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Tics, Troubles Associés Et Consommation De Marijuana Chez Des Adolescents Et Des Jeunes Adultes Atteints Du Syndrome De Gilles De La Tourette

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Tics, Troubles Associés Et Consommation De Marijuana Chez Des Adolescents Et Des Jeunes Adultes Atteints Du Syndrome De Gilles De La Tourette UNIVERSITÉ DU QUÉBEC À MONTRÉAL TICS, TROUBLES ASSOCIÉS ET CONSOMMATION DE MARIJUANA CHEZ DES ADOLESCENTS ET DES JEUNES ADULTES ATTEINTS DU SYNDROME DE GILLES DE LA TOURETTE ESSAI PRÉSENTÉ COMME EXIGENCE PARTIELLE AU DOCTORAT EN PSYCHOLOGIE PAR STÉPHANIE OUELLETTE DÉCEMBRE 2018 UNIVERSITÉ DU QUÉBEC À MONTRÉAL Service des bibliothèques Avertissement La diffusion de cette thèse se fait dans le respect des droits de son auteur, qui a signé le formulaire Autorisation de reproduire et de diffuser un travail de recherche de cycles supérieurs (SDU-522 - Rév.10-2015). Cette autorisation stipule que «conformément à l'article 11 du Règlement no 8 des études de cycles supérieurs, [l'auteur] concède à l'Université du Québec à Montréal une licence non exclusive d'utilisation et de publication de la totalité ou d'une partie importante de [son] travail de recherche pour des fins pédagogiques et non commerciales. Plus précisément, [l'auteur] autorise l'Université du Québec à Montréal à reproduire, diffuser, prêter, distribuer ou vendre des copies de [son] travail de recher~he à des fins non commerciales sur quelque support que ce soit, y compris l'Internet. Cette licence et cette autorisation n'entraînent pas une renonciation de [la] part [de l'auteur] à [ses] droits moraux ni à [ses] droits de propriété intellectuelle. Sauf entente contraire, [l'auteur] conserve la liberté de diffuser et de commercialiser ou non ce travail dont [il] possède un exemplaire.» REMERCIEMENTS Cet essai doctoral n'aurait pu voir le jour sans l'aide de nombreuses personnes. Je tiens d'abord à remercier ma directrice, Julie B. Leclerc pour m'avoir fait confiance en acceptant d'encadrer cet essai et pour toutes les heures consacrées à le diriger. Je suis très reconnaissante pour son écoute ainsi que les révisions et corrections apportées à cet essai. Un grand merci à mes collègues de l'équipe du laboratoire d'étude des troubles de la pathologie en enfance (LETOPE) et à ceux qui ont joint l'équipe à un certain moment, qui par leur aide concrète, par nos discussions et leurs commentaires, m'ont permis de clarifier et d'organiser mes idées, qui étaient parfois confuses ou incohérentes. Un grand merci à Annie, Gabrielle, Mélyane, Mathieu, Carole-Ann, Catherine, Audrey, Mélanie, Joanie, Maude et Julien. J'exprime également toute ma reconnaissance à Sophie Lemieux, qui a travaillé bénévolement sur l'adaptation de mon questionnaire en ligne. Un grand merci aussi à Juliette St-Denis, qui a contacté plusieurs écoles en lien avec mon recrutement. Merci à Sana Raouafi, Hugues Leduc et Philippe Valois pour leur aide et leurs précieux conseils en lien avec les analyses statistiques. Sans vous, la partie méthodologique m'aurait paru insurmontable. Un merci bien spécial à ma très chère maman, qui n'a jamais cessé de croire en moi. Ta présence, tes encouragements et ton amour inconditionnel m'ont donné la force et le courage de continuer à travers les obstacles et durant les moments de découragement. Tu es mon plus beau modèle de persévérance, de résilience et de détermination. iii J'adresse un remerciement tout particulier à mon amoureux pour sa grande patience, son amour, son soutien et ses encouragements tout au long de ce processus. À tous les adolescents et les jeunes adultes atteints du syndrome de Gilles de la Tourette et leurs parents qui ont participé à l'étude, ainsi qu'à l'Association québécoise du syndrome de Gilles de la Tourette, je souhaite exprimer ma gratitude, mon respect et mes remerciements. Enfin, je remercie sincèrement mes amis et collègues pour leur soutien moral et leurs encouragements pendant ces nombreuses années d'études. TABLE DES MATIÈRES LISTE DES TABLEAUX ........................................................................................... vii LISTE DES ABRÉVIATIONS ET ACRONYMES .................................................. viii RÉSUMÉ ..................................................................................................................... ix INTRODUCTION ........................................................................................................ 1 CHAPITRE I CONTEXTE THÉORIQUE .......................................................................................... 4 1.1 DÉFINITION ET CARACTÉRISTIQUES DU SYNDROME DE GILLES DE LA TOURETTE .... 4 1.1.1 Tics .......................................................................................................................... 5 1.1.2 Répercussions des tics ............................................................................................. 8 1.1.3 Troubles concomitants ............................................................................................ 9 1.1.4 Traitement du SGT ............................................................................................... 10 1.2 MARIJUANA .......................................................................................................... 13 1.2.1 Marijuana, adolescence et début de l'âge adulte ................................................... 13 1.2.2 Facteurs de risques à la consommation associés au SGT ..................................... 14 1.2.3 Conséquences associées à la consommation de marijuana ................................... 16 1.2.4 Motifs de consommation de marijuana ................................................................. 18 1.2.5 Marijuana et automédication ................................................................................. 18 1.2.6 Automédication et problèmes de santé physique et mentale ................................. 19 1.2. 7 Données empiriques concernant les effets réels de la marijuana .......................... 20 1.2.8 Actions des cannabinoïdes sur le corps humain .................................................... 22 1.3 MARIJUANA ET SGT ............................................................................................. 23 1.4 PROBLÉMATIQUE .................................................................................................. 26 1.5 OBJECTIFS ET HYPOTHÈSES DE RECHERCHE ........................................................... 27 CHAPITRE II MÉTHODE ................................................................................................................. 29 2.1 PARTICIPANTS ....................................................................................................... 29 2.2 PROCÉDURES DE RECRUTEMENT DES PARTICIPANTS ............................................. 30 V 2.3 INSTRUMENT DE MESURE ...................................................................................... 32 2.4 LE QUESTIONNAIRE CC-TIC ................................................................................. 33 2.5 ANALYSE DES DONNÉES ........................................................................................ 35 CHAPITRE III RÉSULTATS .............................................................................................................. 37 3. l CONSOMMATION DE MARIJUANA .......................................................................... 37 3.2 CONSOMMATION ET TICS ....................................................................................... 39 3.3 CONSOMMATION ET SYMPTÔMES DE TROUBLES ASSOCIÉS AU SGT ..................... .41 3 .4 VISIBILITÉ, FRÉQUENCE DES TICS ET FRÉQUENCE DE CONSOMMATION .................. 45 CHAPITRE IV DISCUSSION ............................................................................................................. 47 4.1 PROPORTION DE CONSOMMATEURS DE MARIJUANA .............................................. 48 4.2 MARIJUANA EN TANT QUE COMPORTEMENT D'AUTOMÉDICATION POUR LES TICS ....................................................................................................................... 51 4.2.1 Automédication des tics et fréquence de consommation ...................................... 55 4.3 AUTOMÉDICATION ET SYMPTÔMES DE TROUBLES ASSOCIÉS ................................. 56 4.4 LIEN ENTRE LA VISIBILITÉ, LA FRÉQUENCE DES TICS ET LA FRÉQUENCE DE CONSOMMATION ................................................................................................... 59 4.5 APPORTS DE L'ÉTUDE ............................................................................................ 60 4.6 LIMITES DE L'ÉTUDE ............................................................................................. 62 4.7 PISTES DE RECHERCHES FUTURES .......................................................................... 63 CHAPITRE V CONCLUSION ........................................................................................................... 64 LISTE DES APPENDICES ........................................................................................ 66 APPENDICE A QUESTIONS DU QUESTIONNAIRE CC-TIC REGROUPÉES SELON LES MOTIFS GÉNÉRAUX DE CONSOMMATION DE MARIJUANA ........................ 67 APPPENDICE B QUESTIONS DU QUESTIONNAIRE CC-TIC REGROUPÉES SELON LES MOTIFS DE CONSOMMATION COMME COMPORTEMENT D'AUTOMÉDICATION POUR LE SGT (TICS, SYMPTÔMES DE TROUBLES ASSOCIÉS) ........................................................................................... 69 VI APPENDICE C VERSION FRANCOPHONE DE L'AFFICHE DE RECRUTEMENT POUR LE CRIUSMM, LES RÉSEAUX SOCIAUX ET LES ASSOCIATIONS ....................... 71 APPENDICE D VERSION ANGLOPHONE DEL'AFFICHE DE RECRUTEMENT POUR LE CRIUSMM, LES RÉSEAUX SOCIAUX ET LES ASSOCIATIONS ....................... 73 APPENDICEE FORMULAIRE DE CONSENTEMENT DES PARTICIPANTS MINEURS (MOINS DE 18 ANS) - VERSION FRANCOPHONE .............................................
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