Hypothèse d’un dysfonctionnement émotionnel chez des adolescents présentant des comportements à risqué : une étude exploratoire

INTRODUCTION

Problem behaviour in adolescents today has become a real public health problem, because of the potentially heavy consequences on their mental integrity. Although a number of studies have pointed out the importance of emotional functioning in this phenomenon, its characteristics have not been clearly defined. In the field of pathological emotional functioning, the aim of the study was to explore the differences in emotion variables, verbal emotion expression ability and behaviour, and notably behaviour inhibition ability. We hypothesised that we would observe significant differences between adolescents who exhibit problem behaviour and those who do not, in the three fields of subjective emotional experience, emotion verbalization, and behavioural reaction.

METHOD

The sample for this investigation consisted in 40 high-school students--divided into two groups of 20 subjects: The first group: Problem Behaviour (PB), mean age: 15.2 +/- 1.2, sex ratio (M/F): 14/6, and the second group: No Problem Behaviour (NPB) mean age: l4.6 +/- 1.5, sex ratio (M/F): 13/6. Subjects were included into the PB group by completing a short questionnaire assessing problem behaviour (including verbal and behavioural violence, multiple exclusions of more than one day, substance use, and other risk-taking behaviour). To explore the emotional reactivity to stimuli, we provoked emotions using films excerpts with three situations: anger, joy and sadness. We assessed the subjective experience of emotion using the Differential Emotion Scale (DES, Izard, 1972), the verbal emotion expression by quantitative discourse analysis, and motor activity using the number of movements during stimuli exposure.

RESULTS

Statistical analysis (repeated ANOVAs) showed significant differences (p<0.0001) in subjective emotional intensity, motor activity (p<0.0001), and verbal emotion expression ability (p<0.0001) between the two groups. Adolescents with problem behaviour presented lower subjective emotional experience intensity, greater motor activity and reported less emotional words to describe their feelings.

DISCUSSION

Our results show an emotional dysfunction in adolescents with problem behaviour. These results are consistent with previous investigations, supporting the importance of emotional processing in the ability of people to cope with environment. This dysfunction may be linked to a pathology in the ability to "feel" the emotions. Implications for clinical practice are discussed.

[Subjective well-being and self-regulation in risk taking behaviors. The case of scuba-diving]

Nowadays, risk-taking behaviors category is a very fast growing domain, yet not well known. Recent studies point out the importance of emotional phenomenons in subjective risk-taking behaviors. According to this axis, on scuba-diving empirical field, we aim to depict the size and the role of psychological process in the realization of the behavior; our research links personality variables and emotional ones. The observation of scuba-Divers behavior lead us to construct a fitting of conceptual positions to give an account of that behavior and its subjective function. The self-regulation concept has been dimensioned through several factors and the scales in respect of: Thrill and Adventure Seeking (Zuckerman, 1980), Anhedonia (Snaith-Hamilton Pleasure Scale, 1995), Subjective Well-being (Diener, 1992) and Differential Emotions (Izard, 1972). The population of this study is composed of 74 subjects. They are grouped in 2 categories depending of the risk-taking behavior, injured or injured less. The data have been statistically treated by classic methods (c2, Student t test) and logistic regression. It appears that Thrill and Adventure Seeking discriminate risk-taking in scuba-diving. The results especially support the weight of emotional variables. It turns out that risk-taking subjects are particularly sensitive to negative emotions. Negative well-being seems to be a central characteristic of the emotional functioning of these subjects. Moreover injured subjects tend to overestimate emotions linked to the behavior. Anhedonia is not a characteristic factor. So it introduces the notion of emotionality and sublines the interactions between risk-taking behavior and emotions through the self-regulation concept.

Development, effects, and educational outcomes of reporting from a clinical database

To develop clinically applicable and educationally useful reports from a clinical database, the authors explored the development of such databases at a medical center. The patient-centered database (PCD) integrates disparate data resources in the service of academic clinicians, postgraduate trainees, and students. From the PCD, daily and monthly reports are generated, which include 1) census update reports, serving as an educational format for a daily case-based morning report discussion and routine rounds; 2) reports of daily admissions and patient census stratified by appropriate housestaff providing the clinical care; and 3) quality assurance measures such as monitoring of length of stay of each patient regardless of the initial housestaff service to which the patient is initially admitted. The results of expanding the number of report beneficiaries, outcomes from a five-month test period, and possibilities for further development and implementation are considered.

The likelihood ratio. An improved measure for reporting and evaluating diagnostic test results

The principles and use of likelihood ratios are presented as an aid to the reporting and interpretation of diagnostic data. Likelihood ratios can be determined for multiple levels of test results and provide a readily comprehensible and convenient measure for computing the posttest probability of disease. Unlike sensitivity and specificity, they convey an immediate and direct description of a test's ability to revise the initial probability of disease upward or downward. By incorporating all the raw data, the use of likelihood ratios can improve the assessment of the clinical utility of test results. Their application to the diagnostic performance of serum creatine kinase concentrations in predicting patients with suspected myocardial infarction is discussed.