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Les expériences de maltraitance vécues à l’enfance ont été associées à une morbidité physique et psychologique, dont un plus grand risque de développer des maladies cardiovasculaires (MCV). Ceci pourrait être expliqué par les effets de la maltraitance sur la régulation émotionnelle et l’indice de masse corporelle (IMC). Objectifs : Évaluer si (1) la maltraitance est associée à un IMC plus élevé au départ et à une augmentation plus importante de l'IMC 5 ans plus tard chez les adultes plus âgés souffrants de maladie coronarienne (MAC) ou d'autres maladies chroniques; (2) le sexe et/ou le statut coronarien influencent ces résultats; et (3) les symptômes d'anxiété, de dépression et de stress perçu (comme indices de dérégulation émotionnelle) expliquent l'association entre la maltraitance et l’IMC au suivi. Participants et méthodes : 1232 hommes et femmes (âgés de 60,86 ± 6,95 ans) ont rempli des questionnaires validés sur la maltraitance et les symptômes de détresse psychologique. Le poids en kilogrammes et la taille du participant ont été recueillis. L'IMC du participant a été calculé en utilisant le rapport poids (kg)/taille (m2). Résultats : La maltraitance n'était pas associée à l'IMC au départ ni lors du suivi. Cette relation n'était pas modérée par le sexe ou le statut de MAC. La maltraitance dans l'enfance était associée à une détresse psychologique significativement plus importante au départ (tous les p < ,001), mais ces derniers n'expliquaient pas cette relation au suivi. Conclusion : La maltraitance n'était pas associée à l'IMC au départ ni à l'IMC cinq ans plus tard. La dysrégulation émotionnelle résultant de la détresse psychologique a été associée à un risque accru de morbidité et de mortalité et peut représenter une cible importante pour la prévention et l'intervention, y compris en ce qui concerne la promotion d'habitudes de vie plus saines chez des personnes ayant vécu de la maltraitance. / Objectives: Childhood trauma has been associated with greater psychological and physical morbidity, including a greater risk of developing coronary artery disease (CAD). Mechanisms leading to increased risk of illness may involve emotional dysregulation and increased body mass index (BMI). This study evaluated whether (1) childhood maltreatment is associated with higher BMI at baseline and with greater increases in BMI 5 years later among older adults with CAD or other chronic illnesses; (2) sex and/or CAD status influence these results; and (3) symptoms of anxiety, depression, and perceived stress (as indicators of emotional dysregulation) mediate the association between childhood maltreatment and BMI at 5-year follow-up. Participants and Methods: A total of 1232 men and women (aged 60.86 [6.95] years) completed validated questionnaires on childhood maltreatment and symptoms of psychological distress. Weight in kilograms and height were collected for each participant, and their BMI was calculated using the ratio of weight (kg)/height (m2).Findings: Childhood maltreatment was not associated with BMI at baseline nor at follow-up. This relation was not moderated by sex nor CAD status. Childhood maltreatment was associated with significantly greater psychological distress at baseline (all ps<.001), though the latter was not found to mediate this relation at follow-up. Conclusion: Childhood maltreatment was not associated with BMI at baseline nor with BMI five years later. Emotional dysregulation resulting from psychological distress has been associated with increased risk for morbidity and mortality and may represent an important target for prevention and intervention, including as concerns promoting healthier lifestyle habits. However, further studies are needed.

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Objective: We aimed to assess psychological distress in patients with intracranial neoplasia, a group of patients who suffer from severe functional, neurocognitive and neuropsychological side effects, resulting in high emotional distress. Methods: We conducted a cross-sectional study, including inpatients with brain tumours. Eligible patients completed validated self-report questionnaires measuring depression, anxiety, distress, symptoms of posttraumatic stress disorder (PTSD), fear of progression and health-related quality of life. The questionnaire set was completed after brain surgery and receiving diagnosis and before discharge from hospital. Results: A total of n = 31 patients participated in this survey. Fourteen of them suffered from malignant (n = 3 metastatic neoplasia) and 17 from benign brain tumours. Mean values of the total sample regarding depression (M = 9.28, SD = 6.08) and anxiety (M = 6.00, SD = 4.98) remained below the cut-off ≥ 10. Mean psychosocial distress (M = 16.30, SD = 11.23, cut-off ≥ 14) and posttraumatic stress (M = 35.10, SD = 13.29, cut-off ≥ 32) exceeded the clinically relevant cut-off value in all the patients with intracranial tumours. Significantly, more patients with malignant (79%) than benign (29%) brain tumours reported PTSD symptoms (p = 0.006). Conclusion: Distress and clinically relevant PTSD symptoms in patients with intracranial neoplasia should be routinely screened and treated in psycho-oncological interventions immediately after diagnosis. Especially, neuro-oncological patients with malignant brain tumours or metastases need targeted support to reduce their emotional burden.

La formation des psychothérapeutes peut être très stressante et les apprentis sont particulièrement à risque de développer des symptômes de détresse psychologique, tels que l'anxiété, la dépression et l'épuisement professionnel. Parallèlement, les interventions de pleine conscience ont montré des résultats prometteurs dans la réduction de ces symptômes chez les professionnels de la santé, y compris les psychothérapeutes. Toutefois, les mécanismes par lesquels la pleine conscience réduit la détresse psychologique sont encore incertains. La théorie de l'autodétermination suggère que la pleine conscience permet aux individus d'être plus ouverts et réceptifs aux informations de leurs mondes intérieur et extérieur, ce qui facilite à son tour la satisfaction de leurs besoins psychologiques fondamentaux d'autonomie, de compétence et d’affiliation, considérés comme essentiels au bien-être psychologique. Cependant, à ce jour, les études visant à tester cette théorie ont été réalisées à l’aide de devis transversaux, ne permettant pas de prouver la présence d’une médiation. L’étude présentée dans ce mémoire visait donc à tester la relation entre le trait de pleine conscience, la satisfaction des besoins psychologiques, et la détresse psychologique d’apprentis psychothérapeutes à travers un modèle de médiation à devis longitudinal. Les données ont été recueillies auprès de 27 apprentis psychothérapeutes au début (T1) et au milieu de l'année universitaire (T2). Les résultats suggèrent que la satisfaction des besoins psychologiques médiait partiellement la relation entre le trait de pleine conscience et la détresse psychologique. Les implications théoriques et pratiques de ces résultats sont discutées. / Psychotherapists’ training can be very stressful, and trainees are especially prone to symptoms of psychological distress, such as anxiety, depression, and burnout. Mindfulness interventions have shown promising results in reducing those symptoms among health care professionals, including psychotherapists. However, the mechanisms through which mindfulness reduces psychological distress are still uncertain. Self-determination theory suggests that mindfulness allows individuals to be more open and receptive to information from their inner and outer worlds, which in turn facilitates the satisfaction of their basic psychological needs of autonomy, competence, and relatedness, considered essential to psychological well-being. However, to this day, studies investigating this theory were limited to cross-sectional designs. The study presented in this thesis therefore aimed at testing the relationship between mindfulness trait, basic psychological needs satisfaction, and psychological distress among psychotherapist trainees through a longitudinal mediation design. Data was collected among 27 trainees at the beginning and mid-point of the academic year. Results indicated that needs satisfaction partially mediated the relationship between trait mindfulness and psychological distress. Theoretical and practical implications are discussed.

[pt] A discriminação percebida é um elemento estressor de saúde mental que consiste na capacidade de percepção dos sujeitos acerca das interações e experiências discriminatórias vividas no cotidiano. O objetivo desta dissertação foi explorar as associações entre a Discriminação Percebida e Sintomas de Saúde Mental. Para tanto, um trabalho dividido em três partes foi concebido. Uma revisão de literatura, sequência, uma revisão narrativa sobre discriminação percebida e transtorno mentais, sintomas psicopatológicos e por fim, avaliação das propriedades psicométricas da Escala de Discriminação Cotidiana e um estudo empírico que avaliou de forma online a presença de sintomas psicopatológicos e testou associações com a discriminação percebida. Trata-se de uma Pesquisa, com delineamento transversal e análise quantitativa, considerou as respostas de 547 brasileiros natos, adultos com idade entre 18 e 72 anos. Os participantes responderam quatro questionários autoaplicáveis, questionários, são eles, o sociodemográfico, a Escala de Discriminação Cotidiana, a Escala de Sofrimento Psicológico e a Escala Transversal de Sintomas Nível 1 do Manual Diagnóstico e Estatístico de Transtornos Mentais, quinta versão. Quanto aos resultados a validade baseada na estrutura interna foi realizada por meio da Análise Fatorial Exploratória que detectou que todos os itens funcionaram normalmente. A escala de demonstrou unidimensional por avaliar apenas um constructo, além de apresentar validade convergente com medidas externas através da Escala K10, que tem por finalidade avaliar relatos de sofrimento psicológico recente. A hipótese de que estigma e a discriminação possam interferir em movimentos de busca por ajuda psicológica foi confirmada neste estudo. Nosso estudo sustenta que a Escala de Discriminação Cotidiana possui propriedades confiáveis para ser utilizada no ambiente virtual, ampliando a viabilidade de estudos na temática. Logo, observamos que a EDS se associa positivamente com sintomas psicopatológicos e com o sofrimento psicológico recente. / [en] Perceived discrimination is a mental health stressor that involves individuals ability toperceive interactions and discriminatory experiences in their daily lives. The aim of this dissertation was to explore the associations between Perceived Discrimination and Psychopathological Symptoms. For this purpose, a three-part study was designed. It includeda literature review, a narrative review on perceived discrimination and disorders, symptoms, and other signs of psychological morbidity, and finally, an assessment of the psychometric properties of the Everyday Discrimination Scale along with an empirical study that evaluatedthe presence of psychopathological symptoms online and tested associations with perceived discrimination. A cross-sectional research design with quantitative analysis was employed, considering responses from 547 native Brazilian adults aged 18 to 72 years old. Participants completed four self-administered questionnaires: sociodemographic, Everyday Discrimination Scale, Psychological Distress Scale, and the Level 1 Cross-Cutting Symptom Scale from the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders. Regarding the results, validity based on internal structure was conducted using Exploratory Factor Analysis,which found that all items functioned appropriately. The scale demonstrated unidimensionalityby assessing a single construct and showed convergent validity with external measures throughthe K10 Scale, designed to assess recent psychological distress reports. The hypothesis that stigma and discrimination might impact seeking psychological help was confirmed by this study. Our research supports that the Everyday Discrimination Scale possesses reliable properties for online use, enhancing the feasibility of studies in this area. Thus, we observed apositive association between the Everyday Discrimination Scale and psychopathologicalsymptoms as well as recent psychological distress.

Contexte. La pandémie du coronavirus COVID-19 a déclenché une crise sanitaire majeure depuis le début de l’année 2020. Les connaissances limitées et la rapidité de propagation du virus ont engendré une réaction précipitée de la santé publique du Québec créant des conditions éprouvantes pour les travailleurs de la santé et des services sociaux. Avant même l’arrivée de cette nouvelle réalité, les chiffres démontraient une problématique majeure quant à la prévalence et aux impacts engendrés par les problèmes psychologiques chez les travailleurs québécois. Les études ayant suivi les précédentes pandémies ont permis d’identifier plusieurs facteurs de risque engendrés par de telles crises chez les travailleurs de la santé et des services sociaux. Parmi les facteurs de risques importants au travail, on retrouve l’augmentation du stress vécu face à de nouvelles tâches, la perte de repères et l’absence de soutien, éléments qui sont généralement liés à une réaffectation des postes. Il est encore à ce jour difficile de bien comprendre l’ensemble des processus et l’interinfluence des facteurs qui affectent la santé psychologique des travailleurs en temps de crise. L’évolution de ces facteurs dans le temps n’est pas documentée. Objectif. Le présent projet évalue l’impact de la réaffectation des postes sur le développement de la détresse psychologique des travailleurs de la santé et des services sociaux du Québec ainsi que l’évolution hebdomadaire de ces aspects au cours de la pandémie COVID-19. Méthode. L’étude porte sur 169 travailleurs du réseau de la santé et des services sociaux du Québec provenant de 3 institutions différentes et occupant une variété de postes. Le projet suit un devis quantitatif longitudinal suivant un plan à série temporelle. Les données ont été collectées par une application mobile d’autosurveillance. Des analyses par modèles linéaires mixtes, puis des analyses de modération ont été effectuées. Résultats. La relation entre la réaffectation des postes et la détresse psychologique ne s’avère pas significative. L’exposition à la maladie et aux décès ne s’illustre pas comme modérant cette relation. La dépression est cependant associée au niveau de stress au travail ainsi qu’à la qualité de vie personnelle et professionnelle. L’anxiété est également associée à ces facteurs. Conclusion. Certaines hypothèses peuvent expliquer l’absence de relation entre la réaffectation des postes et la détresse : professionnels habitués au stress, omniprésence de la maladie au quotidien, niveau de stress constamment élevé. Le manque d’information sur la nature de la réaffectation ainsi que sur le niveau de base limite l’interprétation des résultats. Il est cependant possible que la réaffectation n'engendre aucun impact significatif sur la détresse vécue. Les travailleurs de la santé du réseau québécois ont possiblement fait preuve d’une grande adaptation, atténuant ainsi l’impact attendu de la réaffectation. / Background. The COVID-19 coronavirus pandemic has triggered a major health crisis since the beginning of 2020. health and social services. Even before the arrival of this new reality, the figures showed a major problem about the prevalence and impacts caused by psychological problems among Quebec workers. Studies following previous pandemics have identified several risk factors for such crises in health and social services workers. Among the major risk factors at work are the increase in stress experienced in the face of new tasks, the loss of bearings and the absence of support, elements which are generally linked to a reassignment of positions. It is still difficult to fully understand all the processes and the inter-influence of the factors that affect the psychological health of workers in times of crisis. The evolution of these factors over time is not documented. Objectives. This project considers the impact of job reassignment on the development of psychological distress among health and social services workers in Quebec as well as the weekly evolution of these aspects during the COVID-19 pandemic. Methods. The study focuses on 169 workers in the Quebec health and social services network from 3 different institutions and occupying a variety of positions. The project follows a longitudinal bill of quantities following a time series plan. The data was collected by a mobile self-monitoring application. Analyzes by mixed linear models, then moderation analyzes were carried out. Results. The relationship between job reassignment and psychological distress is not found to be significant. Exposure to illness and death does not appear to moderate this relationship. Depression is, however, associated with the level of stress at work as well as with the quality of personal and professional life. Anxiety is also associated with these factors. Conclusion. Some hypotheses may explain the lack of relationship between job reassignment and distress: professionals accustomed to stress, omnipresence of the disease in daily life, constantly high stress level. The lack of information on the nature of the reassignment as well as on the base level limits the interpretation of the results. It is however possible that the reassignment does not generate any significant impact on the distress experienced. Healthcare workers in the Quebec network may have shown great adaptation, thus mitigating the expected impact of the reassignment.

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