Les différences de genre quant à l’exposition et l’impact d’événements de vie stressants contribuent à expliquer la prévalence différentielle de difficultés d’adaptation comme la dépression ou les problèmes extériorisés. Cette recherche vise à déterminer si de tels processus différentiels s’appliquent également à une autre dimension clé de l’inadaptation des adolescents, soit le décrochage scolaire. Pour ce faire, les événements de vie stressants ont été évalués auprès d’un échantillon d’adolescents âgés de 14 à 18 ans (N= 545, 52 % de garçons), recruté suivant un devis à cas témoins appariés et divisé en trois catégories : 1) des élèves ayant récemment abandonné leurs études; 2) des élèves appariés résilients et 3) des élèves normatifs. Lorsque tous les types d’événements stressants étaient considérés simultanément, l’exposition globale, de même que le lien entre cette exposition et le décrochage scolaire, était similaire pour les adolescents et adolescentes. Toutefois, des différences entre les genres ont émergé pour certains types spécifiques d’événements, les garçons étant particulièrement exposés aux événements en lien avec la performance (échec scolaire, suspension) et les conflits avec des figures d’autorité (enseignants, police), alors que les filles étaient particulièrement exposées à ceux impliquant des problèmes relationnels avec des membres de la famille, des pairs ou des partenaires amoureux. Une association spécifique aux garçons a également été observée entre les événements de vie stressants liés à la performance et aux conflits avec les figures d’autorité. Les implications théoriques et pratiques de ces résultats sont abordées en discussion. / Gender differences in exposure and reactivity to stressful life events contribute to explain adolescent girls’ and boys’ differential sensitivity regarding adjustment difficulties like depression or behavioral problems. However, few studies focus on stressful life events in relation to school dropout and even fewer studies analyze this link considering gender differences in adolescence. This research aims to fill this gap. For this purpose, individual interviews were conducted to assess stressful life events in a sample of academically vulnerable adolescents between the age of 14 and 18 years old (N= 545, 52% boys). This sample included three different groups of participants: 1) students who had recently dropped out of high school, 2) matched students at risk, that were persevering in school and 3) normative students. Global exposure was the same for boys and girls, when all the types of stressful life events were considered as a whole. However, gender differences emerged for specific stressful life events, with boys being more exposed to stressful life events related to performance (e.g., school failure, suspension) and conflicts with authority figures (e.g., teachers, police officers), and girls with stressful life events involving relational conflicts with family, peers and romantic partners. Moreover, stressful life events related to performance and conflicts with authority figures were significantly associated with dropout only for boys. It thus appears important to take into account those gender differences in order to better understand the unfolding of school difficulties that can lead to serious mental health and well-being issues later in their life.

Le stress prénatal maternel (SPM) est un concept largement étudié et ce, autant par de méthodes objectives que subjectives. Certains chercheurs évaluent les symptômes d’anxiété et de dépression des femmes au cours de leur grossesse alors que d’autres préfèrent mesurer les niveaux de cortisol des femmes enceintes. Pour cette thèse, le SPM a été mesuré par deux méthodes différentes, soit l’exposition des femmes enceintes à une catastrophe naturelle et l’exposition des mêmes femmes enceintes à des événements de vie stressants plus courants. Puisqu’il est bien établi que ce type de stress engendre des répercussions négatives sur la femme enceinte ainsi que sur le développement de l’enfant, il est désormais d’intérêt d’accentuer les recherches sur les moyens qui permettent d’atténuer les conséquences d’un tel stress. Dans les études auprès des animaux, nous savons que les conditions de maternage ainsi que l'enrichissement environnemental semblent renverser les effets du SPM, mais nous ne savons pas si, chez les humains, un bon encadrement parental, c’est-à-dire un cadre structuré avec des règles prévisibles et consistantes, peut protéger les enfants des effets du SPM. L’objectif de cette thèse est donc d’augmenter notre compréhension sur l’effet protecteur de l’encadrement parental dans le développement d’enfants qui ont été exposés à différents types de SPM. Cet objectif pourra être atteint grâce à une collaboration internationale initiée par la Dre Suzanne King suite aux inondations qui se sont produites en 2008 dans l'état d'Iowa. Suite à la catastrophe, la Dre King est entrée en contact avec le Dr O’Hara afin d'évaluer la sévérité du stress dû aux inondations chez les femmes enceintes et pour déterminer les effets de ce stress sur leur enfant. Trois types de stress ont été évalués: le degré objectif de difficulté (p. ex., pertes financières), l'évaluation cognitive de la catastrophe en tant qu'expérience négative, neutre ou positive, et la détresse subjective causée par l'inondation (p. ex., symptômes de TSPT). Suite au recrutement des mères, les enfants de l'échantillon ont été évalués à l’âge de 2, 4, 5 et 7 ans. La présente thèse est composée de trois études. La première étude porte sur l’effet modérateur de l’encadrement parental sur les associations entre le SPM causé par les inondations d’Iowa et les problèmes comportementaux chez les enfants âgés de sept ans. Les résultats indiquent qu’un encadrement parental où la discipline est consistante protège les garçons qui ont été exposés au SPM objectif contre différents symptômes de problèmes internalisés et externalisés. La deuxième étude se penche également sur la question de l’effet protecteur de l’encadrement parental sur les associations entre le SPM et les problèmes comportementaux chez les enfants âgés de sept ans. Toutefois, cette étude s’est plutôt penchée sur l’influence du SPM lorsque celui-ci est causé par des événements de vie qui sont plus communs qu’un désastre naturel. De nouveau, les résultats de cette étude nous révèlent qu’un encadrement parental consistant joue le rôle de facteur de protection, chez les garçons qui ont été exposés au SPM causé par des événements de vie stressants, mais seulement en ce qui concerne les problèmes de comportement externalisés. La troisième étude vient reconsidérer l’effet protecteur de l’encadrement parental sur les liens entre le SPM et les problèmes comportementaux des enfants qui ont été exposés à un désastre naturel. Cependant, pour cette étude, les comportements des enfants n’ont pas été évalués par un questionnaire, mais plutôt par une méthode observationnelle (tâche de frustration). Toutefois, dans cette étude, il n’est ressorti aucun effet significatif de l’encadrement parental comme variable modératrice. En somme, nos résultats rapportent que l’implantation d’un cadre structuré et consistant peut venir pallier et même renverser les conséquences du SPM sur le comportement des garçons. / Prenatal maternal stress (PNMS) is a widely studied concept, both by objective and subjective methods. Some researchers assess women's symptoms of anxiety and depression during pregnancy, while others prefer to measure cortisol levels in pregnant women. For this thesis, PNMS was measured by two different methods: either exposure of pregnant women to a natural disaster, or exposure of these same pregnant women to more common stressful life events. Since it is well established that this type of stress has a negative impact on the pregnant woman as well as on the development of the unborn child, it is now of interest to increase research on ways to mitigate the consequences of such stress. In animal studies, we know that rearing conditions and environmental enrichment seem to reverse the effects of PNMS, but we do not know whether, in humans, good parental structure, that is, a structured framework with predictable and consistent rules, can protect children from the effects of PNMS. The aim of this thesis is, therefore, to increase understanding of the protective effect of parental structure in the development of children who have been exposed to different types of PNMS. This goal can be achieved through an international collaboration initiated by Dr. Suzanne King following the 2008 floods in the state of Iowa. Following the disaster, Dr. King contacted Dr. O'Hara to assess the severity of flood stress in pregnant women and to determine the effects of this stress on their children. Following the recruitment of mothers, the children in the sample were assessed at the ages of 2, 4, 5 and 7 years. This thesis consists of three studies. The first study examines the moderating effect of parental structure on the associations between PNMS caused by a natural disaster and behavioural problems in the Iowa Flood Study children at age 7 years as reported by their mothers. The results indicate that consistent parenting protects boys who have been exposed to PNMS from various symptoms of internalizing and externalizing problems. The second study also examines the issue of the protective effect of parental structure on associations between PNMS and behavioural problems, as reported by their mothers, in the Iowa Flood Study seven-year-olds. However, this study looked at the influence of PNMS when it is caused by life events that are more common than a natural disaster while controlling for the severity of their flood exposure. Again, the results of this study reveal that consistent parenting plays the role of a protective factor in boys who have been exposed to PNMS caused by stressful life events, but only with regard to externalizing behaviour. The third study reconsiders the protective effect of parental structure on the links between PNMS and behavioral problems of children who have been exposed to a natural disaster. However, for this study, children's behaviors were not assessed by a questionnaire, but rather by an observational method (task of frustration). However, the limitations of this study did not allow us to observe the effects of parental structure. In summary, our results show that the implementation of a structured and consistent framework can overcome, and even reverse, the consequences of PNMS on boys' behaviour.

Indiana University-Purdue University Indianapolis (IUPUI) / Prospective epidemiologic evidence indicates that both stressful life events (SLEs) and depression are associated with an increased risk of subclinical atherosclerosis and cardiovascular disease (CVD) events. Even though stressful life events (SLEs) and depression co-occur and may act together to influence cardiovascular disease (CVD) risk, these psychosocial factors have been mainly examined in isolation. For instance, depression may moderate the relationship between SLEs and CVD outcomes. I hypothesized that depressive symptoms would potentiate the deleterious effect of SLEs on subclinical atherosclerosis. This hypothesis is plausible, given that depressed adults exhibit exaggerated and prolonged sympathetic nervous system, hypothalamic-pituitary-adrenal (HPA) axis, and inflammatory responses to stress, which in turn could promote atherosclerosis. As compared to their nondepressed counterparts, depressed individuals may also be more likely to engage in maladaptive methods to cope with SLEs (e.g., increased tobacco use, alcohol use, and consumption of low-nutrient, energy dense foods), which could also promote atherosclerosis. I examined cross-sectional data from 274 to 279 (depending on the outcome measure) older, African American adults (mean age = 66 years, 67% female) with no evidence of clinical CVD or dementia who participated in the St. Louis African American Health-Heart study (2009–2011). Number of SLEs was assessed using the Life Events Calendar, a structured interview. From this interview, a continuous SLEs variable was computed (number of adult SLEs: 0, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11+). Severity of depression symptoms was measured using the 17-item Hamilton Rating Scale for Depression (HAM-D). Two measures of subclinical atherosclerosis were obtained: carotid intima-media thickness (CIMT; assessed by ultrasonography) and coronary artery calcification (CAC; assessed by multi-detector computerized tomography). I conducted linear (CIMT) and logistic (CAC) regression models, first adjusted for demographics (age, sex, education) and then fully-adjusted (demographics; mean arterial pressure; low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C); hemoglobin A1c; BMI; tobacco use; diabetes diagnosis; and use of antihypertensitve, lipid lowering, antidiabetic, and antidepressant medications). No main effects of SLEs or HAM-D were found for CIMT or CAC. There were also no SLEs by HAM-D interactions for CIMT or CAC. Because the current results are largely inconsistent with prior literature and there is a paucity of studies utilizing African American samples, future research is needed to examine the independent and interactive associations of SLEs and depressive symptoms with measures of subclinical atherosclerosis. If the present results are replicated, it may suggest that SLEs, depressive symptoms, and their interactive effect are not cardiotoxic among African American adults.

No description available.

Text in Afrikaans / In this study an instrument is suggested for implementation by the Educational Psychologist to design a support programme, aimed at handling family members' stress where a child has sustained a brain injury. Attention was paid to the phenomenon "brain injured child" to ascertain demands and needs (physical, cognitive, psychological and emotional). Specific note was taken of the toll on each family member in their observance, experience, assistance and giving· meaning to the child. Reference was made to existing support programmes for such family members from the acute care phase to the final acceptance and readjustment of the family. With this study the need for a continuous support programme and the contents of such a programme was addressed. Using these guidelines the Educational Psychologist will be able to prepare the family for the stress possibilities in dealing with the brain injured child. / Met hierdie studie is 'n instrument daargestel vir die ontwerp van 'n hulpverleningsprogram vir gebruik deur die Opvoedkundige Sielkundige. Hierdie hulpprogram het as doel, die hantering van stres, deur die gesin van 'n kind, wat 'n breinbesering opgedoen het. In die studie is aandag gegee aan die tipiese gedrag wat oor die algemeen van 'n breinbeseerde kind verwag kan word. Daar is ook gepoog om te bepaal hoe elke lid van die gesin die breinbeseerde kind beleef, aan hom betekenis gee, en hom probeer help ten opsigte van die eise (fisiek en emosioneel) wat hy stel. Verder is daar gekyk na bestaande hulpverlening (gerig op die hantering van stres) aan die gesinslede van 'n breinbeseerde kind vanaf die akute versorgingsfase tot en met die aanpassing en herorganisering van die gesin. Met hierdie studie is 'n behoefte aan 'n kontinue hulpverleningsprogram en die inhoud van so 'n program by gesinslede aangespreek. Aan die hand van die riglyne sal die Opvoedkundige Sielkundige 'n gesin kan voorberei op die stres wat hulle ten opsigte van die hantering van 'n breinbeseerde kind te wagte kan wees. / Psychology of Education / M. Ed. (Voorligting)

Text in Afrikaans / In this study an instrument is suggested for implementation by the Educational Psychologist to design a support programme, aimed at handling family members' stress where a child has sustained a brain injury. Attention was paid to the phenomenon "brain injured child" to ascertain demands and needs (physical, cognitive, psychological and emotional). Specific note was taken of the toll on each family member in their observance, experience, assistance and giving· meaning to the child. Reference was made to existing support programmes for such family members from the acute care phase to the final acceptance and readjustment of the family. With this study the need for a continuous support programme and the contents of such a programme was addressed. Using these guidelines the Educational Psychologist will be able to prepare the family for the stress possibilities in dealing with the brain injured child. / Met hierdie studie is 'n instrument daargestel vir die ontwerp van 'n hulpverleningsprogram vir gebruik deur die Opvoedkundige Sielkundige. Hierdie hulpprogram het as doel, die hantering van stres, deur die gesin van 'n kind, wat 'n breinbesering opgedoen het. In die studie is aandag gegee aan die tipiese gedrag wat oor die algemeen van 'n breinbeseerde kind verwag kan word. Daar is ook gepoog om te bepaal hoe elke lid van die gesin die breinbeseerde kind beleef, aan hom betekenis gee, en hom probeer help ten opsigte van die eise (fisiek en emosioneel) wat hy stel. Verder is daar gekyk na bestaande hulpverlening (gerig op die hantering van stres) aan die gesinslede van 'n breinbeseerde kind vanaf die akute versorgingsfase tot en met die aanpassing en herorganisering van die gesin. Met hierdie studie is 'n behoefte aan 'n kontinue hulpverleningsprogram en die inhoud van so 'n program by gesinslede aangespreek. Aan die hand van die riglyne sal die Opvoedkundige Sielkundige 'n gesin kan voorberei op die stres wat hulle ten opsigte van die hantering van 'n breinbeseerde kind te wagte kan wees. / Psychology of Education / M. Ed. (Voorligting)

The purpose of this dissertation was to examine patterns of antenatal stressful life events (SLEs) experienced by women in the United States (U.S.) and their association with postpartum depression (PPD). It further explored the role of women's state-level socio-economic status (SES) on PPD; the racial/ethnic dispartites in SLE-PPD relationship; and the role of provider communication on perinatal depression. Data from 2009–11 Pregnancy Risk Assessment Monitoring System (PRAMS) and SES indicators published by the Institute of Women’s Policy Research (IWPR) were used. Latent class analysis (LCA) was performed to identify unobserved class membership based on antenatal SLEs. Multilevel generalized linear mixed models examined whether state-level SES moderated the antenatal SLE-PPD relationship. Of 116,595 respondents to the PRAMS 2009-11, the sample size for our analyses ranged from 78% to 99%. The majority (64%) of participants were in low-stress class. The illness/death related-stress class (13%) had a high prevalence of severe illness (77%) and death (63%) of a family member or someone very close to them, while those in the multiple-stress (22%) class endorsed most other SLEs. Eleven percent had PPD; women who experienced all types of stressors, had the highest odds (adjusted odds ratio [aOR]: 5.43; 95% confidence interval [CI]: 5.36, 5.51) of PPD. The odds of PPD decreased with increasing state-level social/economic autonomy index (aOR: 0.75; 95% CI: 0.64, 0.88), with significant cross-level interaction between stressors and state-level SES. Among non-Hispanic blacks and non-Hispanic whites, husband/partner not wanting the pregnancy (aOR: 1.47; 95% CI: 1.14, 1.90) and drug/drinking problems of someone close (aOR: 1.37; 95% CI: 1.21, 1.55) were respectively associated with PPD. Provider communication was protective. That 1 out of every 5 and 1 out of every 8 women were in the high- and emotional-stress classes suggests that SLEs are common among pregnant women. Our results suggest that screening for antenatal SLEs might help identify women at risk for PPD. The finding that the odds of PPD decrease with increasing social/economic autonomy, could have policy implications and motivate efforts to improve these indices. This study also indicates the benefits of antenatal health care provider communication on perinatal depression.