European Journal of Investigation in Health, Psychology and Education

Background and Objectives: Errors generated by clinical artificial intelligence (AI) can obscure responsibility and complicate disclosure and incident reporting. This exploratory study examined AI-error liability literacy and its behavioral correlates among Romanian healthcare professionals. Materials and Methods: An exploratory, single-center cross-sectional survey was conducted from February to May 2026 among 109 clinical, managerial, legal/compliance, and IT/data professionals. No a priori sample-size calculation was performed; only moderate or larger effects were detectable. Participants completed a 20-item AI Error Liability Literacy Index and five-point behavioral measures. Analyses included Spearman correlations, k-means clustering, logistic regression, and covariate-adjusted mediation, with Firth penalization, role-adjusted, use-stratified, and competing-model sensitivity analyses, and bootstrap validation. Results: Mean liability literacy was 11.6 ± 4.2/20. Familiarity was higher for the General Data Protection Regulation (GDPR) (67.9%) than for the EU AI Act (24.8%). Literacy correlated with disclosure confidence (ρ = 0.49; 95% CI [0.33, 0.62]), an association that was attenuated but persisted after adjustment for professional role (partial ρ = 0.41), which correlated with adoption intention (ρ = 0.38), as did trust (ρ = 0.43); defensive stance correlated negatively (ρ = −0.31). Three exploratory profiles were identified (bootstrap Jaccard 0.71–0.82) that also differed on variables not used in clustering, and an indirect statistical association between literacy and adoption intention through disclosure confidence was observed (indirect effect 0.12; 95% CI [0.04, 0.22]), although concurrent measurement precludes causal or temporal interpretation. Under penalization, associations for literacy, trust, and disclosure confidence persisted; defensive stance and prior training did not. Conclusions: In this exploratory sample, adoption readiness was associated with regulatory knowledge, disclosure confidence, and calibrated trust. These hypothesis-generating findings require confirmation in larger, longitudinal studies before informing practice, and the appropriate goal is calibrated rather than maximal adoption.

Background: Cannabis is the most widely used illicit substance, particularly among youth. Earlier onset is associated with poorer clinical trajectories in cannabis use disorder (CUD), but its relationship with hedonic–motivational components remains unclear. Methods: Outpatients with severe CUD (n = 121) were stratified by age at onset (<18 vs. ≥18 years) and compared on hedonic–motivational functioning using the Snaith–Hamilton Pleasure Scale (SHAPS) and the Temporal Experience of Pleasure Scale (TEPS). Healthy subjects (n = 112) served as a reference group. Results: CUD groups were comparable in clinical characteristics and cannabis use patterns. TEPS-Anticipatory scores were lower in patients with onset before age 18 (p < 0.001) and remained associated with onset group after adjustment for gender, education, and CUD duration (p < 0.001). When healthy subjects were included, significant group effects were observed (p < 0.001). Post hoc comparisons confirmed reduced TEPS-Anticipatory scores in early-onset vs. both later-onset and control groups, and higher SHAPS scores in both CUD groups vs. controls. Conclusions: CUD onset before age 18 is associated with reduced anticipatory pleasure, suggesting a greater involvement of anticipatory than other dimensions of hedonic functioning. Age at onset may therefore help identify patients with greater motivational vulnerability and inform early, targeted prevention and intervention strategies.

Introduction: Suicidal ideation during pregnancy is an important public health concern. Psychological inflexibility may be associated with emotional and sleep-related symptoms linked to suicidal ideation; however, these patterns of association remain insufficiently understood in pregnant women. Objective: The objective was to examine the relationship between psychological inflexibility and suicidal ideation in pregnant women by evaluating the multiple mediating roles of depressive symptoms, insomnia, and generalized anxiety. Method: A quantitative, cross-sectional associative study using latent variables was conducted with 962 pregnant women receiving care at the National Maternal and Perinatal Institute (INMP), located in Cercado de Lima, Lima, Peru, between October and December 2025. Participants completed the Acceptance and Action Questionnaire-II (AAQ-II), Frequency of Suicidal Ideation Inventory (FSII), Athens Insomnia Scale (AIS), Patient Health Questionnaire-2 (PHQ-2), and Generalized Anxiety Disorder-2 (GAD-2). Structural equation modeling (SEM) was performed using R version 4.5.1 within the RStudio Version 4.5.1 environment. Results: The proposed model showed a good fit, scaled χ²(179) = 506.334, p < 0.001, robust CFI = 0.968, robust TLI = 0.963, robust RMSEA = 0.052, 90% CI [0.046, 0.057], and SRMR = 0.030. Psychological inflexibility showed a significant direct association with suicidal ideation (β = 0.246, p < 0.001) and significant indirect associations through depressive symptoms (β = 0.245, p < 0.001) and insomnia (β = 0.030, p = 0.007), whereas the indirect association through generalized anxiety was not significant (β = 0.007, p = 0.749). The total indirect association was significant (β = 0.282, p < 0.001), while the direct association remained statistically significant after inclusion of the mediators. Conclusions: Psychological inflexibility was associated with suicidal ideation among pregnant women, with depressive symptoms and insomnia showing significant indirect associations. These cross-sectional findings identify relevant correlates of suicidal ideation that warrant further longitudinal investigation.