Search Results (386)

Background and Objectives: Emerging evidence indicates that individuals exposed to adverse childhood experiences (ACEs) face elevated risks for various chronic illnesses. However, the association between ACEs and osteoporosis risk remains underexplored, particularly regarding potential modifications by genetic susceptibility. This prospective cohort study aims to examine the relationship of ACEs with incident osteoporosis and investigate interactions with polygenic risk score (PRS). Materials and Methods: This study analyzed 124,789 UK Biobank participants initially free of osteoporosis. Cumulative ACE burden (emotional neglect, emotional abuse, physical neglect, physical abuse, sexual abuse) was ascertained through validated questionnaires. Multivariable-adjusted Cox proportional hazards models assessed osteoporosis risk during a median follow-up of 12.8 years. Moderation analysis examined genetic susceptibility interactions using a standardized PRS incorporating osteoporosis-related SNPs. Results: Among 2474 incident osteoporosis cases, cumulative ACEs showed dose–response associations with osteoporosis risk (adjusted hazard ratio [HR]_{per one-unit increase} = 1.07, 95% confidence interval [CI] 1.04–1.11; high ACEs [≥3 types] vs. none: HR = 1.26, 1.10–1.43). Specifically, emotional neglect (HR = 1.14, 1.04–1.25), emotional abuse (HR = 1.14, 1.03–1.27), physical abuse (HR = 1.17, 1.05–1.30), and sexual abuse (HR = 1.15, 1.01–1.31) demonstrated comparable effect sizes. Sex-stratified analysis revealed stronger associations in women. Joint exposure to high ACEs/high PRS tripled osteoporosis risk (HR = 3.04, 2.46–3.76 vs. low ACEs/low PRS) although G × E interaction was nonsignificant (P-interaction = 0.10). Conclusions: These results suggest that ACEs conferred incremental osteoporosis risk independent of genetic predisposition. These findings support the inclusion of ACE screening in osteoporosis prevention strategies and highlight the need for targeted bone health interventions for youth exposed to ACEs. Full article

This study investigates how demographic characteristics, severity of intimate partner violence (IPV), social support, gender equality awareness, and demographic factors (e.g., living with children at home) influence help-seeking behaviors among 2527 IPV-experienced women in Beijing, Shanghai, Guangzhou, and Shenzhen. Drawing on the help-seeking model and conservation of resource theory, the study distinguishes between formal (e.g., police, legal aid) and informal (e.g., family, friends) help-seeking. Logistic regression results reveal that greater violence severity, stronger perceived social support, and higher gender equality awareness significantly increase both formal and informal help-seeking. Notably, living with children is associated with a higher likelihood of seeking formal help, possibly due to increased concerns for children’s safety and the desire to change the abusive environment. While help-seeking behavior is on the rise overall, particularly among women with strong support networks and progressive gender attitudes, structural and cultural barriers remain. The findings underscore the need to improve public education, reduce stigma, and enhance accessibility of support systems. This study contributes to the growing literature on IPV in China and provides evidence for refining policy interventions and service delivery. Full article

Background: Adolescent girls and young women (AGYW) who engage in alcohol and substance abuse face more significant health and social consequences compared to the general population. This study evaluated the prevalence and associated factors of alcohol abuse and substance use among AGYW in Namibia. Methods: We conducted a retrospective analysis of programmatic data from AGYW aged 10–24 who participated in the Determined, Resilient, Empowered AIDS-free, Mentored, and Safe (DREAMS) component of the Reducing HIV Vulnerability: Integrated Child and Youth Health (REACH) Project HOPE Namibia from March to December 2024. Data analysis was conducted employing chi-squared tests alongside binomial and multinomial logistic regression. Results: Among the 19,662 participants included in this analysis, 2068 (10.5%) abused alcohol and/or substances in the previous six months. Participants who were HIV-negative or did not know their status (AOR = 1.57, 95% CI (1.15–2.14), and AOR = 1.50, 95% CI (109–2.07), respectively), from outside Windhoek, those who had failed or repeated school in the previous year (COR = 1.77, 95% CI (1.54–2.05)), those not disabled (AOR = 1.27, 95% CI (1.06–1.52)), those who had dropped out of school or had completed their studies, and those with no adult emotional support (AOR = 1.25, 95% CI (1.11–1.40)), were more likely to have abused alcohol and/or substances recently. In contrast, participants who were not depressed were less likely to have recently abused alcohol and substances. Conclusions: The prioritization of strategies to identify AGYW experiencing depression and to provide them with treatment is essential. Moreover, it is important to encourage parents and guardians to provide emotional support to AGYW, as it prevents them from abusing alcohol and substances. Full article

Consanguinity is the marriage of two related persons. This type of marriage is one of the main pillars when it comes to recessive hereditary diseases, birth defects, infertility, miscarriages, abortion, and infant deaths. Intermarriage continues to be a common practice in various communities in North Africa, the Middle East, and West and South Asia, as well as among migrants from Europe and North America, even though in more and more countries it has become illegal. Even if security and stability are some of the motivations for consanguineous marriage, studies show that women often suffer physical and verbal abuse from their husbands. However, because of the blood bond, tolerance for these habits is much higher. In addition, it seems that the divorce rate is much lower because separation would affect the entire state of the family. The choice of partner is significantly influenced by variables such as limited access to education and financial resources. Illiterate people coming from poor rural areas are much more likely to choose consanguineous marriage to maintain wealth in the family. The lack of medical knowledge about the negative effects of consanguinity leads to an increased rate of abortions, infant deaths, and births of children with congenital birth defects. Today, because of the process of urbanization and increased levels of knowledge, the younger generation is becoming increasingly less receptive to this particular form of marriage. In addition, as education has become more accessible to women, they have become more independent and eager to fulfill their own goals and not the wishes of the family. In conclusion, contrary to the many apparent advantages of consanguineous marriage, partners should put genetic risks first, as medical problems bring with them increased costs in the medical system and also within the family, leading to even lower economic status and consequently perpetuation of this type of marriage. Full article

Background and objectives. Symptoms of Attention Deficit Hyperactivity Disorder (ADHD) are frequently present in university students, even without a clinical diagnosis, and may be aggravated by various factors. This study analyzes the relationship between these symptoms and the use of alcohol, tobacco, cannabis, and other drugs by young university students. Materials and methods. A cross-sectional study was conducted with 397 university students using an anonymous online questionnaire. ADHD symptoms were assessed with the Adult ADHD Self-Report Scale (ASRS), alcohol use with the Alcohol Use Disorders Identification Test (AUDIT-C), nicotine dependence with the Fagerström test, cannabis use with the Cannabis Abuse Screening Test (CAST), and the use of other substances with an adaptation of the latter. Results. The mean age was 21.4 years, and most participants (76.6%) were women. Of the participants, 46.1% presented symptoms compatible with ADHD according to the ASRS. The most frequent items were difficulty maintaining attention during boring tasks (77.3%), avoiding tasks that require mental effort (76.8%), and being easily distracted by noise or external activity (73.8%). Significant differences were found between ASRS scores and gender, with scores being higher and more consistent among those students who identified themselves as non-binary gender (male or female) (p < 0.01). A significant association was also found between smoking and a higher ASRS score (p < 0.01). Although no significant associations with body mass index were detected, a trend toward greater symptomatology was observed in obese individuals. In multivariate analysis, still gender and smoking significantly (p = 0.12 and p = 0.031, respectively) predicted ADHD symptoms (ASRS score). The model R = 0.228 (R squared = 0.052, F = 1.62, p = 0.077). No statistically significant differences were found between ADHD symptoms and the use of alcohol, cannabis, or other substances in either bivariate or multivariate analyses. Conclusions. This study underscores the importance of early detection of ADHD symptoms in the university setting, considering factors such as gender and smoking habit. Future research should focus on aggravating factors such as academic stress and problematic technology use. Full article

Background: Fear of childbirth (FOC) or tokophobia has a detrimental impact on women during and after pregnancy. Childbirth fear is multidimensional and may differ across nations and cultures. We aimed to determine the psychosocial determinants of tokophobia among Asians. Methods: We conducted a systematic literature search using the PubMed, Scopus, and Web of Science databases in September 2023. Included were original English-language articles that focused on Asian cohorts. We identified independent variables associated with maternal childbirth fear based on multivariable logistic and linear regression analysis. Results: Twenty-three studies are discussed in this review. We categorized the factors into (1) psychiatry, (2) psychology, (3) perception and experience, (4) relationships and support, (5) spirituality, and (6) COVID-19. The studies involved 10,538 women with overall FOC prevalence ranging between 56.6% to 82.1%. Maternal history of psychiatric disorder, depression, and anxiety were positive predictors of childbirth fear. Childbirth self-efficacy protects Asian mothers against tokophobia. A reduced level of fear was associated with higher maternal psychological and spiritual well-being, as well as stronger maternal resilience. Spousal and social support alongside good family function were shown to exert a protective effect against childbirth fear. Intimate partner abuse was associated with an increased risk of tokophobia in women. Studies during the pandemic indicated that maternal fear, obsession, and anxiety about COVID-19 were positively correlated to fear of childbirth. Conclusions: Childbirth fear among Asian women is greatly influenced by various psycho-social factors. More culturally driven research is needed to help develop relevant interventions that will enhance maternal psychological and spiritual well-being and reduce the fear of childbirth. Full article

The COVID-19 pandemic is considered a potentially traumatic event, as it introduced new challenges and threats to people around the world, disrupting daily life due to the restrictions imposed. The psychological defenses of individuals mobilized to deal with stress reactions are influenced by a set of factors, including previous traumatic experiences, which can amplify the current trauma. Recognizing that people exposed to adverse childhood experiences (ACEs) have increased risks of an array of adverse mental and physical health outcomes throughout life, the present study aimed to investigate the relationship between ACEs—more specifically, child abuse and child neglect—and PTSD symptoms in a sample of European adults during the pandemic. A sample of 8459 participants (67.1% female and 32.9% male, with a mean of 43.95 years old) was evaluated. The survey questionnaire included questions on sociodemographic and clinical characteristics, the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5), and the Adverse Childhood Experiences (ACEs) questionnaire. According to our findings, younger women who have suffered from child abuse or child neglect are more likely to develop PTSD symptoms. The most significant factor influencing the PTSD risk was child neglect, contrary to many studies that indicate that child abuse is the most impactful adverse childhood experience. Full article

Background The COVID-19 epidemic had a deleterious impact on mental health and substance abuse and led to an increase in several forms of violence, including self-harm and interpersonal violence among youth from low- and middle-income countries. Nevertheless, the relationship between the variables and their directionality has not been recognized. This study describes the relationship directionality between these variables among 18- to 20-year-old Mexican youths during the COVID-19 pandemic. Methods The longitudinal cohort study comprises an evolving group of young Mexican adults: 1390 participants aged 18 in 2021, 654 aged 19 in 2022, and 442 aged 20 in 2023. Proportions by sex—50% were matched in every cohort, and the evolution–age sample accomplishment accounted for 47% in 2022 and 32% in 2023. Results According to a structural equation model, which fit the data from 195 iterations with 246 parameters (X²[2722] = 8327.33, p < 0.001), yielding a CFI of 0.946, a TLI of 0.943, and an RMSEA of 0.029 [0.028–0.029]), perpetrating intimate violence, preceded by suffering intimate violence, combined with suffering anxiety symptoms, was associated with self-harm–suicide thoughts and behaviors (ShSTB), marked distress, dysfunction, and somatization symptoms. The relationship was stronger in women and 20-year-old Mexicans. In men, this pathway was exclusively associated with ShSTB. Suffering from intimate violence has been associated with depression, anxiety, and PTSD symptoms, as well as harmful alcohol use. Conclusions During an epidemic, prevention programs should be designed to warn about self-harm–suicide thoughts and behaviors, not only to ensure the safety of the victims of intimate personal-violence but also to prevent the suicidal behavior of perpetrators. Full article

Background: Benzodiazepines (BZDs), commonly used to treat insomnia and anxiety, are increasingly used in Spain, raising concerns due to their potential for abuse and dependence. This study investigates the use of BZDs and other psychotropic medications among healthcare workers, exploring their prevalence, associated factors, and their relationship with mental health issues following the COVID-19 pandemic. Methods: An anonymous online survey was conducted among healthcare workers at the Salamanca University Healthcare Complex (CAUSA) from March 2023 to January 2024. Of 1121 participants, 685 provided complete responses, which were analysed. Insomnia, anxiety, and depression were assessed using the Insomnia Severity Index (ISI) and Patient Health Questionnaire-4 (PHQ-4). Results: Of the respondents, 23.8% reported using sleep medication, with 27.8% doing so without a prescription. Additionally, 14.7% used medication for depression or anxiety, with only 0.6% without a prescription. Hypnotic medicine use was associated with older age, insomnia, anxiety, depression, psychological or psychiatric treatment, COVID-19 after-effects, and diagnosed sleep disorders. Night-shift work was associated with increased hypnotic medication use in men but not in women. The use of these medications was linked to a reduced quality of life and impaired work performance. Conclusions: The use of BZD and self-medication are prevalent among healthcare professionals, exceeding the rates observed in the general population. These findings highlight the urgent need for targeted interventions to address psychotropic medication use, promote other pharmacological and non-pharmacological alternatives for insomnia, and enhance mental health support for this vulnerable population. Full article

Background: In Japan, new challenges are emerging, such as declining birth rates, an increase in age at childbirth, postpartum depression, and child abuse. Methods: This study examines the factors influencing maternal consultation behavior at public institutions using some of the data from the Japan COVID-19 and Society Internet Survey (JACSIS). A total of 6227 women (1380 pregnant and 4847 postpartum) were analyzed through logistic regression. Results: The results showed different factors influencing consultations between pregnant women and postpartum women. Among pregnant women, different trends were observed between primigravidae and multigravidae, indicating that primigravidae aged ≥40 years and multigravidae with multiple childbirths tend to seek consultations more frequently. In postpartum women, psychological distress (K6), adverse childhood experiences (ACEs), and social support networks significantly influenced consultation behavior. Postpartum women with extensive support networks (≥3 confidants) exhibited higher consultation rates. In contrast, those with elevated Edinburgh Postnatal Depression Scale (EPDS) and Mother-to-Infant Bonding Scale (MIBS-J) scores were less likely to seek help, potentially due to mental health stigma. Conclusions: This study showed that pregnant and postpartum women facing physical, mental, family, or relationship issues are seeking consultations and receiving thorough support. On the other hand, since some pregnant and postpartum women refrained from seeking consultation, it is necessary to further consider support measures that make it easier for all pregnant and postpartum women to seek advice in the future. Full article

This study aimed to examine the role of childhood sexual abuse in attachment styles and involvement in BDSM (bondage, discipline, dominance, submission, and sadomasochism) practices in adult intimate relationships. A model was built to test the predictive value of factors for involvement in BDSM practices. This study included 318 participants. Demographic data were collected and three questionnaires were used: the Childhood Trauma Questionnaire (CTQ) identified past sexual abuse, the Adult Attachment Scale (RSQ) assessed attachment style in adulthood, and the Sadomasochism Checklist (SMCL) assessed interest in masochistic practices. The results show that childhood sexual abuse is associated with practicing and enjoying BDSM, positively with submissiveness, negatively with dominance, and positively with a composite score measuring both submissiveness and dominance. It is also linked to fearful and preoccupied attachment styles in adulthood, but not dismissive attachment. Men exhibit higher levels of submissiveness and dominance in BDSM compared to women. Older individuals are more inclined to engage in BDSM. Urban residents show higher involvement in BDSM compared to those in other environments. Homosexual or bisexual individuals in open relationships are more frequently involved in BDSM. These findings highlight the complexity of connections between past experiences, sexual preferences in BDSM, and secure attachment in intimate relationships. Full article

Background: Adverse childhood experiences (ACEs) are linked to increased risk of deliberate self-harm (DSH), yet little is known about how women in forensic inpatient settings with histories of childhood abuse understand their self-harm. This study aimed to explore how such women make sense of their self-harm, including perceived contributing and protective factors. Methods: Semi-structured interviews were conducted with six female psychiatric inpatients (aged 22–38) detained in a low-secure forensic hospital in the north of England. All had a history of ACEs and DSH. Interpretative phenomenological analysis (IPA) was used to analyse the data. Results: Three overarching themes were identified: (1) Journey of self-harm, (2) reasons for self-harm, and (3) relationships and self-harm. Participants described self-harm as a method of emotional regulation, a way to regain control, or a means of feeling something. Protective factors included supportive relationships, self-awareness, and having meaningful goals. The findings reflect complex, evolving understandings of self-harm shaped by personal histories and relational dynamics. Conclusions: This study highlights the persistent and multifaceted nature of self-harm among women in forensic settings. The findings support the need for trauma-informed interventions that address emotion regulation, relational support, and personal empowerment. Implications for clinical practice and directions for future research are discussed. Full article

Background: Adverse childhood experiences (ACEs) such as abuse (defined as emotional, physical, or sexual abuse without distinguishing type or severity) have long been linked to mental health challenges in adulthood. However, less is known about how these effects differ by sex/gender in global samples, particularly using large-scale, multi-country panel data. Objectives: To examine whether the long-term association between childhood abuse and changes in depressive symptoms during adulthood differ between men and women, after adjusting for demographic and socioeconomic factors. Methods: We conducted a secondary analysis of Waves 1 and 2 of the Global Flourishing Study (GFS), a longitudinal panel study covering 22 diverse countries. The sample included adult participants with complete data on childhood abuse (yes/no); depression at baseline and follow-up; sex/gender; and relevant covariates (age; education; marital status; immigration status; smoking status; and employment). Depression was measured using a two-item scale. Multi-group structural equation models were used to test the effect of ACE on changes in depression over time where groups were defined based on sex/gender. Results: Overall, childhood abuse was associated with a statistically significant increase in depression scores between Wave 1 and Wave 2. This association was significant among women but not among men. Conclusions: Our findings suggest that the mental health consequences of childhood abuse extend into adulthood and disproportionately affect women. These sex/gender differences may reflect variations in stress processing; coping; and social roles. Interventions addressing early adversity may need to be tailored to recognize and respond to such sex/gender-specific vulnerabilities. Full article

Background: Gender-based violence has serious health impacts on survivors and is perpetuated by cultural norms, patriarchy, and traditional values. This study explored women’s (survivors) views, attitudes and the impact of gender-based violence on their health in a selected rural village within the Collins Chabane Municipality, Vhembe District, Limpopo Province. Methods: A qualitative descriptive design was used, involving 20 women aged 18 to 59. Semi-structured in-depth interviews were conducted, and data were analysed thematically using ATLAS.ti 8, based on Braun and Clarke’s six-step framework. Ethical considerations were prioritised due to the sensitive nature of the research. Results: The results revealed that women in the Collins Chabane Municipality experience multiple forms of GBV, including physical, sexual, emotional, and financial abuse, which severely impacts their mental and physical health. Additionally, socioeconomic factors like unemployment and financial dependence exacerbate their vulnerability, making it difficult to escape abusive relationships. Conclusions: Cultural norms, patriarchal beliefs, and limited community support intersect to shape women’s experiences and responses to abuse. Full article

Even though South Africa is a signatory to international declarations that aim to eliminate violence against women, intimate partner violence (IPV) remains a significant problem. While many women eventually leave IPV relationships after enduring violence for a long period, the matter of why women leave IPV relationships is not adequately researched in South Africa. This study explored the turning points that trigger the decision to leave IPV relationships and examined the process of leaving in a sample of women who left their abusive partners. In-depth interviews with 11 women living in shelters of safety for women in Gauteng Province, South Africa, were analyzed using Giorgi’s phenomenological analysis method. Leaving IPV relationships was a complex process that involved multiple decisions and actions over time; thus, most women endured many years of abuse. Leaving was triggered by various turning points, resulting in the leaving process being either planned or unplanned. For some of the women, the turning point was a specific violent event, while, for others, it was a culmination of violent events. Severe or escalating violence and the desire to protect their children from the impact of violence were key turning points for most of the women, such that they feared for their lives and that of their children. Overall, turning points played a crucial role in the decisions to leave abusive partners, and the leaving process for women was characterized to a great extent by fear. Understanding the complexities of the process of leaving and the relevance of turning points is essential to informing the development of appropriate interventions to respond more appropriately to women experiencing IPV. Full article