PHD, PROFESSOR, V Christophe

Christelle Duprez

Anne Congard

E Fournier

A Lesur

P Antoine

L Vanlemmens

Evaluate the subjective experience of the disease and its treatment in the partners of young women with non-metastatic breast cancer

Keywords: Breast Cancer Inventory, partner, caregiving, quality of life, young women

published or not. The documents may come

Evaluate the subjective experience of the disease and its treatment in the partners of young women with non-metastatic breast cancer

INTRODUCTION

Cancer has psychosocial consequences not only on patients but also on their close relatives (for a review, see [START_REF] Hodges | A meta-analytic investigation of the relationship between the psychological distress of cancer patients and their carers[END_REF][START_REF] Given | The challenge of quality cancer care for family caregivers[END_REF], particularly their partners [START_REF] Hagedoorn | Couples dealing with cancer: role and gender differences regarding psychological distress and quality of life[END_REF][START_REF] Hasson-Ohayon | Women with advanced breast cancer and their spouses: diversity of support and psychological distress[END_REF][START_REF] Zwahlen | Adopting a family approach to theory and practice: measuring distress in cancer patient-partner dyads with the distress thermometer[END_REF]. In breast cancer, the partners report negative emotional reactions, changes in their career plans and in the organisation of their home life, worries about their child(ren) and changes in their couple relationship [START_REF] Fitch | Perspectives of husbands of women with breast cancer: impact and response[END_REF][START_REF] Harrow | Ambiguity and uncertainty: the ongoing concerns of male partners of women treated for breast cancer[END_REF].

Although the quality of life and the unmet needs of care-givers of cancer patients are well documented (e.g. [START_REF] Soothill | Informal carers of cancer patients: what are their unmet psychosocial needs?[END_REF][START_REF] Gustafson | Needs assessment for cancer patients and their families[END_REF][START_REF] Campbell | The cancer support person's unmet needs survey: psychometric properties[END_REF][START_REF] Shin | The development of a comprehensive needs assessment tool for cancer-caregivers in patient-caregiver dyads[END_REF][START_REF] Minaya | The CareGiver Oncology Quality of Life questionnaire (CarGOQoL): development and validation of an instrument to measure the quality of life of the caregivers of patients with cancer[END_REF], those of their partners, facing the disease and its repercussions on a daily basis, are less known. Early research works listed the specific need for information about the disease and its treatment (e.g. Kilpa-trick et al. 1998;[START_REF] Hodgkinson | Assessing unmet supportive care needs in partners of cancer survivors: the development and evaluation of the Cancer Survivors' Partners Unmet Needs measure (CaSPUN)[END_REF]). Others high-lighted not only the role of the partner's support, but also the processes of interdependence between the two partners in the adjustment within the couple (e.g. [START_REF] Ben-Zur | Coping with breast cancer: patient, spouse, anddyad models[END_REF][START_REF] Dorros | Interdependence in women with breast cancer and their partners: an interindividual model of distress[END_REF][START_REF] Kraemer | A longitudinal examination of couples' coping strategies as predictors of adjustment to breast cancer[END_REF]. Clinicians are increasingly aware of the concerns of the partner, which partially mirror those of the patient, particularly when she is young (under 45-50 years old at the time of the initial diagnosis): the wish to become a parent, which is some-times incompatible with the treatment offered, problems in managing the education of their sometimes still very young child(ren), deterioration in their marital relationship and sexuality, and a break on their professional career (for a review, see [START_REF] Roche | Follow-up after treatment for breast cancer in young women[END_REF][START_REF] Anders | Breast cancer before age 40 years[END_REF]Gabriel & Dom-chek 2010;[START_REF] Narod | Breast cancer in young women[END_REF][START_REF] Partridge | Model program to improve care for a unique cancer population: young women with breast cancer[END_REF].

Despite these recent works, to the best of our knowl-edge, there is no tool available to understand the subjec-tive experience of the disease and its repercussions in the partners of young women with breast cancer. Having such a tool will thus help clinicians identify the specific prob-lems of partners, in order to guide them towards suitable support care, as is already done for patients (e.g. [START_REF] Velikova | Measuring quality of life in routine oncology practice improves communication and patient well-being: a randomized controlled trial[END_REF][START_REF] Carlson | Screening for distress and unmet needs in patients with cancer: review and recommendations[END_REF].

Based on these observations, the present study aims to validate an inventory to measure the subjective experience of the disease and its treatment in the partners of young patients (<45 years at the initial diagnosis) with non-meta-static breast cancer: the 'Partner-of Young Women with Breast Cancer Inventory' ('Partner-YW-BCI').

PARTICIPANTS AND METHODS

Study population

The sample consisted of 499 partners of young patients with non-metastatic breast cancer (497 men, 2 women), aged 26-68 years (M = 43.29, SD = 7.45). They agreed to participate in the study between January 2010 and June 2012 in 27 French cancer treatment centres. The inclusion criteria were to be the partner of a young patient (<45 years at the initial diagnosis) with non-metastatic breast cancer who was or has been treated by chemother-apy. Only those partners who had been living as a couple for at least 6 months at the time of the study, had no known psychiatric disorders (delirium, psychotic prob-lems, etc.) and were fluent in French, were included.

The study obtained all the necessary legal and ethical au-thorisations (Committee of Protection of Persons; Consul-tative Committee for Data Processing in Research in the Field of Health; National Commission for Data Protection) and was carried out in accordance with the Code of Ethics of the World Medical Association (Declaration of Helsinki).

Procedure

The objectives and procedure of the study were explained to the patients, accompanied or not by their partner, during an outpatient appointment. No partner could participate without the explicit agreement of the patient. Following this agreement, the investigating doctor gave the patient, or her partner if present, a letter of information and a con-sent form for each member of the couple, the question-naire and a socio-demographic data form. The participants completed these documents alone at home and then returned them in the pre-stamped envelope provided to the treatment centre carrying out the study. At the same time, the patient's medical data were collected by each investigator in the participating centres. Conditions of anonymity and confidentiality were guaranteed to all participants.

Questionnaires

All the partners replied to the Partner-YW-BCI. In order to test the concurrent validity of the questionnaire, 105 of them also completed a quality-of-life questionnaire already validated and commonly used: the SF-36 [START_REF] Ware | The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection[END_REF]; French validation by [START_REF] Lepl | The French SF-36 Health Survey: translation, cultural adaptation and preliminary psychometric evaluation[END_REF]. Another group of partners (n = 84) answered the Partner-YW-BCI twice with an interval of 1 month so as to test the reliability of the questionnaire.

Partner-YW-BCI

This is a self-reported questionnaire composed of 77 items resulting from a previous qualitative study carried out with 69 couples in which the young woman (<45 years at the initial diagnosis) was living with non-metastatic breast cancer (Vanlemmens et al. 2012a(Vanlemmens et al. , 2012b)). These items were chosen to assess specifically the impact of the disease and treatment of the patient on their partner. They were organised into different dimensions: (1) psychologi-cal and affective experience concerning the present and the future (14 items, e.g. emotions felt, perception of the future), ( 2) physical (6 items, e.g. impact of the patient's disease on one's own physical health, acceptance of the patient's physical changes), (3) management of daily/ home life (4 items, e.g. new sharing of household tasks, changes in life habits), (4) questions about the child(ren) (8 items assessing the impact of the disease and its treat-ment on their child(ren), i.e. management of daily life with their child(ren), emotional problems experienced by the child(ren), being available for them), (5) professional life (4 items, e.g. personal investment in the job, effective-ness at work), (6) financial difficulties (4 items, e.g. fall in income and lifestyle, additional costs), (7) familial and social relationships (16 items, e.g. communication, cohesion, social support, perception of the impact of the dis-ease on relatives and on social activities) and (8) couple relationship (21 items, e.g. communication, cohesion and support within the couple, social activities, sexuality).

The partners were asked to assess to what extent each item corresponded to their current state ('at this moment, currently') by indicating their degree of agreement for each item on a 5-point Likert scale (from 1 = 'strongly disagree' to 5 = 'strongly agree').

Medical outcome study health survey short form-36 items (SF-36)

In order to test the concurrent validity of the Partner-YW-BCI, the participants were asked to complete the SF-36 [START_REF] Ware | The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection[END_REF]; French validation by [START_REF] Lepl | The French SF-36 Health Survey: translation, cultural adaptation and preliminary psychometric evaluation[END_REF]. This generic quality of life self-reported ques-tionnaire is composed of 36 items related to the 4 weeks before the interview, and divided into nine dimensions: mental health (5 items), vitality (4 items), physical activ-ity (10 items), limitations due to physical state (4 items), physical pain (2 items), perceived health (5 items), social life/relationships with others (2 items), limitations due to psychological state (4 items) and perceived changes in health during the previous year (1 item). For each dimen-sion, the scores were coded then added before being line-arly transformed on a scale from 0 (worst health) to 100 (best health possible).

Statistical analyses

Analyses to identify the factorial structure of the scale/ construct validity Descriptive analyses (examination of the distribution of the answers to items and correlation matrices between items) were first carried out to remove poorly discrimina-tive items.

An exploratory factorial analysis using principal axes with Promax rotation was then carried out with the Statis-tical Package for the Social Sciences (IBM SPSS Statistics, France) version 18 software to identify the factorial struc-ture of the scale. Exploratory factorial analyses were con-ducted on a population of 379 partners randomly chosen from the 499 partners. Confirmatory analyses were carried out on the other 120 partners of this sample. Classic crite-ria were used to extract the factors: the scree test [START_REF] Cattell | Handbook of Multivariate Experimental Psychology[END_REF], and representativeness of the components as a func-tion of the number of items and their coherence with the constructs. At this stage, items showing cross-loadings or loadings less than 0.30 on the factors were eliminated. Another point also guided the removal of items; we wanted to construct an equivalent structure for these part-ners and their spouses, which will be the subject of another publication (thus 35 items were eliminated). Items related to physical feeling were also not retained at this stage as they did not load a unique factor and showed numerous crossloadings (6 items removed).

A confirmatory factorial analysis, based on structural equation modelling, was then applied to the answers to the retained items, using LISREL 8.8 software [START_REF] Joreskog | LISREL 8: User's Reference Guide[END_REF]. The indices used to assess the adjustment of the model were: Chi-squared goodness-of-fit test, Root Mean Square Error of Approximation (RMSEA), Normed Fit Index (NFI), Standardized Root Mean Square Residual (SRMR) and Adjusted Goodness of Fit Index (AGFI).

Analysis of internal consistency and test-retest reliability

The internal consistency of each sub-scale of the question-naire was examined using Cronbach's alpha coefficients (>0.70). Test-retest reliability was investigated using the Bravais-Pearson correlation coefficient between the scores of 84 partners who completed the questionnaire twice with a mean interval of 17 days (Min = 8 days, Max = 30 days, M = 16.99, SD = 5.22).

Analysis of concurrent validity

Concurrent validity was assessed via the Bravais-Pearson correlation coefficients between the scores of participants in the Partner-YW-BCI and their scores in the SF-36.

RESULTS

Sample characteristics

The majority of the participants had a job at the time of the study (94.37%). Concerning their educational level, most of the participants had a secondary (31.79%) or a graduate qualification (23.54%). Almost all the partici-pants were already living in a couple with the patients at the time of the diagnosis (96.99%, mean duration of the couple relationship = 13.91 years, SD = 8.51) and had children (90.30%). Concerning the situation of the patients at the time of the study, they had suffered from breast cancer for 2.59 years on average (SD = 2.86), 143 were undergoing chemotherapy with or without Trast-uzumab, 50 were undergoing Trastuzumab with or with-out hormone therapy, 166 patients were undergoing hormone therapy only and 140 were under follow-up.

Factorial structure of the questionnaire

Exploratory analyses

Exploratory factorial analyses of the principal factors were carried out on a random sample of 436 partners, and revealed a structure of 8 factors explaining 58.02% of the total variance (Table 1): F1: Management of child (ren) and of everyday life (5 items, 21.76% of the total variance), F2: Negative affectivity and apprehension about the future (6 items, 8.53%), F3: Feeling of couple cohesion (5 items, 6.04%), F4: Financial difficulties (4 items, 5.64%), F5: Body image and sexuality (4 items, 4.48%), F6: Deterioration of relationships with close relatives (5 items, 4%), F7: Sharing and support from close relatives (4 items, 3.96%), and F8: Career manage-ment (3 items, 3.52%).

The final inventory thus consisted of 36 items ('YW-BCI36'). The previously identified dimensions were thus found: psychological and affective experience and appre-hension about the future, management of daily life -with items linked to children, professional life and financial dif-ficulties. The dimension related to social and familial rela-tionships was divided into two parts, depending on the positive or negative valence of the interpersonal relation-ships: the first was linked to the feeling of support and the second to the deterioration of relationships with close rel-atives. Similarly, two dimensions emerged related to the couple: cohesion -with items linked to support and close-ness, and body image and sexuality -with items linked more to couple intimacy. These eight dimensions were quite strongly linked, as shown by the correlations presented in Table 2. In particu-lar, the dimension 'negative affectivity and apprehension about the future' was quite strongly and positively corre-lated with all the subscales about problems (concerning the management of child(ren) and of everyday life, body image and sexuality, finances, and relationships with close relatives), like the deterioration of relationships with close relatives.

Confirmatory analyses

The indices of confirmatory factorial analyses carried out on a random sample of 108 partners suggested a good adjustment of the model overall (v²(566) = 802.18; P < 0.001; v²/ddl = 1.41; RMSEA = 0.055; NFI = 0.80, SRMR = 0.075; AGFI = 0.78).

Internal consistency of the scale

Internal consistency was acceptable with Cronbach's alphas going from 0.70 (for the dimensions 'sharing and support from close relatives' and 'career management') to 0.84 (for the dimension 'management of child(ren) and of everyday life') (Table 3).

Test-retest reliability

Overall, the test-retest reliability of the questionnaire (mean interval in days between two completions: M = 16.99, SD = 5.22) was acceptable (Table 3). Only the test-retest correlation coefficient of the dimension 'career management' was lower than the expected threshold (r = 0.496).

Concurrent validity

As expected, the correlations between the dimensions of the two scales were moderate (from -0.211 to-0.456), Table 4. The strongest correlations were observed between the dimensions 'negative affectivity and apprehension about the future' of the Partner-YW-BCI and the scales of social functioning and physical pain of the SF-36 (r = -0.456, P < 0.001 and r = -0.439, P < 0.001, respectively). Consistent with the clinical observations, the dimension 'negative affectivity and apprehension about the future' of the Partner-YW-BCI scale was also negatively correlated with the dimen-sions 'vitality', 'social functioning', and 'perceived gen-eral health' of the SF-36.

DISCUSSION

The aim of the present work was to validate a new tool, in the French language, to assess the repercussions of the dis-ease and its treatment on the daily life of partners of young patients with non-metastatic breast cancer, based on the results from a qualitative study (Vanlemmens et al. 2012a(Vanlemmens et al. , 2012b)). Although some scales are available to eval-uate the unmet needs of partners of cancer patients (e.g. FIN-H, [START_REF] Kilpatrick | Information needs of husbands of women with breast cancer[END_REF], or the overall quality of life of caregivers (e.g. CarGOQoL, [START_REF] Minaya | The CareGiver Oncology Quality of Life questionnaire (CarGOQoL): development and validation of an instrument to measure the quality of life of the caregivers of patients with cancer[END_REF], to our knowledge, there is no specific tool to assess the subjec-tive experience of spouses faced with the patient's cancer. Yet, in a systemic approach, the repercussions of the dis-ease on the spouses and the way in which they deal with it clearly impact the adjustment of the patient towards the disease (e.g. [START_REF] Hagedoorn | Couples dealing with cancer: role and gender differences regarding psychological distress and quality of life[END_REF][START_REF] Ben-Zur | Coping with breast cancer: patient, spouse, anddyad models[END_REF][START_REF] Manne | Cognitive and social processes predicting partner psychological adaptation to early stage breast cancer[END_REF][START_REF] Dorros | Interdependence in women with breast cancer and their partners: an interindividual model of distress[END_REF][START_REF] Kraemer | A longitudinal examination of couples' coping strategies as predictors of adjustment to breast cancer[END_REF]. Moreover, caregivers often express their need to be able to rely on health professionals to learn how to help the patient (e.g. [START_REF] Hoga | Psychosocial perspectives of the partners of breast cancer patients treated with a mastectomy: an analysis of personal narratives[END_REF]. A better understanding of the partner's experience is therefore an undeniable asset in the overall understanding of the patient's own experi-ence, the couple's experience and how they deal together with the disease.

The 'Partner-YW-BCI36' inventory is composed of 36 items, shows good psychometric qualities and enables the specific problems of partners of young patients with non-metastatic breast cancer to be assessed. It has been validated as a structure of eight factors: (1) man-agement of child(ren) and of everyday life (5 items), (2) negative affectivity and apprehension about the future (6 items), (3) feeling of couple cohesion (5 items), (4) financial difficulties (4 items), ( 5) body image and sex-uality (4 items), (6) deterioration of relationships with close relatives (5 items), ( 7) sharing and support from close relatives (4 items) and (8) career management (3 items). This inventory shows good construct validity, as well as good internal and external consistency according to the analyses of items carried out. The con-current validity indicates correlations in agreement with our hypotheses and with a comparable and already validated quality of life tool (SF-36).

The Partner-YW-BCI36, by its structure and the items composing it, is also particularly valuable in identifying not only the daily problems of coping with the disease but also the positive aspects and resources of the partner, espe-cially in terms of cohesion within the couple, and sharing and support from close relatives. Reducing difficulties, lightening the potential burden, limiting negative emo- tional repercussions, and reinforcing positive affective relationships with partners can only be beneficial for the treatment of patients.

Eventually, future research should focus on a longi-tudinal approach of the experience of partners in order to determine which phases of treatment are the most problematic. Similarly, few studies have investigated the experience of spouses in homosexual couples. For example, it would be interesting to see if the subjec-tive experience of female partners of breast cancer patients, who potentially could have or have had the disease themselves, is the same as that of a male part-ner. It is also important to develop dyadic protocols that simultaneously take into account the problems and resources of the patient and their partner at each step of the care pathway. Clearly, a better under-standing of the subjective experience of the partner alongside that of the patient, including the convergenc-es/divergences in the perceptions of the dyad, will enable a better appreciation of the processes of adjust-ment to the disease [START_REF] Romero | Husbands' perceptions of wives' adjustment to breast cancer: the impact on wives' mood[END_REF], and improve the overall treatment of these couples via appropriate and personalised support care. for their invaluable assistance when gath-ering the data. The authors also thank the MESHS USR CNRS and the SIRIC ONCOLille, Grant INCa-DGOS-In-serm 6041, for their help.

Table 2 .

 2 Correlations between the dimensions of the factorial structure of the questionnaire

											1	2	3	4	5	6	7	8
	Management of child(ren) and of everyday life (1)	-
	Negative affectivity and apprehension about the future	0.364** -
	(2)
	Feeling of couple cohesion (3)	-0.202	-0.288*	-
	Financial difficulties (4)	0.502**	0.541** -0.136	-
	Body image and sexuality (5)	0.413**	0.353** -0.285*	0.403** -
	Deterioration of relationships with close relatives (6)	0.507**	0.564** -0.332**	0.550** 0.497** -
	Sharing and support from close relatives (7)	-0.079	-0.071	0.237	-0.059	0.006	-0.266* -
	Career management (8)	0.000	-0.042	0.138	-0.112	0.005	-0.039	-0.025 -
	Bravais-Pearson's r (N = 436).
	*P < 0.05, **P < 0.001.
	Table	3.	Internal	consistency	and	test-retest	reliability	of	the	questionnaire
											Number	of
											items	a	r
	Management		of	child(ren)	and	of	5	0.84	0.824
	everyday	life
	Negative	affectivity	and	6	0.81	0.804
	apprehension	about	the	future
	Feeling	of	couple	cohesion	5	0.81	0.661
	Financial	difficulties	4	0.79	0.795
	Body	image	and	sexuality	4	0.75	0.725
	Deterioration	of	relationships	with	5	0.75	0.776
	close	relatives
	Sharing	and	support	from	close	4	0.70	0.690
	relatives
	Career	management	3	0.70	0.496
	All	the	correlations	are	significant	at P	<	0.01, N	=	84.

Table 4 .

 4 Concurrent validity/correlations between the dimensions of the PARTNER-BCI and those of the SF-36

			Limitations	Limitations
			due to	due to
		Physical	physical	emotional		Emotional	Social	Physical	Perceived	Health
		functioning	state	state	Vitality	well-being	functioning	pain	health	transition
	Management of	-0.308**	-0.283**	-0.376**	-0.410**	0.017	-0.334**	-0.316** -0.366** -0.350**
	child(ren) and
	of everyday
	life
	Negative	-0.180	-0.125	-0.216*	-0.340** -0.015	-0.456**	-0.439** -0.313** -0.233*
	affectivity and
	apprehension
	about the
	future
	Feeling of couple	0.185	0.076	0.152	0.185	0.029	0.237*	0.173	0.170	0.192
	cohesion
	Financial	-0.099	-0.233*	-0.339**	-0.197	-0.058	-0.223*	-0.145	-0.177	-0.202
	difficulties
	Body image and	0.049	-0.120	-0.239*	-0.158	0.019	-0.179	-0.035	-0.181	-0.159
	sexuality
	Deterioration of	-0.211*	-0.153	-0.278*	-0.176	0.004	-0.347**	-0.225* -0.207	-0.082
	relationships
	with close
	relatives
	Sharing and	0.081	0.040	-0.035	0.184	-0.025	0.147	0.121	0.220*	0.08
	support from
	close relatives
	Career	-0.062	0.149	0.183	0.108	0.157	0.030	0.026	-0.003	0.045
	management
	N = 105.
	*P < 0.01, **P < 0.001.

ACKNOWLEDGMENTS

The authors extend their grateful thanks to all the patients of the study, as well as all the investigators: C. Loustalot, C. Guillemmet, M. Leclercq, C. Levy, C. Giraud, C. Lefeu-vre-Plesse, J.S. Frenel, H. Simon, T. Leroy, C. Becuwe, S. De Cordoue, J.M. Ferrero, D. Nierges, S. Tiberghien, J. Grosjean, K. Prulhiere, L. Chossiere for the collected data and the staff of the Clinical Research Unit of the Centre Oscar Lambret

FUNDING

This research was funded by the Ligue Nationale con-tre le Cancer, the Conseil R,egional du Nord-Pas de Calais, the Prix Ruban Rose 2010, and Sanofi-Aventis, Roche and Novartis.


Cornelia Pocnet

Marc Dupuis

Anne Congard

Daniela Jopp

Personality and its links to quality of life: Mediating effects of emotion regulation and self-efficacy beliefs

Keywords: Personality, Emotion regulation, Selfefficacy beliefs, Quality of life

We investigated the relationship between personality and quality of life (QoL) considering emotion regulation and self-efficacy beliefs as mediating factors. A total of 409 participants from the French-speaking regions of Switzerland and from France completed questionnaires on personality, emotion regulation, self-efficacy beliefs, and QoL. Our findings revealed that specific personality traits have significant direct and indirect effects on QoL, mediated by emotion regulation and self-efficacy. Particularly, neuroticism was strongly and negatively related to emotion regulation and QoL, but not significantly linked to self-efficacy, whereas extraversion and conscientiousness were positively associated with all variables. This is the first study to demonstrate that both emotion regulation and self-efficacy are important mechanisms that link specific personality traits to QoL, suggesting that they channel and modulate the personality effects. However, more work is needed to understand these relationships in more detail (e.g., how the personality traits concurrently influence each other as well as emotion regulation and self-efficacy).

Introduction

Quality of life

The World Health Organization defines Quality of Life (QoL) as individuals' perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards, and concerns. It is a broad ranging concept affected in a complex way by the person's physical health, psychological state, level of independence, social relationships, personal beliefs, and their relationship to salient features of their environment [START_REF] Skevington | The World Health Organization's WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial. A report from the WHOQOL group. Quality of life research: an international journal of quality of life aspects of treatment[END_REF]). Although several authors have studied how different personality profiles and self-regulating factors such as emotions or self-efficacy beliefs influence QoL, little is known about how these characteristics may work together simultaneously. For instance, some personality psychologists have explored the personalities of happy and unhappy people and how adaptation and varying standards influence their QoL [START_REF] Lucas | Personality and subjective wellbeing: current issues and controversies[END_REF]. They showed that personality factors influence QoL by associated tendencies to interpret objective conditions (such as behavior and environment) that might lead to stability of self-reported life satisfaction (such as psychological well-being and perceived QoL; [START_REF] Keating | Quality of life of persons with dementia[END_REF]. For example, being faced with a serious illness such as cardiovascular disease is likely to have implication on his or her objective quality of life, for instance, due to constraining the individual's autonomy. However, people with the same illness may differ in terms of life satisfaction, independent from their objective health and life conditions, due to the interpretative tendencies related to, for example, their personality. Thus, both objective and subjective components are assumed to explain unique proportions of variance in people's QoL [START_REF] Wrosch | Personality and quality of life: The importance of optimism and goal adjustment[END_REF].

Personality and quality of life

Among the personality dimensions, neuroticism, extraversion, and conscientiousness are particularly important and are most frequently studied in relation to QoL (Lucas et al. 2000;[START_REF] Wismeijer | Do neuroticism and extraversion explain the negative association between self-concealment and subjective well-being?[END_REF]. These three personality traits are the best predictors of mental health, life satisfaction, and positive affects [START_REF] Finch | Physical health, positive and negative affect, and personality: A longitudinal analysis[END_REF]. Specifically, neuroticism and extraversion predict long-term (over 10 years) the negative and positive affects [START_REF] Costa | Influence of extraversion and neuroticism on subjective well-being: Happy and unhappy people[END_REF] and, together, these two components of emotional well-being influenced overall the QoL [START_REF] Diener | Personality, culture, and subjective well-being: Emotional and cognitive evaluations of life[END_REF][START_REF] Kokkonen | Extraversion and neuroticism as antecedents of emotion regulation and dysregulation in adulthood[END_REF][START_REF] Lucas | Factors influencing the relation between extraversion and pleasant affect[END_REF]. Neuroticism is linked to the frequency and duration of negative affects and therefore to a lower QoL. This personality dimension can be considered as a system of perception of the "threat", real or symbolic, and of reactivity to this threat. A high level of neuroticism predisposes people to more negative experience and distress [START_REF] Watson | Negative affectivity: The disposition to experience aversive emotional states[END_REF]. People with higher neuroticism experience more stress, and are more responsive to negative aspects of situations than those emotionally stable (e.g., [START_REF] Costa | Influence of extraversion and neuroticism on subjective well-being: Happy and unhappy people[END_REF][START_REF] Charles | Age-related differences and change in positive and negative affect over 23 years[END_REF]. These people also experience fewer positive affects and are more prone to diseases such as depression and generalized anxiety. Extravert people, instead, will feel more positive affect with high activation [START_REF] Lucas | Factors influencing the relation between extraversion and pleasant affect[END_REF][START_REF] Yik | A 12-point circumplex structure of core affect[END_REF]. Extraverts and introverts would spend as much time in social interactions, but individuals with a high level of extraversion experience more pleasure [START_REF] Lucas | Extraversion and emotional reactivity[END_REF]. Extravert people implement more active and dynamic specific processes and mechanisms, which was associated with increase in QoL [START_REF] Wilt | The dynamic role of personality states in mediating the relationship between extraversion and positive affect[END_REF]. At the level of activation, extraverts seek stimulation and more exciting activities, whereas introverted individuals may be less motivated to increase their happiness in situations requiring an increase in motivational commitment to a task requiring effort [START_REF] Tamir | Differential preferences for happiness: Extraversion and trait-consistent emotion regulation[END_REF]. Some studies also have shown that high conscientiousness explains significant amounts of variance in people's QoL (e.g., [START_REF] Pocnet | Individuals'quality of life linked to major life events, perceived social support, and personality traits[END_REF]. Conscientious individuals seem to overcome unexpected obstacles more easily than individuals who are less dedicated to achieving important life tasks. These people are oriented towards life situations that are beneficial to QoL, notably by setting higher goals and a higher level of motivation. They encounter fewer stressors because they put in place more preventive and organizational efforts to avoid them (e.g., DeNeve and Cooper 1998). Conscientious individuals are better able to anticipate and prepare for future consequences of potential adversities, more organized, and self-disciplined (Pocnet et al. 2016a). They seem also be more successful in establishing objective indicators of QoL (e.g., having a successful career, good health) [START_REF] Barrick | Personality and performance at the beginning of the new millennium: What do we know and where do we go next[END_REF]Roberts et al. 2005) and therefore experience high levels of subjective well-being [START_REF] Duckworth | Who does well in life? Conscientious adults excel in both objective and subjective success[END_REF][START_REF] Wrosch | Giving up on unattainable goals: Benefits for health?[END_REF].

Emotion regulation and its relationships with personality and QoL

Often, individuals' behaviors, cognitions, and feelings are influenced by basic regulatory tendencies that are associated with the personality of the person. These self-regulating tendencies are related to processes of emotion regulation [START_REF] Deyoung | Testing predictions from personality neuroscience: Brain structure and the big five[END_REF]. Emotion regulation has been defined as a process of initiating, avoiding, inhibiting, maintaining, or modulating the occurrence, form, intensity, or duration of affective states, emotion-related physiological or attentional processes, and/or behavioral concomitants of emotion [START_REF] Reicherts | L'ouverture emotionnelle : une nouvelle approche du vécu et du traitement émotionnels[END_REF]. Emotion regulation has been found to be of high importance when it comes to adapting to various situations in order to meet the expectations of social and cultural environments [START_REF] Eisenberg | Emotion-related regulation: sharpening definition[END_REF].

Considering the relationship between personality and emotion regulation, studies indicate that individuals high in neuroticism, which encompasses impulsivity, are often low in self-control and impulse regulation and show a tendency to act without thought or planning [START_REF] Hoyle | Personality and self-regulation: Trait and information-processing perspectives[END_REF][START_REF] Wismeijer | Do neuroticism and extraversion explain the negative association between self-concealment and subjective well-being?[END_REF]. Neurotic people also exhibit high behavioral inhibition and negative self-evaluation, which can lead to underestimating progress in goal pursuit (Little and Chambers 2004). As such, poor self-regulation may stem from either under-or overcontrol [START_REF] Hoyle | The interplay of personality and self-regulation[END_REF]. Moreover, neuroticism is associated with a style of self-reflection that is ruminative and ego involved that could negatively influence the individual's QoL [START_REF] Norem | The positive psychology of negative thinking[END_REF][START_REF] Field | The moderating effect of self-concept valence on the relationship between selffocused attention and mood: An experience sampling study[END_REF].

Extraversion, besides indicating the tendency of being open towards others and appreciating social contact, is also characterized by experiencing positive emotions that include energy and optimism [START_REF] Costa | Revised NEO Personality Inventory (NEO-PI-R) and NEO-Five-Factor (NEO-FFI) professional Manual[END_REF][START_REF] Schaefer | Overconfidence and the Big Five[END_REF]). These emotional resources are required to initiate and persist in coping efforts, which should facilitate the better use of coping strategies such as problem solving and seeking support [START_REF] Vollrath | Personality and stress[END_REF]. For example, an extroverted person may become less quickly frusterated and may remain focused during problem solving because may rely more easily on emotional social support to regulate emotions [START_REF] Kokkonen | Extraversion and neuroticism as antecedents of emotion regulation and dysregulation in adulthood[END_REF]. [START_REF] Suls | The daily life of the garden-variety neurotic: Reactivity, stressor exposure, mood spillover, and maladaptive coping[END_REF] found that extraversion was associated with low stress-reactivity and positive appraisals of available coping resources. Moreover, extraversion is related to subjective well-being, which seems to be associated with the fact that extravert people are more likely to selectively attend to positive information and dwell on positive events, all of which are strategies that promote and increase in positive affect, and therefore their QoL [START_REF] Tamir | Differential preferences for happiness: Extraversion and trait-consistent emotion regulation[END_REF].

Conscientiousness concerns the ways in which people manage their behavior and cognitions. Its facets-competence, orderliness, dutifulness, achievement striving, self-discipline, and deliberation-reflect different behavioral tendencies that characterize successful self-regulation (Roberts et al. 2005;[START_REF] Mccrae | Self-regulation and the Five-Factor Model of personality traits[END_REF] and predict the use of effective strategies involving behavioral engagement such as problem solving as well as cognitive restructuring that could influence the individual's QoL [START_REF] Augustine | Composition and consistency of the desired affective state: The role of personality and motivation[END_REF]. Some authors explained this link between conscientiousness and effective strategies by the fact that high levels of conscientiousness may be rooted in attentional systems that influence the ability to focus on boring or unpleasant tasks or to disengage from high negative intensity stimuli [START_REF] Derryberry | Temperament and coping: Advantages of an individual differences perspective[END_REF]. Given that conscientious individuals should be able to resist the impulse to give up or vent emotions inappropriately (Vollrath 2001), conscientiousness should predict lower levels of disengagement and negative emotion-focused coping.

Self-efficacy beliefs and their relationships with personality and QoL

Self-efficacy represents an important resource as it reflects the unique capability of humans to learn from experience to handle challenging life situations. Self-efficacy is defined as a person's belief of being able to successfully reach a desired outcome [START_REF] Bandura | Perceived self-efficacy in cognitive development and functioning[END_REF]. Self-efficacy beliefs have an impact on the feeling of accomplishment, leading to a virtuous circle: if a person experiences a success, this will contribute to building up self-efficacy, enhance his/ her motivation and capabilities and broaden his/her interest [START_REF] Bandura | Self-efficacy: The exercise of control[END_REF]. In this context, specific personality traits may play an important role. High self-efficacy has been found to be more likely for individuals with higher conscientiousness and extraversion, and lower neuroticism [START_REF] Hoyle | The interplay of personality and self-regulation[END_REF]. A few empirical studies have investigated how personality traits and self-efficacy beliefs work in concert in order to promote QoL [START_REF] Maddux | Self-efficacy[END_REF]. For example, extraverts may have advantages in verbal information processing that support their sociability. Good language skills, speed of response as well as resistance to distraction are supported by selfefficacy, enhancing their adaptive value that might lead to a feeling of well-being [START_REF] Matthews | The personality theories of H. J. Eysenck and J. A. Gray: A comparative review[END_REF]. However, several studies on stress show that neuroticism leads to an overestimation of threats and an underestimation of personal agency, to ineffective forms of emotion-focused coping such as self-criticism and maladaptive meta-cognition which strengthen negative self-beliefs, and to perseverative and unproductive worry, resulting in feelings of dissatisfaction [START_REF] Matthews | Traits, states and the trilogy of mind: An adaptive states perspective on intellectual functioning[END_REF]. At the same time, conscientiousness defined as the disposition to be purposeful, determined, organized, and controlled [START_REF] Costa | Revised NEO Personality Inventory (NEO-PI-R) and NEO-Five-Factor (NEO-FFI) professional Manual[END_REF]) may be especially interesting in this context because individuals who are higher in conscientiousness have been found to hold also higher self-efficacy beliefs for a given behavior. For example, [START_REF] Chamorro-Premuzic | Personality predicts academic achievement: Evidence from two longitudinal university samples[END_REF] reported in their study that indidivudals with high conscientiousness were better able to build up self-efficacy by task effort and performance, persistence, resilience in the face of failure, effective problem solving, and efficiency of time use. Complementing these findings, [START_REF] Kelly | Time use efficiency and the five-factor model of personality[END_REF] found that given their higher levels of self-efficacy, conscientious people were more likely to successfully engage in acts that were important to them, arguing that self-efficacy beliefs were directly responsible for the level of QoL that these people experienced.

Purpose of this study

The main focus of our study was to examine more closely the impact of personality on QoL considering emotion regulation and self-efficacy beliefs as mediating factors. Given prior findings, we expected that specific personality would be linked to emotion regulation, self-efficacy, and QoL. Particularly, conscientiousness and extraversion were assumed to be positively, whereas neuroticism to be negatively linked to emotion regulation, self-efficacy, and QoL.

Furthermore, emotion regulation was expected to mediate the effect of three personality traits on self-efficacy.

Also, self-efficacy was expected to mediate the effect of emotion regulation as well as the three personality traits on QoL, but the individual effects are expected to be differential. Specifically, neuroticism was assumed to be negatively linked to emotion regulation and to self-efficacy beliefs, while extraversion and conscientiousness were expected to be positively linked to the same variables. Additionally, emotion regulation was expected to be positively associated with self-efficacy beliefs.

Methods

Characteristics of the sample and procedure

A total of 409 individuals [including 211 women (51.6%) and 198 men (48.4%), ages ranging from 20 to 65 years, Mage = 39.72, SDage = 12.87] representing a communitybased sample of the French-speaking regions of Switzerland and of France (Aix en Provence region) participated in this study. Of the 409 participants, 254 (62.1%) were recruited in Switzerland and 155 (37.9%) were recruited in France. The subjects were recruited in the community by psychology students as part of a practical assignment. The participants were professionally active and employed in various institutions. They completed the paper-pencil questionnaires on personality, emotion regulation, self-efficacy beliefs, and QoL. Informed consent was obtained from all participants included in the study. As there were no substantial differences between the two samples, we combined the Swiss and French participants for the analysis.

Measures

Personality

We used the French version of the NEO-FFI-R, a short version of the Revised NEO Personality Inventory [START_REF] Costa | Revised NEO Personality Inventory (NEO-PI-R) and NEO-Five-Factor (NEO-FFI) professional Manual[END_REF], measuring the five main personality dimensions of the five-factor model (neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness). The participants were asked to respond to 60 items using a 5-point Likert scale ranging from 0 (strongly disagree) to 4 (strongly agree). Internal consistency coefficients of the French version of the NEO-FFI-R ranged from 0.70 to 0.82 for the five scales (Mdn = 0.76) [START_REF] Aluja | Comparison of the NEO-FFI, the NEO-FFI-R and an alternative short version of the NEO-PI-R (NEO-60) in Swiss and Spanish samples[END_REF]. In this study, we used only three domains: neuroticism (example item: When I am under the pressure of very difficult situations, I sometimes feel like I'm going to collapse) extraversion (example item: I like to have many people around me), and conscientiousness (example item: I have a well-defined set of goals and I work to achieve them in an orderly way). Internal consistency coefficients in this study were high (neuroticism: = 0.81, extraversion: = 0.76, and conscientiousness: = 0.82).

Self-efficacy

The General Self-Efficacy Scale (GSES; Jerusalem and Schwarzer 1992) translated into French [START_REF] Dumont | Sentiment d'autoefficacité. Traduction française du Generalized Self-Efficacy Scale[END_REF]) consists of 10 items, which are answered on a Likert scale ranging from 1 (not at all true) to 4 (completely true). An example item is: I can always manage to solve difficult problems if I try hard enough. This scale is designed to assess self-beliefs related to solving a variety of challenging demands of life. In contrast to other scales, the GSES explicitly refers to personal agency, i.e. the belief that one's actions are responsible for successful outcomes. In our study, internal consistency was high ( = 0.84).

Emotion regulation

We used a subscale from the Dimensions of Emotional Openness questionnaire (DOE-20) to assess emotion regulation [START_REF] Reicherts | Dimensions of openness to emotions (DOE): A model of affect processing[END_REF]. In this measure, the regulation of emotion dimension represents one's capacity to regulate and monitor emotions. The four items of this subscale were: At moments I'm overwhelmed by strong emotions; I am able to alleviate or postpone the effects of a strong emotion; My feelings can sometimes cause me to break down; I manage to calm my feelings even in difficult situations. Answers were given on a 5-point Likert scale ranging from 1 (not at all) to 5 (extremely). Prior work has shown satisfactory reliability of the 4-item sub-scale [START_REF] Reicherts | L'ouverture emotionnelle : une nouvelle approche du vécu et du traitement émotionnels[END_REF]. In our study the internal consistency for the emotion regulation dimension was satisfactory ( = 0.67).

Quality of life

We used a 12-item version of the World Health Organization Quality of Life questionnaire (WHOQOL-12) to assess QoL, which was recently validated in French using the participants in the present study [START_REF] Dupuis | Crossnational validation of a brief form of the WHO Quality of Life questionnaire[END_REF]). This self-reported questionnaire consists of 12 items (3 per factor) related to 4 dimensions of the WHO Quality of Life Inventory WHOQOL-100, namely: physical health ( = 0.73), psychological health ( = 0.64), social relationships ( = 0.61), and environment ( = 0.69). The fourfactor converged into a higher-order factor of overall QoL, which had a high internal consistency ( = 0.84). Example items for each dimension are: Do you have enough energy for everyday life? is representative of the physical dimension; How much do you enjoy life? corresponds to the psychological dimension; How satisfied are you with your personal relationships? belongs to the subscale covering social relations, and How healthy is your physical environment? corresponds to the QoL dimension covering environment. Items are answered using a 5-point Likert scale, allowing the evaluation of own feeling (ranging from 1 = not at all to 5 = extremely), according to the questions. Analyses of internal consistency, item-total correlations, criterion validity, construct validity, and measurement invariance through confirmatory factor analysis, indicate that the overall WHOQOL-12 has good psychometric properties [START_REF] Dupuis | Crossnational validation of a brief form of the WHO Quality of Life questionnaire[END_REF].

Statistical analysis

After evaluating descriptive findings for demographic and psychological characteristics, we computed the Pearson correlations between key study variables to examine zeroorder relationships. We then tested three structural equation models (SEM) in order to determine the specific effects of the three personality dimensions (i.e., neuroticism, extraversion, and conscientiousness, respectively) on QoL considering emotion regulation and self-efficacy as mediators (Fig. 1). In those models, we also tested whether the effect of emotional regulation on QoL was mediated by self-efficacy. Given that including all personality traits would have QoL was measured by a general latent variable composed of the four dimensions of the WHOQOL-12. Furthermore, the determination coefficient, which indicates the amount of the variance in QoL explained by specific variables, was computed. To evaluate the model fit, the following indices were calculated using the Maximum Likelihood Robust estimation method (MLR): the x 2 / df ratio, the comparative fit index (CFI) and the Tucker-Lewis non-normed index (TLI), the root mean square error of approximation (RMSEA), and the standardized root mean square residual (SRMR). The x 2 /df ratio is considered acceptable when lower than 5, and indicates an excellent fit when it is below 3 (Kline 2011). [START_REF] Hu | Cutoff criteria for indexes in covariance structure analyses: Conventional criteria versus new alternatives[END_REF] suggested that models presenting CFI or TLI indices greater than 0.90 are generally considered to be acceptable. A RMSEA below 0.07 indicates a good model fit and is acceptable as long as the confidence interval of its estimate is lower than 0.08 [START_REF] Maccallum | Power analysis and determination of sample size for covariance structure modeling[END_REF]. The SRMR is acceptable when it is lower than 0.08 [START_REF] Kline | Principle and practice of structural modeling[END_REF]. All analyses were performed with R; the structural equation model was tested using the R package 'Lavaan' [START_REF] Rosseel | Lavaan: An R package for structural equation modeling[END_REF].

Results

Descriptive findings and zero-order correlations

Descriptive statistics and correlations for all central variables are presented in Table 1. As the main variable of interest, QoL had a mean score of 48.30 ± 5.78 indicating a high overall level (range 12-60). Gender, age, and income were not significantly correlated with QoL. However, nationality was negatively linked to all components of QoL. The correlations between QoL and psychological variables were moderate. Specifically, all QoL domains correlated positively with extraversion, conscientiousness, and self-efficacy and negatively with neuroticism. Moreover, it appears that emotion regulation was linked to all QoL domains, except social relationships. In addition, neuroticism was negatively associated with emotion regulation and selfefficacy, while the links between the two others personality dimensions and emotion regulations as well as self-efficacy were significantly positive.

Neuroticism and its links to emotion regulation, self-efficacy, and QoL

The Structural Equation Model (SEM) testing the relations between neuroticism, emotion regulation, self-efficacy, and QoL explained 32.8% of variance in QoL. The model fit was good as indicated by a RMSEA of 0.059, 95% IC = [0.049, 0.070], a SRMR of 0.055, a CFI of 0.942, and a TLI of 0.927. The x 2 /df ratio was 2.43. Our model confirmed both direct and indirect significant effects of the variables (Table 2): Neuroticism showed direct effects, which standardized values ranging from -0.80 to 0.46, and indirect effects ranging from -0.37 to -0.04 on the other variables. As illustrated in Fig. 2 and indicated in Table 2, a large direct negative effect of neuroticism on emotion regulation was found (P = -0.80, p < 0.001), indicating that more neurotic individuals demonstrated less emotion regulation, but in contrast, the effect of emotion regulation on self-efficacy was positive but only approached significance (P = 0.46, p = 0.052), suggesting that individuals with better emotion regulation scored higher in self-efficacy. Consequently, the indirect effect of neuroticism on QoL, mediated by self-efficacy, was negative but not significant due to large standard errors of estimate (/J = -0.37, p = 0.075). Neuroticism had a small negative direct effect on self-efficacy that was not significant (P = -0.11, p = 0.614). Self-efficacy in turn, had a positive and significant effect on QoL (P = 0.32, p < 0.001), resulting in a negligible negative indirect effect (/3 = -0.04, p = 0.618). Given both positive and strong effect of selfefficacy on QoL and a moderate positive effect of emotion regulation on self-efficacy, the indirect effect of emotion regulation on QoL via self-efficacy was positive, but only with an approached significance (P = 0.15, p = 0.065). Nevertheless, the total effect of neuroticism on QoL was negative and very significant (/J = -0.50, p < 0.001).

Extraversion and its links to emotion regulation, self-efficacy, and QoL

In the SEM including extraversion, emotional regulation, self-efficacy, and QoL, a good fit was obtained with a RMSEA of 0.052, 95% IC = [0.041, 0.063], and a SRMR of 0.045. The ,r 2 /df ratio was 2.09, the CFI was 0.946, and TLI was 0.932. The model explained a total of 30.3% of variance in QoL. Regarding the prediction of QoL, all direct effects assumed by the model were significant, although smaller for extraversion and emotional regulation relationship (/3 = 0.20, p = 0.027) (Table 3). In addition, a significant mediation of the effect of extraversion and emotion regulation via self-efficacy on QoL was found (P = 0.12, p < 0.001, and P = 0.21, p < 0.001, respectively). Moreover, small but significant indirect effects of extraversion on selfefficacy via emotion regulation were measured (/J = 0.11, p = 0.020). The indirect effect of extraversion on QoL mediated by emotion regulation and by self-efficacy was also small, although still significant (P = 0.04, p = 0.025).

Consequently, the direct effect (/J = 0.26, p < 0.001), the total indirect (P = 0.16, p < 0.001), and the total effect of extraversion on quality of life (P = 0.42, p < 0.001) were very significant.

Conscientiousness and its links to emotion regulation, self-efficacy, and QoL

The third structural equation model testing the relations between conscientiousness, emotion regulation, self-efficacy, and QoL explained 34.8% of variance in QoL. The model resulted in an RMSEA of 0.058, 95% IC = [0.047, 0.069], and a SRMR of 0.052. The ,r 2 /df ratio was 2.37, the CFI was 0.940 and the TLI was 0.924. All indices confirmed that the model fitted the data well. This last model resulted in both direct and indirect significant effects (Table 4). Conscientiousness showed direct effects ranging from 0.24 to 0.35 and a total indirect effect of 0.15 on QoL. As a consequence, the total effect of conscientiousness on QoL was positive and strongly (P = 0.51, p < 0.001). As depicted in Fig. 2, emotion regulation had a quite large positive effect on both self-efficacy (/J = 0.53, p < 0.001) and QoL (P = 0.34, p < 0.001). These direct effects resulted in

Discussion

This study examined the relationship between personality (i.e., neuroticism, extraversion, and conscientiousness) and QoL, taking into account emotion regulation and selfefficacy beliefs as mediating factors. More specifically, we tested three models using each personality dimension together with emotion regulation and self-efficacy, representing factors mediating on QoL. Moreover, we tested whether self-efficacy mediated the impact of emotion regulation and personality on QoL, whereas emotion regulation mediated the effect of personality on self-efficacy.

Regarding personality, we found that high neuroticism was associated with poor QoL, while high extraversion and conscientiousness were positively related to QoL. One underlying reason for the negative association between neuroticism and QoL may be the fact that more neurotic individuals demonstrated less emotion regulation and low self-efficacy, which may lead them to the conclusion that life problems are beyond their control and therefore not manageable, and that their efforts could not solve them. In line with prior studies [START_REF] Matthews | Traits, states and the trilogy of mind: An adaptive states perspective on intellectual functioning[END_REF][START_REF] Hoyle | The interplay of personality and self-regulation[END_REF][START_REF] Pocnet | Individuals'quality of life linked to major life events, perceived social support, and personality traits[END_REF], our findings suggest that neurotic individuals may underestimate their personal skills or resources, as represented by poor self-efficacy, and that emotion regulation seems to channel effect of this on QoL. Conversely, the positive link between emotion regulation, self-efficacy, and QoL indicated that emotionally stable individuals with high self-efficacy and adaptive emotion regulation may experience higher QoL. Therefore, although neuroticism negatively influenced the QoL, the process of emotional regulation and self-efficacy beliefs seems to temper its effect. Our findings support the role of emotion regulation and self-efficacy as possible regulatory mechanisms which was also found in earlier studies [START_REF] Norem | The positive psychology of negative thinking[END_REF][START_REF] Judge | Self-efficacy and work-related performance: The integral role of individual differences[END_REF]), but for the first time, self-efficacy and emotion regulation were examined concurrently showing their effective interplay. Moreover, QoL was significantly and positively influenced by extraversion, directly or via self-efficacy beliefs and emotion regulation as mediating factors. Self-efficacy seems to channel the effect of extraversion on QoL, maybe by reinforcing the tendency to experiencing positive emotions that enhance self-assurance and self-esteem. Thus, jovial individuals who enjoy the company of others may experience themselves as particularly self-efficacious, as situations with others may allow recognition of one's capacities and skills, which in turn may result in individuals feeling more positive about their life and functioning (e.g., [START_REF] Jopp | Adaptation in very old age: Exploring the role of resources, beliefs, and attitudes for centenarians' happiness[END_REF]. These results are similar to previous findings about the influence of extraversion on QoL [START_REF] Matthews | The personality theories of H. J. Eysenck and J. A. Gray: A comparative review[END_REF][START_REF] Diener | Personality, culture, and subjective well-being: Emotional and cognitive evaluations of life[END_REF][START_REF] Lyubomirsky | The benefits of frequent positive affect: Does happiness lead to success?[END_REF][START_REF] Lucas | Personality and subjective wellbeing: current issues and controversies[END_REF], but to our knowledge, the present study is the first that has empirically confirmed the role of self-efficacy as a mediating factor between positive emotion regulation and high QoL. These positive connections between emotion regulation and self-efficacy is in line with theoretical assumptions [START_REF] Maddux | Self-efficacy[END_REF] and could lead to a tendency to look on the bright side of life. However, contrary to our expectations, extraversion influenced QoL via emotional regulation and selfefficacy only moderately. As emotion regulation involves the ability to manage feelings in difficult situations, which includes the management of interpersonal relationships and the affectivity, we had expected at a more significant effect. One possible explanation is that extravert people are less likely to be affected by failure at a personal level, thus, it could be that individuals high on extraversion have a reduced need for emotion regulation. Also, as extravert individuals often talk to someone about their feelings and receive sympathy and understanding, they have been found to use this as a strategy to receive emotion-focused support and to activate their energy and social resources [START_REF] Tsai | of a model linking employee positive moods and task performance[END_REF]). Talking to a supportive, validating person about one's thoughts and emotions related to an acute stressor facilitates adjustment by reducing the frequency of distressing, intrusive thoughts [START_REF] Lepore | It's not that bad: Social challenges to emotional disclosure enhance adjustment to stress[END_REF], which may make "internal" emotion regulation less needed. Instead, our findings clearly indicate that neuroticism and conscientiousness dimensions of personality are strongly associated with emotion regulation. Specifically, neurotic people are likely to blame others and to underestimate goals progress, while conscientious individuals, who have, as its negative expression, a tendency towards perfectionism or compulsive persistence tend to blame themselves when they fail in the pursuing of their goals. Some authors suggest that the facet of impulsivity belongs within this domain because it reflects a failure to be conscientious, disciplined, or deliberate (McCrae and Löckenhoff 2010). So, both consciousness and neuroticism personality traits are related to emotions that need to be regulated.

Moreover, conscientiousness had significant direct as well as indirect effects on QoL, indicating that this personality dimension is an important factor in the context of QoL. Conscientiousness was strongly and positively related to self-efficacy, suggesting that being conscientious is likely to come with feeling strong about one's competence. Moreover, self-efficacy beliefs mediated the relationship between conscientiousness and QoL: Trusting in one's ability to complete tasks and reach goals seems to be one of the mechanisms linking conscientiousness to QoL, confirming findings by [START_REF] Judge | Self-efficacy and work-related performance: The integral role of individual differences[END_REF]. Our results suggest that conscientious people might have a higher QoL because they are organized, hard-working, and efficient, which likely contributes to their ability to achieve personal goals, as also suggested by other studies [START_REF] Kelly | Time use efficiency and the five-factor model of personality[END_REF][START_REF] Maddux | Self-efficacy[END_REF][START_REF] Pocnet | Individuals'quality of life linked to major life events, perceived social support, and personality traits[END_REF]. In addition, people with high conscientiousness tend to practice healthy behaviors (e.g., engaging in physical exercise) and avoid risky health behaviors (e.g., smoking), behaviors that are part of the health dimension of QoL (e.g., Pocnet et al. 2016a). Conscientiousness was also positive linked to emotion regulation, suggesting that this personality domain seems to be a protective factor for the emotional impact of environmental constraints (e.g., [START_REF] Pocnet | Individuals'quality of life linked to major life events, perceived social support, and personality traits[END_REF]) and that emotion regulation can be seen as an adjustment feature [START_REF] Reicherts | L'ouverture emotionnelle : une nouvelle approche du vécu et du traitement émotionnels[END_REF]. Our findings further support the assumption that tenacity in the pursuit of goals, which characterizes conscientiousness, also involves patterns of goal directed behavior that supports emotion regulation, which in turn promotes QoL [START_REF] Augustine | Personality, affect, and affect regulation[END_REF]. In other words, adaptive emotion regulation includes behavioral adjustment to initiate and maintain the pursuit of goals instead of giving up, as also reported by [START_REF] Wrosch | Giving up on unattainable goals: Benefits for health?[END_REF].

A few important limitations should be noted. When considering all personality aspects of interest simultaneously, our theoretical model would have become very complex and the results of indirect effects, although significant, become smaller (B standardized < 0.05). Given that this is the first study to test the role of personality traits, self-efficacy, and emotional regulation on QoL, we chose to consider the three personality dimensions separately in order to ensure good model properties. Future studies should further develop the underlying theoretical model, considering the more specific interplay between neuroticism, extraversion, and conscientiousness, as well as self-efficacy and emotion regulation. Such a model should then be tested including a larger sample to enhance the statistical power and model fit. Furthermore, this study was based on cross-sectional data. Ideally, mediation effects should be tested longitudinally for a better understanding on the causality of the effects. Finally, in the present study, we were missing some information that may be crucial, which should be considered in future studies: besides including information on coping strategies to disentangle the effects of emotion regulation, context specificity should be taken into account, because situational constraints (e.g., dealing with a specific event) and individual differences (e.g., financial or health status) might better explain the ways in which individuals implement regulation attempts to reach a life of high quality.

Conclusion

Considering the direct and indirect effects of specific personality profiles on QoL, this study has expanded prior work on the relationship between personality and QoL by including emotion regulation and self-efficacy. The present study provides a promising approach for future inquiry that could further advance a more comprehensive understanding of how personality characteristics together with emotion regulation skills and self-efficacy beliefs contribute to QoL. As a starting point, our study demonstrates that both emotion regulation and self-efficacy are central mechanisms that link specific personality dimensions to QoL and, therefore, suggests the chaining and modulation of these complex effects. that these links have implications for the ways in which people experience their daily life and how they influence their affective experiences, more indepth prospective studies are promising avenues to further our understanding.

Funding The author(s) received no financial support for the research, authorship, and/or publication of this article.

Compliance with ethical standards

Conflict of interest The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Ethical approval This article does not contain any studies with animals performed by any of the authors. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Fig. 1

 1 Fig. 1 Theoretical model of the relations between personality, emotional regulation, self-efficacy, and quality of life

Fig. 2

 2 Fig. 2 Models displaying direct relations between personality, emotional regulation, self-efficacy, and quality of life. Note: For each step, standardized β are presented; n.s. not significant

Table 1

 1 Zero-order correlations among sample characteristics and key study variables

	1		2	3	4	5	6	7	8	9	10	11	12	13
	Gender 1
	Nationality 2	0.06
	Age	0.01	-0.06
	Income	0.35**	-0.10	0.31**
	Neuroticism	-0.01	-0.07	0.02	-0.15
	Extraversion	-0.02	-0.12*	0.01	0.01 -0.24**
	Conscientiousness	0.03	-0.11*	0.07	0.09 -0.21** 0.22**
	Emotion regulation	0.03	-0.19** -0.03	0.12* -0.51** 0.09*	0.14**
	General self-efficacy	0.06	0.05	-0.02	0.16* -0.39** 0.34** 0.34** 0.36**
	Physical health	0.01	-0.15** 0.06	0.04 -0.36** 0.34** 0.38** 0.17** 0.37**
	Psychological health	0.05	-0.17** 0.07	0.02 -0.36** 0.23** 0.36** 0.21** 0.35** 0.53**
	Social relationships	0.01	-0.12*	0.07	-0.06 -0.30** 0.34** 0.16** 0.07	0.17** 0.42** 0.47**
	Environment	-0.06	-0.24** 0.08	0.07 -0.26** 0.19** 0.28** 0.12* 0.27** 0.50** 0.53** 0.33**
	Mean	-	-	39.72	-	20.94	29.58	34.36	13.02 31.73 11.97 12.23 11.56 12.51
	Standard deviation	-	-	12.87	-	7.90	6.47	6.70	3.07	4.48	1.88	1.88	2.00	1.77
	Skewness	-	-	0.20	-	0.17	-0.29	-0.35 -0.09 -0.08 -0.60 -0.66 -0.45 -0.42
	Kurtosis	-	-	-1.22	-	-0.20	-0.11	-0.13 -0.15	0.39	0.74	1.13	0.19 -0.10
	1 0 = Women, 1 = Men

2 0 = Swiss/French nationality, 1 = non-Swiss/French nationality *p < 0.05, **p < 0.01

Table 2

 2 Summary of direct and indirect effects among neuroticism, emotional regulation, self-efficacy, and quality of life

	B	SE	p	β

Table 3

 3 Summary of direct and indirect effects among extraversion, emotional regulation, self-efficacy and quality of life

		B	SE		p	β
	Direct effects
	Extraversion (E)
	Emotional regulation (ER)	0.385	0.175		0.027	0.20
	General self-efficacy (GSE)	0.439	0.108		<0.001	0.30
	Quality of life (QOL)	0.639	0.191		0.001	0.26
	Emotional regulation
	General self-efficacy	0.408	0.096		<0.001	0.55
	General self-efficacy
	Quality of life	0.649	0.128		<0.001	0.39
	Indirect effects
	E on GSE mediated by ER	0.157	0.067		0.020	0.11
	E on QOL mediated by GSE	0.285	0.078		<0.001	0.12
	ER on QOL mediated by GSE	0.265	0.083		0.001	0.21
	E on QOL mediated by ER and by GSE	0.102	0.046		0.025	0.04
	Total effects
	Total indirect effect of E on QOL	0.387	0.191		<0.001	0.16
	Total effect of E on QOL	1.026	0.193		<0.001	0.42
	Loadings
	Physical health	0.976	0.090		<0.001	0.74
	Psychological health	1.000				0.77
	Social relationships	0.793	0.082		<0.001	0.57
	Environment	0.820	0.073		<0.001	0.66
	Model fit	,r 2 /df	CFI	TLI	RMSEA (95% CI)	SRMR
		2.09	0.946	0.932	0.052 (0.041-0.063)	0.045
	Cutoff scores for acceptable fit index values: CFI > 0.90; TLI > 0.90; RMSEA < 0.07; SRMR < 0.08

Table 4

 4 Summary of direct and indirect effects among conscientiousness, emotional regulation, self-efficacy, and quality of life

	B	SE	p	β


Julien Leprovost

Joël Lemaire

Hélène Mestdagh

Essyllt Louarn

Gérard Mauclaire

Pierre Boissel

F Arsac

C Gregoire

Michel Heninger

Analyse en temps réel des COV par spectrométrie de masse couplée à l'ionisation chimique : application à la qualité de l'air dans les sous-marins

come

Introduction

Les composés organiques volatils (COV) sont des polluants qui peuvent affecter la santé humaine. Dans l'air extérieur ils sont à l'origine de certaines formes de pollution atmosphérique. Ils sont aussi très présents dans l'air intérieur où ils sont produits par l'activité humaine et par les émissions des matériaux. Le sous-marin est un milieu confiné, les SNLE (sous-marins nucléaires lanceurs d'engins) partent en mission et restent immergés plusieurs semaines. Pendant cette période le sous-marin doit fabriquer son oxygène et régénérer son air intérieur. Pour cela il est équipé d'une usine de production d'oxygène ainsi que d'une usine de dépollution. La mesure des COV se fait par prélèvement d'échantillons qui sont analysés au retour de la mission en laboratoire par une méthode séparative (GC-MS). C'est une technique de référence mais elle ne permet pas un suivi en continu de l'évolution des polluants dans le milieu. L'objectif de ce projet piloté par la DGA, était de développer un analyseur pour contrôler la qualité de l'air du sous-marin. Celui-ci devait être capable de détecter simultanément une grande variété de composés à des concentrations faibles, dans la gamme ppm-ppb, tout en garantissant une analyse semi-quantitative sans calibration préalable et une adaptabilité aux composés inconnus. La solution développée par la société AlyXan et le Laboratoire de Chimie Physique (LCP) associe spectrométrie de masse haute résolution et ionisation chimique. Le gaz à analyser est introduit directement dans l'instrument sans préparation et sans étape de séparation chromatographique permettant ainsi une mesure rapide (quelques secondes)

Ionisation chimique

La spectrométrie FT-ICR qui est une technique en piège est parfaitement adaptée à la mise en oeuvre de techniques d'ionisation chimique contrôlées. Cette méthode consiste à utiliser une réaction ion-molécule pour ioniser les composés d'intérêt.

Par exemple, la réaction de transfert de proton à partir de l'ion H 3 O + (PTR-MS) est une méthode très puissante pour mesurer les Composés Organiques Volatils (COV). En effet l'ion H 3 O + ne réagit pas sur les composés majoritaires de l'air (N 2 , O 2 , Ar, CO 2 ) et sa réaction sur H 2 O reforme l'ion H 3 O + . Par ailleurs le processus d'ionisation contrairement à l'impact électronique à 70 eV (IE) souvent utilisé en spectrométrie de masse ne fragmente pas ou peu les molécules organiques.

Enfin la méthode est quantitative si la constante de vitesse de la réaction est connue.

Pour gagner en sélectivité ou détecter d'autre familles de composés, d'autres réactions peuvent être utilisées. Par exemple l'utilisation de l'ion CF 3 + permet de détecter les petits alcanes ou encore celle de l'ion O -permet la détection des fréons comme le R134a. La présence d'eau n'est pas un problème.

Sensibilité

Précurseur :

  Conçu pour être embarqué H 3 O + + N 2 , O 2 , Ar …  Pas de réaction H 3 O + + VOC  HVOC + + H 2 O Analyse de 9 COV dans l'air : 9 composés, 9 pics ! Pas de fragmentation ! Quels composés ? Validation d'une usine de dépollution d'air Points forts de la technique :  Temps réel : résolution temporelle de la s à la min  Détection simultanée de tous les composés  Analyse quantitative  Précision en masse : mesure de la masse exacte des composés.  Mesures sur site  Multiplexage possible de plusieurs voies d'analyse. Applications potentielles :  Contrôle de processus industriel.  Pollutions intérieures.  Emissions industrielles.  Dégradation des matériaux. Contact: julien.leprovost@alyxan.fr Tel: spectromètre de masse FT-ICR compact La technique de spectrométrie de masse utilisée est la FT-ICR (Fourier Transform Ion Cyclotron Resonance). C'est une technique en piège magnétique dont le point fort est la haute résolution en masse. Depuis de nombreuses années, la société AlyXan et le laboratoire de Chimie Physique développent des spectromètres FT-ICR compacts. Ces instruments intègrent des aimants permanents structurés comme des cylindres de Halbach qui permettent d'obtenir des champs magnétiques intenses : 1,5 T. La technologie est protégée par 2 brevets CNRS et UPS. La spectrométrie de masse haute résolution permet d'obtenir la masse exacte des molécules et donc d'identifier les composés détectés en les différenciant suivant leur formule brute chimique. Comparés aux analyseurs quadrupolaires, les points forts de la technique sont : -La détection simultanée de tous les composés -La mesure de la masse exacte des composés, précision 0,01 u. -La séparation d'ions quasi isobares. Les instruments sont compacts, mobiles et peuvent être installés au plus près du besoin. Pour fonctionner une seule prise de courant suffit ! Séparation d'ions quasi isobares Détection large bande Les auteurs tiennent à remercier la DGA Techniques Navales qui a piloté ce projet et plus particulièrement M. Arsac et Mme Grégoire Une mesure permet d'atteindre une sensibilité de 200 ppb avec un temps de mesure de 2 secondes.En accumulant et en moyennant les signaux, il est possible d'atteindre des sensibilité de quelques ppb en une dizaine de minutes quel que soit le nombre de composés détectés.Des systèmes MIMS (Membrane Inlet Mass Spectrometry) peuvent être utilisés pour augmenter la sensibilité.L'association de la spectrométrie de masse FT-ICR et de l'ionisation chimique contrôlée a permis de développer un outil performant pour l'analyse en ligne et en continu de COV.La dépollution de l'air de bord du sous-marin s'effectue en plusieurs étapes dont les principales sont le passage dans un réfrigérant, puis sur un charbon actif enfin sur un catalyseur.L'objectif principal de ce travail était de caractériser l'efficacité de l'usine à chaque étape de la dépollution. Pour cela un système permettant de multiplexer les voies d'échantillonnage a été développé ainsi qu'un logiciel pour organiser les séquences d'analyse et l'affichage des résultats.Perçage du charbon actif Régénération d'un élément filtrant L'essai a duré au total 35 jours avec des mesures jour et nuit et une fréquence de mesure de 10 à 15 minutes par point.

  d'un mélange de COV de concentration < 100 ppb accumulé 1000 fois H


Rémi Diesler

Marie Legendre

Salim Aymeric

Pierre-Yves Brillet

Lidwine Wemeau

Effrosyni D Manali

Frédéric Gagnadoux

Anne Gondouin

Sandrine Hirschi

Gwenael Lorillon

Phenotypic characterization of interstitial lung disease associated with mutations in SFTPC and ABCA3 in adults

à la diffusion de documents scientifiques de niveau recherche, publiés ou non, émanant des établissements d'enseignement et de recherche français ou étrangers, des laboratoires publics ou privés.