Introdução O Transtorno de Déficit de Atenção/Hiperatividade (TDAH) está associado a um significativo impacto negativo em diferentes esferas da vida dos pacientes e de seus familiares. O tratamento medicamentoso com metilfenidato (MFD), embora reduza os prejuízos associados ao transtorno, não é universalmente eficaz. Existem poucos estudos sobre fatores preditores de resposta ao MFD e a maior parte das informações origina-se de uma única amostra. Objetivos O presente estudo tem por objetivo avaliar fatores preditores de resposta ao tratamento com MFD em crianças e adolescentes com TDAH. Especificamente, foram estudados fatores clínicos, demográficos, funcionamento familiar, psicopatologia parental e fatores ambientais adversos. Métodos Este é um estudo longitudinal com um design de quase-experimento. Crianças e adolescentes com TDAH e indicação primária de MFD foram tratadas e acompanhadas por 6 meses por psiquiatras da infância e adolescência. Foi utilizado MFD em doses otimizadas até o máximo de efeito ou o surgimento de efeitos colaterais limitantes. A eficácia foi avaliada pelas escalas SNAP-IV e CGI-G, preenchidas pelos pais e pelo médico, respectivamente. Os fatores preditores avaliados pertencem a três dimensões: clínica e demográfica, características familiares (psicopatologia parental e funcionamento familiar) e fatores de adversidade psicossocial. O funcionamento familiar foi avaliado através da escala FES; a avaliação de psicopatologia parental foi realizada através da entrevista diagnóstica SCID-IV, da escala ASRS e de avaliação de sintomas de psicopatia. Os fatores de adversidade psicossocial foram derivados dos Indicadores de Adversidade de Rutter. A análise estatística foi realizada através dos testes do 2 ou teste exato de Fisher (para variáveis categóricas) e teste t de Student (para variáveis contínuas). Foram desenvolvidos modelos multivariados para avaliação dos fatores preditores de resposta através de modelos de efeitos mistos. Resultados Foram incluídos 125 pacientes nas análises. Nas análises univariadas, menor idade (p=0,01), subtipo combinado de TDAH (TDAH-C) (p<0,001), comorbidade com Transtorno de Conduta (TC) (p=0,03) e Transtorno de Oposição e Desafio (TOD) (p<0,001) foram associados a pior desfecho. No funcionamento familiar, as dimensões de organização (p=<0,001) e coesão (p=0,01) foram preditores de melhor resposta. A dimensão de conflito (p=<0,001) esteve associada à pior resposta. Em relação à psicopatologia materna, a presença de sintomas antisociais (p=0,002), o número de diagnósticos psiquiátricos de Eixo I (p=0,03) e a gravidade de sintomas de TDAH (p=<0,001) também foram preditores de pior resposta. A psicopatologia paterna não esteve associada à resposta ao tratamento. Em termos de adversidade psicossocial, apenas gestação indesejada (p=0,002) esteve associada à pior desfecho. Nas análises multivariadas, TDAH-C, comorbidade com TOD e maior gravidade de sintomas basais (CGAS) foram preditores de pior resposta. Da mesma forma, conflito familiar e sintomas maternos de TDAH predisseram um pior resultado. O efeito de gestação indesejada manteve-se estatisticamente significativo no modelo multivariado. Em um modelo que abrangeu todas as dimensões estudadas, os seguintes fatores foram preditores de pior resposta ao tratamento: TDAH-C, comorbidade com TOD, sintomas maternos de TDAH e gestação indesejada. CONCLUSÃO Este é o primeiro estudo realizado em população de país em desenvolvimento a avaliar o impacto de diferentes fatores adversos psicossociais na resposta a metilfenidato em crianças e adolescentes com TDAH. Demonstramos que o subtipo combinado de TDAH, a comorbidade com TOD, sintomas maternos de TDAH e gestação indesejada foram preditores de pior resposta ao MFD. Tais achados ressaltam a importância de ter-se uma visão ampla no atendimento destas crianças, levando em consideração o ambiente no qual elas estão inseridas e possíveis fatores preditores de piores desfechos. Além disso, os nossos resultados enfatizam a importância de se avaliar os pais no atendimento de crianças e adolescentes, especialmente investigando sintomas maternos de TDAH. Pesquisas futuras devem expandir o conhecimento acerca de interações entre fatores genéticos e ambientais, possibilitando que sejam desenvolvidas abordagens mais eficazes e que contribuam para a redução do impacto negativo deste transtorno. / Introduction Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with a negative impact in different aspects of patients and their relatives’ lives. Although pharmacological treatment with methylphenidate (MPH) may reduce the impairment associated with the disorder, it is not universally effective. There are few studies of the predictive factors of MPH treatment response and most of available data come from a single sample. Objectives The aim of our study was to evaluate the impact of demographic, clinical, familial (parental psychopathology and family functioning), and psychosocial adversity factors on the response to methylphenidate in a naturalistic sample of children and adolescents with ADHD. Methods This is a longitudinal study with a quasi-experiment design. Children and adolescents with ADHD and a primary indication for MPH treatment were treated and followed for 6 months by child and adolescent psychiatrists. Medication doses were augmented until no further clinical improvement was detected or there were limiting side effects. Treatment response was evaluated according to SNAP-IV and CGI-S scales, completed by parents and researchers, respectively. Predictive factors were divided into three dimensions: clinical and demographic, family characteristics (parental psychopathology and family functioning) and psychosocial adversity. Family functioning was evaluated by the FES scale; parental evaluation consisted of a diagnostic interview (SCID-IV), self-reported ASRS scale and psychopathic symptoms investigation. Psychosocial adversity factors were derived from Rutter’s indicators of adversity. Statistical analysis were performed using 2 test or Fisher’s Exact Test (categorical variables), and Student t test (continuous variables with normal distribution). Multivariable models were constructed with a Mixed-Effects Model (MEM) approach for analysis of predictive factors of treatment response. Results One hundred and twenty-five patients were included. In the univariate analysis, younger age (p=.01), the presence of ADHD combined subtype (p<.001), CD (p=.03) and ODD (p<.001) were associated with a worse response to treatment. Higher scores on the organization (p=<.001) and cohesion (p=.01) dimensions of FES were associated with better response to treatment, while more conflicted families had a worse response (p=<.001). In terms of maternal psychopathology, antisocial symptoms (p=.002) and number of Axis I diagnosis (p=.03) were associated with a worse response to methylphenidate. Also, maternal ADHD symptoms predicted a worse response to treatment (p=<.001). Paternal psychopathology did not predict treatment response. In terms of psychosocial adversity, only undesirable pregnancy (p=.002) predicted a worse response to treatment. In the multivariate analysis, ADHD combined subtype, ODD comorbidity and lower baseline CGAS scores were significant predictors of a reduced response to treatment. Family conflict and maternal ADHD symptoms were also significant predictors of poor response. Undesirable pregnancy also remained significant in the multivariate analysis. A final multivariate mixed-effect model was created including significant predictors of response in each individual multivariate model. Results indicated that ADHD combined subtype, ODD diagnosis, maternal ADHD symptoms, and undesirable pregnancy were significant predictors of a reduced response to methylphenidate during 6 months of treatment. Conclusion This is the first study in a developing country to evaluate the impact of different adversity factors on ADHD treatment response in children and adolescents. We were able to demonstrate that ADHD combined subtype, ODD comorbidity, ADHD maternal symptoms and undesirable pregnancy were predictors of a worse response to MPH. These findings highlight the need to have a global perspective on children’s environment and be aware of the presence of negative predictors of treatment response. In addiction, our results stress the role of parental evaluation, especially maternal ADHD symptoms. Future research should expand our knowledge on how genetic factors interact with environmental factors, which might pave the road to the development of alternative clinical strategies that might reduce the burden associated with ADHD.

Introdução O Transtorno de Déficit de Atenção/Hiperatividade (TDAH) está associado a um significativo impacto negativo em diferentes esferas da vida dos pacientes e de seus familiares. O tratamento medicamentoso com metilfenidato (MFD), embora reduza os prejuízos associados ao transtorno, não é universalmente eficaz. Existem poucos estudos sobre fatores preditores de resposta ao MFD e a maior parte das informações origina-se de uma única amostra. Objetivos O presente estudo tem por objetivo avaliar fatores preditores de resposta ao tratamento com MFD em crianças e adolescentes com TDAH. Especificamente, foram estudados fatores clínicos, demográficos, funcionamento familiar, psicopatologia parental e fatores ambientais adversos. Métodos Este é um estudo longitudinal com um design de quase-experimento. Crianças e adolescentes com TDAH e indicação primária de MFD foram tratadas e acompanhadas por 6 meses por psiquiatras da infância e adolescência. Foi utilizado MFD em doses otimizadas até o máximo de efeito ou o surgimento de efeitos colaterais limitantes. A eficácia foi avaliada pelas escalas SNAP-IV e CGI-G, preenchidas pelos pais e pelo médico, respectivamente. Os fatores preditores avaliados pertencem a três dimensões: clínica e demográfica, características familiares (psicopatologia parental e funcionamento familiar) e fatores de adversidade psicossocial. O funcionamento familiar foi avaliado através da escala FES; a avaliação de psicopatologia parental foi realizada através da entrevista diagnóstica SCID-IV, da escala ASRS e de avaliação de sintomas de psicopatia. Os fatores de adversidade psicossocial foram derivados dos Indicadores de Adversidade de Rutter. A análise estatística foi realizada através dos testes do 2 ou teste exato de Fisher (para variáveis categóricas) e teste t de Student (para variáveis contínuas). Foram desenvolvidos modelos multivariados para avaliação dos fatores preditores de resposta através de modelos de efeitos mistos. Resultados Foram incluídos 125 pacientes nas análises. Nas análises univariadas, menor idade (p=0,01), subtipo combinado de TDAH (TDAH-C) (p<0,001), comorbidade com Transtorno de Conduta (TC) (p=0,03) e Transtorno de Oposição e Desafio (TOD) (p<0,001) foram associados a pior desfecho. No funcionamento familiar, as dimensões de organização (p=<0,001) e coesão (p=0,01) foram preditores de melhor resposta. A dimensão de conflito (p=<0,001) esteve associada à pior resposta. Em relação à psicopatologia materna, a presença de sintomas antisociais (p=0,002), o número de diagnósticos psiquiátricos de Eixo I (p=0,03) e a gravidade de sintomas de TDAH (p=<0,001) também foram preditores de pior resposta. A psicopatologia paterna não esteve associada à resposta ao tratamento. Em termos de adversidade psicossocial, apenas gestação indesejada (p=0,002) esteve associada à pior desfecho. Nas análises multivariadas, TDAH-C, comorbidade com TOD e maior gravidade de sintomas basais (CGAS) foram preditores de pior resposta. Da mesma forma, conflito familiar e sintomas maternos de TDAH predisseram um pior resultado. O efeito de gestação indesejada manteve-se estatisticamente significativo no modelo multivariado. Em um modelo que abrangeu todas as dimensões estudadas, os seguintes fatores foram preditores de pior resposta ao tratamento: TDAH-C, comorbidade com TOD, sintomas maternos de TDAH e gestação indesejada. CONCLUSÃO Este é o primeiro estudo realizado em população de país em desenvolvimento a avaliar o impacto de diferentes fatores adversos psicossociais na resposta a metilfenidato em crianças e adolescentes com TDAH. Demonstramos que o subtipo combinado de TDAH, a comorbidade com TOD, sintomas maternos de TDAH e gestação indesejada foram preditores de pior resposta ao MFD. Tais achados ressaltam a importância de ter-se uma visão ampla no atendimento destas crianças, levando em consideração o ambiente no qual elas estão inseridas e possíveis fatores preditores de piores desfechos. Além disso, os nossos resultados enfatizam a importância de se avaliar os pais no atendimento de crianças e adolescentes, especialmente investigando sintomas maternos de TDAH. Pesquisas futuras devem expandir o conhecimento acerca de interações entre fatores genéticos e ambientais, possibilitando que sejam desenvolvidas abordagens mais eficazes e que contribuam para a redução do impacto negativo deste transtorno. / Introduction Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with a negative impact in different aspects of patients and their relatives’ lives. Although pharmacological treatment with methylphenidate (MPH) may reduce the impairment associated with the disorder, it is not universally effective. There are few studies of the predictive factors of MPH treatment response and most of available data come from a single sample. Objectives The aim of our study was to evaluate the impact of demographic, clinical, familial (parental psychopathology and family functioning), and psychosocial adversity factors on the response to methylphenidate in a naturalistic sample of children and adolescents with ADHD. Methods This is a longitudinal study with a quasi-experiment design. Children and adolescents with ADHD and a primary indication for MPH treatment were treated and followed for 6 months by child and adolescent psychiatrists. Medication doses were augmented until no further clinical improvement was detected or there were limiting side effects. Treatment response was evaluated according to SNAP-IV and CGI-S scales, completed by parents and researchers, respectively. Predictive factors were divided into three dimensions: clinical and demographic, family characteristics (parental psychopathology and family functioning) and psychosocial adversity. Family functioning was evaluated by the FES scale; parental evaluation consisted of a diagnostic interview (SCID-IV), self-reported ASRS scale and psychopathic symptoms investigation. Psychosocial adversity factors were derived from Rutter’s indicators of adversity. Statistical analysis were performed using 2 test or Fisher’s Exact Test (categorical variables), and Student t test (continuous variables with normal distribution). Multivariable models were constructed with a Mixed-Effects Model (MEM) approach for analysis of predictive factors of treatment response. Results One hundred and twenty-five patients were included. In the univariate analysis, younger age (p=.01), the presence of ADHD combined subtype (p<.001), CD (p=.03) and ODD (p<.001) were associated with a worse response to treatment. Higher scores on the organization (p=<.001) and cohesion (p=.01) dimensions of FES were associated with better response to treatment, while more conflicted families had a worse response (p=<.001). In terms of maternal psychopathology, antisocial symptoms (p=.002) and number of Axis I diagnosis (p=.03) were associated with a worse response to methylphenidate. Also, maternal ADHD symptoms predicted a worse response to treatment (p=<.001). Paternal psychopathology did not predict treatment response. In terms of psychosocial adversity, only undesirable pregnancy (p=.002) predicted a worse response to treatment. In the multivariate analysis, ADHD combined subtype, ODD comorbidity and lower baseline CGAS scores were significant predictors of a reduced response to treatment. Family conflict and maternal ADHD symptoms were also significant predictors of poor response. Undesirable pregnancy also remained significant in the multivariate analysis. A final multivariate mixed-effect model was created including significant predictors of response in each individual multivariate model. Results indicated that ADHD combined subtype, ODD diagnosis, maternal ADHD symptoms, and undesirable pregnancy were significant predictors of a reduced response to methylphenidate during 6 months of treatment. Conclusion This is the first study in a developing country to evaluate the impact of different adversity factors on ADHD treatment response in children and adolescents. We were able to demonstrate that ADHD combined subtype, ODD comorbidity, ADHD maternal symptoms and undesirable pregnancy were predictors of a worse response to MPH. These findings highlight the need to have a global perspective on children’s environment and be aware of the presence of negative predictors of treatment response. In addiction, our results stress the role of parental evaluation, especially maternal ADHD symptoms. Future research should expand our knowledge on how genetic factors interact with environmental factors, which might pave the road to the development of alternative clinical strategies that might reduce the burden associated with ADHD.

Les maladies psychiatriques présentent de fortes comorbidités avec des désordres gastrointestinaux, ce qui suggère l’existence de bases physiopathologiques communes. Une littérature abondante démontre que l’adversité précoce (infection, stress) augmente la vulnérabilité aux désordres psychiatriques à l’âge adulte. Chez le rongeur, le modèle de séparation maternelle induit chez la descendance adulte des comportements hyperanxieux associés à une hypersensibilité au stress, ainsi que des dysfonctionnements de la sphère gastrointestinale. De plus, des études récentes rapportent une hyperperméabilité de la barrière intestinale chez les ratons soumis au stress de séparation, un effet conduisant potentiellement à une dysbiose et une perturbation de la communication intestin-cerveau. Le but de ma thèse était donc d’étudier le rôle de l’axe intestin-cerveau dans la mise en place des effets à long terme du stress précoce. Nos travaux récents ont montré que certains effets à long-terme de la séparation maternelle peuvent être atténués par l’exposition des mères à un régime hyperlipidique. Dans un premier temps, nous avons testé les effets du régime hyperlipidique maternel sur le cerveau et l’intestin de ratons soumis à la séparation maternelle. Nos résultats montrent que le régime maternel hyperlipidique protège de l’augmentation de la permeabilité intestinale induite par le stress. Nous avons ensuite testé le rôle causal de la perméabilité intestinale sur les comportements émotionnels à travers une approche pharmacologique et une approche génétique. Nous rapportons 1) que la restauration de la fonction barrière de l’intestin atténue certains effets de la séparation maternelle et 2) qu’une hyperperméabilité intestinale chez des souris transgéniques non soumises à un stress produit des effets similaires à ceux de la séparation maternelle. Enfin, nous avons examiné les effets d’une adversité précoce multifactorielle sur le cerveau et l’intestin (perméabilité et microbiote) chez la descendance adulte mâle et femelle dans un modèle combinant infection prénatale et séparation maternelle. Nos résultats mettent en évidence un effet sexe très marqué sur les phénotypes comportements et intestinaux. D’autres études sont nécessaires pour identifier les mécanismes sous-tendant les effets de la perméabilité et la dysbiose intestinale sur la vulnérabilité émotionnelle associée au stress précoce. / Early-life adversity is a main risk factor for psychiatric disorders at adulthood; however the mechanisms underlying the programming effect of stress during development are still unknown. In rodents, chronic maternal separation has long lasting effects in adult offspring, including hyper-anxiety and hyper-responsiveness to a novel stress, along with gastrointestinal dysfunctions. Moreover, recent studies report gut barrier hyper-permeability in rat pups submitted to maternal separation, an effect that could potentially lead to dysbiosis and altered gut-brain communication. Therefore, the aim of my PhD was to unravel the role of the gut-brain axis in the neurobehavioral effects of early-life stress. We recently reported that some neural, behavioral and endocrine alterations associated with maternal separation in rats could be prevented by maternal exposure to a high-fat diet. We first addressed the effects of maternal high-fat diet on brain and gut during development in the maternal separation model. We show that maternal high-fat diet prevents the stress-induced decrease in spine density and altered dendritic morphology in the medial prefrontal cortex. Moreover, maternal high-fat diet also attenuates the exacerbated intestinal permeability associated with maternal separation. To explore a potential causal impact of gut leakiness on brain functions, we then examined the impact of pharmacological and genetic manipulations of intestinal permeability on brain and behavior. We report 1) that restoration of gut barrier function attenuates some of the behavioral alterations associated with maternal separation and 2) that chronic gut leakiness in naive adult transgenic mice recapitulates the effects of maternal separation. Finally, we examined the effects of multifactorial early-life adversity on behavior, gut function and microbiota composition in males and females using a combination of prenatal inflammation and maternal separation in mice. At adulthood, offspring exposed to early adversity displayed sex-specific behavioral (social behavior deficits in males and increased anxiety in females) and intestinal phenotypes. In conclusion, our work demonstrates an impact of gut dysfunctions, in particular gut leakiness, on the emergence of emotional alterations. Further studies are needed to unravel the role of the gut dysbiosis in the expression of the behavioral phenotypes associated with early-life adversity.

<div>Adversity stemming from socioeconomic risks poses a considerable threat to the wellbeing of parents and youth. Research has shown that children’s exposure to cumulative(consisting of multiple co-occurring risks), chronic(experienced across more than one timepoint), and early(experienced during the birth-to-three-year period) socioeconomic adversity is particularly detrimental to their development. The first aim of this dissertation was therefore to create a measure of socioeconomic adversity that incorporates multiple risk indicators, and that could be used to tap into both the chronicity and timing of exposure. Using this measure, the problem that this dissertation aimed to address is the conflicting evidence that effective parenting is crucial in facilitating positive outcomes in at-risk youth, but that parenting itself is severely compromised in families experiencing socioeconomic adversity. Therefore, the overarching goal of this dissertation was to identify protective factors that can be leveraged to promote positive cascades for parents and youth in the context of socioeconomic adversity. Paper 1 analyzed whether social capital facilitates parental resilience, or the capacity of parents to deliver competent and high-quality parenting to children despite the presence of socioeconomic risks. Paper 2 assessed whether positive parenting in turn facilitates adolescent resilience and well being, or the reduction of maladaptive outcomes and presence of flourishing outcomes despite their exposure to this adversity. Given differences in the experiences of socioeconomic adversity as well as its effects on parents and youth across race-ethnicities, a major goal of this work was to test dissertation aims separately within Black, Hispanic, and White families. Overall, Paper 1 findings suggest that social participation and perceived neighborhood control may attenuate the effects of socioeconomic adversity on positive parenting for Black and White mothers respectively. For Hispanic mothers, social cohesion was found to be a promotive factor for positive parenting in the context of socioeconomic adversity. Paper 2 results indicate that socioeconomic adversity is indirectly associated with higher levels of adolescent substance use in Black youth, and lower levels of adolescent wellbeing in White youth, through lowered self-regulation in middle childhood. However, higher levels of positive parenting in early and middle childhood seemed to weaken these negative effects within non-Hispanic families. These results reinforce the need to enhance social and neighborhood capital for parents facing socioeconomic adversity, in order to facilitate positive parenting behaviors that may in turn protect youth from its negative effects.<br></div>

L’adversité précoce présente une variété de conséquences nuisibles d’ordre cognitif, émotionnel, comportemental ou reliées à la santé. Plusieurs formes d’adversité durant l’enfance peuvent perturber le développement et générer du stress. L’adversité précoce est associée à de moindres volumes hippocampiques, ce qui pourrait être expliqué par l’effet neurotoxique de taux élevés de glucocorticoïdes générés par du stress chronique et l’influence d’expériences précoces et aversives. Les stratégies de navigation représentent la méthode selon laquelle un individu navigue dans l’environnement. En explorant un nouvel environnement, on peut choisir d’utiliser une stratégie spatiale dépendant de l’hippocampe basée sur une carte cognitive ou une stratégie réponse dépendant du noyau caudé basée sur une succession de virages. Nous voulions vérifier s’il existe une association entre les stratégies de navigation et l’adversité familiale précoce. Nous avons donc supposé que les individus utilisant une stratégie spatiale durant le Labyrinthe Virtuel 4/8 (une tâche de navigation à double solution) obtiendraient des scores d’adversité familiale précoce plus faibles que ceux employant une stratégie réponse. Nous supposions aussi que les enfants ayant des scores d’adversité familiale plus élevés présenteraient une performance de mémoire réduite comparativement à ceux aux scores plus faibles. Nous avons observé que les enfants avec un score élevé d’adversité familiale avaient une performance de mémoire réduite dans le Labyrinthe Virtuel 4/8 lorsque comparés au groupe à faible score. Cela soutient que la mémoire serait négativement affectée par l’adversité familiale vécue précocement. Cela suggère aussi l’existence potentielle d’une interaction plus complexe entre l’adversité précoce et les systèmes de mémoire. / Experiencing early adversity presents many varied detrimental consequences, whether they be cognitive, emotional, behavioral or health related. Various forms of adverse manifestations can perturb a child’s development and generate stress. Early adversity shows a lot of associations with lesser hippocampal volumes, which could be explained by the neurotoxic effect of elevated glucocorticoid levels due to chronic stress and the influence of adverse experience at an early age. Navigation strategies represent an individual’s method to navigate in an environment. When exploring a new environment, they may choose to use a hippocampus-dependent spatial strategy, which relies on a cognitive map, or a caudate nucleus-dependent response strategy based on a succession of turns. We wanted to verify if there was an association between navigation strategies and early family adversity. We hypothesised that individuals who use a spatial strategy on the 4/8 Virtual Maze (a dual-solution navigation task) would have a lesser cumulative score of early family adversity. It was also supposed that our group with a high risk of family adversity would manifest a reduced memory performance. We found that our group with a high risk of family adversity had shown reduced memory performance in the 4/8 Virtual Maze when compared to the low-risk group. This supported our initial supposition that memory would be affected by family adversity during early childhood. Our findings support the detrimental effect of early family adversity on memory performance. This also suggests the lingering of a more complex interaction between early adversity and the memory systems.

No description available.

Le décrochage scolaire est un enjeu de taille en raison de ses coûts individuels et sociaux. Des études récentes suggèrent que celui-ci résulte non seulement de l’exposition à des facteurs de risque à long terme, mais aussi de l’exposition proximale à des évènements de vie stressants. Selon le modèle de sensibilisation au stress, le rôle précipitant apparent des stresseurs pourrait être exacerbé chez ceux ayant un historique d’adversité familiale. Cette étude visait à examiner cette hypothèse, en vérifiant d’abord (1) si l’exposition aux évènements stressants et la présence d’adversité familiale perdurant depuis l’enfance étaient directement associées au décrochage scolaire et ensuite (2) si ce type d’adversité exacerbait l’association entre l’exposition à des évènements stressants récents et le décrochage. Ces liens ont été testés auprès d’un échantillon (N = 545) d’adolescents âgés en moyenne de 16 ans (M = 16,5; ÉT = 0,9) surreprésentant les élèves ayant abandonné l’école secondaire avant la diplomation. Au-delà de facteurs confondants potentiels, les résultats suggèrent que les adolescents ayant récemment vécu des évènements de vie stressants sévères sont particulièrement à risque de décrocher, de même que ceux ayant vécu un type d’adversité familiale (ayant mené à un suivi avec la DPJ). Toutefois, les liens directs attendus n’ont pas été observés pour d’autres formes d’adversité familiale (p. ex., problèmes de santé mentale des parents), ni les liens de modération correspondant aux prédictions du modèle de sensibilisation au stress. Ces résultats partiellement concordant avec les hypothèses sont discutés en considérant leurs implications théoriques et pratiques. / High school dropout is a major issue due to its individual and social costs. Recent studies suggest that dropping out results not only from exposure to long-term risk factors, but also from proximal exposure to stressful life events. According to the stress sensitization model, this apparent precipitating role of stressor exposure should be exacerbated among those exposed to family adversity during childhood. The goal of this study was to test this hypothesis, by examining (1) whether exposure to stressful events and the presence of family adversity during childhood were directly associated with high school dropout, and (2) whether this kind of adversity exacerbated the association between exposure to recent stressful events and high school dropout. These associations were tested within a sample (n = 545) of youths aged 16 years old on average (M = 16.5; SD = 0.9) recruited in 12 public high schools located in and around Montreal and overrepresenting early school leavers. After accounting for potential confounders, adolescents who had recently experienced severe stressful life events were found to be more at risk of dropping out, as were those with a history of follow-up with child protection services. However, dropping out was not more frequent among adolescents exposed to other forms of family adversity, namely the presence of family crises and parental chronic mental health problems. Also, the expected sensitization effects were not observed in moderation analyzes. These results partially aligned with hypotheses are discussed in terms of theoretical and practical implications.

No description available.

[pt] O entendimento claro de uma empresa sobre o seu ambiente operacional, assim como suas forças e fraquezas, possibilita um melhor gerenciamento da incerteza imposta por adversidades e ameaças, favorecendo a resiliência organizacional. Para que a resiliência em uma organização seja implementada de forma sistêmica, é preciso que as dimensões Ambiental e Comportamental (tanto em nível organizacional quanto individual), sejam sustentadas por ações gerenciais estratégicas. Visando compreender como as práticas de gestão podem impulsionar a resiliência organizacional, foi elaborado o framework Gestão Estratégica de Resiliência Organizacional [GERO], e validado qualitativamente em cinco empresas brasileiras de setores e portes diferentes, tendo como pano de fundo a pandemia da COVID-19. A partir da análise de conteúdo das entrevistas em profundidade realizadas com os diretores destas organizações, foi possível identificar pontos comuns e pontos não contemplados no framework GERO. Como pontos comuns, as empresas pesquisadas percebem as reservas financeiras como necessárias para gerenciar efetivamente seus negócios; usam crises passadas para desenvolver sua capacidade de aprendizagem e de tomada de decisão, facilitando a agilidade de resposta; e elaboram novos produtos/ serviços rapidamente para dar continuidade aos seus negócios. Por outro lado, o empoderamento das equipes, a gestão horizontal e o fortalecimento dos valores organizacionais não contemplados no GERO foram pontos importantes na crise para estas empresas. Concluímos que este framework pode contribuir para que organizações, de diferentes setores, tamanhos e níveis de complexidade, analisem sistematicamente processos, forças e fraquezas, cenários internos e externos, favorecendo o gerenciamento estratégico da resiliência organizacional. / [en] A clear understanding of a company s operating environment and its strengths and weaknesses enables a better management of the uncertainty related to adversities and threats, promoting organizational resilience. For a systemic implementation of resilience in an organization, the Environmental and Behavioral dimensions (at the individual and organizational levels) must be supported by strategic management actions. In order to understand how management practices can boost organizational resilience, the Strategic Management of Organizational Resilience (SMOR) framework was developed and qualitatively validated in five Brazilian organizations of different sizes and operating in different sectors during the COVID-19 pandemic. The content analysis of in-depth interviews conducted with leaders of these organizations identified aspects in common as well as factors not addressed in the SMOR framework. Regarding the aspects in common, studied companies perceive financial reserves as necessary to effectively manage their businesses, use past crises to develop learning and decision-making capabilities and then facilitate response agility, and develop new products/services quickly for business continuity. On the other hand, team empowerment, horizontal management, and the strengthening of organizational values not addressed in the SMOR framework were important factors in past crises for these companies. We conclude the SMOR framework can help organizations from different sectors and of different sizes and levels of complexity perform systematic analyses of processes, strengths and weaknesses, internal and external scenarios, thus favoring a strategic management of organizational resilience.

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