European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16100165

Authors: Wen Xiao Suqun Liao

This study examined how maternal parenting stress and overparenting are associated with young children’s social–emotional competence using both variable-centered and person-centered approaches. A total of 445 mothers of young children completed measures of parenting stress, overparenting, and children’s social–emotional competence. Variable-centered analyses showed that positive experience was associated with children’s social–emotional competence through overparenting. Latent profile analysis identified three maternal parenting stress profiles based on different combinations of positive experience and strain, namely disengaged, engaged–high-strain, and engaged–low-strain. Children of mothers in the engaged–low-strain profile showed the highest levels of social–emotional competence, whereas those in the disengaged profile showed the lowest levels. Further analyses showed that the association between overparenting and children’s social–emotional competence differed across maternal stress profiles. This association was significantly stronger among mothers with high positive experience and low strain than among mothers experiencing high strain. These findings suggest that the association between overparenting and children’s development depends on mothers’ broader parenting stress profiles. They also highlight the importance of considering the heterogeneous and two-sided nature of maternal parenting stress when examining its implications for children’s social–emotional competence.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16100164

Authors: Annalisa Sarrecchia Nuccio Ludovico Alessandro Milani Valeria Chiozza Marino Bonaiuto

Prolonged environmental threats expose communities to recurring hazard cues and uncertainty, yet psychological consequences and resources involved in adaptation remain underexplored. This study examined psychological outcomes, personal and social resources, and their co-occurrence among inhabitants exposed to bradyseism in Campi Flegrei, southern Italy. Fifty-two semi-structured interviews were conducted with inhabitants of the Campi Flegrei area. Eighteen were recruited without reference to a specific stakeholder role, whereas 34 were recruited based on their institutional, professional, or community roles. Narratives were examined through theory-driven thematic analysis. Six psychological outcomes were considered, including five distress-related negative psychological outcomes (i.e., anxiety, post-traumatic symptoms, depression, sleep disturbances, and suicidal ideation) and one adaptive psychological outcome (i.e., post-traumatic growth). Distress was classified using literature-derived categories, while the Social-psychological Antecedents to Resilience for Adaptation (SARA) classified resources by locus, specificity, and availability. Anxiety-related experiences were most frequent, followed by post-traumatic stress-related experiences, depression-related experiences, and sleep disturbances; post-traumatic growth was rare, and no segments related to suicidal ideation were identified. Risk perception, experience, acceptance, cognitive reappraisal, and place attachment were frequently identified as available resources in narratives involving distress, whereas information emerged predominantly as unavailable and available social support was identified only once in the corpus. These resources co-occurred with manifestations of distress without revealing a consistent protective pattern. The findings document the coexistence of resources and distress without establishing the direction of their relationships or a protective role. Future research should clarify resource–distress directionality and examine whether perceived agency explains why some resource constellations coexist with persistent distress, whereas others are associated with more adaptive responses under prolonged environmental threat.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16100163

Authors: María J. Triguero-López M. Inmaculada Moreno-García Manuel Morales-Ortiz

Social anxiety and disordered eating frequently co-occur, but the psychological processes underlying this association remain unclear. This study examined concern over mistakes, a core dimension of maladaptive perfectionism, as a candidate shared transdiagnostic correlate of both domains. A cross-sectional sample of 890 participants aged 18–25 years (M = 20.02, SD = 1.94), including 338 women (38.0%), 546 men (61.3%), and 6 participants (0.7%) who did not report their sex, from vocational training and university settings in Spain, completed measures of social anxiety, disordered eating behaviours, and concern over mistakes. Structural equation modelling was used to examine two alternative structural specifications differing in the direction of the association between social anxiety symptoms and disordered eating behaviours. Both models showed acceptable and very similar descriptive fit (Model A: CFI = 0.947, TLI = 0.947, RMSEA = 0.044, SRMR = 0.064; Model B: CFI = 0.946, TLI = 0.947, RMSEA = 0.044, SRMR = 0.064). Across both alternative structural specifications, the associations among social anxiety symptoms, disordered eating behaviours, and concern over mistakes were statistically significant, including the indirect associations involving concern over mistakes. These findings suggest that concern over mistakes may represent a shared transdiagnostic cognitive correlate associated with both social anxiety symptoms and disordered eating, without supporting a specific causal direction.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16100162

Authors: Paulo Ferrajão Rebeca Fernandes Rocha Amadeu Quelhas Martins

Adverse childhood experiences are associated with trauma-related psychopathology, but individual differences in affective organization may contribute to heterogeneous outcomes. This study aimed to identify latent profiles of primary emotional systems and examine their associations with attachment, childhood maltreatment, and posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD). A community sample of 917 Portuguese adults completed measures of primary emotional systems, adult attachment, childhood maltreatment, and PTSD/CPTSD symptoms. Latent profile analyses were conducted separately for women and men, followed by measurement invariance testing and multinomial logistic regression analyses. Four profiles were identified in both sexes: Negative Affect, Low Affective Activation, Balanced Affective Functioning, and Positive Affect. Partial measurement invariance indicated sex-related differences in ANGER, FEAR, and PANIC, while the overall profile structure was comparable across sexes. Negative Affect was associated with PTSD, CPTSD, and fearful attachment in both sexes. Low Affective Activation was associated with CPTSD and dismissing attachment, with additional associations varying by sex. The findings indicate that primary emotional systems form heterogeneous configurations that are differentially associated with developmental, interpersonal, and clinical characteristics. Person-centered assessment may complement symptom-based approaches, although causal inference and profile stability cannot be established.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16100161

Authors: Alexandrina A. Grigoreva Ilya A. Fedotov Maksim P. Marachev Anastasia K. Kondratovich

Scars are the most durable consequence of non-suicidal self-injury (NSSI), but how patients appraise them, and how appraisal dimensions combine within individuals, remains unclear. In this cross-sectional study, 234 adults with a history of NSSI and at least one scar, recruited consecutively in Ryazan and Moscow, Russia, completed the Russian NSSI Scar Cognition Scale (Hopelessness, Shame, Inner Strength) and measures of suicidal ideation, social anxiety, rumination, body-image dysphoria and NSSI functions. Profiles were derived by cluster analysis and tested for stability. Three stable profiles emerged: low-salience (55.1%), negative-dominant (28.2%) and strength-dominant (16.7%). The negative-dominant profile showed the highest suicidal ideation, social anxiety, rumination, body-image dysphoria and self-punishment; the strength-dominant profile showed suicidal ideation and social anxiety similar to the low-salience profile, intermediate rumination and body-image dysphoria, and the strongest endorsement of NSSI functions. These differences persisted after covariate adjustment. Scar appraisal explained a further 7.9% of variance in suicidal ideation beyond demographics, self-injury status and general distress; scar visibility explained none. In behavioural remission, the negative-dominant profile reported higher suicidal ideation than the other profiles. Scar appraisal distinguishes subgroups with different clinical correlates. Longitudinal studies are needed to establish whether these profiles predict outcomes or can guide treatment.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16100160

Authors: Margaret E. Gruen Navika Mittal Peggy Gross Mariam A. Hamad Anika R. Kadumpalli Rebecca J. Harney David C. Dorman

Animal-assisted interventions (AAI) are increasingly used to support pediatric health, education, and psychosocial well-being. While most research has focused on dogs and horses, a growing body of literature has examined the use of other less traditional animal species. This scoping review mapped the existing evidence on non-traditional AAI in children and adolescents. Using a Population–Concept–Context framework, studies involving participants aged ≤18 years and non-traditional AAI were identified and reviewed. Data were extracted on intervention characteristics, animal species, populations, settings, outcomes, and study design. Forty-eight studies met inclusion criteria. Interventions involved diverse species, including dolphins, rabbits, guinea pigs, donkeys, goats, cows, cats, fish, reptiles, insects, turtles, giant snails, and elephants. Studies were conducted primarily in schools, therapy centers, farms, hospitals, and residential settings. Common populations included children with autism spectrum disorder, Down syndrome, developmental disabilities, anxiety, trauma-related experiences, and other health conditions. Outcomes are most frequently related to social communication, emotional well-being, anxiety, stress, self-esteem, cognition, and physical functioning. Although favorable outcomes were frequently reported, the studies varied considerably in design, populations, interventions, and outcome measures. Because the methodological quality and risk of bias of included studies were not formally assessed, conclusions regarding the efficacy or effectiveness of non-traditional AAI cannot be drawn from this review. The findings instead characterize the scope and diversity of the existing literature and identify areas for further investigation. The evidence base is characterized by small samples, methodological heterogeneity, and relatively few controlled studies, highlighting the need for more rigorous research.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16100159

Authors: Claudia Venuleo Paolo Colavero Silvia De Padova Monica Scotto Di Carlo

Living with cancer involves an ongoing effort to make sense of experiences that disrupt identity, relationships, and future expectations. Meaning-making is embedded in interpersonal and healthcare contexts, including psychosocial support settings where illness experiences are shared with others. This exploratory longitudinal study examined the evolving configuration of illness meanings in an oncology support group. Verbatim transcripts from 19 sessions involving 11 women with recent or ongoing cancer treatment were analyzed using Lexical Correspondence Analysis across four temporal blocks, with speaker roles as illustrative variables. Descriptive analyses of group climate, working alliance, and open-ended responses contextualized discursive findings. Two semantic dimensions organized group discourse: one contrasting illness as situated experience with experiential elaboration, and the other emotional elaboration with embodied experiences of safety. After Benzécri’s adjustment, the two dimensions accounted for 33.86% of the explained inertia. Their salience varied across temporal blocks rather than linearly. Illness-related meanings remained salient while becoming embedded within experiential, relational, and embodied configurations. Group process data indicated engagement, low conflict, and collaboration, while open-ended responses highlighted normalization, belonging, emotional safety, emotional resonance, coping resources, and facilitator support. The study contributes to process-oriented psycho-oncology research by examining how illness meanings are negotiated within a support-group.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16100158

Authors: Adem Peker Serkan Cengiz Yüksel Eroğlu Carlos Laranjeira Murat Yıldırım

Earthquakes can have substantial consequences for psychological well-being, including post-traumatic stress and depressive symptoms. Drawing on Acceptance and Commitment Therapy (ACT), which conceptualizes psychological flexibility as a central process in adaptive psychological functioning, this study examined the sequential mediating roles of psychological flexibility and positivity in the association between post-traumatic stress symptoms and depressive symptoms among survivors of the two major earthquakes that struck Türkiye on 6 February 2023. This cross-sectional study included 834 earthquake survivors (Mage = 26.7; 71.1% female) who were assessed approximately three months after the earthquakes. Participants completed validated self-report measures of post-traumatic stress symptoms, psychological flexibility, positivity, and depressive symptoms. Depressive symptoms were assessed using the 12-item depression subscale of the Brief Symptom Inventory and were analyzed as a continuous variable. Correlation and sequential mediation analyses were conducted, with indirect effects evaluated using bootstrapping. Post-traumatic stress symptoms were positively associated with depressive symptoms and negatively associated with psychological flexibility and positivity. Psychological flexibility was positively associated with positivity and negatively associated with depressive symptoms, while positivity was negatively associated with depressive symptoms. Sequential mediation analysis indicated that psychological flexibility and positivity mediated the association between post-traumatic stress symptoms and depressive symptoms. These findings suggest that psychological flexibility and positivity may represent relevant psychological processes in the association between post-traumatic stress and depressive symptoms among earthquake survivors and may inform post-disaster psychological support.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16100157

Authors: Jonathan Peñalver Hugo Figueiredo-Ferraz Wenceslao Unanue Deissy Johana Correa Estupiñán María del Pilar Gómez Carreño

Burnout is a prevalent occupational phenomenon with significant consequences for employee well-being. Although emotions have been studied in relation to burnout, less attention has been paid to their function as burnout outcomes and to the role of guilt as a boundary condition of this process. This study examined the relationships between burnout and positive and negative emotions at work, as well as the moderating role of guilt, from a cross-national and gender perspective. A sample of 857 employees (57.2% women; M age = 38.50 years) from Spain, Chile, Colombia, and Mexico completed validated measures of burnout (Spanish Burnout Inventory), emotions at work, and guilt. Structural equation modelling and multigroup analyses were conducted, complemented by moderation analyses using the PROCESS macro. Burnout was negatively associated with positive emotions and positively associated with negative emotions. Multigroup analyses supported strict invariance across gender and configural–metric invariance across countries. Guilt significantly moderated both relationships, such that the associations between burnout and emotional experiences were weaker at higher levels of guilt. At comparable levels of burnout, higher guilt was associated with less favorable predicted emotional levels, indicating that guilt shapes the strength, rather than the direction, of the burnout–emotion association. These findings position guilt as a boundary condition of the burnout–emotion association, with implications for burnout prevention and employee well-being interventions.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16100156

Authors: Tyrone C. Cheng Celia C. Lo

This study investigated relationships between low-income children’s food insecurity and five factors: social disorganization, social structural factors, social relationships, health/mental health, and access to services. A sample of 12,215 low-income children and parents was extracted from the 2021 National Survey of Children’s Health. Logistic regression results showed the likelihood of such children’s food insecurity to be associated positively with several factors: racial discrimination, child aged 6–10 years, child aged 11–13 years, child aged 14–17 years, Black child, child’s chronic health condition, family member mental health problem, Supplemental Nutrition Assistance Program participation, receipt of Special Supplemental Nutrition Program for Women, Infants, and Children, and lunch program participation. As well, children’s food insecurity likelihood was associated negatively with parents’ age and education, neighbor support, parents’ general health and mental health, and receipt of Temporary Assistance for Needy Families. Research implications include interventions at the individual level (e.g., screening for food insecurity, treatment of sick or mentally ill family members), community level (e.g., food pantries, neighbor support network), and macro level (e.g., advocating for racial/ethnic minorities, expanding cash and food benefits).

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16100155

Authors: Mónica Rego Sónia Caridade

Background: Cyber intimate partner violence (C-IPV) refers to abusive and controlling behaviors enacted through digital technologies toward a current or former intimate partner. Previous research suggests that pathological narcissism may be associated with C-IPV. Methods: This study examined the psychometric properties of the Brief Pathological Narcissism Inventory (B-PNI), the frequency of self-reported C-IPV perpetration and related behaviors, and the association between C-IPV perpetration and pathological narcissism among emerging adults. The sample comprised 371 participants aged 18–25 years (M = 21.52, SD = 1.97), of whom 78.7% were female. Results: Confirmatory factor analysis provided support for the a priori two-factor model of the B-PNI (CFI = 0.982, TLI = 0.965, RMSEA = 0.076), comprising grandiose and vulnerable narcissism. The B-PNI showed satisfactory internal consistency and theoretically expected associations with psychopathological symptoms and broader personality dimensions. Overall, 79.5% of participants reported at least one C-IPV behavior, with 61.5% reporting online control, 62.0% online jealousy, and 31.5% online intrusive behaviors. C-IPV perpetration was positively and significantly associated with both grandiose and vulnerable narcissism, although the associations were small in magnitude. Conclusions: The findings provide preliminary support for the use of the B-PNI among Portuguese emerging adults and indicate that pathological narcissism is associated with C-IPV perpetration. Given the modest magnitude of these associations, narcissistic traits should be considered as one of multiple individual and relational factors potentially involved in C-IPV.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16100154

Authors: Víctor Juan Vera-Ponce Fiorella E. Zuzunaga-Montoya María Julia Cómina-Tamayo Darwin A. León-Figueroa César Iván Guerrero Uceda Oriana Rivera-Lozada Jhosmer Ballena-Caicedo Holly Estrella Delgado-Toro Mario J. Valladares-Garrido

Background/Objectives: In health sciences students, academic procrastination can affect performance, mental health, and professional development. This systematic review and meta-analysis aimed to estimate the pooled prevalence of study-defined elevated academic procrastination among health sciences students and to describe the methodological and measurement characteristics of the instruments used to assess it. Methods: A systematic review with meta-analysis was conducted. We included observational studies reporting the prevalence of academic procrastination among undergraduate students enrolled in health sciences programs, including medicine, nursing, dentistry, psychology, and related health professions. The reported measurement characteristics of the instruments used to assess academic procrastination, including validity, reliability, and cut-off criteria, were reviewed and systematized. The meta-analysis was performed employing a random-effects model and the double arcsine transformation (Freeman–Tukey) to stabilize variance. Subgroup analyses and meta-regressions were calculated to explore possible sources of variation. Results: Twenty-six studies were included with a total of 8211 students. The pooled prevalence of study-defined elevated academic procrastination was 55.35% (95% CI: 46.55–63.98%, I2 = 98%). The prevalence was higher in nursing students (62.60%), followed by psychology (61.67%), medicine (52.62%), and dentistry (45.76%). The most commonly used instruments were the Procrastination Assessment Scale for Students (38.5%), Academic Procrastination Scale (23.1%), Tuckman’s Procrastination Scale or its adaptations (15.4%), Academic Procrastination Scale by McCloskey and Scielzo or related APS versions (11.5%), Lay’s Procrastination Scale (7.7%), and MHCA (3.8%). Most studies used non-probabilistic sampling, and only 8% validated instruments specifically for their target populations. Reliability coefficients were generally adequate (α = 0.75–0.95). The meta-regression revealed a slight upward trend in prevalence as a function of publication year, although this was not statistically significant. Conclusions: Academic procrastination appears to be frequent among health sciences students; however, the pooled estimate should be interpreted as a descriptive summary of study-defined prevalence rather than as a universal prevalence estimate, given the very high between-study heterogeneity and the variability in instruments, cut-off criteria, and population-specific validation. Educational institutions should implement prevention and support strategies, while research should prioritize instrument validation, measurement standardization, and transparent case definition criteria.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16100153

Authors: Daian-Ionel Popa Ciprian Gîndac Florina Buleu Rotaru Roxana Elena Codrina Mihaela Levai

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.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16100152

Authors: Maria Pepe Francesco Traccis Giuseppe Mandracchia Marco Massetti Martina Platia Isabella Panaccione Raffaella Franza Gabriele Sani Marco Di Nicola

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.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16100151

Authors: Jonatan Baños-Chaparro Juan Artica-Martinez Tomás Caycho-Rodríguez

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.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16100150

Authors: Ahmed Mohamed Hasanein Bassam Samir Al-Romeedy Hazem Ahmed Khairy Nadir Aliane

Grounded in Social Cognitive Theory, this study examines the association between ChatGPT-assisted learning effectiveness and students’ academic performance, emphasizing the mediating roles of cognitive engagement and academic self-efficacy. Data were collected from tourism and hospitality students at Egyptian universities. Findings indicate that perceived ChatGPT-assisted learning effectiveness is positively associated with students’ academic performance, cognitive engagement, and academic self-efficacy. Cognitive engagement and academic self-efficacy also show significant positive associations with academic performance, and both constructs significantly mediate the relationship between ChatGPT-assisted learning effectiveness and academic performance. These findings suggest that the educational value students attribute to ChatGPT may operate through complementary cognitive and motivational pathways, while the cross-sectional design prevents causal conclusions.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16100149

Authors: Jairo Rodríguez-Medina Carlota Alcover Van de Walle Paula San Martín González Clara González-Sanguino

Mental health literacy (MHL) plays a crucial role in the early identification, management, and prevention of mental health problems, especially among young adults. For future health and education professionals, robust MHL is a foundational component of clinical readiness, ensuring they are adequately prepared to recognize early signs of psychological distress, mitigate stigma, and facilitate timely referrals in healthcare and community settings. This study aimed to examine the internal structure and psychometric properties of the Mental Health Literacy Questionnaire for Young Adults (MHLq-YA) within a Spanish university population. An initial sample of 425 university students enrolled in Nursing and Education programs was recruited. Following data screening for invariant and aberrant responding, the final analytical sample comprised 416 participants. Confirmatory Factor Analysis (CFA) supported a four-factor structure (Knowledge, Stereotypes, Help-Seeking, and Self-Help) with an adequate and structural fit to the data, supporting its multidimensionality with an adequate model fit (CFI = 0.949, TLI = 0.944, RMSEA = 0.068). Evidence of convergent and discriminant validity was observed in three of the four dimensions, while the relationship between Knowledge and Self-Help warranted theoretical interpretation. Convergent validity was supported for three dimensions (Stereotypes, Help-Seeking, and Self-Help), whereas the Knowledge dimension showed comparatively weaker convergent validity (AVE = 0.436). Discriminant validity was supported for all factor pairs under the HTMT criterion, although the stricter Fornell–Larcker criterion was not met for the Knowledge–Self-Help pair, reflecting a conceptual and empirical overlap between these two dimensions that is discussed as a structural limitation of the model. Item Response Theory (IRT) analyses revealed high measurement precision in the lower and moderate ranges of the latent traits, particularly for the Help-Seeking and Self-Help subscales. Ceiling effects and cross-loadings in specific items were resolved through a stepwise model re-specification. The final 26-item version demonstrated robust psychometric performance. These findings support the MHLq-YA as a valid and reliable tool for assessing mental health literacy in academic settings. Crucially, it allows educators to identify gaps in clinical preparedness before students interact with actual patients or vulnerable populations. Ultimately, these results inform targeted interventions to improve mental health awareness, help-seeking behavior, and the overall quality of future clinical care provided by university students.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16100148

Authors: Zhixian Lian Mengting Zhang Zeyu Liu Xue Dou

Problematic social media use (PSMU) has become a growing concern worldwide, highlighting the need for reliable and culturally valid assessment tools to examine its psychological correlates. However, comprehensive psychometric evaluations of PSMU measures in the Japanese context remain limited. The present study aimed to develop and validate the Japanese version of the Bergen Social Media Addiction Scale (BSMAS-J) among Japanese college students. A total of 314 undergraduate students completed the BSMAS-J, along with the Internet Addiction Test (IAT), the Behavioral Inhibition and Behavioral Activation Scales (BIS/BAS), and the Ten-Item Personality Inventory (TIPI-J). Of these, 257 participants completed a follow-up assessment 4 weeks later. To rigorously evaluate the factor structure, an independent split-sample cross-validation approach was employed, with exploratory factor analysis conducted on one subsample (n = 100) and confirmatory factor analysis on the other (n = 214). Results confirmed a robust unidimensional structure with good model fit, high internal consistency across waves (Cronbach’s α 0.89, McDonald’s ω 0.91), and moderate 4-week test–retest reliability (ICC = 0.65). Furthermore, evidence supported both longitudinal and multigroup sex measurement invariance. Convergent validity was established through strong positive associations with generalized internet addiction. Multiple regression analysis indicated that female sex, higher neuroticism, and elevated behavioral inhibition predicted BSMAS-J scores, highlighting potential avoidance-oriented coping mechanisms. Overall, the BSMAS-J demonstrates sound psychometric properties as a brief and reliable assessment tool, establishing a solid empirical foundation for future cross-cultural and longitudinal investigations in Japan.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16100147

Authors: Raaya Alon Ayelet Harel-Gadassi

Emerging adulthood is marked by increasing independence and responsibility across educational, occupational, and social domains. During wartime, disruptions to daily routines, security, and perceived control may threaten mental well-being, understood as positive emotional, social, and psychological functioning. These challenges may be particularly salient for individuals with specific learning disabilities (SLD) and/or attention deficit hyperactivity disorder (ADHD), who may experience difficulties in executive functioning and maintaining everyday routines. This study examined differences in mental well-being between emerging adults with and without SLD and/or ADHD and assessed the contributions of executive functioning, health-promoting daily activities, psychological capital, and perceived social support during wartime. Participants were 317 Israeli emerging adults aged 18–28 years. Among the 316 participants with valid diagnostic-group classification, 115 reported SLD and/or ADHD and 201 reported neither condition. Emerging adults with SLD and/or ADHD reported lower mental well-being, greater executive functioning difficulties, and lower engagement in health-promoting daily activities than those without SLD and/or ADHD. Mental well-being was positively associated with psychological capital, health-promoting daily activities, and perceived social support, and negatively associated with executive functioning difficulties. In the hierarchical regression, diagnostic-group status was initially associated with mental well-being but was no longer significant after psychological capital, health-promoting daily activities and executive functioning were entered; perceived social support made a small additional contribution. The final model explained 37.2% of the variance in mental well-being. These findings highlight the relevance of cognitive-functional, psychological, occupational, and social factors to mental well-being during a prolonged national crisis.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16100146

Authors: Diana Ramos-Camino Camila Miño José Adrián Montenegro-Espinosa Fiorella Quiroz-Cárdenas Lucille Ridgell Rodrigo Yáñez-Sepúlveda Jorge Olivares-Arancibia Jacqueline Páez-Herrera Dong Keon Yon José Francisco López-Gil

Body dissatisfaction is prevalent among adolescents and linked to adverse outcomes. This study examined sociodemographic and anthropometric factors associated with body dissatisfaction in Spanish adolescents. Cross-sectional data from the Eating Healthy and Daily Life Activities (EHDLA) study (N = 1378 students aged 12–17 years) were analyzed. Body dissatisfaction was assessed using the Body Image Dimensional Assessment (BIDA) instrument (overall index and three subscales). Variables included age, sex, socioeconomic status, immigrant status, family structure, parental education, area of residence, and body mass index. Robust multivariable linear models adjusted for all a priori covariates were fitted. Multivariable complete-case models included n = 747 of 1378 adolescents. Younger age, female sex, and excess weight were associated with higher body dissatisfaction on one or more BIDA dimensions. Excess weight showed the largest standardized associations and was linked to all BIDA dimensions (p < 0.001). Maternal educational attainment was not significant in the fully adjusted primary models but remained associated with lower Body Dissatisfaction Score in a reduced-model sensitivity analysis. No significant associations were observed for socioeconomic status, immigrant status, family structure, or area of residence in the primary models. Younger adolescents, female adolescents, and those with excess weight represent subgroups at greater risk of body dissatisfaction. These findings underscore the need for targeted prevention and intervention strategies addressing both anthropometric and sociodemographic risk factors during adolescence.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16090145

Authors: Enma T. Huaman-Chulluncuy Verónica Luna-Ccoa Arturo Zuñiga-Blanco Máximo Córdova Huamaní Juan Huillca Ochoa

Risk perception regarding air pollution in Andean urban environments poses significant challenges to psychological well-being, highlighting the emergence of climate anxiety. Despite this, evidence on how cognitive appraisals of environmental and health risks predict this distress in vulnerable communities remains scarce. This study analyzed the explanatory capacity of environmental risk perceptions and perceived health effects on the variance of climate anxiety among residents of hillside communities in an Andean region of Peru. Using a quantitative, cross-sectional, and analytical design, 205 participants selected by quota sampling were assessed. Validated scales were applied to measure risk perception (individual and social), perceived health effects, climate anxiety, and sociodemographic factors. Hierarchical linear regression analyses revealed that individual risk perception, perceived symptoms and discomfort, as well as health concerns and the adoption of preventive measures, exhibited positive and statistically significant associations with climate anxiety, demonstrating greater explanatory power than sociodemographic variables. The final model explained 34.3% of the variance in climate anxiety (R2 = 0.343; adjusted R2 = 0.316), representing a moderate explanatory capacity. Furthermore, significant differences were identified based on gender, educational level, and type of residence (native vs. migrant). It is concluded that climate anxiety in vulnerable urban communities is not an abstract concern, but rather an internalized emotional response. This distress is intensified by immediate somatic experience, the proximal interpretation of atmospheric threats, and the subjective experience of risk at the individual level.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16090144

Authors: Latefa Ali Dardas Amal Abuabada Amjad Al-Khayat Firas Al-Mahasneh Belal Aldabbour

Background: Medical students who volunteer during armed conflict may help sustain overwhelmed health services while experiencing concurrent social, academic, psychological, and physical consequences. However, no context-sensitive instrument has been available to assess these multidimensional benefits and burdens in active conflict settings. This study primarily aimed to develop and conduct an initial psychometric evaluation of the Volunteering Impact Scale (VIS) among medical students volunteering in Gaza and, secondarily, to characterize their volunteering experiences. Methods: A cross-sectional survey was conducted among 169 medical students who volunteered in hospitals in Gaza during the ongoing war. An initial 28-item pool was generated from a focused literature review, relevant theoretical frameworks, and consultations with Gaza-based medical students and clinicians. A multidisciplinary team reviewed the items for relevance, clarity, redundancy, and contextual appropriateness. Following item refinement and psychometric evaluation, the final 16-item VIS comprised five domains: social impact, mental burden, physical burden, academic development, and wellbeing and fulfillment. Its structure was assessed using exploratory factor analysis with principal axis factoring and Promax rotation, followed by confirmatory factor analysis. Internal consistency and convergent and discriminant validity were also examined. Domain scores and their associations with participant, volunteering, and war-exposure characteristics were subsequently analyzed. Results: Exploratory factor analysis revealed a five-factor structure explaining 51.2% of the variance. Parallel analysis favored three factors, whereas a theoretically informed five-domain solution was retained for further evaluation. Primary factor loadings ranged from 0.23 to 0.89. Most items met the prespecified loading criterion of 0.40; however, three Social items demonstrated weaker loadings and were retained provisionally because of their conceptual relevance to the construct. Confirmatory analysis provided support for the proposed measurement structure (RMSEA = 0.059, SRMR = 0.075, CFI = 0.911, and TLI = 0.888). Cronbach’s alpha coefficients ranged from 0.64 to 0.75, and discriminant validity was supported by heterotrait–monotrait ratios below 0.85. Participants reported perceived social (M = 4.31/5), academic (M = 4.19), and wellbeing-related (M = 3.96) benefits. Mean reverse-scored Mental and Physical scores were 2.71 and 2.60, respectively, with lower scores indicating greater burden. Longer volunteering was associated with greater physical strain but also with stronger academic and wellbeing outcomes. Conclusions: The VIS demonstrated a conceptually coherent five-domain structure and promising initial psychometric properties for assessing the concurrent benefits and burdens of healthcare volunteering in a war-affected setting. Further validation in independent and more diverse samples is required. The findings also indicate that volunteer programs should combine meaningful clinical participation with structured supervision, recovery time, role rotation, and context-sensitive psychosocial support.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16090143

Authors: Sandra Lizzette León Luyo Heyner Yuliano Marquez-Yauri Christian David Corrales Otazú Sarita Jessica Apaza Miranda César Pol Arévalo-Aranda Marcos Marcelo Flores Castillo Luisa Angélica Orejuela Guerrero César Augusto Guzmán Valle Marco Agustín Arbulú Ballesteros Ana Elizabeth Paredes Morales

University students’ adoption of generative artificial intelligence has become nearly universal, yet institutional guidance has not kept pace, leaving responsible use dependent on students’ own self-regulation. Drawing on social cognitive theory, this study examined whether self-regulated learning accounts for the association between AI literacy and self-reported responsible use of generative AI, and how technostress relates to that association. A cross-sectional survey of 820 Peruvian undergraduates from public and private universities was analyzed using covariance-based structural equation modeling; a two-stage moderated mediation model with latent interactions was estimated using latent moderated structural equations. Measurement invariance held across gender and university type, and the available diagnostics did not indicate a dominant common-method factor. AI literacy predicted self-regulated learning (β = 0.626) and responsible use (β = 0.243), and self-regulated learning predicted responsible use (β = 0.445). The indirect effect was significant, β = 0.278, 95% CI [0.226, 0.337], accounting for 53.4% of the total effect. Technostress showed no significant moderation of the first stage or the direct path, but the second-stage path was significantly weaker at higher levels of technostress (b2 = −0.211, p < 0.001): the conditional indirect effect was 0.344 at low and 0.111 at high technostress and was not statistically distinguishable from zero above the estimated region-of-significance boundary of +1.40 SD. Technostress was not associated with weaker self-regulation, but with a weaker association between self-regulation and its behavioural expression. Because the design is cross-sectional, all estimates are reported as associations.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16090142

Authors: Alexis Serna-Menor Juan Pablo Hervás-Pérez José Antonio Guerra-Guirao Cibeles Serna-Menor Gema Mata-González Andrés García-Notario María Arnazazu Sánchez-Calabuig Ivan Herrera-Peco

Humanized healthcare depends on professionals’ capacity to communicate empathically, respond compassionately, and establish therapeutic relationships. This globally focused systematic review aimed to synthesize comparative evidence on educational and professional development interventions designed to strengthen humanistic and relational practice among patient-facing healthcare professionals across international healthcare contexts. MEDLINE via PubMed, Scopus, Web of Science Core Collection, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched. Comparative intervention studies involving practicing healthcare professionals were included. Findings were synthesized narratively by relational domain and assessment source. Risk of bias was evaluated using the revised Cochrane risk-of-bias tool for randomized trials (RoB 2), its extension for cluster-randomized trials, and the Risk Of Bias In Non-randomized Studies of Interventions Version 2 (ROBINS-I V2). Thirty-five reports representing 33 independent studies were included. Reports addressed clinical empathy and emotional responsiveness (n = 22); compassion, caring, and humanistic practice (n = 7); and trust, rapport, and therapeutic relationships (n = 6). Favorable effects were most consistent for proximal professional outcomes, including self-reported empathy, compassion, caring competence, confidence, and self-efficacy. Several studies also reported improvements in specific observed communication behaviors. However, patient- and family-reported outcomes were less frequently assessed and showed less consistent favorable between-group differences. Longer-term maintenance was also uncertain. Most individually randomized trials raised some concerns about risk of bias (13/19), while the two cluster-randomized trials were judged as having some concerns and high risk, respectively; all 12 nonrandomized comparative studies were at serious risk of bias. Educational interventions may strengthen selected relational competencies, but evidence of sustained transfer to routine practice, patient experience, trust, and therapeutic alliance remains limited and heterogeneous.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16090141

Authors: Melany León-Méndez Iván Padrón Ascensión Fumero Lilisbeth Perestelo-Pérez Rosario J. Marrero

Background: Problematic Social Media Use (PSMU) and Internet Gaming Disorder (IGD) are online behaviors associated with adverse psychosocial outcomes in young adults. However, person, affective, cognitive, and executive correlates of these behaviors remain insufficiently examined. This study examined I-PACE (Interaction of Person–Affect–Cognition–Execution) model dimensions associated with PSMU and IGD, and their co-occurrence in young adults from dimensional and categorical perspectives. Methods: A total of 1586 students (68.9% female; M = 20.42 years, SD = 2.41) completed self-report measures assessing PSMU, IGD, personality traits, emotion regulation difficulties, decision-making styles, and executive functioning. Results: Overall, 17.97% screened positive for PSMU, 16.02% for IGD, and 10.65% for both behaviors. In the entire sample, PSMU and IGD were both related to lower conscientiousness, difficulties in goal-directed behavior, non-acceptance of negative emotions, and emotional and executive control deficits. PSMU was additionally related to extraversion, limited access to effective emotion regulation strategies, and dependent decision-making style, whereas agreeableness, impulse control difficulties, and social behavior control deficits were related to IGD. From a categorical perspective, executive deficits were associated with higher PSMU symptomatology, whereas lower agreeableness and conscientiousness, greater difficulties in goal-directed behavior, and a lower tendency to use an intuitive decision-making style were related to higher IGD symptomatology. Among participants with co-occurring PSMU and IGD, lower agreeableness, lower openness to experience, and greater difficulties in goal-directed behavior were associated with higher PSMU and IGD symptoms. Dependent decision-making was additionally associated with higher PSMU symptoms. Furthermore, mean comparisons revealed that the PSMU and IGD co-occurring group showed higher levels of neuroticism, emotion dysregulation, spontaneous/avoidant decision-making styles, and executive, emotional, and social behavior control deficits than single-behavior groups. Conclusions: The findings suggest partially distinct patterns of association between person, affective, cognitive, and executive dimensions, depending on whether problematic online behaviors were considered from a dimensional or categorical perspective. These exploratory results require longitudinal replication and validation in clinical samples and in samples from other cultures, or from different developmental stages.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16090140

Authors: Ibrahim A. Elshaer Alaa M. S. Azazz Chokri Kooli

As smartphones become progressively embedded in students’ social, academic, and personal lives, concerns have been raised about the emotional consequences of nomophobia (no-mobile-phone phobia). Although previous research has shown an overall correlation between nomophobia and increased mental health symptoms, little is known about whether its main dimensions exerted differential associations with different mental health symptom dimensions or whether sleep quality can influence these relationships. Addressing these gaps, this research tested the associations between four dimensions of nomophobia—Not Being Able to Communicate (NBAC), Losing Connectedness (LC), Not Being Able to Access Information (NBAI), and Giving Up Convenience (GUC)—and three mental health symptoms: depression (Dprtn), anxiety (Enzt), and stress (Strs), while testing the moderating role of sleep quality (SQ) among university students. Drawing upon Conservation of Resources (COR) Theory and Self-Determination Theory (SDT), a quantitative cross-sectional survey was conducted among 980 university students. The proposed research model was analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM). The results demonstrated that the psychological consequences of nomophobia are dimension-specific rather than homogeneous. LC emerged as the most consistent predictor, showing significant positive associations with depression, anxiety, and stress. In contrast, NBAC was not significantly associated with any of the three mental health outcomes. NBAI showed mixed effects, with a significant positive association with depression, a significant negative association with anxiety, and no significant association with stress. GUC was significantly and positively associated with depression, anxiety, and stress. Furthermore, sleep quality functioned as a selective moderator, with significant interaction effects for SQ × NBAC on depression and anxiety, SQ × NBAI on depression, and SQ × GUC on depression and stress. No significant moderation effects were observed for the remaining hypothesized interactions. These findings highlight the dimension-specific nature of nomophobia and indicate that the role of sleep quality varies across the specific nomophobia dimension and the mental health outcome considered.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16090139

Authors: Adelinda Araújo Candeias

The Emotional Quotient Inventory: Youth Version (EQ-i:YV) assesses how young people perceive their emotions, relationships, coping with pressure, adaptability, and general mood. We evaluated whether its five domains provide a coherent yet differentiated representation of emotional-social functioning in 931 Portuguese participants aged 8–16 years. Responses to 54 substantive items were analysed as ordered categories in stratified exploratory and confirmatory subsamples. A restrictive five-factor confirmatory factor analysis did not adequately represent the response pattern, whereas a five-domain Target-ESEM that allowed small associations with related competencies provided a better and internally replicated representation. Domain reliability was adequate to strong (ordinal α = 0.744–0.865; ω = 0.760–0.866). Although the overall composite was reliable, variance attributable to one general factor was only moderate (ωH = 0.592), and the higher-order solution was unstable. The Portuguese EQ-i:YV should therefore be interpreted primarily through its five-domain profile. A global score, when required for descriptive continuity, should be presented only as a secondary multidimensional summary alongside the domain scores.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16090138

Authors: Carlos Santiago-Torner Elisenda Tarrats-Pons José-Antonio Corral-Marfil

This scoping review examines how leadership shapes employees’ mental health in disruptive, uncertain organizational contexts between 2020 and 2025. Following PRISMA-ScR guidelines, a systematic search across Web of Science, Scopus, PubMed, and PsycINFO yielded 43 eligible sources (30 empirical, 13 conceptual/theoretical). Data were extracted and synthesized through critical interpretive synthesis. Findings indicate that transformational, ethical, servant, inclusive, and health-oriented leadership are associated with favorable well-being outcomes and with psychosocial resources including psychological safety, trust, and psychological capital. Conversely, authoritarian, toxic, destructive, and laissez-faire leadership are associated with burnout, psychological distress, organizational silence, and turnover intentions. Building on these observed associations, the interpretive synthesis generates three theoretically plausible propositions: leaders’ emotional regulation may condition the protective potential of prosocial leadership; resource depletion under disruption may contribute to the intensification of dysfunctional leadership; and psychological safety, trust, and psychological capital may operate as interconnected mechanisms linking leadership with emotional exhaustion and resilience. These propositions represent synthesis-generated relationships requiring direct empirical testing rather than effects established by the reviewed evidence. Synthesizing these insights, this review proposes a dynamic emotional regulation framework of leadership under disruption. Rather than viewing leadership through static styles, the framework conceptualizes it as a relational, context-sensitive process whose implications for occupational mental health depend on psychosocial and contextual conditions.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16090137

Authors: Eva Roy Alain Guerrien Claire Arnaud Rachel F. Rodgers Amélie Rousseau

Body functionality is a promising target for the promotion of positive body image. However, research on body functionality in French-language contexts is currently limited due to the lack of validated assessment tools. This study aims to translate and evaluate the psychometric properties of the French versions of the Functionality Satisfaction Scale (FSS) and the Functionality Intent Scale (FIS). Exploratory factor analyses were conducted in a sample of 528 French adults (study 1), revealing a two-factor structure for both the FSS and FIS. Participants also completed validated measures of positive body image (functionality appreciation, body appreciation, and body esteem). A subsample (n = 150) completed the FSS and FIS again, three weeks later. Results supported convergent and divergent validity, good internal consistency, and satisfactory test–retest reliability. A second sample of 272 French adults was recruited for confirmatory factor analyses (study 2). Results confirmed the eight-item, two-factor solution for the FSS. However, support was found for a unidimensional structure of the FIS, which was ultimately retained as a four-item, one-factor scale. Measurement invariance analyses supported gender and age invariance up to the scalar level, but not at the strict level, for the FSS. The FIS also showed configural, metric, and scalar invariance across gender, whereas the scale was invariant across age only up to the metric level. This study provides support for the FSS as a useful tool for research focused on body functionality in French populations. Although the FIS demonstrated promising psychometric properties, it still requires further independent cross-validation to confirm its unidimensional structure.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16090136

Authors: Henrique Pereira

Loneliness among older men may remain unrecognized when unwanted relational disconnection is not explicitly named as loneliness. This qualitative longitudinal, multimethod study examined how 32 community-dwelling men aged 60 years and older in Lisbon, Portugal, experienced, interpreted, and communicated relational disconnection between January and July 2025. Data were generated through narrative life-history interviews, participant-generated photographic, audio, or written diaries, elicitation interviews, and follow-up interviews. Six interrelated themes were developed and interpreted processually as disruptions and absences, forms of disconnection, identity-protective meaning-making, and responses. The analysis distinguished topics deliberately elicited by the design from empirical refinements and unanticipated temporal or material insights. The four processes initially used to sensitize inquiry—nonrecognition, linguistic substitution, identity protection, and relational concealment—were therefore not treated as discoveries; the data clarified their boundaries, interactions, and reversibility. Four longitudinal patterns were used as non-exclusive interpretive summaries rather than participant classifications. The most distinctive findings were that connection depended not only on contact but on relational consequentiality—being expected, needed, consulted, and able to contribute—and that greater willingness to name loneliness could reflect interpretive change rather than worsening symptoms. Unnamed loneliness was inferred only where participants described unwanted relational disconnection; chosen and satisfying solitude was excluded. Responses should foster emotionally safe, reciprocal, and meaningful relationships while protecting autonomy.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16090135

Authors: Ana María Morales-Rodríguez Francisco Manuel Morales-Rodríguez

University students are increasingly exposed to academic and emotional demands associated with burnout and psychological distress in contemporary higher education contexts. Objective: This study examined academic-context well-being indicators, multidimensional happiness and global life satisfaction among university students in Spain and Germany, as well as their associations with burnout and compassion-related variables. Methods: A quantitative, cross-sectional study with exploratory between-sample comparisons was conducted using a convenience sample of university students from both countries. Measures assessing academic-context well-being indicators, global life satisfaction, multidimensional happiness, burnout-related dimensions and compassion-related variables were administered. Analyses included descriptive statistics, Pearson correlations, gender comparisons and exploratory between-sample observed-score comparisons using Welch’s independent-samples t-tests with Holm adjustment for multiple comparisons. Results: Descriptive findings indicated positive scores on several well-being indicators alongside burnout-related strain. Global life satisfaction was positively associated with dimensions of happiness and inversely associated with burnout-related indicators. No significant gender differences were observed. After Holm adjustment, statistically significant observed-score differences between the two samples remained for 10 of the 17 indicators examined. The largest differences were observed for compassion satisfaction, ProQOL burnout and expected job satisfaction. Conclusions: The exploratory comparisons indicated a domain-specific pattern of observed-score differences between the Spanish and German samples rather than a general well-being advantage for either group. The results highlight the relevance of promoting student well-being and addressing burnout-related strain while considering the contextual characteristics of different university settings.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16090134

Authors: Georgios Giannakopoulos Aikaterini Fostini Renati Marinou Varvara Salavou

Adolescents’ perceived security in relationships with parents and peers relates to psychosocial adjustment, yet the psychometric performance of the Inventory of Parent and Peer Attachment (IPPA) has not been examined in Greece. This study evaluated the Greek IPPA in a non-probability sample of 432 adolescents aged 12–16 years from five schools in Attica (Greece). Internal consistency, item-level analyses, floor and ceiling effects, and one-factor, two-factor, correlated three-factor, and bifactor models were examined using ordinal WLSMV estimation. Relations with Strengths and Difficulties Questionnaire scores were assessed. Parent Total Security and Peer Total Security showed high internal consistency (α = 0.94 and 0.93, respectively; ω = 0.94 for both). The correlated three-factor model showed acceptable fit for the parent form and weaker fit for the peer form, while Trust and Communication were highly correlated in both forms. Bifactor indices indicated substantial general-factor saturation, although the specific Trust factors were poorly defined. Higher total security scores were associated with fewer psychosocial difficulties. Overall, the parent and peer total scores appear more defensible than the separate subscales for preliminary, group-level descriptive use in similar samples, whereas subscale interpretation, particularly distinctions between Trust and Communication, should remain cautious. These findings require independent replication and do not support individual clinical decision-making or the identification of attachment classifications, attachment disorders, or disorganization.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16090133

Authors: Fatima Al-Ghadban Ahmad Salman

Background: Perceived social support is consistently associated with lower psychological distress among university students, but the strength of this association may vary. We examined whether help-seeking self-stigma modifies it. Methods: In a cross-sectional online survey, 507 Kuwait University students completed the Patient Health Questionnaire-4 (PHQ-4), the Multidimensional Scale of Perceived Social Support (MSPSS) and the Self-Stigma of Seeking Help Scale (SSOSH). Hierarchical linear regression tested the perceived support × self-stigma interaction, adjusting for age, sex, nationality and year of study; SSOSH structure was examined by confirmatory factor analysis. Results: Of 507 eligible students (80.9% female; mean age = 21.4 years, SD = 4.4), 458 had complete PHQ-4 data. The inverse association between perceived support and distress weakened as self-stigma increased (B = 0.003, 95% CI 0.001–0.005, p = 0.007; p = 0.040 with heteroscedasticity-consistent standard errors; ΔR2 = 0.015) and was not detectable at high self-stigma. The Arabic SSOSH was not unidimensional: positively and reverse-worded items formed uncorrelated factors (r = −0.01), and the interaction was carried by the reverse-worded items. Conclusions: Help-seeking self-stigma may index variation in this association, but the finding is exploratory and constrained by the measurement properties of the SSOSH in this population.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16090132

Authors: Laura Elvira Prino Donatella Scarzello

Maternal technoference has increasingly been recognized as a factor that may compromise mothers’ emotional availability and the quality of mother–child interactions, particularly during early childhood, when responsive caregiving and co-regulation play a pivotal role in children’s development. However, the psychological mechanisms underlying this phenomenon remain poorly understood. Maternal loneliness may represent an important vulnerability factor, although the processes linking loneliness to technoference have yet to be clarified. This study examined whether nomophobia and social media addiction mediate the association between maternal loneliness and technoference. This cross-sectional study included 355 Italian mothers of children aged 0–6 years, who completed measures of loneliness (UCLA 3-item Loneliness Scale), nomophobia (NMP-Q), social media addiction (BSMAS), and technoference (DISRUPT). A parallel mediation model was tested while controlling for maternal age. Loneliness was positively associated with both nomophobia and social media addiction, which were, in turn, positively associated with technoference. Both indirect effects were significant, whereas the direct association between loneliness and technoference was no longer significant. These findings suggest that maternal loneliness may be associated with technoference through its link with nomophobia and social media addiction, highlighting the importance of understanding technoference as a relational phenomenon rather than merely a consequence of technology use.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16090131

Authors: Sergey Malykh Valeriia Demareva Victoria Ismatullina Timofey Adamovich Tamara Malykh Tatiana Tikhomirova

Post-COVID symptoms frequently include cognitive complaints, yet evidence on objectively measured cognitive performance in large samples of young adults remains limited. This study examined associations between self-reported post-COVID consequences and objective cognitive performance in university students, with particular attention to acute COVID-19 severity. The sample comprised 7482 students aged 17–23 years: 3945 reported no previous COVID-19, 1676 reported previous COVID-19 without post-COVID consequences, and 1861 reported previous COVID-19 with post-COVID consequences. Visuospatial working memory was assessed using the Corsi Block Tapping Test (CTB), and choice-response performance was assessed using accuracy and mean correct-response latency in a four-choice reaction time task. Analyses accounted for age, sex, and clustering by university; among previously infected participants, models additionally adjusted for perceived acute COVID-19 severity. The primary adjusted analyses included 7117 participants for CTB and 6361 participants for the cleaned choice-response accuracy and latency analyses. In the three-group analysis, students reporting post-COVID consequences had slightly lower CTB scores than those without previous COVID-19 (B = −0.146, 95% CI [−0.277, −0.015], p = 0.029), although the effect was small and was not fully robust in an ordinal sensitivity model (OR = 0.91, 95% CI [0.82, 1.00], p = 0.052). No reduction in choice-response accuracy or robust slowing of response latency was observed in the post-COVID consequence group. Among previously infected participants, post-COVID consequences were not significantly associated with CTB performance (B = −0.149, 95% CI [−0.311, 0.013], p = 0.071), choice-response accuracy (OR = 0.80, 95% CI [0.60, 1.07], p = 0.126), or response latency (−0.79%, 95% CI [−2.06%, 0.49%], p = 0.224) after adjustment for acute severity, age, and sex; none of these associations remained significant after false discovery rate correction. Acute COVID-19 severity was likewise not significantly associated with the cognitive outcomes. Overall, self-reported post-COVID consequences were associated with, at most, small and outcome-dependent differences in objective cognitive performance in this young university sample. The findings do not support a broad objective cognitive deficit associated with self-reported post-COVID consequences after accounting for acute disease severity and demographic factors.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16090130

Authors: Marco Zuin Vanessa Donadel

Academic research on Artificial Intelligence (AI) has primarily focused on usage motivations, AI literacy, trust, overreliance, and critical use. However, the mechanisms through which critical thinking influences passive reliance on AI-generated output in academic contexts remain largely unexplored. This study examined the role of Critical Thinking and Decision Fatigue in students’ passive acceptance of AI-generated output. A sample of 383 Italian university students completed an online survey including the Critical Thinking Disposition Scale and the Decision Fatigue Scale. Of these, 332 students reported having used GenAI in the previous three months and were presented with six task-specific items assessing reliance on unmodified AI-generated output across six academic tasks (Idea generation, Text generation, Text revision, Creating quizzes, Receiving feedback, and Information search). Multiple hierarchical regression analyses tested the moderating role of Decision Fatigue. Decision Fatigue was not a significant direct predictor but moderated the relationship between Critical Thinking and passive acceptance in several academic activities, with the strength of this evidence varying according to the applied correction for multiple comparisons. The findings highlighted the role of critical thinking as a protective filter against the passive use of generative AI. However, this disposition is not always available, particularly under conditions of cognitive fatigue. The study offers new educational insights into the need to design instructional interventions that foster critical thinking while promoting cognitively sustainable learning environments.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16090129

Authors: Alba Peraza Delgado Yurena María Rodríguez Novo Miguel López Martínez Mercedes Novo Muñoz

Background: Population aging has led to an increasing proportion of older adults (aged 65 and older) acting as informal caregivers. These caregivers face risks of burden, stress, and depression. While research frequently documents negative psychological outcomes, resilience represents a crucial protective process. This systematic review synthesizes and maps the empirical evidence regarding the association between the socio-ecological resilience process and the well-being of older informal caregivers. Methods: Following Joanna Briggs Institute (JBI) mixed-methods guidelines, a convergent segregated mixed studies systematic review was conducted. A systematic search of Medline (PubMed), CINAHL, PsycINFO, and Scopus identified primary articles (2014–2025) in English and Spanish. Methodological quality was appraised using JBI critical appraisal checklists and the Mixed Methods Appraisal Tool. PROSPERO registration number: CRD420251142190. Results: Thirty-one studies were included. Elevated caregiver resilience was associated with lower reported symptoms of depression and anxiety, higher self-rated health, and positive psychological adaptation. Framed within a social ecological model, personal resources such as spirituality, hope, and self care, alongside relational assets like dyadic relationship quality and mutual coping, demonstrated a positive association with resilience and a reduction in subjective burden. Within the community context, informal peer networks and Online Health Communities functioned as essential supportive resources. On a structural level, both household wealth and the regional availability of long-term care beds acted as moderators for spousal well-being, whereas exceeding 30 weekly caregiving hours acted as a temporal threshold for positive adaptation. Conclusions: These findings suggest that resilience in older caregivers may be best conceptualized not as a static individual trait, but as a multi-level, dynamic socio-ecological process. Rather than relying on individual coping alone, public policies and clinical practice should prioritize systemic, relational, and structural environmental support, including formal respite services and long-term care infrastructure, to preserve the well-being of older spousal caregivers.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16090128

Authors: Hao Wu Shanhong Luo Whitney Wall Karryll Winborne-Phillips

Research on assortative mating has shown that couples share strong similarities in demographic and attitudinal variables, while the similarity in personality is generally weak. However, a recent meta-analysis indicated that couple similarity in dark traits is considerably greater than that in the Big Five. If these differential similarities are primarily due to active preference, we expect that (1) the desire for similarity in dark traits should be higher than that for the Big Five and (2) the strongest desire for partner similarity in dark traits should come from the “darkest” individuals (i.e., with the darkest core). Participants (n = 2465) rated themselves and their ideal partner in Dark Triad and Big Five traits. They also rated their own dark core. The results showed consistent evidence for desired similarity in dark traits; however, this similarity was no greater than that for the Big Five. Further, dark core generally moderated desired similarity on dark traits such that people with a darker core preferred stronger partner similarity in dark traits. This pattern was only observed for Agreeableness on the Big Five. A new explanation was proposed to reconcile these paradoxical findings concerning desired and actual similarity in dark traits in comparison to the Big Five.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16090127

Authors: Selman Çutuk Zeynep Akkuş Çutuk Rukiye Aydoğan Jason Perez Pablo Prieto-González

(1) Background: As university students increasingly engage with digital tools in their academic and daily lives, digital well-being has become an important issue. This study aimed to examine a comprehensive sequential mediation model in which cognitive flexibility and digital literacy explain the relationship between metacognitive awareness and digital well-being among university students. (2) Methods: This cross-sectional correlational study included 711 university students. Data were collected using the Metacognitive Awareness Scale, Cognitive Flexibility Inventory, Digital Literacy Scale, and Digital Well-Being Scale. The proposed model was tested using structural equation modeling, and indirect associations were examined using bootstrap analyses. (3) Results: The findings indicated that metacognitive awareness was positively associated with cognitive flexibility and digital literacy, whereas cognitive flexibility was positively associated with both digital literacy and digital well-being. Digital literacy was also positively associated with digital well-being. Bootstrap results supported significant indirect associations between metacognitive awareness and digital well-being through cognitive flexibility and digital literacy, including their sequential mediation. (4) Conclusions: These findings suggest that university students’ digital well-being can be better understood by considering metacognitive awareness, cognitive flexibility, and digital literacy together. Therefore, holistic approaches that focus on developing these three areas together may be beneficial in interventions aimed at supporting digital well-being.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16090126

Authors: Ascensión Fumero Francisco Rivero Rosario J. Marrero Alessandro Grecucci Teresa Olivares Wenceslao Peñate

Small-animal phobia (SAP) is characterized by exaggerated fear responses to biologically relevant threat cues, yet the extent to which personality traits influences neural threat processing remains unclear. This study examined whether Cluster C personality traits (avoidant, dependent, and obsessive–compulsive) modulate neural responses to phobic stimuli in SAP. Functional magnetic resonance imaging (fMRI) data were collected from 39 individuals with SAP and non-phobic controls while viewing phobia-relevant and neutral stimuli. Whole-brain analyses were conducted to identify group differences in brain activation, and additional models assessed the influence of Cluster C personality traits on neural responses. Compared with controls, individuals with SAP showed greater activation in regions involved in threat processing and emotional salience, including the anterior cingulate cortex, parahippocampal gyrus, pallidum, fusiform gyrus, and thalamus. Higher avoidant traits were associated with increased activation in visual regions implicated in threat detection, whereas dependent and obsessive–compulsive traits were linked to greater recruitment of prefrontal areas involved in cognitive control and emotion regulation. These findings suggest that neural responses to phobic stimuli are influenced not only by the presence of SAP but also by personality-related vulnerability, highlighting the role of Cluster C traits in shaping perceptual and regulatory aspects of threat processing.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16090125

Authors: Angelo Fumia Luana Sorrenti Carmelo Mario Vicario Francesca Ferraioli Simona Massimino Rosa Angela Fabio Pina Filippello Daniele Mollaioli

Promoting positive student attitudes toward STEM is essential for fostering innovation; however, many existing measures do not adequately distinguish attitudes across specific disciplines, particularly within hard sciences such as physics and chemistry. This study presents the development and validation of the STEM Disciplines Attitude Scale (SDAS). Across three studies involving 2577 high school students, Exploratory and Confirmatory Factor Analyses supported a 25-item, five-factor structure assessing attitudes toward Mathematics, Physics, Chemistry, Engineering, and Science and Technology. The SDAS showed good internal consistency and strong convergent and discriminant validity. Measurement invariance analyses demonstrated full invariance across grade levels and metric invariance across genders. Gender comparisons indicated more positive attitudes among males in mathematics, physics, engineering, and science and technology, whereas no gender differences emerged in chemistry. Correlational and regression analyses identified Mastery Orientation and Problem-Solving Confidence as positively related to attitudes across several STEM domains. Learned Helplessness and Emotional Control showed more discipline-specific associations, particularly for Mathematics and Engineering. The SDAS fills an important measurement gap by providing a reliable tool for assessing discipline-specific STEM attitudes and their psychological correlates, thereby supporting both research and educational interventions.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16090124

Authors: María de la Rocha Díaz Inmaculada Méndez Nuria Antón-Ros Cecilia Ruiz-Esteban

Background: Motivation for academic reading is a relevant component of initial teacher training. However, little is known about whether distinct motivational profiles exist in association with patterns of substance use and problematic behaviors among prospective teachers. Methods: A cross-sectional study was conducted with 289 students (77.5% female; aged 18–34) enrolled in Early Childhood Education and Primary Education degree programs. Motivation for academic reading was assessed using the Academic Reading Motivation Scale (EMLA), while substance- and behavior-related problems were evaluated using the MULTICAGE CAD-4 questionnaire. Latent profile analysis was used to identify academic reading motivation profiles, and multivariate and post hoc analyses were performed to examine differences in scores across profiles. Results: Three motivational profiles were identified, characterized by high, intermediate, and low levels of academic reading motivation. Significant differences between profiles were observed regarding problems related to alcohol, drug use, gambling, video games, and compulsive spending. Conclusions: Academic reading motivation profiles were associated with various screening indicators for substance use and problematic behaviors. Given the cross-sectional and self-report nature of the study, these findings should not be interpreted in terms of causality. The results highlight the potential value of jointly considering academic motivation and health-related behavioral indicators in future teacher training.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16090123

Authors: Roxana Bernal-Rojas David Quispe-Sanca Gutember Peralta-Eugenio Wilter C. Morales-García Liset Z. Sairitupa-Sanchez

Background: Academic performance does not depend solely on cognitive abilities, but also depends on socioemotional processes. Emotional experiences may be associated with school performance; however, their effects are often inconsistent, suggesting the need to examine mediating mechanisms such as self-esteem and developmental conditions such as age. Objective: We aimed to analyze the association between positive and negative emotional experiences and academic performance in school students, assessing the mediating role of self-esteem and the moderating effect of age. Methods: A cross-sectional explanatory study was conducted with 325 students from Lima, Peru (149 boys and 176 girls). Emotional experiences were assessed using the PANAS-N, self-esteem with the Rosenberg Self-Esteem Scale, and academic performance with final grades in Communication and Mathematics. Data were analyzed using partial least squares structural equation modeling (PLS-SEM), with bootstrapping based on 10,000 subsamples. Results: Positive emotional experiences were positively associated with self-esteem (β = 0.434, p < 0.001) and academic performance (β = 0.272, p < 0.001). Negative emotional experiences were negatively associated with self-esteem (β = −0.489, p < 0.001) but showed no significant direct association with academic performance (β = −0.005, p > 0.05). Self-esteem was positively associated with academic performance (β = 0.114, p = 0.043). The model explained 40.8% of the variance in self-esteem and 11.3% of the variance in academic performance. Age moderated only the association between negative emotional experiences and self-esteem (Δβ = 0.183, p = 0.035). Conclusions: Self-esteem plays a significant mediating role in the association between emotional experiences and academic performance, and this effect is especially relevant during adolescence. The findings suggest that self-worth constitutes a key psychological process for understanding how emotional experiences are linked to school performance.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16090122

Authors: Ana María Carroza-Pacheco Benito León-del-Barco Carolina Bringas-Molleda

Classroom social climate has become a factor of increasing interest within the educational field due to its potential influence on students’ well-being and adjustment. The present study focused on analysing the relationship between the different dimensions of classroom social climate and school resilience in a sample of 609 Spanish secondary education students aged between 11 and 17 years. The Classroom Social Climate Scale (CSC) and the School Resilience Scale (SRS) were used as data collection instruments. The data were analysed using correlations and linear regressions to examine associations while retaining the continuous nature of the resilience scores, complemented by multinomial logistic regressions to examine the probability of belonging to relatively low, medium, or high resilience resource groups. The results showed positive and significant associations between the dimensions Relationship, Interest and Communication with Teachers (RIC) and Group Cohesion and Satisfaction (GCS), and both the Internal Resources and External Resources dimensions of resilience. Linear regression models explained 17.2% and 18.0% of the variance in Internal and External Resources, respectively, whereas multinomial logistic regression models yielded Nagelkerke R2 values of 0.160 and 0.190. Furthermore, the GCS dimension appeared to show a stronger predictive contribution to the different dimensions of resilience, particularly for External Resources. The findings suggest that positive peer relationships and group cohesion constitute relevant contextual factors for the development of resilience during adolescence.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16090121

Authors: Ana Cristina Maia Rocha Ana João César Fonseca Leonel Lusquinhos Lara Guedes de Pinho

Life skills are cognitive, emotional and social competencies that help adolescents manage everyday demands and participate in school and social contexts. This study aimed to translate, culturally adapt and examine the psychometric properties of the European Portuguese Life Skills Scale (LSS). A cross-sectional methodological study included a convenience sample of 1807 Portuguese adolescents aged 13–19 years from public secondary schools in Central Portugal. The sample was randomly split for exploratory factor analysis (EFA; n = 903) and confirmatory factor analysis (CFA; n = 904). EFA supported an interpretable eight-factor solution explaining 50.7% of the variance. CFA compared the original ten-factor model with the EFA-derived eight-factor model. The ten-factor model showed significant standardised loadings (λ = 0.444–0.849) and comparatively better fit, with acceptable root mean square error of approximation (RMSEA = 0.045) and standardised root mean square residual (SRMR = 0.062), although the comparative fit index (CFI = 0.855) and Tucker–Lewis index (TLI = 0.849) remained below preferred thresholds. Internal consistency was satisfactory to excellent (α = 0.782–0.963; ω = 0.783–0.964). Average variance extracted (AVE) and heterotrait–monotrait ratio (HTMT) analyses provided partial evidence of convergent validity and additional support for discriminant validity. Supplementary multi-group CFA provided preliminary support for measurement invariance across female and male adolescents. Findings provide initial support for the European Portuguese LSS as a multidimensional measure of adolescent life skills.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16080120

Authors: Kuanysh Shonbay Olga M. Shikhova Yevgeniy Duplyakin Raikhan S. Sagimova Maiya Taushanova Indira Karibayeva

Sleep supports cognition across the lifespan, but its significance may differ developmentally: in adults, it largely maintains and restores functioning within mature neural systems, whereas in children and adolescents it may also support the formation of cognitive, emotional, and self-regulatory capacities. This systematic review and evidence and gap map, prospectively registered in PROSPERO and conducted according to PRISMA 2020, searched PubMed, PsycINFO, Scopus, and Web of Science for studies of sleep duration, quality/fragmentation, timing/regularity, and daytime sleepiness in relation to executive function/self-regulation, attention/vigilance, emotion/behavior regulation, and academic functioning among typically developing children and adolescents. Twenty-five studies contributed 46 study–outcome links. Across nearly all populated evidence cells, more adequate sleep profiles were associated with better developmental outcomes. The strongest and most experimentally supported evidence concerned sleep duration in relation to executive function, emotion/behavior regulation, and academic functioning; evidence for sleep timing/regularity and daytime sleepiness was weaker and predominantly cross-sectional. Unlike adults, for whom sleep primarily restores a mature system, children may lose not only today’s functioning but tomorrow’s developmental trajectory when sleep is chronically curtailed. Sleep duration currently provides the strongest basis for intervention, whereas the long-term developmental effects of sleep quality, timing, regularity, and sleepiness require further longitudinal and experimental investigation during this formative period.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16080119

Authors: Martina Trnčević Ivana Pišćenec Višnja Pranjić Ljerka Armano Aleksandar Racz

Empathy is essential to humanized nursing care, yet its relationship with emotional competence before professional entry remains insufficiently specified. This single-school cross-sectional study examined whether distinct dimensions of emotional competence were differentially associated with emotional empathy among 337 secondary-level vocational nursing students enrolled in a five-year Croatian program for general care nurses/medical technicians. Students completed the Emotional Skills and Competence Questionnaire (ESCQ-45) and the Emotional Empathy Scale from the E-Questionnaire, which primarily captures affective responsiveness to others’ distress and other negative-valence states. Spearman correlations, Kruskal–Wallis tests with Dunn–Holm post hoc comparisons, Welch tests, and hierarchical linear regression with heteroscedasticity-consistent type 3 robust standard errors were used. Emotional empathy correlated with emotion perception and understanding (ρ = 0.35, p < 0.001) and emotion management (ρ = 0.28, p < 0.001), but not with emotion expression and naming (ρ = 0.10, p = 0.070). In the fully adjusted regression model, emotion perception and understanding (β = 0.254, p < 0.001), emotion management (β = 0.254, p = 0.003), and female versus male reported sex (β = 0.277, p < 0.001) were statistically significant predictors, whereas clinical exposure was not (p = 0.429). Emotion expression and naming had a negative adjusted coefficient (β = −0.158, p = 0.040) after simultaneous control for the remaining predictors. The findings support a dimensional interpretation of emotional competence and indicate that negative-valence emotional empathy is more closely associated with recognizing, understanding, and managing emotions than with expressive emotional skills considered in isolation.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16080118

Authors: Luisa Leonie Brokmeier Sophia Haas Laura Ilic Wolfgang Uter Markus Vincent Heppt Olaf Gefeller Isabelle Kaiser

Immunosuppressed patients have a substantially increased risk for developing skin cancer. Therefore, it is mandatory that such patients are adequately informed and aware of skin cancer and their increased risk to modify their behavior. Numerous studies have evaluated the topic, but no synthesis of their findings exists. The protocol of this systematic review was registered on PROSPERO (CRD42024618851) and its reporting followed the PRISMA-2020 guideline. To identify all studies assessing knowledge or perception of skin cancer in immunosuppressed patients, forward and backward citation tracking was employed in addition to an electronic literature search across five databases. For the risk of bias (ROB) assessment, the Joanna Briggs Institute checklist for prevalence studies was used. Quantitatively comparable outcomes were meta-analyzed, while all others were qualitatively synthesized. Thirty-two reports comprising 4214 patients were included. Acknowledging substantial heterogeneity between studies, just over two thirds of patients recalled having been informed about their increased skin cancer risk (pooled proportion: 68.34%, 95% confidence interval (CI): 55.48–78.90). Awareness of the increased risk for skin cancer varied widely (34.5–100%), and pooled mean Skin Cancer and Sun Knowledge scores were 14.77 (CI = 8.57–20.96). About half of those patients asked about risk factors for skin cancer knew that immunosuppression was among them. This indicates that immunosuppressed patients are insufficiently educated about their increased skin cancer risk. However, the high heterogeneity in the synthesized outcomes and the minimal proportion (3%) of low ROB ratings for the included studies call for further research to better understand the awareness of skin cancer risk in this vulnerable population.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16080117

Authors: Carlos Hurtado-Martínez Luis Botella Alejandro Sanfeliciano Ernesto Aranda-Escolástico Luis Angel Saúl

In psychotherapy, case formulation can organize clinically relevant information into a coherent account of how psychological difficulties emerge, persist, and may change. The Personal Meaning System Fuzzy Cognitive Map (PMS-FCM) represents the client’s bipolar construct system as a weighted directed graph, whereas the FCM-FRHP (Fuzzy Cognitive Map of Human Problem Formation and Resolution) provides a professional functional reference model for problem formation and resolution. This paper proposes a semantically constrained method for identifying systemic archetype-inspired configurations in PMS-FCM representations enriched with FCM-FRHP semantics. Rather than importing classical systemic archetypes directly, the method reformulates them as configurable graph templates adapted to intrapersonal bipolar construct systems. Detection combines FCM-FRHP functional roles, predefined semantic-affinity rules and PB-based structural criteria, edge-weight thresholds, and ranking criteria. The goal is to support the traceable identification of static structures that may inform the examination of clinically relevant systemic hypotheses, without treating them as diagnoses or evidence of observed temporal dynamics. The pipeline combines property-graph querying, RDF/SHACL conformance checking, ranked materialization, and rule-based trace generation. A local language model is used only after detection and conformance checking, as a constrained graph-to-text layer grounded in graph evidence and FCM-FRHP semantics. The approach offers a formally specified and reproducible method for conducting explicit, auditable pattern-level analysis of psychological case formulations.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16080116

Authors: Christopher Bryan Ruba Ahmed Tatiana Tairi Oliver Bones Muna Amr Sariah Daouk

University students in diverse higher education contexts face concurrent risks: flourishing often below optimal levels alongside elevated depression and anxiety, though these are often addressed through generic, undifferentiated wellbeing provision. In diverse settings such as United Arab Emirates (UAE) universities, where international students constitute the majority of many student bodies, how campus activities relate to social belonging is both a wellbeing question and an equity issue. This study examined how extracurricular participation, sport (a subset of extracurricular participation), and exercise were associated with student wellbeing among 801 students across two UAE institutions. Extracurricular participation was associated with social belonging, which showed significant indirect associations with flourishing, depression, and anxiety, consistent across covariate adjustment and robustness checks. Exercise showed a similarly consistent direct association with flourishing; it was also associated with lower depression and anxiety in the primary model, though these associations were less robust than the flourishing finding and did not hold under further sensitivity checks. Sport showed a small association with stress mindset and anxiety, though this relies on a measure with low reliability and should be treated as tentative. Loneliness was not significantly associated with any engagement form. These findings point to a differentiated picture of campus engagement, in which extracurricular participation and exercise show the clearest links to wellbeing, while sport’s association with stress appraisal requires further evidence.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16080115

Authors: Dániel Kormos Attila Lengyel Anetta Müller Éva Bácsné Bába Antonia Kinczel Melinda Bíró

Background: Tattooed teachers are increasingly visible in schools, yet the norms governing their professional acceptability remain poorly understood. This study tests whether pluralistic ignorance—private acceptance systematically exceeding the acceptance attributed to others—operates in attitudes toward tattooed teachers, and identifies individual-level predictors of this misperception. Methods: A cross-sectional online survey was conducted with 1226 individuals in Hungary across four groups: physical education (PE) teacher trainees, university students from other disciplines, secondary school students, and in-service teachers. Participants rated their own acceptance of tattooed PE and academic-subject teachers and the acceptance they attributed to other teachers and to parents, and reported tattoo status, gender, and professional background. Results: Own acceptance exceeded attributed acceptance in all four groups and for both reference targets, consistent with pluralistic ignorance; gaps were largest among secondary school students and smallest—though still positive—among in-service teachers. Personal tattoo experience was the strongest individual predictor of acceptance after group membership, and among teachers both age and experience were negatively associated with acceptance. Acceptance was predominantly conditional, structured by a visibility hierarchy in which arm placements were most acceptable and facial or neck placements least so. Conclusions: The apparent disapproval of tattooed teachers reflects collective misperception more than genuine consensus, suggesting that making actual peer attitudes visible could reduce conformity pressure and support more authentic professional self-expression.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16080114

Authors: Giorgio Maria Regnoli Anna Parola Andrea Zammitti Barbara De Rosa

Young adults today are required to envision and plan for the future in a context marked by interconnected societal threats, such as climate change, geopolitical conflicts, and economic instability, giving rise to a condition of polycrisis. Understanding how these threats are perceived and their relationship with future-oriented psychological functioning is essential for promoting adaptive development during emerging adulthood. This study used a person-centered approach to identify different profiles of societal threat perception among university students and examine their links to social resources, future-oriented psychological resources, and well-being. The study involved a sample of 800 Italian university students. Latent profile analysis identified five distinct profiles. These profiles ranged from students who reported consistently low levels of perceived threat (Low Threat) to those characterized by elevated levels of threat across all domains (High Threat). Other profiles reflected specific concerns, such as heightened anxiety about climate change and war (Climate–War Concern), predominant financial threat concerns (Financially Focused Threat), and moderate threat perceptions combined with adaptive functioning (Moderate Threat). R3STEP analyses revealed that perceived social support and trust in institutions were significant predictors of profile membership. The lowest levels were observed among those with a High Threat profile. BCH analyses revealed significant differences in future orientation, meaning in life, and life satisfaction across profiles. Moderate Threat profile students reported the highest levels of future-oriented resources and well-being, whereas High Threat profile students reported the lowest. These findings suggest that university students differ in both the intensity of their societal threat perceptions and the configuration of these perceptions and their associated psychological resources. The results highlight the protective role of social and institutional resources, suggesting that adaptive functioning in times of global uncertainty depends less on the absence of concern and more on the capacity to maintain future-oriented psychological resources despite perceived threats.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16080113

Authors: Luana Sorrenti Carmelo Francesco Meduri Concettina Caparello Pina Filippello

The literature has shown that contextual and individual factors of an emotional and motivational nature are often associated with good academic performance and regular school attendance. The present study aimed to examine indirect associations involving Academic Procrastination and School Climate in the relationship between learning behavior patterns (MO-LH) and school success in a sample of 539 Italian secondary school students (Mage = 16.5). Structural equation modeling was used to test the hypothesized relationships. The results showed that LH was positively associated with Academic Procrastination, whereas MO was negatively associated with it. Academic Procrastination was negatively associated with all dimensions of perceived School Climate (Teacher Support, Peer Connectedness, School Connectedness, Affirming Diversity, Rule Clarity, and Reporting and Seeking Help). School Achievement was positively associated with MO, School Connectedness, and Affirming Diversity, and negatively associated with Peer Connectedness. School Absence was negatively associated with MO. Mediation analyses suggested significant indirect associations between learning behavior patterns and school achievement, with Academic Procrastination and Affirming Diversity emerging as potential mediating variables. Findings highlight the importance of addressing emotional and motivational vulnerabilities and fostering a supportive school climate as potential factors associated with adaptive academic functioning and reduced maladaptive outcomes.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16080112

Authors: Paula Rodríguez-Fernández Ema Di Petrillo Matteo Villanova Valeria Caggiano Juana María Gutiérrez-Caballero Luna Blázquez-Gutiérrez Alberto Blázquez-Manzano Jerónimo Javier Gonález-Bernal

(1) Background: Teacher mental health is a growing concern due to the high emotional and professional demands of teaching. Anxiety is particularly prevalent among teachers, yet it is often conceptualized as a unitary construct, overlooking its multidimensional nature. This study examined the role of transdiagnostic psychological variables and sociodemographic factors as predictors of different dimensions of anxiety (physical, cognitive, and social) in secondary school teachers. (2) Methods: A total of 444 Spanish secondary school teachers (Mage = 41.76, SD = 10.80; 50% women) participated. Data were collected via an online questionnaire. A quantitative, non-experimental, cross-sectional design was used. Pearson correlations and hierarchical multiple regression analyses were conducted to analyze associations and predictive relationships. (3) Results: Anxiety showed a multidimensional structure, with hierarchical regression models explaining a substantial proportion of variance (R2 = 0.26–0.47). Transdiagnostic psychological variables accounted for the largest increases in explained variance beyond sociodemographic and work-related factors. Intolerance of uncertainty was the most consistent predictor across all anxiety dimensions, whereas fear of negative evaluation was the strongest predictor of social anxiety and was also associated with physical and cognitive anxiety. Procrastination predicted cognitive and social anxiety. Female teachers reported higher anxiety levels, while teaching experience showed a protective effect on cognitive anxiety. (4) Conclusions: Findings support a transdiagnostic framework and highlight the central role of psychological processes, particularly intolerance of uncertainty and fear of negative evaluation, in explaining teacher anxiety. Interventions targeting these shared mechanisms may contribute to improving teachers’ mental health and wellbeing.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16080111

Authors: Sergio Martinez-Zujeros Pedro J. Zufiria Aránzazu Vázquez Sasot María Luisa Delgado-Losada

Functional decline in older adults represents a major challenge in geriatric rehabilitation, and machine learning (ML) clustering techniques may help identify functional recovery profiles and support personalized rehabilitation strategies. This study characterizes functional recovery profiles in older adults admitted for rehabilitation using unsupervised clustering techniques. A retrospective longitudinal study was conducted including 957 older adults admitted to a geriatric rehabilitation unit between 2019 and 2025. Clinical and functional variables, including the Modified Barthel Index (MBI), Daniels and Worthingham’s Muscle Testing, and Functional Ambulation Category, were collected from medical records. Considering the baseline functional status and the temporal changes in MBI scores, a clustering of the functional trajectories has been performed using a k-means algorithm based on the silhouette score. The robustness of the resulting segmentation has been evaluated by comparing alternative partitions obtained from bootstrap-sampling, hierarchical clustering, and the centroids of Gaussian Mixture Models. Four distinct functional recovery profiles were identified, showing different trajectories of independence, ambulation, and muscle strength during rehabilitation. Two clusters demonstrated favorable recovery and higher functional resilience, whereas the remaining profiles were characterized by chronic impairment or severe damage with limited recovery. These findings support the usefulness of unsupervised ML clustering techniques for identifying clinically meaningful recovery profiles and may facilitate patient stratification and individualized intervention planning in geriatric rehabilitation.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16080110

Authors: Rubén Pérez-Elvira Daniel Cordeiro María Agudo Juan Antonio Sánchez Cabaco

Individual alpha peak frequency (iAPF) is a stable neurophysiological marker associated with cognitive processing and healthy brain aging. However, the interpretation of alpha activity in older adults remains limited by the use of fixed canonical frequency bands, which may not adequately capture age-related slowing. The aim of this study was to develop an exploratory age-adjusted model of iAPF in cognitively healthy older adults using FOOOF-based spectral parameterization of resting-state EEG. Eighty-one participants aged 52–87 years were selected from the PDWAVES database. Resting-state, eyes-closed EEG recordings were analyzed over nine parieto-occipital electrodes, and iAPF was defined as the center frequency of the highest alpha peak within the 7–14 Hz range after separating periodic and aperiodic spectral components. Linear regression showed a significant negative association between age and iAPF, described by the equation iAPF = 13.22 − 0.054 × age (F(1,79) = 19.56, p < 0.001), indicating an average decrease of 0.54 Hz per decade. Age explained 19.8% of the variance (R2 = 0.198), with a mean iAPF of 9.527 ± 1.064 Hz. Bootstrap resampling confirmed that the age–iAPF association was statistically reliable (95% CI for the slope excluding zero), although cross-validation indicated limited predictive performance on held-out data (10-fold mean R2 = 0.019; LOOCV R2 = 0.155). These findings provide a preliminary age-adjusted reference equation for describing iAPF trajectories in healthy older adults at the group level and support the use of spectral parameterization as a more specific alternative to fixed-band approaches in aging research.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16080109

Authors: Maja Ribar Josip Razum Goran Milas

Adolescence is a developmental period characterized by increased exposure to stress and elevated vulnerability to mental health problems. The present study examined the structure of perceived stress, its longitudinal stability, and its associations with mental health in adolescents. Data were collected from a probabilistic sample of 1679 Croatian adolescents who were in the first or second year of high school at baseline and were followed across three measurement waves approximately six months apart. Perceived stress was assessed across six domains (school, future, parents, friends, romantic partners, and self), and structural equation modeling was used to test factor structure, measurement invariance across time and sex, and temporal stability. Competing models supported a hierarchical structure comprising six domain-specific factors and a higher-order general perceived stress factor. The measure demonstrated strong longitudinal and sex invariance. General perceived stress showed high stability across the three waves, despite being assessed as a current subjective experience. Perceived stress was moderately to strongly associated with depression, generalized anxiety, internalizing and externalizing symptoms, life satisfaction, and happiness, with no evidence of sex differences in these associations. These findings suggest that adolescent perceived stress is best conceptualized as a hierarchical and highly stable construct that is closely linked to multiple indicators of mental health and well-being.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16080108

Authors: Giuseppe Marano Senad Hasaj Oksana Di Giacomi Marco Lanzetta Gabriele Sani Marianna Mazza

Background: The widespread use of appearance-focused social media platforms has transformed how body-related attitudes are constructed, internalized, and evaluated, particularly among adolescent girls and young women, yet the existing literature remains heterogeneous in conceptual frameworks, populations, and outcome measures. Objective: This scoping review maps the extent, nature, and characteristics of the available evidence on the relationship between appearance-focused social media use, body image, self-esteem, and psychological wellbeing in adolescent girls and young women. Methods: Following PRISMA-ScR, PubMed, Scopus, and Web of Science were searched for quantitative, qualitative, and mixed-methods studies on female samples aged 10–30; data were charted and synthesized descriptively. Results: Fifty-eight studies (2014–2026) met the inclusion criteria. Evidence was concentrated in Australia and the United States and skewed toward emerging adults, with adolescent girls aged 10–17 examined in only nine studies. Appearance-focused engagement was consistently linked to body dissatisfaction, body surveillance, drive for thinness, and negative affect, with appearance comparison, internalization of appearance ideals, and self-objectification emerging as recurrent explanatory mechanisms. Body positive and body neutrality content emerged as the most promising protective categories. Conclusions: The review clarifies current evidence and identifies critical gaps for future research, informing clinical, educational, and preventive interventions.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070107

Authors: Keren Dopelt Shiran Bord Nourit Houminer-Klepar

The journal retracts the article titled “What Drives the Non-Medical Use of Stimulants Among College Students [...]

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070106

Authors: Julie C. Mitchiner Tahleen A. Lattimer Gigi Zheng Emma Kane Gabrielle Majeri Christina Whetsel Jessica Contreras Michael M. McKee Peter C. Hauser

Deaf parents experience higher rates of healthcare barriers and adverse parenting outcomes compared with their hearing peers. This qualitative study explored the parenting experiences of Deaf parents to better understand barriers and facilitators to optimal parenting situations. Semi-structured, individual remote interviews were conducted with twenty Deaf parents in the United States who primarily communicate using American Sign Language (ASL) and have children aged 13 years old and under. Interviews examined experiences related to access to information and resources, relationships with healthcare providers, communication accessibility, and involvement with the educational system. Data were analyzed using thematic analysis. Four major themes emerged: communication accessibility across parenting contexts, lack of accessible parenting-related information and services, family dynamics, and the role of assistive technologies in parenting. Participants reported that systemic barriers across healthcare, educational, and service systems create persistent communication challenges and delays, disempowering experiences, and contribute to a critical lack of resources designed for Deaf parents. These findings underscore the need for increased awareness and improved communication access for Deaf parents across healthcare, educational, and legal settings to support positive parenting experiences.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070105

Authors: Heyner Yuliano Marquez-Yauri Sandra Lizzette León Luyo Moises David Reyes-Perez César Pol Arévalo-Aranda Luisa Angélica Orejuela Guerrero Carlos José Sandoval Reyes Angelica María Minchola Vásquez Marco Agustín Arbulú Ballesteros Roger Ernesto Alarcón García

The rapid integration of artificial intelligence (AI) into higher education has renewed concern that technology-related strain may erode students’ higher-order thinking. Drawing on a social–cognitive framework, this study tested whether AI self-efficacy and technostress predict critical thinking in 340 Peruvian undergraduates, who completed three validated scales (Yoon’s Critical Thinking Disposition Inventory; the brief General Self-Efficacy Scale for AI, GSE-6AI; and the RED-Technostress scale). Data were modeled with PLS-SEM, with significance from 5000 bootstrap resamples and an out-of-sample predictive assessment (PLSpredict, CVPAT). AI self-efficacy was a robust positive predictor of critical thinking (β = 0.42, p < 0.001), whereas technostress had no direct effect (β = −0.06, p = 0.50); AI self-efficacy was associated with higher technostress (β = 0.24, p < 0.001), but that path did not carry over to critical thinking (no mediation). A hypothesized moderation (AI self-efficacy mattering more at higher technostress) was not confirmed: it reached significance under the two-stage method but not under a stricter bootstrap, and the hypothesis was therefore not supported. The model explained a modest share of variance in critical thinking (R2 = 0.17) and was invariant across public and private universities. These findings reposition technostress as, at most, a distal correlate and identify confident, literate engagement with AI, rather than the absence of strain, as the more promising lever for cultivating critical thinking.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070104

Authors: Quentin Hallez Sandrine Gil

Time is a peculiar object for psychological science [...]

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070103

Authors: Jeffrey Levi Palmer Carrie Lou Bloom Mary Sanderson Linling Shen

Education is a well-established determinant of health and well-being, yet its benefits may not be equally distributed across populations. This study examines whether educational attainment predicts psychological well-being, financial difficulty, and social support among deaf adults and whether these associations differ from those observed among hearing adults. Using nationally representative data from the U.S. Household Pulse Survey, we analyzed a weighted sample of adults aged 25–54 (N = 36,810), employing multivariate linear regression models that included education, hearing status, their interaction, and demographic covariates. Higher education was generally associated with more favorable outcomes among deaf adults, particularly in psychological well-being and social and emotional support, though effects were modest and less consistent for financial difficulty. Hearing adults reported significantly better outcomes across all domains, and interaction effects indicated that the benefits of education were significantly larger for hearing adults than for deaf adults. These findings suggest that while education remains beneficial for deaf people, its protective effects are limited, likely due to persistent structural and communication barriers. Given the importance of education, improving access alone will not eliminate disparities in well-being without concurrent efforts to address structural and social inequities.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070102

Authors: Eva-María Barroso-Márquez María-de-los-Ángeles Merino-Godoy Izaro Eraña-Méndez David Gómez-Asencio Yeray Cabrera-Arana Cristina Arana-Álvarez Francisco-Javier Gago-Valiente Eva-María Carrasco-Barroso

Background: The global prevalence of anxiety and internalizing disorders in adolescence has increased epidemiologically over the past decade, compounded by the impact of the COVID-19 pandemic and the expansion of digital social networks. Despite the availability of empirically based interventions, their systematic implementation in Spanish educational settings—especially in socioeconomically vulnerable environments—remains insufficient. This study aimed to assess the emotional symptomatology profile in a sample of adolescents enrolled in the 2nd year of Compulsory Secondary Education (CSE) and to describe the changes in symptomatology observed after implementation of a multicomponent intervention program in an ordinary school setting. Methods: a quasi-experimental single-group repeated-measures design was used, with pretest–posttest measurements (T1–T2). The sample included 79 participants (age in completed years: M = 13.28 years, SD = 0.64; range: 12–15; 49.4% female, 44.3% male, 6.3% undisclosed), selected by convenience at IES Estuaria (Huelva). The assessment instrument was the Revised Child Anxiety and Depression Scale (RCADS-47), which measures total anxiety, total internalization, and six clinical subdimensions aligned with DSM-5: generalized anxiety disorder (GAD), major depressive disorder (MDD), panic disorder (PD), separation anxiety (SA), social phobia (SP), and obsessive–compulsive disorder (OCD). The intervention consisted of five multicomponent group workshops (45 min/session; three class groups) integrating emotional psychoeducation, receptive music therapy, cognitive–behavioral emotional regulation, assertive communication, and body expression/mindfulness. Results: At pretest, Social Phobia (SP) showed the highest clinical impairment, significantly affecting more females (66.67%) than males (20.00%). Generalized Anxiety Disorder (GAD) also presented high impairment in females. Significant correlations between pairs of subdimensions revealed a high comorbidity pattern. Following the intervention, reductions in clinically significant levels were observed across all dimensions. Matched-pairs Wilcoxon signed-rank tests confirmed statistically significant score reductions from T1 to T2 in Total Anxiety, Total Internalization, Social Phobia, and Generalized Anxiety Disorder (all p < 0.05), with the largest effect for Social Phobia (r = 0.46); no significant change was detected for Panic Disorder, Separation Anxiety, Major Depressive Disorder, or Obsessive–Compulsive Disorder, although the direction of change favored improvement in all cases. Conclusions: The multicomponent intervention program produced improvements in emotional symptomatology over the short-term follow-up period, although without achieving complete clinical remission in any subdimension. The persistent sex differences—with greater residual impairment in the female group after intervention—underscore the need to incorporate a gender perspective in the design of school emotional health programs. High comorbidity rates between subdimensions support the utility of transdiagnostic approaches. Implications for school nursing practice and future research are discussed.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070101

Authors: Alexis Emmanuel Salinas-Santoyo Gabriela Luna-Hernández Victor Horacio Orozco-Covarrubias Janvier Andre Martinez-Godinez Jaime Briseno-Ramírez Cecilia Alejandra Zamora-Figueroa

Undergraduate nursing students are trained to promote health in clinical and community settings, but their own health-promoting behaviors occur in the context of academic demands, clinical training, work responsibilities, and limited time for self-care. The primary objective of this cross-sectional analytic study was to estimate the adjusted association between health-professional advice seeking and global Health-Promoting Lifestyle Profile II (HPLP-II) scores among 506 undergraduate nursing students at the Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara. Secondary analyses described HPLP-II scores, stress ratings, information sources, subscale-specific associations, and propensity-score sensitivity analyses; exploratory analyses evaluated HPLP-II psychometrics, level-based lifestyle profiles, and stress-by-advice-seeking interaction. The overall median HPLP-II score was 2.40 (IQR: 2.06, 2.79). Internal consistency was high for the global scale (Cronbach’s alpha = 0.961) and ranged from acceptable to high across subscales (alpha = 0.812–0.900). Ordinal exploratory factor analysis using polychoric correlations supported exploratory use of the theoretical six-domain structure but did not provide confirmatory validation; parallel analysis suggested eight factors. Two level-based lifestyle profiles were identified: Low HPLP (58.1%) and High HPLP (41.9%), reflecting broad score-level separation rather than distinct validated phenotypes. In the primary HC3 robust model, health-professional advice seeking was associated with higher global HPLP-II scores (b = 0.242, 95% CI: 0.140, 0.344; p < 0.001), whereas academic stress and vacation-period stress showed small inverse adjusted associations with HPLP-II scores. Sensitivity analyses, including IPTW, a modified HPLP-II score excluding Health Responsibility, and a model excluding willingness to improve lifestyle, showed advice-seeking coefficients in the same positive direction. The exploratory stress-by-advice-seeking interaction was not statistically significant. Findings should be interpreted as associations rather than causal effects.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070100

Authors: Bonginkosi A. Thango Lerato Matshaka Alaa M. S. Azazz Ibrahim A. Elshaer

This study investigates how positive affect during ChatGPT-4 use is associated with perceived academic skill development in higher education, emphasising the mediating role of attitudes toward ChatGPT and the moderating role of learning orientation, grounded in Broaden-and-Build Theory and the Technology Acceptance Model. The enrichment of academic skills through ChatGPT is proposed to be maximised when students who experience positive affect develop positive attitudes toward the tool and channel their interactions through deep learning orientations. This study uses quantitative analysis with n = 12,035 active ChatGPT-using students from 135 countries. PLS-SEM using bootstrapping with 200 resamples is employed for data analysis. The results confirm that positive affect is positively associated with perceived academic skill development (H1: β = 0.199, p < 0.001) and attitude (H2: β = 0.267, p < 0.001), and that attitude is significantly associated with skill development (H3: β = 0.354, p < 0.001). Attitude partially mediates the positive affect to skill development relationship (H4: β = 0.095, t = 24.923, p < 0.001). Learning orientation negatively moderates both the attitude skill development (H5: β = −0.021) and positive affect skill development (H6: β = −0.045) pathways, indicating a desirable difficulty effect: when learning orientation is high, less evaluative scaffolding is needed for skill acquisition, consistent with cognitive challenge theory. What this implies for practice is that access alone is not enough. Institutions need to cultivate AI interactions that feel emotionally positive and, alongside them, a learning-oriented form of engagement; only when the two are developed together does ChatGPT’s potential for academic skill development carry across the diverse global contexts of higher education.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070099

Authors: Zhengqi Wei Hualing Miao Cheng Guo

Subjective well-being is a crucial indicator of higher vocational college students’ mental health, while materialistic values may be associated with poorer well-being. This study examined the mechanisms through which materialism is related to subjective well-being among Chinese higher vocational college students, with subjective well-being operationalized using life satisfaction and depressive symptoms, focusing on the mediating role of basic psychological need satisfaction (BPNS) and the moderating role of self-compassion. The final analytic sample included 4012 higher vocational college students from southwestern China (Mage = 18.79 years, SD = 0.96, 37.1% male), and the data were analyzed using structural equation modeling with robust maximum likelihood estimation and latent moderated structural equations. Results indicated that materialism was associated with lower life satisfaction and higher depressive symptoms. BPNS partially mediated the associations between materialism and both outcomes. Self-compassion moderated the associations between BPNS and both life satisfaction and depressive symptoms, but the moderated mediation effect was significant only for depressive symptoms. Specifically, self-compassion weakened the indirect association between materialism and depressive symptoms through BPNS. These findings contribute to SDT-based research by integrating vulnerability and resilience perspectives and suggest that self-compassion may be particularly relevant to lower depressive symptoms associated with lower BPNS among higher vocational college students.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070098

Authors: Giuseppe Forte Elena Cilloco Micaela Ambalagi Ilaria Corbo Renata Tambelli Maria Casagrande Francesca Favieri

Personality research has traditionally focused on stable trait differences, but increasing attention has been devoted to the internal organization of personality traits within individuals. The present study examined whether intraindividual variability in the Big Five traits, operationalized as the within-person standard deviation across trait scores (iSD_BFI), is associated with problematic digital engagement in young adults. A sample of 316 participants completed the Big Five Inventory and selected subscales of the Behavioral Addiction Questionnaire assessing smartphone use, internet use and video gaming. Pearson correlations, hierarchical regression and independent samples t-tests were conducted to evaluate associations between personality trait-profile dispersion and digital behaviors. Results showed that higher iSD_BFI was weakly but significantly associated with greater problematic smartphone use (r = 0.115, p = 0.044) and internet use (r = 0.141, p = 0.012), whereas no significant association emerged with video gaming (r = 0.029, p = 0.764). Hierarchical regression analyses further indicated that iSD_BFI explained a small but statistically significant additional proportion of variance in smartphone use (ΔR2 = 0.014, p = 0.023) and internet use (ΔR2 = 0.019, p = 0.008) beyond age, sex, and the five Big Five traits, but not in video gaming. Participants in the problematic smartphone use group exhibited significantly higher iSD_BFI than those in the moderate risk group. Rather than representing a direct measure of self-coherence or identity fragmentation, iSD_BFI was considered an exploratory structural indicator of personality profile dispersion. Accordingly, a more heterogeneous personality profile may be associated with a greater approach to digitally mediated environments, possibly because these environments provide predictability, feedback, and reinforcement. Overall, the study highlights the importance of exploring intraindividual personality configuration as a complementary dimension to traditional trait-based approaches.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070097

Authors: Hiruni Hewapathiranage-Mayadunne Erika Bergeron Poorna Kushalnagar

Deaf, deafblind, and hard-of-hearing (DDBHH) American Sign Language (ASL) users assigned female at birth experience disparities in cervical cancer screening. There is a need to further clarify the roles of education status and English proficiency in adherence to the U.S. Preventive Services Task Force (USPSTF) screening guidelines. Using the NCI Health Information National Trends Survey in ASL, we surveyed participants; those who reported being female and within the USPSTF age-eligible range (21–65) were included in analyses. Associations were determined using Pearson Chi-squared tests. A two-sided p ≤ 0.05 was considered significant. Six hundred and forty-three participants, recruited between July 2023 and October 2025, answered questions in ASL and English, with 65% self-reporting screening adherence. Chi-square results indicated that more years of education were significantly associated with screening adherence [X2 (2) = 9.72, p = 0.008]. Consistent with the results, English proficiency was not a significant predictor of screening adherence [Fisher’s exact p = 0.267]. Those who self-report as HS graduates and/or have left college demonstrate lower adherence as well. These findings suggest that educational attainment may be an important factor associated with screening adherence among DDBHH ASL users and warrants further investigation in efforts to improve adherence toward Healthy People 2030 targets.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070096

Authors: Achraf Ammar Atef Salem Khaled Trabelsi Martha Montalvan Bassem Bouaziz Mohamed Ali Boujelbane Mohamed Kerkeni Liwa Masmoudi Hadeel Ali Ghazzawi Adam Tawfiq Amawi Bekir Erhan Orhan Raynier Zambrano-Villacres Juliane Heydenreich Christiana Schallhorn Tarak Driss Evelyn Frias-Toral Giuseppe Grosso Piotr Zmijewski Haitham Jahrami Waqar Husain Hamdi Chtourou Wolfgang I. Schöllhorn

Sleep is a multidimensional health domain influenced by behavioural, psychological, and lifestyle factors. However, multinational evidence integrating insomnia severity and multiple sleep outcomes within the Mediterranean lifestyle framework remains limited. This study examined correlates of insomnia severity and key sleep outcomes in adults from Mediterranean and neighbouring countries participating in the MEDIET4ALL survey. Data were collected from 4010 adults (59.5% female) across 10 countries using a standardized multilingual e-survey. Insomnia severity was assessed as primary outcome using the Insomnia Severity Index (ISI), while sleep characteristics were assessed using sleep duration, sleep latency, sleep efficiency, and subjective sleep quality. Regression analyses examined sociodemographic, health-related, Mediterranean dietary, movement-related, psychological, and social correlates. Exploratory statistical indirect association analyses involving life satisfaction were also conducted. Insomnia severity showed the highest explained variance among sleep outcomes (adjusted R2 ≈ 0.29). Higher insomnia severity was associated with female sex, higher body mass index, and greater depression, anxiety, and stress (β ≈ 0.15–0.17), whereas lower insomnia severity was associated with older age, better self-reported health status, higher life satisfaction, and greater adherence to Mediterranean dietary consumption patterns (β ≈ −0.04 to −0.11). Models for secondary sleep outcomes explained more modest variance and should be interpreted as exploratory. Across these outcomes, psychological well-being and distress showed the most consistent associations, while Mediterranean dietary dimensions and social participation showed smaller and outcome-specific associations. Exploratory indirect association analyses showed small but statistically significant indirect associations involving life satisfaction between Mediterranean dietary dimensions, social participation, and selected sleep outcomes, particularly sleep quality and insomnia severity. The findings confirm and contextualize established associations between sleep, psychological well-being, distress, Mediterranean lifestyle-related behaviours, and regional context within a large multinational sample. Psychological well-being and distress emerged as the most consistent correlates. Insomnia severity was the most robustly explained sleep outcome, whereas secondary sleep dimensions reflected more modest exploratory correlational profiles.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070095

Authors: Vasiliki Katsarou Vassiliki Pliogou Maria Gasouka Evaggelia Kalerante

This study examines parents’ and teachers’ perceptions of Comprehensive Sexuality Education (CSE) in preschool and primary school settings in Greece. Using a quantitative survey design, data were collected from 326 parents and 212 teachers. The study explored perceptions of the importance of CSE, appropriate age and content, implementation barriers, and the influence of socio-demographic and ideological factors. Both groups expressed strong support for CSE, particularly when framed as a means of protecting children and providing reliable information. However, support appeared conditional and selective, with greater hesitation toward topics directly related to sexuality and sexual behaviour. Significant differences emerged, with parents expressing greater concerns regarding age appropriateness and potential negative consequences, while teachers showed stronger support for earlier and more comprehensive implementation. Both groups endorsed a developmental approach, with increasing acceptance of more complex topics at older ages. Although statistically significant differences emerged in several areas, effect sizes were generally small, indicating substantial overlap between parents’ and teachers’ views. Teachers were more likely to identify key implementation barriers, including lack of training, limited resources, and parental resistance. Ideological orientation appeared to be consistently associated with the perceived importance of CSE across both samples.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070094

Authors: Roman V. Reshetnikov Yuriy A. Vasilev Yuliya F. Shumskaya Dina A. Akhmedzyanova Yulya A. Alymova Anton V. Vladzymyrskyy Ilya A. Tyrov Olga V. Omelyanskaya Ivan A. Blokhin

Background: Large language models (LLMs) are increasingly integrated into real-world medical practice as chatbots for answering clinical queries. However, the perceptions of this technology among its end-users remain understudied. Existing research on physicians’ attitudes toward LLMs relies on non-validated questionnaires, raising concerns about the accuracy and reliability of the findings. The aim of this study is to develop and validate a questionnaire to assess physicians’ attitudes toward LLM-based chatbots used as a reference tool for answering queries. Methods: The instrument was based on the previously developed and validated ATRAI-14 questionnaire assessing radiologists’ attitudes toward artificial intelligence. Items for the new questionnaire were formulated and refined through focus group testing. Validation involved 562 physicians of various specialties working in medical institutions within the Moscow healthcare system. Some respondents had prior experience working with medical LLMs. We assessed face, content, construct, and criterion validity. Criterion validity was evaluated through correlation between respondents’ self-assessed attitudes toward LLMs measured by visual analogue scale (VAS), and construct validity through confirmatory factor analysis. Results: The resulting ATRAI-LLM questionnaire comprised 19 items (8 in the background part and 11 in the main part). The questionnaire demonstrated acceptable internal consistency (Cronbach’s α = 0.770, McDonald’s ωt = 0.830). It encompasses three domains: “Willingness to Use”, “Implementation Perspective”, and “Hopes and Fears.” Confirmatory factor analysis supported the three-factor structure, with satisfactory fit indices achieved (RMSEA = 0.05, CFI = 0.97, TLI = 0.96, SRMR = 0.03). Criterion validity was confirmed as acceptable with moderate correlation between the final score and VAS scores (Spearman’s rho 0.68, p < 0.001). Conclusions: ATRAI-LLM is a validated instrument for assessing physicians’ attitudes toward LLMs as a knowledge base.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070093

Authors: Katia Rolán Francisca Fariña Miguel Cuevas-Alonso

Peer conflict in early adolescence ranges from everyday disagreements to repeated aggression and bullying-related experiences. Bullying should not be reduced to physical violence: it may involve relational exclusion, psychological harassment, or verbal aggression without direct physical harm, whereas isolated aggressive acts do not necessarily constitute bullying. This study evaluated Reformulando, a school-based program that trains communication-based socio-emotional skills through pragmatic reformulation and respectful language. Using a quasi-experimental pretest–posttest design with a non-equivalent control group, we assessed changes in conflict management strategies, peer aggression, and bullying-related experiences among students aged 10–13 years. Initial analyses suggested reductions in verbal peer aggression in the experimental group relative to the control group, although these effects were attenuated in age-adjusted and classroom-clustered sensitivity analyses. Collaborative conflict management increased over time, although this change did not differ significantly between groups. Bullying-related experiences decreased during the study period, but these reductions were not specific to the experimental group. This pattern emerged in the primary analyses but was attenuated in age-adjusted and cluster-adjusted sensitivity analyses. Findings suggest the potential value of brief communication-based training for addressing verbal peer conflict, while highlighting the need for cautious interpretation due to baseline group differences, grade-level imbalance, classroom clustering, and the quasi-experimental design.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070092

Authors: Luis Edgardo Cruz Salinas Marco Agustín Arbulú Ballesteros Carlos José Sandoval Reyes Gerardo Antero Barba Ureña Carla Mercy Flores Sánchez

The general objective of this study is to test an integrative PLS-SEM model that simultaneously explains thesis quality and process efficiency among undergraduate students through the affective-motivational mediators of research self-efficacy and project management. Students who stall in the final stage of their degree rarely do so because they lack technical skill. More often, confidence erodes under sustained uncertainty, motivation shifts from intrinsic engagement to anxious compliance, and the demands of organizing months of research exceed what willpower alone can sustain. This study examines those emotional and motivational dynamics directly, treating research self-efficacy and intrinsic motivation not as background variables but as the affective-motivational core of thesis performance. Using partial least squares structural equation modeling (PLS-SEM) grounded in self-determination theory and social cognitive theory, we tested an integrative model with data from 396 undergraduate students actively completing theses at public and private universities in the northern region of Peru. Four enabling factors—methodological competencies, intrinsic motivation, tutorial support, resources and conditions—were linked to thesis quality and process efficiency through two mediating mechanisms: research self-efficacy (the confidence to face methodological difficulty without retreating) and project management (the behavioral self-regulation that converts motivation into organized work). Resources and conditions showed the strongest associations in the model, with the largest effects on both project management (β = 0.533) and research self-efficacy (β = 0.418). Self-efficacy, in turn, showed the strongest association with thesis quality (β = 0.518), while project management and quality were jointly associated with process efficiency. The model explained 70.5% of variance in thesis quality and 81.4% in process efficiency. These patterns point to a concrete institutional lever: securing the material and temporal conditions that allow students to do the work, rather than attributing delays solely to failures of individual motivation. Because the design is cross-sectional and based on self-report, these relationships are interpreted as theory-consistent associations rather than causal effects.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070091

Authors: Amy L. Stamates Sabrina M. Todaro Anna L. Sherman Melissa C. Rothstein Dahianna López Lisa L. Weyandt

Background: Alcohol use and attention-deficit/hyperactivity disorder (ADHD) are prevalent among college students. Individuals with ADHD are at increased risk for developing alcohol use disorder, but mechanisms contributing to this risk are unclear. Subjective alcohol response, or how one experiences the effects of alcohol use, is an important factor that contributes to alcohol consumption. Research suggests that individuals with ADHD, as compared to those without ADHD, may differentially experience the effects of alcohol. Consequently, the purpose of the present study was to examine the association between ADHD symptoms and subjective alcohol response (i.e., subjective effects of alcohol, perceived intoxication, and craving). Methods: Participants (N = 26; 38.5% male, 61.5% female) were college students who completed an in-person alcohol administration session where they received a 0.65 g/kg dose of alcohol. Breath alcohol concentrations and subjective effects of alcohol (feel, like, sedation, and stimulation), perceived intoxication (intoxication and willingness to drive), and craving were assessed at multiple time points throughout the session. ADHD symptoms were assessed at baseline. Results: Area under the curves (AUC) were generated for each participant and each subjective effect, perceived intoxication, and craving. Controlling for typical alcohol use, multiple regressions revealed that higher ADHD symptoms were associated with greater liking the drink, willingness to drive, and craving AUC scores. Conclusions: Individuals with higher ADHD symptoms may experience greater liking and craving during a drinking session. The present findings may also be useful to consider when tailoring intervention and prevention efforts to help reduce risk for college students who report elevated ADHD symptomology.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070090

Authors: Othman A. Alfuqaha Rasha M. Abdelrahman Kyle Msall

(1) Background: Artificial intelligence tools have become integrated into undergraduate students from academic assignments to seek help with psychological concerns, particularly during the crises period. Scales measuring Artificial Intelligence-help-seeking behavior (AI-HSB) are still limited. This study aims to develop a new bilingual scale (Arabic and English) to assess AI-HSB by providing a reliable and useful tool for researchers worldwide. (2) Methods: We conducted a methodological cross-sectional design among 416 undergraduate students in United Arab Emirates (AUE) between the period of 1 October 2025 and 10 December 2025, using an online Google Form. The development, translation, validation, and reliability processes were conducted for the AI-HSB scale. (3) Results: It has been found that 13 items (two factors) are strong indications of factorial validity, reliability, and construct validity of AI-HSB scale. The two factors explained about 58% of the total variance. The confirmatory factor analysis confirmed the two-factor structure with all items loading above recommended thresholds and the goodness-of-fit indices of AI-HSB all exceeded 0.90. (4) Conclusions: The AI-HSB is a valid and reliable tool for assessing AI-based psychological help-seeking behavior among university students in the UAE. This scale will allow universities, counselors, and policymakers to use a well-validated scale to measure the extent to which students are using AI for psychological coping.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070089

Authors: Tina Vilovic Josko Bozic Marko Kumric Roko Santic Josip Vrdoljak Marion Tomicic Marko Rada Edvard Kamsigovski Mariana Radovic Marino Vilovic

Background: Mental health disorders (MHDs) are an important concern among biomedical students, but estimates vary depending on whether studies assess confirmed diagnoses, perceived problems or current symptoms. This study assessed the presence of self-reported MHD history, operationalised as a heterogeneous combined outcome that included either a confirmed MHD diagnosis or a subjective perception of having or having had an MHD without official confirmation, and examined its associations with self-reported coping behaviours, resilience, study-related exhaustion and disengagement symptoms and healthy lifestyle adherence. Methods: A cross-sectional online survey was conducted among students from Medicine, Dental Medicine and Pharmacy programmes. Of 936 eligible students, 520 completed the survey (55.6%). The survey assessed self-reported MHD history and coping behaviours, while standardised questionnaires measured resilience, exhaustion and disengagement symptoms and healthy lifestyle adherence. Analyses included descriptive statistics, group comparisons, Spearman correlations, false-discovery-rate correction for exploratory coping-behaviour analyses and age- and gender-adjusted logistic regression. Results: Overall, 159 students (30.6%) had self-reported MHD history present, including 32 (6.2%) with a confirmed diagnosis and 127 (24.4%) with a subjectively perceived MHD without official confirmation. Exhaustion/disengagement scores negatively correlated with resilience and lifestyle scores, while resilience positively correlated with lifestyle scores (all p < 0.001). In adjusted logistic regression, higher resilience (OR = 0.539, 95% CI = 0.389–0.747, p < 0.001) and lifestyle scores (OR = 0.951, 95% CI = 0.929–0.974, p < 0.001) were associated with lower odds of self-reported MHD history being present. Conclusions: Self-reported MHD history was common among respondents and was associated with lower resilience, poorer lifestyle adherence and higher study-related exhaustion and disengagement symptoms. Because the outcome was heterogeneous and the design was cross-sectional, findings should be interpreted as associations rather than clinically verified prevalence estimates or causal effects.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070088

Authors: Sandra Pérez-Rodríguez Blanca Gallego-Hernández de Tejada María José Beneyto-Arrojo Xavier Sanz-Sendra

Background: Non-suicidal self-injury (NSSI) is highly prevalent during adolescence and is associated with a range of emotional, cognitive, and interpersonal vulnerabilities. Although prior research has identified key correlates such as emotion dysregulation, hopelessness, interpersonal distress, and attachment insecurity, these factors have largely been examined in isolation, limiting understanding of how they jointly contribute to NSSI. Methods: The present study examined the network structure of NSSI and associated vulnerability processes in a community sample of 2067 Spanish adolescents (M age = 14.62, SD = 1.80). A regularized partial correlation network (EBICglasso) was estimated, including NSSI frequency and functions, emotion dysregulation, hopelessness, perceived burdensomeness, thwarted belongingness, and attachment representations. Centrality and network stability were evaluated using standard indices and bootstrapping procedures. Results: The network revealed a differentiated structure of associations. Perceived burdensomeness and intrapersonal NSSI functions emerged as the most influential nodes, whereas emotion dysregulation occupied a key bridging position connecting attachment-related experiences, interpersonal vulnerability, and NSSI processes. In contrast, NSSI frequency and interpersonal functions showed a more peripheral role. Attachment security was negatively associated with core risk variables, consistent with a protective role within the network. Conclusions: Findings suggest that NSSI in adolescence is embedded within a system of interacting emotional and interpersonal processes, structured around the functional meaning of the behavior and key interpersonal appraisals. Emotion dysregulation emerged as a highly connected node linking multiple domains, while attachment was associated with several key variables within the network. These findings suggest potential targets for early identification and intervention, particularly focusing on emotion regulation, perceived burdensomeness, and intrapersonal functions of NSSI.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070087

Authors: Christian J. Wiedermann Verena Barbieri Giuliano Piccoliori Doris Hager von Prainsack Strobele

Adolescents growing up in multilingual regions experience diverse educational contexts that may shape their daily routines and psychosocial environments, but their independent relevance for mental health remains unclear. South Tyrol, with its parallel German-, Italian-, and Ladin-language school systems, provides a unique setting to examine these associations. This study assessed whether school language and home–school language mismatch are associated with mental health, psychosomatic symptoms, and health-related behaviors among adolescents. We analyzed data from a population-based survey of 2005 adolescents aged 11–19 years who provided self-reported information on mental health, psychosomatic complaints, school stress, social support, digital behaviors, lifestyle, and sleep. Multivariable regression analyses examined the independent association of home–school language mismatch with mental health outcomes, adjusting for sociodemographic and educational factors and further incorporating sleep-related behaviors. Mental health outcomes, psychosomatic symptoms, and most health-related behaviors showed little variation by school language, with generally small effect sizes. Home–school language mismatch was associated with slightly higher depressive symptom scores in unadjusted analyses but was not independently associated with mental health outcomes after adjustment. In contrast, weekly sleep problems emerged as the strongest correlate of depressive symptoms, accounting for a substantial proportion of explained variance. These findings indicate that adolescent mental health in this multilingual context is associated less with the language of schooling itself than with broader behavioral and developmental factors, highlighting sleep-related behaviors as a central and modifiable target for prevention.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070086

Authors: Filipa Gomes Carol Coelho Daniela Fumega Bárbara C. Machado Sónia Gonçalves

Non-suicidal self-injury (NSSI) is a significant public health concern, with disproportionately higher prevalence among sexual and gender minority (SGM) populations compared to cisgender heterosexual individuals. While prior research has examined NSSI and related outcomes in SGM groups, evidence on specific risk and protective factors remains limited. This scoping review aimed to systematically map and synthesize risk and protective factors associated with NSSI in SGM populations. A systematic search was conducted in PubMed, Scopus, and Web of Science up to 2 February 2026. A total of 43 studies were included, the majority of which were conducted in the United States and employed cross-sectional designs. Data were charted and synthesized using a minority stress-informed socioecological framework. Findings indicate that NSSI is consistently associated with the co-occurrence of minority stress processes and intrapersonal vulnerabilities. Additional risk factors were identified across family, peer, and community domains. Protective factors were less frequently examined but included social support, family connectedness, school safety, and adaptive coping strategies. Overall, the findings suggest that NSSI among SGM populations is best understood as the result of interacting risk processes across multiple ecological levels. These results support a minority stress-informed, multi-level conceptualization of NSSI in SGM individuals and highlight the need for longitudinal research and greater focus on protective factors.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16060085

Authors: Velia Graciela Vera-Calmet Haydee Mercedes Aguilar-Armas Mabel Ysabel Otiniano León Marco Agustín Arbulú Ballesteros Lucy Angelica Yglesias-Alva Cristian Edgardo Alegría-Silva

Psychological empowerment is associated with women’s well-being, yet how it translates into life satisfaction in high-informality Latin American settings remains untested—as does whether empowerment must cross a threshold before any benefit appears. We tested mediation and moderation hypotheses as separate questions with 251 women aged 18–44 from three northern Peruvian regions using PLS-SEM with 5000 bootstrap resamples. Coping engagement fully mediated the empowerment–life satisfaction relationship (indirect β = 0.134, 95% CI [0.065, 0.213]; VAF = 87.6%; R2 [engagement] = 0.070, R2 [life satisfaction] = 0.285); the direct path was non-significant (β = 0.019, p = 0.754). Mediation and moderation were examined as separate analytical questions; the formal index of moderated mediation was non-significant, indicating that the indirect effect did not differ significantly across subgroups. In exploratory threshold analyses, empowerment predicted life satisfaction only above a normative cut-point anchored to the IMWE scoring manual (≥136; β = 0.382, p < 0.001); below it, the association was flat (β = 0.047, p = 0.547). This pattern is instrument-anchored rather than empirically derived and should be treated as hypothesis-generating pending replication with an independently optimized cut-point. Age moderated the engagement–satisfaction link (β = −0.239, p = 0.031), with stronger effects among younger women; motherhood amplified the negative impact of disengagement on satisfaction (β = −0.272, p = 0.021). Tentatively, programs that move participants only modestly along the empowerment continuum may under-deliver on well-being outcomes, though firm prescriptions require independent confirmation; tailored design for mothers and younger women is warranted.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16060084

Authors: Shimin Zhu Yuxi Hu Di Qi An Xi Shiyun Chen Ruobing Wang Paul Lee Paul Wai Ching Wong

Adolescent depression and anxiety are prevalent, yet brief and scalable parent–child digital interventions remain understudied. This study evaluated the effects of a digital parent–child single-session growth mindset intervention targeting beliefs about intelligence, failure, and emotion on adolescent internalizing of symptoms. In a three-arm waitlist cluster randomized controlled trial, 390 parent–child dyads from seven secondary schools in Hong Kong were assigned to a parent–child intervention group, a child-only intervention group, or a waitlist control group. Students were assessed at baseline, 2 weeks, and 3 months, and parents at baseline and 3 months. Cluster-adjusted generalized estimating equations were used for intention-to-treat analyses. A significant time-by-group interaction was observed for child-reported depression, whereas the interaction effects for other outcomes were non-significant. However, cluster-adjusted baseline differences across groups limited attribution of changes in depression to intervention effects. Relative to controls, the parent–child intervention descriptively showed short-term improvement in hopelessness and sustained gains in child-reported parent–child relationships over 3 months. Moderation analyses suggested clearer short-term benefits among adolescents with higher baseline symptoms and among girls. Overall, the PC-SMILE intervention in this study did not show statistically significant effect on reducing internalizing symptoms. Improvement on intervention design and implementation would benefit further refinement of brief, scalable parent–child digital interventions. Trial registration: ClinicalTrials.gov NCT05493865.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16060083

Authors: Ateret Gewirtz-Meydan Kimberly J. Mitchell Jennifer E. O’Brien Deirdre Colburn

Childhood family support is widely recognized as a protective factor for mental health, yet it remains unclear whether its buffering role is maintained under conditions of cumulative adversity. This study examined whether perceived childhood family support is associated with adult mental health distress and whether this association varies across levels of childhood adversity and victimization. Data were drawn from a convenience sample of 1571 adults in the United States who completed an online survey assessing childhood family support, adult mental health distress (PHQ-4), childhood victimization, non-victimization adversity, family substance use, and childhood social determinants of health (SDoH) hardship. Ordinary least squares regression models with interaction terms were used to test main and moderating effects. Greater perceived family support was associated with lower adult mental health distress (β = −0.23, p < 0.001). Childhood adversity (β = 0.11, p = 0.002) and childhood victimization (β = 0.13, p = 0.001) were independently associated with higher distress. Importantly, both adversity and victimization significantly moderated the association between family support and distress, such that the protective effect of family support weakened at higher levels of cumulative risk. Robustness analyses indicated that these patterns did not differ by family structure. These results suggest that while family support is beneficial, its protective effects are context-dependent and reduced under conditions of elevated risk. Overall, the findings highlight the importance of conceptualizing resilience as a multi-system process and underscore the need for interventions that address both relational and structural sources of adversity.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16060082

Authors: Emily Jo Noschese Alina Engelman Leah R. Oakes Lorne Farovitch

Deaf people experience significant barriers to education, healthcare, employment, and information access, resulting in inequities across a myriad of contexts. To better understand these disparities, our all-deaf research team conducted semi-structured interviews with deaf and hearing (parents, caregivers, and educators) adults across Ecuador, exploring how structural, institutional, and social factors influence daily life and well-being. Participants (n = 36) described systemic exclusion from education and employment, limited access to interpreters and assistive technologies, and constrained autonomy due to insufficient family support and institutional resources. These barriers compound health risks by restricting access to care, information, and social participation. Participants’ narratives highlighted how political and economic instability, institutional neglect, and discrimination create structural vulnerabilities that extend beyond individual-level factors. Findings underscore the importance of public health interventions that address structural and communicative inequities, including inclusive education, accessible health services, and community-based support, to improve health equity and quality of life for deaf populations in Ecuador.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16060081

Authors: Colin T. Henning Emily Storey-Hurtubise Yelnura N. Autalipova Samantha M. Van Rens Laura J. Summerfeldt James D. A. Parker

The present study examined the psychometric properties of a short form of the Emotional Quotient Inventory Youth Version (EQ-i:YV-S), a 30-item scale developed to be an efficient tool to assess trait emotional intelligence (TEI) in children and adolescents. The 4-factor model of TEI used to develop the measure (also used in the development of the original adult form) consists of intrapersonal, interpersonal, adaptability, and stress management dimensions. Confirmatory factor analysis showed acceptable fit in a large sample of youth and was invariant across gender and education level. The results also showed the EQ-i:YV-S scale to have good internal and 6-month test–retest reliabilities. Relationships between the TEI measure and alexithymia in older adolescents provide additional evidence of convergent validity. Overall, the results suggested that the EQ-i:YV-S is a valid and reliable short, multidimensional measure of core TEI dimensions in youth.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16060079

Authors: Soraya Jaime-Jorge Cristina García-Ael Garazi Azanza Ana María Fernández-Fernández Gabriela Topa

This paper analyses associations between psychological health at work and life satisfaction among employees. Specifically, it investigates the association between work stress and emotional exhaustion and explores whether connectedness to nature and work engagement are involved in the indirect association between emotional exhaustion and life satisfaction. Structural Equation Modelling (SEM) was used to analyse data from a final sample of 1851 Spanish workers from diverse professional categories. These included technical and support professionals, administrative employees, middle managers, civil servants and healthcare professionals, unskilled workers, and other occupational groups. SEM analyses were conducted with 1850 valid cases due to one missing or invalid case in the SEM model. The results indicated that work stress was positively associated with emotional exhaustion, whereas emotional exhaustion was negatively associated with life satisfaction. Connectedness to nature and work engagement were involved in this indirect association: higher emotional exhaustion was associated with lower levels of connectedness to nature and work engagement, while higher levels of connectedness to nature and work engagement were associated with higher life satisfaction. The findings suggest that connectedness to nature and work engagement may be relevant psychological and work-related resources in this relationship.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16060080

Authors: Vincenzo Caretti Eleonora Topino Andrea Fontana Gianluigi Di Cesare Clara Mucci Adriano Schimmenti Alessio Gori

The internal saboteur may be understood as a multidimensional configuration of maladaptive inner processes involving recurrent negative self-evaluation, distressing relational expectations, repetitive negative thinking, and self-undermining inner experiences. Within this framework, the present study aimed to develop and examine the psychometric properties of the Internal Saboteur Scale (ISS), a self-report measure designed to assess this construct. A sample of 328 Italian adults (women 71.6%; Mage = 37.37, SD = 14.88) completed the survey. Confirmatory factor analyses supported both an eight-factor correlational model and a theoretically meaningful higher-order model, in which the lower-order dimensions were grouped into four broader domains: Negative Relational Expectations (Expected Rejection; Expected Judgment), Self-Devaluation (Negative Self-Appraisal; Interpersonal Unworthiness), Rumination (Retrospective Rumination; Anticipatory Rumination), and Internal Destructiveness (Helplessness; Defensive Relational Withdrawal). Measurement invariance across gender was also supported. All dimensions showed satisfactory-to-good internal consistency. Furthermore, ISS scores were negatively associated with secure attachment, self-reassurance, and mentalizing and positively associated with insecure attachment, self-criticism, shame, and anger. Overall, the ISS appears to be a theoretically grounded and psychometrically promising instrument for the assessment of maladaptive inner dialogue and self-sabotaging internal processes. It may represent a useful tool for both research and clinical practice, particularly in supporting transdiagnostic assessment and case formulation.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16060078

Authors: Paweł Grygiel Sylwia Opozda-Suder Roman Dolata

Background: Loneliness and depression are interrelated constructs that significantly impact adolescents’ mental health. Understanding their interplay, particularly at the symptom level, is critical for developing effective interventions. Objective: To examine longitudinal relationships between loneliness and depressive symptoms during late childhood, aiming to identify symptom-level interactions and directional effects. Participants and Setting: A total of 4333 children (Mage = 11.06, SD = 0.73; 50.8% girls) from the NLSY79 Children and Young Adults survey participated, with data collected over two years. Methods: A cross-lagged panel network (CLPN) model was employed to analyze symptom-level associations between loneliness and depressive symptoms. This approach combines network analysis and cross-lagged panel modeling, allowing for the estimation of both autoregressive effects (stability of symptoms over time) and cross-lagged effects (directional relationships between symptoms across time points). Results: The longitudinal network suggests the following: (1) a reciprocal link between loneliness and both sadness and parental pressure; (2) a forward effect of loneliness on anxiety and being busy; (3) the loneliness-reducing effect of prior happiness and loneliness-increasing effect of boredom. Conclusions: The findings highlight the complex interplay between loneliness and depressive symptoms, emphasizing reciprocal and unidirectional effects at the symptom level. These insights underscore the need for targeted, symptom-focused interventions to address loneliness and its impact on adolescent mental health.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16060077

Authors: Verónica Estruch-García María Dolores Gil-Llario Encarnación Satorres

Background: Sexuality remains an important dimension of well-being in later life, yet it is often surrounded by misconceptions and ageist stereotypes. Understanding sociodemographic, cognitive, attitudinal, motivational, and behavioral aspects of sexuality among older adults may contribute to a more comprehensive view of sexual well-being in aging. Objectives: This study aimed (1) to describe older adults’ knowledge, attitudes, sexual motivation, behaviors, and satisfaction; (2) to examine differences between individuals who reported engaging in partnered eroto-genital activity during the previous six months and those who did not; and (3) to identify sociodemographic (age, gender, religiosity and health condition), cognitive, attitudinal, and motivational factors associated with engagement in partnered eroto-genital activity. Methods: A cross-sectional study was conducted with 186 adults aged 65–88 years (M = 73.29). Participants completed the Aging Sexual Knowledge and Attitudes Scale (ASKAS) and a Sexual Behavior Questionnaire assessing sexual motivation, sexual behaviors, and sexual satisfaction. Descriptive analyses, group comparisons, and hierarchical logistic regression analyses were performed. Results: Participants showed relatively adequate knowledge and generally favorable attitudes, although several misconceptions persisted. Affective behaviors were more frequent than eroto-genital practices. Individuals reporting partnered eroto-genital activity showed higher knowledge, more positive attitudes, greater perceived importance of sexuality, and higher sexual satisfaction. Regression analyses indicated that age, gender, attitudes toward sexuality, and perceived importance of sex were significant predictors of partnered eroto-genital activity, with perceived importance of sex showing the strongest association. Conclusions: Sexuality in later life reflects diverse patterns shaped by cognitive, attitudinal, and especially motivational dimensions. These findings highlight the central role of subjective importance and attitudes in sexual engagement, suggesting that interventions may benefit from moving beyond information provision to also address motivational and relational aspects of sexuality in aging populations.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16060076

Authors: Lucía Quinde Victor López-Guerra Sandra Guevara-Mora

This study examined the mediating role of negative stress in the relationship between Psychological Capital (PsyCap) and psychological distress indicators among Ecuadorian university students. PsyCap was conceptualized as a higher-order construct composed of hope, self-efficacy, resilience, and optimism. A cross-sectional study was conducted with 1732 university students (55% women; M = 20.44, SD = 2.29) from three Ecuadorian universities using validated self-report measures. Structural equation modeling supported the proposed mediational model and demonstrated an adequate fit to the data, χ2(367) = 1732, p < 0.001, CFI = 0.972, TLI = 0.969, RMSEA = 0.061 (90% CI [0.058, 0.063]), and SRMR = 0.041. PsyCap showed a significant negative association with negative stress (β = −0.311, p < 0.001). In turn, negative stress was positively associated with anxiety–depression symptoms (β = 0.785, p < 0.001) and psychological inflexibility (β = 0.774, p < 0.001). Mediation analyses revealed significant indirect effects of PsyCap on anxiety–depression (β = −0.244, p < 0.001) and psychological inflexibility (β = −0.241, p < 0.001) through negative stress. Direct effects remained significant but smaller in magnitude (β = −0.131 and β = −0.107, respectively), supporting a partial mediation model. The model explained 69.7% of the variance in anxiety–depression and 66.3% of the variance in psychological inflexibility. These findings suggest that PsyCap functions primarily as a protective psychological resource through its capacity to reduce maladaptive stress responses, which subsequently influence broader transdiagnostic indicators of psychological distress. The study highlights the relevance of integrating strengths-based approaches and stress-reduction strategies in university mental health interventions. Furthermore, it provides empirical evidence from a Latin American context, contributing to the understanding of mechanisms linking positive psychological resources and mental health among university students.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16060075

Authors: Waleed El-Sayed Mohammed Hemaida Ekram Mohammed Gomaa Geenedy Mohamed Sayed Abdellatif Mohamed Ali Nemt-allah

Despite growing recognition that nurses must be equipped with sustainability competencies to address climate-related health challenges, the psychological mechanisms through which nursing education fosters sustainability attitudes are not yet fully understood. This study examined the mediating role of clinical performance self-efficacy in the relationship between simulation-based learning quality and sustainability attitudes among undergraduate nursing students. A cross-sectional correlational design was employed with a main sample of 679 nursing students from four Egyptian universities. Data were collected using the CHEST, SECP Scale, and SANS_2. Mediation analysis used Hayes’ PROCESS macro with 5000 bootstrap resamples. Simulation-based learning quality significantly predicted both self-efficacy (β* = 0.772) and sustainability attitudes (β* = 0.613). Self-efficacy partially mediated this relationship, accounting for 68.34% of the total effect (indirect β* = 0.419, Boot 95% CI [0.343, 0.494]). Nursing educators should design simulation curricula that deliberately cultivate self-efficacy while embedding sustainability content, producing clinically competent and environmentally responsible graduates.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16060074

Authors: Naomi Odira Owuor Bettina F. Piko

Mental well-being has been considered a fundamental contributor to overall academic success and psychological stability. Based on the Transactional Theory of Stress and Coping, this study examined the mediating role of academic resilience in the relationship between perceived academic support and mental well-being of Kenyan TVET trainees. A quantitative cross-sectional design was employed, with a sample of 1933 trainees (Mage = 22.87 years; 57.7% male) from 239 public TVET institutions in Kenya. The following measures were administered: Perceived Academic Support Questionnaire, Academic Resilience Scale, and the Short Warwick–Edinburgh Mental Well-Being Scale. Correlation analysis demonstrated that perceived academic support showed a strong positive association with mental well-being, whereas academic resilience indicated a moderate association. Consistent with the hypothesized model, parallel mediation analysis indicated that academic resilience partially mediated the relationship between academic support and mental well-being. The indirect effects observed across resilience dimensions indicated that emotional response was the dominant mediating pathway, while perseverance showed a small positive indirect effect, and adaptive help-seeking demonstrated a small but significant negative indirect effect. These findings contribute to the growing but limited literature on well-being in vocational training and suggest that while academic resilience serves as a key mediating mechanism, perceived academic support may also function as a direct protective factor, underscoring the importance of embedding structured emotional coping support within TVET academic environments.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16060073

Authors: Shan Chen Penkarn Kanjanarat Tinakon Wongpakaran Danny Wedding

Parental divorce, as an adverse childhood experience, may disrupt family systems and exert enduring effects on psychological development, with impacts becoming particularly salient during emerging adulthood, a stage characterized by identity exploration and increasing autonomy. Within the Thai cultural context, inner strengths grounded in Buddhist values may serve as important resources for resilience. This study examined associations between inner strength dimensions derived from the Ten Perfections (Pāramīs) and resilience among emerging adults who experienced parental divorce in childhood. A cross-sectional design was employed with 160 Thai participants aged 20 to 29 years, who completed the Inner Strength-Based Inventory (I-SBI) and the Resilience Inventory (RI-9). Correlation analysis indicated that equanimity, determination, perseverance, wisdom, meditation, and loving-kindness were positively correlated with resilience. Multiple regression analysis showed that equanimity (β = 0.312, p < 0.001), determination (β = 0.227, p < 0.01) and loving-kindness (β = 0.213, p < 0.01) were significantly associated with resilience. These findings suggest that culturally embedded inner strengths are associated with resilience in a non-Western context. More specifically, among the ten dimensions examined, equanimity, determination, and loving-kindness emerged as being significantly associated with resilience in Thai emerging adults with childhood parental divorce experiences.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16060072

Authors: Giordano Mayer De Freitas Guilherme Teixeira Lopes Graziele Borges Bueno Mariana Lentino Coelho Julia Gomes Caroline Leffa Venturini Maria Eduarda Louzada Sara Machado Peres Barbara Regina França Iraci L. S. Torres Pham Felipe Fregni Andrea Cristiane Janz Moreira Wolnei Caumo

Background: Work disability in fibromyalgia is only partially explained by symptom severity, suggesting a relevant contribution of cognitive–behavioral mechanisms. Objective: This study aimed to determine whether kinesiophobia is associated with fibromyalgia impact and work-related disability and to assess whether pain catastrophizing mediates these relationships within a hierarchical biopsychosocial framework. Methods: This cross-sectional study included 2096 women with fibromyalgia recruited through a nationwide online survey. Participants completed validated instruments assessing fibromyalgia impact (FIQ), pain catastrophizing (PCS), depressive symptoms (PHQ-9), central sensitization (CSI), and kinesiophobia (Tampa Scale). Pain-related work disability was defined using the Graded Chronic Pain Scale–Revised (GCPS-R). Hierarchical logistic regression models identified factors independently associated with work disability. Mediation was tested using bootstrapped analyses (5000 resamples). Results: Kinesiophobia demonstrated a robust independent association with work disability (OR 1.03; 95% CI 1.02–1.05) after adjustment for sociodemographic factors, clinical pain phenotype, systemic burden, pain severity, psychocognitive load, and medication burden. Other relevant contributors included pain severity (OR 1.96; 95% CI 1.70–2.27), psychocognitive burden (OR 1.35; 95% CI 1.15–1.58), use of benzodiazepines (OR 1.74; 95% CI 1.33–2.28), and opioid use (OR 1.29; 95% CI 1.06–1.56). Mediation analysis indicated a significant indirect effect of kinesiophobia on work disability through pain catastrophizing (β = 0.131; 95% CI 0.078–0.188). Conclusions: Kinesiophobia is a proximal determinant of work disability in fibromyalgia, exerting direct and cognitively mediated effects through pain catastrophizing, reinforcing the fear-avoidance framework and the need for psychologically informed rehabilitation.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16050071

Authors: Olivia Bruce Wan H. Sim Aspasia Stacey Rabba Anthony F. Jorm Elizabeth Nicolaou Ling Wu Marie B. H. Yap

Depression and clinical anxiety (also known as ‘internalising disorders’) are commonly experienced by autistic children. Parents play an important role in reducing their child’s risk of developing internalising disorders, and existing technology-assisted parenting programs have shown promise in empowering parents in this role. Yet, existing interventions do not currently meet the unique needs of parents of autistic children. This study aimed to co-design adaptations to an existing technology-assisted parenting program (Partners in Parenting Kids) to enhance its relevance and acceptability for parents of school-aged autistic children. An iterative two-phase co-design study was conducted with parents of autistic children (n = 5) and service providers (n = 5). In Phase 1, semi-structured interviews explored participant experiences and needs in the context of parenting support, as well as perspectives on parenting programs. In Phase 2, eight co-design workshops were conducted with parents and service providers to build on the findings from Phase 1 and to collaboratively adapt the program content, delivery, and design features. Workshops involved participatory design activities to foster collaborative sharing of ideas and decision-making. Transcripts from both phases were analysed using reflexive thematic analysis. Themes identified in Phase 1 included: (1) Day-to-day challenges of parenting an autistic child; (2) Unique parent knowledge base and skill set; and (3) Desired qualities of parenting programs. Themes from Phase 2 of the study included: (1) Meaningful connections with others in the community; (2) Acceptance of autism; and (3) Diversity within the community. These themes are described in terms of their design implications for the resultant parenting program (Partners in Parenting Kids-Autism). The findings provide critical insights into desired qualities of parenting programs for parents of autistic children. Importantly, they also shed light on key design recommendations for future work focused on empowering parents to support their child’s mental health through interventions.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16050070

Authors: María J. Navas-Martínez Lourdes Contreras Nazaret Bautista-Aranda M. Carmen Cano-Lozano

Background: The aim of this study was to examine the pattern of child-to-parent violence (CPV) across a broad age range, from early adolescence to late emerging adulthood. Specifically, the objectives were to analyze the linear and quadratic relationships between CPV types (psychological, physical, financial, and control/domain behaviors) and age, as well as to examine the interaction of sex within this relationship. Methods: A total of 1959 adolescents (13–17 years) and 1046 young adults (18–25 years) completed, respectively, the adolescent and young adult versions of the Child-to-Parent Violence Questionnaire (CPV-Q). Results: Age was curvilinearly associated with psychological CPV (increasing until approximately age 19 and then decreasing), positively linearly associated with financial CPV (increasing with age), and negatively linearly associated with control/domain behaviors (decreasing with age). No significant association was found between age and physical CPV. Furthermore, boys and girls showed different age-related patterns in some CPV types. Conclusions: These findings suggest that CPV does not disappear after adolescence, and that the pattern is not uniform throughout development nor the same for boys and girls. The results (1) underscore the importance of studying CPV considering developmental stage, sex, and the specific CPV types, and (2) may contribute to facilitate the early detection of CPV, anticipating changes in violence patterns, and guiding prevention strategies tailored to each developmental stage.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16050069

Authors: Christian Scholtes Petru Lucian Curșeu Sabina Ramona Trif

This systematic literature review synthesizes and integrates research on dysfunctional cognition (DC) in organizational settings, addressing the lack of a coherent model explaining how cognitive vulnerabilities shape work-related outcomes. Following the PRISMA guidelines, we analyzed 41 manuscripts (selected from more than 4523 initial and secondary search hits), leading to an integrative model of DC at work. Results show that DC is activated by job demands, alongside other demanding situational and contextual features. The model specifies maladaptive appraisal processes as the cognitive–affective mechanism through which DC shapes (dis)engagement in the task and relational domains at work and ultimately impacts outcomes such as well-being, stress, burnout, performance, and decision quality. It further incorporates job, personal, and social resources as buffering contingencies that promote adaptive appraisal and attenuate the detrimental role of DC. By integrating insights from clinical, cognitive–behavioral and organizational research, this review advances theory in three ways: (1) by emphasizing the role of appraisal as the cognitive–affective mechanism linking DC to work (dis)engagement, (2) by embedding DC in the job demands–resources model and identifying job demands as activating conditions and resources as regulatory factors for dysfunctional cognitive dynamics at work and (3) by differentiating between task and interpersonal (dis)engagement as domain-specific paths through which self-focused and relational schema impact work-related outcomes. The integrative DC model provides a foundation for future research using longitudinal and mixed-method designs, and for more fine-grained examinations of how specific forms of DC relate to distinct cognitive–affective pathways and work-related outcomes, while offering practical implications for developing schema-informed and resource-based interventions in organizations.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16050068

Authors: Peipei Wang Yanan Li Xu Cheng Hong Xie Huanxian Huang Jun Yang Yangwei Chen Alex Pak Ki Kwok Jiacheng Chen

Relapse in substance use disorders remains a persistent clinical challenge. Identity reconstruction, the psychological transition from an internalized “addict” identity to a recovery-oriented self, may be a core coping mechanism for abstinence maintenance. This exploratory pilot stratified randomized controlled trial examined the feasibility and preliminary effects of a Narrative Therapy (NT) group intervention, delivered within an evidence-based practice framework. Forty-five male residents of a closed rehabilitation facility were randomly assigned (n = 15 each) to an 8-week NT intervention, standard psychoeducation (TAU), or waitlist control (WLC). The Self-Identity Scale and an abbreviated four-item Stimulant Relapse Risk Scale served as outcomes. The Self-Concept Clarity Scale assessed a candidate process variable. A 3 (group) × 3 (time) repeated-measure ANOVA showed significant group × time interactions for self-identity (F = 64.215, p < 0.001, and η2p = 0.754) and relapse-risk indicators (F = 62.131, p < 0.001, and η2p = 0.747). For self-identity, only the NT group showed significant within-group gains. For relapse-risk indicators, NT scores were significantly lower than both control groups at post-test and follow-up (all pairwise p ≤ 0.008), with these reductions maintained at two-month follow-up. Within-group self-concept clarity gains emerged for NT, though between-group differences were nonsignificant. Because the study was conducted in a custodial setting, the relapse-risk findings reflect psychological vulnerability rather than observed behavior. Larger adequately powered trials are needed.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16050067

Authors: Mostafa Aboulnour Salem

Excessive gaming (EG) is increasingly recognised as a modifiable behavioural risk among youth, with potential implications for mental health and well-being in digitally mediated environments. This study examines excessive gaming as a behavioural exposure and AI cyber-shielding (AI-CS) as a perceived digital protective factor among Generation Z university gamers. AI-CS is conceptualised as users’ perceived exposure to AI-enabled safety mechanisms embedded in gaming-related digital environments. The study investigates the associations of EG and AI-CS with four psychological outcomes: depressive symptoms (DEP), anxiety symptoms (ANX), hostile behaviours (HB), and personal well-being (PWB). Data were collected through a cross-sectional online survey of 983 university students aged 18 to 22 years from multicultural Middle Eastern backgrounds enrolled in Saudi universities. The sample included 54.2% males and 45.8% females. The proposed relationships were analysed using Partial Least Squares Structural Equation Modelling (PLS-SEM). The results show that excessive gaming is positively associated with depressive and anxiety symptoms and negatively associated with personal well-being. No significant association was found between excessive gaming and hostile behaviours. AI cyber-shielding is negatively associated with depressive and anxiety symptoms and positively associated with personal well-being, but it does not significantly predict hostile behaviours. These findings indicate that excessive gaming is primarily associated with internal psychological outcomes rather than external behavioural responses. They also suggest that perceived AI-enabled safety affordances in gaming-related digital environments are associated with lower psychological distress and higher well-being. The study contributes to research on digital well-being by introducing and empirically examining AI cyber-shielding as a perception-based environmental factor associated with psychological functioning among university students.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16050066

Authors: Pablo J. Marcos-Pardo Adrián Mateo-Orcajada Rodrigo Gomes de Souza Vale Raquel Vaquero-Cristóbal

Growing urbanization has significantly contributed to the global burden of cardiovascular and musculoskeletal diseases. Green exercise, defined as structured physical activity in natural environments, has emerged as a potential intervention to address these health outcomes. This scoping review aims to synthesize the current scientific evidence on the cardiovascular and musculoskeletal benefits of green exercise among middle-aged (35–64 years) and older adults (≥65 years), examining potential mechanisms, intervention characteristics, and practical implications. A systematic search was conducted across PubMed, Web of Science, Scopus, and Google Scholar databases. Methodological quality was assessed to contextualize the strength of the findings. The available evidence suggests potential cardiovascular benefits, particularly in blood pressure regulation and heart rate variability, supported by both high and moderate-quality studies. Regarding musculoskeletal health, high-quality evidence appears to show improvements in muscle strength, lean mass and functional capacity, as well as reductions in fat mass. While green exercise appears to offer additional psychophysiological advantages over indoor exercise, results remain mixed regarding the clinical superiority of natural versus urban outdoor settings. Notably, significant benefits were observed across diverse frequencies and durations, suggesting that a strictly optimal dose–response remains elusive due to study heterogeneity. Consequently, green exercise appears to be a promising, evidence-informed strategy for healthy aging. While it is associated with improvements in cardiovascular and musculoskeletal health, its added value over traditional settings should be viewed as a complementary factor for adherence. Future research should prioritize high-quality mechanistic trials and standardized protocols to refine clinical prescriptions.