Search Results (162)

Background: In the wake of the COVID-19 pandemic, nursing students and educators are navigating an increasingly complex academic environment. The rigorous demands of nursing education, combined with diminished academic preparedness and growing mental health concerns, have heightened the need for effective wellness interventions. The SKY Happiness Retreat©, an evidence-based program incorporating breathwork, meditation, and mindfulness practices, offers a potential strategy to enhance student resilience and reduce stress. Purpose: This pilot study examined the impact of integrating the SKY Happiness Retreat© into a Bachelor of Science in Nursing (BSN) program. This study evaluated whether participation reduced perceived stress and improved students’ ability to manage stressful situations. Methods: A quasi-experimental pretest–post-test design was used with junior-level BSN students recruited through convenience sampling at a rural university. Participants completed a structured three-day retreat focused on breathwork, meditation, and mindfulness. Outcomes were measured using the Mood and Anxiety Symptom Questionnaire (Mini-MASQ), the Perceived Stress Scale (PSS), and the Brief Resilience Scale (BRS). Results: Perceived stress significantly decreased following the intervention (PSS: pre M = 18.50, SD = 4.583; post M = 17.30, SD = 5.841; t(43) = 2.072, p = 0.022). General distress also significantly improved (Mini-MASQ: pre M = 15.51, SD = 6.535; post M = 12.82, SD = 5.118; t(44) = 3.941, p < 0.001). No significant changes were observed in anxious arousal or anhedonic depression. BRS scores demonstrated a modest increase in resilience. Conclusions: The SKY Happiness Retreat© shows promise as an experiential learning strategy within undergraduate nursing education. Findings suggest participation was associated with reductions in perceived stress and general distress while promoting resilience. Integrating evidence-based wellness programs into prelicensure nursing curricula may better prepare students to manage academic and professional stress. Larger, longitudinal studies are needed to evaluate long-term effectiveness. Full article

Background: Visual impairment is associated with mental health difficulties in children, yet emotional and behavioral profiles across different etiologies and levels of visual impairment remain poorly characterized. We investigated whether these outcomes were associated with syndromic etiology or visual impairment severity. Methods: In this cross-sectional study, parents of 69 children and adolescents aged 6–17 years with visual impairment completed the Child Behavior Checklist (CBCL/6–18). Participants were grouped by etiology (syndromic, n = 14; non-syndromic, n = 55) and by visual impairment severity (mild-to-moderate, n = 33; severe-to-profound, n = 36). Group differences were assessed using Mann–Whitney U tests with false discovery rate (FDR) correction, complemented by categorical analyses using scale-specific CBCL clinical thresholds. Results: No significant differences in emotional or behavioral symptoms were observed between the syndromic and non-syndromic groups, although the small syndromic subgroup limited statistical power. In contrast, children with mild-to-moderate visual impairment had significantly higher scores on the Anxious/Depressed and Somatic Complaints scales than those with severe-to-profound impairment, with both differences remaining significant after FDR correction. Categorical analyses also showed a higher prevalence of clinically significant Anxious/Depressed and Internalizing Problems in the mild-to-moderate group. Conclusions: Children with mild-to-moderate visual impairment exhibited higher Anxious/Depressed and Somatic Complaints scores than those with severe-to-profound impairment. These findings suggest that children with residual vision may represent an underrecognized subgroup at risk for emotional difficulties and support routine psychological screening across the spectrum of pediatric visual impairment. Full article

Background/Objectives: Identifying pregnant women with heightened emotional vulnerability remains a challenge in antenatal care. A positive screening result is a comparatively infrequent event in clinical samples of moderate size, which complicates the statistical modelling of associated factors. This study aimed to characterise the psychosocial profile associated with a positive antenatal depression screen, integrating attachment style, perception of motherhood, previous emotional history and sleep problems. Methods: A total of 140 women in the third trimester of pregnancy were assessed cross-sectionally using the Edinburgh Postnatal Depression Scale (EPDS), with a threshold of 14 or above defining a positive screen; the Adult Attachment Scale; and single-item psychosocial indicators. Associations were examined using the chi-square test, the Fisher–Freeman–Halton exact test, and Firth penalized logistic regression, chosen to correct the separation arising from the small number of events. Results: The screen was positive in 15.0% of participants. Negative perception of motherhood, anxious–ambivalent attachment, previous emotional history and sleep disturbances were all significantly associated with depressive symptoms; in the multivariable model, only negative perception of motherhood remained independently associated with a positive screen. Conclusions: Structured psychosocial assessment may usefully complement standard EPDS screening in the early identification of antenatal emotional vulnerability. Full article

Background: The available evidence highlights that low back pain (LBP) can be categorized into neuropathic or nociceptive pain, according to mechanical- or lesion/disease-related issues. Both types of pain are associated with increased psychological and sleep problems and well-being. However, little is known about how a specific type of LBP pain (neuropathic vs. nociceptive) has an impact on these lifestyle factors. Therefore, the main purpose of the study was to examine the differences in depression and anxiety symptoms, quality of life (QoL) and quality of sleep in patients with LBP. Materials and Methods: In this cross-sectional study, we included 150 patients [mean ± standard deviation (SD) age: 46.54 ± 13.36 years; height: 178.06 ± 10.80 cm; weight: 85.26 ± 15.53 kg; body mass index (BMI): 26.77 ± 3.63 kg/m²; 45.0% women] from three centers in Bosnia and Herzegovina and Croatia between July and October 2025. All patients suffered from chronic LBP confirmed by computerized tomography (CT). The classification of pain was conducted using the Leeds Assessment of Neuropathic Symptoms and Signs (LANNS), the Douleur Neuropathique 4 (DN4) and the PainDETECT (PD-Q) questionnaires. Positive scores in all three questionnaires denoted neuropathic pain. Factors of depression (Beck’s Depression Inventory), anxiety [Hamilton Anxiety Rating Scale (HARS)], QoL (SF-36 scale) and sleep quality [Pittsburgh Sleep Quality Index (PSQI)] were also collected. Results: After adjusting for sociodemographic covariates, neuropathic patients reported higher depression [F_1,149 = 7.790, p = 0.006, partial eta squared (ηp²) = 0.051] and anxiety level scores (F_1,149 = 8.140, p = 0.005, ηp² = 0.053), lower QoL (F_1,149 = 19.088, p < 0.001, ηp² = 0.116) and poorer sleep quality (F_1,149 = 19.654, p < 0.001, ηp² = 0.119). Conclusions: In summary, this study shows that neuropathic patients with LBP are more depressed and anxious, and have lower levels of QoL and poorer sleep quality, in comparison to nociceptive patients. The findings suggest that these lifestyle factors need to be considered when establishing the appropriate rehabilitation and management of LBP. Full article

Objectives: Fear of falling (FoF) is a common psychological phenomenon in later life and is often accompanied by avoidance behavior and activity restriction. Although FoF is associated with anxiety, depressive symptoms, reduced self-efficacy, and fear of loss of autonomy, older adults with FoF may differ substantially in the configuration of these characteristics. The present study aimed to identify data-derived profiles of older adults based on FoF, avoidance behavior, self-efficacy, and fear of loss of autonomy, and to examine profile-specific psychological predictors of FoF and avoidance behavior. Methods: The main analytical sample included 217 older adults aged 60–97 years (M = 76.45, SD = 10.14) with Mini-Mental State Examination scores of 20 or higher. Latent profile analysis was conducted using FoF, avoidance behavior, self-efficacy, and fear of loss of autonomy. Anxiety components, depressive symptoms, coping strategies, pain catastrophizing, and loneliness-related indicators were examined in class-specific regression models. The stability of the class solution was tested across different MMSE cut-off scores. Between-class comparisons were conducted for functional, fall-related, socio-demographic, and psychological indicators. Results: A three-class solution was selected and interpreted as adaptive, vulnerable, and maladaptive profiles. The profile structure remained relatively consistent across MMSE cut-off scores, including in the broader sample with MMSE ≥ 15. The classes did not differ significantly in postural balance or number of falls, suggesting that the profiles could not be fully explained by objective fall-risk indicators. Significant between-class differences were found for age, daily pain level, and state social defense. Class-specific regression models suggested that psychological variables associated with FoF and avoidance behavior differed across profiles. Pain appraisal and emotion-related coping were more relevant in the adaptive profile, phobic anxiety and anxious appraisal of future events in the vulnerable profile, and anxiety-related, depressive, interpersonal, and coping-related factors in the maladaptive profile. All reported associations remained significant after false discovery rate correction. Conclusions: FoF and avoidance behavior are related but not identical phenomena and vary across data-derived psychological profiles. A profile-oriented approach may provide a more differentiated understanding of activity restriction in older adults and help identify profile-specific targets for psychological support. Full article

The current study examined how interpersonal coping styles (anxious/expressive, dismissive, and adaptive) within parent and peer domains were associated with depressive symptoms in emerging adults, and whether these associations were moderated by gender. The sample included 352 undergraduate students at a Midwestern university (41% women, 59% men), primarily White/Caucasian (88.9%), with a mean age of 18.91 years (SD = 0.97). Participants completed the Interpersonal Coping Styles Questionnaire and the Brief Symptom Inventory. At the bivariate level, anxious/expressive coping with both parents and peers were associated with higher depressive symptoms, whereas adaptive coping was not significantly related to depressive symptoms. Dismissive coping was associated with depressive symptoms only in the parent domain. In regression analyses, peer-related coping accounted for additional variance in depressive symptoms beyond parent-related coping, whereas the reverse was not observed. Gender moderated several associations. Among men, anxious/expressive coping with peers was positively associated with depressive symptoms, whereas adaptive coping with peers was negatively associated. Among women, dismissive coping with peers was associated with higher depressive symptoms. These findings highlight the relevance of relational context and gender in understanding depressive symptoms. Full article

This study examines how religious and spiritual identities relate to depression and anxiety at baseline and longitudinally. Using data from the Family Foundations of Youth Development Project, which sampled parent–child dyads from the Western United States, we investigated how mental health relates to the conjunction of spirituality and religiosity (S/R), the lack of either, or one separate from the other. At baseline, children identifying as “Spiritual but not Religious” (SBNR) reported the highest levels of anxiety and depression, whereas children who identified as “Religious and Spiritual” (RAS) exhibited the lowest levels of depression. The difference between RAS identity and the SBNR identity was significant across all baseline scales, with SBNR individuals demonstrating greater pathology. Among parents, the “religious but not spiritual (RBNS) group” was more depressed than the RAS group, and both RBNS and SBNR parents were more anxious than the “not religious, nor spiritual” (NRNS) parents. Longitudinally, SBNR children uniquely showed significant decreases in their depression levels, and no increases in their anxiety levels, likely reflecting a ceiling effect given their initially high symptoms. Regarding adults, all groups except RBNS decreased in depressive symptoms over time. It is important to note that this study does not investigate the effects of spiritual or religious identity shift: i.e., conversion or deconversion. This study highlights the nuanced relationship between psychological well-being and S/R. It examines participants from the Western United States, in predominantly white, highly homogenous areas, with a large presence of members from the Church of Jesus Christ of Latter-day Saints, and is not generalizable to world populations. It offers possible interpretations, intending to alleviate suffering and encourage flourishing by identifying risk and protective factors. Full article

Background and Objectives: Rates of obesity have been consistently increasing in recent years across all age groups, with a notable rise among young people. Obesity represents a persistent inflammatory condition and a key contributor to various chronic health problems, such as cardiovascular disorders, metabolic abnormalities, cancer, and psychological conditions. The move from high school to university is a transitional phase accompanied by specific pressures that can affect both body weight control and mental health in students. This cross-sectional investigation aimed to investigate potential associations between excess weight and the presence of depressive and anxiety symptoms in university populations. Methods: This cross-sectional analysis included 5298 students enrolled at universities across ten geographic areas of Greece. Participants filled out questionnaires concerning demographic information and lifestyle behaviors. Levels of depression and anxiety were measured using the Beck Depression Inventory (BDI-II) and the short form of the State Anxiety Inventory (STAI-6), respectively. Measurements of height and body weight were obtained to compute Body Mass Index (BMI). Results: The presence of overweight or obesity among students was significantly and independently related to female sex, urban residence, living independently, tobacco use, and lower academic performance (p = 0.0103, p = 0.0102, p = 0.0203, p = 0.0075, and p = 0.0168, respectively). Individuals reporting insufficient physical activity had 85% higher odds of being overweight or obese (p = 0.0068). Similarly, participants experiencing depressive or anxious symptomatology had more than double odds of excess body weight compared with those without such symptoms (p = 0.0015 and p = 0.0012, respectively). Furthermore, poor Mediterranean diet adherence was linked to more than a twofold increase in the odds of overweight or obesity (p = 0.0005). Conclusions: These findings offer considerable evidence that symptoms of depression and anxiety may serve as significant contributors to the development of overweight and obesity among university students. Additional longitudinal studies are strongly encouraged to substantiate these observations. Full article

Objective: Anxiety symptoms frequently occur alongside mood disorders and are associated with poorer clinical outcomes, highlighting the importance of early and accurate detection. This study evaluated the diagnostic accuracy and psychometric properties of the Anxious Distress Assessment Scale (ADS), a newly developed brief self-report instrument designed to detect anxious distress. Method: The study was conducted in two phases. Phase 1 involved the development of the ADS as a five-item instrument reflecting the DSM-5-TR anxious distress criteria. In Phase 2, 105 adults diagnosed with major depressive disorder (MDD) completed the ADS alongside the Generalized Anxiety Disorder-7 (GAD-7) and the Montgomery–Åsberg Depression Rating Scale (MADRS). Psychometric evaluation included internal consistency reliability (Cronbach’s α), analyses of convergent validity, and diagnostic accuracy assessment using correlation and receiver operating characteristic (ROC) analyses. Results: Anxious distress was highly prevalent, with 71% of participants meeting DSM-5-TR criteria. The ADS demonstrated strong diagnostic performance, with sensitivity of 88.0%, specificity of 90.0%, positive predictive value of 95.7%, and negative predictive value of 75.0%. ROC analysis yielded an area under the curve (AUC) of 0.97 (95% CI: 0.943–0.997), with an optimal cut-off score of ≥10. Internal consistency was excellent (Cronbach’s α = 0.897). Principal component analysis supported a unidimensional structure, accounting for 71.5% of the total variance, with all items loading above 0.80. The ADS also demonstrated strong convergent validity, correlating significantly with the GAD-7 (r = 0.82) and MADRS (r = 0.68). Conclusions: The ADS demonstrates promising psychometric properties, including strong reliability, meaningful convergent validity, and excellent diagnostic accuracy. Its brief format and direct alignment with DSM-5-TR anxious distress criteria support its potential utility as a practical screening tool in clinical settings. However, these findings should be interpreted in light of the study’s focus on English-speaking Malaysian adults with MDD recruited from a tertiary-care setting. Further validation across diagnostic groups, clinical contexts, and cultural and linguistic populations is warranted. Full article

Background: Postpartum depression (PPD) is a clinically significant condition shaped by emotional regulation processes and close relational contexts. Anxiety is often theorized as a mediating mechanism linking relational vulnerabilities to depressive symptoms, yet empirical findings remain mixed. Objectives: This study examined whether state anxiety mediates the association between insecure attachment styles and PPD symptoms or whether its effects depend on relational context, specifically perceived partner support. Methods: In this cross-sectional study, a sample of 249 women assessed within 12 months postpartum completed self-report measures of attachment styles in the intimate relationship, state and trait anxiety, perceived partner support, and PPD symptoms. Hypotheses were tested using multiple regression analyses with heteroskedasticity-consistent standard errors, including mediation and moderation models. Results: Both anxious–ambivalent and avoidant attachment styles were associated with greater PPD symptom severity. State anxiety was neither an independent predictor nor a mediator of the attachment–PPD relationship. Instead, its association with PPD symptoms was conditional: anxiety was positively related to depressive symptoms only when perceived partner support was insufficient. Conclusions: Anxiety may function as a context-sensitive amplifier rather than a universal mechanism of postpartum depressive risk. These findings highlight the potential importance of relational context in understanding emotional vulnerability and depressive symptoms during the postpartum period. Full article

Background: Youth mental health services increasingly encounter adolescents and young adults with complex affective presentations and trauma histories. Dissociation has been proposed as a clinically relevant marker within bipolar vulnerability pathways but remains underrecognized in early-intervention settings. This pilot study investigated the prevalence and clinical correlates of bipolar at-risk (BAR) status in a help-seeking youth sample, with specific focus on dissociative symptoms in this vulnerable population. Methods: A pilot study with a cross-sectional design was conducted in a specialized outpatient clinic for 14–25-year-olds. Seventy-six participants without Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision bipolar disorder completed a multidimensional assessment, including dissociative (Dissociative Experiences Scale version 2 [DES-II], Adolescent-DES [A-DES], Structured Clinical Interview for DSM Dissociative Disorders [SCID-D]), affective, anxiety, impulsivity, and prodromal symptom measures. BAR status (BAR+) was determined via clinical interview according to Bechdolf criteria. Clinically significant dissociation (DES+) was defined by established cut-offs at the DES-II and A-DES scales. Group comparisons, binary logistic regression and exploratory mediation analysis were performed. Results: In our sample, 44.7% of the participants met BAR+ criteria and 42.9% displayed clinically significant dissociation. Patients with BAR+ status more frequently reported familiar history of affective disorders, previous antidepressant use, loneliness, and non-suicidal self-injury. They displayed more severe depressive symptoms and impulsivity, as well as higher scores at all the affective temperament subscale except for hyperthymic. BAR+ patients displayed higher prevalence of dissociative symptoms than BAR− (51.6% vs. 24.2%; p = 0.045). Among the BAR+ subgroup, DES+ youths showed greater traumatic burden, depressive symptoms, and anxious temperament scores. Dissociation was associated with BAR+ status (OR 3.2) after adjusting for age, gender, and loneliness, while attentional impulsivity did not mediate this relationship. Conclusions: Dissociative symptomatology is highly prevalent among help-seeking youths and is directly associated with subthreshold bipolar-spectrum vulnerability. A dissociative BAR phenotype, marked by emotional instability and trauma exposure, may delineate a clinically complex subgroup, supporting the integration of dissociation-focused assessment into youth bipolar-risk staging and early-intervention protocols. Full article

Background: Anorexia nervosa (AN) is a severe eating disorder occurring most frequently in adolescence, characterized by a high prevalence of psychiatric comorbidity. Emotional dysregulation (ED) refers to a transdiagnostic construct that often drives disordered eating behavior. The present study aimed to evaluate differences and similarities in the clinical presentation and response to treatment of young AN patients with high levels of ED (AN+ED) and with low levels of ED (AN−ED). Methods: A total of 40 female inpatients aged between 12 and 18 years were consecutively recruited and subdivided into two groups (AN+ED: n = 21; AN−ED: n = 19), based on the median of the subscale Affective Instability (AI) of the Reactivity, Intensity, Polarity and Stability questionnaire—youth version (RIPoSt-Y). At the recruitment (T0), and after 6 months (T1), the Body Mass Index (BMI) was calculated, and questionnaires and scales were administered to assess (a) the general functioning; (b) the severity of the eating disorder; and (c) the associated psychopathology. Results: At T0, an independent-samples t-test showed that the AN+ED group was characterized by a significantly greater impairment in clinical functioning and a greater severity of both the eating disorder and the associated psychopathology compared to the AN−ED group. At T1, the AN+ED group also showed significantly higher levels of cyclothymic, depressive, and anxious symptoms than the AN−ED group. Moreover, repeated-measures ANOVAs revealed a statistically marked improvement over time of the bulimic behaviors in the AN+ED group only. Conclusions: The present study underscored distinctive clinical features in AN patients with high and low levels of ED. Specifically, the AN+ED group was characterized by a most likely severe clinical phenotype that requires tailored intervention strategies. Full article

Psychedelic-assisted therapies (PATs) can produce rapid and sustained antidepressant effects, yet variability in response remains substantial. Identifying predictors and moderators is essential for optimising patient selection, preparation, and delivery. To map and synthesise the evidence on the predictors of antidepressant response to classic/serotonergic psychedelics administered with psychotherapeutic support in adults with depressive disorders, including treatment-resistant depression. Following PRISMA-ScR principles, we conducted a scoping review of major biomedical and psychology databases (PubMed (MEDLINE), Embase, PsycINFO, and Web of Science) and trial registries (searches September–October 2025), supplemented by reference-list screening. We included randomised trials, open-label studies, and naturalistic cohorts reporting associations between candidate predictors (baseline traits/clinical features, set/setting variables, acute in-session phenomenology, and biological measures) and validated depression outcomes. We charted study characteristics, analytic approaches (including moderation/mediation where available), and indicators of robustness (e.g., adjustment for overall intensity, preregistration, external validation). A total of 48 studies were included in the review. Across study designs, process-level features during the dosing session were the most consistent correlates of antidepressant improvement. Greater emotional breakthrough, mystical/unitive experiences, and ego dissolution-linked reappraisal/insight generally predicted larger and more durable symptom reductions, whereas anxiety-dominant or dysphoric states tended to attenuate benefit, often independent of overall subjective intensity. Set and setting—particularly a stronger therapeutic alliance and music experienced as resonant—predicted both the emergence of therapeutically salient acute experiences and downstream clinical gains. Baseline moderators showed smaller and mixed effects: PTSD comorbidity sometimes weakened trajectories; extensive prior psychedelic exposure was associated with smaller incremental gains; demographics were typically uninformative. Converging biological findings associated better outcomes with markers consistent with increased neural flexibility and plasticity (e.g., less segregated network dynamics; EEG indices), alongside peripheral changes implicating neurotrophic, inflammatory, and HPA axis pathways. Current evidence suggests that antidepressant response in PATs is driven less by static patient characteristics and more by what occurs during dosing and how the context shapes that experience. Optimising preparation, alliance, and music; facilitating emotional breakthrough and meaning making; and mitigating anxious dysregulation are actionable levers. Future trials should harmonise measures, pre-specify and validate moderators/mediators, intensively sample in-session experience and physiology, and report benefits and harms more consistently. Full article

Depression is the most common psychiatric disorder and is frequently comorbid with epilepsy. Despite the high incidence of depression in epilepsy and the well-established sex differences in depression in clinical studies, sex differences in depression in epilepsy models remain unclear. This study aimed to investigate sex differences in depression comorbid with absence epilepsy and their neurochemical mechanisms in the WAG/Rij rat model. WAG/Rij rats, regardless of sex, exhibited symptoms of depression-like behaviour in the forced swimming test: increased immobility and decreased climbing, swimming, and diving. Both strain and sex differences were found in sucrose preference and splash tests, indicating anhedonia. However, anhedonia was more pronounced in WAG/Rij females compared to males. Unlike the males, WAG/Rij females showed signs of increased anxiety, suggesting an anxious depression phenotype. In WAG/Rij rats compared to Wistar controls, a reduced content of dopamine and its metabolites in brain structures was revealed, indicating a reduced dopaminergic tone of the brain. In WAG/Rij females compared to males, a more pronounced dopamine insufficiency and alterations in serotonin metabolism were found. The results indicate that sex differences in neurochemical alterations in brain structures may underlie sex differences in the manifestation of depressive pathology in the WAG/Rij rat preclinical model. Full article

Animals may offer vital psychosocial support, particularly for neurodiverse individuals. However, evidence surrounding the effects of pet ownership remains equivocal, especially in relation to cat–human dynamics. This study explored the relationship between cat–human-related factors (CHRFs) and psychological well-being in a sample of 127 adults, including individuals formally diagnosed with autism (30), ADHD (15), and/or co-occurring autism and ADHD (AuADHD; 22). Participants completed measures assessing neurodiverse traits, CHRF engagement, and symptoms of anxiety, depression, and suicidality. Spearman’s correlations analysed the relationships between CHRFs, neurodiverse traits, and well-being. Kruskal–Wallis tests established group differences in well-being and engagement in CHRFs between individuals with and without neurodevelopmental differences. The findings confirmed that autistic and ADHD traits were positively associated with greater anxiety, depression, and suicidality. Autistic individuals reported significantly elevated anxiety and depression; co-occurring diagnoses (AuADHD) were associated with heightened anxiety. Neurodiverse and neurotypical individuals demonstrated similar patterns of CHRF engagement. Several CHRFs, such as anxious cat behaviour, inability to provide for the cat, poor cat health, and close proximity, were linked to negative well-being outcomes. These findings highlight the nuanced, bi-directional nature of cat–human interactions, underscoring the importance of mitigating negative relational factors to support mental health in neurodiverse populations. Full article