European Journal of Investigation in Health, Psychology and Education

(1) Background: Understanding suicide risk across cultures requires examining both universal and culturally specific factors that inform assessment and intervention. This study explores the influence of interpersonal variables—such as interpersonal competence, perceived social support, and constructs from the Interpersonal Theory of Suicide (ITS)—on suicidal behaviour in two culturally distinct samples: young adults from Spain and Japan. (2) Methods: A total of [437] participants (Spanish sample: n = 260; Japanese sample: n = 177) completed validated measures assessing suicide risk, depression, perceived burdensomeness, thwarted belongingness, acquired capability for suicide, interpersonal competence, and perceived social support. Moderated mediation and SEM comparative analyses were conducted to identify predictors of suicide risk in each cultural context. (3) Results: Social support was a consistent protective factor against depression and suicidal ideation, and interpersonal competence showed more contextual protective effects, significant only in the Japanese sample. Perceived burdensomeness stood out as a robust predictor of depression and suicidal ideation in both samples, and suicidal ideation was strongly associated with suicidal behaviour, while acquired capability for suicide and interpersonal competence did not show a direct association with it. (4) Conclusions: The findings highlight the protective role of interpersonal competence and perceived social support in the progression to suicidal behavior, suggesting cultural similarities and differences in how these factors operate.

(1) Background: Mental health disparities persist across culturally diverse populations despite robust cognitive–behavioral therapy (CBT) efficacy evidence. Cultural neuroscience suggests that neurobiological processes underlying therapeutic mechanisms may exhibit culturally variable patterns, yet integration of neuroscientific frameworks into culturally adapted interventions remains limited. (2) Methods: Following PRISMA 2020 guidelines, we systematically searched PubMed/MEDLINE, PsycINFO, Scopus, and Web of Science (January 2014–December 2024) for peer-reviewed studies examining CBT interventions targeting depression, anxiety, PTSD, or psychological distress in culturally diverse populations. Ninety-four studies were synthesized using narrative methods; methodological heterogeneity precluded meta-analytic pooling. (3) Results: Culturally adapted CBT interventions consistently demonstrated superior outcomes compared to standard protocols across diverse populations. Group formats showed exceptional retention in collectivistic cultures, while hybrid technology-enhanced models achieved strong completion rates across contexts. Cultural adaptation enhanced engagement (e.g., 84% vs. 52% retention in refugee populations) and maintenance of treatment gains. Individual studies reported effect sizes ranging from d = 0.29 to d = 2.4; substantial within-group variability was observed, and identified patterns likely reflect learned cultural adaptations rather than inherent biological differences. Direct neuroimaging evidence within included studies remained limited (13.8%). (4) Conclusions: The evidence supports culturally adapted interventions as essential for equitable mental health outcomes. Cultural experiences may influence therapeutic processes, suggesting potential benefit from considering culturally variable processing patterns alongside universal mechanisms. However, conclusions regarding specific neural pathways remain preliminary, and individual assessment remains paramount, with cultural background representing one factor among many in treatment planning.

The Japanese version of the eHealth Literacy Scale (J-eHEALS) measure has primarily been applied to younger populations; however, the psychometric properties of the J-eHEALS in older adults have not been investigated. Therefore, in this cross-sectional study, we aimed to evaluate the psychometric properties of the J-eHEALS in community-dwelling older adults. A total of 553 adults aged ≥ 65 years (mean age, 73.5 years) attending routine health checkups in a single Japanese municipality completed the J-eHEALS and the Japanese version of the 12-item Health Literacy Scale (J-HLS-Q12). We examined internal consistency, item characteristics, factorial validity using exploratory and confirmatory factor analyses, measurement invariance by sex, and convergent and criterion-related validity with general health literacy. The J-eHEALS scores indicated moderate to slightly low perceived eHealth literacy in this population. The scale demonstrated excellent internal consistency (Cronbach’s α = 0.94), a stable unidimensional factor structure with acceptable model fit across sexes, and moderate positive associations with general health literacy. Overall, these findings support the J-eHEALS as a reliable and valid instrument for assessing perceived eHealth literacy in older Japanese adults and its suitability for use in research and practice.