Search Results (727)

Previous research has found significant associations among childhood trauma, dissociation, and shame. Furthermore, the clinical literature suggests that dissociation may foster feelings of shame in individuals who were exposed to childhood trauma. The current study aimed to test the potential mediating effect of dissociation on the association between childhood trauma and shame. The study sample consisted of 763 adults (479 females, 62.8%) from the general Italian population, aged between 18 and 65 years (M = 31.31, SD = 13.29). Self-report instruments assessing childhood trauma, dissociation, and shame were administered to participants via an anonymous online survey. Structural equation modeling showed that childhood trauma was associated with increased levels of both dissociation and shame. Moreover, dissociation partially mediated the predictive association between childhood trauma and shame. These findings suggest that dissociation might heighten the tendency to unconsciously reenact self-devaluation and self-blame in individuals exposed to childhood trauma, increasing feelings of shame. Full article

Although evidence suggests adiposity as a modifiable risk factor for postmenopausal breast cancer (BC), its association with premenopausal BC remains uncertain. This potential differential relationship for menopausal status has been insufficiently investigated in the Moroccan population due to limited data. This study aims to assess the relationship between various indicators of adiposity and the risk of BC among Moroccan women by menopausal status. A multicenter case-control study was conducted in Morocco between December 2019 and August 2023, including 1400 incident BC cases and 1400 matched controls. Detailed measures of adiposity and self-reported measures from different life stages were collected. Unconditional logistic regression analyses were conducted to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) for the association between body size indicators and the risk of BC, adjusting for a range of known risk factors for BC. Higher waist circumference (WC) and hip circumference (HC) were associated with an increased risk of BC in both pre- (p-trend < 0.001 for both WC and HC) and post-menopausal women (p-trend < 0.001 for WC, 0.002 for HC). Current body mass index (BMI) ≥30 kg/m² increased the risk of postmenopausal BC (p-trend = 0.012). Among postmenopausal women, higher weight at age 20 was positively associated with BC risk (p-trend < 0.001), while, weight at age 30 was significantly associated with increased BC risk in both pre- (p-trend = 0.008) and post-menopausal women (p-trend = 0.028). Interestingly, weight gain since age 20 was inversely associated with BC risk in postmenopausal women in the adjusted model (p-trend = 0.006). Young-adult BMI observed a significant increased trend with BC risk in both pre- (p-trend = 0.008) and post-menopausal women (p-trend < 0.001). In premenopausal women, larger body shape during childhood and early adulthood was positively associated with BC risk (p-trend = 0.01 and = 0.011, respectively). In postmenopausal women, larger childhood and adolescent body silhouettes were also associated with increased BC risk (p-trend = 0.045 and 0.047, respectively). These results suggest that anthropometric factors may have different associations with pre- and post-menopausal BC among Moroccan women. This underscores the importance of conducting large prospective studies to better understand these findings and explore their links to different molecular subtypes of BC. Full article

Background: Chronic stress in childhood and adolescence leads to excessive cortisol secretion, adipokines production and obesity with all the negative mental and physical effects on the health of individuals and adulthood. Objectives: The aim of the present non-randomized controlled trial was to investigate the effect of a stress management protocol with diaphragmatic breathing (DB) and physiotherapy exercise on stress, body composition, cardiorespiratory and metabolic markers of children and adolescents with morbid obesity. Methods: The study included 31 children and adolescents (5–18 years old) with morbid obesity (22 in the intervention arm and 9 controls). All participants completed anxiety questionnaires and a self-perception scale. Forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), blood pressure (BP) and SpO₂ were measured. Fasting glucose, uric acid, triglycerides, HbA1c, (AST/SGOT), (ALT/SGPT), HDL, LDL, insulin, ACTH, cortisol, HOMA-IR, 17-OH, S-DHEA, SHBG were assessed, and anthropometric measurements were also performed. Results: In the intervention group, 4 months after the treatment, an improvement was noted in the BMI, BMI z-score, waist-to-height ratio, FEV1, SpO₂, pulse and systolic BP. HDL increased, ALT/SGPT and insulin resistance improved. Positive changes were observed in temporary and permanent stress and self-esteem of children in the intervention group, including anxiety, self-perception, physical appearance, etc. Conclusions: A combined exercise and DB protocol has a positive effect on stress, by improving body composition, reducing insulin resistance, and ameliorating physical and mental health and quality of life of pediatric patients with morbid obesity. Full article

Background: Youth with chronic rheumatologic diseases undergo medical experiences that can lead to post-traumatic stress disorder (PTSD). Understudied in pediatric rheumatology, medical PTSD can be significantly distressing and impairing. Objective: This study explored the prevalence of medical PTSD symptoms in youth with chronic inflammatory arthritis and associated factors, including pain, disease activity, mental health history, and anxiety sensitivity. Methods: A cross-sectional study of 50 youth (ages 8–18) with juvenile idiopathic arthritis (JIA) and childhood-onset systemic lupus erythematous (cSLE) was conducted at a pediatric rheumatology clinic. Participants completed self-report measures assessing post-traumatic stress symptoms (CPSS-V), pain, anxiety sensitivity (CASI), pain-related self-efficacy (CSES), adverse childhood experiences (ACEs), and fibromyalgia symptoms (PSAT). Clinical data included diagnoses, disease activity, treatment history, and demographics. Results: Forty percent had trauma symptoms in the moderate or more severe range. The 14% likely meeting criteria for probable medical PTSD were older (median 17 vs. 15 years, p = 0.005), had higher pain scores (median 4 vs. 3, p = 0.008), more ACEs (median 3 vs. 1, p = 0.005), higher anxiety sensitivity scores (median 39 vs. 29, p = 0.008), and higher JIA disease activity scores (median cJADAS-10 11.5 vs. 7.5, p = 0.032). They were also more likely to report a history of depression (71 vs. 23%, p = 0.020). No associations were found with hospitalization or injected/IV medication use. Conclusions: Medical trauma symptoms are prevalent in youth with chronic inflammatory arthritis. Probable PTSD was associated with pain and psychological distress. These findings support the need for trauma-informed care in pediatric rheumatology. Full article

Research on human–animal relationships suggests that close bonds with animals can enhance empathy, reduce speciesism, and improve human physical and psychological health. This study investigated whether pet ownership—particularly attachment to a companion animal during childhood—is associated with differences in moral concerns toward all animals in adulthood. It also aimed to explore the potential effects of empathy and speciesism on overall moral concerns toward animals. Using self-report questionnaires among 72 participants recruited online, the analyses revealed a significant effect of animal categories on moral concerns, F(1, 1.98) = 59.37, p < 0.001. Mean moral concern scores were significantly higher for companion animals (M = 6.04, SD = 1.15) than for food animals (M = 4.90, SD = 1.44), unappealing wild animals (M = 4.20, SD = 1.87), and appealing wild animals (M = 5.73, SD = 1.32), p < 0.05. Additionally, childhood pet owners reported greater moral concerns for all animals, F(1, 1.98) = 4.87, η² = 0.065, p < 0.05. Attachment to a companion animal in childhood was positively correlated with moral concerns for all animal categories. Finally, although attachment and empathy were both positively related to moral concern, only attachment was a significant predictor (p < 0.05). Further research is needed to understand the psychological mechanisms influencing views on animal rights and welfare. Full article

Background/Objectives: Medical and nursing students, as future healthcare professionals, influence public trust and vaccine acceptance. Knowledge gaps or misconceptions regarding immunization may undermine their confidence and effectiveness in addressing vaccine hesitancy. This study explores perceptions and attitudes toward childhood vaccination among Bulgarian healthcare students and factors shaping these outcomes. Methods: A cross-sectional survey was conducted in 2024, using an online self-administered questionnaire completed by 374 medical and nursing students. Descriptive statistics were used to analyze vaccine-related responses, comparing attitudes between healthcare programs and education years. Binomial logistic regression was applied to identify predictors of support for mandatory vaccination, first considering demographic and academic variables, and then adding students’ beliefs and common misconceptions. Results: Medical students showed more positive attitudes toward vaccination than nursing students, with 96.8% of medical students versus 89.4% of nursing students believing vaccines are effective (p = 0.005). Students in advanced years demonstrated stronger belief in vaccine effectiveness (p = 0.038). Additionally, misbeliefs about the measles vaccine causing autism decreased significantly, with most students in higher years rejecting this misconception (p = 0.009). Logistic regression revealed that belief in following the vaccine schedule (OR = 22.71; p < 0.001) and confidence in vaccine effectiveness (OR = 10.20; p < 0.001) were the strongest predictors of support for mandatory vaccination, with attitudinal factors explaining over half of the variance. Conclusions: Healthcare students’ attitudes about vaccination influence public health outcomes, as their perspectives reflect experience and beliefs. Targeted vaccine education helps address misconceptions and improve vaccination rates. Full article

Background and Clinical Significance: Juvenile ossifying fibroma (JOF) is a rare, benign, but locally aggressive fibro-osseous neoplasm that primarily affects the craniofacial skeleton of children and adolescents. Early surgical intervention is often required due to the lesion’s rapid growth and potential for significant facial deformity. Long-term functional and esthetic rehabilitation following maxillary resection in early childhood remains a clinical challenge. Case Presentation: This case reports a unique long-term follow-up of a 22-year-old female patient who underwent partial maxillary resection at the age of five due to JOF. Initial reconstructive efforts failed, necessitating a removable prosthesis to restore function and appearance. The patient experienced persistent self-consciousness and social withdrawal during adolescence, attributed to altered facial esthetics and repeated surgical disappointment. Nevertheless, prosthetic rehabilitation significantly improved mastication, phonetics, facial symmetry, and psychological well-being. Conclusions: The enduring psychosocial and functional impact of early maxillary resection for JOF and the pivotal role of prosthodontic management in long term rehabilitation are highlighted. A multidisciplinary approach that includes psychological support is suggested. This case report is among the few reports documenting long-term prosthetic outcomes for pediatric JOF patients extending into adulthood. Full article

Background/Objectives: Obesity among university students is a growing concern, often influenced by biological, psychological, and social factors. Few studies in Saudi Arabia have addressed this issue using a comprehensive framework. This study aims to examine the prevalence of obesity and its biopsychosocial predictors among university students, as well as their perceptions, behaviors, and comorbidities. Methods: A cross-sectional study was conducted at Jazan University during the 2024–2025 academic year. A total of 819 undergraduate students completed a structured, self-administered Arabic questionnaire. The tool assessed sociodemographic variables, body mass index (BMI) (calculated from self-reported height and weight), biological and psychological factors, social influences, lifestyle behaviors, and comorbidities. Bivariate associations were tested using chi-square analyses, and multivariate logistic regression was used to identify independent predictors of obesity. Results: The prevalence of obesity was 19.6%, and 22.6% of students were overweight. Obesity was significantly more prevalent among males (26.7%) than females (9.6%, p < 0.001) and among students aged 24 years and above (24.0%, p = 0.024). Independent predictors of obesity included being overweight in childhood (AOR = 5.23, 95% CI: 3.47–7.90), belief in a genetic predisposition (AOR = 4.66), emotional eating (AOR = 2.57), academic or personal stress (AOR = 5.36), and social pressures related to body image (AOR = 2.96). Comorbidities significantly associated with obesity included high cholesterol (AOR = 5.40), sleep disorders (AOR = 2.99), and joint pain (AOR = 1.96). More than 80% of students with obesity reported current or past weight loss attempts, and nearly 60% received medical advice to lose weight. Conclusions: Obesity among Jazan University students is significantly associated with male gender, early-life weight history, emotional and academic stress, and social pressures. Students with obesity also experience a higher burden of comorbid conditions, even at a young age. These findings highlight the need for integrated, student-centered interventions that address both the psychological and social dimensions of weight management in university settings. Full article

Although smart device use among children is increasing, most interventions overlook their cognitive and emotional development or rely too heavily on external control. Such approaches often overlook the developmental needs of children for emotional regulation and autonomy. Therefore, this study aims to propose a child-centred user experience (UX) framework to support digital self-regulation in preschool-aged children. The proposed system integrates multiple psychological theories—including Piaget’s concept of animistic thinking, executive function theory, Self-Determination Theory, and Acceptance and Commitment Therapy—to support cognitive and emotional regulation during screen use. Key features include persistent visual cues to enhance time awareness and behavioural anticipation, narrative-based character interactions to foster empathy and agency, and ritualised closure routines supported by multimodal and tangible interaction elements. Developed as a mobile prototype, the system was iteratively refined through two-stage consultations with child and adolescent psychiatrists and a developmental psychologist, including formative design feedback and follow-up expert review. Their feedback provided preliminary validation of the system’s developmental validity and emotional coherence. These findings suggest that affectively attuned UX design is a viable alternative to conventional control-based screen-time interventions in early childhood. Full article

Background/Objectives: The role of maternal diet in atopic dermatitis (AD) requires better understanding, as AD often manifests early in life and precedes other allergic diseases. We evaluated the association between maternal diet and AD up to 2 years of age. Methods: A total of 116 mother–child dyads from the CARE birth cohort study were included. Maternal diet during pregnancy was assessed with a validated self-administered 97-item food frequency questionnaire, and dietary scores were calculated. AD was evaluated at ages 4 months, 1 year, and 2 years. The associations between maternal dietary patterns and AD were examined by logistic regression analysis adjusting for total energy intake, gender of the child, maternal antibiotic therapy during pregnancy, and history of atopic disease among both parents. Results: Of the 116 children, 27 (23.3%) developed AD by 2 years, 11 of whom (40.7%) had persistent AD within the first 2 years. AD risk was reduced with a higher Mediterranean diet score during pregnancy (upper median > 3 points versus lower median: adjusted OR 0.24, 95% CI 0.08–0.69, p = 0.009) and with greater dietary diversity, as measured by the number of items consumed (upper median > 53 items versus lower median: OR 0.19, 95% CI 0.06–0.58, p = 0.005). No association was found with macronutrients and micronutrients. Red meat consumption showed a positive association with the persistent AD phenotype (adjusted OR 5.04, 95% CI 1.47 to 31.36, p = 0.034). Conclusions: Adherence to a Mediterranean diet and a diverse diet during pregnancy may decrease the risk of developing early childhood AD. This highlights the synergistic role of nutrients in dietary patterns as they modulate immune development and disease susceptibility. Full article

Background/Objectives: Hypohidrotic ectodermal dysplasia (HED) is a rare hereditary disorder affecting ectoderm-derived tissues including teeth, hair, and sweat glands. The dental abnormalities associated with HED, such as oligodontia and conical teeth, often result in significant functional, esthetic, and psychosocial challenges, particularly during childhood. Methods: A 10-year-old child presented with psychosocial concerns related to missing and malformed teeth. Clinical examination revealed oligodontia, conical anterior teeth, and a resorbed mandibular ridge. Based on clinical findings and a positive family history, a diagnosis of HED with significant dental involvement was confirmed. Results: A conservative prosthodontic approach was selected. A maxillary overdenture was fabricated over the retained primary teeth to enhance retention and preserve the alveolar bone, and a resin-bonded bridge was placed in the mandible due to poor ridge anatomy. The treatment restored oral function and esthetics and improved the child’s self-esteem. A recall visit after three months confirmed good prosthesis adaptation and a positive response from the patient and parents. Conclusions: This case highlights the importance of early, conservative, and developmentally appropriate prosthetic rehabilitation in pediatric patients with HED. Interim prostheses can significantly improve oral function, appearance, and psychosocial well-being while preserving future treatment options as the child matures. Full article

Cerebral palsy (CP) is one of the most common disorders in childhood that significantly impacts quality of life. Background/Objectives: This study conducted a literature review of physical activity (PA)-based interventions for children and adolescents with CP, highlighting the physical, cognitive, and social benefits, as well as the factors and barriers that influence practice. Methods: The PRISMA methodology was used to identify and analyze the most relevant studies up to December 2024 through specific search equations and the databases Science Direct, Scopus, and Dialnet. Of the 707 articles identified, a total of 62 publications were selected for further analysis. These were subjected to a quality assessment through a checklist based on seven items. Results: The practice of PA guaranteed improvements in balance, postural control, strength, socialization, and self-confidence. On the other hand, some programs, such as Makey Makey, Ballet, aquatic PA, and Matrogymnasia, among others, were highlighted because they promoted an increase in physical practice among the population. However, there are still some barriers, such as sedentary lifestyles (90%), limited accessibility, and a lack of qualified professionals that hinder the intervention and ensure motivation and interest in its practice for those individuals who have not yet begun to practice it. Conclusions: PA is an effective tool to favor quality of life in children and adolescents, as it contributes to their integral development and social inclusion. The need for interdisciplinary strategies to reduce barriers and increase the benefits of PA is emphasized. A joint effort to promote integration in leisure time could promote optimal long-term results. Full article

Background: Social determinants of health—including both adversity and socioeconomic position—are known to shape physical health, health-related behaviors, and overall well-being. However, the psychological mechanisms that link these determinants to diverse outcomes remain insufficiently explored across international contexts. Objective: The objective of this study is to test whether sense of mastery and control over one’s life mediates the associations between key stressors (childhood abuse, financial insecurity) and socioeconomic resources (education, employment, and marital status) with a wide range of outcomes spanning health, behaviors, and well-being. Methods: Using cross-sectional data from Wave 1 of the Global Flourishing Study (GFS), we analyzed responses from more than 200,000 adults in 23 countries. Predictors included exposure to childhood abuse, perceived financial insecurity, and indicators of socioeconomic position (education, employment, and marital status). Outcomes included self-rated physical and mental health, depression, anxiety, smoking, drinking, physical activity, life satisfaction, and happiness. Structural equation modeling (SEM) was used to evaluate both direct and indirect (mediated) effects through sense of mastery and control over life. Results: Stressors were associated with poorer health, higher engagement in risk behaviors, and lower well-being. In contrast, higher levels of education, employment, and being married were linked to more favorable outcomes. In all tested models, sense of mastery and control over life significantly mediated the effects of both stressors and socioeconomic resources on health, behaviors, and well-being outcomes. Conclusions: Sense of mastery and control over life may represent key psychological pathways linking both adversity and social advantage to diverse health-related outcomes. Interventions that enhance individuals’ perceived control may offer cross-cutting benefits to improve health, promote well-being, and reduce behavioral risk factors globally. Full article

Executive function (EF) and effortful control (EC) are two similarly defined constructs implicated in self-regulation. Recent debates have questioned whether EF and EC may in fact represent a single construct, and they have undergone scrutiny regarding construct independence. Efforts to differentiate them have further queried whether one may in fact precede the other in early childhood. In a cohort-sequential study of 191 typically developing 4-to-7 year olds (97 girls, 59.7% White), confirmatory factor analysis supported the correlated yet separable two-factor structure of EF and EC with partial scalar invariance across preschool and school-age groups. Longitudinal multi-group modeling was then used to identify predictive pathways between EF, EC, and psychopathology. For both developmental groups, EF predicted externalizing behaviors one year later while EC did not directly predict behavioral outcomes. Internalizing behaviors were found to be highly stable and predictable over time and across age; however, externalizing behaviors significantly predicted internalizing behaviors one year later in the school-age group but not the preschool group. These findings have implications for the measurement of EF and EC in early childhood, as well as the development and prediction of internalizing and externalizing behaviors across the transition to school. Full article

Sexual minority men (SMM) experience anti-SMM stressors and have elevated rates of mental health issues compared to heterosexual men, such as depression. Importantly, strengths-based factors may directly increase wellbeing and provide a buffer against the detrimental effects of such stressors. In the present study, we integrated risk and strengths-based models to examine predictors of depression symptoms in a sample of 465 Canadian SMM across three time points using multilevel modeling. Higher scores on a measure of childhood physical abuse at baseline, and greater within-person (i.e., deviation from individual’s average) and between-person (i.e., deviation from group average) internalized homonegativity and heterosexist discrimination were associated with higher depression scores. Higher within- and between-person scores on measures of self-esteem, social support, and hope were associated with lower depression scores. Social support buffered the effects of between-person heterosexist discrimination on depression symptoms: at mean and high levels of social support, heterosexist discrimination was not associated with depression symptoms. This is the first study to disaggregate between-person and within-person effects of both risk factors and strengths-based factors among SMM, which has critical importance for the development of tailored individual-level interventions that target internalized homonegativity, hope, social support, and self-esteem to alleviate symptoms of depression among SMM. Full article