Mémoire de reconnaissance verbale (dynamique spatio-temporelle de la familiarité et de la recollection (remémoration))

Il existe plusieurs systèmes mnésiques (mémoire sémantique, épisodique et de reconnaissance) organisés de façon hiérarchique et parallèle. De nombreux travaux, ont montré que la mémoire de reconnaissance était susceptible de mettre en jeu deux types de mécanismes, la familiarité et la recollection, régis par des contraintes temporelles et des substrats neuronaux différents, la familiarité étant sous tendue par les structures sous hippocampiques et la recollection dépendant de l'activité hippocampique. Une autre théorie va à l'encontre de ce modèle "dual", suggérant que la mémoire de reconnaissance serait sous-tendue par les mêmes structures temporales internes. Au delà de ce débat théorique, les recherches concernant les troubles de la mémoire de reconnaissance comme la maladie d'alzheimer ont montré que les stades précoces de celle-ci toucheraient préférentiellement la familiarité et donc le cortex péri-rhinal. C'est par un paradigme, manipulant familiarité et recollection par du matériel verbal ainsi que l'enregistrement et l'analyse de potentiels évoqués que nous avons obtenu des résultats montrant un effet "old/new frontal" aux alentours de 400 ms correspondant à la reconnaissance par familiarité et un effet "old/new pariétal"aux alentours de 600-1000 ms correspondant à la reconnaissance par recollection. Ces données sont en faveur du modèle dual qui stipule que la familiarité et la recollection sont des processus temporellement et anatomiquement distincts. Ceci pouvant conduire à l'avenir, à l'élaboration d'un test neuropsychologique évaluant spécifiquement la familiarité et son substrat neuroanatomique atteints au stade prodromal de la maladie d'alzheimer.CLERMONT FD-BCIU-Santé (631132104) / SudocSudocFranceF

Affectivité, alexithymie et craving: une revue systématique [Présentation par e-poster]

E-Poster PresentationInternational audienceIntroductionCraving has been linked to situational and emotional psychological processes (DiFranza et al., 2012) in substance use disorders. Few studies have evaluated the influence of emotional dimensions through affectivity (Watson D, & Clark LA., 1984) on craving (Zuo et al., 2016) and the impact of alexithymia which represents the major disorder of emotional regulation in addiction (Thorberg et al., 2009). ObjectivesThe main objective of this review is to bring together studies on the emotional dynamic of craving by simultaneously considering affects (negative and positive) and alexithymia. MethodsA systematic review complying with the PRISMA protocol was conducted, and identified 23 studies targetting craving for addictions with substances. ResultsAs much as 20 of the 23 studies selected show a correlation between affectivity, alexithymia and craving; highlighting 55% of direct links and 48% of partial links. Studies on negative affects (78%) put forth their causal link with craving, while studies on positive affectivity (26%) present it as a moderating element. Studies on alexithymia (17%) show its effects on emotional reactivity only in negative affectivity situations. ConclusionsThe results confirm the impact of emotional processes on craving by highlighting the distinct and interdependent roles of negative affectivity, positive affectivity and alexithymia. These aspects of the psychological functioning will therefore have to be target elements in the care.introductionLe craving est lié à des processus psychologiques situationnels et émotionnels (DiFranza et al., 2012) dans les troubles liés à l'usage de substances. A ce jour, peu d'études ont évalué l'influence des dimensions émotionnelles par l'intermédiaire du concept d'affectivité (Watson D, & Clark LA., 1984) sur le craving (Zuo et al., 2016) et l'impact de l'alexithymie qui représente le trouble majeur de la régulation émotionnelle dans la dépendance (Thorberg et al., 2009). ObjectifsL'objectif principal de cette revue est de rassembler des études qui étudient la dynamique émotionnelle sous-jacente au craving en considérant simultanément les affects (négatifs et positifs) et l'alexithymie. MéthodeUne revue systématique conforme au protocole PRISMA a été mené et a identifié 23 études ciblant le craving dans les troubles liés à l'usage de substances. Résultats20 des 23 études sélectionnées montrent une corrélation entre l'affectivité, l'alexithymie et le craving. Les résultats montrent que 55% de liens sont directs et 48% de liens sont indirects. Les études sur les affects négatifs (78%) confirment que l'affectivité négative est un facteur de risque à la survenue du craving. Les études portant sur l'affectivité positive (26%) souligne le caractère modérateur de cette variable. Les études sur l'alexithymie (17%) montrent ses effets sur la réactivité émotionnelle uniquement dans des situations d'affectivité négative. ConclusionsNos résultats confirment l'impact des processus émotionnels sur le déclenchement du craving et mettent en évidence les rôles distincts et interdépendants de l'affectivité négative, de l'affectivité positive et de l'alexithymie. Ces aspects du fonctionnement psychologique devront donc être pris en compte dans les prises en charge ciblant la prévention de la rechute en addictologie

Association Between Negative Affectivity and Craving in Substance-Related Disorders: A Systematic Review and Meta-analysis of Direct and Indirect Relationships

International audienceBackground A sizeable literature highlighted that negative affectivity and craving are both known to be implicated in relapses. Objectives The present study synthetized the existing litterature to determine strength of the interaction between negative affectivity and craving for substance-related disorders including illicit drugs, alcohol and tobacco. Methods We conducted a systematic review in accordance with PRISMA guidelines followed by a meta-analysis. Online computer databases PubMed, PsycINFO and Web of Science were searched systematically and thoroughly. Jamovi 1.8.1 Current version was used to conduct meta-analysis. Results Thirty studies were included in the review, and 14 of these, including 2257 subjects, were used for meta-analysis. The raw correlation ranged from 0.17 to 0.58, which indicated weak to moderate association between negative affects and craving. In total, approximately 90% of the selection revealed a positive correlation between negative affects and craving. Alcohol and tobacco use disorders have received the most attention. Additionally, negative affectivity was often defined as a transient state rather than a stable personality trait. Conclusions In both of our meta-analyses and in the narratively reported studies, we found that negative affectivity is an important component related to craving, but individual differences in craving reactivity existed

Drawing alcohol craving process: A systematic review of its association with thought suppression, inhibition and impulsivity

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Barriers and levers in screening and care for alcohol use disorders among French general practitioners: results from a computer-assisted telephone interview-based survey

International audienceAlcohol use disorders (AUD) is a major public health concern. General practitioners (GP) must play a key role in identifying this disorder and offering appropriate interventions. The authors conducted a survey among French GP in the Provence – Alpes – Côte-d’Azur (PACA) region to better understand their practices regarding AUD. Random sampling was used to enrol 101 GP in a 15-minute survey. A Computer-Assisted Telephone Interview exploring demographic and professional characteristics was conducted using a questionnaire. One third (31.7%) of the participants systematically addressed alcohol use with their patients whereas six (5.9%) never addressed it. Logistic regression analyses showed that after adjustment for the number of AUD patients followed up (odds ratio [OR] = 1.92; 95% confidence interval [CI] [1.19, 3.08]) and GP interest in addiction medicine (5.41 [2.17, 13.40]), GP who systematically screened patients for AUD were more likely to accept controlled drinking as a therapeutic goal (5.41 [2.17, 13.33]), and to perceive patient denial of AUD as a major barrier to care (1.39 [0.60, 3.22]). GP providing care for AUD were more likely to monitor tobacco cessation (9.08 [2.60, 31.64]) and to prescribe opioid maintenance treatment (7.35 [2.52, 21.41]). Alcohol screening is insufficient in general practice in France. Providing updated guidelines is essential to foster experience in this field among GP

Screening and care for alcohol use disorder in France: expectations, barriers and levers using a mixed-methods approach

International audienceBackground: The widespread under-screening and under-treatment of alcohol use disorder (AUD) contributes to its health and socioeconomic burden. We conducted a mixed-methods (qualitative and qualitative) study in people with alcohol use disorder (PWAUD) to explore their expectations, as well as barriers and levers to AUD care. Methods: Individuals with AUDIT > 15 (N = 179) were interviewed using computer-assisted interviews in several medical and non-medical sites (e.g., bars) (quantitative substudy). We also conducted semi-structured face-to-face interviews with 36 PWAUD (qualitative substudy). Using logistic regression, we explored factors associated with having previously received/sought care for AUD. Three major themes were identified in the qualitative textual analysis using a descending hierarchical classification. Results: Not socializing with heavy drinkers (AOR [95%CI]:3.84[1.66-8.85]), regular smoking (9.72[3.91-24.15]) and feeling discriminated against (2.35[1.10-5.05]) were independent levers to having sought/received care for AUD, while being aged < 50 and employment were independent barriers. The five predominant themes in PWAUD discourses emerging from the textual analysis were: drinking context, medical care, alcohol treatment, tobacco/ addiction and family. When triangulating results from the logistic regression and the textual analysis, two barriers (social drinking and difficulties with the medical care system), and two levers (family influence and tobacco addiction), emerged. Conclusion: These results underline the need for interventions targeting families and the social network to increase awareness about AUD and related care. Simplified and novel comprehensive care trajectories are urgently needed to reduce the clinical and public health burden of AUD

Access to care for people with alcohol use disorder in France: a mixed-method cross-sectional study protocol (ASIA)

International audienceIntroduction Alcohol use disorder (AUD) is a major public health concern worldwide. In France, only 10% of people with AUD (PWAUD) receive medical care. General practitioners (GP) are one of the main entry points for AUD care. The present ongoing study, entitled ASIA (Access to Care and Indifference toward Alcohol, Acces aux Soins et Indifference a l'Alcool in French), aims to improve knowledge about factors associated with access to care for AUD by exploring related GP and PWAUD practices, experiences and perceptions. Methods and analysis The ASIA project is an ongoing cross-sectional multisite study based on a complementary mixed-method approach (quantitative and qualitative) using a convergent parallel design. The double-perspective design of the study will enable us to collect and compare data regarding both PWAUD and GP points of view. For the PWAUD quantitative study, 260 PWAUD will be interviewed using a telephone-based questionnaire. For the qualitative study, 36 PWAUD have already been interviewed. The GP quantitative study will include 100 GP in a 15min survey. Fifteen GP have already participated in semistructured interviews for the qualitative study. Logistic regression will be used to identify predictors for access to care. With respect to data analyses, qualitative interviews will be analysed using semantic analysis while quantitative logistic regression will be used for quantitative interviews. Ethics and dissemination This study was approved by the CNIL (French National Commission on Informatics and Liberties) (approval reference number: C16-10, date of approval: 17 July 2017), the CCTIRS (Advisory Committee on Information Processing in Material Research in the Field of Health) and the CEEI (Evaluation and Ethics Committee) (approval reference number: 16-312, date of approval: 8 July 2016) of INSERM (French National Institute of Health and Medical Research). Results from ASIA will be disseminated in peer-reviewed publications, conference presentations, reports and in a PhD thesis

Evaluation of a novel therapeutic education programme for people with alcohol use disorder in France: a mixed-methods intervention study protocol (ETHER)

Abstract Background ETHER (“Education THEérapeutique pour la Réduction des dommages en alcoologie” or Therapeutic education for alcohol-related harm reduction) is a multicentre community-based mixed-methods study, which aims to evaluate the effectiveness of the innovative therapeutic patient education (TPE) programme ‘Choizitaconso’ in a sample of French people with alcohol use disorder (people with AUD). Choizitaconso teaches people with AUD psychosocial skills to help them (re)establish controlled drinking and reduce alcohol-related harms. Recruitment started in October 2019. We present here the protocol of the ETHER study. Methods ETHER’s quantitative component involves a 6-month controlled intervention study which evaluates Choizitaconso’s effectiveness by comparing 30 people with AUD following the programme with a control group of 60 people with AUD not enrolled in it, using a questionnaire co-constructed by the research team and members of the people with AUD community. Thirty-four alcohol-related harms are assessed and summed to provide an individual measure of the ‘harm burden’ from consuming alcohol (primary outcome). Secondary outcomes are anticipated and internalized stigma, alcohol consumption measures, craving for alcohol, coping strategies, health-related quality of life, self-confidence to control or abstain from drinking, treatment self-regulation, anxiety and depressive symptoms, alcohol-related neuropsychological impairments, and capabilities (a measure of wellbeing in adults). Data will be collected in face-to-face and phone-based interviews at enrolment and 6 months later. Linear regression models will be used to assess the impact of the TPE programme on changes in the primary and secondary outcomes, while adjusting for other correlates and confounders. The study’s qualitative component comprises semi-structured interviews with 16 people with AUD who have already completed the TPE programme at least 6 months before the interview. Qualitative interviews will be analysed using thematic analysis. Results and conclusions ETHER is the first evaluation study of an innovative TPE programme specifically designed to reduce alcohol-related harms and reach controlled drinking in France. The involvement of the people with AUD community in selecting which experienced and perceived alcohol-related harms to measure ensures that ETHER will provide healthcare staff and researchers with a relevant set of harm reduction criteria for use in future research. Finally, ETHER will provide scientific justification for implementing novel alcohol-related harm reduction approaches and champion controlled drinking as a therapeutic goal. Trial registration ClinicalTrials.gov, NCT03954054. Registered 17 May 2019—Prospectively registered, https://clinicaltrials.gov/ct2/show/NCT03954054?cond=alcohol&cntry=FR&city=Marseille&draw=1&rank=1

Barriers and levers in screening and care for alcohol use disorders among French general practitioners: results from a computer-assisted telephone interview-based survey

International audienc