The purpose of this study was to examine people's experiences of self-medication with cannabis in relation to post-traumatic stress disorder and professions’ opinions of cannabis for medical use. The study focuses on norms and values as well as its impact on individuals. A qualitative approach was used with thematically open interview questions, in order to gain an insight into the interviewees’ reality and their experiences. Selected theories emphasize on norms, social control and gateway. The study has chosen to point out Sweden's drug policy attitudes to cannabis, research on cannabis as a complement to post-traumatic stress disorder, resources and therapies in the section earlier research. The results showed patterns of how the social control and norms affect the individual who chooses to deviate from the prevailing norm. The informants who have chosen to self-medicate cannabis in relation to post-traumatic stress disorder describes itself countered in their experiences with emotions such as contempt, exclusion and being misunderstood. It also emerged that there is transparency in the professions to the possibilities of cannabis as medicine, at present, it is a lack of evidence and research. It was also found that the informants who self-medicated strives cannabis as medicine in the market, controlled dosage.

Mobile technology is increasingly leveraged for mental health interventions, with users expressing overall satisfaction and finding the apps helpful and user-friendly. While the apps offer diverse features for symptom management, self-help, and treatment support, evidence regarding their effectiveness remains limited, suggesting a need for further research. Usability, engagement, and tailoring to user preferences emerge as critical factors, emphasizing the importance of customization for different populations. This research presented a systematic literature review aimed at evaluating studies specifically focusing on post-traumatic stress disorder (PTSD) apps, with a subsequent quality assessment using the MARS scale. Additionally, the research involves an in-depth analysis of user reviews for these PTSD apps through thematic, and path analysis. The technology acceptance model (TAM) model serves as the framework for path analysis, and the performance of VADER, Flair, and TextBlob is evaluated. Sentiment analysis is then employed to explore relationships among TAM model factors and additional factors derived from the systematic literature review and thematic analysis. In conclusion, this dissertation contributes to the understanding of PTSD apps, their usability, and their potential for mental health support. It underscores the need for further research, customization, and ongoing collaboration to optimize the effectiveness of these applications in managing PTSD symptoms and supporting individuals in their mental health journey.

Le blocage de la reconsolidation mnésique sous propranolol est utilisé pour traiter le trouble de stress post-traumatique (TSPT) et le trouble de l’adaptation (TA), montrant une réduction significative des symptômes auto-rapportés chez environ 70% des patients. La présente étude d’archive a examiné l’impact de la dose de propranolol sur l’efficacité de cette thérapie. Les données de quatre essais cliniques ont été regroupées. Un modèle mixte a été utilisé pour comparer les symptômes de stress entre deux groupes (dose de 1,67 mg/kg vs 1 mg/kg) sur la durée normale d’un traitement, soit 6 semaines. Les résultats ont indiqué que, comparativement au groupe (n = 61) ayant reçu la dose la plus élevée, celui (n = 76) ayant reçu une dose moins élevée a présenté une amélioration plus importante des symptômes à travers le temps, révélant ainsi un effet d'interaction, F(6, 740) = 8.54, p < .001. L’analyse secondaire examinant la corrélation dose-effet (dose absolue, p. ex., 40 mg, 50 mg, 60 mg, etc.) à travers les séances de traitement au sein de chacun des deux groupes n’a pas mis en lumière un effet de dose, ce qui était attendu. Des études prospectives seront nécessaires pour clarifier la relation dose-effet dans le cadre de cette thérapie. / Blocking memory reconsolidation with propranolol is used to treat post-traumatic stress disorder (PTSD) and adjustment disorder (AD), showing a significant reduction in self-reported symptoms in about 70% of patients. This archival study examined the impact of propranolol dosage on the efficacy of this therapy. Data from four clinical trials were pooled. Linear Mixed Model was used to compare stress symptoms between two groups (1.67 mg/kg vs. 1 mg/kg) over the typical 6-week treatment period. The results indicated that, compared to the group (n = 61) receiving the higher dosage, the group (n = 76) receiving the lower dosage showed a greater improvement in symptoms over time, revealing an interaction effect, F(6, 740) = 8.54, p < .001. A secondary analysis examining the dose-response correlation (absolute dose, e.g., 40 mg, 50 mg, 60 mg, etc.) over treatment sessions within each of the two groups did not reveal a dose effect, as expected. Prospective studies are needed to clarify the dose-response relationship in this therapy.

Borderline-Persönlichkeitsstörung (BPS) ist eine schwere psychiatrische Störung, die durch tiefgreifende Probleme in Emotionsregulation und zwischenmenschlichen Beziehungen gekennzeichnet ist. Die gestörten Beziehungsmuster werden als ein Kernmerkmal von BPS betrachtet, obwohl die empirische Evidenz dafür weitestgehend fehlt. Bisherige Ergebnisse sind auf behavioraler und neuronaler Ebene bei BPS durch das häufig komorbide Auftreten einer posttraumatischen Belastungsstörung (PTBS) verzerrt. Eine vielversprechende Möglichkeit, die Beziehungsstörung von Patienten mit BPS näher zu untersuchen, bietet das multidimensionale Konzept der Empathie. Daher konzentriert sich die vorliegende Arbeit auf die Identifizierung behavioraler und neuronaler Korrelate kognitiver und emotionaler Empathie bei BPS Patienten und den Einfluss einer komorbiden PTBS auf diese. Die Ergebnisse zeigen, dass Patienten mit BPS Einschränkungen in beiden Facetten von Empathie zeigen, aber komorbide PTBS, intrusive Symptomatik und sexuelle Traumatisierung in der Vergangenheit mit schlechterer kognitiver Empathie einhergehen. Außerdem ist unter kognitiver Empathie die neuronale Aktivität im linken superior temporal Sulcus/Gyrus (STS/STG) bei BPS Patienten reduziert und mit der Ausprägung ihrer intrusiven Symptomatik assoziiert. Während emotionaler Empathie zeigen Patienten mit BPS im rechten insulären Kortex mehr Aktivität, die mit dem Hautleitwiderstand der BPS Patienten assoziiert ist. Die hier dargestellten Ergebnisse unterstützen ein Bild von BPS als eine Störung der emotionalen und kognitiven Empathie. Eine komorbid diagnostizierte PTBS scheint sich dabei zusätzlich verschlechternd auf die Fähigkeit zur kognitiven Empathie auszuwirken. Die veränderte Funktion von STS/STG und Insula könnte einen pathophysiologischen Vermittlungsmechanismus auf neuronaler Ebene für BPS darstellen, dabei scheinen die intrusiver Symptomatik und dem Grad der Erregung der Patienten eine wesentliche Rolle zu spielen. / Borderline personality disorder (BPD) is a severe psychiatric malfunction, which involves deficits in emotion regulation and interpersonal relationships. Especially the interpersonal problems are seen as a core feature in BPD, even if there is only weak empirical evidence. Furthermore, the current results on behavioral and functional alterations of patients with BPD are biased by the high rate of comorbidity with posttraumatic stress disorder (PTSD). The multidimensional concept of empathy seems to be an eligible framework for the interpersonal problems of patients with BPD. Hence, the present work focuses on the identification of behavioral and neural correlates of cognitive (i.e., social cognition) and emotional (i.e., empathic concern) empathy in patients with BPD. Moreover the influence of comorbidities (e.g., PTSD) on the behavioral and neural alterations of patients with BPD was explored. Patients with BPD showed impairments in both facets of empathy, but comorbid PTSD, intrusive symptoms, and history of sexual trauma were only associated with outcomes in cognitive empathy. In this condition the brain responses were significantly reduced in BPD patients compared to controls in the left superior temporal sulcus and gyrus (STS/STG), where this reduction was associated with levels of intrusive symptomatology in the BPD group. During emotional empathy, patients with BPD exhibited greater brain activation than controls in the right middle insular cortex, a response that was associated with skin conductance responses in the patients. Thus, these findings support a conceptualization of BPD as involving deficits in emotional as well as in cognitive empathy. A comorbid PTSD seems to impair the cognitive empathic outcome additionally. Findings at the neural level indicate that altered functioning of the STS/STG and insula represents pathophysiological mediators for BPD, with an important role for intrusive symptomatology and levels of arousal.

South Asians are the third fastest growing racial/ethnic minority group in the United States with distinct cultural characteristics. The coronavirus disease 2019 (COVID-19) pandemic has disproportionately impacted racial and ethnic minorities in the U.S, including South Asians, across several life domains: work, home life/education, social activities, economic, emotional and physical health, infection, quarantine, and positive changes. The COVID-19 pandemic may have critically impacted South Asians with traumatic event experiences and posttraumatic stress disorder (PTSD) symptom severity across several life domains. Limited work suggests high rates of interpersonal traumas and substantial PTSD symptom severity in the South Asian community. Uniquely, the current study examined which life domains impacted by the COVID-19 pandemic associated with a greater count of traumatic event types, interpersonal vs. non-interpersonal traumas, and PTSD symptom severity. Results revealed that negative experiences in social activities, as well as distress in economic, emotional, and physical health domains, were significantly associated with the count of traumatic event types. Negative social activity experiences, and distress in the economic and emotional health domains, were also significantly associated with PTSD symptom severity. Quarantine and physical health domains significantly associated with the count of interpersonal traumas, while COVID-19-related experiences (in social, quarantine, and infection domains) significantly associated with the count of non-interpersonal traumas. Findings inform clinically relevant pandemic research in a vulnerable population and provide trauma and PTSD prevalence estimates in the South Asian community.

The purpose of the present study was to explore a theoretically based social-cognitive model of posttraumatic stress disorder (PTSD) by investigating attachment-related and social-cognitive predictors of PTSD in a sample of 125 post-9/11 U.S. combat veterans. Subjects completed an online survey assessing PTSD symptomology, attachment-related internal working models, perceived social support, and mentalizing capacity. Path analysis provided empirical support for a respecified version of the model. More negative internal working model of self and poorer mentalizing capacity predicted higher PTSD symptom levels. Contrary to previous findings, greater perceived social support predicted higher, not lower, PTSD symptom levels. Mentalizing capacity mediated the relationship between internal working model of self and PTSD symptoms in a complementary manner, whereas perceived social support as a mediator was dampening. The relationship between internal working model of others and PTSD symptom levels was fully mediated by perceived social support, which buffered the effect of negative working model of others on PTSD symptom levels. These findings underscore the importance of social-cognitive processing, rooted in early attachment experiences, in the development and symptomology of PTSD in trauma-exposed veterans. In preparing clients for trauma work, clinicians may consider employing modalities that promote earned secure attachment and highlight mentalization in the therapeutic change process.

Total institutions' (which include prisons) unique context prescribes "confinement" of inmates. Coping mechanisms applied "outside" (especially the ability to create distance from stressful events) is thus ineffective. Another common feature is lack of privacy, which may result in "forced intimacy" - individuals being forced into a situation of physical and psychological "invasion" (beyond the norm) of their person/personal space. Victims lose control over intimate decisions, including who may and may not be intimate with them. Within prisons, gangs "force intimacy" by sexually victimizing inmates, taking advantage of the context to heighten their power, and to control inmates "under" them. Four (subjects) victims' experiences and means of adaptation/ empowerment were investigated phenomenologically. Results indicated that inadequately empowered victims suffer prolonged and repeated victimization - a continued "posttraumatic stress disorder" - which is more traumatizing and draining than one circumscribed traumatic event (due to its intensity, immobilization and resulting drastic change of "personality"). / Psychology / M.A. (Clinical Psychology)

Objectifs : Étudier l’incidence de la dépendance à l’alcool ou aux drogues chez les étudiants exposés à la fusillade du Collège Dawson dans les 18 mois suivant celle-ci. Identifier les précurseurs au développement d’une dépendance à une substance psychoactive en tenant compte de la sévérité d’exposition à l’événement. Examiner si la consommation d’alcool 18 mois après les événements est en lien avec les différents groupes de symptômes d’état de stress post-traumatique. Méthode : La population à l’étude est composée de l’ensemble des étudiants du Collège Dawson au moment de l’événement. Les analyses ont été faites auprès de 854 étudiants inscrits au Collège au moment de la fusillade. Résultats : Cinq pourcent des femmes et 7 % des hommes présentent pour la première fois de leur vie un problème de dépendance à une substance suite à la fusillade. Pour les hommes, leur jeune âge, la présence de pensées suicidaires au cours de leur vie, ainsi que le fait d’avoir vu le tireur au moment de la fusillade sont les principaux précurseurs de cas incidents de dépendance. Aucun des précurseurs étudiés n’est significatif pour les femmes. Les hommes et les femmes se distinguent également quant aux symptômes d’état de stress post-traumatique qui prédisent la consommation d’alcool 18 mois après la fusillade. Conclusion : La principale retombée de l’étude est de souligner l’importance de considérer le sexe des individus pour étudier leur consommation de substances psychoactives suite à un traumatisme. / Objectives: To determine the incidence of a drug or alcohol addiction among the students who witnessed the Dawson shooting, in the 18 months that followed the event. Identify predictors of development of an addiction to a psychoactive substance, taking into account the severity of the exposure to the event. Consider whether alcohol consumption, 18 months after the event, is connected to the different categories of symptoms of post-traumatic stress. Method: The population under study includes the students at Dawson College at the time of the event. Analyses were conducted with data from 854 students enrolled at the College when the shooting took place. Results: In the 18 months following the shooting, 5 % of women and 7 % of men developed an addiction to a substance for the first time in their lives. For men, younger age (< 20 years old), the prevalence of suicidal thoughts throughout their lives, as well as having seen the perpetrator at the time of the shooting, were key predictors. No predictors were significant for women. Men and women also differed with regards to post-traumatic stress symptoms that predict alcohol consumption, 18 months after the shooting. Conclusion: The main outcome of this study stresses the importance of considering the gender of individuals, when evaluating their consumption of psychotropic drugs or alcohol after a trauma.

Il est possible qu’une personne qui consulte pour un problème d’utilisation de substances souffre également d’un problème associé à un état de stress post-traumatique ( ESPT ). Plusieurs auteurs croient qu’il existe un lien expliquant cette co-morbidité. Voilà pourquoi plusieurs hypothèses ont été formulées pour expliquer le lien entre un trouble tel que celui lié à l’utilisation de substance (TUS) pouvant exister avant l’ESPT, la vulnérabilité suite au TUS, ainsi que l’automédication. Plusieurs recherches proposent deux types d’interventions afin d’aider les personnes aux prises avec cette double problématique. La première consiste à traiter les deux problèmes séparément alors que la seconde, préconise une approche intégrée et simultanée. Puisque les écrits conseillent davantage un traitement intégré, il y aura une présentation d’une de ces formes de traitement nommé « À la recherche de la sécurité ». Le volet académique visait à comprendre le lien existant entre le TUS, les traumas psychologiques et l’ESPT ainsi que les différentes formes d’interventions pour aider les personnes ayant cette co-morbidité. Nous avons utilisé un module du programme « À la recherche de la sécurité » récemment traduit en français afin de vérifier sa mise en application et l’appréciation qu’en ont fait cinq usagers du Centre Dollar-Cormier-Institut universitaire sur les dépendances (CDC-IUD) ayant vécu un traumatisme au cours de leur vie. En conclusion, il sera démontré dans nos résultats que les hypothèses quant au lien de comorbidité sont effectivement présentes dans la réalité des personnes ayant un ESPT et un TUS, et qu’une intervention intégrée offre des points positifs autant pour l’usager que pour l’intervenant. / It is possible that the substance abuse disorder for which a person consults is associated with Posttraumatic Stress Disorder (PTSD). Several authors believe that there is a link explaining this co-morbidity. For this reason, several hypotheses have been formulated to explain this link as the substance abuse disorder (SUD) prior to PTSD, vulnerability following the SUD and selfmedication. Moreover, research shows the various interventions to help people struggling with these twin problems. The first is to separate the two issues while the second includes PTSD and the SUD. Research advice a more integrated treatment, there will be a presentation of one of these forms of treatment called "Seeking Safety". The academic component of our apprenticeship was to understand the link between the SUD, psychological trauma and PTSD and the various forms of interventions to help people with this co-morbidity. We used a module of "Seeking Safety" recently translated in French to ensure its implementation and its assessment from five users of the Centre Dollar-Cormier-Institut universitaire sur les dépendances who experienced trauma in their lives. In conclusion of the study, it is clearly shown that different assumptions are present in the reality of people with PTSD and SUD and an integrated response has positives for both the user and for the speaker.

Les mauvais traitements représentent un facteur de risque pouvant entraver le développement normal des enfants qui en sont victimes. L’objectif général de cette thèse est de mieux comprendre le concept d’état de stress post-traumatique-complexe (ÉSPT-C) et ce, en permettant l’évaluation rigoureuse de ses symptômes et en documentant sa relation avec d’autres variables. La présente thèse est composée de deux articles empiriques. L’objectif du premier article est d’obtenir une mesure de l’ÉSPT-C pour une population francophone. Pour ce faire, les qualités psychométriques de la traduction francophone du Structured Interview of Disorders of Extreme Stress-Self-Report (SIDES-SR) ont été testées par le biais d’analyses préliminaires auprès de 438 adultes canadiens-français provenant de la population générale et de l’Université de Montréal. Les résultats démontrent que l’instrument possède une structure factorielle de 5 facteurs comparable à celle obtenue pour l’instrument en anglais dans sa version originale. Les facteurs obtenus sont : 1) les croyances pessimistes par rapport aux autres et au futur, 2) la gestion des affects, 3) l’évitement des contacts physiques et sexuels, 4) la somatisation et 5) la prise de risques. La cohérence interne de 4 facteurs sur 5 varie d’acceptable à très satisfaisante alors que leur stabilité temporelle et leur validité convergente, divergente et concurrente ressortent comme étant assez satisfaisantes. Le but du deuxième article de cette thèse est d’examiner l’apport des symptômes d’ÉSPT-C retrouvés chez les mères et de leurs pratiques parentales (supervision et utilisation abusive de la punition) pour expliquer les symptômes d’ordre psychologique chez leurs enfants victimes d’agression sexuelle (AS). Les symptômes d’ÉSPT-C des mères et leurs pratiques éducatives ont été évalués auprès de 96 mères à l’aide de mesures auto-rapportées alors que les symptômes de leur enfant ont été mesurés à partir d’un instrument qui leur était destiné. Les résultats suggèrent qu’en contrôlant les variables sociodémographiques et les caractéristiques de l’AS de l’enfant, les symptômes d’ÉSPT-C des mères sont liés à plusieurs symptômes retrouvés chez les enfants après le dévoilement de l’AS qu’ils ont subie. Le rôle modérateur de la supervision maternelle dans la relation entre l’ÉSPT-C des mères et les symptômes de dépression et d’opposition des enfants a également été démontré. Les implications théoriques et cliniques concernant les résultats obtenus dans le cadre de ce projet doctoral sont finalement abordées. / Maltreatment is a risk factor that may hinder the normal development of children. The principal objective of this thesis is to better understand complex posttraumatic stress disorder, by evaluating it and documenting its relationship with other variables. This thesis includes two empirical articles. The objective of the first article is to develop a measure of complex posttraumatic stress disorder for French-speaking adults. The psychometric properties of the translated version of the Structured Interview for Disorders of Extreme Stress-Self-Report (SIDES-SR) were tested through preliminary analyses with 438 French-speaking adults from the general population and the University of Montreal. Results demonstrate that the instrument has a factor structure of five factors similar to the English version of the instrument. The factors obtained are: 1) pessimistic beliefs about others and future, 2) managing emotions, 3) avoidance of physical and sexual contact, 4) somatization, and 5) risk-taking behaviours. The internal consistency of 4 of the 5 factors varies from acceptable to very satisfactory, while their temporal stability and convergent, divergent and concurrent validity are acceptable. The purpose of the second article is to examine the contribution of complex posttraumatic stress disorder found in mothers and parenting practices (monitoring and abusive punishment) on psychological symptoms reported by children victims of sexual abuse. Symptoms of 96 mothers and their rearing practices were assessed using self-report measures, while children’s symptoms were measured with an instrument designed for children. Results demonstrate that, after controlling for sociodemographic variables and characteristics of the child sexual abuse, complex posttraumatic stress disorder is associated with several symptoms in children. The moderating role of maternal monitoring in the relationship between complex posttraumatic stress disorder of mothers and symptoms of depression and opposition of children is also demonstrated. Theoretical and clinical implications are discussed concerning the results obtained in this doctoral project.