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THE ABSTRACT It has been shown recently that workload, stress, and burnout syndrome among the staff of the medical rescue service may be major risk factors in terms of triggering the use of psychoactive substances. Representing what is understandably a delicate issue, substance use among emergency medical staff has not been thoroughly studied in our country. Emergency medical workers' difficult working conditions and the chronic stress they are exposed to, in combination with a lack of support and care on the part of their employers, result in exhaustion and general distress, accompanied by the development of symptoms associated with both physical and mental disorders. This condition may lead to the use of psychoactive substances as a negative coping strategy. Consisting of both theoretical background and case studies, the paper points out the relationship between the chronic effect of stressors pertaining to the job of emergency medical workers and the use of psychoactive substances as a way of coping with and compensating for the implications of work-related stress and fatigue. Thorough case studies are presented to demonstrate the onset and development of addictive behaviour within a wider context, with special emphasis being placed on its association with coping with both acute and chronic occupational...

Objectifs : Ce mémoire propose de répertorier par une revue systématique les instruments de mesure clinique des conduites addictives établies et émergentes; de les comparer au moyen d’une grille d’analyse afin de de déterminer si ces conduites sont cohésives au plan conceptuel. Méthode : La stratégie analytique employée s’est déroulée en trois étapes : 1) Via les moteurs de recherche Pubmed, Psychinfo, HAPI et Embase, nous avons cherché, pour l’ensemble des conduites addictives, les questionnaires ayant fait l’objet d’une étude de validation interne au plan psychométrique. 2) Une grille d’analyse a été développée et validée, couvrant 21 paramètres tirés de 4 catégories conceptuelles : les critères diagnostiques de dépendance (DSM-IVTR), le tempérament (Cloninger et Zuckerman), le processus de production du handicap social (Fougeyrollas) et une grille d’analyse cognitivo-comportementale (Beck). 3) tous les instruments ont été analysés et comparés au moyen de cette grille qui a été développée est validée par un accord inter-juge élevé. Résultats : Nous avons répertorié 191 questionnaires répartis sur 21 conduites addictives. On constate que les conduites les plus prévalentes sont également celles pour lesquelles on retrouve le plus grand nombre de questionnaires. Les catégories que les questionnaires évaluent le plus sont celles des critères de la dépendance et l’analyse cognitivo-comportementale, les catégories beaucoup moins bien représentées étant celles du tempérament et du processus de production du handicap social. On note des tendances semblables pour les paramètres entre les questionnaires portant sur la toxicomanie et ceux portant sur les addictions sans drogues. Conclusion : Ce mémoire confirme une cohésion clinique dans la mesure des addictions, tel que déterminé par une grille validée appliquée sur un ensemble exhaustif de questionnaires répertoriés par une revue systématique. / Aims: To conduct a systematic review of instruments for the clinical measurement of established and emerging addictions; and to determine whether these addictive behaviours are similarly conceptualised in clinical research. Methods: The analytic strategy employed comprised three steps: 1) major search engines were used to do an inventory of available psychometrically validated clinical instruments for assessing addictions; 2) an analytical grid was developed and validated, covering 21-parameters related to four conceptual categories: dependence (DSM-IV-TR), temperament (Cloninger and Zuckerman), social handicap (Fougeyrollas), and cognitive behaviour analysis (Beck); 3) all instruments were analysed and compared through the grid. Results: The method yielded 191 questionnaires covering 21 addictive behaviours. The most prevalent behaviours were those best represented in terms of number of questionnaires. The criteria categories most evaluated by the questionnaires were dependence and cognitive behaviour; temperament and social handicap were much less often considered. Patterns were generally similar in terms of parameters, whether questionnaires concerned substance or non-substance addictions. Conclusions: The measurement of addictions appears clinically cohesive, as determined by a validated analysis grid applied to an exhaustive set of questionnaires identified via a systematic literature review.

THE ABSTRACT It has been shown recently that workload, stress, and burnout syndrome among the staff of the medical rescue service may be major risk factors in terms of triggering the use of psychoactive substances. Representing what is understandably a delicate issue, substance use among emergency medical staff has not been thoroughly studied in our country. Emergency medical workers' difficult working conditions and the chronic stress they are exposed to, in combination with a lack of support and care on the part of their employers, result in exhaustion and general distress, accompanied by the development of symptoms associated with both physical and mental disorders. This condition may lead to the use of psychoactive substances as a negative coping strategy. Consisting of both theoretical background and case studies, the paper points out the relationship between the chronic effect of stressors pertaining to the job of emergency medical workers and the use of psychoactive substances as a way of coping with and compensating for the implications of work-related stress and fatigue. Thorough case studies are presented to demonstrate the onset and development of addictive behaviour within a wider context, with special emphasis being placed on its association with coping with both acute and chronic occupational...

No description available.