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Background and Aims: Craving is central in the definition of addictive disorders because of its diagnostic and prognostic value. Its measurement is essential in clinical practice. Previous reviews provided a better overview of existing instruments; however, they do not consider emerging substances and behaviors such as sexual addictions. Our objectives were threefold: (1) to provide a systematic review of craving assessment instruments and their psychometric characteristics within a transdiagnostic approach, (2) to highlight and map their conceptual relationships and (3) to identify potential sexual craving assessment instruments., Methods: The review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. The PubMed, Embase, PsychInfo and Cochrane/Central databases were searched for publications that met the following inclusion criterion: validation studies of craving assessment instruments, regardless of target substance or behavior. The original search identified 4561 references and included 147 articles. Each selected study was a peer-reviewed publication., Results: This review provides a synthesis of the psychometric properties of 36 original instruments and identified 93 variations of these instruments (e.g. translations). We were able to highlight five transdiagnostic families of instruments, each corresponding to a conceptual model. Only one instrument for assessing craving in the domain of compulsive sexual behavior, focused on pornography use, has been identified: the Pornography Craving Questionnaire., Conclusion: This review mapped all craving assessment instruments from a transdiagnostic perspective, finding 36 original instruments and 93 variations. The evolution of instruments to measure craving mirrors the evolution of the concept of craving which has progressively integrated cognitive, conditioning and sensory dimensions, and attests to the importance of the context of assessment. Development of an instrument to measure 'sexual craving' is needed and could be based on the data from our review., (© 2023 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.)

Objective: This study aimed to investigate ADHD in adult outpatients seeking treatment for a behavioral addiction and to identify the specificity of psychopathological features if the behavioral addiction cooccurs with adult ADHD., Method: Sixty-five outpatients consulting for a behavioral addiction were assessed for ADHD (DIVA-5), addictive disorder (alcohol, tobacco, cannabis, gambling, gaming, food, and sex), impulsivity (UPPS-P), and emotion dysregulation (DERS-36)., Results: In our sample of outpatients seeking treatment for a behavioral addiction, adult ADHD was independently associated with higher compulsive sexual behavior disorder severity, "sensation seeking," "positive urgency," difficulties in "goal-directed behavior," "impulse control," and use of "emotion regulation strategies" in the context of intense emotions. A 29% of the sample was diagnosed for adult ADHD., Conclusion: The association of adult ADHD with specific dimensions of impulsivity and emotion dysregulation, pave the way for future clinical and research perspectives.

Blaszczynski and Nower's (Addiction 97:487-499, 2002) Pathways Model, an integrative model based on problem gamblers' paths and comorbidities, aids in understanding the heterogeneity of problem gamblers' profiles by classifying them into three subgroups. The profiles of problem gamblers may be linked to the type of gambling practiced. Poker is a popular game, primarily due to the involvement of both chance and strategy in its outcome. However, no study has attempted to fit poker players into the Pathways Model. We recruited an online sample of 245 regular poker players (including 146 non-problem gamblers, 83 problem-gambling poker players, and 16 probable pathological gamblers). We assessed multiple variables (impulsivity, sensation seeking, alcohol and tobacco consumption, anxiety, depression, cognitive distortions) from the Pathways Model to determine whether the profiles of poker players fit into one or more gambler subgroups. Cluster analysis showed that poker players had a unique profile with a gambling practice intensity gradient. Compared to non-problem gamblers, problem gamblers displayed significantly higher levels of depression, impulsivity, gambling-related cognitive distortions, and alcohol consumption. Our results suggest that problem-gambling poker players fit into Blaszczynski and Nower's behaviorally conditioned gamblers group. This study opens avenues for both research into and treatment for problem gambling among poker players., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Interindividual differences in personality traits, especially impulsivity traits, are robust risk factors for addictive disorders. However, their impact on addictive disorders during the COVID-19 lockdown remains unknown. This study assessed patients being followed for addictive disorders before the lockdown. We aimed to determine whether impulsivity traits (i.e., negative- and positive urgency) were associated with addictive disorders severity during the lockdowns. We also explored the patients' subjective experiences, focusing on high versus low impulsivity. The quantitative study assessed 44 outpatients consulting for addictive disorders, for impulsivity, emotion regulation, anxiety/depression, and their addictive disorder characteristics, using self-administered questionnaires. In the qualitative study, six patients from the quantitative study were assessed using guided interviews. We observed that higher negative and positive urgencies were associated with addictive disorder severity. The subjective experiences of patients during the lockdowns differed according to their emotion-related impulsivity: high versus low. Low impulsive patients used online technologies more effectively to maintain follow-up, with more positive reappraisal. In contrast, highly impulsive patients reverted more frequently to self-medication with substances and/or behaviors, more social isolation, and found coping with negative emotions more challenging. Overall, the patient's ability to cope with stressful events, like the COVID-19 lockdown, depended on their emotion-related impulsivity.

The structural addictive characteristics of gambling products are important targets for prevention, but can be unintuitive to laypeople. In the PictoGRRed (Pictograms for Gambling Risk Reduction) study, we aimed to develop pictograms that illustrate the main addictive characteristics of gambling products and to assess their impact on identifying the addictiveness of gambling products by laypeople. We conducted a three-step study: (1) use of a Delphi consensus method among 56 experts from 13 countries to reach a consensus on the 10 structural addictive characteristics of gambling products to be illustrated by pictograms and their associated definitions, (2) development of 10 pictograms and their definitions, and (3) study in the general population to assess the impact of exposure to the pictograms and their definitions (n = 900). French-speaking experts from the panel assessed the addictiveness of gambling products (n = 25), in which the mean of expert's ratings was considered as the true value. Participants were randomly provided with the pictograms and their definitions, or with a standard slogan, or with neither (control group). We considered the control group as representing the baseline ability of laypeople to assess the addictiveness of gambling products. Each group and the French-speaking experts rated the addictiveness of 14 gambling products. The judgment criterion was the intraclass coefficients (ICCs) between the mean ratings of each group and the experts, reflecting the level of agreement between each group and the experts. Exposure to the pictograms and their definition doubled the ability of laypeople to assess the addictiveness of gambling products compared with that of the group that read a slogan or the control group (ICC = 0.28 vs. 0.14 (Slogan) and 0.14 (Control)). Laypeople have limited awareness of the addictive characteristics of gambling products. The pictograms developed herein represent an innovative tool for universally empowering prevention and for selective prevention., (© 2022. The Author(s).)

This study aimed to determine whether dissociative symptoms and childhood trauma (CT) may help identify a specific subgroup of patients among those hospitalized for alcohol use disorder (AUD). We assessed 587 patients hospitalized for an AUD in a French addiction rehabilitation center (cross-sectional study) regarding dissociative symptoms (DES-taxon), childhood trauma (CTQ), depression (BDI), anxiety (STAI-state and STAI-trait), posttraumatic stress disorder (PTSD; PCL-5), and AUD symptoms (AUDIT). We ran a hierarchical cluster analysis and compared the clusters in terms of dissociation and CT, as well as AUD, depressive, anxiety, and PTSD symptoms. We identified three clusters of patients: (1) patients with low AUD severity and low dissociation (LALD); (2) patients with high AUD severity and low dissociation (HALD); (3) patients with high AUD severity and high dissociation (HAHD). Patients from the HAHD group had significantly higher dissociation and more severe depression, anxiety, and PTSD symptoms than those with LALD and HALD. They also reported more emotional and sexual abuse than those with LALD. Among patients with an AUD, those with high dissociation may constitute an independent subgroup that exhibits a higher prevalence for CT and higher AUD severity, as well as higher depression, anxiety, and PTSD symptoms. Patients with more severe AUD and associated psychiatric symptoms should be systematically screened for dissociation and provided with tailor-based treatments.

Background and Aims: Blaszczynski and Nower (2002) conceptualized their Pathways Model by postulating the existence of three subtypes of problem gamblers who share common characteristics, but also present specific ones., Methods: This study investigated how the psychological mechanisms postulated in the Pathways Model predict clinical status in a sample that combined treatment-seeking gamblers (n = 59) and non-problematic community gamblers (n = 107). To test the Pathways Model, we computed a hierarchic logistic regression in which variables associated with each postulated pathway were entered sequentially to predict the status of the treatment-seeking gambler. Self-report questionnaires measured gambling-related cognitions, alexithymia, emotional reactivity, emotion regulation strategies and impulsivity. Behavioural tasks measured gambling persistence (slot machine task), decision-making under uncertainty (Iowa Gambling Task) and decision-making under risk (Game of Dice Task)., Results: We showed that specific factors theorized as underlying mechanisms for each pathway predicted the status of clinical gambler. For each pathway, significant predictors included gambling-related cognitive distortions and behaviourally measured gambling persistence (behaviourally conditioned pathway), emotional reactivity and emotion regulation strategies (emotionally vulnerable pathway), and lack of premeditation impulsivity facet (impulsivist-antisocial pathway)., Discussion and Conclusions: Our study adds to the body of literature confirming the validity of the Pathways Model and hold important implications in terms of assessment and treatment of problem gambling. In particular, a standardized assessment based on the Pathways Model should promote individualized treatment strategies to allow clinicians to take into account the high heterogeneity that characterizes gambling disorder.

The co-occurrence of attention-deficit/hyperactivity disorder (ADHD) and problematic Internet use (PIU) is associated with increased severity of PIU and poorer treatment outcomes. The main objective of this study was to examine the association between PIU and adult ADHD symptoms and determine whether adult ADHD symptoms were a predictor of PIU in the general adult population. We also examined the potential mediating role of the dimensional psychopathological factors, including anxiety, depression, impulsivity, and emotion regulation, in this relationship. To achieve these aims, we recruited 532 regular Internet users online from the general adult population. The participants completed an online questionnaire assessing PIU (Internet Addiction Test), anxiety and depression symptoms (Hospital Anxiety and Depression Scale), adult ADHD symptoms (Adult ADHD Self-Report Scale-V1.1), emotion regulation (Emotion Regulation Questionnaire), and impulsivity (UPPS-P Impulsive Behavior Scale). We conducted a multiple regression analysis to determine the predictors of PIU and mediation analyses to identify the psychopathological mediators of the association between adult ADHD symptoms and PIU. PIU was observed in 17.9% of our sample. A significantly higher proportion of respondents with PIU screened positive for adult ADHD symptoms compared to respondents without PIU (50.5 vs. 21.7%; p < 0.001). Individuals with PIU reported significantly higher scores than those without PIU for anxiety and depressive symptoms, impulsivity, and the emotion regulation strategy of expressive suppression. Additionally, they had significantly lower scores than those without PIU on cognitive reappraisal than non-problematic Internet users. In addition to adult ADHD symptoms, the multiple regression analysis revealed that PIU was also positively predicted by depressive symptoms, positive urgency, lack of perseverance, and expressive suppression, and is negatively predicted by cognitive reappraisal and negative urgency. The mediation analysis showed that lack of perseverance, positive urgency, and depressive and anxiety symptoms were partial mediators of the relationship between adult ADHD symptoms and PIU. Our results highlight the significant co-occurrence of PIU and adult ADHD symptoms. This study also provides support for a theoretical model in which impulsivity dimensions, emotion regulation strategies, as well as the tendency to anxiety and depressive symptoms, may play a mediating role in this co-occurrence. In summary, the findings emphasize the need to assess these psychological characteristics in problematic Internet users, as they can be a factor of clinical complexity, as well as the importance of targeting them as part of integrated interventions for both adult ADHD symptoms and PIU., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The Handling Editor FV declared a shared affiliation, though no other collaboration, with the author IV at the time of the review., (Copyright © 2022 El Archi, Barrault, Brunault, Ribadier and Varescon.)

Introduction: Attention-deficit/hyperactivity disorder (ADHD) is associated with binge eating (BE), food addiction (FA), and obesity/higher BMI in individuals without alcohol use disorder (AUD). ADHD is highly prevalent in patients with AUD, but it is unknown whether the presence of comorbid AUD might change the nature of the association between ADHD, BE, FA and BMI (food and alcohol may either compete for the same brain neurocircuitry or share vulnerability risk factors). Here, we filled this gap by testing the association between ADHD and FA/BE in adult patients hospitalized for AUD, with the strength of simultaneously assessing childhood and adult ADHD. We also investigated the association between ADHD and BMI, and the other factors associated with BMI (FA/BE, AUD severity)., Methods: We included 149 AUD inpatients between November 2018 and April 2019. We assessed both childhood and adulthood ADHD (Wender Utah Render Scale and Adult ADHD Self-Report Scale), FA (modified Yale Food Addiction Scale 2.0), BE (Binge Eating Scale), and BMI and AUD (clinical assessment)., Results: In multivariable analyses adjusted for age, adult ADHD was associated with higher BE scores (p = .048), but not significant BE (9% vs. 7%; p = .70). ADHD was also associated with FA diagnosis and the number or FA symptoms, with larger effect size for adult (ORs: 9.45[95%CI: 2.82-31.74] and 1.38[1.13-1.69], respectively) than childhood ADHD (ORs: 4.45[1.37-14.46] and 1.40[1.13-1.75], respectively). In multivariable analysis, BMI was associated with both significant BE (p < .001) and FA diagnosis (p = .014), but not adult ADHD nor AUD severity., Conclusion: In patients hospitalized for AUD, self-reported adult ADHD was associated with FA and BE, but not BMI. Our results set the groundwork for longitudinal research on the link between ADHD, FA, BE, and BMI in AUD inpatients., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: Addictive-like eating and attention-deficit/hyperactivity disorder (ADHD) are both common among persons seeking treatment for severe obesity. Given that ADHD and addictive-like eating, especially binge eating (BE) and food addiction (FA), are both strongly associated with personality dimensions and emotion dysregulation, it is possible emotional and personality characteristics contribute to the link between addictive-like eating behaviors and ADHD in people with severe obesity. This study aimed to investigate the psychological factors associated with BE and FA in bariatric surgery candidates, and to explore the mediational role of emotional factors (emotion dysregulation and alexithymia) and personality dimensions in the association between ADHD and BE. Method: Two hundred and eighty-two ( n = 282) bariatric surgery candidates were recruited during the systematic preoperative psychiatric assessment (University Hospital of Tours, France). We assessed significant BE (Binge Eating Scale), probable adult ADHD (Wender Utah Render Scale and Adult ADHD Self-Report Scale), FA (Yale Food Addiction Scale 2.0, YFAS 2.0), emotion dysregulation (Difficulties in Emotion Regulation Scale-16), alexithymia (Toronto Alexithymia Scale-20) and personality dimensions (Big Five Inventory). Mediation analyses were performed using the PROCESS macro for IBM SPSS Statistics 22. Results: Prevalence of probable adult ADHD, significant BE and FA were 8.2, 19.1, and 26.6%, respectively. Participants who screened positive for addictive-like eating showed higher prevalence of probable adult ADHD, as well as higher scores on adult and childhood ADHD symptoms. They also reported lower conscientiousness, but higher emotion dysregulation, higher alexithymia, and higher neuroticism. Only BE (as opposed to FA) was also associated with lower scores on agreeableness and openness. Analysis of the association between adult ADHD and BE suggests that emotion dysregulation, conscientiousness, agreeableness, and neuroticism are total mediators and alexithymia a partial mediator. Conclusion: Our findings suggest a significant association between ADHD and addictive-like eating among bariatric surgery candidates, and also suggest a significant role of emotion dysregulation and personality dimensions in this association. For individuals with ADHD and obesity, eating may be a way to cope with negative emotions, potentially increasing the risk for addictive-like eating behavior., Competing Interests: NB reports personal fees from Lundbeck, Astra-Zeneca and D&A Pharma, unrelated to the submitted work. PB reports personal fees and non-financial support from Lundbeck, personal fees from Astra-Zeneca and D&A Pharma, unrelated to the submitted work. SC declares honoraria and reimbursement for travel and accommodation expenses for lectures from the following non-profit associations: Association for Child and Adolescent Central Health (ACAMH), Canadian ADHD Alliance Resource (CADDRA), British Association of Pharmacology (BAP), and from Healthcare Convention for educational activity on ADHD. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 El Archi, Brunault, De Luca, Cortese, Hankard, Bourbao-Tournois, Ballon, Réveillère and Barrault.)

Objective: Increasing number of studies show an association between adult ADHD (a-ADHD) and posttraumatic stress disorder (PTSD). We explored this association in alcohol use disorder (AUD) inpatients. Method: In total, 551 inpatients cross-sectionally completed self-administered questionnaires regarding sociodemographics, lifetime trauma exposure, PTSD Checklist for DSM-5 , Adult ADHD Self-Report Scale (ASRS), and Wender Utah Rating Scale (WURS). We considered self-reported a-ADHD when ASRS and WURS had significant scores. Results: Prevalence for a-ADHD was 20%. PTSD prevalence was higher in a-ADHD patients (84% vs. 40%; p < .001). They also were younger ( p < .001) and women ( p = .015). Adult ADHD was associated with more traumatic events, and symptoms were correlated with PTSD severity. After adjusting for age, gender and marital status, PTSD severity was associated with a-ADHD. Conclusion: Our study confirms that a-ADHD is associated with PTSD in AUD inpatients, and thus, may represent a specific subpopulation. Future studies should explore implication of this dual diagnosis on AUD and treatment outcome.

The present research aimed to study the relationship between emotion dysregulation, impulsivity, anxiety, depression and sexual addiction. A survey was conducted among 398 voluntary subjects recruited online through specialized forums. The participants completed validated questionnaires. Our results showed that individuals with sexual addiction reported more difficulty regulating emotions and higher levels of impulsivity than those individuals who were not defined as having a sexual addiction. In addition, anxiety and depression were significantly associated with sexual addiction. Furthermore, anxiety and depression seemed to partially mediate the links between impulsivity, emotion dysregulation and this addiction. Finally, emotion dysregulation and impulsivity had mediating effects on the relationship between anxious-depressive affects and sexual addiction. Despite the limitations of this study, our results seem to be consistent with the literature on sexual addiction and have clinical and research implications.

Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with disordered eating, especially addictive-like eating behavior (i.e., binge eating, food addiction, loss of control overeating). The exact mechanisms underlying this association are unclear. ADHD and addictive-like eating behavior are both associated with negative affectivity and emotion dysregulation, which we hypothesized are mediators of this relationship. The purpose of this systematic review was to review the evidence related to this hypothesis from studies assessing the relationship between childhood or adulthood ADHD symptomatology, negative affectivity, emotion dysregulation and addictive-like eating behavior. The systematic review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) recommendations. The literature search was conducted in PubMed and PsycINFO (publication date: January 2015 to August 2020; date of search: 2nd September 2020). Out of 403 potentially relevant articles, 41 were retained; 38 publications reported that ADHD and disordered eating or addictive-like eating behavior were significantly associated, including 8 articles that suggested a mediator role of negative affectivity or emotion dysregulation. Sixteen publications reported that the association between ADHD symptomatology and disordered eating or addictive-like eating behavior differed according to gender, eating behavior and ADHD symptoms (hyperactivity, impulsivity and inattention). We discuss the practical implications of these findings and directions future research., Competing Interests: S.C. declares reimbursement for travel and accommodation expenses from the Association for Child and Adolescent Central Health (ACAMH) in relation to lectures delivered for ACAMH, and from Healthcare Convention for educational activity on ADHD. N.B. reports personal fees from Lundbeck, Astra-Zeneca and D&A Pharma, unrelated to the submitted work. P.B. reports personal fees and non-financial support from Lundbeck, personal fees from Astra-Zeneca and D&A Pharma, unrelated to the submitted work. S.E.A., CR A.D.L. and SB declares no conflict of interest.

The recent literature shows that the type of gambling practiced influences problem gambling. This study was aimed at investigating the factors associated with gambling type, including gambling severity, gambling motives, and cognitive distortions. A total of 291 regular male gamblers (229 skill gamblers and 62 mixed gamblers, i.e., those who play at least one game of chance and one skill game) were recruited online and assessed for gambling severity (South Oaks Gambling Screen), gambling motives (Gambling Motives Questionnaire-Financial), cognitive distortions (Gambling-Related Cognition Scale), and psychological distress (Hospital Anxiety and Depression Scale). After controlling for the number of games played and psychological distress, we found that gambling type was significantly associated with gambling severity. Moreover, controlling for psychological distress showed that gambling type was also significantly associated with coping motives and interpretative bias. First, mixed gamblers had higher severity scores and higher coping motivation than skill gamblers; second, skill gamblers seemed more at risk of developing interpretative bias. Thus, the gamblers presented different psychological, motivational, and cognitive profiles according to gambling type, indicating that different clinical interventions may be relevant. Working on coping motives and anxiety and depression symptoms with an abstinence purpose would be more suitable for mixed gamblers. Indeed, working on these points could lead to the gambler reducing or eventually ceasing gambling, as the need to regulate negative emotions through gambling behavior would fade in parallel. Gambling type, psychological distress, gambling motives, and cognitive distortions should be taken into consideration systematically in clinical interventions of patients with plural and mixed practice of games., Competing Interests: The authors have declared that no competing interests exist.

Introduction: The Sexual Addiction Screening Test (SAST) is one of the most frequently used tools on the international level for assessing sexual addiction. This study aimed to translate the English version of the SAST, and adapt and test the psychometric properties of its French version (the SAST-Fr) by establishing its factor structure, internal consistency and convergent validity., Methods: Three hundred ninety eight voluntary participants were recruited online through specialized forums. Participants completed a sociodemographic questionnaire, the SAST-Fr and the diagnostic criteria of sexual addiction proposed by Goodman. We tested the psychometric properties of SAST-Fr through an exploratory factorial analysis, especially its internal consistency, using the Kuder-Richardson alpha (KR-20) given that the items were dichotomous. We also performed correlation analyses of Bravais-Pearson on numerical variables. Finally, we studied the predictive validity of Goodman's score in predicting SAST-Fr criteria using a ROC (Receiver Operating Characteristics) analysis., Results: Mean age of participants was 29.08 years (±11.30) and included 54% of women (n=215). Statistical analysis had shown that SAST-Fr had a one-factor structure explaining 31% of the variance, an excellent internal consistency (KR-20=0.90). We found significant correlation between SAST-Fr item scores and PEACCE scores (r=0.87; P<0.001) and Goodman's criteria (r=0.79; P<0.001)., Conclusion: Our results indicate that the psychometric properties of the French version of the SAST are comparable to its original English version with a one-factor structure. The SAST-Fr is a reliable and valid questionnaire to assess symptoms of sexual addiction., (Copyright © 2020 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.)

Post-traumatic stress disorder (PTSD) is highly prevalent among patients hospitalized for an alcohol use disorder (AUD). Hospitalization can improve PTSD and AUD outcomes in some but not all patients, but we lack data on the baseline predictors of PTSD non-remission. This study aimed to determine the baseline risk factors for non-remitted PTSD in patients hospitalized for an AUD. Of 298 AUD inpatients recruited in a rehabilitation center (Le Courbat, France), we included 91 AUD inpatients with a co-occurring PTSD and a longitudinal assessment at baseline (T1) and before discharge (T2: 8 weeks later). Patients were assessed for PTSD diagnosis/severity (PCL-5=PTSD Checklist for DSM-5), different types of trauma including childhood trauma (LEC-5=Life Events Checklist for DSM-5/CTQ-SF=Childhood Trauma Questionnaire, Short-Form), and AUD diagnosis/severity (clinical interview/AUDIT=Alcohol Use Disorders Identification Test). Rate of PTSD remission between T1 and T2 was 74.1%. Non-remitted PTSD at T2 was associated with a history of childhood trauma (physical, emotional or sexual abuse, physical negligence), but not with other types of trauma experienced, nor baseline PTSD or AUD severity. Among patients hospitalized for an AUD with co-occurring PTSD, PTSD remission was more strongly related to the existence of childhood trauma than to AUD or PTSD severity at admission. These patients should be systematically screened for childhood trauma in order to tailor evidence-based interventions.

The number of hematopoietic stem cell transplantation is in constant rise. This increase has put in spotlight the lack of physician availability. Some healthcare centers have already organised a nurse's consultation under the supervision of an expert physician. We conducted a survey among nurses and physicians from the French Society of Bone Marrow Transplantation and Cell Therapy (SFGM-TC) centers who confirmed the need to create a special transplantation-skilled population of nurses. During this ninth annual workshop of the SFGM-TC, we have defined the required conditions for a transplant nurse consultation until day 100 post-transplant with the responsibility of the transplant expert physician. To help the centers in this dynamic, we provided practical tools to support this consultation. The current heath policy is in favor of an increased autonomy of the expert nurse. The implementation of the status of nurse in advanced practice is the first step in this professional development., (Copyright © 2019. Published by Elsevier Masson SAS.)

Introduction: Since their first appearance in 1992 smartphones have improved constantly, and their use, combined with the rapid spread of the Internet, has increased dramatically. The recent emergence of this technology raises new issues, at both individual and societal levels. Several studies have investigated the physical and psychological harm that may be caused by smartphones. The issue of excessive smartphone use as an addictive disorder is frequently raised and debated, although it is not acknowledged in international classifications. In France, there is no validated assessment tool for smartphone addiction. Therefore, the aims of this research were: to validate a French translation of the Internet Addiction Test-smartphone version (IAT-smartphone); to study the links between smartphone addiction, Internet addiction, depression, anxiety and impulsivity., Method: Two hundred and sixteen participants from the general population were included in the study (January to February 2016), which was available online using Sphinx software. We assessed smartphone addiction (French version of the Internet Addiction Scale - smartphone version, IAT-smartphone), specificity of smartphone use (time spent, types of activity), Internet addiction (Internet Addiction Test, IAT), impulsivity (UPPS Impulsiveness Behavior Scale), and anxiety and depression (Hospital Anxiety and Depression scale, HAD). We tested the construct validity of the IAT-smartphone (exploratory factor analysis, internal consistency, non-parametric correlation tests for convergent validity). We also carried out multiple linear regressions to determine the factors associated with IAT-smartphone., Results: Mean age was 32.4±12.2 years; 75.5% of the participants were women. The IAT-smartphone had a one-factor structure (explaining 42 % of the variance), excellent internal consistency (α=0.93) and satisfactory convergent validity. Smartphone addiction was associated with Internet addiction (ρ=0.85), depression (ρ=0.31), anxiety (ρ=0.14), and some impulsivity subscales, including "negative urgency" (ρ=0.20; P<0.01), "positive urgency" (ρ=0.20; P<0.01), and "lack of perseverance" (ρ=0.16; P<0.05). Age was negatively associated with the IAT-S total score (ρ=-0.25; P<0.001), and there was a non-significant difference between the IAT-S total scores of men and women (29.3±10.2 vs. 32.7±12.4; P=0.06). Multiple linear regression showed that age, anxiety, depression, average time spent on the smartphone, impulsivity and Internet addiction explained 71.4 % of the variance of IAT-smartphone scores. However, this score dropped to 13.2 % when Internet addiction was removed from the model. This variable alone explained 70.8 % of the IAT-smartphone scores., Conclusion: The French version of the IAT-smartphone is a reliable and valid questionnaire to assess smartphone addiction. This addiction appears to be strongly linked to anxiety, depression and impulsivity. The strong association between smartphone addiction and Internet addiction suggests that smartphone addiction is one of the many forms of Internet addiction. In fact, smartphones may not be the object of the addiction but rather a medium facilitating Internet access as it makes it possible to connect anywhere anytime. This raises the issue of the potential role of smartphones in speeding up and facilitating the development of Internet addiction., (Copyright © 2017 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.)

Background: In police officers, posttraumatic stress disorder (PTSD) is associated with alcohol use disorder (AUD), but we lack data on the association between PTSD and other substance-related and addictive disorders., Objectives: We assessed whether PTSD could be a risk factor for different substance-related and addictive disorders in police officers, including alcohol, tobacco, cannabis, and gambling., Method: This cross-sectional study included all police officers admitted consecutively for alcohol to an inpatient ward dedicated to police officers (Le Courbat rehabilitation center, France; n= 133). Each patient completed self-administered questionnaires that assessed lifetime exposure to potentially traumatic events (Life Event Checklist for DSM-5), PTSD severity and diagnosis (PTSD Checklist for DSM-5), AUD severity (Alcohol Use Disorder Identification Test [AUDIT]), tobacco dependence (Fagerström test for Nicotine Dependence), cannabis dependence (Cannabis Abuse Screening test), and gambling disorder (Canadian Problem Gambling Index)., Results: Mean AUDIT score was 23.7 ± 8.0; 66.2% had an AUDIT score ≥20. Our sample comprised a high prevalence for PTSD (38.3%) and for substance-related and addictive disorders: tobacco dependence (68.4%), cannabis dependence (3.8%), and pathological gambling (3%). Patients with PTSD experienced higher lifetime exposure to traumatic experiences: physical assault, severe human suffering, sudden accidental death of another person, and other types of stressful events/experiences. In multiple linear regressions adjusted for age, sex, and marital status, PTSD was a significant predictor of the severity of AUD and tobacco use disorder, but not of the severity of cannabis use disorder nor gambling disorder., Conclusions: PTSD is common in police officers hospitalized for alcohol and associated with a higher severity of some addictive disorders (alcohol/tobacco). PTSD and its comorbid addictive disorders should be systematically screened and treated in this population., (© 2019 S. Karger AG, Basel.)

The purpose of this research was to examine the relationship between sensation seeking and online poker gambling in a community sample of adult online poker players, when controlling for age, gender, anxiety and depression. In total, 288 online poker gamblers were recruited. Sociodemographic data, gambling behavior (CPGI), sensation seeking (SSS), depression and anxiety (HADS) were evaluated. Problem online poker gamblers have higher sensation seeking scores (total, thrill and adventure, disinhibition and boredom susceptibility subscores) and depression scores than non-problem online poker gamblers. Being male, with total sensation seeking, disinhibition and depression scores are factors associated with online poker problem gambling. These findings are interesting in terms of harm reduction. For example, because disinhibition could lead to increased time and money spent, protective behavioral strategies like setting time and monetary limits should be encouraged in poker online gamblers., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Gambling behavior is partly the result of varied motivations leading individuals to participate in gambling activities. Specific motivational profiles are found in gamblers, and gambling motives are closely linked to the development of cognitive distortions. This cross-sectional study aimed to predict cognitive distortions from gambling motives in poker players. The population was recruited in online gambling forums. Participants reported gambling at least once a week. Data included sociodemographic characteristics, the South Oaks Gambling Screen, the Gambling Motives Questionnaire-Financial and the Gambling-Related Cognition Scale. This study was conducted on 259 male poker gamblers (aged 18-69 years, 14.3% probable pathological gamblers). Univariate analyses showed that cognitive distortions were independently predicted by overall gambling motives (34.8%) and problem gambling (22.4%) (p < .05). The multivariate model, including these two variables, explained 39.7% of cognitive distortions (p < .05). The results associated with the literature data highlight that cognitive distortions are a good discriminating factor of gambling problems, showing a close inter-relationship between gambling motives, cognitive distortions and the severity of gambling. These data are consistent with the following theoretical process model: gambling motives lead individuals to practice and repeat the gambling experience, which may lead them to develop cognitive distortions, which in turn favor problem gambling. This study opens up new research perspectives to understand better the mechanisms underlying gambling practice and has clinical implications in terms of prevention and treatment. For example, a coupled motivational and cognitive intervention focused on gambling motives/cognitive distortions could be beneficial for individuals with gambling problems.

Poker is a type of gambling that has specific features, including the need to regulate one's emotion to be successful. The aim of the present study is to assess emotion regulation, anxiety and depression in a sample of regular poker players, and to compare the results of problem and non-problem gamblers. 416 regular online poker players completed online questionnaires including sociodemographic data, measures of problem gambling (CPGI), anxiety and depression (HAD scale), and emotion regulation (ERQ). The CPGI was used to divide participants into four groups according to the intensity of their gambling practice (non-problem, low risk, moderate risk and problem gamblers). Anxiety and depression were significantly higher among severe-problem gamblers than among the other groups. Both significantly predicted problem gambling. On the other hand, there was no difference between groups in emotion regulation (cognitive reappraisal and expressive suppression), which was linked neither to problem gambling nor to anxiety and depression (except for cognitive reappraisal, which was significantly correlated to anxiety). Our results underline the links between anxiety, depression and problem gambling among poker players. If emotion regulation is involved in problem gambling among poker players, as strongly suggested by data from the literature, the emotion regulation strategies we assessed (cognitive reappraisal and expressive suppression) may not be those involved. Further studies are thus needed to investigate the involvement of other emotion regulation strategies.

Background and Objectives: The aim of this study is to see if: (i) alexithymia is associated with PG and with the severity of gambling behavior; (ii) alexithymia is associated with strategic and non-strategic gambling., Methods: Two hundred and twenty-six gamblers were recruited in different gambling locations. First, pathological gamblers (PGs) (n = 106) were compared to non-pathological gamblers (NPGs) (n = 120). Second, strategic gamblers (n = 92) were compared to non-strategic gamblers (n = 96)., Results: After controlling for being or not depressed, PGs have significantly higher alexithymia scores. Alexithymia is positively correlated to the intensity of gambling behavior and associated with PG: being alexithymic (OR = 4.21, SEB = .32, p < .001), "difficulty identifying feelings" (OR = 1.07, SEB = .03, p = .038), and "externally-oriented thinking" (OR = 1.07, SEB = .03, p = .026) factors. Nevertheless, while alexithymia is associated with PG in strategic gamblers (being alexithymic (OR = 6.80, SEB = .50 p < .001) and "difficulty identifying feelings" (OR = 1.12, SEB = .05 p = .026) factor), this is not the case in non-strategic gamblers. In the latter, only depression is associated with PG (OR = 3.43, SEB = .50 p = .013)., Discussion and Conclusion: The results highlight the importance of taking into account the gambling type in the relationship between alexithymia, depression, and PG., Scientific Significance: In non-strategic PGs, specific therapies targeting depression could be appropriate, while for strategic PGs, specific psychotherapeutic techniques like body-centered psychotherapy could help them to differentiate feelings from bodily sensations. (Am J Addict 2017;26:152-160)., (© 2017 American Academy of Addiction Psychiatry.)

Background and aims Online gambling appears to have special features, such as anonymity, speed of play and permanent availability, which may contribute to the facilitation and increase in gambling practice, potentially leading to problem gambling. The aims of this study were to assess sociodemographic characteristics, gambling practice and impulsive sensation seeking among a population of regular poker players with different levels of gambling intensity and to compare online and live players. Methods 245 regular poker players (180 online players and 65 live players) completed online self-report scales assessing sociodemographic data, pathological gambling (SOGS), gambling practice (poker questionnaire) and impulsive sensation seeking (ImpSS). We used SOGS scores to rank players according to the intensity of their gambling practice (non-pathological gamblers, problem gamblers and pathological gamblers). Results All poker players displayed a particular sociodemographic profile: they were more likely to be young men, executives or students, mostly single and working full-time. Online players played significantly more often whereas live players reported significantly longer gambling sessions. Sensation seeking was high across all groups, whereas impulsivity significantly distinguished players according to the intensity of gambling. Discussion Our results show the specific profile of poker players. Both impulsivity and sensation seeking seem to be involved in pathological gambling, but playing different roles. Sensation seeking may determine interest in poker whereas impulsivity may be involved in pathological gambling development and maintenance. Conclusions This study opens up new research perspectives and insights into preventive and treatment actions for pathological poker players.

Objective: We investigated whether alexithymia is at the root of the decision-making deficit classically reported in pathological gamblers., Background: Alexithymia has been shown to be a recurrent personality trait of pathological gamblers and to impair the decision-making abilities of nonpathological gamblers, but no previous studies have investigated whether alexithymia significantly affects pathological gamblers' decision making. Although investigations of pathological gamblers typically have studied those seeking treatment, most pathological gamblers do not seek treatment. Thus, to study people representative of the general population of pathological gamblers, we conducted our study in "sportsbook" casinos with a small sample of gamblers who were not seeking treatment., Methods: We recruited gamblers in sportsbooks and classified them based on their scores on the South Oaks Gambling Screen and the Toronto Alexithymia Scale: 3 groups of pathological gamblers (6 alexithymic, 8 possibly alexithymic, and 6 nonalexithymic) and 8 healthy controls. All of the participants completed an adaptation of the Iowa Gambling Task., Results: The alexithymic group chose less advantageously on the task than the other groups. The severity of the deficit in decision-making abilities was related to the severity of alexithymia, even when we controlled for the effects of anxiety and depression., Conclusions: Our findings provide preliminary evidence that alexithymia might be a critical personality trait underlying pathological gamblers' decision-making deficits.

The aims were to assess cognitive distortions and psychological distress (anxiety and depression) among online poker players of different levels of gambling intensity (non-pathological gamblers [NPG], problem gamblers [PbG], and pathological gamblers [PG]), and to examine the relationship between these variables and gambling pathology. Overall, 245 regular online poker players recruited on an Internet forum completed online self-report scales assessing pathological gambling (South Oaks Gambling Screen [SOGS]), psychological distress (Hospital Anxiety and Depression Scale [HADS]) and cognitive distortions (Gambling-Related Cognition Scale). Based on their SOGS scores, poker players were ranked into three groups: NPG (n=146), PbG (n=55), and PG (n=44). All poker players appeared to be more anxious than depressive. PG exhibited higher levels of depression and anxiety than did PbG and NPG. Cognitive distortions also significantly discriminated PG from PbG and NPG. A regression model showed that the perceived inability to stop gambling, the illusion of control, depression (HADS D), and anxiety were good predictors for pathological gambling among poker players. Our results suggest that cognitive distortions play an important role in the development and maintenance of gambling pathology. This study also underlines the role of anxiety and depression in pathological gambling among poker players. It seems relevant to take these elements into account in the research, prevention, and treatment of pathological gambling poker players.

Introduction: The rapidly expanding gambling offline and online have resulted in an increasing number of gamblers and the problem is likely to get worse in the future. However, online pathological gambling is a not well known. This rapidly developing modality of gambling, which requires to be studied, notably in its links with regular pathological gambling and Internet addiction. Depression and personality disorders are known to be often associated with pathological gambling. Personality disorders have an influence on pathological gambling, increasing its severity. Online gamblers seem to have a particular personality profile, compared to offline gamblers, and could present different personality disorders. Depression is a common comorbidity among online gamblers, as well as offline gamblers. Both types of gamblers have personality disorders, but the nature of these disorders differs: prevalency of personality disorders of cluster B (dramatic, emotional or erratic disorders) is more important in offline gamblers, whereas cluster C (anxious or fearful disorders) is more present in online pathological gamblers. In France, few studies have specifically examined this subject., Aims: The objective of the study is to evaluate scores on depression, personality disorders and internet addiction in online pathological gamblers., Method: The South Oaks Gambling Screen (SOGS) is used to assess pathological gambling, Beck's Depression Inventory (BDI) to measure depression, the Personality Disorders Questionnaire (PDQ 4) to assess personality disorders and the Internet Addiction Test (IAT) to assess internet addiction. Participants completed the self-report scales. Questionnaires were strictly confidential., Population: The participants were recruited in gambling places (cafés) and Internet forums. Two groups of pathological gamblers were formed: online gamblers (N=15) and offline gamblers (N=15). Participants gave their informed consent. Participation was voluntary and anonymous and no payment was made. ANALYSIS OF THE DATA: The data collection was carried out with an anonymous file and then placed in a data bank. The statistical analysis was carried out using traditional techniques: averages, frequency, standard deviations. Differences among groups were tested using the t-test., Results: The results showed that the majority of subjects met diagnostic criteria for at least one personality disorder. The majority of pathological online gamblers evidenced personality of cluster C grouping avoidant, dependant and obsessive-compulsive personalities. Personality disorders differ according to the type of gambling: offline gamblers have more disorders of cluster B, while online gamblers have more disorders of cluster C. Some personality disorders, in particular borderline and narcissistic personality disorders, are often associated with pathological gambling and seem to have an increasing effect on depression and pathological gambling's intensity. Pathological gambling is strongly correlated to depression. Online pathological gambling, Internet addiction and offline pathological gambling appear to be strongly correlated., Discussion/conclusion: This study opens new perspectives of questioning and research, in particular for existing links between online and offline pathological gambling and internet addiction, and in existent differences between online and offline pathological gamblers. Online pathological gambling shares common characteristics with pathological gambling and Internet addiction, without being able to be assimilated with one or the other. This type of gambling, therefore, requires to be studied to adapt the actions of prevention and treatment intended for online pathological gamblers., (Copyright © 2011 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.)

Association genetics is a powerful method to track gene polymorphisms responsible for phenotypic variation, since it takes advantage of existing collections and historical recombination to study the correlation between large genetic diversity and phenotypic variation. We used a collection of 375 maize (Zea mays ssp. mays) inbred lines representative of tropical, American, and European diversity, previously characterized for genome-wide neutral markers and population structure, to investigate the roles of two functionally related candidate genes, Opaque2 and CyPPDK1, on kernel quality traits. Opaque2 encodes a basic leucine zipper transcriptional activator specifically expressed during endosperm development that controls the transcription of many target genes, including CyPPDK1, which encodes a cytosolic pyruvate orthophosphate dikinase. Using statistical models that correct for population structure and individual kinship, Opaque2 polymorphism was found to be strongly associated with variation of the essential amino acid lysine. This effect could be due to the direct role of Opaque2 on either zein transcription, zeins being major storage proteins devoid of lysine, or lysine degradation through the activation of lysine ketoglutarate reductase. Moreover, we found that a polymorphism in the Opaque2 coding sequence and several polymorphisms in the CyPPDK1 promoter nonadditively interact to modify both lysine content and the protein-versus-starch balance, thus revealing the role in quantitative variation in plants of epistatic interactions between a transcriptional activator and one of its target genes.

External fixators are standard devices to stabilize bone fractures and their compliance aims at producing an interfragmentary motion that promotes rapid and successful healing. While evaluation of their axial compliance is a routine test, the quantification and interpretation of their full 6 x 6 compliance matrix is an extensive and delicate task. In this context, the objective of this study was to develop, validate and demonstrate the potential of a rigorous method to quantify their 6 x 6 compliance matrix. An experimental system was developed to apply six independent static forces and moments to an external fixator in the field of view of two infrared cameras quantifying the induced motion. The system was then tested with a calibration structure which compliance could be calculated analytically and numerically. Finally, the system was applied to compare three configurations of a commercial external wrist fixator. The results of the method proved to be reproducible and highly consistent with the linear elasticity theory in the physiological range of small deformations. A rigorous method for evaluation of the 6D compliance becomes therefore available for research in mechanobiology of fracture healing by external fixation.

The authors reported three cases of branchial cycts containing a thyroid adenocarcinoma. This rare condition imposed a search for the primary tumor. All complementary investigations remained negative as in the few cases reported in the medical literature. A loboisthmectomy for one and a total thyroidectomy for the two others, with cervical recurential neck dissection for all was carried out. Histological examination of the operative specimen after total blocking in paraffin helped discover microscopic foci of papillary carcinoma in the thyroid gland. These data justified this therapeutic attitude because the nature of the adenocarcinoma found in the branchial cyst is likely to be metastatic.

The authors have realized a retrospective study about 246 patients who underwent partial thyroidectomy for a benign nodule or goiter between 1982 and 1991. Recurrence was analized with the method of Kaplan-Meier and concerned 11% of the patients at 3 years and 30% at 8 years. The statistical analysis showed that only patients with postoperative hormonal treatment were at risk of recurrence. This treatment was not randomized. Other studied factors (sex, age, type of surgery, pathological results, TSH level) are not correlated with recurrence. Surgical management is discussed.

We assessed retrospectively functional and endoscopic results obtained in 110 patients who underwent endonasal ethmoidectomy (n = 218). The patients were divided into 3 groups according to associated pathology (polyposis alone, asthma without intolerance to aspirin, Widal's disease) and outcome was evaluated after a mean 19.5 month follow-up. Function was improved in 88% of the patients. Endoscopic recurrence was seen in 40% of the patients including 10% with major polyposis. Oedema of the mucose remained in 20% of the patients and the mucosa was normal in 40%. Improvement in patients with Widal's disease was the least favourable among the three groups and was best in those with asthma and no intolerance to aspirin. Post-operative complications occurred in 12.6% of the patients and were severe in 0.9%. These satisfactory results, both in terms of function and the low rate of complications, suggest that the current medicosurgical management should be continued with particular attention to the rate of endoscopic recurrence.

47 cases of nasal polyposis and 19 cases of suppurated ethmoiditis were treated by intranasal ethmoidectomy. Results were evaluated by functional signs and nasosinusal endoscopy. 15 patients, among nasal polyposis, suffered from corticodependent asthma and 5 from Widal's disease. 64 patients were regularly followed-up for 1 to 4 years. Results in polyposis, after two years, in 47% of cases no recurrence was noted, a minor recurrence in 40% of cases, and 13% of failures with predominant Widal's disease. These results with low percentage of complications have lead us to choose intranasal ethmoidectomy. In suppurated ethmoiditis, results are good in 90% of cases if follow up is regular.