A dimensional and processual approach to emotive-cognitive-behavioural responses to stress and trauma : Empirical studies and validation of the French version of the Global Psychotrauma Screen

Un demi-siècle à compter de l'introduction du trouble de stress post-traumatique (TSPT) dans le DSM-III laisse en suspens des questions majeures. Pourquoi tous les individus exposés à des événements potentiellement traumatiques ne développent-ils pas des troubles psychopathologiques ? Pourquoi tous ne réagissent-ils pas de la même manière à un même événement ? Certains en effet sont « résilients » tandis que d'autres développent des symptômes parfois chroniques et invalidants. L'exposition à de tels événements peut entraîner, chez certaines personnes, divers impacts psychologiques transdiagnostiques, eux-mêmes modulés par des facteurs de risque et de protection péritraumatiques. Parmi les conséquences pathologiques de l'exposition au trauma, le trouble de stress post-traumatique (TSPT) est le plus étudié. La multitude de trajectoires post-traumatiques potentielles se traduit par une hétérogénéité inter et intra individuelle, cliniquement et empiriquement avérée, qu'il convient de mieux comprendre et évaluer à la lumière des facteurs de risque et de protection contextuels et individuels. Pourtant, la recherche sur les symptômes du TSPT (et plus largement sur les conséquences globales du psychotraumatisme) n'inclut pas systématiquement une évaluation des processus sous-jacents à certains facteurs de risque et de protection individuels. Or, il nous semble tout particulièrement nécessaire d'évaluer systématiquement les processus émotionnels et cognitifs, et ce de façon conjointe. Sur le plan conceptuel, notre recherche a porté sur l'implication des styles d'adaptation au stress, des processus de régulation émotionnelle et de ceux relevant du fonctionnement exécutif et attentionnel. Sur le plan clinique, aucun outil de dépistage bref, fiable et incluant un relevé des facteurs de risque/protection, en particulier ceux faisant consensus dans la littérature, n'était disponible avant que l'échelle Global Psychotrauma Screen (GPS ; Olff et al., 2020) ne soit mise au point. Ainsi, notre programme de recherche doctorale adopte une approche processuelle, intégrative et transdiagnostique dans l'étude et le dépistage des symptômes et des facteurs de risque et de protection liés au trauma à travers deux études empiriques et une étude de validation d'un instrument spécifique aux symptômes et aux facteurs de risque liés au trauma. L'un de nos résultats les plus importants (étude 1) souligne les enjeux d'un modèle théorique processuel plus détaillé, intégratif et adapté à la complexité des actions autorégulatrices face au stress et au stress post-traumatique et mobilisées en faveur de la résilience. L'étude menée auprès de patients souffrant de TSPT chronique (étude 2) a révélé l'intérêt d'une évaluation bimodale des difficultés exécutives et attentionnelles, c'est-à-dire incluant des mesures basées sur la performance et sur la perception. Les apports d'une approche globale et transdiagnostique dans le dépistage des conséquences du psychotraumatisme et de la prise en compte des facteurs de risque et protection dans cette évaluation sont aussi manifestes au vu des qualités psychométriques du GPS Français (étude 3).Half a century since the introduction of post-traumatic stress disorder (PTSD) in the DSM-III leaves major questions unanswered. Why do not all individuals exposed to potentially traumatic events develop psychopathological disorders? Why don't they all react in the same way to the same event? Some are indeed "resilient" while others develop symptoms that are sometimes chronic and disabling. In some people, exposure to such events can lead to various transdiagnostic psychological impacts, modulated by peritraumatic risk and protective factors. Among the pathological consequences of exposure to trauma, post-traumatic stress disorder (PTSD) is the most studied. The multitude of potential posttraumatic trajectories results in clinically and empirically proven inter- and intraindividual heterogeneity, which needs to be better understood and assessed in light of contextual and individual risk and protective factors. However, research on the symptoms of PTSD (and more broadly on the global consequences of psychotrauma) does not systematically include an assessment of the processes underlying certain individual risk and protective factors. We believe there is a particular need to systematically assess emotional and cognitive processes and do so jointly. Conceptually, our research focused on the involvement of stress coping styles, emotional regulation processes, and executive and attentional functioning processes. Clinically, no brief, reliable screening tool that includes a record of risk/protective factors, particularly those that are agreed upon in the literature, was available before the Global Psychotrauma Screen (GPS; Olff et al., 2020) was developed. Thus, our doctoral research program takes a processual, integrative, and transdiagnostic approach to the study and screening of trauma-related symptoms and risk and protective factors through two empirical studies and a validation study of an instrument specific to trauma-related symptoms and risk factors. One of our most important results (Study 1) highlights the need for a more detailed, integrative, processual theoretical model adapted to the complexity of self-regulatory actions in the face of stress and post-traumatic stress and mobilized for resilience. The study conducted with patients suffering from chronic PTSD (Study 2) revealed the interest of a bimodal evaluation of executive and attentional difficulties, i.e. including measures based on performance and perception. The contribution of a global and transdiagnostic approach in screening the consequences of psychotrauma and taking into account risk and protective factors in this assessment is also evident from the psychometric qualities of the French GPS (Study 3)

Look to the left, look to the right, to the left, to the right… A review on the effect of horizontal saccades on cognitive performance

Look to the left, now look to the right, then to the left, to the right… This is essentially what is asked to the participants in the studies examining the effects of horizontal saccadic eye movements on cognitive performance, mainly on memory. It has been suggested that short (about 30 seconds) series of horizontal saccades preceding an episodic memory task appear to improve memory performance, especially in highly right-handed individuals. However, studies have not yielded conclusive evidence, sometimes showing a positive effect on episodic retrieval, sometimes failing to report this effect. As the question of whether and how bilateral saccades may modulate cognitive efficiency seems to be of undeniable interest, both on a theoretical and a clinical perspective, we aim at reviewing the existing work. The paper presents basic information about the cerebral substrates of saccade generation, a classical experimental paradigm used in the field, the main results and the different hypotheses about the cerebral and cognitive mechanisms underlying the effects. We emphasise that studies are still scarce and carried out by a limited number of teams, and attempts of explanations are still very preliminary. We also describe a research approach of “adversarial collaboration”, which we consider particularly appropriate in this context. Finally, as it seems necessary to take into account the links between this scientific study of the effects of eye movements on cognitive and cerebral functioning and the numerous publications on the effectiveness of the psychotherapies using eye movements, we propose some considerations on the treatments based on the Eye movement desensitisation and reprocessing (EMDR) approach

Post-traumatic stress disorder (PTSD) in patients with epilepsy

International audienc

Correlation between fluorodeoxyglucose positron emission tomography brain hypometabolism and posttraumatic stress disorder symptoms in temporal lobe epilepsy

International audienceThe relationship between posttraumatic stress disorder (PTSD) and focal epilepsy is poorly understood. It has been hypothesized that there is a complex and reciprocal potential reinforcement of the symptoms of each condition. In this study, we investigated whether there are PTSD-specific brain changes in temporal lobe epilepsy (TLE). Brain fluorodeoxyglucose positron emission tomography (PET) metabolism was compared between controls and two groups of TLE patients: one group of 15 patients fulfilling the criteria for a potential diagnosis of PTSD (TLE-PTSD+), another group of 24 patients without a diagnosis of PTSD (TLE-PTSD-), and a group of 30 healthy control participants. We compared the differences in brain PET metabolism among these three groups, and we studied their correlations with interictal and peri-ictal scales of PTSD symptoms. TLE-PTSD+ patients showed more significant hypometabolism involving right temporal and right orbitofrontal cortex in comparison to TLE-PTSD- patients and healthy subjects. Moreover, degree of reduced metabolism in these brain areas correlated with interictal and peri-ictal PTSD questionnaire scores. PTSD in temporal epilepsy is associated with specific changes in neural networks, affecting limbic and paralimbic structures. This illustrates the close intertwining of epileptogenic and psychogenic processes in these patient