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"Brunet, Alain"
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Psychometric Validation of the English and French Versions of the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5)
2016
The purpose of this study is to assess the psychometric properties of a French version of the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), a self-report measure of posttraumatic stress disorder (PTSD) symptoms, and to further validate the existing English version of the measure. Undergraduate students (n = 838 English, n = 262 French) completed the PCL-5 as well as other self-report symptom measures of PTSD and depression online. Both the English and French versions PCL-5 total scores demonstrated excellent internal consistency (English: α = .95; French: α = .94), and strong convergent and divergent validity. Strong internal consistency was also observed for each of the four subscales for each version (α's > .79). Test-retest reliability for the French version of the measure was also very good (r = .89). Confirmatory factor analysis indicated that the four-factor DSM-5 model was not a good fit of the data. The seven-factor hybrid model best fit the data in each sample, but was only marginally superior to the six-factor anhedonia model. The French version of the PCL-5 demonstrated the same psychometric qualities as both the English version of the same measure and previous versions of the PCL. Thus clinicians serving French-speaking clients now have access to this highly used screening instrument. With regards to the structural validity of the PCL-5 and of the new PTSD diagnostic structure of the DSM-5, additional research is warranted. Replication of our results in clinical samples is much needed.
Journal Article
The mental health impacts of receiving a breast cancer diagnosis: A meta-analysis
by
Leblanc, Mélissandre
,
Fortin, Justine
,
Marin, Marie-France
in
692/4028/67/1347
,
706/689/477/2811
,
Anxiety
2021
Background
Receiving a breast cancer diagnosis can be a turning point with negative impacts on mental health, treatment and prognosis. This meta-analysis sought to determine the nature and prevalence of clinically significant psychological distress-related symptoms in the wake of a breast cancer diagnosis.
Methods
Ten databases were searched between March and August 2020. Thirty-nine quantitative studies were meta-analysed.
Results
The prevalence of clinically significant symptoms was 39% for non-specific distress (
n
= 13), 34% for anxiety (
n
= 19), 31% for post-traumatic stress (
n
= 7) and 20% for depression (
n
= 25). No studies reporting breast cancer patients’ well-being in our specific time frame were found.
Conclusion
Mental health can be impacted in at least four domains following a diagnosis of breast cancer and such effects are commonplace. This study outlines a clear need for mitigating the impacts on mental health brought about by breast cancer diagnosis. CRD42020203990.
Journal Article
The effects of maternal stress and illness during pregnancy on infant temperament: Project Ice Storm
2016
Background:
To determine whether disaster-related prenatal maternal stress and maternal illness during pregnancy predict maternal-rated temperament status in 6-mo-old infants.
Method:
The temperamental status of 121 infants (60 boys and 61 girls) exposed
in utero
to varying degrees of maternal stress and/or illness during either first (
n
= 40), second (
n
= 43), or third (
n
= 38) trimester of pregnancy was assessed using the Infant Characteristics Questionnaire.
Results:
Higher levels of maternal subjective distress and illness were primarily independently associated with poorer temperamental status in the infants. Maternal subjective distress explained 3.4, 3.1, and 9.8% and early pregnancy illness explained 4.3, 5.8, and 2.9% of the variance of the infants’ fussy/difficult, dullness, and needs attention temperament dimensions, respectively.
Conclusion:
This is the first study to assess whether temperament status is influenced by disaster-related prenatal maternal stress. Moreover, this is the first study to assess whether maternal stress and illness during pregnancy interact to determine infant temperament status. The findings suggest that while both factors predict temperament status at 6 mo, they do so primarily in an independent manner. These results suggest that pathways through which maternal stress and illness during pregnancy influence temperament status differ.
Journal Article
Impairing memory reconsolidation with propranolol in healthy and clinical samples: a meta-analysis
by
Rotondo, Olivia
,
Lonergan, Michelle
,
Brunet, Alain
in
Adrenergic beta-Antagonists - pharmacology
,
Adult
,
Diagnosis
2022
Reconsolidation impairment using propranolol is a novel intervention for mental disorders with an emotional memory at their core. In this systematic review and meta-analysis, we examined the evidence for this intervention in healthy and clinical adult samples.
We searched 8 databases for randomized, double-blind studies that involved at least 1 propranolol group and 1 placebo group. We conducted a meta-analysis of 14 studies (n = 478) in healthy adults and 12 studies in clinical samples (n = 446).
Compared to placebo, reconsolidation impairment under propranolol resulted in reduced recall of aversive material and cue-elicited conditioned emotional responses in healthy adults, as evidenced by an effect size (Hedges g) of −0.51 (p = 0.002, 2-tailed). Moreover, compared to placebo, reconsolidation impairment under propranolol alleviated psychiatric symptoms and reduced cue-elicited reactivity in clinical samples with posttraumatic stress disorder, addiction or phobia (g = −0.42, p = 0.010).
Methodological differences between studies posed an obstacle for identifying sources of heterogeneity.
Reconsolidation impairment is a robust, well-replicated phenomenon in humans. Its clinical use is promising and deserves further controlled investigation.
Journal Article
PTSD is not the emblematic disorder of the COVID-19 pandemic; adjustment disorder is
by
Superka, Julia
,
Meng, Xiangfei
,
Rivest-Beauregard, Marjolaine
in
Adjustment disorder
,
Adjustment disorders
,
Adjustment Disorders - diagnosis
2022
Background
Posttraumatic stress disorder (PTSD) has been hailed by some as the emblematic mental disorder of the COVID-19 pandemic, assuming that PTSD’s life-threat criterion was met de facto. More plausible outcomes like adjustment disorder (AD) have been overlooked.
Methods
An online cross-sectional survey was launched in the initial stage of the pandemic using a convenience sample of 5 913 adults to compare the prevalence of COVID-related probable PTSD versus probable AD. The abridged Impact of Event Scale – Revised (IES-6) assessed the severity of trauma- and stressor-related symptoms over the previous week. Demographic and pandemic-related data (e.g., receiving a formal diagnosis of COVID-19, job loss, loss of loved one, confinement, material hardship) were collected. A Classification and Regression Tree analysis was conducted to uncover the pandemic experiences leading to clinical ‘caseness’. Caseness was defined by a score > 9 on the IES-6 symptom measure and further characterized as PTSD or AD depending on whether the Peritraumatic Distress Inventory’s life-threat item was endorsed or not.
Results
The participants were predominantly Caucasian (72.8%), women (79.2%), with a university degree (85%), and a mean age of 42.22 (
SD
= 15.24) years; 3 647 participants (61.7%; 95%CI [60.4, 63.0]) met the threshold for caseness. However, when perceived life-threat was accounted for, only 6.7% (95%CI [6.1, 7.4]) were classified as PTSD cases, and 55% (95%CI [53.7, 56.2]) as AD cases. Among the AD cases, three distinct profiles emerged marked by the following: (i) a worst personal pandemic experience eliciting intense fear, helplessness or horror (in the absence, however, of any life-threat), (ii) a pandemic experience eliciting sadness/grief, and (iii) worrying intensely about the safety of significant others.
Conclusions
Studies considering the life-threat criterion as met de facto during the pandemic are confusing PTSD for AD on most counts. This misconception is obscuring the various AD-related idioms of distress that have emerged during the pandemic and the actual treatment needs.
Journal Article
Peritraumatic Distress and the Course of Posttraumatic Stress Disorder Symptoms: A Meta-Analysis
by
Thomas, Émilie
,
Brunet, Alain
,
Saumier, Daniel
in
Adult and adolescent clinical studies
,
Anxiety disorders. Neuroses
,
Biological and medical sciences
2012
Objective:
To examine how peritraumatic distress modulates the severity of posttraumatic stress disorder (PTSD) according to the timing of the PTSD symptom assessments.
Method:
A systematic literature review of English- and French-language studies having administered the Peritraumatic Distress Inventory (PDI) was conducted. Meta-analyses were performed on correlations relating PDI and PTSD symptom scores obtained from the sampled studies. The meta-analyses, which included calculations of regression slopes, took into consideration the time at which PTSD symptoms were assessed following the traumatic event and the timing of the PDI assessment.
Results:
The literature review yielded a total of 22 studies. The meta-analysis performed over all studies resulted in a pooled correlation coefficient of 0.55 between the PDI and PTSD symptom scores. Meta-regression analyses conducted over all data revealed no apparent decrease in the correlations according to the timing of the PTSD symptom assessments. However, there were numerical or statistically significant declines in regression slopes when the meta-regressions were separately conducted on studies having administered the PDI either within, or following, a 1-month period after a traumatic event.
Conclusions:
While PDI or PTSD symptom score correlations remain generally significant, they tend to decline as time elapses between the traumatic event and the PTSD assessment. This suggests there may be factors other than peritraumatic distress that increasingly account for the long-term trajectory PTSD symptoms.
Journal Article
Propranolol’s effects on the consolidation and reconsolidation of long-term emotional memory in healthy participants: a meta-analysis
by
Olivera-Figueroa, Lening A.
,
Brunet, Alain
,
Lonergan, Michelle H.
in
Adult
,
Analysis
,
Biological and medical sciences
2013
Considering the pivotal role of negative emotional experiences in the development and persistence of mental disorders, interfering with the consolidation/reconsolidation of such experiences would open the door to a novel treatment approach in psychiatry. We conducted a meta-analysis on the experimental evidence regarding the capacity of the β-blocker propranolol to block the consolidation/reconsolidation of emotional memories in healthy adults.
Selected studies consisted of randomized, double-blind experiments assessing long-term memory for emotional material in healthy adults and involved at least 1 propranolol and 1 placebo condition. We searched PsycInfo, PubMed, Web of Science, Cochrane Central, PILOTS, Google Scholar and clinicaltrials.org for eligible studies from the period 1995–2012. Ten consolidation (n = 259) and 8 reconsolidation (n = 308) experiments met the inclusion criteria. We calculated effect sizes (Hedges g) using a random effects model.
Compared with placebo, propranolol given before memory consolidation reduced subsequent recall for negatively valenced stories, pictures and word lists (Hedges g = 0.44, 95% confidence interval [CI] 0.14–0.74). Propranolol before reconsolidation also reduced subsequent recall for negatively valenced emotional words and the expression of cue-elicited fear responses (Hedges g = 0.56, 95% CI 0.13–1.00).
Limitations include the moderate number of studies examining the influence of propranolol on emotional memory consolidation and reconsolidation in healthy adults and the fact that most samples consisted entirely of young adults, which may limit the ecological validity of results.
Propranolol shows promise in reducing subsequent memory for new or recalled emotional material in healthy adults. However, future studies will need to investigate whether more powerful idiosyncratic emotional memories can also be weakened and whether this weakening can bring about long-lasting symptomatic relief in clinical populations, such as patients with posttraumatic stress or other event-related disorders.
Journal Article
Trauma exposure and PTSD prevalence among Yazidi, Christian and Muslim asylum seekers and refugees displaced to Iraqi Kurdistan
by
Zarzour, Myriam
,
Dwaf, Azzam
,
Herdane, Marie
in
Catholic churches
,
Christian Islamic relations
,
Christianity
2020
There is unreliable, and negligible information on the mental health and trauma-exposure of asylum-seekers and displaced refugees in the Iraqi Kurdistan region. To evaluate how responsible the ethno-religious origins are, for the prevalence of trauma exposure and post-traumatic stress disorder (PTSD) in displaced Iraqi asylum-seekers and refugees residing in the Iraqi Kurdistan region. Structured interviews with a cross-sectional sample of 150 individuals, comprised of three self-identified ethno-religious groups (50 participants in each): Christians, Muslims, and Yazidis. 100% prevalence of trauma exposure and 48.7% of current PTSD among refugees, 70% PTSD rate of Yazidi participants, which is significantly higher (p < 0.01) compared to 44% of Muslim participants and 32% of Christian participants. These findings were corroborated using the self-rated PTSD, DSM-5 Checklist, with more severe PTSD symptom scores (p < 0.001) obtained among Yazidis (43.1; 19.7), compared to Muslims (31.3; 20.1) and Christians (29.3; 17.8). Self-rated depressive symptoms (Patient Health Questionnaire-9) were also higher (p < 0.007) among Yazidis (12.3; 8.2) and Muslims (11.7; 5.9), compared to Christians (8.1; 7).
Journal Article
Reconsolidation Blockade with Propranolol as a Novel Treatment for Chronic Low-Back Pain: A Double-Blind Randomized Placebo-Controlled Feasibility Study
by
Coulombe-Leveque, Alexia
,
Lafrenaye, Sylvie
,
Marchand, Serge
in
amygdala
,
Backache
,
Chronic pain
2026
Nociplastic pain is often characterized by maladaptive plasticity in the nervous system similar to that observed in patients with post-traumatic stress disorder (PTSD). The aim of this study was to investigate whether reconsolidation therapy, a treatment for PTSD consisting in reactivating (through trauma narrative) the synapses encoding the excessive threat response and blocking their reconsolidation using propranolol, is feasible in patients with nociplastic low-back pain.
Design: triple-blind, placebo-controlled feasibility study. Population: 24 adults with chronic (>6 months) nociplastic low-back pain with no comorbid PTSD or contra-indication to propranolol. Intervention: Pain education (10 short videos) and 6 weekly sessions of reconsolidation therapy with propranolol (n=12) or placebo (n=12) administered orally 1h pre-reactivation. Outcome measures: Feasibility: recruitment rates, adverse events (frequency/severity). Effect of intervention: Brief Pain Inventory (BPI) and other self-reported pain questionnaires, 4 weeks post-intervention.
Sixty-six patients were screened over 6 months; 24 participants were enrolled; 2 dropped out. Adverse events were mild and infrequent (asymptomatic decrease in heart rate (n=4), headache and nausea (n=1)). No clinically meaningful difference was observed between the two groups on the pain questionnaires at the 4-week follow-up. Prevalent catastrophic/kinesiophobic discourse was noted during the sessions, and the reactivation methods appeared to have been suboptimal for the population.
Reconsolidation therapy is a feasible intervention for chronic pain. Preliminary results suggest no effect on pain symptoms. Additional studies are warranted to assess the adequacy of reactivation procedures (proper reactivation being required to trigger reconsolidation), and to investigate whether the absence of negative pain beliefs might be a prerequisite (unmet in this study) for the success of the intervention.
Journal Article