The influence of children's emotional regulation on internet addiction during the COVID-19 pandemic: the mediating role of depression

Internet addiction (IA) and depression present significant public health challenges, especially during a pandemic. Previous research conducted outside of pandemic contexts highlighted the importance of emotional regulation (ER) for depression, with specific strategies such as cognitive reappraisal (CR) and expressive suppression (ES) showing effectiveness in predicting the internalization of problems. However, knowledge regarding ER strategies for depression and IA during the pandemic remains limited, thus hindering our implementation of effective strategies. This study aimed to examine the relationships between IA, ER strategies, and depressive symptoms, and to identify protective factors against depression and IA. Additionally, it sought to investigate the mediating role of depressive symptoms. Data were collected from 824 students across the pre-pandemic and pandemic periods. Results highlight the risks associated with ES for both depressive symptoms and IA, while CR demonstrates potential in reducing depressive symptoms and IA. Interventions that promote the development of CR and discourage reliance on ES can effectively mitigate depressive symptoms and IA.

Exploring the Potential of a Digital Intervention to Enhance Couple Relationships (the Paired App): Mixed Methods Evaluation

BACKGROUND

Despite the effects of poor relationship quality on individuals', couples', and families' well-being, help seeking often does not occur until problems arise. Digital interventions may lower barriers to engagement with preventive relationship care. The Paired app, launched in October 2020, aims to strengthen and enhance couple relationships. It provides daily questions, quizzes, tips, and detailed content and facilitates in-app sharing of question and quiz responses and tagged content between partners.

OBJECTIVE

To explore the potential of mobile health to benefit couple relationships and how it may do this, we examined (1) Paired's impact on relationship quality and (2) its mechanisms of action.

METHODS

This mixed methods evaluation invited Paired subscribers to complete (1) brief longitudinal surveys over 3 months (n=440), (2) a 30-item web-based survey (n=745), and (3) in-depth interviews (n=20). For objective 1, survey results were triangulated to determine associations between relationship quality measures and the duration and frequency of Paired use, and qualitative data were integrated to provide explanatory depth. For objective 2, mechanisms of action were explored using a dominant qualitative approach.

RESULTS

Relationship quality improved with increasing duration and frequency of Paired use. Web-based survey data indicate that the Multidimensional Quality of Relationship Scale score (representing relationship quality on a 0-10 scale) was 35.5% higher (95% CI 31.1%-43.7%; P=.002), at 7.03, among people who had used Paired for >3 months compared to 5.19 among new users (≤1 wk use of Paired), a trend supported by the longitudinal data. Of those who had used Paired for >1 month, 64.3% (330/513) agreed that their relationship felt stronger since using the app (95% CI 60.2%-68.4%), with no or minimal demographic differences. Regarding the app's mechanisms of action, interview accounts demonstrated how it prompted and habituated meaningful communication between partners, both within and outside the app. Couples made regular times in their day to discuss the topics Paired raised. Daily questions were sometimes lighthearted and sometimes concerned topics that couples might find challenging to discuss (eg, money management). Interviewees valued the combination of fun and seriousness. It was easier to discuss challenging topics when they were raised by the "neutral" app, rather than during stressful circumstances or when broached by 1 partner. Engagement seemed to be enhanced by users' experience of relationship benefits and by the app's design.

CONCLUSIONS

This study demonstrates proof of concept, showing that Paired may have the potential to improve relationship quality over a relatively short time frame. Positive relationship practices became embedded within couples' daily routines, suggesting that relationship quality improvements might be sustained. Digital interventions can play an important role in the relationship care ecosystem. The mixed methods design enabled triangulation and integration, strengthening our findings. However, app users were self-selecting, and methodological choices impact our findings' generalizability.

Psycometric Validation of an Instrument to Measure Person-Centred Teamwork in Hospital Settings

Aim: To validate an instrument for measuring healthcare workers' perceptions of person-centred teamwork in hospital units. Design: Quantitative cross-sectional descriptive design. This approach collected numerical data to explore and describe the characteristics of the instrument items, with the goal of generating insights as to the validity and reliability of the items. Methods: The target population included healthcare workers who worked in hospital settings. Total sampling was used to identify healthcare workers. Convenience sampling was used to select the participants. The participants completed the instrument. The data were captured and analysed using the software IBM SPSS Statistics Version 28 and RStudio 2023.06. Results: A 38-item instrument measuring the perceptions of healthcare workers of person-centred teamwork was tested psychometrically. A total of 388 healthcare workers working in private (n = 160) and public (n = 228) hospitals completed the instrument. Confirmatory factor analysis was used, indicating that the items were significant and that the constructs were well measured. Factor loading was present, and bifactor analysis confirmed the multidimensionality of each construct. The Cronbach's α confirmed the reliability of each of the 38 items. Conclusion: The person-centred teamwork instrument was reliable and validated as a multidimensional scale comprising 38 items. The instrument is psychometrically suitable for measuring person-centred teamwork in hospital settings. Implications: The person-centred teamwork instrument provides the ability to measure person-centred teamwork efforts to improve practice. As a measurable concept, person-centred teamwork can be improved by distinguishing areas for improvement. Link to Practice: The 38 item person-centred teamwork instrument indicated good fit for measuring the constructs, and the instrument was validated. Each of the items was reliable for measuring person-centred teamwork. The instrument can be applied internationally to assist in the measurement of person-centred teamwork practices to improve clinical outcomes.

Mobile phone addiction and interpersonal problems among Chinese young adults: the mediating roles of social anxiety and loneliness

Mobile phone addiction leads to difficulties that arise in relationships with others; however, the psychological mechanisms that underpin this relationship are not well understood. The present study examined a multiple mediation model with both social anxiety and loneliness as mediators in the relationship between mobile phone addiction and interpersonal problems among young adults. A sample of 758 Chinese college students reported items on the survey, including demographics, the Mobile Phone Addiction Tendency Scale, UCLA Loneliness Scale, Interaction Anxiousness Scale, and Interpersonal Comprehensive Diagnostic Scale. Results showed that mobile phone addiction was positively associated with interpersonal problems. Loneliness and social anxiety served as both independent and sequential mediators in this relationship. Moreover, these two types of mental states play equally important mediating roles. These results suggested that young adults with mobile phone addiction tended to have more interpersonal problems, not only due to their higher loneliness but also their higher social anxiety. In other words, both loneliness and social anxiety were factors that increase the risk of interpersonal problems.

Protocol for the diabetes, distress and disparities (3D) study: an explanatory sequential mixed-methods design

INTRODUCTION

Psychosocial factors impact diabetes outcomes, yet healthcare systems remain inadequately equipped to address these needs. Research centring on the experiences of people with diabetes (PWD) can inform programme implementation, policies and partnerships to address psychosocial care needs. The goals of the diabetes, distress and disparities (3D) study are to quantify the psychosocial care needs of PWD in a large academic medical centre, generate insights regarding how psychosocial factors shape diabetes outcomes and identify modifiable determinants of psychosocial care.

METHODS AND ANALYSIS

The 3D study is recruiting adults with type 1 (T1D), type 2 (T2D), latent autoimmune diabetes in adults (LADA) and gestational diabetes (GD) from the Caswell Diabetes Registry at Michigan Medicine. The 3D study uses an explanatory sequential mixed-methods design with two phases. Phase I (P1: target n=500, began July 2023) consists of an online survey to quantify prevalence and examine correlates of a wide range of psychosocial factors (eg, diabetes-related distress, depression, stigma). This survey was refined through consultation with PWD. Phase II (P2) involves semi-structured telephone interviews with n=40 P1 respondents, recruited using maximum variation sampling informed by demographic characteristics and responses to psychosocial survey measures. P2 will explore a subset of factors (eg, patient-provider communication, social support, barriers/promoters to care). To date, n=573 (5% response rate) have completed P1. In March 2024, we identified a target sample of P1 respondents (n=65) for recruitment into P2. All data collection was completed by September 2024. Analysis will involve quantitative linear and logistic regression to understand correlates of psychosocial outcomes from P1, and qualitative content analysis to clarify potential points of intervention from P2.

ETHICS AND DISSEMINATION

This study is approved by the University of Michigan Institutional Review Board (HUM00223735). Protocol materials are available at https://osf.io/yfz6b/. Findings from this study will be disseminated through peer-reviewed publications, presentations at conferences and outreach to key stakeholders, including creating educational materials for patient advocacy groups and interprofessional practice.

The application of metaverse in mental health

Rapid technological progress is reshaping human existence globally. The metaverse, a 3D digital realm merging virtual reality (VR) with physical space, exemplifies this fusion. Users can replicate and customize real-world elements within this immersive environment. Over the past decade, VR, augmented reality (AR), and mixed reality (MR) have become effective tools for addressing mental health conditions, offering solutions to the shortage of mental health professionals and limited access to care. However, extensive participation in 3D immersive gaming and social media can lead to insecurity, anxiety, depression, and addictive behaviors, particularly among young adults. This engagement may also impair attention spans, exacerbating symptoms in adolescents with attention deficit hyperactivity disorder. This research examines the impact of expanding metaverse applications on mental health, exploring both risks and benefits.

Understanding the Relationship Between Ecological Momentary Assessment Methods, Sensed Behavior, and Responsiveness: Cross-Study Analysis

Background

Ecological momentary assessment (EMA) offers an effective method to collect frequent, real-time data on an individual's well-being. However, challenges exist in response consistency, completeness, and accuracy.

Objective

This study examines EMA response patterns and their relationship with sensed behavior for data collected from diverse studies. We hypothesize that EMA response rate (RR) will vary with prompt time of day, number of questions, and behavior context. In addition, we postulate that response quality will decrease over the study duration and that relationships will exist between EMA responses, participant demographics, behavior context, and study purpose.

Methods

Data from 454 participants in 9 clinical studies were analyzed, comprising 146,753 EMA mobile prompts over study durations ranging from 2 weeks to 16 months. Concurrently, sensor data were collected using smartwatch or smart home sensors. Digital markers, such as activity level, time spent at home, and proximity to activity transitions (change points), were extracted to provide context for the EMA responses. All studies used the same data collection software and EMA interface but varied in participant groups, study length, and the number of EMA questions and tasks. We analyzed RR, completeness, quality, alignment with sensor-observed behavior, impact of study design, and ability to model the series of responses.

Results

The average RR was 79.95%. Of those prompts that received a response, the proportion of fully completed response and task sessions was 88.37%. Participants were most responsive in the evening (82.31%) and on weekdays (80.43%), although results varied by study demographics. While overall RRs were similar for weekday and weekend prompts, older adults were more responsive during the week (an increase of 0.27), whereas younger adults responded less during the week (a decrease of 3.25). RR was negatively correlated with the number of EMA questions (r=-0.433, P<.001). Additional correlations were observed between RR and sensor-detected activity level (r=0.045, P<.001), time spent at home (r=0.174, P<.001), and proximity to change points (r=0.124, P<.001). Response quality showed a decline over time, with careless responses increasing by 0.022 (P<.001) and response variance decreasing by 0.363 (P<.001). The within-study dynamic time warping distance between response sequences averaged 14.141 (SD 11.957), compared with the 33.246 (SD 4.971) between-study average distance. ARIMA (Autoregressive Integrated Moving Average) models fit the aggregated time series with high log-likelihood values, indicating strong model fit with low complexity.

Conclusions

EMA response patterns are significantly influenced by participant demographics and study parameters. Tailoring EMA prompt strategies to specific participant characteristics can improve RRs and quality. Findings from this analysis suggest that timing EMA prompts close to detected activity transitions and minimizing the duration of EMA interactions may improve RR. Similarly, strategies such as gamification may be introduced to maintain participant engagement and retain response variance.

Attitudes of Arab Family Caregivers in Israel Toward Robot-Delivered Care For ADL-Dependent (Activities of Daily Living-Dependent) Older People: Identifying Ethical and Social Issues

Older people are often cared for by family caregivers who may experience a variety of challenges. Robots may be helpful. Understanding the attitudes of family caregivers in this context is essential as they are a major factor in robot use. To date, most studies on family caregivers ' attitudes toward robot assistance in elder care have been conducted in East Asian or Western societies, but as such perceptions are affected by culture, in the present study, we investigated the attitudes of Arab family caregivers in Israel. Semi-structured interviews were conducted with twenty Arab family caregivers who provide care to ADL (activities of daily living)-dependent older people. All participants were Muslim and adult children of a person requiring care. The majority (75 per cent) were women, and the average age was fifty-one. Analysis of the interviews revealed two main themes: (1) Attitudes: Most participants strongly objected to the assistance of a robot in caring for older people, and perceived it as a violation of family values; and (2) Reasons for attitudes: Participants preferred human care over robot care due to concerns previously documented among other populations regarding system malfunctions, the risk of loneliness, and lack of technological literacy. We also identified a unique factor: the family 's moral obligation to care for older people. The absolute opposition of family members to the use of a robot in the care of older people requires the development of intervention programmes to increase technological literacy among family caregivers and reduce negative attitudes. These programmes need to address the opportunities and risks associated with the use of robots, and how these risks can be avoided.

Dental anxiety and empathy among undergraduate oral health students in Norway, South Africa and Namibia

PURPOSE/OBJECTIVES

Dental anxiety is a common type of fear that can complicate dental treatment. The dental practitioner is crucial in both treating dental fear and anxiety as well as prevent it from arising. The ability to feel empathy is important in that matter. The dental practitioner's own level of dental anxiety can possibly affect his or her ability to treat patients in an empathetic manner. The aim of this study was to assess and examine the relationship between level of empathy and dental anxiety in undergraduate oral healthcare students from Namibia, South Africa and Norway.

MATERIAL AND METHODS

A cross-sectional study was performed. Questionnaires were distributed, and responses were analyzed anonymously. Dental anxiety was assessed using Modified Dental Anxiety Scale (MDAS), and empathy level was assessed using Toronto Empathy Questionnaire (TEQ). Data were presented as means or medians and analyzed using a linear regression model in STATA with a 5% level of significance.

RESULTS

The response rate was 16.0%, and 298 completed questionnaires were received. MDAS was low in all groups (medians 7-10), however, significantly lower in Norway compared to Namibia and South Africa. The mean TEQ score was 46.8 in Namibia, 47.5 in South Africa and 50.4 in Norway, all above average empathy levels but significantly higher in Norway than in Namibia and South Africa.

CONCLUSIONS

Oral healthcare students in Africa and Norway showed high empathy and low dental anxiety, which is reassuring for future oral health care professionals.

From robots to chatbots: unveiling the dynamics of human-AI interaction

The rapid integration of artificial agents-robots, avatars, and chatbots-into human social life necessitates a deeper understanding of human-AI interactions and their impact on social interaction. Artificial agents have become integral across various domains, including healthcare, education, and entertainment, offering enhanced efficiency, personalization, and emotional connectivity. However, their effectiveness in providing successful social interaction is influenced by various factors that impact both their reception and human responses during interaction. The present article explores how different forms of these agents influence processes essential for social interaction, such as attributing mental states and intentions and shaping emotions. The goal of this paper is to analyze the roles that artificial agents can and cannot assume in social environments, the stances humans adopt toward them, and the dynamics of human-artificial agent interactions. Key factors associated with the artificial agent's design such as physical appearance, adaptability to human behavior, user beliefs and knowledge, transparency of social cues, and the uncanny valley phenomenon have been selected as factors that significant influence social interaction in AI contexts.

Social Anxiety and Smartphone Addiction in Chinese University Students: A Moderated Mediation Model of Rumination and Gender

Background: Research has shown that social anxiety can trigger smartphone addiction, but relatively few studies have explored the specific mechanisms underlying the relationship between social anxiety and smartphone addiction. This study explores the specific mechanisms underlying the relationship between social anxiety and smartphone addiction by examining the mediating role of rumination and the moderating role of gender. Methods: In five universities, 10 classes of university students were randomly selected from each university. A total of 2500 university students participated in the actual assessment throughout this study and completed the Mobile Phone Addiction Index Scale, Ruminative Responses Scale, and Interaction Anxiousness Scale. The data were analysed using SPSS 27.0. Results: The results of this study revealed that (1) rumination plays a partial mediating role in the relationship between social anxiety and smartphone addiction and that social anxiety not only has a direct effect on smartphone addiction but also indirectly affects smartphone addiction through rumination. (2) The mediating role of rumination between social anxiety and smartphone addiction is moderated by gender. Conclusions: Social anxiety is significantly and positively associated with smartphone addiction among university students, with rumination influencing this association. In addition, the indirect relationship between rumination and smartphone addiction was moderated by gender; however, the direct relationship between social anxiety and smartphone addiction was not affected by gender.

Adaptation and Validation of the Spanish Version of the Smartphone Application-Based Addiction Scale (SABAS)

Smartphone addiction is very prevalent among university students and can negatively impact both their physical and mental health. This study aimed to translate the smartphone application-based addiction scale (SABAS) into Spanish and evaluate its psychometric properties among Spanish university students. A total of 297 university students (222 women and 75 men) participated in this study (M age = 20.88, SD = 4.58) by completing a sociodemographic questionnaire, the smartphone addiction scale-short version, the depression, anxiety, and stress scale-21, the fear of missing out scale, and the SABAS. The SABAS was translated into Spanish using the forward-backward method. The factor structure was analyzed using confirmatory factor analysis, while reliability was assessed with Cronbach's alpha and McDonald's omega coefficients. The SABAS showed acceptable reliability (α = 0.72; ω = 0.73), and all of its items were kept. Factor analysis revealed that the Spanish version of the SABAS was unifactorial and demonstrated excellent validity (χ2 = 10.285; p = 0.246; RMSEA = 0.034; CFI = 0.991; SRMR = 0.030). Significant associations were also observed between the SABAS score and the number of hours of smartphone use, fear of missing out, and psychological distress. Despite its brevity, the Spanish version of the SABAS provides good validity and reliability. Therefore, it can be used as a tool for screening smartphone addiction in Spanish university students.

Understanding the Impact of Algorithmic Discrimination on Unethical Consumer Behavior

The prevalence of artificial intelligence (AI) increases social concern surrounding unethical consumer behavior in human-AI interaction. Existing research has mainly focused on anthropomorphic characteristics of AI and unethical consumer behavior (UCB). However, the role of algorithms in unethical consumer behavior, which is central to AI, is not yet fully understood. Drawing on social exchange theory, this study investigates the impact of algorithmic discrimination on UCB and explores the interrelationships and underlying mechanisms. Through three experiments, this study found that experiencing algorithmic discrimination significantly increases UCB, with anticipatory guilt mediating this relationship. Moreover, consumers' negative reciprocity beliefs moderated the effects of algorithmic discrimination on anticipatory guilt and UCB. In addition, this study distinguish between active and passive UCB based on their underlying ethical motivations. This enhances the study's universality by assessing both types of behaviors and highlighting their differences. These insights extend current research on UCB within the purview of AI agents and provide valuable insights into effectively mitigating losses caused by UCB behaviors, offering improved directions for facilitating AI agents to provide fair, reliable, and efficient interactions for both businesses and consumers.

Environmental contamination associated with biofuel production involving pesticide-coated seed corn as feedstock: a survey of community environmental and health impacts

BACKGROUND

A United States ethanol company used pesticide-coated seed corn for fuel ethanol production, resulting in highly contaminated byproducts. Improper storage and disposal of the waste led to widespread environmental contamination. Detectable levels of neonicotinoids have been found in soil, water, and air samples, raising questions about the potential impacts to the environment and human health. The study objective was to evaluate the community's perceived physical and mental health impacts and needs resulting from the contamination linked to bioenergy production by a single company.

METHODS

A 54-question survey was administered to households located within a 10-mile radius of the facility. Respondents could complete the paper survey and return it by mail or electronically. The general topics were household members' awareness, concerns, and perceptions of environmental and health impacts. Quantitative data were presented as frequencies and percentages, while qualitative data were grouped into themes based on keywords and summarized as counts.

RESULTS

A total of 459 respondents completed the survey, a 38% response rate. The average household size was 2.7 (SD = 1.4). Responding households were primarily single-family homes (89%) that were owned (85%), and were long-time residents (mean = 18.4 years, SD = 15.5). A total of 36% of households included children aged 18 or younger. Respondents were concerned about contaminants affecting water (82%), soil (79%), and air (72%) quality. Most respondents (74%) felt some or a lot of stress related to potentially compromised health; however, 51% did not believe they had health symptoms resulting from the contamination. The most common self-reported symptoms among primary respondents were sinus (n = 17), respiratory (n = 22), cognitive/neurological symptoms (n = 15), and allergies (n = 17). Depression and anxiety were the primary mental health symptoms reported with 31 mentions. The top community need was wanting the environment cleaned-up, including proper removal of waste and land restoration.

CONCLUSIONS

This study evaluated community-level perceived impacts of environmental contamination directly related to an ethanol plant's improper handling of production waste containing pesticides. Findings can support immediate actions by state officials and community leaders and serve as a baseline for future health and environmental monitoring.

Patterns of social media use in Vietnamese youths: status and associations with psychological well-being

BACKGROUND

Vietnam ranked 18th globally in internet users and among the top 10 countries with the highest number of social media users, with 78.6% of the population using the internet and 73.7% active on social media. Despite the high prevalence of social media users, there remains a paucity of studies investigating social media usage and its impact. This study aims to examine social media usage patterns and their impact on the psychological well-being of Vietnamese youths.

METHODS

A cross-sectional study utilized a convenience sampling method to recruit 1,477 participants aged 14 to 24 from five provinces in Vietnam. The primary outcomes of interest were health-related quality of life and psychological well-being, assessed using the Kessler Psychological Distress Scale (K6) and a Visual Analogue Scale (VAS). Key predictors included socio-demographic characteristics, health behaviors, and patterns of social media usage, which were systematically examined to explore their associations with the primary outcomes.

RESULTS

50% of participants who used social media met the criteria for the existence of underlying psychological distress. Communicating with friends and staying updated with news were the main purposes of using social media among the participants. The study also revealed the significant correlations between Vietnamese youths' psychological distress and social media usage patterns and sociodemographic traits.

CONCLUSIONS

This study is perhaps the first study to have examined and explored the patterns of social media use amongst Vietnamese youths and to explore the psychological impact of their social media usage. The findings underscores the critical need for a multifaceted approach involving the participation of school and family to foster healthier social media habits and protect mental well-being among youth as well as prepare strategies to early coping with psychiatric consequences.

Development and Validation of the Psychological Abuse in Relationships Scale

Psychological abuse within intimate relationships is a highly prevalent subtype of intimate partner violence (IPV) that is frequently associated with other types of IPV such as sexual or physical violence. Psychological abuse can cause enduring harm, including the loss of agency and self-belief, and entrapment in a relationship. Previous measures of psychological abuse have been characterized by inconsistencies in conceptualization and measurement contributing to problems in identifying its prevalence, impact, and patterns. To address many of the existing challenges and gaps, we developed a new measure of psychological abuse, building upon scale development work to date, and in consultation with lived experience and academic experts. A sample of 765 adult women in Australia completed our survey of 31 psychologically abusive behaviors to establish reliability and validity evidence for a new measure of psychological abuse victimization and impact. Exploratory factor analysis generated a scale comprising 20 items and four factors-Severe Psychological Abuse, Coercive Emotional Abuse, Restrictive Isolating Abuse, and Financial Abuse-with Cronbach's alphas ranging from 0.73 to 0.85 and overall explained variance of 57.2%. Exhibiting evidence of validity and reliability, the Psychological Abuse in Relationships Scale is a contemporary, concise, and comprehensive measure of psychological IPV that will improve the ability of researchers to identify this common and harmful type of abuse.

Musculoskeletal Pain as a Risk Factor for Poor Dizziness Outcomes: A Longitudinal Study Among Patients With Persistent Vestibular Dizziness

OBJECTIVE

Musculoskeletal pain and psychological distress are prevalent comorbidities in patients with persistent dizziness. Little is known about how comorbid pain influences the outcome of persistent dizziness. This study examined the impact of pain on dizziness outcomes and the potential modifying role of psychological distress.

METHODS

This study was a longitudinal study of 150 patients with persistent dizziness. Vertigo Symptom Scale - short form (VSS-SF), Dizziness Handicap Inventory (DHI), number of pain sites, pain intensity, and Hospital Anxiety and Depression Scale (HADS) were assessed at baseline, 6 months and 12 months. Linear mixed effects model for longitudinal data was used to explore the association between musculoskeletal pain and dizziness. Interaction analysis was used to assess whether psychological distress had a modifying effect on the association between pain and dizziness.

RESULTS

VSS-SF and DHI decreased during follow-up but not to a clinically relevant level for the patients. Patients reporting comorbid psychological distress reported higher scores on VSS-SF, DHI, more pain sites and higher pain intensity. A positive association was observed between the number of pain sites and VSS-SF and between pain intensity and VSS-SF, and these associations were stronger in patients reporting psychological distress. Similar associations were found for DHI. Patients reporting ≥4 pain sites or pain intensity of ≥4 out of 10 at baseline, still reported severe dizziness and moderate disability 12 months later.

CONCLUSION

Musculoskeletal pain is a risk factor for poor dizziness outcomes, especially when comorbid psychological distress is present. Clinicians should be attentive to musculoskeletal pain when the number of pain sites exceeds 4 or pain intensity exceeds 4 on a numeric rating scale.

IMPACT

A new understanding of the impact of musculoskeletal pain on persistent dizziness could be the key to successful recovery and the prevention of prolonged issues.

Exploring the Relationship Between Cyberchondria and Suicidal Ideation: Cross-Sectional Mediation Analysis

BACKGROUND

The proliferation of internet-based health information has intensified cyberchondria, or anxiety resulting from excessive health-related searches. The relationship between cyberchondria and suicidal ideation remains underexplored, although there are indications that people with high levels of cyberchondria may also be suicidal. Understanding this relationship is critical, given rising digital health-seeking behaviors and the need to mitigate suicide risk. Emerging evidence suggests that psychological distress can mediate the relationship between cyberchondria and suicidal ideation. However, to the best of our knowledge, no research has directly examined these associations.

OBJECTIVE

This study had two aims. The first was to examine the relationship between cyberchondria and suicidal ideation in a sample of the general Chinese population. The second aim was to investigate the possible role of psychological distress, reflecting the symptoms of depression and anxiety, as a mediator in the relationship between cyberchondria and suicidal ideation.

METHODS

Data were obtained from a cross-sectional and web-based survey conducted in 2024. Structural equation modeling analysis was used to assess the hypothesized association between cyberchondria and suicidal ideation, as well as the mediating effect of psychological distress on this association. The Cyberchondria Severity Scale-12 items, Suicidal Ideation Attributes Scale, and Kessler Psychological Distress Scale-10 items were used to measure cyberchondria, suicidal ideation, and psychological distress, respectively. Standardized (β) estimates, along with their 95% CIs, were calculated for all structural paths, adjusting for participants' background characteristics.

RESULTS

A total of 2415 individuals completed the questionnaire (response rate=98.5%). Scores on the Cyberchondria Severity Scale-12 items ranged from 12 to 60, with the mean score being 40 (SD 7.9). The mean score on the Suicidal Ideation Attributes Scale was 12.7 (SD 9.9). Scores on the Kessler Psychological Distress Scale-10 items ranged from 10 to 50, and the mean score was 22 (SD 6.9). Cyberchondria, suicidal ideation, and psychological distress were significantly correlated. Structural equation modeling revealed a significant association between cyberchondria and psychological distress (β=.281; P<.001), between psychological distress and suicidal ideation (β=.504; P<.001), and between cyberchondria and suicidal ideation (β=.107; P<.001). The indirect effect of cyberchondria on suicidal ideation through psychological distress was also significant (β=.142; P<.001).

CONCLUSIONS

The main contribution of this study is that it highlights an important relationship between cyberchondria and suicidal ideation, with a direct and statistically significant association between these variables. Their relationship is also mediated by psychological distress, which reflects the role of depressive and anxiety symptoms.

Digital Phenotyping Measurement of Smartphone Social Behavior is Associated with Illness Progression Risk Scores in Young People at Clinical High Risk for Psychosis

BACKGROUND

Young people at clinical high risk for psychosis (CHR-p) commonly experience social impairment, which contributes to functional decline and predicts transition to psychotic illness. Although the use of smart phone technology and social media platforms for social interaction is widespread among today's youth, it is unclear whether aberrant digital social interactions contribute to risk for conversion and functional impairment in CHR-p. The current study sought to characterize the nature of social smartphone and social media use in a CHR-p sample and determine its association with clinical symptoms and risk for conversion to psychosis.

STUDY DESIGN

CHR-p (n = 132) and HC (n = 61) participants completed clinical interviews and 6 days of digital phenotyping that monitored total smartphone use, ratio of outgoing to incoming text messages and phone calls, social media use, and ecological momentary assessment surveys focused on in-person and electronic social interactions. Study Results: CHR-p did not differ from HC in total smartphone use for social communication or active social media use. However, CHR-p participants reported significantly less daily passive social media use compared to HC peers, and decreased text message reciprocity predicted 1- and 2-year conversion risk.

CONCLUSIONS

Results demonstrate a nuanced digital social landscape with divergent relationships from in-person social behavior and suggest online socialization has implications for high-precision identification and intervention strategies among the CHR-p population.

The central mediating effect of inhibitory control and negative emotion on the relationship between bullying victimization and social network site addiction in adolescents

BACKGROUND AND OBJECTIVES

Bullying victimization is strongly associated with social network site addiction among adolescents. However, the underlying mechanisms between these variables remain unclear. This study aims to explore the psychological mechanisms linking bullying victimization to social network site addiction by examining the mediating roles of depression, anxiety, stress, and inhibitory control.

METHODS

A self-report survey was conducted among a sample of 1,005 adolescents in China. The survey included measures of bullying victimization, social network site addiction, depression, anxiety, stress, and inhibitory control. Descriptive and correlational analyses were performed, followed by the construction of a chain mediation model.

RESULTS

Bullying victimization was significantly positively associated with social network site addiction. However, this relationship became non-significant when negative emotional states (depression, anxiety, stress) and inhibitory control were introduced as mediating variables. Specifically, bullying victimization significantly predicted negative emotional states and was negatively associated with inhibitory control. Negative emotional states were also negatively related to inhibitory control, while inhibitory control was negatively associated with social network site addiction. Among the negative emotional states, stress and anxiety showed a significant negative correlation with social network site addiction.

CONCLUSION

This study sheds further light on the psychological mechanisms linking bullying victimization and social network site addiction among adolescents. Depression, anxiety, stress, and inhibitory control act as mediating factors in this relationship. These findings highlight the importance of targeting these variables in understanding and developing interventions for social network site addiction among adolescents.

A validity and reliability study of the artificial intelligence attitude scale (AIAS-4) and its relationship with social media addiction and eating behaviors in Turkish adults

BACKGROUND

In recent years, there has been a rapid increase in the use of the internet and social media. Billions of people worldwide use social media and spend an average of 2.2 h a day on these platforms. At the same time, artificial intelligence (AI) applications have become widespread in many fields, such as health, education, and finance. While AI has the potential to monitor eating behaviors and provide personalized health support, excessive use of social media and AI can lead to negative effects. These include addiction and reduced quality of life. It is important to examine the attitude toward AI and its relationship with social media addiction, eating behavior, and life satisfaction. Research on the connection between AI attitudes and eating habits is lacking, which emphasizes the necessity of validating AIAS-4 in Turkish in order to ensure its efficacy in this context. The first stage of the study aimed to adapt Grassini's (2023) Artificial Intelligence Attitude Scale (AIAS-4) into Turkish and assess its validity and reliability. In the second stage, it was aimed to examine the relationship between artificial intelligence attitude and social media addiction, eating behavior, and life satisfaction.

METHODS

This study cross-sectional and methodological study was conducted in two stages in Türkiye. 172 adult individuals underwent a validity and reliability study in the first stage (43% of them were men and 57% were women), which involved adapting the AIAS-4 into Turkish. In the second stage, the relationships between artificial intelligence attitude, social media addiction, eating behavior, and life satisfaction of 510 individuals were evaluated with an average age of 24.88 ± 7.05 years (30.8% male, 69.2% female). Using the snowball sampling technique, the survey was carried out on adults by reaching out to staff and their families from both universities (Gazi University and Tokat Gaziosmanpaşa University) as well as students and their relatives. A face-to-face survey approach (delivered by an interviewer) was used for the study. In this study, the Social Media Addiction Scale-Adult Form(SMAS-AF) was used to assess social media addiction, the Scale of Effects of Social Media on Eating Behavior (SESMEB) was used to measure the impact of social media on eating behavior, the Contentment with Life Assessment Scale was used to evaluate life satisfaction, and the Eating Disorder Examination Questionnaire (EDE-Q total) was used to assess eating disorder symptoms. Pearson Correlation and Spearman Correlation according to normality and Linear regression analysis were used to analyse variables.

RESULTS

AIAS-4 was a valid and reliable instrument in this study conducted in Türkiye (Cronbach's alpha = 0.90 and McDonald's omega = 0.89). Individuals spend an average of 3.7 ± 1.99 h per day on social media. All participants used WhatsApp, while 89.8% used Instagram. A negative correlation was found between AIAS and EDE-Q total, (r=-0.119 p < 0.05). BMI correlated positively with EDE-Q total (r = 0.391, p < 0.01). Higher AIAS scores were associated with increased time spent on social media (r = 0.129, p < 0.001). Conversely, higher AIAS scores were associated with lower EDE-Q total scores (r= -0.119, p < 0.001). SESMEB correlated positively with EDE-Q total (r = 0.169; p < 0.001). The model showed that BMI (β = 0.311; p < 0.001), AIAS (β =-0.157, p = 0.005), SMAS-AF (β = 0.036; p = 0.002) and SESMEB (β = 0.022; p = 0.038) affected EDE-Q total (p < 0.001 R2 = 0.198).

CONCLUSION

This study revealed that the Artificial Intelligence Attitude Scale (AIAS) is valid and reliable for Turkish adults. The results show that BMI, social media addiction have positive, and AI attitude has negative impact on eating behaviors. These findings emphasize the importance of multidisciplinary approaches and awareness programs in the prevention and management of eating disorders.

The impact of emotional dysregulation on food addiction: Examining the intervention role of gender

Food addiction (FA) is a significant barrier to the overall well-being of college students. Consequently, it is crucial to investigate the factors contributing to FA to address and alleviate the obesity issue among college students effectively. This study assessed the impact of emotional dysregulation (ED) on FA in a sample of 501 students at three universities in China and explored the gender disparities in this relationship. The results indicated a substantial positive association between ED and FA among college students. ED was found to be a significant and positive predictor of FA. Additionally, gender was found to moderate the influence of ED on FA. The results of this study offer a comprehensive empirical analysis to identify the factors contributing to FA in college students. Additionally, it provides recommendations for assisting college students in effectively managing their emotions, which in turn aids in accurately perceiving and successfully combating FA.

Translating and Validating the Japanese Version of the Tolerance for Ambiguity Scale

Background

Ambiguity is inherent in medicine, and tolerance for ambiguity (TFA) has recently been of substantial interest. Effective medical education for TFA requires a validated inventory; one validated measure in wide use is the seven-item TFA scale. In Japan, however, a tool for measuring TFA in undergraduate medical education has not been available. Here, we aimed to develop and validate the Japanese version of the TFA scale (J-TFA scale).

Methods

We translated the original English scale into Japanese following an international guideline. We then conducted a validation survey by distributing an online anonymous self-administered questionnaire to medical students at three medical schools in Japan. We assessed the structural validity and internal reliability of consistency of the scale.

Results

A total of 399 participants were included in our analysis. We used a split-half validation approach, with exploratory factor analysis (EFA) on the first half and confirmatory factor analysis (CFA) on the second. EFA indicated a two-factor structure. CFA showed that the two-factor structure suggested by EFA had acceptable model fitness indices. Cronbach's alpha was 0.72, exceeding the satisfactory internal reliability consistency criteria.

Conclusions

The J-TFA scale was developed and its psychometric properties were confirmed. This instrument may be useful for future educational interventions and research on TFA.

Identifying impaired mental health in patients with type 2 diabetes: a cross-sectional study in general practice

BACKGROUND

Type two diabetes (T2D) is linked to impaired mental health. International guidelines emphasise the importance of including psychological aspects in diabetes care. Yet, no systematic approach has been implemented to assess mental health in patients with T2D in general practice.

AIM

To evaluate the mental health of patients with T2D in general practice, and to investigate the effectiveness of asking patients about their wellbeing by using a single-item question compared with the five-item World Health Organization-Five Wellbeing Index (WHO-5).

DESIGN & SETTING

A cross-sectional study was undertaken, which included 230 patients with T2D in Danish general practice, from 1 May 2023-31 January 2024.

METHOD

Eligible patients were recruited at the annual chronic care consultation. They answered a single-item question on wellbeing and four validated measures of general wellbeing (WHO-5), depression (Patient Health Questionnaire-9; PHQ-9), anxiety (Generalised Anxiety Disorder-7; GAD-7), and diabetes distress (Problem Areas in Diabetes-5; PAID-5).

RESULTS

Overall, 32% of patients expressed symptoms of impaired mental health. Notably, the WHO-5 identified 53% of these patients, whereas only 12% of patients were identified through the single-item question. Importantly, among the patients exhibiting symptoms of impaired mental health, those identified by the WHO-5 displayed statistically significantly lower mental health scores across all measures (except PAID-5) compared with those not identified by the WHO-5.

CONCLUSION

A significant proportion of patients with T2D in general practice are affected by mental health issues. Our findings indicate that a single-item question may not sufficiently detect these issues, highlighting the importance of incorporating tools, such as the WHO-5, to offer a more comprehensive approach in diabetes care.

Self-Reported ADHD Diagnosis Status Among Working-Age Adults in the United States: Evidence From the 2023 National Wellbeing Survey

OBJECTIVE

To estimate the percentage of U.S. working-age (18- to 64-year-old) adults in 2023 who self-reported ever being diagnosed with ADHD by a health care professional.

METHOD

We analyze data from the 2023 National Wellbeing Survey (N = 7,053) to estimate self-reported lifetime ADHD diagnosis status among working-age adults, overall and by sex, age, race/ethnicity, nativity, education, and rural-urban residence.

RESULTS

Among U.S. working-age adults in 2023, we estimate that 13.9% (95% confidence interval [13.0%, 15.0%]) self-reported ever being diagnosed with ADHD by a health care professional. We find statistically significant variation by each of the demographic variables analyzed, with higher rates among working-age adults who are female, younger, non-Hispanic White, U.S.-born, less well-educated, and residing in metro areas with 250,000 to 1 million people (relative to those living in metro areas with 1+ million population).

CONCLUSION

The percentage of U.S. working-age adults who self-report in 2023 that they have ever been diagnosed with ADHD by a health care professional (13.9%) is substantially higher than estimates from 2012 (4.25%) and a 2023 estimate of 7.8% among adults of all ages (18+ years). The increase over time may reflect changes in diagnostic criteria for children and adults, greater acceptance of adult diagnosis, over- and mis-diagnosis, and methodological issues. The difference between the 2023 estimates likely reflects study-specific differences in the constructs measured, the age range of the samples, and methodological differences in the online panels used for sampling, in quality control approaches, and in post-survey weight construction. Additional data collection and empirical research is needed to validate or refine provisional estimates based on samples drawn from online panels, and to determine explanations for the observed increase over time.

Sentiment of Nurses Towards Artificial Intelligence and Resistance to Change in Healthcare Organisations: A Mixed-Method Study

BACKGROUND

Research identified preliminary evidence that artificial intelligence (AI) has emerged as a transformative force in healthcare, revolutionising various aspects of healthcare delivery, from diagnostics to treatment planning. However, integrating AI into healthcare systems in Egypt is challenging, particularly concerning healthcare professionals' acceptance and adoption of these technologies. This mixed-method study aimed to explore the sentiment of nurses at different organisational levels towards AI and resistance to change in healthcare organisations.

METHODS

A mixed-method design was employed, with quantitative data collected through a survey of 500 nurses using the general attitudes towards AI and resistance to change scale and qualitative data from semi-structured interviews with 17 nurses. Quantitative data were analysed using descriptive and inferential statistics, while qualitative data were analysed thematically.

RESULTS

The survey demonstrated that positive attitudes were inversely correlated with resistance behaviour and resistance to change. Additionally, perceptions of AI's usefulness, ease of use and value were strongly and positively correlated with positive attitudes and negatively correlated with negative attitudes. Moreover, the influence of colleagues' opinions, self-efficacy for change and organisational support showed significant positive correlations with positive attitudes towards AI and negative correlations with negative attitudes. Qualitatively, nurses cited obstacles such as lack of familiarity with AI technologies, biases affecting decision-making, technological challenges, inadequate training and fear of technology replacing human interaction. Readiness for AI integration was associated with the necessity of training and the timing of AI use.

CONCLUSION

Nurses demonstrated varied understanding of AI's applications and benefits. Some acknowledged its potential for efficiency and time-saving, while others highlighted a need for up-to-date knowledge.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Protocol for a Randomized Controlled Trial to Enhance Executive Function via Brief Mindfulness Training in Individuals with Internet Gaming Disorder

BACKGROUND

Internet Gaming Disorder (IGD) is characterized by uncontrolled gaming behavior, leading to emotional distress, neglect of academic or life responsibilities, and damage to interpersonal relationships, all of which have serious negative impacts on individuals and society. IGD has been associated with neuropsychological impairments, especially executive function deficits, and emotional difficulties. Mindfulness interventions have been indicated to improve executive functions to varying degrees in individuals with IGD. The purpose of this study is to investigate whether the three subcomponents of executive function (i.e., inhibition, updating, and shifting) are impaired in individuals with internet gaming disorder, as well as to examine the effectiveness of a brief mindfulness intervention on executive function.

METHODS

A total of 82 individuals diagnosed with IGD and 40 non-addicted gamers will be recruited for this study. These participants will be evenly divided into an intervention group and a control group at a ratio of 1:1. The intervention group will undergo a 7-day mindfulness training program focusing on breathing meditation, while the control group will receive progressive muscle relaxation training. Both groups' outcomes will be assessed at seven different time points. Primary outcome measures will include electroencephalography (EEG) data (band power, functional connectivity, source localization, and N2/P3 amplitudes), behavioral metrics (response times and accuracy from psychological experimental paradigms), physiological indices (specifically heart rate variability), self-reported measures (game craving and mindfulness levels, executive function performance, and impulsivity emphasizing inhibitory control). Secondary outcome measures will encompass anxiety, stress, positive and negative affect, sleep quality, and other indicators such as demographic information, physical and mental health status, and the Big Five personality traits.

DISCUSSION

This study aims to explore the efficacy of a brief mindfulness intervention on executive function impairments in IGD individuals and to elucidate its underlying neural mechanisms. It is anticipated that the findings will contribute to more targeted intervention strategies for executive function research, offering novel insights into the treatment of IGD and related cognitive dysfunctions. This study is expected to explore the effectiveness of brief mindfulness intervention on IGD and its underlying brain functional mechanisms, particularly providing more targeted intervention strategies for improving executive functions in this population.

TRIAL REGISTRATION

Trial registration number: ChiCTR2400081509, registered on March 4th 2024. Protocol Version1.0.

Career Impact of High-Performance Work System: A Kaleidoscope Perspective

High-performance work system (HPWS) is considered a solid predictor of individual outcomes, but there is less evidence about the impact HPWS on subjective career success (SCS). The current study examines the direct impact of HPWS on SCS through the lens of the Kaleidoscope Career Model. In addition, employability orientation is expected to mediate the relationship while employees' HPWS attribution is hypothesized to moderate the HPWS-SCS linkage. A quantitative research design with two-wave survey collected data from 365 employees working in 27 firms in Vietnam. Partial least square structural equation modelling (PLS-SEM) is used to test the hypotheses. Results indicate that HPWS is significantly associated with SCS through the achievements of career parameters. In addition, employability orientation mediates the above relationship while HPWS external attribution moderates the relationship between HPWS and SCS. This research suggests that HPWS may influence employees' outcomes beyond the current employment, such as career success. HPWS fosters employability orientation which may encourage the employees to seek career advancements outside the current employer. Therefore, HPWS-implementing organizations should provide career opportunities to the employees. In addition, attention should be paid to employees' evaluative reports of HPWS implementation.

AI in medical diagnosis: A contextualised study of patient motivations and concerns

Patients' reactions to the implementation of Artificial Intelligence (AI) in healthcare range from adverse to favourable. While AI holds the promise of revolutionising healthcare by enhancing, accelerating, and improving the precision of care services, our understanding of patients' reactions to these paradigm shifts remains limited. In particular, little is known about the extent to which patients are receptive to independently use AI-enabled applications for diagnosis. This research seeks to develop a holistic, context-specific model capturing both the negative and positive cognitive responses of patients utilising AI-powered diagnostic services. Employing a sequential mixed-methods approach, the study draws on Behavioural Reasoning Theory to decode patients' cognitive reactions, including their reasons for and reasons giants using such applications. The research begins with a qualitative exploration, analysing user reviews to identify context-specific barriers and motivators. Building on these qualitative insights, the model's empirical validity is tested through a quantitative phase involving survey data analysis. Our findings provide a nuanced understanding of the context-dependent factors shaping patients' cognitive responses to AI-enabled diagnostic services, offering valuable insights for the design and implementation of patient-centred AI solutions in healthcare.

Using Social Media to Promote Life Skills Among Adolescents: A Debate on Opportunities, Challenges, and Implications for Health and Education

The digitalization of society increasingly blurs boundaries between analog and digital worlds, offering opportunities such as telemedicine and global connectivity through digital platforms. However, it also presents risks, including cyberbullying, addiction potential, harmful content, misinformation, and privacy concerns from data breaches and surveillance technologies. Social media, with its global reach, amplifies both opportunities for positive engagement and the responsibility to navigate largely unregulated content. Adolescents, due to their developing critical evaluation skills and high prevalence of mental health challenges, are particularly vulnerable in this space and must navigate the risks associated with social media while simultaneously leveraging it for essential developmental tasks, such as identity formation and building social connections. To support them in this challenge, we propose adapting the traditional life skills approach to address the challenges of social media use, empowering adolescents to navigate both digital and analog environments effectively. These life skills include critical thinking, communication, and managing emotions and stress - all of which are essential for navigating social media. Despite its complexities, social media offers a unique platform for health promotion and prevention interventions due to its wide accessibility and reach. It holds significant promise for adolescent health by providing information, motivation, and social support. However, evidence-based, youth-centered prevention strategies on these platforms are still in early development and require further research to ensure effectiveness. Prevention programs integrating proven behavior change techniques, aligning with the preferences and needs of adolescents, and teaching essential life skills can empower them to navigate digital and analog challenges effectively.

The role of a Medical Examiner Service in an acute NHS hospital: Perspectives from doctors and next of kin

A new Medical Examiner system was introduced in England and Wales in 2019 to scrutinise all non-coronial deaths. The three key roles of independent Medical Examiner scrutiny are to establish accurate causes of death, determine whether coronial referral is required and identify any care concerns. This is the first published service evaluation exploring the views of doctors and next of kin with whom Medical Examiner Services interact. The aims were to understand whether the Medical Examiner Service was achieving its three main roles. Surveys were sent electronically to the qualified attending practitioners, and by post to the next of kin, of a consecutive series of deceased patients reviewed by an acute NHS hospital Medical Examiner Service in the East of England. Recruitment took place over a five month period in 2023. Results are based on 100 returned surveys from doctors (response rate 35%) and 179 completed by next of kin (response rate 65%). Findings suggest the Medical Examiner Service was successfully achieving its three key roles and well received by both doctors and next of kin. Service user feedback is clearly important as Medical Examiner Services continue to develop into the statutory phase during 2024, when they are anticipated to review approximately 400,000 deaths per annum in England and Wales. This study demonstrates such feedback is not only useful for service development, but also eminently possible.

The executive function, behavioral systems, and heart rate variability in college students at risk of Mobile gaming addiction

OBJECTS

The prevalence of mobile gaming addiction (MGA) has risen as a result of technical advancements that have made it more portable and handier. Emotional distress and a decline in inhibitions might worsen addictions. The study sought to examine the physiological and neuropsychological indicators of MGA.

METHODS

Following the examination of the online activities of 1774 students in their first year, we recruited 13 participants with MGA and 27 controls, utilizing the internet gaming disorder test (IGDT) and problematic mobile gaming questionnaire (PMGQ). They filled daily executive function scale (DEFS), brief symptom rating scale-50 (BSRS-50), and behavior inhibition/activation scale (BIS/BAS). The Iowa gambling task (IGT-2), Stroop color-word test (SCWT), and the digit-span of the Wechsler intelligence scale were administered. The Heart Rate Variability (HRV) was measured at baseline, playing mobile games, and recovery condition. The independent t-test and repeated-measures ANOVA were used for analysis.

RESULTS

There were similar demographics between groups. The MGAs exhibited reduced inhibitions in SCWT, decreased DEFS, less total money in IGT-2, and elevated distress in BSRS. Both groups showed decreased SDNN, very low frequency, and total power during gameplay. However, the F-test indicated interaction effects of the proportion of NN50 divided by total number of NNs and high-frequency during gameplay, indicating an elevated state for MGAs than controls.

CONCLUSION

MGAs exhibit lower executive function, inhibition, and increased negative mood. The MGAs decreased in HRV during gaming, suggesting potential connections to impaired inhibitory control and stress-related responses. Further study is needed to clarify the mechanisms that contribute to MGA and differentiate it from broader frameworks of internet addiction.

Identifying and comparing types of social comparisons on social networking sites among mothers with infants: Differences in maternal loneliness by types

PURPOSE

Loneliness among mothers of infants is a serious problem that leads to increased stress and depression. Social networking sites (SNS) are platforms commonly used by mothers to gain information and socialize; however, the sites can also lead to social comparison. This study aimed to identify and compare the types of parental social comparisons on SNS among mothers with infants and examine their differences regarding maternal loneliness.

METHODS

A random sampling cross-sectional survey of 233 Japanese mothers with infants aged 6-11 months old was conducted. The questionnaire considered the frequency of parental social comparisons on SNS and the associated positive/negative emotions, loneliness, perceived social support, SNS use, and participant characteristics. Hierarchical cluster analysis and analysis of covariance were used to examine differences in loneliness by social comparison type.

RESULTS

Identified types of parental social comparisons on SNS included: "Negative-leaning comparisons (n = 40)," "Ambivalent comparisons (n = 53)," "Heavy comparisons (n = 39)," and "Positive-leaning comparisons (n = 67)." The "non-comparative group (n = 34)" made no comparisons. The loneliness scores of the "Negative-leaning comparisons" group were significantly higher than those of the "Ambivalent comparisons," "Positive-leaning comparisons," and "Non-comparative" groups (p = 0.019, p = 0.017, and p < 0.001, respectively). Additionally, the loneliness scores of the "Heavy comparisons" group were higher than those of the "Non-comparative" group (p = 0.005).

CONCLUSION

Interventions aimed at enhancing digital literacy among mothers and providing tailored support based on their social comparison types are crucial for mitigating the negative effects of parental social comparisons on SNS.

An Investigation of the Longitudinal Bidirectional Associations Between Interactive Versus Passive Social Media Behaviors and Youth Internalizing Difficulties. A Within-Person Approach

Ongoing concerns about the mental health of young people have intensified interest in the role of social media, with research suggesting that the nature of social media behaviors-whether interactive or passive-may differentially impact mental health. However, the bidirectional relationships between specific types of social media use and internalizing difficulties (anxiety and depression) remain underexplored, particularly at the within-person level over time. Data were extracted from the Dutch population-based Longitudinal Internet Studies for the Social Sciences (LISS) panel. Four yearly studies assessing time spent on interactive (communication) and passive use of social media in October (2019-2022) and four annual studies evaluating internalizing difficulties (anxiety and depression) in November (2019-2022) were used. Respondents who were 16- 25 years old in October 2019 (N = 321; M = 20.49; SD = 2.94; 61.7% female). Random Intercept Cross Lagged Path Models were used to analyze the data. There were no significant associations between passive social media use and internalizing difficulties at the within-person level over time. Within-person interactive use was associated with decreases in internalizing difficulties at one time point (2021 to 2022). The results provide marginal evidence that distinct social media behaviors are prospective factors associated with internalizing difficulties in young people.

The More, the Better? Social Capital Profiles and Adolescent Internalizing Symptoms: A Latent Profile Analysis

Past research suggests that offline and online social capital are empirically linked to adolescent psychological adjustment. However, little is known regarding the implications of distinctive combinations of social capital for adolescent internalizing symptoms. The present study aimed to examine adolescent social capital patterns and their associations with internalizing symptoms by using latent profile analysis. A cross-sectional web-based survey was conducted among 1595 Chinese adolescents (mean age = 14.30 years, 50.7% male). All adolescents completed self-report questionnaires on their perceived offline and online social capital, depressive symptoms and anxiety symptoms. Latent profile analysis revealed four profiles of social capital: (1) Low Social Capital, (2) Moderate Social Capital, (3) High Social Capital, and (4) Only High Offline Social Capital. Further, analysis of covariance demonstrated that the Only High Offline Social Capital profile had significantly fewer internalizing symptoms than other three profiles. No statistical differences of internalizing symptoms were found between the other three profiles, except that the Moderate Social Capital profile showed fewer anxiety symptoms than the Low Social Capital profile. These findings suggest that more social capital does not equal to better mental health status. The social capital profiles and their associations with adolescent internalizing symptoms may provide practitioners with meaningful implications regarding the role of offline and online social capital in adolescent psychological adjustment.

Which social media platforms facilitate monitoring the opioid crisis?

Social media can provide real-time insight into trends in substance use, addiction, and recovery. Prior studies have used platforms such as Reddit and X (formerly Twitter), but evolving policies around data access have threatened these platforms' usability in research. We evaluate the potential of a broad set of platforms to detect emerging trends in the opioid use disorder and overdose epidemic. From these, we identified 11 high-potential platforms, for which we documented policies regulating drug-related discussion, data accessibility, geolocatability, and prior use in opioid-related studies. We quantified their volume of opioid discussion, including in informal language by including slang generated using a large language model. Beyond the most commonly used Reddit and X/Twitter, the platforms with high potential for use in opioid-related surveillance are TikTok, YouTube, and Facebook. Leveraging a variety of social platforms, instead of merely one, yields broader subpopulation representation and safeguards against reduced data access in any single platform.

Comparisons of Self-Report With Objective Measurements Suggest Faster Responding but Little Change in Response Quality Over Time in Ecological Momentary Assessment Studies

Response times (RTs) to ecological momentary assessment (EMA) items often decrease after repeated EMA administration, but whether this is accompanied by lower response quality requires investigation. We examined the relationship between EMA item RTs and EMA response quality. In one data set, declining response quality was operationalized as decreasing correspondence over time between subjective and objective measures of blood glucose taken at the same time. In a second EMA study data set, declining response quality was operationalized as decreasing correspondence between subjective ratings of memory test performance and objective memory test scores. We assumed that measurement error in the objective measures did not increase across time, meaning that decreasing correspondence across days within a person could be attributed to lower response quality. RTs to EMA items decreased across study days, while no decrements in the mean response quality were observed. Decreasing EMA item RTs across study days did not appear problematic overall.

eHealth Literacy and Its Association With Demographic Factors, Disease-Specific Factors, and Well-Being Among Adults With Type 1 Diabetes: Cross-Sectional Survey Study

Background

The use of digital health technology in diabetes self-care is increasing, making eHealth literacy an important factor to consider among people with type 1 diabetes. There are very few studies investigating eHealth literacy among adults with type 1 diabetes, highlighting the need to explore this area further.

Objective

The aim of this study was to explore associations between eHealth literacy and demographic factors, disease-specific factors, and well-being among adults with type 1 diabetes.

Methods

The study used data from a larger cross-sectional survey conducted among adults with type 1 diabetes in Sweden (N=301). Participants were recruited using a convenience sampling method primarily through advertisements on social media. Data were collected between September and November 2022 primarily through a web-based survey, although participants could opt to answer a paper-based survey. Screening questions at the beginning of the survey determined eligibility to participate. In this study, eHealth literacy was assessed using the Swedish version of the eHealth Literacy Scale (Sw-eHEALS). The predictor variables, well-being was assessed using the World Health Organization-5 Well-Being Index and psychosocial self-efficacy using the Swedish version of the Diabetes Empowerment Scale. The survey also included research group-developed questions on demographic and disease-specific variables as well as digital health technology use. Data were analyzed using multiple linear regression presented as nested models. A sample size of 270 participants was required in order to detect an association between the dependent and predictor variables using a regression model based on an F test. The final sample size included in the nested regression model was 285.

Results

The mean Sw-eHEALS score was 33.42 (SD 5.32; range 8-40). The model involving both demographic and disease-specific variables explained 31.5% of the total variation in eHealth literacy and was deemed the best-fitting model. Younger age (P=.01; B=-0.07, SE=0.03;95% CI -0.12 to -0.02), lower self-reported glycated hemoglobin levels (P=.04; B=-0.06, SE=0.03; 95% CI -0.12 to 0.00), and higher psychosocial self-efficacy (P<.001; B=3.72, SE=0.53; 95% CI 2.68-4.75) were found associated with higher Sw-eHEALS scores when adjusted for demographic and disease-specific variables in this model. Well-being was not associated with eHealth literacy in this study.

Conclusions

The demographic and disease-specific factors explained the variation in eHealth literacy in this sample. Further studies in this area using newer eHealth literacy tools are important to validate our findings. The study highlights the importance of development and testing of interventions to improve eHealth literacy in this population for better glucose control. These eHealth literacy interventions should be tailored to meet the needs of people in varying age groups and with differing levels of psychosocial self-efficacy.

Short Screener of the Cyber Aggression in Relationships Scale: Construct Validity and Reliability Cross-Cultural Samples

The Cyber Aggression in Relationships Scale (CARS) is a widely used and validated measure of adult cyber intimate partner violence (C-IPV). The current study aimed to create a short screener of CARS (CARS-SS) through testing cross-cultural samples. To do so, we examined the rate of chosen items of the original scale on five pre-existing study samples: we then procured and tested the construct validity and reliability of the CARS-SS among two study samples (United States and Israel). Results of an item factor analysis confirmed one factor for both perpetration and victimization and analyses suggested good internal reliability. Overall, the CARS-SS was associated with a measure of in-person intimate partner violence. Findings suggest the CARS-SS may be a helpful measure of C-IPV among clinical and community samples of young adults.

Role of introvert and extrovert personalities in perception of COVID-19's impact, psychological state, knowledge, infection, and preparedness preferences

BACKGROUND

The role of introversion and extraversion in shaping pandemic responses remains understudied in the field of public health. This study aimed to comprehensively investigate differences in perceptions of COVID-19's impact, psychological status, knowledge of COVID-19, infection rate, and preferred preparations among introverts and extroverts.

METHODS

This study utilized a cross-sectional design. From May to June 2022, an online survey was conducted, involving 1,990 adults in Hong Kong. Regression analyses were employed to identify personality differences across 58 outcomes of interest. To account for multiplicity, adjustments were made using the Holm-Bonferroni method.

RESULTS

Extroverts reported a greater increase in having a meal at home (adjusted p [adj.p] < 0.001), while introverts' sleep quality decreased more (adj.p < 0.001). Although no statistical difference was detected between the decrease they showed in emotional stress (adj.p = 1.000) and mental burden (adj.p = 1.000), introverts had higher levels of anxiety (adj.p = 0.006), depression (adj.p < 0.001), and fear (adj.p = 0.026), whereas extroverts had stronger out of control feelings (adj.p = 0.010). Besides, extroverts had higher self-rated knowledge on COVID-19 knowledge (adj.p = 0.016) and prevention (adj.p < 0.001). Moreover, extroverts perceived higher importance in online consultation with doctors, instant personalized health by online chatbot, online courses, instant streaming courses, medicine delivery, online shopping, and food delivery (all adj.p < 0.05).

CONCLUSIONS

Introverts could benefit most from interventions addressing sleep quality, anxiety, depression, fear, and knowledge promotion about COVID-19, while extroverts could benefit most from approaches that address feeling out of control. Extroverts had higher preferences for online consultations, instant personalized health via online chatbots, streaming courses, online courses, and medicine delivery, emphasizing the importance of considering personality in field of telemedicine, e-health, and remote medicine practice. These findings have important implications for pandemic response and preparedness, highlighting the role of personality in public health emergencies.

How and when screens are used: comparing different screen activities and sleep in Norwegian university students

Introduction

Screen use in bed has become a widespread habit, particularly among young people. This behavior has been associated with poor sleep, with some studies indicating that social media use may be especially detrimental. However, there is a scarcity of research directly comparing the relationship between various screen activities and sleep, and most existing studies focus on adolescents rather than young adults. This study aims to explore the relationship between screen use in bed and sleep among students, specifically comparing social media use to other screen-based activities.

Methods

This study utilized data from the cross-sectional Students' Health and Wellbeing Study of 2022 and included n=45,202 participants aged 18-28 years. Regression analyses were used to assess the relationship between screen time in bed and sleep, comparing social media use with other activities.

Results

A one-hour increase of screen time after going to bed was associated with 59% higher odds of having symptoms of insomnia and a reduction in sleep duration of 24 minutes. The associations between screen time and sleep outcomes did not differ for social media use versus other activities. Independent of screen time, participants who exclusively used social media had lower odds of insomnia and longer sleep duration compared to those engaging in other activities or a mix of activities.

Discussion

The present study found that increased screen time in bed is linked to poorer sleep, across activity type. Future research should refine classifications, assess specific content, and employ experimental approaches to determine causal mechanisms.

How Do Social Media Influencers Support College Students' Mental Well-Being? A Theory-Driven Content Analysis of YouTube Videos on Mental Health

Grounded in social learning theory, this study investigates the impact of social media influencers (SMIs) on the mental well-being of college students through YouTube videos. By analyzing 115 videos from 88 influencers with over 5,000 subscribers, this study identifies distinct communication strategies tied to influencer attributes. Notably, findings reveal that strategies such as cultivating affective social presence, showing identification with friends and mental health organizations, and incorporating narrative evidence, are positively linked to increased user commenting behavior. The study also examines variations in strategy use across gender and influencer tiers, with micro-influencers excelling in employing most of these effective strategies. Emphasizing the pivotal role of SMIs, as observational learning role models, this research sheds light on their influence in fostering supportive online communities that encourage open dialogue and reflective learning on mental health. The implications can extend to the field of digital health communications.

Vestibular Rehabilitation in Saudi Arabia: Practice, Knowledge, and Beliefs of Physical Therapists

Background: Vestibular physical therapy is a specific type of exercise intervention that is designed to treat symptoms caused by vestibular disorders and to enhance postural control. The level of expertise in the practice of vestibular rehabilitation therapy (VRT) varies widely around the world. The practice of VRT is advanced in some countries, yet practice may be less advanced in others. No previous studies have evaluated the knowledge and beliefs of vestibular rehabilitation in the Kingdom of Saudi Arabia (KSA) to date. Objective. This study aimed to evaluate the knowledge and beliefs about VRT among physical therapists in the KSA. Methods: We used an electronic cross-sectional survey containing 25 questions and divided into four sections: demographics, clinical experience, vestibular rehabilitation knowledge, and physical therapists' beliefs. The survey was answered by 219 licensed physical therapists. Results: Of the 219 responders, 59 (27%) physical therapists reported having experience with VRT. A total of 119 (54%) participants felt confident talking to other medical members when managing persons with dizziness. Only 59 (26%) clinicians were using vestibular assessment techniques, and 103 (47%) clinicians used VRT if they had patients with vestibular disorders. The majority of physical therapists believed in the efficacy of vestibular rehabilitation. Conclusions: Although the majority of physical therapists consider vestibular rehabilitation a crucial aspect of their practice, they acknowledge having limited knowledge of vestibular disorders and treatment techniques.

μετὰ τὰ ϕυσικά: Vision Far Beyond Physics

Vision Science is an area of study that focuses on specific aspects of visual perception and is conducted mainly in the restricted and controlled context of laboratories. In so doing, the methodological procedures adopted necessarily reduce the variables of natural perception. For the time being, it is extremely difficult to perform psychophysical, neurophysiological, and phenomenological experiments in open scenery, even if that is our natural visual experience. This study discusses four points whose status in Vision Science is still controversial. Namely, the copresence of distinct visual phenomena of primary and secondary processes in natural vision; the role of visual imagination in seeing; the factors ruling the perception of global ambiguity and enigmatic and emotional atmosphere in the visual experience of a scene; and if the phenomena of subjective vision are considered, what kind of new laboratories are available for studying visual perception in open scenery. In the framework of experimental phenomenology and the use of pictorial art as a complement and test for perceptual phenomena, a case study from painting showing the copresence of perceptual and mental visual processes is also discussed and analyzed. This has involved measuring color and light in specific zones of the painting chosen for analysis, relative to visual templates, using Natural Color System notation cards.

Psychometric properties and Turkish adaptation of the artificial intelligence attitude scale (AIAS-4): evidence for construct validity

Artificial intelligence (AI) attitude scales can be used to better evaluate the benefit and drawback cons of AI. This article consists of two different studies examining attitudes towards AI. In Study I (N = 370), the four-item Artificial Intelligence Attitude Scale-4 (AIAS-4) has a one-dimensional structure as a result of confirmatory factor analysis and the fit index values ​​are at an acceptable level [Comparative Fit Index (CFI) = 0.991; Goodness of Fit Index (GFI) = 0.989; Normed Fit Index (NFI) = 0.988; Tucker-Lewis Index (TLI) = 0.973; Standardized Root Mean Square Residual (SRMR) = 0.018]. Additionally, according to the results of the item response analysis conducted to support construct validity at this stage, the scale items have sufficient discrimination (discrimination value range = 2.22-3.80). Later, measurement invariance analysis revealed that the scale measured the same construct in females and males. In Study II (N = 331), the reliability of AIAS-4 was reached by calculating different reliability coefficients. Then, AI attitude was found to be associated with depression, anxiety, and stress, as well as mental health variables such as mental wellbeing and flourishing. Moreover, openness to experience, conscientiousness, extraversion, and neuroticism are significantly related to an AI attitude. Lastly, psychological distress has a significant mediating role in the relationship between AI attitude and mental health. The findings of this pioneering research on AI attitudes were discussed and interpreted in light of the literature.

Vaping, Acculturation, and Social Media Use Among Mexican American College Students: Protocol for a Mixed Methods Web-Based Cohort Study

BACKGROUND

The tobacco industry has a history of targeting minority communities, including Hispanic individuals, by promoting vaping through social media. This marketing increases the risk of vaping among Hispanic young adults, including college students. In Texas, college enrollment among Mexican Americans has significantly increased over recent years. However, little research exists on the link between social media and vaping and the underlying mechanisms (ie, outcome expectations, attitudes, and beliefs) explaining how vaping-related social media impacts vaping among Mexican American college students. Moreover, there is limited knowledge about how acculturation moderates the association between social media and vaping. Hispanic individuals, particularly Mexican Americans, are the largest ethnic group in Texas colleges; thus, it is crucial to understand the impact of social media and acculturation on their vaping behaviors.

OBJECTIVE

We outline the mixed methods used in Project Vaping, Acculturation, and Media Study (VAMoS). We present descriptive analyses of the participants enrolled in the study, highlight methodological strengths, and discuss lessons learned during the implementation of the study protocol related to recruitment and data collection and management.

METHODS

Project VAMoS is being conducted with Mexican American students attending 1 of 6 Texas-based colleges: University of Texas (UT) Arlington, UT Dallas, UT El Paso, UT Rio Grande Valley, UT San Antonio, and the University of Houston System. This project has 2 phases. Phase 1 included an ecological momentary assessment (EMA) study and qualitative one-on-one interviews (years 1-2), and phase 2 includes cognitive interviews and a 4-wave web-based survey study (years 2-4) with objective assessments of vaping-related social media content to which participants are exposed. Descriptive statistics summarized participants' characteristics in the EMA and web-based survey.

RESULTS

The EMA analytic sample comprised 51 participants who were primarily female (n=37, 73%), born in the United States (n=48, 94%), of middle socioeconomic status (n=38, 75%), and aged 21 years on average (SD 1.7 years). The web-based survey cohort comprised 1492 participants self-identifying as Mexican American; Tejano, Tejana, or Tejanx; or Chicano, Chicana, or Chicanx heritage who were primarily female (n=1042, 69.8%), born in the United States (n=1366, 91.6%), of middle socioeconomic status (n=1174, 78.7%), and aged 20.1 years on average at baseline (SD 2.2 years). Of the baseline cohort, the retention rate in wave 2 was 74.7% (1114/1492).

CONCLUSIONS

Project VAMoS is one of the first longitudinal mixed methods studies exploring the impact of social media and acculturation on vaping behaviors specifically targeting Mexican American college students. Its innovative approach to objectively measuring social media exposure and engagement related to vaping enhances the validity of self-reported data beyond what national surveys can achieve. The results can be used to develop evidence-based, culturally relevant interventions to prevent vaping among this rapidly growing minority population.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/63584.

Connecting self-esteem to problematic AI chatbot use: the multiple mediating roles of positive and negative psychological states

The emergence of AI chatbot products has ushered in a new era of human-AI interaction, yet scholars and practitioners have expressed concerns about their use due to potential addictive and adverse effects. Currently, the understanding of problematic AI chatbot use (PACU) remains incomplete and inconclusive. Despite previous findings that indicate negative outcomes associated with the use of AI products, limited studies have explored the underlying factors that drive the complex process leading to the formation of PACU. Furthermore, while existing literature highlights how personal traits influences problematic IT use via evoked psychological states, it largely overlooks that the positive psychological experience may also have a potential influence on problematic outcomes. Incorporating flow experience into the compensatory internet use theory, this study presents a multiple mediation model to investigate how social anxiety, escapism, and AI chatbot flow influence the relationship between self-esteem and PACU. We examine the model using Partial Least Squares Structural Equation Modeling (PLS-SEM) with cross-sectional data collected from 563 online users who have engaged with AI chatbots. Our findings indicate that users with low self-esteem are more likely to conduct problematic behavior when using AI chatbots. This relationship can be mediated by social anxiety, escapism and AI chatbot flow. This study sheds light on how self-esteem negatively affects PACU, unraveling the underlying psychological processes experienced by users with low self-esteem in their interactions with AI chatbots. Also, we provide practical insights for online users and practitioners to mitigate the potential negative impacts of AI product usage.

The role of social media messages and content creators in shaping COVID-19 vaccination intentions

Introduction

Social media plays a crucial role in shaping health behaviors by influencing users' perceptions and engagement with health-related content. Understanding these dynamics is important as new social media technologies and changing health behaviors shape how people engage with health messages.

Aim

The current study explored the relationship between the characteristics of content creators, the messaging strategies employed in social media, and users' engagement with social media content, and whether these features are linked to users' behavioral intentions.

Methods

This study adopts a cross-sectional survey design. A total of 1,141 participants were recruited. We have developed a structural equation model to investigate the relationships between the characteristics of content creators, the messaging strategies employed in social media, users' perceived HBM constructs, user engagement, and users' behavioral intentions.

Results

Results revealed that social media posts focusing on self-efficacy were linked to increased willingness to engage in healthy behaviors. Additionally, individuals who demonstrate stronger perceptions of HBM constructs-such as higher perceived susceptibility and benefits of vaccination-are more likely to engage with posts, which was associated with higher vaccination intention. Posts authored by celebrities garnered a relatively higher number of favorites, while a greater proportion of politicians as content creators was linked to increased user comment intention.

Conclusion

Our study underscores the potential of integrating the Health Belief Model into social media to help promote health behaviors like the COVID-19 vaccination. Furthermore, our findings offer valuable insights for professionals and policymakers, guiding them in crafting effective message strategies and selecting appropriate sources to promote health behaviors on social media platforms.

In sync with oneself: spontaneous intrapersonal coordination and the effect of cognitive load

Spontaneous intrapersonal coordination is the unintentional coordination of periodic behaviors within an individual. Spontaneous interlimb coordination involving finger-, arm-, foot-, leg- and orofacial muscle movements may be weaker between finger-tapping and walking than between finger-tapping and vocalizing. This could be due to the additional attentional cost of walking, which may be more complex than other periodic movements. Here we compared the coordination stability of simultaneous finger-tapping and walking against simultaneous finger-tapping and repetitive vocalization. We also tested the coordination stability of tapping-walking and tapping-vocalizing under additional cognitive load imposed through concurrent cognitive tasks. Two experiments conceptually replicated spontaneous intrapersonal coordination between the pairs of periodic tasks as well as the effect of concurrent cognitive tasks on coordination stability. To assess coordination, we compared the phase coherence of two periodic tasks, tapping with walking (Experiment 1) or tapping with vocalization (Experiment 2), when produced separately (single task) versus simultaneously (dual task). In the first experiment, participants regularly tapped a microphone while walking, either with no concurrent cognitive task or with concurrent backward counting. In the second experiment, participants tapped while repeating the word "tick," again either with no concurrent cognitive task, or with concurrent visual pattern-matching. Higher spontaneous intrapersonal coordination was evident between periodic tasks when performed simultaneously compared to separately, and lower task coordination stability was evident with a concurrent cognitive task compared to without. These results were in line with past findings. Coordination stability between tapping and walking was lower than that between tapping and ticking overall. This finding supports the categorization of walking as a more complex cognitive task compared to other periodic tasks, as the additional attentional load involved in walking could have resulted in lower coordination stability between tapping and walking. Spontaneous intrapersonal coordination appears sensitive to the attentional costs of performing periodic activities and achieving / maintaining coordination between them.