Prévention de la vitesse sur la route : législation, disposition au changement et intervention brève

Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal

Répercussions d’une enfance vécue en institution : le cas des Enfants de Duplessis

Les conséquences négatives d’un placement en institution sur les enfants ont été documentées, mais aucune étude n’a porté sur les orphelins et les enfants placés une fois devenus adultes. Au Québec, les Enfants de Duplessis offrent un témoignage poignant des répercussions à long terme d’une enfance vécue en institution. Les histoires recueillies auprès de 40 hommes et 41 femmes ayant grandi en institution à l’époque de Duplessis font état d’un nombre élevé d’abus et d’expériences adverses, incluant les agressions physiques, psychologiques et sexuelles. Le milieu était peu stimulant et offrait peu d’opportunités de développer des relations d’attachement positives et significatives. Lorsqu’ils sont appariés et comparés à des adultes provenant de l’enquête Santé-Québec, les Enfants de Duplessis devenus adultes rapportent plus de problèmes de santé liés au stress et une détresse psychologique plus importante. Nos résultats indiquent également que les personnes ayant disposé de peu de ressources et d’aptitudes personnelles dans l’enfance sont les plus affectées par les expériences adverses.Whereas the immediate consequences of institutionalized placements on children have been documented, no study has investigated adults who were raised in orphanages or institutions. In Quebec, les enfants de Duplessis offer a unique testimony of the long term consequences of an institutionalized childhood. Stories collected from 40 men and 41 women who grew up in institution in Duplessis’era indicate a high number of abuse and aversive experiences, including physical, psychological and sexual aggressions. In addition, the environment was poor in stimulation and opportunities to develop positive attachment relationships with adults. When matched and compared to adults from the Santé-Québec survey, les enfants de Duplessis report a higher number of health problems associated with stress and more psychological distress. Moreover, our results indicate that those who had fewer strengths and aptitudes in childhood are the most affected by unfavourable experiences.Se han documentado las consecuencias negativas del ingreso de los niños a una institución, pero ningún estudio trata acerca de los adultos que fueron internados cuando eran niños o quedaron huérfanos. En Quebec los niños de Duplessis son un testimonio desgarrador de las repercusiones a largo plazo de una infancia vivida en una institución. Las historias recopiladas de 40 hombres y 41 mujeres que crecieron en una institución en la época de Duplessis constatan el número elevado de abusos y experiencias adversas, incluyendo agresiones físicas, psicológicas y sexuales. El medio era poco estimulante y ofrecía pocas oportunidades de desarrollar relaciones de apego positivas y significativas. Al emparejarlos y compararlos a los adultos provenientes de la encuesta de Salud Quebec, los niños de Duplessis, quienes ya son adultos, reportan más problemas de salud relacionados al estrés y un desasosiego psicológico más importante. Nuestros resultados indican también que las personas que disponen de pocos recursos y aptitudes personales en su infancia son las más afectadas por las experiencias adversas.As conseqüências negativas de uma internação em instituição sobre as crianças foram documentadas, mas nenhum estudo foi realizado sobre os órfãos e as crianças internadas quando já se tornaram adultas. No Quebec, as “crianças de Duplessis” testemunham de maneira profunda das repercussões a longo prazo de uma infância vivida em instituição. As histórias recolhidas junto a 40 homens e 41 mulheres que cresceram em instituição na época do governo de Duplessis relatam um alto número de abusos e de experiências adversas, incluindo agressões físicas, psicológicas e sexuais. O meio era pouco estimulante e oferecia poucas oportunidades de desenvolver relações de apego positivas e significativas. Quando eles foram colocados lado a lado e comparados aos adultos vindos da pesquisa de Santé-Québec, as “crianças de Duplessis” que se tornaram adultas sofrem mais de problemas de saúde ligados ao estresse e a uma depressão psicológica mais importante. Nossos resultados indicam igualmente que as pessoas que dispuseram de poucos recursos e aptidões pessoais na infância são mais afetadas pelas experiências adversas

Les expériences vécues par les enfants de Duplessis institutionnalisés : les conséquences après plus de 50 ans

Dans cet article, les auteurs présentent les résultats qualitatifs recueillis à partir de questionnaires et d’entrevues semi-structurées destinés à documenter les expériences tant actuelles que passées des enfants de Duplessis institutionnalisés (EDI). Des exemples typiques et deux cas représentatifs sont présentés. Les résultats indiquent que les abus et la négligence subis par les EDI pendant l’enfance ont compromis leur ajustement psychosocial à long terme. Ils révèlent aussi que les EDI qui ont rapporté au moins quatre forces pendant leur enfance étaient plus susceptibles d’être protégés à l’âge adulte contre les effets négatifs de leur placement.In this article, the authors present qualitative results, derived from questionnaires and semi-structured interviews, to describe past and present experiences of the Duplessis children. Examples representative of their experience and a detailed description of two cases are provided. Results indicate that childhood abuse and negligence are related to poorer long-term psychological adjustment. The findings also demonstrate that reporting at least four strengths in childhood can have long-term protective effects.En este artículo, los autores presentan los resultados cualitativos recopilados a partir de cuestionarios y entrevistas semiestructuradas destinadas a documentar las experiencias, tanto recientes como pasadas, de los niños de Duplessis que fueron institucionalizados (EDI). Se presentan ejemplos típicos y dos casos representativos. Los resultados indican que los abusos y la negligencia sufridos por los EDI durante la infancia han comprometido su ajuste psicosocial a largo plazo. También revelan que los EDI que han reportado al menos cuatro fuerzas durante su infancia eran más susceptibles de estar protegidos en la edad adulta contra los efectos negativos de su colocación.Neste artigo, os autores apresentam os resultados qualitativos coletados a partir de questionários e entrevistas semi-estruturadas destinados a documentar as experiências tanto atuais quanto passadas das crianças de Duplessis institucionalizadas (CDI). São apresentados exemplos típicos e dois casos representativos. Os resultados indicam que os abusos e a negligência sofridos pelas CDI durante a infância comprometeram seu ajuste psicossocial a longo prazo. Eles revelam também que as CDI que relataram, pelo menos, quatro aspectos positivos durante sua infância eram mais susceptíveis de ser protegidas durante a idade adulta contra os efeitos negativos de sua internação

Passenger Age and Gender Effects on Adult Driver Fatal Crash Rate

Driver behavior and crash rates vary with the presence of passengers but the details of this relationship are not well understood. The literature generally does not take into account the characteristics of passengers, yet effects on crashes may vary dramatically with passenger age and gender. This study estimated the amount of exposure (driving miles) done by various driver age/gender categories with various combinations of passengers. Statistical imputation techniques were used to derive travel estimates for various pairings using data from the 2001 National Household Travel Survey. Crash frequencies for every pairing were obtained from the Fatality Analysis Reporting System and were used to compute fatal crash rates (per 10 million trip miles). The findings reported here focus on adult (21 and older) drivers. The results show that drivers of a given type (age/gender group) show dramatically different crash rates as a function of passenger type. Some passenger types are associated with fatal crash rates higher than that with no passenger, while other passenger types are associated with lower crash rates. The details of this relationship depend to some degree on driver characteristics. Crash rates for different driver age/gender groups overlap substantially based on the passenger, so that the “best” and “worst” driver groups are passenger-specific. For adult male drivers, female passengers are generally associated with lower crash rates. For male drivers, there is a higher crash rate with a male passenger of a given age than with a female passenger of the same age, even for child passengers

Étude pilote de l’entretien motivationnel chez des personnes condamnées pour conduite avec facultés affaiblies

Dans cette étude pilote contrôlée et randomisée (N = 51), nous avons examiné l’impact d’une intervention brève, l’entretien motivationnel (EM, Motivational Interviewing), comparée à une simple séance d’information comme condition contrôle, chez des personnes condamnées pour conduite avec facultés affaiblies. Les participants devaient avoir un diagnostic actif d’abus ou de dépendance à l’alcool et devaient être recrutés en dehors des programmes officiels de traitement pour conducteurs avec facultés affaiblies de façon à tester l’EM chez des individus qui n’étaient pas nécessairement prêts à changer. Nous avons évalué le pourcentage de jours de forte consommation d’alcool (≥ 6 consommations standards d’alcool par jour), les résultats à l’AUDIT et l’utilisation de services après trois et six mois de suivi. Les résultats indiquent que l’exposition à l’EM a entraîné une réduction significativement plus grande du nombre de jours à forte consommation d’alcool et du nombre de visites à des professionnels de la santé après six mois de suivi. L’ampleur des effets observés est comparable à celle que l’on peut retrouver dans d’autres études employant l’EM avec différentes populations ayant un problème d’alcool. Quoique préliminaires, ces résultats suggèrent que l’emploi de l’EM pourrait être avantageux, même chez des individus qui ne sont pas engagés dans un processus de réhabilitation. Une étude plus approfondie du potentiel de l’EM conduisant directement à une amélioration de la conduite en état d’ébriété est clairement justifiée.A pilot randomized controlled trial (N = 51) investigated the impact of a brief intervention approach : Motivational Interviewing (MI), compared to a simple information session as a control condition, in offenders convicted of driving under the influence (DUI). Participants had a current diagnosis of alcohol abuse or dependence, and were recruited outside of mandated DUI remedial programs, in order to test MI in individuals who were not necessarily prepared to change. We evaluated the percentage of days of significant alcohol consumption (≥ 6 standard drinks a day), AUDIT scores and service utilization at three and six months follow-up. Results indicated that exposure to MI resulted in a significantly greater reduction in the number of days of significant alcohol consumption and fewer visits to health professionals at six months follow-up. Observed effect sizes were comparable to other studies of MI in different populations with alcohol problems. While preliminary, these results suggest that MI for DUI could have benefits, even in individuals who are not involved in a remedial process. A comprehensive study of MI’s potential in more directly improving drinking and driving outcomes is clearly warranted.En este estudio piloto controlado y aleatorio (N = 51), hemos examinado el impacto que produjo una breve intervención, la entrevista de motivación (EM, Motivational Interviewing), en personas condenadas por conducir con facultades debilitadas, comparándola a una simple sesión de información como condición de control. Los participantes debían tener un diagnóstico activo de abuso o de dependencia de alcohol y haber sido reclutados fuera de los programas oficiales de tratamiento para conductores con facultades debilitadas, con el objetivo de probar la entrevista de motivación en individuos que no estaban necesariamente preparados para cambiar. Hemos evaluado el porcentaje de días de fuerte consumo de alcohol (≥ 6 consumos regulares de alcohol por día), los resultados en la verificación y la utilización de los servicios luego de tres y seis meses de seguimiento. Los resultados indican que la exposición a la entrevista de motivación generó una reducción significativamente más importante de días de fuerte consumo de alcohol y de la cantidad de visitas a profesionales de la salud luego de seis meses de seguimiento. La amplitud de los efectos observados es comparable a la que se puede encontrar en otros estudios que emplean la entrevista de motivación con diferentes poblaciones que tienen un problema de alcohol. Si bien preliminares, estos resultados sugieren que el uso de las entrevistas de motivación podría ser ventajoso, incluso con individuos que no están comprometidos en un proceso de rehabilitación. Se justifica ampliamente un estudio más profundo de las posibilidades de la entrevista de motivación como medio para lograr directamente una mejoría en cuando a la conducción de vehículos en estado de ebriedad

Personality, executive control, and neurobiological characteristics associated with different forms of risky driving

Background: Road crashes represent a huge burden on global health. Some drivers are prone to repeated episodes of risky driving (RD) and are over-represented in crashes and related morbidity. However, their characteristics are heterogeneous, hampering development of targeted intervention strategies. This study hypothesized that distinct personality, cognitive, and neurobiological processes are associated with the type of RD behaviours these drivers predominantly engage in. Methods: Four age-matched groups of adult (19-39 years) males were recruited: 1) driving while impaired recidivists (DWI, n = 36); 2) non-alcohol reckless drivers (SPEED, n = 28); 3) drivers with a mixed RD profile (MIXED, n = 27); and 4) low-risk control drivers (CTL, n = 47). Their sociodemographic, criminal history, driving behaviour (by questionnaire and simulation performance), personality (Big Five traits, impulsivity, reward sensitivity), cognitive (disinhibition, decision making, behavioural risk taking), and neurobiological (cortisol stress response) characteristics were gathered and contrasted. Results: Compared to controls, group SPEED showed greater sensation seeking, disinhibition, disadvantageous decision making, and risk taking. Group MIXED exhibited more substance misuse, and antisocial, sensation seeking and reward sensitive personality features. Group DWI showed greater disinhibition and more severe alcohol misuse, and compared to the other RD groups, the lowest level of risk taking when sober. All RD groups exhibited less cortisol increase in response to stress compared to controls. Discussion: Each RD group exhibited a distinct personality and cognitive profile, which was consistent with stimulation seeking in group SPEED, fearlessness in group MIXED, and poor behavioural regulation associated with alcohol in group DWI. As these group differences were uniformly accompanied by blunted cortisol stress responses, they may reflect the disparate behavioural consequences of dysregulation of the stress system. In sum, RD preference appears to be a useful marker for clarifying explanatory pathways to risky driving, and for research into developing more personalized prevention efforts

Validity of the C-RDS Self-Reported Risky Driving Measure

This study examined the reliability and validity of the Checkpoints Risky Driving Scale (C-RDS) in relation to the Dula Dangerous Driving Index (DDDI) and an objective measure of risky driving. Naturalistic and survey data were collected over an 18-month period from 42 newly-licensed teenage drivers. Kinematic Risky Driving was operationally defined as the rate of elevated gravitational-force events per 100 miles obtained from accelerometers and global positioning systems. Two self-report measures of risky driving, the C-RDS and the DDDI, were assessed at 6-months, 12-months, and 18-months after licensure. Reliability was examined for each measure with correlations and autoregressive models over three time points. Validity was assessed by correlations between the measures and cross-lagged autoregressive models of the longitudinal association of self-reported measures with Kinematic Risky Driving and vice versa. Both the C-RDS and DDDI measures demonstrated substantial stability over time and were highly correlated with each other. The C-RDS measure was significantly associated with Kinematic Risky Driving. The findings provide evidence for the reliability and validity of C-RDS

Measuring Young Drivers’ Behaviors during Complex Driving Situations

Driving behaviors of teenagers and adults in complex driving situations, viz., merges and intersections, from an 18-month longitudinal naturalistic driving study were analyzed. Variables from multiple sources were selected to create an Unsafe Driving Index to rate drivers’ behaviors in these locations. Teenagers scored lower on this index, corresponding to safer driving behaviors, than adults. However, the teenagers’ scores for the index increased across the study period. The interpretations of these findings are discussed with respect to the methodological aspects of the study and in terms of driver training and rule following

Lower Cortisol Activity is Associated with First-Time Driving while Impaired

Driving while impaired (DWI) is a grave and persistent high-risk behavior. Previous work demonstrated that DWI recidivists had attenuated cortisol reactivity compared to non-DWI drivers. This suggests that cortisol is a neurobiological marker of high-risk driving. The present study tested the hypothesis that this initial finding would extend to first-time DWI (fDWI) offenders compared to non-DWI drivers. Male fDWI offenders (n = 139) and non-DWI drivers (n = 31) were exposed to a stress task, and their salivary cortisol activity (total output and reactivity) was measured. Participants also completed questionnaires on sensation seeking, impulsivity, substance use, and engagement in risky and criminal behaviors. As hypothesized, fDWI offenders, compared to non-DWI drivers, had lower cortisol reactivity; fDWI offenders also showed lower total output. In addition, cortisol activity was the most important predictor of group membership, after accounting for alcohol misuse patterns and consequences and other personality and problem behavior characteristics. The findings indicate that attenuated cortisol activity is an independent factor associated with DWI offending risk at an earlier stage in the DWI trajectory than previously detected