[Self-esteem, coping, perceived social support and substance use in young adults with a cannabis dependence disorder].
BACKGROUND
Self-esteem, coping strategies and perceived social support play a role in the adaptive functioning of the human being: they allow the adjustment of the subject to his/her environment. These dimensions could be protective factors regarding multiple risks associated with adolescent development, and particularly substance use. Thus our objective was twofold: to evaluate self-esteem, coping strategies and perceived social support in adolescents and young adults with a cannabis dependence in comparison with subjects from the general population; to establish the correspondence between these psychological dimensions and the patients' substance use pattern.


METHODS
Data from 43 young patients (36 males; mean age=19.6±3), consulting for their cannabis dependence, and 50 young adults from the general population (39 males; mean age=19.7±3.4) were included. Participants completed the Rosenberg Self-Esteem Inventory, the Social Self-Esteem Inventory of Lawson, the Coping Inventory for Stressful Situation of Endler & Parker, and the Perceived Social Support Questionnaire of Sarason. The MINI was administered to evaluate cannabis abuse or dependence; a semi-structured clinical interview was given to determine psychoactive substance use.


RESULTS
Between-group comparisons (two independent sample t-tests) showed that the patients had significantly lower scores on global (P=0.002) and social (P=0.035) self-esteem, task-oriented coping (P<0.001) and both availability and satisfaction regarding perceived social support (respectively P=0.029 and P<0.001). Conversely, patients had significantly higher scores on emotion-focused coping subscale (P=0.003). Logistic regressions showed that the satisfaction regarding social support and task-oriented coping scores were the more powerful to distinguish the patients from the controls (respectively β=1.16, P=0.043 and β=1.06, P=0.015). Unvaried linear regression analyses revealed a negative association between the age of first cannabis use and the avoidant-social coping score (P=0.025), and positive associations between the length of daily cannabis use and emotion-focused coping score (P=0.028), and frequency of cannabis use and global self-esteem scores (P=0.028). Moreover, polysubstance misuse is associated with low distraction-avoidant coping scores. No association was found between clinical scores and tobacco and alcohol uses variables.


CONCLUSIONS
These results suggest that cannabis dependent patients may present a lack in individual and interpersonal resources. This clinical study underscores the potential contribution of maladaptive coping to the development or maintenance of substance use in young adulthood.
EA 4057, laboratoire de psychopathologie et processus de santé, IUPDP, institut Henri-Piéron, université Paris Descartes-Sorbonne Paris-Cité, 71, avenue Édouard-Vaillant, 92100 Boulogne-Billancourt, France. Electronic address: geraldine.dorard@parisdescartes.fr.
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Dorard
EA 4057, laboratoire de psychopathologie et processus de santé, IUPDP, institut Henri-Piéron, université Paris Descartes-Sorbonne Paris-Cité, 71, avenue Édouard-Vaillant, 92100 Boulogne-Billancourt, France.
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Bungener
Inserm U669 PSIGIAM, universités Paris Descartes et Paris-Sud, Cochin-maison des adolescents, 97, boulevard Port-Royal, 75014 Paris, France; Département de psychiatrie de l'adolescent et du jeune adulte, institut mutualiste Montsouris, 42, boulevard Jourdan, 75674 Paris cedex 14, France.
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Corcos
Inserm U669 PSIGIAM, universités Paris Descartes et Paris-Sud, Cochin-maison des adolescents, 97, boulevard Port-Royal, 75014 Paris, France; Département de psychiatrie de l'adolescent et du jeune adulte, institut mutualiste Montsouris, 42, boulevard Jourdan, 75674 Paris cedex 14, France.
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Berthoz
D000223:Adaptation, Psychological; D000293:Adolescent; D003674:Defense Mechanisms; D004644:Emotions; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000175:diagnosis / Q000523:psychology*; D010555:Personality Inventory / Q000706:statistics & numerical data; D011594:Psychometrics; D012649:Self Concept; D012932:Social Facilitation; D012944:Social Support; D013223:Statistics as Topic; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000523:psychology*; D055815:Young Adult
Coping; Dependence; Dépendance; Estime de soi; Self-esteem; Social support; Soutien social; Stratégies de coping; Substance use; Substances psychoactives