The impact of trauma and how to intervene: a narrative review of psychotraumatology over the past 15 years

To mark 15 years of the European Journal of Psychotraumatology, editors reviewed the past 15-year years of research on trauma exposure and its consequences, as well as developments in (early) psychological, pharmacological and complementary interventions. In all sections of this paper, we provide perspectives on sex/gender aspects, life course trends, and cross-cultural/global and systemic societal contexts. Globally, the majority of people experience stressful events that may be characterized as traumatic. However, definitions of what is traumatic are not necessarily straightforward or universal. Traumatic events may have a wide range of transdiagnostic mental and physical health consequences, not limited to posttraumatic stress disorder (PTSD). Research on genetic, molecular, and neurobiological influences show promise for further understanding underlying risk and resilience for trauma-related consequences. Symptom presentation, prevalence, and course, in response to traumatic experiences, differ depending on individuals' age and developmental phase, sex/gender, sociocultural and environmental contexts, and systemic socio-political forces. Early interventions have the potential to prevent acute posttraumatic stress reactions from escalating to a PTSD diagnosis whether delivered in the golden hours or weeks after trauma. However, research on prevention is still scarce compared to treatment research where several evidence-based psychological, pharmacological and complementary/ integrative interventions exist, and novel forms of delivery have become available. Here, we focus on how best to address the range of negative health outcomes following trauma, how to serve individuals across the age spectrum, including the very young and old, and include considerations of sex/gender, ethnicity, and culture in diverse contexts, beyond Western, Educated, Industrialized, Rich, and Democratic (WEIRD) countries. We conclude with providing directions for future research aimed at improving the well-being of all people impacted by trauma around the world. The 15 years EJPT webinar provides a 90-minute summary of this paper and can be downloaded here [http://bit.ly/4jdtx6k].

Development and psychometric testing of a self-management scale for cancer survivors with radiotherapy/chemotherapy-induced oral mucositis in China

Objective

This study aims to develop and validate a self-management scale for radiotherapy/chemotherapy-induced oral mucositis (SMS-RIOM/CIOM) in cancer survivors, addressing the need for a comprehensive tool to assess self-management capabilities.

Methods

This study employed a two-phase process: (1) initial scale development through literature review, semi-structured interviews, and expert consultations, and (2) psychometric testing with 420 cancer survivors from five wards of Zibo Hospital. The psychometric evaluation included item analysis, content validity testing, reliability assessments, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA).

Results

The finalized SMS-RIOM/CIOM consists of 15 items across four dimensions: medication management, oral pain management, disease monitoring, and daily life management. EFA explained 77.322% of the total variance, while CFA demonstrated an excellent model fit (χ²/df=1.909, RMSEA=0.064, RMR=0.052, GFI=0.911, CFI=0.964, NFI=0.928, TLI=0.955, IFI=0.964). Reliability metrics were robust, including Cronbach's alpha of 0.902, split-half reliability of 0.849, test-retest reliability of 0.862, and a scale content validity index of 0.910.

Conclusions

The SMS-RIOM/CIOM is a reliable and valid tool for assessing self-management in cancer survivors with RIOM/CIOM. It provides valuable insights for clinical practice, enabling targeted interventions to improve self-management and enhance the quality of life for cancer survivors. Further research is recommended to validate its application across diverse populations and healthcare settings.

Parents' wellbeing: perceptions of happiness and challenges in parenthood in Latin America

INTRODUCTION

Traditional research on parenthood and wellbeing often employs a positivist perspective and focuses on non-LA samples -limiting our knowledge and understanding of the influence of cultural components such as Machismo and Marianismo, have in parents' wellbeing. This study explored how Latin American (LA) parents' wellbeing is influenced by parenthood in a culture strongly influenced by such gender-based perspectives.

METHODS

An interpretative perspective was employed to qualitatively explore fifteen LA parents' lived experiences and data were analysed via Thematic Analysis. The American Psychological Association's Journal Article Reporting Standards for Qualitative Research (JARS-Qual), was followed to compile this paper.

RESULTS

Results showed that socio-economic factors such as crime, violence, and economic inequality, negatively influence parents' wellbeing -emotions experienced and life satisfaction.

DISCUSSION

Parents find joy in sharing own personal experiences with their children and passing on gender-based models. However, parents perceive family pressure as a "burden" when expected to follow principles of Machismo/Marianismo. Similar to Asian, but unlike European parents, LA parents experience a mixture of positive and negative emotions whilst parenting -shaped by Machismo and Marianismo. This study makes a unique contribution by uncovering the unique influence of LA socio-economic challenges and cultural impositions and expectations and its influence on parental wellbeing.

The interpersonal theory of suicide risk in male US service members/veterans: the independent effects of perceived burdensomeness and thwarted belongingness

Introduction: Suicide rates remain high among US military service member/veteran (SM/V) males with overall trends showing an upward trajectory. Several empirical studies and official US government reports show that interpersonal challenges can substantially increase suicide risk. One theory, the Interpersonal Theory of Suicide (IPT), focuses thwarted belongingness, perceived burdensomeness, capability for suicide, and their interactions, as key contributors to suicide risk. Extant military studies are subscribed to specific subsamples and/or do not test the full theory. This has resulted in mixed findings or findings with limited generalizability. The current study addressed these limitations.Method: A convenience sample of 508 male SM/Vs completed self-report measures of lifetime suicide ideation, likelihood of making a future attempt, thwarted belongingness, perceived burdensomeness, capability for suicide, and demographics. Suicide ideation and risk was regressed on IPT variables, relevant interactions, and covariates.Results: The variance accounted for in suicide ideation and likelihood of a future attempt was 32% and 62%, respectively. Higher perceived burdensomeness was associated with suicide ideation, and higher thwarted belongingness had a marginally significant association with suicide ideation. The presence of suicide ideation and higher thwarted belongingness were associated with the likelihood of making a future attempt. Capability for suicide was not associated with the likelihood of making a future attempt.Discussion: Perceived burdensomeness, suicide ideation, and thwarted belongingness appear to individually create risk for future suicide behaviour among US military service members and veterans. Additional work is needed to establish comprehensive theories of suicide risk in this population.

Epigenome-wide association study of perceived discrimination in the Multi-Ethnic Study of Atherosclerosis (MESA)

Perceived discrimination, recognized as a chronic psychosocial stressor, has adverse consequences on health. DNA methylation (DNAm) may be a potential mechanism by which stressors get embedded into the human body at the molecular level and subsequently affect health outcomes. However, relatively little is known about the effects of perceived discrimination on DNAm. To identify the DNAm sites across the epigenome that are associated with discrimination, we conducted epigenome-wide association analyses (EWAS) of three discrimination measures (everyday discrimination, race-related major discrimination, and non-race-related major discrimination) in 1,151 participants, including 565 non-Hispanic White, 221 African American, and 365 Hispanic individuals, from the Multi-Ethnic Study of Atherosclerosis (MESA). We conducted both race/ethnicity-stratified analyses as well as trans-ancestry meta-analyses. At false discovery rate of 10%, 7 CpGs and 4 differentially methylated regions (DMRs) containing 11 CpGs were associated with perceived discrimination exposures in at least one racial/ethnic group or in meta-analysis. Identified CpGs and/or nearby genes have been implicated in cellular development pathways, transcription factor binding, cancer and multiple autoimmune and/or inflammatory diseases. Of the identified CpGs (7 individual CpGs and 11 within DMRs), two CpGs and one CpG within a DMR were associated with expression of cis genes NDUFS5, AK1RIN1, NCF4 and ADSSL1. Our study demonstrated the potential influence of discrimination on DNAm and subsequent gene expression.

Considering the impact of vaccine communication in the COVID-19 pandemic among adults in Canada: A qualitative study of lessons learned for future vaccine campaigns

We aimed to understand how experiences with vaccine-related information and communication challenges during the COVID-19 pandemic impacted motivations and behaviors among Canadian adults regarding future vaccines. Semi-structured interviews were conducted with participants purposively selected to ensure diversity in age, sex at birth, self-identified gender, and region. Data were analyzed using thematic analysis; findings were mapped to the Information-Motivation-Behavioral Skills Model focusing on factors affecting vaccine hesitancy and uptake. Of 62 interviews completed, most were with woman (n = 32, 51.6%) and residents of Ontario (n = 36, 58.1%); the median age was 43.5 yr (interquartile range 23.3 yr). Themes included: 1) accessibility of information, 2) ability to assess information accuracy and validity, 3) trust in communications from practitioners and decision-makers, and 4) information seeking behaviors. Participants expressed various concerns about vaccines, including fears about potential side effects, particularly regarding the long-term effects of novel vaccinations. These concerns may reflect broader societal anxieties, which have been intensified by widespread misinformation and an overload of vaccine information. Moreover, participants highlighted a lack of trust in the information provided by government agencies and pharmaceutical companies, primarily driven by concerns regarding their underlying motives. Concerns about COVID-19 vaccine safety and effectiveness negatively impacted future vaccine attitudes and behaviors. Vaccine hesitancy studies should consider how individuals receive, perceive, and seek information within social contexts and risk profiles.

Maximizing expectancy violation and exposure outcomes in patients with PTSD

Background: It has been proposed that maximizing expectancy violation enhances the efficacy of exposure therapy. The clinical utility of expectancy violation remains unclear and it has not yet been studied in PTSD.Objective: We aimed to test whether explicitly focusing on expectancy violation leads to superior exposure outcomes.Method: Adult treatment-seeking patients with PTSD (N = 60) were randomly assigned to one 90-minute exposure session focusing on either expectancy violation or a control condition without an expectancy focus. Assessments occurred before the session and one week later, measuring changes in fear responses during a script-driven imagery task, and PTSD symptoms.Results: Using multilevel analyses, we found no between-condition differences. On average, fear responses to the imagery and PTSD symptoms decreased over time. The expectancy violation condition exhibited a greater decrease in threat appraisal, which appeared to mediate symptom reduction.Conclusions: We found no evidence that explicitly focusing on expectancy violation led to superior immediate effects. However, it may lead to more changes in expectancies which could affect symptom improvement over an extended period. Further research is needed to determine whether emphasizing expectancy violation in exposure therapy for PTSD is advantageous.

Assessing neurocognitive outcomes in PTSD: a multilevel meta-analytical approach

Background: Evidence supporting the association between posttraumatic stress disorder (PTSD) and cognitive impairment is accumulating. However, less is known about which factors influence this association.Objective: The aims of this meta-analysis were to (1) elucidate the association between PTSD and a broad spectrum of cognitive impairment, including the risk of developing neurocognitive disorder (NCD) later in life, using a multilevel meta-analytic approach, and (2) identify potential moderating factors of this association by examining the effects of age (20-39, 40-59, 60+), study design (cross-sectional or longitudinal), study population (war-exposed populations/veterans or the general population), neurocognitive outcome assessed (i.e. a diagnosis of NCD or type of cognitive domain as classified according to A Compendium of Neuropsychological tests), gender (≥50% women or <50% women), study quality (high vs low), type of PTSD measure (self-report or clinical diagnosis), as well as the presence of comorbidities such as traumatic brain injury (TBI), depression, and substance use (all coded as either present or absent).Method: Peer-reviewed studies on this topic were extracted from PubMed and Web of Science with predetermined keywords and criteria. In total, 53 articles met the criteria. Hedge's g effect sizes were calculated for each study and a three-level random effect meta-analysis conducted.Results: After accounting for publication bias, the results suggested a significant association between PTSD and cognitive impairment, g = 0.13 (95% CI: 0.10-0.17), indicating a small effect. This association was consistent across all examined moderators, including various neurocognitive outcomes, age, gender, study design, study population, study quality, type of PTSD measure, and comorbidities such as depression, substance use, and TBI.Conclusions: These findings collectively suggest that PTSD is associated with both cognitive impairment and NCD. This emphasizes the need for early intervention (including prevention strategies) of PTSD, alongside monitoring cognitive function in affected individuals.International Prospective Register of Systematic Reviews (PROSPERO) registration number: CRD42021219189, date of registration: 02.01.2021.

Brain functional connectivity changes on fMRI in patients with chronic pelvic pain treated with the Neuro Emotional Technique: a randomised controlled trial

BACKGROUND

Chronic pelvic pain is a substantial clinical challenge that profoundly impacts quality of life for many women. The Neuro Emotional Technique (NET) is a novel mind-body intervention designed to attenuate emotional arousal of distressing thoughts and pain. This study evaluated functional connectivity changes in key areas of the brain in patients with chronic pelvic pain receiving the NET intervention. The goal was to assess whether the NET intervention was associated with functional connectivity (FC) changes in the brain related to reductions in emotional distress and pain, particularly in the limbic areas, sensory/pain regions, and cerebellum.

METHODS

This is a prospectively designed study that included twenty-six patients with a diagnosis of chronic pelvic pain who were randomised to either the NET intervention or a waitlist control. To evaluate the primary outcome of neurophysiological effects, all participants received resting state functional blood oxygen level dependent (BOLD) magnetic resonance imaging (rs-fMRI) before and after the NET intervention or waitlist control period. Pain, mood, anxiety, and quality of life also were assessed.

RESULTS

Compared to the control group, the NET group demonstrated significant improvements in pain interference and pain intensity, and in emotional measures such anxiety and depression. Functional connectivity in the NET group compared to controls, was significantly decreased in the amygdala, cerebellum, and postcentral gyrus. There were also significant correlations between FC changes and changes in clinical measures.

CONCLUSIONS

This study is an initial step towards describing a neurological signature of reducing emotional distress in women with chronic pelvic pain. Specifically, FC changes between the cerebellum and the amygdala and sensory areas appears to be associated with a reduction in pain and the effects of that pain. Future, larger clinical trials are warranted to further evaluate these mechanisms and NET as a potential therapeutic intervention in patients with chronic pelvic pain.

The silent pandemic of stress: impact on menstrual cycle and ovulation

In the current age of technological advancement, stress has emerged as a silent pandemic affecting individuals, especially young generations, globally. Factors such as increased competition, social pressures fueled by social media and smartphones, and a sense of diminished control in the face of modern challenges contribute to rising stress levels. In addition to the negative implications on mental well-being, stress affects physiological processes such as the menstrual cycle. Functional hypogonadotropic hypogonadism is a spectrum ranging ranging from regular menstrual cycles with short or insufficient luteal phases to irregular cycles, oligomenorrhea, anovulation, and complete amenorrhea, depending on how stress variably disrupts gonadotropic-releasing hormone (GnRH) drive. Functional hypothalamic amenorrhea (FHA), the most severe manifestation, is a complex global neuroendocrinopathy with several serious health consequences in addition to amenorrhea and infertility. Concomitant health consequences include bone loss, endothelial dysfunction, and cardiovascular risks. The collective health burden underscores the need for clinical awareness and comprehensive treatment strategies addressing behavioral and biopsychosocial stressors that lead to chronic hypothalamic-pituitary-adrenal (HPA) axis activation. Despite its prevalence and numerous adverse health consequences, research on this condition remains limited, revealing a significant gap in understanding and addressing this condition. Larger and long-term follow-up studies are important to accurately assess FHA prevalence, its health consequences, intervention efficacy, and recovery outcomes.

Understanding and supporting parenting in parents seeking PTSD treatment: a qualitative study

Background: Parental post-traumatic stress disorder (PTSD) can impact parenting and child psychosocial wellbeing. Complementing trauma-focused psychotherapy with parenting interventions can thus have important preventive value. Understanding parents' lived experiences is necessary to tailor such interventions to their needs.Objective: This study addressed the question: how can preventive parenting support be shaped to the needs of parents entering specialized psychotherapy for PTSD? To answer this question, we investigated parenting challenges, parent-child communication about PTSD, strengths, and social support experiences of parents with PTSD.Method: The sample included 14 parents seeking PTSD treatment at a tertiary mental healthcare institution, while parenting children aged 4-17. Data were collected using semi-structured interviews and analysed using reflexive thematic analysis.Results: On the one hand, parental dysregulation (e.g. exploding or shutting down) was an important challenge. On the other hand, parents' attempts to remain regulated (e.g. through overcontrol and overprotectiveness) also affected family life. When talking to their child about PTSD, parents were guided by what they considered beneficial for the child to know. An important strength was that parents tried to remain attuned to the child's needs, regardless of their own struggles. Parents also described experiences that could be understood as post-traumatic growth through parenting. Generally, parents experienced a lack of social support.Conclusion: Our findings illustrate that parents entering PTSD treatment are highly motivated to do what is best for their child. Based on parents' lived experiences, preventive parenting interventions should address the impacts of both dysregulation and overcontrolling regulation attempts. Another important goal is reducing feelings of incompetence. Integrating the parenting role in psychotherapy for PTSD could also be beneficial. For example, setting parenting-related therapy goals can be motivating. Furthermore, parent-child interactions can be a mirror that reflects the parents' inner state: considering these interactions can help recognize changes in symptomatology.

Making people meet: volunteers' contributions to social connection for the well-being of self and others

PURPOSE

Social isolation and loneliness are significant public health challenges that reduce well-being. The voluntary sector is suggested to be an important contributor in reducing loneliness and enhancing social connectedness and well-being in everyday life. This study aimed to contribute knowledge about how volunteers may help promote social connections and well-being, by exploring the experiences and perspectives of volunteers themselves.

METHODS

We conducted a qualitative study in Norway interviewing nine volunteers. Data was analysed using reflexive Thematic Analysis.

FINDINGS

We developed three themes: Being part of and facilitating a variety of meaningful relationships and roles, Creating spaces of trust in places of shared activity, and Calling for more diversity in volunteering while acknowledging challenges.

CONCLUSIONS

Volunteers' may contribute to social connection and well-being, particularly through arranging social activities where relationships are equal and established spontaneously. Some challenges remain before volunteer activities are fully inclusive for all. Extended organizational support of volunteers may be necessary for recruitment and continuity of volunteer efforts towards some marginalized groups.

Childhood abuse and neglect and adult body attitude

Background: The body is the medium through which humans experience the world, and the body is key to most suffering, healing, and clinical mental diagnoses. Body attitude refers to the affective, cognitive, and behavioural aspects of embodiment, which typically is more negative in clinical samples.Objective: We examine how adult body attitude is associated with self-reported childhood abuse and neglect. We hypothesised that child sexual abuse is associated stronger with a negative adult body attitude than emotional or physical abuse/neglect would. Second, we expected that the association between body attitude and childhood sexual abuse was gender equivalent. Third, we expected a more positive body attitude in men than women after childhood physical abuse/neglect or emotional abuse/neglect.Method: Body attitude was measured with the Dresden Body Image Questionnaire (DBIQ-NL) and the severity and type of childhood trauma with the Childhood Trauma Questionnaire-Short Form (CTQ-SF) in 749 Dutch adults aged 18-77. We fit multiple regression models and focused on childhood abuse and neglect with moderate to severe intensity.Results: Childhood sexual abuse (∼15%), physical neglect (∼14%), emotional abuse (∼20%) and emotional neglect (∼30%) are associated with a more negative body attitude, while childhood physical abuse (moderate/severe, ∼6%) associated with a slightly more positive adult body attitude. Body attitude associations with childhood abuse/neglect were similar for both genders (no moderation).Conclusion: Child maltreatment seems to precede the development of a more negative adult body attitude and more negative body experiences compared to individuals without child maltreatment.

Effectiveness of a resilience, gender equity and mental health group intervention for young people living in informal urban communities in North India: a cluster randomized controlled trial

BACKGROUND

Mental health problems are the leading cause of disease burden among young people in India. While evidence shows that youth mental health and resilience can be improved with group interventions in school settings, such an intervention has not been robustly evaluated in informal urban settings.

OBJECTIVE

This study aimed to evaluate whether the Nae Disha 3 group intervention could improve youth resilience, mental health and gender equal attitudes among disadvantaged young people from low-income urban communities in India.

METHODS

This cluster randomised controlled trial used an analytic sample of 476 adolescents and young adults aged 11-25 years from randomised clusters in urban Dehradun, India. The 251 intervention group participants were 112 boys and 139 girls, and the 225 young people in the wait-control group were 101 boys and 124 girls. Five validated tools measuring resilience gender equity and mental health were filled by participants at three different points in time.

RESULTS

Difference in difference (DiD) analysis at T2 showed that scores improved among girls in intervention group, for adjusted model, resilience (DiD = 4.12; 95% CI: 2.14, 6.09) and among boys, for resilience (DiD = 5.82; 95% CI: 1.57, 9.74).

CONCLUSIONS

The Nae Disha 3 intervention among disadvantaged urban youth moderately improved resilience for both young men and women, though it did not significantly impact mental health, self-efficacy, or gender-equal attitudes. We establish potential merit for this approach to youth mental health but recommend further research to examine active ingredients and the ideal duration of such group interventions.

Gut microbiome changes with micronutrient supplementation in children with attention-deficit/hyperactivity disorder: the MADDY study

Micronutrients have demonstrated promise in managing inattention and emotional dysregulation in children with attention-deficit/hyperactivity disorder (ADHD). One plausible pathway by which micronutrients improve symptoms is the gut microbiome. This study examines changes in fecal microbial composition and diversity after micronutrient supplementation in children with ADHD (N = 44) and highlights potential mechanisms responsible for the behavioral improvement, as determined by blinded clinician-rated global improvement response to micronutrients. Participants represent a sub-group of the Micronutrients for ADHD in Youth (MADDY) study, a double blind randomized controlled trial in which participants received micronutrients or placebo for 8 weeks, followed by an 8-week open extension. Stool samples collected at baseline, week 8, and week 16 were analyzed using 16S rRNA amplicon sequencing targeting the V4 hypervariable region. Pairwise compositional analyses investigated changes in fecal microbial composition between micronutrients versus placebo and responders versus non-responders. A significant change in microbial evenness, as measured by alpha diversity, and beta-diversity, as measured by Bray-Curtis, was observed following micronutrients supplementation. The phylum Actinobacteriota decreased in the micronutrients group compared to placebo. Two butyrate-producing bacterial families: Rikenellaceae and Oscillospiraceae, exhibited a significant increase in change following micronutrients between responders versus non-responders. These findings suggest that micronutrients modulated the composition of the fecal microbiota and identified specific bacterial changes associated with micronutrient responders.

Neural dynamics of deception: insights from fMRI studies of brain states

Deception is a complex behavior that requires greater cognitive effort than truth-telling, with brain states dynamically adapting to external stimuli and cognitive demands. Investigating these brain states provides valuable insights into the brain's temporal and spatial dynamics. In this study, we designed an experiment paradigm to efficiently simulate lying and constructed a temporal network of brain states. We applied the Louvain community clustering algorithm to identify characteristic brain states associated with lie-telling, inverse-telling, and truth-telling. Our analysis revealed six representative brain states with unique spatial characteristics. Notably, two distinct states-termed truth-preferred and lie-preferred-exhibited significant differences in fractional occupancy and average dwelling time. The truth-preferred state showed higher occupancy and dwelling time during truth-telling, while the lie-preferred state demonstrated these characteristics during lie-telling. Using the average z-score BOLD signals of these two states, we applied generalized linear models with elastic net regularization, achieving a classification accuracy of 88.46%, with a sensitivity of 92.31% and a specificity of 84.62% in distinguishing deception from truth-telling. These findings revealed representative brain states for lie-telling, inverse-telling, and truth-telling, highlighting two states specifically associated with truthful and deceptive behaviors. The spatial characteristics and dynamic attributes of these brain states indicate their potential as biomarkers of cognitive engagement in deception.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11571-025-10222-4.

Development of a dyadic mindfulness self-compassion intervention for patients with lung cancer and their family caregivers: A multi-method study

Objective

Lung cancer and its prolonged treatment are profoundly unsettling for patients and their family caregivers, and developing dyadic measures to alleviate their negative affectivity is pivotal. This study aimed to develop a complex intervention to alleviate dyadic psychological stress among patients with lung cancer and their family caregivers.

Methods

A stepwise multi-method study was conducted following the Medical Research Council framework. Three phases were adopted, namely: (1) a preparation phase, a systematic review was conducted to identify the evidence base, (2) a development phase, empirical data from a quantitative study and a qualitative study were integrated to identify effective components, and (3) a modification phase, an online Delphi survey was carried out to refine the intervention.

Results

The dyadic Mindfulness Self-Compassion intervention developed in this study consists of six weekly sessions. The key components of the intervention include: (1) getting along with cancer (introductory session targets illness perception), (2) practising mindful awareness (core session for mindfulness), (3) defining dyadic relationships and introducing self-compassion (core session for self-compassion), (4) promoting dyadic communication (maintenance session targets communication skills), (5) promoting dyadic coping (maintenance session targets coping skills), and (6) a summary session reviewing the rewards and challenges of dyadic adaptation named embracing the future.

Conclusions

An evidence-based, theory-driven, and culturally appropriate dyadic Mindfulness Self-Compassion intervention was developed for patients with lung cancer and their family caregivers. Future studies are warranted to pilot and evaluate the usability, feasibility, acceptability, satisfaction, and effectiveness of this complex intervention.

Trial registration

ClinicalTrial.gov NCT04795700.

"They are just as different as the rest of us" - a focus group study of primary teachers' perceptions of children with ADHD who struggle socially

PURPOSE

Difficulties in peer interactions are common among children with ADHD and associated with severe consequences. Prevailing interventions have been criticized for not accounting for the significance of context and for limited effect on important social outcomes. Given the importance of the school environment and the teacher for children's social development, we wanted to explore how teachers perceive their own role and responsibilities when children are struggling socially, and how they intervene in their daily practice.

METHODS

We conducted semi-structured interviews in five focus groups of primary school teachers in Bergen, Norway and analysed the data through reflexive thematic analysis.

RESULTS

We discerned two overarching themes, each with several subthemes. The first theme, "Monitoring and Attending to Individual Needs in a Context", represents teachers' perceptions of their role and responsibilities. The second theme, "Tailoring Interventions Through Continuous Assessments", represents the teachers' strive to fulfil this role in their everyday practice.

CONCLUSION

Our findings reflect a complex, contextual understanding of social difficulties, acknowledging the uniqueness of each child, regardless of diagnosis. The teachers' practice was characterized by continuous tailoring to accommodate the specific, contextualized needs of each child, both "behind the scenes" and trough participating in children's everyday social interactions.

Development of color learning protocol based on music-color association for people with visual impairment

BACKGROUND

This research developed and confirmed the feasibility of a color-learning mobile application for people with visual impairment based on the hypothesis that the music-color association may be synaesthetically induced through emotion.

METHODS

In total, 120 participants with visual impairment, comprising 60 congenital and 60 adventitious cases, were recruited. They underwent sequential procedures: Procedure 1 involved selecting color-music associations and designing tasks; Procedure 2 focused on application development with accessibility features; and Procedure 3 verified usability and effectiveness.

RESULTS

Significant improvements were observed in hue, luminance, and saturation scores following the use of the music-color association application among participants with both congenital and adventitious visual impairment. The effectiveness of the application in facilitating color learning is evident, suggesting its potential utility in enhancing color perception in this population.

CONCLUSIONS

This research introduces a novel framework for color learning among visually impaired individuals using a music-based synesthetic approach. The developed mobile application offers a promising avenue for efficiently improving color perception and learning, thereby addressing the critical need for accessibility and education for this population. Further research should explore the long-term effects and broader applications of synesthetic-induced learning in diverse contexts.

Trait dissociation in borderline personality disorder: influence on immediate therapy outcomes, follow-up assessments, and self-harm patterns

Background: Dissociative symptoms are suggested to compete with the effectiveness of psychotherapeutic treatment and frequently co-occur with early life trauma and self-harm patterns, including self-injury, suicidal ideation, and suicide attempts, which are characteristic for borderline personality disorder (BPD).Objective: We explore the connections between dissociation and other BPD features like self-harm and childhood traumatization and examine the impact of trait dissociation on both immediate and follow-up psychotherapy outcomes.Method: In this naturalistic prospective evaluation study, we investigated psychopathology including general psychological distress (SCL-90), depression (BDI-II), and borderline-specific pathology (BSL) in 131 patients with BPD pre and post of a certified 8-week inpatient Dialectical Behaviour Therapy (DBT), as well as 3- and 6-month post inpatient treatment. Prior to therapy, we evaluated trait dissociation (Dissociative Experience Scale), early life trauma (Childhood Trauma Questionnaire), and self-harm patterns (clinical interview). We performed a network analysis to explore the interplay between dissociation, self-harm, and childhood traumatization. To analyse the influence of dissociation on treatment outcomes, we employed linear mixed models.Results: Psychopathology (SCL-90, BDI-II and BSL) exhibited significant reductions at post-treatment and follow-up assessments when compared to baseline measurements. Higher levels of trait dissociation were consistently related to higher psychopathology but did not suggest poorer symptom reduction during DBT. However, trait dissociation predicted reduced 6-month follow-up benefits from DBT, regardless of the baseline symptom burden. The network analysis revealed a close association between self-injury and derealization/depersonalization, while the frequency of suicide attempts was more closely connected to childhood emotional abuse, which was identified as a central node of the network.Conclusions: Dissociation was not related to poorer outcomes regarding inpatient DBT. However, trait dissociation predicted reduced follow-up benefits, highlighting the need to address dissociation during psychotherapeutic interventions. Based on the estimated network structure, treating dissociative symptoms could potentially mitigate self-injury while especially childhood emotional abuse was linked with suicide attempts.

Dissociative experiences in individuals with subclinical psychosis and a history of developmental trauma: a qualitative study

Background: Among individuals with psychotic experiences, those with a history of developmental trauma face greater symptom severity and worse clinical outcomes compared to those without. Dissociation constitutes a prominent, characteristic of this group's clinical presentation, whose nuances and associated characteristics remain however understudied in psychosis research. We aimed to address this gap by conducting a qualitative study to investigate the phenomenology, context, and impact of dissociative experiences in individuals with subclinical psychosis and a history of developmental trauma.Methods: 25 UK-based participants with a history of developmental trauma and meeting criteria for subclinical psychosis, based on the CAPE-15, were recruited via social media. Participants attended semi-structured interviews online, which were transcribed verbatim and analysed with thematic analysis by two researchers.Results: Thematic analysis yielded the following themes: (1) Phenomenology of Dissociation; (2) Context of Dissociation; (3) Impact of Dissociation; (4) Dissociation and Psychotic-like Phenomena. Participants described experiences of detachment and compartmentalisation, which when experienced were confusing and often distressing. Dissociation was linked to affective experiences, their history of developmental trauma and psychotic-like experiences.Conclusion: This study elucidates the complex and varied nature of dissociative experiences in individuals with subclinical psychosis with a history of developmental trauma. These findings highlight the need for further research to understand the manifestation of dissociation in this population and the links with distress and other aspects of psychopathology. Importantly, it is essential to use this understanding to inform the development of interventions and improve clinical recognition and management.

Metacognition of one's strategic planning in decision-making: the contribution of EEG correlates and individual differences

The metacognition of one's planning strategy constitutes a "second-level" of metacognition that goes beyond the knowledge and monitoring of one's cognition and refers to the ability to use awareness mechanisms to regulate execution of present or future actions effectively. This study investigated the relation between metacognition of one's planning strategy and the behavioral and electrophysiological (EEG) correlates that support strategic planning abilities during performance in a complex decision-making task. Moreover, a possible link between task execution, metacognition, and individual differences (i.e., personality profiles and decision-making styles) was explored. A modified version of the Tower of Hanoi task was proposed to a sample of healthy participants, while their behavioral and EEG neurofunctional correlates of strategic planning were collected throughout the task with decisional valence. After the task, a metacognitive scale, the 10-item Big Five Inventory, the General Decision-Making Style inventory, and the Maximization Scale were administered. Results showed that the metacognitive scale enables to differentiate between the specific dimensions and levels of metacognition that are related to strategic planning behavioral performance and decision. Higher EEG delta power over left frontal cortex (AF7) during task execution positively correlates with the metacognition of one's planning strategy for the whole sample. While increased beta activity over the left frontal cortex (AF7) during task execution, higher metacognitive beliefs of efficacy and less willingness to change their strategy a posteriori were correlated with specific personality profiles and decision-making styles. These findings allow researchers to delve deeper into the multiple facets of metacognition of one's planning strategy in decision-making.

EEG-based cross-subject passive music pitch perception using deep learning models

Pitch plays an essential role in music perception and forms the fundamental component of melodic interpretation. However, objectively detecting and decoding brain responses to musical pitch perception across subjects remains to be explored. In this study, we employed electroencephalography (EEG) as an objective measure to obtain the neural responses of musical pitch perception. The EEG signals from 34 subjects under hearing violin sounds at pitches G3 and B6 were collected with an efficient passive Go/No-Go paradigm. The lightweight modified EEGNet model was proposed for EEG-based pitch classification. Specifically, within-subject modeling with the modified EEGNet model was performed to construct individually optimized models. Subsequently, based on the within-subject model pool, a classifier ensemble (CE) method was adopted to construct the cross-subject model. Additionally, we analyzed the optimal time window of brain decoding for pitch perception in the EEG data and discussed the interpretability of these models. The experiment results show that the modified EEGNet model achieved an average classification accuracy of 77% for within-subject modeling, significantly outperforming other compared methods. Meanwhile, the proposed CE method achieved an average accuracy of 74% for cross-subject modeling, significantly exceeding the chance-level accuracy of 50%. Furthermore, we found that the optimal EEG data window for the pitch perception lies 0.4 to 0.9 s onset. These promising results demonstrate that the proposed methods can be effectively used in the objective assessment of pitch perception and have generalization ability in cross-subject modeling.

Identifying traumatization in young children through structured play: validation of the Odense Child Trauma Screening (OCTS) in Lithuania

Background: There is a need for valid methods to evaluate young children's (4-8 years) psychological difficulties related to traumatic experiences. The Odense Child Trauma Screening (OCTS), developed by Danish researchers, is a play-based story stem assessment tool developed to screen for indicators of traumatization in young children. Just a few studies of the OCTS have been published so far.Objective: The current study aimed to test the reliability and convergent validity of the OCTS in the Lithuanian community and risk subsamples of young children aged 4-8 years.Method: The total sample consisted of 209 participants (58.9% girls) from the community (47.4%) and risk (52.6%) subsamples, Mage = 6.29 (SD = 1.48). All children were screened with the OCTS, and caregivers completed self-report questionnaires: demographics, the Child and Adolescent Trauma Screen-Caregiver (CATS-C), and the Strengths and Difficulties Questionnaire (SDQ).Results: The data suggests that the OCTS has good inter-rater reliability. The OCTS, SDQ, and CATS-C scores were significantly higher in the risk subsample, with small to large effect sizes. Boys and younger children (3-4-year-olds) scored higher on the OCTS. Out of all the OCTS stories, the Burnt hand story had significant correlation coefficients with all the CATS-C PTSD symptoms.Conclusions: The study provides initial information about the reliability and the validity of the OCTS and calls for further exploration of this instrument. There were also variations in scores between the Lithuanian data and an earlier study of the Danish sample. Future studies on the OCTS would benefit from further cross-cultural, reliability and the validity examination.

Imageless optical navigation system is clinically valid for total knee arthroplasty

Achieving optimal implant position and orientation during total knee arthroplasty (TKA) is a pivotal factor in long-term survival. Computer-assisted navigation (CAN) has been recognized as a trusted technology that improves the accuracy and consistency of femoral and tibial bone cuts. Imageless CAN offers advantages over image-based CAN by reducing cost, radiation exposure, and time. The purpose of this study was to evaluate the accuracy of an imageless optical navigation system for TKA in a clinical setting. Forty-two consecutive patients who underwent primary TKA with CAN were retrospectively reviewed. Femoral and tibial component coronal alignment was assessed via post-operative radiographs by two independent reviewers and compared against coronal alignment angles from the CAN. The primary outcome was the mean absolute difference of femoral and tibial varus/valgus angles between radiograph and intra-operative device measurements. Bland-Altman plots were used to assess agreement between the methods and statistically analyze potential systematic bias. The mean absolute differences between navigation-guided cut measurements and post-operative radiographs were 1.16 ± 1.03° and 1.76 ± 1.38° for femoral and tibial alignment respectively. About 88% of coronal measurements were within ±3°, while 99% were within ±5°. Bland-Altman analysis demonstrated a bias between CAN and radiographic measurements with CAN values averaging 0.52° (95% CI: 0.11°-0.93°) less than their paired radiographic measurements. This study demonstrated the ability of an optical imageless navigation system to measure, on average, femoral and tibial coronal cuts to within 2.0° of post-operative radiographic measurements in a clinical setting.

Examining attentional avoidance in post-traumatic stress disorder: an exploratory 'Face in the Crowd' paradigm using eye-tracking

Background: Maladaptive patterns of attention to emotional stimuli are a clinical feature of posttraumatic stress disorder (PTSD). Using eye-tracking-based methodology, research points out the presence of sustained attention to threatening stimuli in individuals with PTSD. However, most eye-tracking studies in this field used free-viewing tasks on negative stimuli.Methods: PTSD patients (n = 38), trauma-exposed healthy controls (TEHC; n = 30), and non-trauma-exposed healthy controls (HC; n = 33) performed a Face in the Crowd (FiC) task. The FiC task was chosen to explore specific responses to emotional stimuli within a competitive visual environment, thus providing insights into visual search patterns. Both reaction time and gaze patterns (dwell time, scanpath length, first fixation duration, and latency) were recorded.Results: Individuals with a provisional PTSD diagnosis presented decreased dwell time on both positive and negative targets in comparison with HC and TEHC, as well as shorter scanpath length for all matrixes when no targets were present. No evidence of attentional bias was observed in the TEHC group based on reaction times or eye-tracking measures in response to positive, negative, or neutral cues.Discussion: We found an attentional avoidance pattern among PTSD patients, along with indexes of lowered perceptual threshold for all emotional information. This study allows raising the question of cognitive load on the emergence of differential attentional strategies presented by PTSD participants. We discuss the generalization of fear processes across different emotional stimuli and underscore the need for incorporating a variety of emotional stimuli in PTSD research.

Development and validation of the Oxford Benchmark Scale for Rating Vaccine Technologies (OBSRVT), a scale for assessing public attitudes to next-generation vaccine delivery technologies

Next-generation vaccine delivery technologies may provide significant gains from both a technical and behavioral standpoint, but no scale has yet been developed to assess public attitudes to novel vaccine delivery technologies. We therefore performed a cross-sectional validation study that included 1,001 demographically representative participants from the UK and US to develop and validate a novel scale, the Oxford Benchmark Scale for Rating Vaccine Technologies (OBSRVT). A sample of 500 UK participants was used to perform exploratory factor analysis with categorical variables (using a polychoric correlation matrix) followed by promax oblique factor rotation to develop the initial model. This yielded a 15-item 4-domain scale with domains including acceptance (6 items), effectiveness (4 items), comfort (3 items), and convenience (2 items). This model was tested for robustness on a 501-participant demographically representative sample from the US. A confirmatory factor analysis with a Satorra-Bentler scaled test statistic was performed, which demonstrated adequate goodness of fit statistics including the root mean squared error of approximation (0.057), standardized root mean squared residual (0.053), and comparative fit index (0.938). Reliability as internal consistency was excellent (alpha = 0.92). Convergent validity with the Oxford Needle Experience Scale was supported by an adequate correlation (r = 0.31, p < .0001), while discriminant validity was supported by a lack of correlation with an unrelated question (r = -0.03, p < .0001). These findings suggest that the OBSRVT scale represents a feasible, valid, and reliable scale that could be used to gauge the acceptability of existing and future vaccine delivery technologies, and further investigation and testing should be considered.

Effects of congruent and incongruent appetitive and aversive well-being comparisons on depression, post-traumatic stress, and self-esteem

Background: People compare their current well-being to different comparison standards (e.g. social or temporal comparisons). These standards are considered as aversive if perceived as threatening to self-motives or appetitive if perceived as consistent with self-motives. However, it remains unknown whether the congruence (vs. incongruence) of aversive and appetitive well-being comparisons (high levels of both vs. preponderance of aversive comparisons over appetitive comparisons) is differentially related to symptoms of depression and post-traumatic stress disorder (PTSD) and self-esteem.Methods: We conducted response surface analysis (RSA) on data from a study with two-timepoints three months apart (N = 921). RSA tests whether the degree of (in-)congruence of two variables is positively or negatively related to an outcome variable. Here, baseline aversive and appetitive well-being comparisons (comparison frequency, discrepancy, and affective impact) served as the two predictor variables, while depression, PTSD, and self-esteem three months later served as outcomes.Results: Findings partially confirmed our hypotheses. Congruently high (vs. low) levels of aversive and appetitive comparison frequency and discrepancy predicted more depressive/PTSD symptoms and lower self-esteem. Some evidence indicated more pronounced depressive symptoms and lower self-esteem (but not PTSD) for the preponderance of aversive over appetitive comparisons.Conclusions: The effects of congruent and incongruent aversive and appetitive comparisons as well as a potentially more crucial role of aversive than appetitive well-being comparisons in depression and self-esteem align with comparison theory.

Maladaptive appraisals and posttraumatic stress reactions in young terror survivors across 8 years: a random intercepts cross-lagged analysis

Background: Though there is substantial support for the importance of maladaptive appraisals for the development of posttraumatic stress reactions (PTSR), little is known about the long-term temporal relationship between maladaptive appraisals and PTSR beyond the first year after a traumatic event.Objective: We aimed to investigate three research questions: (1) Does the level of maladaptive appraisals change over time? (2) Are maladaptive appraisals and PTSR concurrently related to each other in the long term? (3) What is the direction of the temporal relationship between maladaptive appraisals and PTSR?Method: The participants were young survivors after the terror attack at Utøya island in Norway in 2011. We included data measured at 14-15 months, 30-32 months, and 102-108 months post trauma. The participants (N = 315) were all younger than 25 years at the time of the attack (mean age was 18.4, SD = 2.3), and 48.3% were female. The aims were investigated using correlations, paired t-tests, random intercept cross-lagged panel models (RI-CLPM), and cross-lagged panel models (CLPM).Results: We found a significant decrease in PTSR severity from 14-15 months to 30-32 months, and there was a significant increase in the mean level of maladaptive appraisals from 30-32 months to 102-108 months post trauma. Maladaptive appraisals and PTSR were highly associated across the three time points. Stable individual differences seem to account for most of the longitudinal relationship between maladaptive appraisals and PTSR, and we did not find clear indications of a direction of the temporal relationship between the variables.Conclusions: Our results indicate that the level of maladaptive appraisals can be quite stable once established, that they remain associated with PTSR, and that the long-term relationship between maladaptive appraisals and PTSR in the years following a trauma may best be explained by stable individual differences.

Adverse childhood experiences and intimate partner violence in adulthood among transgender women: exploring the chain mediating role of self-esteem and LGBT minority stress

BACKGROUND

Transgender women experience a high incidence of intimate partner violence (IPV) in adulthood. The well-documented risk factors contributing to IPV include adverse childhood experiences (ACEs), low self-esteem, and the minority stress experienced by LGBT individuals. The object of the present study was to examine how ACEs influence IPV in adulthood, and to explore the chain mediating function of self-esteem and LGBT minority stress.

METHODS

In February 2022, we recruited 264 transgender women through snowball sampling in Shenyang, China. Participants completed a questionnaire assessing background characteristics, ACEs, IPV in adulthood, self-esteem and LGBT minority stress. Relationships among study variables were examined through variance and correlation analyses. A chain mediation model was tested using PROCESS.

RESULTS

There was a significant correlation among the four variables. ACEs positively predicted IPV in adulthood (r = 0.449, p < 0.001). The sequential mediation model demonstrated that self-esteem (the estimated effect = 0.0708, 95%CI: 0.0152-0.1327) and minority stress (the estimated effect = 0.0404, 95%CI: 0016-0.0847) had the potential to mediate the connection between ACEs and IPV respectively. Additionally, the combined mediating influence of self-esteem and minority stress (the estimated effect = 0.0298, 95%CI: 0.0105-0.0591) similarly exerted such an effect. In summary, the mediating effect accounts for 34.59% of the overall effect size.

CONCLUSION

Taken together, the findings underscore the high prevalence of IPV among Chinese transgender women, highlighting the need for additional attention from violence service providers and other healthcare professionals on ACEs, low self-esteem, and minority stress, as these factors may place this population at risk for IPV.

Self-compassion, self-coldness, and social support and their relationship with depression, anxiety, and PTSD symptoms following a massive terror attack: a prospective study

Background: On 7 October 2023, Israel suffered a massive deadly terror attack with 1400 civilians murdered and 240 kidnapped. Recent studies have documented an increase in depression, anxiety, and posttraumatic symptoms in the aftermath of the attack. In the area of trauma, it has been shown that while some individuals are vulnerable to developing psychopathology following exposure to a traumatic event, the majority are not.Objective: In the present prospective study, we examined the contributions of internal (self-compassion and self-coldness) and external (social support) resources to depression, anxiety, and posttraumatic symptoms among civilians following a massive terror attack.Method: A total of 250 participants - 126 females (50.4%) and 124 males (49.6%); 156 Jews (62.4%) and 94 Arabs (37.6%) - aged 21-60 (M  = 41.7, SD = 10.63) completed questionnaires at two time points: T1 was in September 2023 (3-4 weeks before the attack) and T2 was in February-March 2024 (19-20 weeks after the attack). Participants were assessed using the Multidimensional Scale of Perceived Social Support (MSPSS), Self-Compassion Scale - Short Form (SCS-SF), Depression, Anxiety, and Stress Scale-21 Items (DASS-21), and International Trauma Questionnaire (ITQ).Results: Self-compassion and social support were negatively associated with depression and anxiety, while self-coldness was positively associated with depression and anxiety. In addition, self-coldness uniquely contributed to the prediction of psychopathological outcomes, including the sense of threat symptoms cluster of posttraumatic stress disorder, beyond known risk factors.Conclusions: Our study highlights the role of self-coldness as a vulnerability factor for civilians following a terror attack. It is important to view the distinct facets of self-compassion as a therapeutic target when building both intervention and prevention programs for people exposed directly and indirectly to trauma.

Study of glucose homeostasis in burnout cases using an oral glucose tolerance test

Burnout is caused by long term psychosocial stress and has, besides the fatigue and mental health burden, been associated with increased risk of adverse physical health, such as for example type 2 diabetes. This study aims to investigate the glucose and insulin levels in individuals with stress related burnout, by assessing these metabolic markers in response to a standard oral glucose tolerance test (OGTT). 38 cases with burnout (13 men and 25 women) and 35 healthy controls (13 men and 22 women) in the age 24-55 were included in the study. The burnout group overall did not differ from healthy controls in glucose or insulin levels during the OGTT. However, the burnout cases who reported more severe burnout symptoms exhibited significantly higher levels of both glucose and insulin levels during the OGTT compared to burnout cases reporting lower severity of symptoms. Furthermore, the group of burnout cases who reported symptoms of depression exhibited higher insulin levels during OGTT compared to the burnout cases without depressive symptoms. The observed higher levels in the burnout cases with most severe symptoms indicate an increased diabetic risk in these patients and it may be of importance to follow glucose and insulin levels in individuals with more severe symptoms of burnout i.e. to perform an OGTT.

Insights into depression prediction, likelihood, and associations in children and adolescents: evidence from a 12-years study

Purpose

The severity of depression among young Australians cannot be overstated, as it continues to have a profound impact on their mental health and general wellbeing. This study used machine learning (ML) algorithms to analyse longitudinal data, identifying key features to predict depression, assess future risk, and explore age-specific behaviours that contribute to its progression over time. The results emphasize the significance of early detection to prevent unfavourable consequences and shed light on the alterations in depressive symptoms during various stages of development.

Methods

Three widely regarded ML techniques-random forest (RF), support vector machine (SVM), and logistic regression (LR)-are being applied and compared with a longitudinal data analysis. Additionally, the Apriori algorithm is being utilized to explore potential relationships between health, behaviour, and activity issues with depression among different age groups (10-17).

Results

The analysis results indicate that the RF model is performing exceptionally well in diagnosing depression, with a 94% accuracy rate and weighted precision of 95% for non-depressed and 88% for depressed cases. In addition, the LR model shows promising results, achieving an 89% accuracy rate and 91% weighted precision. Moreover, insights from the Apriori algorithm underscore the significance of early detection by examining potential associations between health, behaviour, and activity problems and depression across diverse age groups.

Conclusion

Combining early screening programs with the RF model and the Apriori algorithm is crucial for understanding depression and developing effective prevention strategies. Emphasizing Apriori's factors and regularly updating strategies with new information will enhance depression management and prevention.

Supplementary Information

The online version contains supplementary material available at 10.1007/s13755-025-00335-9.

Societal perspectives on psychedelics use in clinical context: Development of Concerns and Openness towards Psychedelic Scale (COPS)

INTRODUCTION

Psychedelics are gaining recognition for their therapeutic potential in mental health treatment, yet societal attitudes remain divided, influenced by both skepticism and curiosity. This study aimed to develop and validate a scale assessing attitudes toward psychedelics.

METHODS

Study 1 (n = 1000, convenience sample) explored the factor structure, identifying two dimensions: Openness toward Psychedelics and Concerns toward Psychedelics. Study 2 (n = 843, representative Polish sample) confirmed the scale's validity.

RESULTS

The Concerns factor negatively correlated with meaning in life, while the Openness factor was positively associated with openness to experience, agreeableness, conscientiousness, mindfulness, meaning in life, and nature-relatedness. These associations suggest that individuals with greater openness and psychological flexibility may hold more favorable views on psychedelics.

DISCUSSION

The Concerns and Openness towards Psychedelics Scale (COPS) is a psychometrically sound tool for assessing attitudes toward psychedelics. Its meaningful correlations with established psychological constructs underscore its utility in research and public health. By providing insight into societal perceptions, COPS may help inform discussions on psychedelic therapy, policy, and education, ultimately fostering a more nuanced understanding of their potential benefits and risks.

Anti-inflammatory effects of immunotherapy in clinical treatment and its potential mechanism in alleviating sleeping disorders: A systematic bibliometric study

Sleeping disorders negatively affect cancer patient management, quality of life, and recovery. Immunotherapy, a rising cancer treatment, shows potential to improve sleep quality by reducing inflammation. This study analyzed 255 publications (2000-2024) from the Web of Science Core Collection using bibliometric methods. The US and China dominate research output, with The Mayo Clinic as a key contributor. Core topics are "immunotherapy," "quality of life," and "antibodies." Emerging keywords like "cancer," "encephalitis," and "depression" highlight a shift toward clinical psychology in treating tumors and rare diseases. It is noteworthy that with the rapid expansion of immunotherapy in cancer treatment, clinical trials have shown that it can improve sleep quality in cancer patients by reducing inflammation. As its application in cancer treatment expands, immunotherapy's potential for treating sleep disorders is promising. Future development is expected to improve sleep quality and address clinical issues, offering broad prospects for patient outcomes.

Advancing virtual and hybrid team well-being through a job demand-resources lens

As the modern workplace evolves, the shift to virtual and hybrid team working necessitates a re-evaluation of well-being. While workplace well-being research has predominantly focused on the individual level, understanding team-level well-being is critical, as its underlying psychological and social processes differ. This study applies the Job Demands-Resources (JD-R) framework to virtual and hybrid contexts globally, demonstrating the dual nature of demands and resources at the team level, where the same constructs may contribute to driving positive gain cycles or negative loss cycles of well-being. Through reflexive thematic analysis, we analysed thirty semi-structured interviews with leaders and twenty-nine focus groups with 3-6 team members each (n = 110) across more than twelve industries and geographies. Our findings revealed three candidate themes: "Choice Matters", "It's Business and It's Personal" and "Leader as Social Influencer". This research extends JD-R theory by advancing its applicability to team-level well-being in virtual and hybrid contexts. Practical insights include empowering teams through redesigning work practices to establish sustainable boundaries, aligning communication norms, and fostering inclusive connections that accommodate diverse needs in the modern workplace.

MicroRNAs as potential biomarkers for diagnosis of post-traumatic stress disorder

Post-traumatic stress disorder is a mental disorder caused by exposure to severe traumatic life events. Currently, there are no validated biomarkers or laboratory tests that can distinguish between trauma survivors with and without post-traumatic stress disorder. In addition, the heterogeneity of clinical presentations of post-traumatic stress disorder and the overlap of symptoms with other conditions can lead to misdiagnosis and inappropriate treatment. Evidence suggests that this condition is a multisystem disorder that affects many biological systems, raising the possibility that peripheral markers of disease may be used to diagnose post-traumatic stress disorder. We performed a PubMed search for microRNAs (miRNAs) in post-traumatic stress disorder (PTSD) that could serve as diagnostic biomarkers and found 18 original research articles on studies performed with human patients and published January 2012 to December 2023. These included four studies with whole blood, seven with peripheral blood mononuclear cells, four with plasma extracellular vesicles/exosomes, and one with serum exosomes. One of these studies had also used whole plasma. Two studies were excluded as they did not involve microRNA biomarkers. Most of the studies had collected samples from adult male Veterans who had returned from deployment and been exposed to combat, and only two were from recently traumatized adult subjects. In measuring miRNA expression levels, many of the studies had used microarray miRNA analysis, miRNA Seq analysis, or NanoString panels. Only six studies had used real time polymerase chain reaction assay to determine/validate miRNA expression in PTSD subjects compared to controls. The miRNAs that were found/validated in these studies may be considered as potential candidate biomarkers for PTSD and include miR-3130-5p in whole blood; miR-193a-5p, -7113-5p, -125a, -181c, and -671-5p in peripheral blood mononuclear cells; miR-10b-5p, -203a-3p, -4488, -502-3p, -874-3p, -5100, and -7641 in plasma extracellular vesicles/exosomes; and miR-18a-3p and -7-1-5p in blood plasma. Several important limitations identified in the studies need to be taken into account in future studies. Further studies are warranted with war veterans and recently traumatized children, adolescents, and adults having PTSD and use of animal models subjected to various stressors and the effects of suppressing or overexpressing specific microRNAs.

Breaking the cycle: Psychological and social dimensions of pediatric functional gastrointestinal disorders

BACKGROUND

Functional gastrointestinal disorders (FGIDs) in children present with chronic symptoms like abdominal pain, diarrhea, and constipation without identifiable structural abnormalities. These disorders are closely linked to gut-brain axis dysfunction, altered gut microbiota, and psychosocial stress, leading to psychiatric comorbidities such as anxiety, depression, and behavioral issues. Understanding this bidirectional relationship is crucial for developing effective, holistic management strategies that address physical and mental health.

AIM

To examine the psychiatric impacts of FGIDs in children, focusing on anxiety and depression and their association with other neurodevelopmental disorders of childhood, such as attention-deficit/hyperactivity disorder, emphasizing the role of the gut-brain axis, emotional dysregulation, and psychosocial stress. Key mechanisms explored include neurotransmitter dysregulation, microbiota imbalance, central sensitization, heightening stress reactivity, emotional dysregulation, and symptom perception. The review also evaluates the role of family dynamics and coping strategies in exacerbating FGID symptoms and contributing to psychiatric conditions.

METHODS

A narrative review was conducted using 328 studies sourced from PubMed, Scopus, and Google Scholar, covering research published over the past 20 years. Inclusion criteria focused on studies examining FGID diagnosis, gut-brain mechanisms, psychiatric comorbidities, and psychosocial factors in pediatric populations. FGIDs commonly affecting children, including functional constipation, abdominal pain, irritable bowel syndrome, gastroesophageal reflux, and cyclic vomiting syndrome, were analyzed concerning their psychological impacts.

RESULTS

The review highlights a strong connection between FGIDs and psychiatric symptoms, mediated by gut-brain axis dysfunction, dysregulated microbiota, and central sensitization. These physiological disruptions increase children’s vulnerability to anxiety and depression, while psychosocial factors - such as chronic stress, early-life trauma, maladaptive family dynamics, and ineffective coping strategies - intensify the cycle of gastrointestinal and emotional distress.

CONCLUSION

Effective management of FGIDs requires a biopsychosocial approach integrating medical, psychological, and dietary interventions. Parental education, early intervention, and multidisciplinary care coordination are critical in mitigating long-term psychological impacts and improving both gastrointestinal and mental health outcomes in children with FGIDs.

Visuals versus textual scales: Optimizing reliability and user experience in observational assessment of parent-child interaction

Objective

Assessment of parent-child interaction by practitioners is of great importance but hindered by a lack of instruments that withstand the constraints daily practice places on usage. Visuals may offer an alternative format. Visualizations were tested on reliability, accuracy, and feasibility in observational assessment of parent-child interaction, as alternatives for textual rating scales.

Methods

In Study 1, 95 students rated parent-child interactions with a video or text anchor scale, and in Study 2, 217 professionals rated the same interactions with a decision tree including visual components or a text anchor scale.

Results

Students using the video anchor scale were less reliable and accurate, slower, and had a less positive user experience than students using the text anchor scale. Professionals using the decision tree did not differ in reliability and were comparable in user experience with professionals using the text anchor scale. Rater accuracy showed similar dependency on quality of parental behavior for both scales: ratings were less accurate when the quality of the parent-child interaction was low, and more accurate when the quality was high. However, professionals were less accurate and slower in using the decision tree than the text anchor scale.

Conclusion

With a first iteration of a decision tree performing the same to or only slightly worse, efforts to further develop decision trees might be worthwhile.

Innovation

These nonintuitive findings underscore the value of experimental testing in assessment design in daily practice.

Measuring implicit associations with behaviours to improve resident mood: development of implicit association tasks for nursing home care providers

Objective

To develop and evaluate instruments for measuring implicit associations of nursing home care providers with behaviours aimed at improving resident mood.

Method

Study 1 (N = 41) followed an iterative approach to develop two implicit association tasks measuring implicit attitude (positive versus negative valence) and motivation (wanting versus not wanting) regarding mood-improving behaviours, followed by an evaluation of the content validity for target stimuli representing these behaviours. In Study 2 (N = 230), the tasks were assessed for stimulus classification ease (accuracy and speed) and internal consistency. A subsample (n = 111) completed additional questionnaires to evaluate convergent validity (with self-reported attitudes towards depression, altruism, and mood-improving behaviours), and discriminant validity (against social desirability), and repeated the tasks after 2 weeks to assess test-retest reliability.

Results

Content validity indexes for target stimuli were satisfactory. Error rates were acceptable for attribute stimuli, but exceeded the 10 % limit for target stimuli. Response times for all stimuli exceeded the 800-millisecond threshold. Both tasks demonstrated good internal consistency but poor test-retest reliability. Regarding convergent validity, both tasks significantly correlated with altruism, the implicit attitude task associated with self-reported mood-improving behaviours, and the implicit motivation task correlated with the behavioural scale of attitudes towards depression. Discriminant validity was supported as neither task was significantly associated with social desirability.

Conclusions

The implicit association tasks show potential for measuring implicit associations with mood-improving behaviours of care providers, offering an innovative pathway for exploring processes influencing caregiving behaviours. However, limitations in psychometric properties were identified, aligning with challenges observed in similar measures.

Counterfactual thinking is associated with impoverished attentional control in women prone to self-critical rumination

BACKGROUND AND OBJECTIVES

Excessive engagement in counterfactual thinking (CFT), where individuals imagine alternative outcomes to past events, is associated with rumination, a process characterized by repetitive negative self-referential thoughts. Attentional control difficulties are closely linked with rumination, and negative thoughts can negatively impact attentional control among rumination-prone individuals. This study aimed to investigate the relationship between CFT and emotional and non-emotional attentional control among individuals with varying levels of self-critical rumination.

METHODS

A sample of 100 female participants, characterized by varying levels of self-critical rumination, completed a choice task resulting in goal failure, during which they reported their levels of CFT. Subsequently, participants performed an attentional control task involving eye-tracking measures to assess emotional attentional engagement, emotional attentional disengagement, and emotional and non-emotional attentional shifting.

RESULTS

Among women with high (but not low) self-critical rumination tendencies, increased levels of CFT were associated with slower attentional shifting from emotional stimuli of opposing valence, as well as between non-emotional stimuli.

LIMITATIONS

The correlational design of the study prevents causal interpretations of the findings. Additionally, the exclusive inclusion of female participants may limit the generalizability of the results.

CONCLUSIONS

This study underscores the association of CFT with subsequent attentional control among women prone to self-critical rumination, aligning with prior research suggesting a link between negative thoughts and attentional processes. Future research should explore these relationships in diverse populations and consider longitudinal designs to elucidate causal pathways.

A cross-sectional study on the association between executive functions and social disabilities in people with a psychotic disorder

Background

Social recovery (SR) in people with psychotic disorders involves taking on social roles and completing daily tasks. Functional recovery (FR), particularly executive functions, is critical for these roles. Psychotic disorder patients often experience severe cognitive impairments, especially in executive functions. This study investigates the relationship between functional and social recovery in individuals with psychotic disorders and examines the effect of employment status on this association.

Method

This cross-sectional study involved people with a psychotic disorder. SR was measured using the WHO-DAS, divided into Daily Functioning (DF) and Social Functioning (SF) scales. FR was measured using the BRIEF-A and the TOL. Employment status was categorized into Non-active, Otherwise Active, and Active. The Likelihood-ratio Test (LRT) was used for model selection.

Results

Data from 251 participants (mean age 41.5) showed that the BRIEF-A affected both DF and SF, while the TOL only affected DF. Only being Otherwise Active influenced DF. Employment status had no influence on SF. Being Otherwise Active positively influenced perceived disabilities in Daily Functioning.

Conclusion

Measuring executive functions using both performance-based and self-report measures is important. Both measures are associated differently with perceived disabilities in daily and social functioning. Being a volunteer or looking for a job positively influences perceived disabilities in Daily Functioning.

Cognitive function in physically healthy, unmedicated individuals with major depression: Relationship with depressive symptoms and antidepressant response

We studied cognitive dysfunction in Major Depressive Disorder (MDD) in a sample of healthy, unmedicated individuals without comorbidities. Additionally, we studied the association of cognitive function with response to selective serotonin reuptake inhibitors (SSRIs). Our sample consisted of 113 adult MDD participants and 88 matched healthy controls (HC). Sixty-nine of the MDD participants completed 8 weeks of SSRI treatment. All participants completed a cognitive battery assessing processing speed, executive function, and learning and memory at baseline. This was repeated at week 8 for MDD participants. MDD "Responders" were defined as having ≥50 % improvement on the Hamilton Depression Rating Scale score at week 8 compared to baseline. At baseline, MDD participants performed significantly worse than HC participants on the Symbol Digit Modalities Test (SDMT) (p < .001), Stroop color naming (p = .005) and color-word naming (p = .047), and Brief Visuospatial Memory Test-Revised (BVMT) total recall (p = .02), delayed recall (p < .001), and percent retention (p = .01). MDD participants improved significantly on 6 of the cognitive assessments over 8 weeks. However, there were no significant baseline differences between Responders and Non-responders. SSRI Response was associated with improvement only in the HVLT total recall (p = .02). Our results suggest: 1) a differentiated pattern of cognitive dysfunction exists in healthy, unmedicated MDD compared to HCs; 2) baseline cognition does not delineate an SSRI-responsive/-nonresponsive subgroup, and 3) SSRI response is not associated with broad cognitive improvement after 8 weeks when compared to Non-responders, emphasizing unmet therapeutic challenges.

Nicotine and cannabis vaping among early high school adolescents: Disparities of use across sociodemographic characteristics and associations with psychosocial factors

Objective. This study examines whether adolescent nicotine and cannabis vaping types (i.e., nicotine-only, cannabis-only, and dual use) differ across sociodemographic and school characteristics (e.g., age, gender, sexual identity, race/ethnicity, socioeconomic status [SES], school setting/type), and associations of vaping types with psychosocial factors. Methods. From 2021 to 2022, 9th and 10th grade adolescents (N = 2,476) in Colorado and Ohio participated in a survey measuring vaping behaviors and psychosocial factors including substance use attitudes, alcohol use, mental health, aggression, and family and school risk and protective factors. Results. Past month vaping prevalence was 89.7 % for non-use, 5.9 % for nicotine-only, 1.0 % for cannabis-only, and 3.4 % for dual use. Chi-square tests of independence showed several significant sociodemographic differences for past month vaping: higher nicotine-only vaping prevalence for females (vs. males) (p < 0.001), higher nicotine-only and dual vaping prevalence for LGB+ (vs. heterosexual) youth (ps < 0.01), higher dual vaping prevalence for Hispanic and multiethnic (vs. White) adolescents (p < 0.001), and higher nicotine-only, cannabis-only, and dual vaping prevalence for lower (vs. higher) mother education (ps < 0.001). Regression models examining associations between vaping types (vs. non-use) and psychosocial factors indicated a robust pattern of worse levels of substance use attitudes, alcohol use, mental health, aggression, and family and school factors for nicotine-only and dual users. Results followed a similar pattern but to a lesser degree for cannabis-only users. Conclusions. Findings identify characteristics of adolescents who may be particularly vulnerable to higher vaping risk (females, LGB+, Hispanic, multiethnic, low SES) and suggest needs for preventive interventions aimed to reduce all types of vaping for better adolescent behavioral health.

A Dual Biomarker Approach to Stress: Hair and Salivary Cortisol Measurement in Students via LC-MS/MS

Stress is a significant issue among students, affecting both their mental and physical health. In this study, we investigated cortisol levels, a key biomarker for stress, in students at the United Arab Emirates University (UAEU) during their exam period. Using a sensitive liquid chromatography-tandem mass spectrometry (LC-MS/MS) methodology we measured cortisol concentrations in hair and saliva samples and explored the potential correlation between exam-induced stress and cortisol levels. The results revealed an increase in cortisol levels during the exam period, with male students showing an average hair cortisol concentration of 150.625 pg/mg and female students displaying an average of 77.756 pg/mg. Salivary cortisol levels ranged from 0.002 to 9.189 ng/mL, with an overall average of 4.505 ng/mL. Statistical analysis revealed significant differences in cortisol levels between male and female students, underscoring the impact of exam-related stress on both acute and chronic stress markers. This study underscores the importance of addressing academic stress and suggests targeted strategies to mitigate its impact on student health ultimately fostering an environment encouraging both academic success and psychological well-being within the student community. Future research directions include exploring additional clinical parameters and expanding the study population to further understand the long-term effects of academic stress.

Development and psychometric validation of the frontline health workers' occupational risk and characteristics in emergencies index (FORCE-index) - The covid Hospital cohort study

Objectives

A lack of tools for the systematic identification of frontline health workers' changing occupational risks, characteristics, and needs, poses a major barrier to supporting vital personnel to stay in practice through health emergencies and beyond. The current study reports on the development and psychometric evaluation of the Frontline health workers' Occupational Risk and Characteristics in Emergencies index (FORCE-index).

Study design

The Covid hospital study is a large, multisite, four-wave, open cohort study of frontline health workers responding to the first four waves of the COVID-19 pandemic (2020-2022).

Methods

2496 frontline health workers responded to questionnaires assessing various aspects of their work environment. Using exploratory factor analysis, we estimated the latent structure of the FORCE-index at the first and second waves. This structure was evaluated using confirmatory factor analysis at the third and fourth waves. The internal consistency of the instrument's subscales (e.g., factors) was evaluated using omega reliability, Cronbach's alpha coefficient, and mean inter-item correlation.

Results

A nine-factor solution provided best fit to the data. These factors mapped onto the following aspects of the work environment; competency, stress management, familiarity, workload manageability, work performance, infection safety, personal protective equipment, social safety, and social support. Internal consistency for the full FORCE-index and the nine factors was satisfactory.

Conclusions

The initial psychometric validation indicates that the FORCE-index is a valid measure which can be used by health authorities, services, and institutions to adequately and systematically assess central aspects of frontline health workers' work environment that are commonly challenged in health emergencies.

Advancing GIS-based suitability analysis of BtX, PtX, PBtX, and eBtX facilities using the fuzzy analytic hierarchy process

To address the urgent need for sustainable fuel production, this study proposes a novel methodology that integrates Geographic Information Systems (GIS) and Multi-Criteria Decision Analysis (MCDA) techniques to identify optimal sites for Biomass-to-X (BtX), Power-to-X (PtX), or hybrid (e-/PBtX) facilities. The proposed methodology provides a systematic and quantitative approach to evaluate location suitability, offering valuable insights for spatial decision-making in sustainable fuel production from BtX, PtX, or e-/PBtX. The CES-GIS-SAFAHP methodology uses selected and relevant geospatial data, which is processed to derive criteria-specific datasets, such as spatially resolved energy density maps for biomass-based systems and combined wind and solar energy datasets for hybrid processes. These data are then subjected to a Fuzzy Analytic Hierarchy Process (FAHP), which involves the use of pairwise comparisons and Fuzzy normalization to assign weights to the criteria, ultimately resulting in the generation of weighted overlay maps. The results of both the weighed overlay and a concurrently performed exclusion analysis, delineating areas that fail to meet key conditions or constraints, are combined to produce a final suitability map enabling the identification of optimal plant locations based on their overall suitability index. The proposed approach offers a robust, quantitative framework for spatial optimization in the siting of sustainable fuel production facilities with significant applications for policy-makers, industry, and researchers involved in BtX, PtX, and e-/PBtX scale-up. The methodology encompasses a comprehensive suitability analysis, …•Providing a recommended list of suitability and exclusion criteria, categorized into ``requisite,'' ``infrastructure,'' and ``environmental'' criteria, tailored for sustainable fuel production site selection.•Offering a structured workflow for deriving suitability maps through a combination of GIS-based FAHP with exclusion analysis.•Providing a practical, replicable algorithm that can guide users through the process, making it easier to apply in various geographic and project contexts.

Development of false memories in 5- and 8-year-olds: The role of working memory maintenance mechanisms

Previous research has shown that false memories-that is, remembering things that did not happen but are consistent with the gist of the actual experiences-increase during development. The current study shows that this developmental reversal of false memory is moderated by the development of working memory (WM). In two experiments, 5- and 8-year-olds (N = 184; 103 girls; European) were asked to memorize lists of three or four semantically related words during retention intervals of a few seconds in which the opportunities to maintain the studied words in WM were varied. The children then performed an immediate recall test and a delayed recognition test. Experiment 1 showed that 8-year-olds made more semantic recall errors-that is, false memories-than non-semantic recall errors in the immediate test, whereas the opposite was true for 5-year-olds. Experiment 2, which introduced a stronger manipulation of WM maintenance, showed that 8-year-olds made more semantic errors than 5-year-olds in the immediate test when the opportunity to maintain the studied words in WM was reduced. This developmental reversal disappeared when children had more opportunities to maintain the studied words in WM. These results suggest that the development of WM maintenance mechanisms during childhood reduces the age-related increase in false memories.

Effect of physical activity interventions on executive functions in school-age children with ADHD: A meta-analysis of randomized controlled trials

BACKGROUND

Physical activity interventions positively influence executive functions in both the general population and individuals with ADHD. However, there is limited research focusing on school-aged children, who have the highest ADHD diagnosis rates. This study aims to provide targeted intervention strategies for improving executive function in this population, offering a practical reference for selecting specific exercise types when designing interventions for children with ADHD.

METHODS

A systematic search was conducted across PubMed, Embase, Web of Science, and the Cochrane Library to identify relevant RCTs up to September 2023. Two independent reviewers handled literature screening, data extraction, and quality assessment. Stata 15.1 software was used for the meta-analysis.

RESULTS

The meta-analysis included 19 studies, revealing that physical activity interventions significantly improved executive functions in school-aged children with ADHD. Cognitive flexibility (SMD = 0.70, 95 % CI: 0.09, 1.31) and working memory (SMD = 0.74, 95 % CI: 0.20, 1.28) showed moderate to large effects, while inhibition switching had a small to medium effect (SMD = -0.35, 95 % CI: -0.74, 0.03). Subgroup analysis indicated that cognitively engaging exercises were more effective, with intervention outcomes moderated by duration, frequency, and length.

LIMITATIONS

Inconsistent measurement tools among the included studies may introduce biases.

CONCLUSIONS

Physical activity interventions are effective in enhancing executive functions in school-aged children with ADHD. Cognitively engaging exercises show the most promise, especially when tailored by intervention duration, frequency, and length.

Can an app designed to reduce repetitive negative thinking decrease depression and anxiety in young people? Results from a randomized controlled prevention trial

BACKGROUND AND OBJECTIVES

Rates of mental health disorders are rising among adolescents and young adults. Therefore, scalable methods for preventing psychopathology in these age groups are needed. As repetitive negative thinking (RNT) is a risk factor for depression and anxiety disorders, targeting RNT via smartphone app promises to be an effective, scalable strategy. The current three-arm, parallel group, randomized controlled trial tested whether a self-help app designed to reduce RNT decreased psychopathological symptoms and RNT in adolescents and young adults at risk for mental disorders.

METHOD

A sample of 16-22-year-olds with elevated levels of RNT (N = 365) were randomly allocated to either use a one of two self-help apps designed to reduce RNT for 6 weeks or to a waitlist. The full RNT-focused intervention app encompassed a variety of RNT-reducing strategies, whereas the concreteness training app focused on one of these strategies, namely, concrete thinking.

RESULTS

The apps did not decrease depressive symptoms, anxiety symptoms and RNT relative to the waitlist. However, exploratory analyses using a minimum dose criterion showed that participants who used the full-RNT-focused intervention app more often, reported greater baseline to follow-up decreases in depressive symptoms compared to waitlist.

LIMITATIONS

Include decreased power due to slightly more dropout than expected and limited generalizability due to the mostly female and highly educated sample.

CONCLUSIONS

RNT-focused prevention via a self-help app did not decrease depression and anxiety, presumably due to too little engagement with the app content provided.