Françoise Jermann

Depression relapse prophylaxis with Mindfulness-Based Cognitive Therapy: replication and extension in the Swiss health care system.

Background Mindfulness-Based Cognitive Therapy (MBCT) is a group intervention that integrates elements of Cognitive Behavioural Therapy (CBT) with components of mindfulness training to prevent depressive relapse. The efficacy of MBCT compared to Treatment As Usual (TAU), shown in two randomized controlled trials indicates a significant decrease in 1-year relapse rates for patients with at least three past depressive episodes. The present study is the first independent replication trial comparing MBCT + TAU to TAU alone across both language and culture (Swiss health care system). Methods Sixty unmedicated patients in remission from recurrent depression (≥ 3 episodes) were randomly assigned to MBCT + TAU or TAU. Relapse rate and time to relapse were measured over a 60 week observation period. The frequency of mindfulness practices during the study was also evaluated. Results Over a 14-month prospective follow-up period, time to relapse was significantly longer with MBCT + TAU than TAU alone (median 204 and 69 days, respectively), although both groups relapsed at similar rates. Analyses of homework adherence revealed that following treatment termination, the frequency of brief and informal mindfulness practice remained unchanged over 14 months, whereas the use of longer formal meditation decreased over time. Limitations Relapse monitoring was 14 months in duration and prospective reporting of mindfulness practice would have yielded more precise frequency estimates compared to the retrospective methods we utilized. Conclusions Further studies are required to determine which patient characteristics, beyond the number of past depressive episodes, may predict differential benefits from this therapeutic approach.

Impulsivity and decision making.

The purpose of the present study was to explore the links among the four facets of impulsivity (urgency, lack of premeditation, lack of perseverance, and sensation seeking) proposed by Whiteside and Lynam (2001) and decision-making processes. Thirty undergraduate students completed a self-report questionnaire evaluating impulsivity as well as a task measuring decision-making processes, the Iowa Gambling Task. Zero-order correlations and multilevel analysis revealed that only lack of premeditation was specifically linked to disadvantageous decisions on the Gambling Task. This suggests that premeditation is related to decision making influenced by somatic (or emotional) markers.

A French Adaptation of the UPPS Impulsive Behavior Scale

Impulsivity is an important and multifaceted psychological construct. Recently, Whiteside and Lynam (2001) have developed the UPPS Impulsive Behavior Scale that distinguishes four dimensions of impulsivity: Urgency, lack of Premeditation, lack of Perseverance, and Sensation seeking. In the present study, we investigated the psychometric properties of a French adaptation of the UPPS Impulsive Behavior Scale. Two hundred and thirty-four undergraduate students completed the UPPS Scale. Exploratory and confirmatory analyses revealed a four factors solution similar to that found in the original study. Also, the results indicated that there was good to very good internal reliability for the four subscales.

Mindful Attention Awareness Scale (MAAS) : psychometric properties of the French translation and exploration of its relations with emotion regulation strategies

Over the past few years, several questionnaires have been developed to measure mindfulness. The Mindful Attention Awareness Scale (MAAS) was created to specifically capture attention and awareness in daily life (Brown & Ryan, 2003). In this article, we present a French adaptation of the MAAS. In the 1st study, we explored the psychometric properties of this adaptation. In the 2nd study, we investigated its relation to cognitive emotion regulation and depressive symptomatology using path analysis. As in the original version of the MAAS, the French adaptation has a strong 1-factor structure. Moreover, there was a negative relationship between the MAAS and the severity of depressive symptoms, both directly and indirectly. The indirect pathway was mediated by the nonadaptive cognitive emotion regulation strategy of self-blame and the adaptive cognitive emotion regulation strategy of positive reappraisal. In conclusion, this questionnaire represents a valid mindfulness measure for French-speaking clinicians and researchers.

Cognitive Emotion Regulation Questionnaire (CERQ)

The main purpose of this study was to validate a French version of the Cognitive Emotion Regulation Questionnaire (CERQ). A sample of 224 young adults completed the French translation of the CERQ and the Beck Depression Inventory II. Exploratory and confirmatory factor analyses showed that a nine-factor model also explained the data collected with the French version. Internal reliability scores for each strategy ranged from .68 to .87. As in the original version, we found that the emotion regulation strategies could be grouped into adaptive and less adaptive cognitive regulation strategies. In addition, we observed that Self-blame and Rumination are key cognitive regulation strategies predicting whether high or low depressive symptoms are reported.

Prevalence of pathological gambling in Switzerland after the opening of casinos and the introduction of new preventive legislation

Objective: This survey aimed to evaluate the prevalence of pathological gambling (PG) in the Swiss population in 2005 and the link between PG and alcohol abuse. This replication study made it possible to compare the prevalence rates of PG measured before and after the introduction of casinos and new preventive legislation.

Investigation of implicit memory during isoflurane anesthesia for elective surgery using the process dissociation procedure

Background:This prospective study evaluated memory function during general anesthesia for elective surgery and its relation to depth of hypnotic state. The authors also compared memory function in anesthetized and nonanesthetized subjects. Methods:Words were played for 70 min via headphones to 48 patients (aged 18–70 yr) after induction of general anesthesia for elective surgery. Patients were unpremedicated, and the anesthetic regimen was free. The Bispectral Index (BIS) was recorded throughout the study. Within 36 h after the word presentation, memory was assessed using an auditory word stem completion test with inclusion and exclusion instructions. Memory performance and the contribution of explicit and implicit memory were calculated using the process dissociation procedure. The authors applied the same memory task to a control group of nonanesthetized subjects. Results:Forty-seven patients received isoflurane, and one patient received propofol for anesthesia. The mean (± SD) BIS was 49 ± 9. There was evidence of memory for words presented during light (BIS 61–80) and adequate anesthesia (BIS 41–60) but not during deep anesthesia (BIS 21–40). The process dissociation procedure showed a significant implicit memory contribution but not reliable explicit memory contribution (mean explicit memory scores 0.05 ± 0.14, 0.04 ± 0.09, and 0.05 ± 0.14; mean automatic influence scores 0.14 ± 0.12, 0.17 ± 0.17, and 0.18 ± 0.21 at BIS 21–40, 41–60, and 61–80, respectively). Compared with anesthetized patients, the memory performance of nonanesthetized subjects was better, with a higher contribution by explicit memory and a comparable contribution by implicit memory. Conclusion:During general anesthesia for elective surgery, implicit memory persists even in adequate hypnotic states, to a comparable degree as in nonanesthetized subjects.

Self- and clinician-rated Montgomery-Asberg Depression Rating Scale: evaluation in clinical practice.

BACKGROUND Time- and cost-effective self-rating scales of depressive symptoms are particularly valuable for frequent use in large-scale effectiveness trials. The aim of the present study was to examine the psychometric properties of the French version of the self-rated Montgomery-Asberg Depression Rating Scale (MADRS-S) and determine whether it might complement the MADRS in monitoring depression severity and change over time in routine clinical practice. METHODS Sixty-three adult outpatients with a current depressive episode completed the MADRS-S and were interviewed with the MADRS on two occasions, within a 1-month interval. RESULTS All patients readily accepted the MADRS-S. It showed good to excellent internal consistency (Cronbachs alpha 0.85 at Time 1; 0.94 at Time 2). Its factor structure revealed that a single component explained a large proportion of variability (47.0% at Time 1; 68.8% at Time 2). Concurrent validity of the self- and clinician-rated versions was good (Pearsons correlation coefficients for total scores 0.81 at Time 1; 0.91 at Time 2). The MADRS-S was sensitive to change over the 4-week observation period (correlation of 0.71 between change scores on self- and clinician-rated instruments). LIMITATIONS Generalizability is restricted to outpatients with moderate to severe depression, and the MADRS-S ability to measure treatment effects needs to be examined. CONCLUSIONS The present study indicates that the MADRS-S displays favourable psychometric properties and suggests that it might be a valid complement to the MADRS, both in research settings and clinical practice.

Anatomy of the White Bear Suppression Inventory (WBSI): A Review of Previous Findings and a New Approach

The White Bear Suppression Inventory (WBSI; Wegner & Zanakos, 1994) was originally designed to assess peoples inclination toward thought suppression. In this article, we provide a detailed review of previous findings on the structure of this instrument and present a study that took a new statistical approach. It involved an exploratory factor analysis of the French WBSI using the weighted least squares mean and variance estimator as well as parametric item response theory analyses. Results clearly supported a 2-factor structure with a “suppression” and an “intrusion” dimension. Follow-up regression analyses revealed that intrusion significantly predicted anxiety and depression scores, whereas suppression did not. *Both authors contributed equally.

Mindfulness skills in borderline personality disorder patients during dialectical behavior therapy: preliminary results.

Objective. One of the components of dialectical behavior therapy (DBT) is the use of mindfulness skills as a core component of treatment for subjects with borderline personality disorder (BPD). In this study, we investigated changes in and correlates of mindfulness skills over a 1-year follow-up including a 4-week session of intensive DBT followed by 10 months of standard DBT. Methods. Fifty-two BPD subjects were assessed several times using the Kentucky Inventory of Mindfulness Skills (KIMS) which describes mindfulness in four discrete dimensions: observing (Obs), describing (Des), acting with awareness (AwA) and accepting without judgment (AwJ). Results. AwJ was the only dimension that increased significantly over time after adjustment for potential confounding factors (β = 0.24; P = 0.0002). Increases in AwJ correlated with improvement in BPD symptoms. Conclusions. This study highlights the usefulness of investigating changes in mindfulness dimensions during DBT. AwJ is a possible mechanism for positive change. Encouraging this skill should lead to a more adaptive response to problematic situations and counteract impulsive and problematic behaviors. The lack of specific control groups means that these findings are preliminary and replication is required.