The purpose of this dissertation is to identify the variables associated with abstinence from binge-eating disorder and Bulimia Nervosa in the twelve-step recovery program of Overeaters Anonymous. The data were gathered through the completion of a survey by 231 active members of Overeaters Anonymous in the Washington metropolitan area. In addition to assessing the demographic composition of the aforementioned population, the variables that were assessed comprise the 'tools' of Overeaters Anonymous. They include: attendance at OA meetings, reading/writing from the Twelve Step literature, adhering to a food plan, having a sponsor, giving service, taking time for prayer and meditation, and making phone calls to other members. The activities of binge eating and bulimic participants were also examined to determine whether or not statistically significant differences exist between these two populations. Results revealed the typical OA participant to be a college educated (80%), Caucasian (89%) female (84%), between the ages of 34 and 44 (30%), married or living with a partner (44%), and employed in a full-time capacity (71%). Eight-four percent of the respondents were binge eaters, 15% were bulimic, and 1% anorexic. Multiple regression analyses revealed longer lengths of involvement in OA, a decrease in the frequency of relapse or 'slips', performing service, greater attendance at meetings, and progress on the ninth step, to be predictors of abstinence at the .05 level of significance. A lower frequency of relapse was predicted by longer lengths of involvement in OA, greater adherence to a food plan, increased frequency of phone calls to other members, and more time spent writing about one's thoughts and feelings at the .05 level of significance. Lastly, Independent Sample t-tests revealed bulimics to have significantly longer mean lengths of abstinence than did binge eaters. Alternately, the difference in the frequency of relapse or 'slips' between the two populations was not significant, suggesting that both bulimics and binge eaters have a comparable likelihood to relapse or slip back into eating disordered behaviors. / Ph. D.

This study uses autobiographical reflection to investigate the negative impact of essentialist masculine gender socialization on men's lives. In particular, I use personal recollective accounts both from my early childhood socialization-in the traditional Greek-Cypriot culture of the 1970s and 80s-and from my own introspections and analytical conceptualizations concerning intimate relationships in general. I analyze these accounts by using a feminist postmodern ideology of gender deconstruction and reconstruction. Men oftentimes fall victims of patriarchal masculine scripting by suppressing their needs for intimacy, connectedness, and self-disclosure, qualities traditionally devalued as feminine traits. Suppressing such needs exacerbates inadequacies in male intimacy with possible manifestations in the form of generalized non-clinical male sexual anxiety. Implications are also discussed in terms of the by-products of male sexual anxiety, such as non-clinical sexual addiction and male victimization. / Ph. D.

This qualitative study explored the challenges and stressors that are experienced by addiction counsellors in providing substance abuse treatment. In order to tap into rich and descriptive information on occupational stress in the addictions field, a modified grounded theory focused on conceptual ordering (Corbin & Strauss, 1998) was used for the research design. Participant sample consisted of 10 addiction counsellors who were recruited using purposeful selection from addiction treatment centres in Ontario, Canada. Data collection was conducted through face-to-face interviews using semi-structured, open-ended questions. Four major categories emerged from the data analysis using systematic thematic analysis: 1) Sources of Stress, 2) Signs and Consequences of Stress, 3) Stress Management and Intervention, and 4) Resiliency Against Stress. Results from this study contribute to the understanding of occupational stress in addictions counsellors. Implications for addiction organizations, educators, and counsellors are discussed.

This qualitative study explored the challenges and stressors that are experienced by addiction counsellors in providing substance abuse treatment. In order to tap into rich and descriptive information on occupational stress in the addictions field, a modified grounded theory focused on conceptual ordering (Corbin & Strauss, 1998) was used for the research design. Participant sample consisted of 10 addiction counsellors who were recruited using purposeful selection from addiction treatment centres in Ontario, Canada. Data collection was conducted through face-to-face interviews using semi-structured, open-ended questions. Four major categories emerged from the data analysis using systematic thematic analysis: 1) Sources of Stress, 2) Signs and Consequences of Stress, 3) Stress Management and Intervention, and 4) Resiliency Against Stress. Results from this study contribute to the understanding of occupational stress in addictions counsellors. Implications for addiction organizations, educators, and counsellors are discussed.

This qualitative study explored the challenges and stressors that are experienced by addiction counsellors in providing substance abuse treatment. In order to tap into rich and descriptive information on occupational stress in the addictions field, a modified grounded theory focused on conceptual ordering (Corbin & Strauss, 1998) was used for the research design. Participant sample consisted of 10 addiction counsellors who were recruited using purposeful selection from addiction treatment centres in Ontario, Canada. Data collection was conducted through face-to-face interviews using semi-structured, open-ended questions. Four major categories emerged from the data analysis using systematic thematic analysis: 1) Sources of Stress, 2) Signs and Consequences of Stress, 3) Stress Management and Intervention, and 4) Resiliency Against Stress. Results from this study contribute to the understanding of occupational stress in addictions counsellors. Implications for addiction organizations, educators, and counsellors are discussed.

This qualitative study explored the challenges and stressors that are experienced by addiction counsellors in providing substance abuse treatment. In order to tap into rich and descriptive information on occupational stress in the addictions field, a modified grounded theory focused on conceptual ordering (Corbin & Strauss, 1998) was used for the research design. Participant sample consisted of 10 addiction counsellors who were recruited using purposeful selection from addiction treatment centres in Ontario, Canada. Data collection was conducted through face-to-face interviews using semi-structured, open-ended questions. Four major categories emerged from the data analysis using systematic thematic analysis: 1) Sources of Stress, 2) Signs and Consequences of Stress, 3) Stress Management and Intervention, and 4) Resiliency Against Stress. Results from this study contribute to the understanding of occupational stress in addictions counsellors. Implications for addiction organizations, educators, and counsellors are discussed.

L'impulsivité, un trait multidimensionnel, détermine la sévérité d'affections comportant des désordres compulsifs (syndrome de Gilles de la Tourette, maladie de Parkinson, troubles obsessionnels compulsifs), mais la nature de la relation impulsivité / compulsivité reste méconnue. L'intérêt du présent travail est d'identifier les substrats neurobiologiques de la balance impulsivité / compulsivité, dans une approche transnosographique, en s'aidant au plan préclinique, de manipulations causales et au plan clinique, d'une approche corrélationnelle. Ainsi, nous démontrons pour la première fois en dehors du champ de l'addiction, non seulement que l'impulsivité motrice, endophénotype de vulnérabilité à la compulsivité, prédit, sous l'influence de la transmission noradrénergique, la transition vers la compulsivité, mais aussi que (dans le modèle de la maladie de Parkinson) la dénervation de la voie nigrostriée et les traitements substitutifs dopaminergiques amplifient l'état impulsif. D'où l'interaction complexe entre le trait impulsif, les traitements et le processus dégénératif. Enfin, nous démontrons le bénéfice thérapeutique de la stimulation de la portion antérieure du pallidum interne dans les formes sévères de tics et suggérons dans un modèle préclinique d'une grande valeur heuristique, que le trait impulsif prédit l'efficacité de la stimulation du core du noyau accumbens. Nos résultats démontrent l'intérêt de mieux caractériser le trait impulsif des patients présentant des désordres compulsifs (syndrome de Gilles de la Tourette, maladie de Parkinson) et ouvrent ainsi de nouvelles perspectives thérapeutiques, tant pour la prévention de la transition de l'impulsivité à la compulsivité, que dans le traitement de ceux-ci. / Impulsivity, a multidimensional trait, determines the severity of compulsive disorders (Tourette's syndrome, Parkinson's disease, obsessive compulsive disorders), but the impulsive / compulsive relation remains unclear. The aim of this work is to identify the neurobiological substrates of impulsive / compulsive balance, using causal manipulations in rats and correlational studies in patients. The results demonstrate - for the first time beside the field of addiction - that, not only high impulsive trait is a transnosological endophenotype of increased vulnerability to develop compulsive disorders, but also that the transition from impulsivity toward compulsivity depends upon the noradrenergic transmission. Furthermore, we also show that, in a Parkinson's disease preclinical model, both the nigrostriatal denervation and dopaminergic treatments increase impulsive state, thereby indicating the contribution of a complex interaction between impulsive trait, medications and neurodegenerative process to the impulsive/compulsive balance. Finally, we show the therapeutic benefit of anterior globus pallidus interna in severe forms of tics and suggest in a preclinical model, with great heuristic value, that impulsive trait predicts the efficacy of nucleus accumbens core stimulation. Together, our results demonstrate the need to address the impulsive/compulsive balance in compulsive disorders and show promise for developing new pathophysiological-based therapeutic strategies that will treat both impulsivity and compulsivity.

Le comportement envers une activité physique (AP) peut être compris sur un continuum où les individus inactifs et les individus qui pratiquent de façon excessive représentent les deux extrémités. Au milieu de ce continuum se trouvent les individus qui pratiquent de façon modérée et régulière. Ce sont ces derniers qui semblent bénéficier le plus de la pratique d’une AP (Canning et al., 2014; Kern et al., 2013; Warburton et al., 2006; Spirduso, 1995) (Spirduso, 1995). Cette thèse a pour but de comprendre les comportements dites ‘à risque pour la santé’ par rapport à la pratique d’AP, notamment l’inactivité physique et la pratique problématique d’exercice physique (PPEP). Cette thèse s’articule donc en deux parties. La première partie ‘‘Perspectives théoriques’’ a pour but la présentation d’une recherche adaptée afin de fournir une compréhension complète des comportements vis à vis la pratique d’AP et plus particulièrement l’inactivité physique et la PPEP. Cette partie vise également à faire un état de lieu de leurs méthodes d’évaluation, leurs causes et conséquences, ainsi que leurs préventions et traitements. La deuxième partie ‘‘Perspectives empiriques’’ qui sera elle même divisée en deux sous sections, sera consacrée aux différents articles (publiés ou en cours) englobant l’inactivité physique chez les étudiants universitaires et la PPEP: le but de cette dissertation est donc double et s’articule autour de sept articles. 1/Pour comprendre le problème d’inactivité physique à travers: (a) Une revue systématique de la prévalence globale de l’inactivité physique au sein des étudiants universitaires; (b) Une étude croisée effectuée au sein des communautés estudiantines françaises et indiennes; (c) Une étude exploratoire afin de tracer le profil des étudiants inactifs en Inde. 2/ Afin de mieux cerner le phénomène de la PPEP grâce à:(a) La validation d’un modèle hiérarchique définissant la PPEP; (b) L’étude du cas clinique d’un homme de cinquante ans mettant en lumière le développement et les motivations vis à vis la PPEP;(c) Une etude exploratoire sur les liens entre la PPEP et les traits d’impulsivité; (d) Cette étude vise à reproduire le modèle de Cook & Hausenblas (2008) qui postule que la PPEP joue un rôle de médiateur entre l’exercice physique et les troubles du comportements alimentaires (TCA). / Behavior towards physical activity (PA) can be investigated on a continuum with physical inactivity on one end and excessive exercise leading to the dangers of doping and/or problematic practice of physical exercise (PPPE), on the other. The aim of the current dissertation is to further clarify the concepts of physical inactivity as well as PPPE, in order to promote the adoption of regular and moderate PA while taking into account the negative consequences of excessive exercising. This dissertation is divided into two parts. The purpose of Part I – ‘Theoretical Perspectives’ is to present pertinent research and provide a general understanding of physical inactivity and PPPE. Part II – ‘Empirical Perspectives’, consists of the various research papers encompassing the two phenomena. Thus, the aim of this dissertation is twofold and is achieved through seven papers: 1/To understand the epidemic of physical inactivity through (a) a systematic review of prevalence of physical inactivity in college students globally on studies done between 2002 and 2015, (b) a cross sectional study done on a cohort of French and Indian university students and (c) an analysis of the psychological correlates of physical inactivity amongst Indian university students. 2/ To understand the phenomenon of PPPE through (a) the validation of an hierarchical model explaining PPPE, (b) a clinical case study of a 50 year old man throwing light upon the development and motivations towards PPPE, and (c) the possible links between traits of impulsivity and PPPE. This section also presents a fourth working article which (d) aims to replicate the mediation model of exercise, PPPE and eating pathology validated by Cook & Hausenblas (2008) along with the motivation to control weight.

Selon l’expertise épidémiologique, le tabagisme, la consommation excessive d’alcool, le manque d’exercice physique et une alimentation mal équilibrée expliqueraient 40% des décès avant 65 ans dans les pays les plus riches. Cet argument chiffré fait comprendre que la prévention, qui vise la réforme des conduites individuelles, est appelée à prendre une place croissante dans les politiques de santé publique, car, pour réduire cette mortalité dite précoce, qui est aussi socialement déterminée, l’augmentation des dépenses médicales de santé n’aura sans doute qu’un impact marginal. Nous voulons montrer à travers ce travail que la prévention, tournée vers les conduites individuelles, est digne d’un intérêt philosophique, car, à leur manière, les messages de prévention parlent du « bien », ou, d’ « un bien », mais aussi de maux qui seraient évitables par des « conduites vertueuses ». Toutefois, une des particularités de ce discours, peut-être piloté par un désir de contrôle social des conduites, est de postuler soit un individu introuvable, dont les désirs seraient sans opacité ni contradiction et dont l’action se déduirait toujours de la connaissance, soit un individu que la peur de la maladie et de la mort rendrait enfin « raisonnable ». En quoi les conduites dites à risques pour leurs auteurs sont-elles motivées par la recherche du plaisir ? Relèvent-elles nécessairement de l’ignorance ou de l’aveuglement ? Prévenir les maux évitables par une réforme des conduites individuelles autorise-t-il à faire de la santé une fin en soi ? Nous tenterons de répondre à ces questions en esquissant une éthique de la prévention conciliant santé publique et libertés individuelles. / According to epidemiological reports, smoking, excessive alcohol drinking, the lack of exercise as well as unbalanced food habits would account for fourty per cent of mortality before the age of sixty-five in the wealthiest countries. This argument based on statistics clearly shows that prevention whose purpose is to change individual lifestyles is bound to have an increasing part in public health policies. Indeed, to reduce what is called premature death, which is also socially determined, the increase of medical expenses is likely to have but little impact. Through this work, we want to show that prevention when it applies to individual lifestyles deserves philosophical interest as, in their own way, prevention messages refer to good or a kind of good. They also refer to evils that could be prevented by “virtuous behaviours”. However, one of the characteristics of this position – that might aim at a control of people’s conducts – is to postulate either the existence of an individual still to be found, whose desires would be obvious and unambiguous, whose action would always result from knowledge, or of one that the fear of illness and death would make sensible at last. To what extent are risk behaviours caused by the pursuit of pleasure? Do they necessarily stem from ignorance and blindness? Should preventing avoidable evils through a reform of individual conducts allow the authorities in charge in those issues to consider health as a goal in itself? We will try to answer these questions by outlining an ethic approach of prevention that balances public health and individual liberty.

Pathological gambling is a maladaptive behaviour associated with diminished self-control over persistent compulsive gambling behaviour despite negative consequences. A significant revision to the clinical perspective of pathological gambling is underway, and the disorder will likely be recognized as a behavioural addiction in the fifth edition of Diagnostic and Statistical Manual of Mental Disorders. However, the neurobiological, cognitive and behavioural processes that drive a ‘behavioural addiction’ are unclear. A series of five studies were conducted to investigate cognitive mechanisms associated with neural and behavioural substrates of addictive processes in disordered gambling. Studies 1 through 3 investigated neurobiological correlates of addiction in individuals with pathological gambling as compared to individuals with cocaine dependence, and as compared to non-addicted healthy controls. Study 1 investigated brain activity associated with anticipatory and consummatory reward processing during slot-machine gambling. Study 2 investigated executive control processes by examining functional brain networks associated with loss-chasing behaviour. Study 3 employed voxel-based morphometry (VBM) to explore alterations in grey-matter volumes in individuals with addictive disorders. Studies 4 and 5 investigated the behavioural substrates of addiction in regular gamblers utilizing emerging and novel research techniques. Study 4 examined continuous hand motion trajectories to explore approach biases and implicit processing. Study 5 employed an adaptive testing methodology to explore the influence of gaming machine preferences on cognitive processes and gambling behaviour. Research identified neurobiological and behavioural substrates of gambling-related beliefs and biases that indicate significant contributions of cognitive mechanisms to the development and persistence of a behavioural addiction. Results suggest addictive disorders may share some common features of anticipatory reward processing and brain structure (Studies 1 and 3), while neural signals associated losing outcomes and decision-making during gambling may be specific to disordered gambling (Studies 1 and 2). Furthermore, cognitive distortions in regular gamblers may influence reinforcement and executive control processes (Study 4), and individual preferences for gaming speed may influence cognitions and behaviour during machine gambling. As additional psychological disorders are being considered for classification as behavioural addictions, and clinicians will be faced with the challenges of treating individuals with these non-substance-related addictive disorders, a better understanding of behavioural addictions, through the study of disordered gambling, will be essential under the new diagnostic framework.