Search Results (240)

Background: Lung cancer carries a high psychosocial burden. Tobacco use, the stigma attached to the disease, and coping strategies are thought to interact and shape psychological outcomes, yet they have rarely been examined together. This review aimed to synthesise the evidence on the relationship between tobacco use, lung cancer stigma, and coping, and how these factors interact and influence patients’ psychological outcomes. Methods: Following the PRISMA 2020 guideline, PubMed/MEDLINE and Dialnet were searched (window 2014–April 2026) for empirical studies conducted in adults with lung cancer that addressed stigma, coping, or relevant psychological outcomes (e.g., anxiety, depression, distress, or quality of life). Study selection and data extraction were performed independently by two reviewers, with discrepancies resolved by consensus and, where needed, by a third reviewer. Methodological quality was appraised with design-specific tools (JBI for cross-sectional and cohort studies, CASP for qualitative studies, and COSMIN-oriented criteria for the psychometric study). Given the clinical and methodological heterogeneity, a structured narrative synthesis was conducted following the SWiM guideline. The protocol was registered in the Open Science Framework. Results: Twenty-four studies were included. Stigma was prevalent and consistently associated with depression, anxiety, distress, and poorer quality of life, with longitudinal evidence indicating that stigma precedes and predicts distress. Internalised stigma (guilt, shame, self-blame) was the facet most strongly linked to depression and anxiety. Smoking history graded stigma intensity (current > former > never smokers) but did not determine it, since clinically significant stigma also affected never-smokers. Adaptive coping (e.g., fighting spirit, positive reappraisal) and social support were consistently associated with better psychological adjustment and quality of life, while maladaptive coping (e.g., helplessness, avoidance, anxious preoccupation) was associated with worse outcomes; cross-sectional evidence further indicated that coping modes mediated the relationship between stigma and quality of life and that social support and self-compassion attenuated the impact of stigma on distress. Conclusions: Internalised stigma is a central, modifiable psychosocial stressor in lung cancer that affects smokers and never-smokers alike. Systematic screening for stigma, coping, and social support, together with non-stigmatising care, is warranted. Full article

The postnatal period involves significant emotional and relational shifts that can challenge early mother–infant interactions, particularly under conditions of psychosocial vulnerability (e.g., maternal anxiety/depression) or infant-related risk (e.g., preterm birth). Maternal mentalization, operationalized as Parental Reflective Functioning (PRF), is a key protective factor for sensitive caregiving and dyadic regulation. Objectives: This protocol describes a multicenter, open-label, single-arm feasibility study evaluating a brief, fully online, mentalization-based video-feedback intervention (VFI-RF). The study is designed to assess the feasibility and acceptability of the intervention, rather than its efficacy. We aim to recruit 48 mothers, 24 in each of two risk groups, through socio-health services and neonatal intensive care units. Risk Group 1 will include mothers with clinically significant depressive and/or anxiety symptoms, defined as EPDS > 9 and/or GAD-7 ≥ 10, whereas Risk Group 2 will include mothers of preterm infants, defined as infants born before 37 weeks of gestation. Methods: The intervention consists of 8 + 2 synchronous online sessions over approximately 5 months. Mothers record brief everyday caregiving interactions (~5 min) to review with a trained clinician, focusing on the infant’s internal states and reflective meaning-making. Assessments occur at baseline (T0, infant age ~3 months), post-intervention (T1, ~8 months), and follow-up (T2, ~12 months). Primary feasibility outcomes include recruitment/referral metrics, uptake, retention, assessment completion, missing data, and participant-reported acceptability. Secondary exploratory clinical outcomes include maternal PRF, symptoms, parenting stress, social support, and mother–infant attachment, evaluated via validated self-report questionnaires. Results: The study is designed to evaluate referral and recruitment patterns, intervention uptake, and participant retention, as well as the acceptability and suitability of study procedures and outcome measures for a future controlled trial. Preliminary trajectories of change in maternal reflective functioning and early relational indicators will be examined descriptively and exploratorily. Conclusions: Findings will inform the feasibility and refinement of a brief online mentalization-based video-feedback intervention to support at-risk mother–infant dyads during the first postnatal year. Trial registration: Registered on Open Science Framework, osf.io/6g9ja, date of registration 4th March 2026. Full article

Neither women’s studies nor lesbian and gay studies offers an adequate theoretical or political base for disruptive scholarship. Reading and interpreting Southern African writers, especially Sindiwe Magona and Ngugi wa Thiong’o, promotes women’s studies as an academic and political approach to both gender and the erotic. Drawing on genealogies of rupture and intergenerational studies, we argue that the feminist is a positionality that must be widely available to challenge heterosexual perspectives and become a catalyst for audiences to engage in nuanced analyses of discourses on places and genres—narrative in particular—where memories are rearticulated and elaborated. This article explores how the narratives of Magona, Ngugi, and Soyinka inform and complicate the erasure, erosion, and amnesia that accompany contemporary imaginaries of what is re/membered. We challenge the tendency to evaluate African feminisms as only either oppressive or empowering and read the selected texts and their prototypical characters as dynamic embodiments that inform gendered spaces across both the attachments that people hold to particular gender identities and styles and recognising the punitive realities of dominant gender expectations. The article takes a positionality on the often troubled relationship between feminism and femininity, a critical but generous reading that highlights the potential for an affirmative orientation towards identity politics. This study utilises the theoretical lenses of border thinking and decolonial and African feminisms to interrogate matrifocal borderlands and the sociohistorical and cultural dis/continuities of being and becoming. We explore notions of the entanglement of motherhood, daughterhood, wifehood, and sisterhood as morphing identities. These are identities at the margins of political, sociocultural, and gender normativities in African literature. Magona’s “threshold people”, like Ngugi’s perfect nine, destabilise, disrupt, and refuse to be subordinated as they codify living differently in the in-between worlds. Magona, for instance, laminates the challenging discourse of contestation to map difficult, dangerous, and marginal spaces where women live at the borders of sociocultural, religious, ethnic, and gendered norms. These are spaces suffused with affective possibilities—defensiveness, shame, anxiety, anger, curiosity—and the women have to develop relational solidarities in negotiating hyper-visibilities or (in)visibilities within the 21st-century global south. Full article

Population aging demands accessible interventions for psychological well-being in later life. This work evaluated the feasibility and acceptability of an 8-week mindful walking program in community-dwelling older adults and generated exploratory estimates of within-person change across emotional, psychosomatic, and psychological outcomes. Thirteen community-dwelling older adults participated in a pilot human trial with assessments at baseline, post-intervention, and one-month follow-up. Measures included depression, anxiety, somatic symptoms, mindfulness, mind wandering, alexithymia, quality of life, and attachment style. Primary feasibility outcomes indicated high acceptability and participant satisfaction, good physiological tolerance and full adherence. Secondary exploratory analyses suggested within-person reductions in depressive symptoms and alexithymia, while somatic symptoms decreased notably by follow-up. Mindfulness increased and was maintained over time, while mind wandering displayed a probable long-term decrease. Psychological quality of life improved and remained elevated, whereas physical, social, and environmental quality-of-life domains showed uncertain trends. Trait anxiety decreased post-intervention but returned toward baseline at follow-up, while state anxiety and attachment styles remained stable. Within pilot design limits, mindful walking may be a feasible intervention for older adults, associated with exploratory within-person patterns suggesting possible improvements in certain psychological outcomes, which should be interpreted as preliminary and descriptive signals pending confirmation in controlled trials. These preliminary findings support further investigation in controlled trials to determine effectiveness and to formally test hypothesized mechanisms. Full article

Adolescents with LGBTQ+ parents and LGBTQ+ adolescents navigate unique social and identity-related challenges as compared to those without minoritized sexual and/or gender identities. Adolescents with LGBTQ+ parents (regardless of their own sexual or gender identity) and adolescents who personally identify as LGBTQ+ are distinct populations, though they sometimes overlap. Research on adolescents with LGBTQ+ parents has often focused on parent–adolescent relationships and family structures. How do friends help youth cope with identity-based minority stressors, like peer microaggressions, bullying, and exclusion, common for those with minoritized identities? Friendships are developmentally pivotal during adolescence, shaping social competence, identity exploration, and psychological adjustment. Grounded in ecological systems, social learning, and minority stress theories, we sought to understand how friendships relate to mental health and coping in adolescents with LGBTQ+ parents. This cross-sectional quantitative study included 98 adolescents (ages 12–19) with LGBTQ+ parents in the U.S., recruited via community sampling and Prolific. Higher-quality peer attachment, conceptualized by trust, communication, and alienation in close friendships, was associated with lower depression and greater social competence, but not associated with anxiety or adaptive coping (after accounting for avoidant coping). Avoidant coping was most strongly associated with poorer mental health. This study, with implications for practice, emphasizes the importance of peer relationships for adolescents with LGBTQ+ parents—particularly how high-quality friendships offer important possible protection via social competence and against depression—while also highlighting the complex interplay between friendships, coping, and adjustment. Full article

Background/Objectives: This systematic review aims to synthesize existing evidence on the impact of nursing interventions based on Watson’s Theory of Human Caring (THC) on women’s mental health and to provide an evidence-based framework for clinical practice. Methods: The review followed the PRISMA guidelines and was registered in the PROSPERO database (Registration No: CRD420251111577). A comprehensive literature search was conducted across databases, including PubMed, CINAHL, and Google Scholar. Ten studies (nine randomized controlled trials and one quasi-experimental study), involving 869 participants, met the eligibility criteria. Data were analyzed using a narrative synthesis approach due to methodological and clinical heterogeneity. Results: A total of 10 studies involving 894 women met the inclusion criteria. Geographically, nine studies were conducted in Türkiye and one in Iran. The included studies spanned various clinical contexts directly associated with significant mental health challenges for women, including medical abortion, infertility, gynecological oncology, and the postpartum period. The synthesized findings demonstrated that nursing interventions based on Watson’s Human Caring Theory led to statistically significant reductions in anxiety, depression, stress, postpartum depression risk, and infertility-related distress. Furthermore, these caritas-based frameworks significantly enhanced positive psychological assets, including self-efficacy, hope, meaning in life, prenatal attachment, and social support perception. Conclusions: Watson’s Theory of Human Caring provides a transformative framework for women’s health nursing that extends beyond symptom management to strengthen the individual’s internal resources and spiritual integrity. Integrating this theory into clinical protocols and nursing curricula is essential for humanizing care and protecting women’s mental health during challenging life transitions, particularly within the examined sociocultural contexts. Full article

Anxiety disorders are disabling and treated with cognitive-behavioral or exposure-based psychotherapy. However, many patients remain symptomatic, fail to remit, relapse, or discontinue treatment. This narrative review examined whether psychotherapy non-response, defined here as persistent clinically significant anxiety symptoms, avoidance, or functional impairment after an apparently adequate psychotherapy trial, may reflect mismatch between therapeutic mechanisms and the dominant processes maintaining anxiety, and aimed to develop a usable taxonomy of mechanistic non-response. This structured narrative review followed SANRA principles. PubMed/MEDLINE, Scopus, PsycINFO, Web of Science, and the Cochrane Library were searched for peer-reviewed literature published from 1 January 2000 to 30 April 2026, including selected earlier landmark studies. Clinical, experimental, neurobiological, psychophysiological, process, and theoretical evidence were synthesized narratively. Psychotherapy mechanisms were organized around inhibitory learning, cognitive reappraisal, attentional modulation, emotion regulation, avoidance reversal, and interpersonal learning. Anxiety maintenance was multilevel, involving threat neurocircuitry, stress-related learning conditions, intolerance of uncertainty, attentional threat capture, safety behaviors, avoidance reinforcement, developmental adversity, and attachment insecurity. Non-response was framed as mismatch between the dominant maintaining process and the therapeutic mechanism expected to modify it. Six failure modes were identified: impaired inhibitory learning, cognitive rigidity/intolerance of uncertainty, stress-related learning impairment, attentional dysregulation, attachment-related barriers, and chronic avoidance dominance. Psychotherapy non-response in adult anxiety disorders should prompt mechanistic reformulation rather than repetition of the same intervention or labeling as treatment resistance. The taxonomy links recognizable failure signatures to mechanism-matched adaptations: redesigned exposure, uncertainty-focused work, attentional interventions, sequencing when arousal or sleep impairs learning, relational repair, and reduction in avoidance contingencies. The narrative review provides a concise clinical taxonomy and practical mechanism-matched adaptations to guide reformulation and treatment redesign after psychotherapy non-response in routine care. The taxonomy supports mechanism-matched reformulation after psychotherapy non-response and requires prospective validation. Full article

The present study examined the relationship between eco-emotions (i.e., eco-anxiety, eco-depression, and eco-anger) and pro-environmental behaviours (PEBs), focusing on the moderating role of place attachment. A total of 250 participants (mean age = 33.69 years, SD = 14.67; 170 females) were enrolled. Results showed that only eco-anger was positively correlated with PEBs. Moreover, results indicated that place attachment moderated the association between eco-anger and PEBs, such that the positive relationship was weakened at higher levels of place attachment. No moderating effects of place attachment emerged for eco-anxiety and eco-depression. These findings suggest that place attachment may function as a subjective context-related factor associated with how eco-anger and PEBs co-vary at a single point in time. Overall, this study contributes to a more nuanced understanding of the cross-sectional associations between eco-emotions, subjective place-related bonds, and PEBs. The study offers implications for residential environmental communication strategies grounded in locally feasible behavioural options. Full article

This study examined parent–child physiological synchrony within the context of interactions and attachment-related differences. Specifically, this study investigated physiological synchrony, as indexed by the association between parent and child root mean square of successive differences (RMSSD) during free-play interactions, and differences in children’s mean heart rates according to attachment classification. The participants were 25 parent–child dyads (mean child age = 36.48 months). Physiological responses were assessed during free-play interactions using heart rate (HR) and heart rate variability (HRV). Children’s attachment was classified as secure or resistant based on their behaviors observed during the separation–reunion procedure. The results showed a significant positive association between the parent and child RMSSD (ρ = 0.48, p < 0.05). Parental anxiety was positively associated with both parents’ and children’s physiological arousal. Attachment-related group differences were observed only in the mean heart rate, with children with resistant attachment showing a significantly higher HR than those with secure attachment (t = 2.69, p < 0.05). No significant group differences were observed in the RMSSD or HR/RMSSD ratios. Overall, these findings suggest that the parent–child RMSSD association, as a component of physiological synchrony, may reflect a normative feature of parent–child interaction that emerges across attachment classifications. In addition, attachment-related differences were primarily observed in physiological arousal. Full article

Background/Objectives: Pediatric hematology and oncology patients are at increased risk for psychosocial and neurocognitive difficulties following treatment. Survivorship programs monitor late effects associated with disease and treatment history, with most programs focusing on screening and referring. Relatively less focus is placed on psychoeducation and intervention. The current paper describes the process of creating a novel psychology trainee-led consultation service embedded within a multidisciplinary survivorship clinic. Methods: A psychology intern collaborated with clinic staff and reviewed existing literature to inform the nature of the service. Patients seen in clinic met with the psychology intern for a 20-min visit focused on an area of concern identified during existing neuropsychology and/or social work assessment visits. Topics addressed included coping with stress, anxiety management, improving mood, sleep hygiene, parenting responses to common behavioral issues, and the acquisition of academic support. Pilot patient satisfaction data were collected via a questionnaire at the end of the visit, without any patient-identifiable factors attached to response data. Results: Most patients and families (90%) found the service helpful. Moreover, the majority of families (90%) found a 20-min service delivery to be adequate. The most common topic area addressed was anxiety management. Conclusions: Results demonstrate high patient satisfaction. Advantages of this service include rapid access to a no-fee support addressing common mental health and neurocognitive sequelae of childhood cancer and the expansion of psychology training opportunities. Future research should evaluate the service using validated outcome measures and examine its long-term effects. Full article

Emerging evidence suggests that psychological trauma, chronic stress, and unresolved emotional conflict may influence cancer-related processes through neuroendocrine and immunological pathways. However, the clinical relevance of trauma-related psychological profiles in oncology remains insufficiently defined, particularly in women with breast and gynecological cancers. This exploratory observational study included 135 women with breast, cervical, ovarian, and endometrial cancers undergoing multimodal oncological treatment. Psychological assessments were performed using validated instruments, including the PTSD Checklist (PCL), Hamilton Anxiety and Depression Scales (HAM-A, HAM-D), the Adult Attachment Scale (AAS), and a Lazarus-based checklist of stressful life events to assess cumulative stress exposure. Descriptive and exploratory analyses were conducted to identify clinically relevant patterns. A high prevalence of anxiety, depressive symptoms, and trauma-related distress was observed. Insecure attachment patterns were frequent and associated with increased psychological burden. Many patients reported moderate-to-high cumulative stress exposure, suggesting broader vulnerability profiles characterized by emotional dysregulation. These findings support a biopsychosocial model in which trauma, attachment insecurity, and cumulative stress are associated with psychological vulnerability in oncology. Although causal relationships cannot be established, these factors may influence coping and adaptation to disease. Integrating trauma-informed psychological assessment into oncology care may enhance patient-centered management. Full article

Background: Foster adolescents face elevated socioemotional risk, yet the joint and differential contributions of family adversity, attachment insecurity, and relational trauma to distinct adjustment domains remain poorly understood. The present study aimed to examine their joint, incremental, and differential contribution to emotional regulation difficulties and social competence. Methods: Forty-six adolescents (12–17 years; 63% female) in residential care in Uruguay completed self-report measures of family problems, attachment dimensions (anxiety, avoidance, socioemotional functioning), and relational trauma (SENA, CAA-R, CaMir-R). Hierarchical multiple regression examined their sequential prediction of emotional regulation difficulties and social competence. Results: Emotional regulation difficulties were explained by family problems, avoidant attachment, and relational trauma, whereas social competence was explained by anxious attachment and socioemotional attachment functioning. Final models explained 49% and 47% of variance, respectively. Discussion: This differential predictive pattern aligns with theoretical distinctions between deactivating and hyperactivating attachment strategies. Relational trauma’s specific contribution to regulatory, but not social, functioning supports neurobiologically grounded models of complex trauma. Conclusions: Findings suggest that emotional regulation difficulties were more closely associated with family problems, avoidant attachment, and relational trauma, whereas social competence was more strongly linked to anxious attachment and socioemotional attachment functioning. These results support differentiated, attachment-informed, and trauma-sensitive approaches in residential care settings. Full article

Positive mental health (PMH) has recently become a key topic in biomedical research. Previous studies have explored the correlation between biological and psychological measures, but only a few have focused on the relationship between PMH and aging. This study aimed: (i) to explore the association between PMH and biological aging; (ii) to determine if and to what extent the observed association could be explained by shared genetic and environmental effects. A total of 401 twins (age 19–81 years, 32% male) from the Italian Twin Registry were recruited, and the twin study design was applied. A self-report psychological test battery was used to evaluate several PMH components. Blood samples were collected from participants to determine telomere length (TL) and mitochondrial DNA copy number (mtDNAcn). TL was negatively associated with attachment anxiety (r = −0.11, p = 0.037). A bivariate twin model provided heritability estimates of 0.14 (95% CI 0.001–0.43) for TL and 0.32 (0.16–0.45) for attachment anxiety, and a substantial negative genetic correlation [r_g = −0.55 (−1.00–0.00)] between them. Under the limitations of a cross-sectional study with a self-report wellbeing assessment, these results suggest that anxiety in the relationship with a partner may contribute to accelerated TL shortening, and shared genetic factors may underlie this link. 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: Emotion regulation and attachment styles are interrelated and are critical factors in psychopathology and treatment outcomes, particularly in youths with suicidal behavior receiving psychiatric inpatient care. This study examined the influence of emotion regulation and attachment style on psychiatric hospitalization duration among adolescents admitted due to suicidal ideation or behavior. Methods: Participants included 79 Israeli adolescents (mean age 15.35 years, 87.3% female) admitted to a tertiary psychiatric inpatient unit following a suicidal crisis. Data was collected using the Difficulties in Emotion Regulation Scale (DERS), the Experience in Close Relationships Scale (ECR), the Screen for Child Anxiety-Related Emotional Disorders (SCARED), the Patient Health Questionnaire (PHQ-9), and the Columbia-Suicide Severity Rating Scale (C-SSRS). Data were analyzed using correlation and multiple regression analyses. Results: Analysis revealed that greater emotion regulation difficulties predicted longer hospitalization duration (β = 0.41, p < 0.001), while avoidant attachment style was associated with shorter hospitalization duration (β = −0.35, p < 0.001). Notably, the level of suicidality as well as psychopathology symptoms (depression and anxiety) did not predict hospitalization duration. Conclusions: These findings underscore the important role of emotion regulation and attachment style in determining treatment duration in suicidal adolescents, beyond the severity of psychopathology and suicidality, suggesting their unique contribution to treatment planning. Clinical interventions targeting emotion regulation and attachment styles could enhance inpatient care effectiveness, offer a more personalized treatment approach and potentially reducing hospitalization duration. Full article