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Observance, personnalité et impulsivité dans les troubles thymiques : analyses psychométriques des échelles d’observances et de personnalité ainsi que de leurs relations

Abstract : This work analyses the use of an adherence scale (EGOMAC) in a population of 334 subjects with a chronic psychiatric disorder, followed by a psychiatric center. The aim is to study the trait characteristics associated with adherence behaviors. These characteristics include personality traits. These personality traits have been studied from the broadest General Factor of Personality, then at the level of the five dimensions of the Five-Factor Model and, at the more specific level, traits of impulsivity measured by the UPPS-P scale. The patients answered two scales assessing adherence (EGOMAC and MARS), two scales assessing personality (BFI-Fr and HEXACO-60), two scales assessing impulsivity (UPPS-P and IS-12), and a shortened scale of social desirability (BIDR). The main results are the psychometric sound characteristics of the EGOMAC scale with a four factors solution: 1. Voluntary adherence to medical advice, 2. Involuntary forgetting of drugs, 3. Following of hygiene-dietetic advice, 4. Adherence to medical appointments. In a bifactorial model, a general adherence dimension appears with three first-level factors. These factorials scores correlated well with scores at the MARS. The general factor of the EGOMAC scale correlated significantly with plasmatic lithium dosage in a subgroup of patients taking oral lithium. The General Factor of Personality correlated significantly with adherence factorial scores, as the stability factor of the Big Two Model. The factorial score of Consciousness, obtained in factorial models with a social desirability factor and an acquiescence factor, correlated significantly with adherence factorial scores. We conclude that the markers of behavioral management abilities, as Consciousness or stability factors from the personality scale or the level of perseverance from the UPPS-P scale are the most strongly related to adherence assessed both by self-report questionnaire and by plasma level. This study allows to better understand why these patients have difficulty with adherence, they present chronic affective lability, even in euthymic phase. This tells us that psychoeducation should not be the only way to help the patient take his treatment better, but that helping the patient to increase his behavioral management capacities (psychotherapy, cognitive remediation) could increase his adherence.
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Submitted on : Tuesday, November 23, 2021 - 3:54:08 PM
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Renaud Cohen. Observance, personnalité et impulsivité dans les troubles thymiques : analyses psychométriques des échelles d’observances et de personnalité ainsi que de leurs relations. Psychologie. Université de Lorraine, 2021. Français. ⟨NNT : 2021LORR0153⟩. ⟨tel-03443796⟩

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