Psychogenic nonepileptic seizures (PNES) are abrupt paroxysmal changes in behaviour, sensation, or experience that mimic epilepsy, but that are not accompanied by the electrophysiological changes typical for epilepsy. Their cause is psychological. An examination of neuropsychological correlates of PNES is therefore crucial for understanding, effective diagnosis and treatment of this disorder. The aim of our study is to explore a specific neuropsychological profile of patients with PNES, particularly cognitive impairment, early parental bonding and occurrence of selected life events during childhood and before the onset of PNES. We examined 38 patients with PNES and 38 healthy controls matched for age and sex using neuropsychological battery RBANS, PBI questionnaire and a checklist of life events. The results showed that overall cognitive performance of patients with PNES was significantly worse in comparison with healthy controls. However, there was no significant difference between the two groups in immediate memory and language domains. Furthermore, patients with PNES recollected significantly more paternal control in childhood, more stressful situations, more opportunities for social learning of the sick role, more health problems in childhood and also significantly more troubles preceding the...

Chez les personnes âgées, la maladie d'Alzheimer et les pathologies apparentées représentent actuellement un véritable problème de santé publique. Si les lésions anatomo-pathologiques de ces maladies sont bien définies, leur étiologie reste incertaine et vraisemblablement plurifactorielle. En tant que psychologue clinicienne, ce sont les théories impliquant le psychisme dans l'étiologie des maladies démentielles de l'âgé qui ont d'abord retenu mon attention. Une revue de question a permis d'en dresser une liste qui se veut exhaustive et qui se découpe en trois grandes catégories : les théories psycho-dynamiques, les théories psychosociales et enfin les modèles intégratifs plurifactoriels. Parmi ces derniers, celui faisant intervenir les évènements de vie en tant que facteurs de risque a suscité cette double recherche.Ainsi, dans une démarche qualitative, deux études ont débuté en parallèle. La première rétrospective, qui porte sur les histoires de vie d'une population de 30 malades Alzheimer ou apparentés, hébergés dans une unité de vie protégée ; la seconde prospective, qui explore l'évolution cognitive sur plusieurs années de 30 personnes âgées indemnes de troubles au début de l'étude, selon que leurs histoires de vie soient riches ou pas en événements de vie.Si un certain nombre d'évènements perturbants sont relatés par l'entourage pour la plupart des patients de la recherche rétrospective, l'étude prospective montre qu'un nombre important d'évènements de vie n'est ni une condition suffisante, ni une condition nécessaire pour constituer un facteur de risque de troubles cognitifs. Par contre, l'élaboration ou non de ce(s) même(s) évènement(s), leur caractère traumatique ou non, en lien avec le soutien et les aides reçus ou non semblent déterminants dans l'évolution cognitive des sujets.Enfin, chez la plupart des sujets pour qui les évènements anciens se révèlent traumatiques, un épisode contemporain de type « perte » viendrait réactiver les souvenirs et serait un facteur précipitant de troubles cognitifs, voire de décompensation vers une pathologie de la mémoire. / Among the elderly, Alzheimer disease and related pathologies currently constitute a real public health issue. The anatomo-pathological lesions of these diseases may be clearly defined but their etiology remains uncertain and is likely multifactorial. As a clinician psychologist, theories involving psychism in the etiology of demential diseases among elderly, first held my attention. A review of the question enabled me to make a list supposed to be exhaustive and divided into 3 categories : psycho-dynamic, psycho-social theories and multifactorial integrative patterns. Among the latter, the one involving life events as risk factors motivated this double research. Thus is a qualitive procedure, 2 studies started in parallel. The first retrospective dealing with life stories of a population of 30 people affected by Alzheimer or related diseases, hosted in a protected life-unit ; the second prospective scanning through cognitive evolution based on several years for 30 elderly people unharmed by troubles at the start of the study (depending on their life stories having many or few life events). If a certain amount of disturbing events are recounted by relatives for most of the patients of the retrospective research, the prospective research shows that an important number of live events is neither a sufficient nor a necessary condition to represent a risk factor of cognitive troubles. On the other hand, the elaboration or non elaboration of there events, their traumatic or non traumatic aspect (linked with the received or not received support and help) seems to be determining in the cognitive evolution of the subjects. Finally, among most of the subjects for whom past events prove to be traumatic, a contemporary "loss"-like episode would revive memories and would be an accelerating factor of cognitive troubles and even a collapse to a memory pathology.

Cette étude a pour objectif comparer deux populations selon les facteurs socio-démographiques, personnels, psychopathologiques, psycho-corporels et relationnels et étudier le vécu de la maladie sur la vie personnelle, familiale et sociale chez les schizophrènes français et péruviens à travers les récits de vie recueillis au cours de la recherche. Nous avons formulé deux hypothèses générales : Les récits et évènements de vie rapportés par les patients schizophrènes français et péruviens ne seront pas fondamentalement différents du fait de l’universalité de la pathologie et le dessin de l’arbre utilisé chez les patients schizophrènes français et péruviens permettra de mettre en évidence des différences en fonction de la population étudiée. Population : Elle est composée de 26 patients hommes et femmes âgés de 18 à 57 ans (âge moyen : 36 ans) stabilisés par leur traitement, ayant fait l’objet d’un diagnostic de Schizophrénie de type paranoïde (F20.0x), schizophrénie de type indifférenciée (F20.3X) et trouble délirant (F22.0) selon le DSM IV-R. Instruments : Nous avons utilisé trois types d’outils pour tester nos hypothèses : Dessins de l’arbre, questionnaire d’événements de vie d’Amiel Lebigre et récits de vie. Résultats : Les résultats indiquent que les récits, évènements de vie et des dessins de l’arbre des patients schizophrènes français et péruviens sont différents (situation familiale, professionnelle, événements de vie, troubles psychologiques). Conclusion : Cette étude nous a permis d’appréhender la réalité des patients schizophrènes dans les deux pays : le contexte social et la prise en charge des patients. Nous avons repéré que les histoires des patients schizophrènes péruviens sont plus interrompues et peu élaborés. Elle met en lumière des aspects encore peu étudiés chez les patients schizophrènes (sexualité, image du corps, aspect social, couleur des dessins). / This study aims to compare two populations by socio-demographic, personal, psychopathology, psycho-physical and relational factors and to study the experience of the disease on the personal, family and social life in French and Peruvian schizophrenics through the life stories collected during the research. We made two general hypotheses: Stories and life events reported by the French and Peruvian schizophrenic patients will not be fundamentally different because of the universality of the pathology ; and the tree test made by French and Peruvian schizophrenic patients will highlight differences depending on the population studied. Population : It’s composed of 26 men and women patients aged from 18 to 57 years (mean age 36 years) stabilized by treatment, having been diagnosed with paranoid Schizophrenia (F20.0x), schizophrenia undifferentiated type (F20.3X) and delusional disorder (F22.0) according to DSM IV-R. Instruments : We used three types of tools to test our hypotheses: tree test, life events and life stories. Results : The results indicate that the stories, life events and tree test of French and Peruvian schizophrenic patients are different (family situation, professional, life events, psychological disorders). Conclusion : This study allowed us to understand the reality of schizophrenic patients in the two countries: the social context and the care given to patients. We've detected that stories of Peruvian schizophrenic patients are interrupted and unsophisticated. It highlights aspects that have not been deeply studied yet in schizophrenia (sexuality, body image, social, color drawings).

Suicidal Behavior in the U.S. Army is a problem that persists despite significant efforts to promote help-seeking behaviors and the investment of millions of dollars to develop resilience-building interventions. Evidence-based literature supports the use of reasons for living as a protective factor against suicidal behavior in clinical and nonclinical samples, yet it has rarely been studied in an active duty (AD) Army population. This study examined the relationship between self-reported reasons for living and self-reported suicidal behavior, to determine if high levels of reasons for living correlated with low risk of suicidal behavior, over and above demographics, depression, stressful life events, and social support, using standardized questionnaires. The study sample consisted of 244 AD Army soldiers attending the Warrior Leadership Course in Germany. The results analysis showed that reasons for living were inversely related to suicidal behavior among this sample. Although African American soldiers scored higher on measures of reasons for living and suicidal behavior, demographic variables did not significantly predict suicidal behavior. Reasons for living accounted for a unique amount of variance in suicidal behavior; however, depression, stressful life events, and social support were better predictors. This study demonstrates the benefits of incorporating reasons for living in military research and practice, as efforts are made to identify AD Army personnel at risk for suicide. The study findings also support the claim that examining protective and risk factors supersedes efforts to study risk factors alone. It promotes positive social change by informing efforts to develop comprehensive suicide prevention policies, programs, and procedures aimed at effectively reducing the rate of suicide in the U.S. Army.

Psychological stress is a major risk factor for cardiovascular diseases. While the relevance of early life stress, such as that which is due to child maltreatment (CM), is well known to impact individual stress responses in the long-term, and data on the interplay between CM and stressful events in adulthood on cardiovascular health are sparse. Here, we aimed to assess how stressful life events in adulthood are associated with cardiovascular health infarction in later life and whether this association is independent of CM. In a cross-sectional design, a probability sample of the German population above the age of 14 was drawn using different sampling steps. The final sample included 2510 persons (53.3% women, mean age: 48.4 years). Participants were asked about sociodemographic factors, adult life events, CM, and health conditions in adulthood. Results indicate that the number of experienced adverse life events in adulthood is associated with significantly increased odds for obesity (Odds Ration (OR)women = 1.6 [1.3; 2.0], ORmen = 1.4 [1.1; 1.9]), diabetes (ORwomen = 1.5 [1.1; 2.1], ORmen = 1.5 [1.1; 2.3]) and myocardial infarction (ORwomen = 2.1 [1.0; 4.3], ORmen = 1.8 [1.1; 2.8]). This association is not moderated by the experience of CM, which is associated with cardiovascular problems independently. Taken together, adult stressful life events and CM are significantly and independently associated with cardiovascular health in men and women in the German population in a dose-dependent manner. General practitioners, cardiologists and health policy-makers should be aware of this association between psychosocial stressors during childhood and adulthood and cardiovascular health.

Les joueurs à risque modéré et pathologiques probables représentent respectivement 1,4 % et 0,4 % de la population dans la province de Québec (Kairouz, Paradis, Nadeau, Hamel, & Robillard, 2015). Bien que prolifique, la recherche sur les trajectoires des joueurs présente plusieurs limites méthodologiques menant à l'hétérogénéité des résultats et peu d’études ont empiriquement examiné les facteurs associés aux changements dans les habitudes de jeu. Par ailleurs, il est reconnu que les évènements de vie ont un impact sur le développement de la psychopathologie (Brown & Harris, 1989). L'objectif de cette thèse est d'étudier la façon dont les joueurs évoluent au fil du temps en fonction de la gravité de leurs comportements de jeu et des conséquences néfastes, et d'examiner de manière prospective les associations entre les évènements de vie et la sévérité des problèmes de jeu. Au cours d’un suivi de deux ans, comprenant trois temps de mesure, 179 joueurs sélectionnés à partir d'une enquête populationnelle ont été répartis dans quatre groupes (non-problème, à faible risque, à risque modéré et les joueurs pathologiques probables) selon leur score à l’indice canadien du jeu excessif (Ferris et al, 2001). La présence d'évènements de vie a également été évaluée chaque année. Nos analyses révèlent que les joueurs à risque modéré sont très hétérogènes, tant dans leur composition que dans leur évolution. Les joueurs pathologiques restent vulnérables et sont à risque de vivre des problèmes de jeu chroniques au fil du temps. Nos analyses ont également montré que certains évènements de vie spécifiques liés à la sphère professionnelle, financière, sociale et aux habitudes de vie, ainsi que le nombre cumulé d'évènements de vie, sont prospectivement associés à un niveau plus élevé de sévérité des problèmes de jeu un an plus tard. Cette thèse montre ainsi l'importance de tenir compte des spécificités du groupe des joueurs à risque modéré dans les programmes de prévention secondaire et de favoriser la continuité des soins et la prévention des rechutes dans les programmes de traitement. De plus, les circonstances sociales et le stress affectent les trajectoires de jeu et doivent également être pris en compte dans le champ de la prévention secondaire et du traitement. / Moderate risk and problem gamblers in the Province of Quebec represent 1.4% and 0.4% of the population, respectively (Kairouz et al., 2015). Albeit prolific, the research on gamblers’ trajectories has been hampered by several methodological shortcomings leading to heterogeneity in results. Moreover, few have empirically investigated factors that were associated with change. However, it is known that life events or significant changes in people's life have an impact on the development of psychopathology (Brown & Harris, 1989). The purpose of this thesis is to explore the ways in which gamblers evolve over time depending on the severity of their gambling behaviors and harmful consequences, and to examine prospectively associations between life events and problem gambling severity. Using a two-year follow-up prospective design including three measurement waves, 179 gamblers selected from a representative survey divided into the four categories (non-problem, low-risk, moderate-risk, and problem gamblers) of the Problem Gambling Severity Index (Ferris et al., 2001) were examined. Occurrence of life events was also assessed annually. Our analyses reveal that the moderate-risk gamblers are highly heterogeneous, both in their composition and their evolution. Problem gamblers remain vulnerable and are at-risk of experiencing chronic problems over time. Cross-lagged analyses showed that some specific life events related to work, financial, social and lifestyle arenas, as well as the cumulative number of life events, were prospectively associated with an increase in severity of problem gambling 12-months later. Thus, this dissertation shows the significance of addressing sub-group specificities in secondary prevention programs, and the necessity for continuity of cares and relapse prevention in treatment programs. Moreover, social circumstances and stress affect gambling trajectories and need to be taken into account in secondary prevention and treatment.

Objectif: Examiner l’association entre l'exposition aux évènements stressants de la vie et le cancer du poumon. Méthodes: Les données proviennent d’une étude cas-témoins, menée chez les hommes et les femmes vivant dans la région métropolitaine de Montréal entre 1996 et 2001. Le cancer du poumon d’un cas éligible devait être confirmé histologiquement à l’un des 18 hôpitaux de cette région. Les témoins ont été sélectionnés aléatoirement de la liste électorale du Québec et ont été appariés au cas par fréquence de groupes d'âge et par sexe. Un questionnaire a été administré en entrevue pour recueillir les données, dont l’évaluation de huit évènements stressants de la vie par le participant. Si le participant avait vécu un évènement stressant ciblé durant les six dernières années, il devait aussi coter cet évènement sur une échelle de trois points. La régression logistique non conditionnelle a été utilisée pour estimer les rapports de cotes ainsi que leurs intervalles de confiance à 95%. Des analyses par sexe, niveau de tabagisme et par type histologique ont été réalisées. Nous avons aussi analysé l’association entre le cancer du poumon et le nombre total d'évènements, les évènements de perte et les évènements socioéconomiques, ainsi que chaque évènement individuellement. Les analyses des scores d'impact autoévalués et avec un score externe de perception, ont également été menées. Résultats: La population de ce projet comprend 1061 cas et 1422 témoins, âgés de 35 à 70 ans. Les participants inclus avaient répondu aux sections du questionnaire portant sur les facteurs de style de vie et sur l'historique de tabagisme. Dans l'ensemble, nous n’avons pas observé d’association entre le cancer du poumon et l'exposition aux évènements stressants de la vie. Nous avons observé une diminution du risque pour les évènements socioéconomiques autoévalués comme peu stressants (RC=0,50; IC 95%= 0,31 - 0,81). Conclusion: Nos résultats suggèrent que les évènements socioéconomiques sont associées à un risque réduit si ces évènements sont considérés comme peu stressant. / Objective: To examine exposure to stressful life events in relation to lung cancer risk. Methods: Our research used data from a case-control study conducted in Montreal from 1996 to 2001. Cases were diagnosed with histologically confirmed incident lung cancer at one of 18 Montreal-area hospitals. Controls were randomly selected from the Quebec electoral list and frequency matched to the distribution of cases by sex and 5 year age groups. Data was collected on sociodemographic characteristics, lifetime smoking, and lifestyle factors including 8 stressful life events. Participants indicated the stressful life events they experienced over the past six years, and an appraisal of their level of stress due to each event on a three-point scale. Unconditional logistic regression was used to estimate adjusted odds ratios and 95% confidence intervals. Each stressful life event was analyzed individually as well as in grouped variables measuring total number of events, loss events and socioeconomic events. Analyses of self-appraised impact scores were also conducted; additionally an external perceived stress score was also employed. Results: 1061 cases and 1422 population controls were included in the analyses. Overall, we observed no association between lung cancer and stressful life events. A decrease in risk for socioeconomic events self-appraised as not very stressful was observed (OR, 0.50; 95% CI, 0.31, 0.81), which included job loss, increase in debt, and move to another city. Conclusion: Our results suggest that socioeconomic events, deemed not very stressful, may reduce the risk of lung cancer.

The theoretical part of the thesis mainly deals with the definition of humor, sense of humor, stress, life events and personal well-being and at the same time presents an overview of the basic theories related to these topics. The aim of the work is to look for individual links between mentioned topics. Primarily tries to highlight the positive impact of a sense of humor for coping with stress and life events. The research seeks to show a sense of humor as one of the coping strategies. The research seeks is based on processing the conclusions brought about a qualitative probe, based on in-depth interviews on a sense of humor and its connections with another variables. Qualitative analysis of verbal material suggests a sense of humor in connection with personal well-being and presents a sense of humor as one of the coping strategies of stress and life events. . Keywords: humour, sense of humour, well-being, stress, life events, coping strategies

Made available in DSpace on 2016-04-04T18:27:31Z (GMT). No. of bitstreams: 1 Marcela Fileti.pdf: 341605 bytes, checksum: 22b6ac71b02c0368db63564346f9cb49 (MD5) Previous issue date: 2007-02-26 / Pontif?cia Universidade Cat?lica de Campinas / Cancer is among the most important causes of death in Brazil and around the world. The most common type to origin death in women is the breast cancer. This study intended to analyze the possible contingences that people with breast cancer were exposed before the beginning of the disease in order to understand the relationship between the behavior and development of cancer. Participated of this study four women with primary diagnosis of breast neoplasm, without history breast cancer in their family (mother and/or sister), age between 40 and 51, that have had children and with medical following in an Oncology s Ambulatory of a general hospital. The theory selected was the Behavior Analysis, based on Radical Behaviorism Philosophy. Considering the data obtained by the relates of the participants during the clinical interview, it was done the analysis of behaviors that presented relevant in previous period of the disease establishment, that had variation of 4 to 8 years depending on the medical diagnosis to each participant. The results indicated that there is a common behavior style of social reinforce strong rules, behaviors maintained by negative reinforcement, lack of repertory to identify the uncovered behaviors and their aversive consequences and absence of selfknowledge. The exposition on aversive events and the reduced repertory of escape s behavior suggest a poor repertory in order to work with aversive life events, that would contribute to an organism s vulnerability and possible development of neoplasm. The results may suggest that behavioral standard maybe have link with the development of diseases like the breast cancer. Other surveys in Analysis of Behavior area relating contingences and diseases must be conduced. / O c?ncer figura entre as principais causas de morte no Brasil e no mundo. O tipo mais comum a provocar mortes em mulheres ? o c?ncer de mama. Esta pesquisa objetivou analisar as prov?veis conting?ncias a que pessoas portadoras de c?ncer de mama estiveram expostas antes do in?cio da doen?a, a fim de compreender a rela??o entre o comportamento e o desenvolvimento do c?ncer. Participaram do estudo 4 mulheres com diagn?stico prim?rio de neoplasia maligna de mama, sem hist?ria da doen?a na fam?lia (m?e e/ou irm?), com idade entre 40 e 51 anos, com filhos, que encontravam-se em acompanhamento m?dico em um ambulat?rio de oncologia de um hospital geral. A abordagem te?rica selecionada foi a An?lise do Comportamento, baseada na filosofia do Behaviorismo Radical. Por meio dos dados obtidos pelos relatos das participantes durante a entrevista cl?nica, fez-se a an?lise dos comportamentos que se mostraram relevantes na ?poca anterior ao in?cio da doen?a, que variou de 4 a 8 anos dependendo do diagn?stico m?dico para cada participante. Os resultados indicaram um padr?o comportamental comum de presen?a de auto-regras r?gidas refor?adas socialmente, comportamentos mantidos por refor?amento negativo, falta de repert?rio para identifica??o de comportamentos encobertos e as conseq??ncias aversivas desses comportamentos, aus?ncia de autoconhecimento. A exposi??o aos eventos aversivos e o baixo repert?rio de comportamentos de fuga sugerem um pobre repert?rio para lidar com eventos aversivos de vida, o que colaboraria para a vulnerabilidade do organismo e poss?vel desenvolvimento da neoplasia. Os resultados permitem sugerir que padr?es comportamentais possivelmente relacionamse com o desenvolvimento de doen?as como o c?ncer de mama. Outras pesquisas na ?rea da An?lise do Comportamento relacionando conting?ncias e doen?as devem ser conduzidas.

Approximately 43% of college students report experiencing suicidal ideation in the past year, and suicide is the 2nd leading cause of death among college students, making it a significant public health concern. Development of successful suicide intervention and prevention strategies is predicated on identification of risk (e.g. negative life events, hopelessness) and protective factors (e.g. self-compassion) that may be targeted for treatment. A well-established linkage exists between life stressors and suicidal behavior; however, potential mechanisms of action underlying this association are under-researched. It may be that negative life events contribute to feelings of hopelessness, which is conceptualized as negative beliefs and expectations about one’s self and future. However, not all persons who experience negative life events and hopelessness become suicidal, perhaps due to protective factors such as self-compassion. Comprised of self-kindness, mindfulness and sense of common humanity, self-compassion may contribute to emotional resilience when negative life events occur; however, this premise has not been previously examined. We hypothesized that hopelessness would mediate the relation between negative life events and suicidal behaviors, such that negative life events would be related to increased feelings of hopelessness and, in turn, to greater risk for suicidal behavior. We also hypothesized that self-compassion would beneficially moderate the mediating effect of hopelessness. Our sample of college students (n=338) were primarily female (67%; n=227) and White (89.6%; n=294), with a mean age of 21.8 years (SD=4.7). Participants completed self-report measures including the Life Events Scale, the Beck Hopelessness Inventory, the Suicide Behaviors Questionnaire - Revised, and the Self-Compassion Scale. Supporting our hypotheses, hopelessness fully mediated the relation between negative life events and suicidal behavior (DE=.07, SE=.06, 95% CI=.05,.28,p