Arnaud Carré

Validation of a short French version of the UPPS-P Impulsive Behavior Scale

BACKGROUND Impulsivity is a multifaceted construct that has a prominent role in psychiatry. Lynam et al (2006) have developed the UPPS-P, a 59-item scale measuring 5 impulsivity components: negative urgency, positive urgency, lack of premeditation, lack of perseverance, and sensation seeking. The aim of the present study was to validate a short, 20-item French version of the UPPS-P. METHODS Six hundred fifty participants filled out the short French UPPS-P. A subgroup of participants (n = 145) took part in a follow-up study and completed the scale twice to determine test-retest stability; another subgroup (n = 105) was screened with other questionnaires also to establish external validity. RESULTS Confirmatory factor analyses supported a hierarchical model comprising 2 higher order factors of urgency (resulting from negative urgency and positive urgency) and lack of conscientiousness (resulting from lack of premeditation and lack of perseverance) as well as a separate factor of sensation seeking. The results indicated good internal consistency and test-retest stability. External validity was supported by relationships with psychopathological symptoms. CONCLUSION The short French version of the UPPS-P therefore presents good psychometric properties and may be considered a promising instrument for both research and clinical practice.

The Basic Empathy Scale in adults (BES-A): factor structure of a revised form.

Initially thought of as a unitary ability, empathy has been more recently considered to consist of 2 components (i.e., an affective and a cognitive component). The Basic Empathy Scale (BES) is a tool that has been used to assess empathy in young people and adolescents on the basis of this dual-component conception (Jolliffe & Farrington, 2006). Recent studies of empathy have led to it being defined as underpinned by 3 components, namely, emotional contagion, emotional disconnection, and cognitive empathy. The aims of this study were (a) to validate the BES in Adults and (b) to compare the different conceptions of empathy. Three hundred seventy French adults took part in the study, and 160 of them filled out complementary scales measuring empathy, alexithymia, and emotional consciousness. The confirmatory factor analyses showed that the 3-factor model was the model that was best able to account for the data. Complementary tools confirmed the relationships previously observed between empathy as assessed with the BES and other scales assessing emotional processes. The results of this study make it clear that empathy can be seen as process-dependent. This conception of empathy, which is based on 3 factors, is consistent with the current, more integrated view of empathy. The implications of this conception and the opportunity to use the 2 or 3 factors of the BES in adults are presented in the discussion.

What is the emotional core of the multidimensional Machiavellian personality trait

Machiavellianism is a personality trait characterized by interpersonal manipulation and associated with specific patterns of emotional and social cognition skills. The aim of this study was to investigate its socio-cognitive characteristics by determining its association and predictors on the basis of a multidimensional approach to Machiavellianism. We used Mach IV scale to assess “Machiavellian Intelligence” skill of participants (Christie and Geis, 1970). It includes three subscales that are (1) the use of deceit in interpersonal relationships, (2) a cynical view of human nature and (3) the lack of morality. Associations were found between Machiavellianism and low levels of empathy and affective ToM, and high levels of alexithymia, anhedonia, depression, and anxiety. These associations were observed in varying proportions depending on the three subscales of Machiavellianism. The addition of anhedonia and trait-anxiety to the concepts of empathy and alexithymia made it possible to gain a better understanding of the emotional core of Machiavellianism. These findings are discussed in the light of developmental and adaptive perspectives.

Linear association between social anxiety symptoms and neural activations to angry faces: from subclinical to clinical levels

Social anxiety disorder (SAD), which is characterized by the fear of being rejected and negatively evaluated, involves altered brain activation during the processing of negative emotions in a social context. Although associated temperament traits, such as shyness or behavioral inhibition, have been studied, there is still insufficient knowledge to support the dimensional approach, which assumes a continuum from subclinical to clinical levels of social anxiety symptoms. This study used functional magnetic resonance imaging (fMRI) to examine the neural bases of individual differences in social anxiety. Our sample included participants with both healthy/subclinical as well as clinical levels of social anxiety. Forty-six participants with a wide range of social anxiety levels performed a gender decision task with emotional facial expressions during fMRI scanning. Activation in the left anterior insula and right lateral prefrontal cortex in response to angry faces was positively correlated with the level of social anxiety in a regression analysis. The results substantiate, with a dimensional approach, those obtained in previous studies that involved SAD patients or healthy and subclinical participants. It may help to refine further therapeutic strategies based on markers of social anxiety.

Tracking social motivation systems deficits: the affective neuroscience view of autism.

Abnormal functioning of primary brain systems that express and modulate basic emotional drives are increasingly considered to underlie mental disorders including autism spectrum disorders. We hypothesized that ASD are characterized by disruptions in the primary systems involved in the motivation for social bonding. Twenty adults with ASD were compared to 20 neurotypical participants on the basis of self-reports and clinical assessments, including the Social Anhedonia Scale (SAS) and the Affective Neuroscience Personality Scales (ANPS). ASD diagnosis was related to SAS, as well as to positive (PLAYFULNESS) and negative (FEAR) ANPS-traits. In the overall sample, levels of autistic traits (AQ) were related to SAS and PLAYFULNESS. We argue that PLAYFULNESS could be at the root of social bonding impairments in ASD.

Risk factors for substances use and misuse among young people in France: what can we learn from the Substance Use Risk Profile Scale?

BACKGROUND The prevention of addictions in young people is a challenge for Mental and Public Health policies, and requires specific risk-screening tools. Specific personality traits, as assessed using the Substance Use Risk Profile Scale (SURPS), could play a key role in the onset and escalation of substance use. This study aimed to examine (1) measurement invariance across age and gender (2) the effects of age and gender on associations between SURPS scores and the most frequently-consumed substances. METHODS Analyses were based on the responses from 5069 participants (aged 14-20 years) from the 2011 ESPAD-France dataset. Substance-use outcomes were experimentation and current frequency of alcohol, tobacco and cannabis use, and drunkenness. RESULTS Our approach, consisting in analysing measurement and structural invariance and interaction terms, established the stability of (i) SURPS profiles, and (ii) relationships between these scores and substance experimentation and use over a developmental period ranging from mid-adolescence to early adulthood. Measurement invariance across genders was also confirmed despite the absence of scalar invariance for 2 items. Significant interactions between gender and SURPS factors were established, highlighting differential vulnerability, especially concerning Hopelessness and experimentation of alcohol and drunkenness, or Impulsivity and tobacco experimentation. Finally, Anxiety Sensitivity could be protective against substance use, especially for cannabis in girls. CONCLUSIONS Our results suggest the relevance of the SURPS to assess vulnerability towards drug use, and underline the need to consider gender differences in addiction risks.

P02-321 - Difficulties identifying feelings, alexithymic features and brain responses in social phobia trait: an fMRI study

Aims A growing body of research now documents a specific pattern of brain activation during emotional tasks in patients with social phobia. Furthermore, recent studies indicate that non-clinical participants show a similar pattern of responses. Clinical and physiological data from literature highlight that social anxiety is associated with difficulties in emotional managing. However, much less is known about the part of alexithymia in social phobia, as far as clinical and infra-clinical (high shyness) approaches are concerned. Method Four hundred undergraduate university students were screened with an anxiety and social phobia questionnaire. Forty participants, with low and high levels of social phobia, were then included according to a dimensional approach. Each participant underwent a comprehensive psychiatric evaluation that included a structured clinical interview for current and past psychiatric disorders and psychometric scales, including the Liebowitz Social Anxiety Scale (LSAS) and the Toronto Alexithymia Scale (TAS-20). Participants were asked to make gender discrimination choices when viewing faces that showed happiness, fear, anger, sadness, neutral expressions or distractors while in a 3 Tesla fMRI scanner. Results As expected, social phobia trait was correlated with TAS-20 scores, and specifically in “difficulties identifying feelings”. Brain activations showed an evolutionary pattern response in correlation with social phobia and alexithymia concerning limbic regions (amygdala and insula). Social phobia trait seems to be particularly receptive to anger faces. Conclusion Our findings support the hypothesis that alexithymia play a major role in social anxiety disorder. Identifying feelings could explain alexithymic functioning in social phobia, clinically and physiologically.

The real-life effectiveness of psychosocial therapies on social autonomy in schizophrenia patients: Results from a nationwide cohort study in France

The objectives of the present study were to describe the prescribing patterns for psychosocial therapies in routine clinical practice and to assess the impact of psychoeducation on symptoms and social autonomy of patients with schizophrenia. We used data from the nationwide French ESPASS observational cohort study including 5967 patients with schizophrenia, which provided data on exposure to psychosocial therapies from 4961 (83%) participants. Patients who initiated psychosocial therapy within the first 3 months of study onset (n=143) were compared to patients not subject to psychosocial therapy throughout follow up (n=4268), using parametric tests. Symptom severity and social autonomy at 6 months from baseline were compared between patients undergoing psychoeducation (n=117) and patients not subject to psychosocial therapy, matched (1:1) on propensity scores. Patients who initiated psychosocial therapy were significantly younger, more severely ill and used less often antipsychotic drugs than patients in the reference group. At 6 months, patients who initiated psychoeducation and their matched referents did not differ significantly in terms of symptom severity, but their level of improvement in social autonomy was significantly greater (p=0.005). In routine clinical practice, psychoeducation in addition to antipsychotic drugs provides some benefit among schizophrenia patients, particularly in terms of social autonomy.

Dysfunctional Beliefs Related to Alcohol Craving as a Prognostic Factor of Six-months Relapse After Inpatient Alcohol Withdrawal

Introduction According to the cognitive model of addiction by Beck taking substance represents the final common voice of the activation of beliefs through the involvement of craving. Objectives To assess whether beliefs related to craving is a prognostic factor for relapse 6 months after a residential alcohol withdrawal and analyze the evolution of these beliefs. Methods 107 participants were solicited for this non-interventional prospective study in a department of Psychiatry and Addictive Medicine. All patients showed a dependence on alcohol, and were hospitalized for alcohol withdrawal and had to master the French language and be reachable by telephone to help ensure follow-up. The presence of severe cognitive disorders or schizophrenia constitute a basis for non-inclusion. In the end, 68 patients were included. Beliefs related to craving on alcohol were assessed by Craving Beliefs Questionnaire (CBQ), psychiatric and addictive comorbidities by the MINI and consumption of alcohol by the AUDIT. Results Among the 68 patients, 27 were abstinent and 25 had relapsed at 6 months. The CBQ score at baseline was positively correlated with relapse at 6 months (p Conclusions This study supports the role of beliefs related to alcohol craving in the relapse after residential withdrawal. These beliefs could be assessed in routine practice and treated with cognitive therapies.

P01-52 Impulsiveness and neuropsychological performance in first degree relatives of patients with alcohol dependence

Aims It is now well known that unaffected first-degree relatives of patients with alcohol disorder have electrophysiological abnormalities (less P3 amplitude). These abnormalities are associated with higher scores in impulsivity self-rating scales and are assumed to reflect central nervous system disinhibition and/or hyperexcitability. However very much less is known about the performance of this population in neuropsychological tests assessing executive functioning and in particular the inhibition process. Method Thirty-five first-degree relatives of patients with alcohol dependence were compared to thirty-five healthy controls, matched in terms of age, gender and education level. They completed a self-rating scale of impulsiveness (Barratt Impulsiveness Scale) and a battery of neuropsychological tests. The test battery included the Wisconsin Card Sorting Test, a measure of overall executive functioning, and two performance measures of inhibition process (a Stroop task and a Go-No Go task). Results As expected, the Barratt Impulsiveness Scale showed differences between the two groups, with first-degree relatives having higher overall scores and increased scores in the non-planning subscale. Results from neuropsychological testing indicated significant differences among the three tasks (WCST, Stroop task and Go-No Go). Conclusion Our findings are consistent with the view that unaffected first-degree relatives of patients with alcohol dependence show decrements in executive functioning and inhibition process. Studies are underway to identify genes associated with the underlying predisposition involved in disinhibitory disorders in this population.