion fatigue or compassion satisfaction. To arrive at this proposition, the notions of compassion fatigue and identity theory are first reviewed. These concepts are then articulated around four work-related stressors specific to child-protection work. In light of this e...
Psychological trauma : theory, research, practice and policy, 2013
In 2006, following the shooting at Dawson College, the authorities implemented an intervention pl... more In 2006, following the shooting at Dawson College, the authorities implemented an intervention plan. This provided an opportunity to analyze the responses to services offered, and afforded a learning opportunity, which led to the proposal of an extensive multimodal short- and long-term psychological plan for future needs. Both quantitative and qualitative data were gathered 18 months after the event, involving the participation of 948 students and staff. Mental health problems and the perception of services offered after the shooting were investigated, using standardized measures. Second, focus groups and individual interviews were conducted among a subgroup of participants (support team members; teachers and employees; students and parents) and permitted to gather data on services received and services required. Individual report of events, the extent of psychological impact and services offered and received were analyzed in terms of the following dimensions: intervention philosoph...
Conducted a study with 146 young adults from Québec (aged 18–25 yrs, 106 females and 40 males) in... more Conducted a study with 146 young adults from Québec (aged 18–25 yrs, 106 females and 40 males) involved in an intimate relationship. Ss were evaluated on jealousy expectation, degree of jealousy, perceived relationship stability, and use of coping strategies in a jealousy-induced hypothetical situation. Study results show that jealousy, suspicion and insecurity regarding the relationship, perceived instability of the relationship, and use of extra-punitive coping strategies (e.g., insults and threats toward suspected rival, victim attitude toward partner) are significantly correlated with jealousy expectation. Moreover, suspicion, insecurity regarding the relationship, perceived instability of the latter, and use of extra-punitive coping strategies facilitate prediction of jealousy expectation. (English abstract) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
OBJECTIVE: To educate family physicians about screening, diagnosis, and treatment of psychologica... more OBJECTIVE: To educate family physicians about screening, diagnosis, and treatment of psychological disorders related to traumatic events. QUALITY OF EVIDENCE: PsycLIT, PsychINFO, PILOTS, and MEDLINE databases were searched from January 1985 to December 2000 using the terms "acute stress disorder," "posttraumatic stress disorder," "traumatic stress," "psychotherapy," "psychosocial treatment," "treatment," and "pharmacotherapy." Recommendations concerning treatment of acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) are based on evidence from trials of the highest quality. Conclusions about assessment and diagnosis are based on the most recent epidemiologic studies, consensus, and expert opinion. MAIN MESSAGE: Very often, ASD and PTSD are underdiagnosed and undertreated. Family physicians are likely to see patients suffering from these disorders. Early screening in primary care is a function of a...
L’importance des états de stress post-traumatique (ÉSPT) en milieu de travail est indéniable. Les... more L’importance des états de stress post-traumatique (ÉSPT) en milieu de travail est indéniable. Les statistiques de la Commission de la santé et de la sécurité du travail (CSST) pour la période 2002 à 2004 indiquent que les travailleurs aux prises avec un ÉSPT ont entraîné des débours de 17 747 600 $ ce qui est considérablement supérieur à ceux relatifs au stress et à l’anxiété (7 724 669 $), aux états dépressifs (3 626 814 $) et à l’épuisement professionnel (797 165 $). Par ailleurs, l’ÉSPT entraîne des répercussions sur le fonctionnement psychosocial, le retour au travail et la qualité de vie des personnes atteintes. Malgré ces conséquences, rares sont les études qui ont évalué l’efficacité des interventions pour prévenir les ÉSPT et leurs résultats demeurent peu probants. Le Centre jeunesse de Montréal-Institut universitaire (CJM-IU), par sa mission d’aide, de protection et ses clientèles en difficultés présente un potentiel élevé d’exposition à des événements traumatiques. C’est d...
Canadian journal of psychiatry. Revue canadienne de psychiatrie
To study alcohol and drug addiction incidence in students exposed to the Dawson College shooting ... more To study alcohol and drug addiction incidence in students exposed to the Dawson College shooting within the 18 months following the event, to identify the precursors of a psychoactive substance addiction development while considering the severity of event exposure, and to examine whether alcohol use, 18 months after the event, is related to any of the various posttraumatic stress disorder (PTSD) symptom groups. The population of this study was comprised of all the Dawson College students at the time of the event. Analyses were conducted with 854 students enrolled in the college at the time of the shooting. Five per cent of women and 7% of men showed, for the first time in their life, a problem with substance addiction following the shooting. In men, young age, lifetime suicidal ideation, and having seen the killer during the shooting are the main precursors of incident accident cases. None of the studied precursors were significant in women. Men and women were also different in term...
Canadian journal of public health = Revue canadienne de santé publique
Investigate the links between different types of social support, psychological well-being and dis... more Investigate the links between different types of social support, psychological well-being and distress among individuals with anxiety disorders. Data were drawn from the Canadian Community Health Survey (CCHS cycle 1.2) which had 36,984 participants, 1,803 of whom presented with anxiety disorders. Classical linear regression analyses were conducted to examine the links between different social support dimensions and psychological well-being on one hand, and psychological distress on the other hand. Women reported perceiving significantly higher levels of affective, emotional/informational, tangible support and positive social interactions than men. After controlling for potentially confounding variables (socio-demographic variables and the presence of a major depressive disorder), three types of social supports appeared to be predictors for the psychological well-being of women with anxiety disorders: positive social interactions, emotional/informational support, and affective suppo...
This study examines if the timing of disclosure (early or late) of a sexual assault and if the ro... more This study examines if the timing of disclosure (early or late) of a sexual assault and if the romantic partner's participation in the study have an impact on relational and affective aspects of the victims at Time 1 (initial interview) and Time 2 (4 months later). The sexual assault occurred to victims (N = 27) between 1 month to 7 years prior to the first assessment interview. Twenty-six percent of victims were diagnosed with posttraumatic stress disorder (PTSD). Descriptive analyses indicate a difference between timing of disclosure and romantic partner's participation in the assessment process of the study. All victims indicate that they have received more emotional support at the second assessment in the study, whether they have disclosed the aggression early or lately. Victims have disclosed the assault early reported more depressive symptoms.
Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2007
Cognitive-behavioural therapy (CBT) has proved effective in treating delusions, both in schizophr... more Cognitive-behavioural therapy (CBT) has proved effective in treating delusions, both in schizophrenia and delusional disorder (DD). Clinical trials of DD have mostly compared CBT with either treatment as usual, no treatment, or a wait-list control. This current study aimed to assess patients with DD who received CBT, compared with an attention placebo control (APC) group. Twenty-four individuals with DD were randomly allocated into either CBT or APC groups for a 24-week treatment period. Patients were diagnosed on the basis of structured clinical interviews for mental disorders and the Maudsley Assessment of Delusion Schedule (MADS). Completers in both groups (n = 11 for CBT; n = 6 for APC) showed clinical improvement on the MADS dimensions of Strength of Conviction, Insight, Preoccupation, Systematization, Affect Relating to Belief, Belief Maintenance Factors, and Idiosyncrasy of Belief. When compared with APC, CBT produced more impact on the MADS dimensions for Affect Relating to ...
Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2007
The goal of this study was to identify rates, characteristics, and predictors of mental health tr... more The goal of this study was to identify rates, characteristics, and predictors of mental health treatment seeking by military members with posttraumatic stress disorder (PTSD). Our sample was drawn from the 2002 Canadian Community Health Survey-Canadian Forces Supplement (CCHS-CF) dataset. The CCHS-CF is the first epidemiologic survey of PTSD and other mental health conditions in the Canadian military and includes 8441 nationally representative Canadian Forces (CF) members. Of those, 549 who met the criteria for lifetime PTSD were included in our analyses. To identify treatment rates and characteristics, we examined frequency of treatment contact by professional and facility type. To identify predictors of treatment seeking, we conducted a binary logistic regression with lifetime treatment seeking as the outcome variable. About two-thirds of those with PTSD consulted with a professional regarding mental health problems. The most frequently consulted professionals, during both the las...
Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2006
This study had a twofold purpose: to validate the French-Canadian version of a measure of deploym... more This study had a twofold purpose: to validate the French-Canadian version of a measure of deployment risk and resilience factors and to examine the relation between deployment risk and resilience factors and postdeployment functioning. Canadian veterans at an outpatient clinic (n = 131) completed a mail-in survey that included a measure on deployment risk and resilience factors, the Deployment Risk and Resilience Inventory (DRRI) (1), as well as measures on psychological and physical health. Internal consistency and test-retest reliability coefficients for the DRRI scales were very good. As expected, DRRI risk factors were negatively associated with psychological and physical functioning, and DRRI resilience factors were positively associated with psychological and physical functioning. Low- as well as high-magnitude deployment risk factors were associated with functioning. The French-Canadian version of the DRRI is a reliable and valid measure of deployment risk and resilience fact...
Sexual assault results in important consequences for victims. An inadequate social support may ha... more Sexual assault results in important consequences for victims. An inadequate social support may have an impact on the victim's psychological condition and interfere with her adjustment. The purpose of the present article is to describe different support reactions linked to sexual assault and their impact on the psychological condition of the victims, the posttraumatic symptoms and the recovery. The specific contribution of the spouse living with the victim is exposed. The impact of the consequences resulting from the sexual assault on the quality of the support is also presented. Finally, clinical implications and research approach are proposed.
A new measure of the social support specifically intended for anxiety disorders has been elaborat... more A new measure of the social support specifically intended for anxiety disorders has been elaborated ; this new scale entitled "Questionnaire sur les Comportements de Soutien en situation d'Anxiété" (QCSA ; Guay et al., 2003) consists of 65 items measuring positive and negative perceived social support. Among a sample of 257 university students, the QCSA shows good psychometric properties (internal consistency and correlations with related constructs). Results of an exploratory factor analysis identified three factors : 1) criticism and coercive strategies, 2) anxiety management and reinforcement, and 3) distraction. Significant correlations were found with measures of anxiety, functioning and psychological distress. The QCSA is an adequate scale to evaluate social support in relation to mental health.
This article's first objective is to better situate the concept of social support within the ... more This article's first objective is to better situate the concept of social support within the vast field of social relations. The authors then describe theoretical models allowing to explain the importance of social support in mental health as well as the implications within the context of the intervention, the various measures of social support, their respective values and the major instruments which have been developed in order to apprehend them. Recent studies then allow to illustrate the narrow links between mental health and social support identified in population and clinical studies. In conclusion, the authors present interventions that favor the development of social support and propose recommendations for clinicians.
Over approximately the past 20 years, posttraumatic stress disorder (PTSD) has been increasingly
... more Over approximately the past 20 years, posttraumatic stress disorder (PTSD) has been increasingly recognized as a significant personal and societal problem (Alonso et al., 2004; Kessler, 2000).With this recognition has come a burgeoning amount of research examining the neurobiological and cognitive characteristics of the disorder. Much of the early research on PTSD focused on military veterans, in particular those who served in World War II and the Vietnam War (Card, 1987; Foy & Card, 1987). More recently, considerable emphasis has been placed on understanding the etiology and consequences of PTSD in military personnel returning from operations in the Middle East termed ‘‘Operation Enduring Freedom’’ and ‘‘Operation Iraqi Freedom’’(OEF/OIF; Vasterling, Verfaellie,& Sullivan, 2009). Research has also involved individuals with PTSD secondary to a variety of other common causes including rape, criminal victimization, motor vehicle accidents, and physical abuse in childhood or adulthood (Darves-Bornoz et al., 2008; Kessler, 2000). In this chapter, we first provide an overview of the diagnostic criteria for PTSD and common assessment measures, as well as the epidemiology and course of the disorder. We then review the neuropsychological correlates of PTSD, including variables that may contribute to the heterogeneity of findings. We briefly address current treatment approaches to PTSD and what is known about their impact on neuropsychological functioning, as well as the potential role of neuropsychological assessment in treatment planning. Finally, we conclude with a discussion of brain imaging research that has informed our understanding of neural substrates and its associated cognitive limitations
Contexte: Les relations avec les proches jouent un rôle dans le développement, l'évolution et... more Contexte: Les relations avec les proches jouent un rôle dans le développement, l'évolution et le traitement des troubles anxieux. L'objectif de cette recherche est d'étudier les facteurs spécifiques de soutien qui sont offerts aux patients ayant un trouble anxieux. Méthode : Des participants diagnostiqués avec un TPA ou un TOC ont été recrutés à l'IUSMM et une interaction filmée entre la personne atteinte du trouble et un proche a été complétée. Une analyse lexicale de type thématique (verbal) et conversationnel (non-verbal) a été réalisée à partir des transcriptions des discussions actives (interactions filmées). Plus précisément, des mesures de spécificité ont été effectuées en fonction de cinq variables: le type et la durée de la relation, le trouble, le sexe et le rôle. Résultats : Les résultats préliminaires obtenus à partir des transcriptions de 17 discussions actives ont montré que les pleurs sont spécifiques aux couples dont la femme a un TPA, alors que les r...
Contexte: Le soutien social est un des facteurs qui influencent le développement, la sévérité et ... more Contexte: Le soutien social est un des facteurs qui influencent le développement, la sévérité et l'évolution de l'état de stress post-traumatique (ÉSPT). Quand il est positif, il est généralement considéré comme bénéfique, mais quand il est négatif (e.x. critique), il corrèle positivement avec la détresse psychologique. L'objectif de cette étude vise à explorer, au-delà des mesures autorapportées, les facteurs de nature interactive (conjugaux ou non) du soutien social chez les gens avec un ÉSPT. Méthode: Des participants avec un ÉSPT ont été recrutés à l'IUSMM et une interaction filmée entre la personne atteinte du trouble et un proche a été complétée. Seize discussions actives (interactions filmées) ont été transcrites et une analyse lexicale de type thématique et conversationnel a été réalisée. Plus précisément, des analyses de spécificité (Brunet, 2003) ont été faites en fonction de cinq variables: l'apparition du trouble, le type de relation, la durée de la r...
Compassion fatigue is currently the dominant model in work-related stress studies that explain th... more Compassion fatigue is currently the dominant model in work-related stress studies that explain the consequences of caring for others on child-protection workers. Based on a deterministic approach, this model excludes the role of cognition a priori and a posteriori in the understanding of the impact of caregiving or providing social support. By integrating the notion of professional identity, this article adds a subjective perspective to the compassion fatigue model allowing for the consideration of positive outcomes and takes into account the influence of stress caused by accountability. Mainly, it is argued that meanings derived from identity and given to situations may protect or accelerate the development of compassion fatigue or compassion satisfaction. To arrive at this proposition, the notions of compassion fatigue and identity theory are first reviewed. These concepts are then articulated around four work-related stressors specific to child-protection work. In light of this e...
Psychological trauma : theory, research, practice and policy, 2013
In 2006, following the shooting at Dawson College, the authorities implemented an intervention pl... more In 2006, following the shooting at Dawson College, the authorities implemented an intervention plan. This provided an opportunity to analyze the responses to services offered, and afforded a learning opportunity, which led to the proposal of an extensive multimodal short- and long-term psychological plan for future needs. Both quantitative and qualitative data were gathered 18 months after the event, involving the participation of 948 students and staff. Mental health problems and the perception of services offered after the shooting were investigated, using standardized measures. Second, focus groups and individual interviews were conducted among a subgroup of participants (support team members; teachers and employees; students and parents) and permitted to gather data on services received and services required. Individual report of events, the extent of psychological impact and services offered and received were analyzed in terms of the following dimensions: intervention philosoph...
Conducted a study with 146 young adults from Québec (aged 18–25 yrs, 106 females and 40 males) in... more Conducted a study with 146 young adults from Québec (aged 18–25 yrs, 106 females and 40 males) involved in an intimate relationship. Ss were evaluated on jealousy expectation, degree of jealousy, perceived relationship stability, and use of coping strategies in a jealousy-induced hypothetical situation. Study results show that jealousy, suspicion and insecurity regarding the relationship, perceived instability of the relationship, and use of extra-punitive coping strategies (e.g., insults and threats toward suspected rival, victim attitude toward partner) are significantly correlated with jealousy expectation. Moreover, suspicion, insecurity regarding the relationship, perceived instability of the latter, and use of extra-punitive coping strategies facilitate prediction of jealousy expectation. (English abstract) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
OBJECTIVE: To educate family physicians about screening, diagnosis, and treatment of psychologica... more OBJECTIVE: To educate family physicians about screening, diagnosis, and treatment of psychological disorders related to traumatic events. QUALITY OF EVIDENCE: PsycLIT, PsychINFO, PILOTS, and MEDLINE databases were searched from January 1985 to December 2000 using the terms "acute stress disorder," "posttraumatic stress disorder," "traumatic stress," "psychotherapy," "psychosocial treatment," "treatment," and "pharmacotherapy." Recommendations concerning treatment of acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) are based on evidence from trials of the highest quality. Conclusions about assessment and diagnosis are based on the most recent epidemiologic studies, consensus, and expert opinion. MAIN MESSAGE: Very often, ASD and PTSD are underdiagnosed and undertreated. Family physicians are likely to see patients suffering from these disorders. Early screening in primary care is a function of a...
L’importance des états de stress post-traumatique (ÉSPT) en milieu de travail est indéniable. Les... more L’importance des états de stress post-traumatique (ÉSPT) en milieu de travail est indéniable. Les statistiques de la Commission de la santé et de la sécurité du travail (CSST) pour la période 2002 à 2004 indiquent que les travailleurs aux prises avec un ÉSPT ont entraîné des débours de 17 747 600 $ ce qui est considérablement supérieur à ceux relatifs au stress et à l’anxiété (7 724 669 $), aux états dépressifs (3 626 814 $) et à l’épuisement professionnel (797 165 $). Par ailleurs, l’ÉSPT entraîne des répercussions sur le fonctionnement psychosocial, le retour au travail et la qualité de vie des personnes atteintes. Malgré ces conséquences, rares sont les études qui ont évalué l’efficacité des interventions pour prévenir les ÉSPT et leurs résultats demeurent peu probants. Le Centre jeunesse de Montréal-Institut universitaire (CJM-IU), par sa mission d’aide, de protection et ses clientèles en difficultés présente un potentiel élevé d’exposition à des événements traumatiques. C’est d...
Canadian journal of psychiatry. Revue canadienne de psychiatrie
To study alcohol and drug addiction incidence in students exposed to the Dawson College shooting ... more To study alcohol and drug addiction incidence in students exposed to the Dawson College shooting within the 18 months following the event, to identify the precursors of a psychoactive substance addiction development while considering the severity of event exposure, and to examine whether alcohol use, 18 months after the event, is related to any of the various posttraumatic stress disorder (PTSD) symptom groups. The population of this study was comprised of all the Dawson College students at the time of the event. Analyses were conducted with 854 students enrolled in the college at the time of the shooting. Five per cent of women and 7% of men showed, for the first time in their life, a problem with substance addiction following the shooting. In men, young age, lifetime suicidal ideation, and having seen the killer during the shooting are the main precursors of incident accident cases. None of the studied precursors were significant in women. Men and women were also different in term...
Canadian journal of public health = Revue canadienne de santé publique
Investigate the links between different types of social support, psychological well-being and dis... more Investigate the links between different types of social support, psychological well-being and distress among individuals with anxiety disorders. Data were drawn from the Canadian Community Health Survey (CCHS cycle 1.2) which had 36,984 participants, 1,803 of whom presented with anxiety disorders. Classical linear regression analyses were conducted to examine the links between different social support dimensions and psychological well-being on one hand, and psychological distress on the other hand. Women reported perceiving significantly higher levels of affective, emotional/informational, tangible support and positive social interactions than men. After controlling for potentially confounding variables (socio-demographic variables and the presence of a major depressive disorder), three types of social supports appeared to be predictors for the psychological well-being of women with anxiety disorders: positive social interactions, emotional/informational support, and affective suppo...
This study examines if the timing of disclosure (early or late) of a sexual assault and if the ro... more This study examines if the timing of disclosure (early or late) of a sexual assault and if the romantic partner's participation in the study have an impact on relational and affective aspects of the victims at Time 1 (initial interview) and Time 2 (4 months later). The sexual assault occurred to victims (N = 27) between 1 month to 7 years prior to the first assessment interview. Twenty-six percent of victims were diagnosed with posttraumatic stress disorder (PTSD). Descriptive analyses indicate a difference between timing of disclosure and romantic partner's participation in the assessment process of the study. All victims indicate that they have received more emotional support at the second assessment in the study, whether they have disclosed the aggression early or lately. Victims have disclosed the assault early reported more depressive symptoms.
Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2007
Cognitive-behavioural therapy (CBT) has proved effective in treating delusions, both in schizophr... more Cognitive-behavioural therapy (CBT) has proved effective in treating delusions, both in schizophrenia and delusional disorder (DD). Clinical trials of DD have mostly compared CBT with either treatment as usual, no treatment, or a wait-list control. This current study aimed to assess patients with DD who received CBT, compared with an attention placebo control (APC) group. Twenty-four individuals with DD were randomly allocated into either CBT or APC groups for a 24-week treatment period. Patients were diagnosed on the basis of structured clinical interviews for mental disorders and the Maudsley Assessment of Delusion Schedule (MADS). Completers in both groups (n = 11 for CBT; n = 6 for APC) showed clinical improvement on the MADS dimensions of Strength of Conviction, Insight, Preoccupation, Systematization, Affect Relating to Belief, Belief Maintenance Factors, and Idiosyncrasy of Belief. When compared with APC, CBT produced more impact on the MADS dimensions for Affect Relating to ...
Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2007
The goal of this study was to identify rates, characteristics, and predictors of mental health tr... more The goal of this study was to identify rates, characteristics, and predictors of mental health treatment seeking by military members with posttraumatic stress disorder (PTSD). Our sample was drawn from the 2002 Canadian Community Health Survey-Canadian Forces Supplement (CCHS-CF) dataset. The CCHS-CF is the first epidemiologic survey of PTSD and other mental health conditions in the Canadian military and includes 8441 nationally representative Canadian Forces (CF) members. Of those, 549 who met the criteria for lifetime PTSD were included in our analyses. To identify treatment rates and characteristics, we examined frequency of treatment contact by professional and facility type. To identify predictors of treatment seeking, we conducted a binary logistic regression with lifetime treatment seeking as the outcome variable. About two-thirds of those with PTSD consulted with a professional regarding mental health problems. The most frequently consulted professionals, during both the las...
Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2006
This study had a twofold purpose: to validate the French-Canadian version of a measure of deploym... more This study had a twofold purpose: to validate the French-Canadian version of a measure of deployment risk and resilience factors and to examine the relation between deployment risk and resilience factors and postdeployment functioning. Canadian veterans at an outpatient clinic (n = 131) completed a mail-in survey that included a measure on deployment risk and resilience factors, the Deployment Risk and Resilience Inventory (DRRI) (1), as well as measures on psychological and physical health. Internal consistency and test-retest reliability coefficients for the DRRI scales were very good. As expected, DRRI risk factors were negatively associated with psychological and physical functioning, and DRRI resilience factors were positively associated with psychological and physical functioning. Low- as well as high-magnitude deployment risk factors were associated with functioning. The French-Canadian version of the DRRI is a reliable and valid measure of deployment risk and resilience fact...
Sexual assault results in important consequences for victims. An inadequate social support may ha... more Sexual assault results in important consequences for victims. An inadequate social support may have an impact on the victim's psychological condition and interfere with her adjustment. The purpose of the present article is to describe different support reactions linked to sexual assault and their impact on the psychological condition of the victims, the posttraumatic symptoms and the recovery. The specific contribution of the spouse living with the victim is exposed. The impact of the consequences resulting from the sexual assault on the quality of the support is also presented. Finally, clinical implications and research approach are proposed.
A new measure of the social support specifically intended for anxiety disorders has been elaborat... more A new measure of the social support specifically intended for anxiety disorders has been elaborated ; this new scale entitled "Questionnaire sur les Comportements de Soutien en situation d'Anxiété" (QCSA ; Guay et al., 2003) consists of 65 items measuring positive and negative perceived social support. Among a sample of 257 university students, the QCSA shows good psychometric properties (internal consistency and correlations with related constructs). Results of an exploratory factor analysis identified three factors : 1) criticism and coercive strategies, 2) anxiety management and reinforcement, and 3) distraction. Significant correlations were found with measures of anxiety, functioning and psychological distress. The QCSA is an adequate scale to evaluate social support in relation to mental health.
This article's first objective is to better situate the concept of social support within the ... more This article's first objective is to better situate the concept of social support within the vast field of social relations. The authors then describe theoretical models allowing to explain the importance of social support in mental health as well as the implications within the context of the intervention, the various measures of social support, their respective values and the major instruments which have been developed in order to apprehend them. Recent studies then allow to illustrate the narrow links between mental health and social support identified in population and clinical studies. In conclusion, the authors present interventions that favor the development of social support and propose recommendations for clinicians.
This exploratory study intends to characterize the neuropsychological profile in persons with pos... more This exploratory study intends to characterize the neuropsychological profile in persons with post-traumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) using objective measures of cognitive performance. A neuropsychological battery of tests for attention, memory and executive functions was administered to four groups: PTSD (n = 25), mTBI (n = 19), subjects with two formal diagnoses: Post-traumatic Stress Disorder and Mild Traumatic Brain Injury (mTBI/PTSD) (n = 6) and controls (n = 25). Confounding variables, such as medical, developmental or neurological antecedents, were controlled and measures of co-morbid conditions, such as depression and anxiety, were considered. The PTSD and mTBI/PTSD groups reported more anxiety and depressive symptoms. They also presented more cognitive deficits than the mTBI group. Since the two PTSD groups differ in severity of PTSD symptoms but not in severity of depression and anxiety symptoms, the PTSD condition could not be considered as the unique factor affecting the results. The findings underline the importance of controlling for confounding medical and
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recognized as a significant personal and societal problem (Alonso et al., 2004; Kessler,
2000).With this recognition has come a burgeoning amount of research examining the neurobiological
and cognitive characteristics of the disorder. Much of the early research on PTSD
focused on military veterans, in particular those who served in World War II and the Vietnam
War (Card, 1987; Foy & Card, 1987). More recently, considerable emphasis has been placed
on understanding the etiology and consequences of PTSD in military personnel returning
from operations in the Middle East termed ‘‘Operation Enduring Freedom’’ and ‘‘Operation
Iraqi Freedom’’(OEF/OIF; Vasterling, Verfaellie,& Sullivan, 2009). Research has also involved
individuals with PTSD secondary to a variety of other common causes including rape, criminal
victimization, motor vehicle accidents, and physical abuse in childhood or adulthood
(Darves-Bornoz et al., 2008; Kessler, 2000).
In this chapter, we first provide an overview of the diagnostic criteria for PTSD and
common assessment measures, as well as the epidemiology and course of the disorder. We then review the neuropsychological correlates of PTSD, including variables that may contribute to the heterogeneity of findings. We briefly address current treatment approaches to PTSD and what is known about their impact on neuropsychological functioning, as well as the potential role of neuropsychological assessment in treatment planning. Finally, we conclude with a discussion of brain imaging research that has informed our understanding of neural substrates and its associated cognitive limitations
Papers by Stéphane Guay
recognized as a significant personal and societal problem (Alonso et al., 2004; Kessler,
2000).With this recognition has come a burgeoning amount of research examining the neurobiological
and cognitive characteristics of the disorder. Much of the early research on PTSD
focused on military veterans, in particular those who served in World War II and the Vietnam
War (Card, 1987; Foy & Card, 1987). More recently, considerable emphasis has been placed
on understanding the etiology and consequences of PTSD in military personnel returning
from operations in the Middle East termed ‘‘Operation Enduring Freedom’’ and ‘‘Operation
Iraqi Freedom’’(OEF/OIF; Vasterling, Verfaellie,& Sullivan, 2009). Research has also involved
individuals with PTSD secondary to a variety of other common causes including rape, criminal
victimization, motor vehicle accidents, and physical abuse in childhood or adulthood
(Darves-Bornoz et al., 2008; Kessler, 2000).
In this chapter, we first provide an overview of the diagnostic criteria for PTSD and
common assessment measures, as well as the epidemiology and course of the disorder. We then review the neuropsychological correlates of PTSD, including variables that may contribute to the heterogeneity of findings. We briefly address current treatment approaches to PTSD and what is known about their impact on neuropsychological functioning, as well as the potential role of neuropsychological assessment in treatment planning. Finally, we conclude with a discussion of brain imaging research that has informed our understanding of neural substrates and its associated cognitive limitations