Search Results (747)

Background/Objectives: Adolescent substance use and mental health problems frequently co-occur and share common risk and protective factors. Some school-based prevention programs address substance use and mental health within an integrated approach. However, the characteristics and intervention components of these integrated approaches remain insufficiently understood. This review aimed to describe the program characteristics of school-based integrated mental health and substance use prevention programs for adolescents that were evaluated in randomized or cluster randomized controlled trials (RCTs/cRCTs), with particular attention to their intervention components, delivery approaches and prevention strategies. Methods: This review used a structured approach comprising a systematic literature search, predefined eligibility criteria, independent study selection, standardized data extraction and coding, and descriptive synthesis. Electronic databases (PubMed, Embase, Cochrane Library, CINAHL, PsycINFO, KMbase, KoreaMed, ScienceON, DBpia, KISS, RISS, and PQDT) were searched for studies published between January 2016 and April 2026. Studies were eligible if they were randomized or cluster randomized controlled trials evaluating school-based interventions that incorporated both substance use prevention and mental health promotion components among adolescents. Data were extracted and synthesized descriptively at the program level to summarize program characteristics and intervention components. Results: Fifteen studies representing 10 unique programs were included. Mental health literacy was identified in 5 programs and emotional regulation in 4. Drug literacy and resistance skills were each identified in 6 programs, alcohol prevention in 5, and cannabis prevention in 4. A descriptive cross-domain analysis identified overlapping patterns involving literacy, self-regulation, help-seeking, social competence, peer support, and family-focused approaches rather than mutually exclusive program types. Conclusions: The school-based integrated prevention programs evaluated in randomized or cluster randomized controlled trials and included in this review combined substance use prevention with mental health promotion components, including psychosocial skill development, peer support, and, in one program, a family-focused approach. The descriptive synthesis of program characteristics provides an initial basis for understanding the diverse approaches used in integrated school-based prevention and may inform the future design and evaluation of programs targeting adolescent mental health and substance use. Full article

Background: Resilience is an important resource in nursing education, supporting students in adapting to demanding academic and clinical environments. However, evidence regarding the factors associated with resilience among nursing students remains inconsistent. This study aimed to examine the factors associated with resilience among undergraduate nursing students, with particular emphasis on gender, age, academic progression, institutional context, and selected sociodemographic characteristics. Methods: A cross-sectional quantitative study was conducted with 263 undergraduate nursing students from two higher education institutions in Portugal. Data were collected using the Takviriyanun Resilience Factors Scale, adapted and validated for the Portuguese population. Descriptive and inferential statistical analyses were performed to examine the two dimensions of the scale—Personal and Social Support Skills and Problem-Solving Skills—and their associations with sociodemographic and academic variables. Results: Students reported generally favourable levels of resilience-related factors, with higher scores observed in items reflecting personal responsibility and perceived social support. Comparatively lower scores were observed for items related to calmness and patience, confidence, optimism, and perceived social acceptance. A statistically significant gender difference was found in Problem-Solving Skills, with male students showing higher mean ranks than female students (p = 0.038); however, the effect size was small (r = 0.13). A moderate positive correlation was observed between Problem-Solving Skills and Personal and Social Support Skills (ρ = 0.394, p < 0.001). No statistically significant associations were found between the resilience dimensions and age, year of study, higher education institution, displacement status, place of residence, or religious affiliation. Conclusions: Undergraduate nursing students demonstrated generally favourable levels of resilience-related factors. Personal and Social Support Skills and Problem-Solving Skills were positively associated, suggesting a meaningful relationship between interpersonal resources and problem-solving competencies. Although a small gender difference was observed in Problem-Solving Skills, the findings do not indicate substantial gender-related differences in resilience-related factors. Educational strategies aimed at strengthening problem-solving, adaptive coping, emotional self-regulation, and social support may be relevant throughout undergraduate nursing education. Longitudinal and multicentre studies are warranted to further investigate the factors associated with resilience and to evaluate the effectiveness of resilience-focused educational interventions. Full article

Emotional education is fundamental in teacher training due to its impact on teacher well-being and student learning. In Chile, initial teacher training has addressed this dimension in a fragmented manner, and little is known about whether in-service teachers exhibit distinct patterns of retrospectively perceived preparation across different domains of emotional education. This study aimed to identify and characterize latent profiles of retrospectively perceived knowledge in emotional education acquired during initial teacher training among Chilean in-service teachers. Using a retrospective design, 412 practicing teachers participated (86.7% female; mean age = 39.2 years; mean teaching experience = 12.6 years). The EEITT Scale assessed perceived knowledge acquired in Mood, Emotional Regulation, Psychosocial Well-being, and Identity. Confirmatory factor analysis supported the predefined four-factor structure, and latent profile analysis was conducted in R by comparing solutions from one to eight profiles. Six profiles were retained, showing a combination of differences in overall perceived preparation and more specific configurations across dimensions. Emotional Regulation emerged as one of the most discriminating dimensions, particularly in profiles characterized by comparatively low perceived preparation in this domain, alone or together with Psychosocial Well-being. The six-profile solution showed adequate classification quality (entropy = 0.824), although classification uncertainty was greater for one intermediate profile. Overall, the findings indicate that teachers do not report a uniform pattern of perceived preparation in emotional education; instead, distinct subgroups differ in both the overall level and configuration of perceived preparation across domains. These results suggest that reliance on sample-level averages may obscure meaningful variation in teachers’ retrospective perceptions of their initial training and may inform future research on differentiated professional development strategies. Full article

Background: Cervical cancer remains a major public health concern worldwide, particularly in low- and middle-income countries. Limited knowledge regarding cervical cancer prevention and elevated anxiety levels may hinder women’s participation in preventive measures. Mindfulness-Based Social–Emotional Learning integrates mindfulness practices with social–emotional learning strategies and may enhance health knowledge while reducing anxiety. Materials and Methods: A quasi-experimental pretest–posttest non-equivalent control group design was conducted among 80 women attending gynecological outpatient clinics in Egypt. Participants were assigned to a study group (n = 40) and a control group (n = 40). Data were collected using a structured interview questionnaire, a cervical cancer knowledge questionnaire, and the Beck Anxiety Inventory (BAI). The study group received an eight-week MBSEL intervention incorporating mindfulness exercises, social–emotional learning activities, and cervical cancer education, while the control group received routine health education. Pre- and post-intervention assessments were performed. Results: Baseline characteristics were comparable between groups. Following the intervention, the study group had significantly higher mean knowledge scores regarding cervical cancer prevention, with mean knowledge scores increasing from 38.71 ± 10.41 to 66.25 ± 8.95 compared with 42.09 ± 15.95 in the control group (t = 8.355, p < 0.001). Good knowledge levels increased from 2.5% to 35.0%, while poor knowledge declined from 62.5% to 0.0%. Anxiety levels significantly improved in the study group, with mean BAI scores decreasing from 38.68 ± 6.32 to 22.20 ± 3.91 compared with 34.28 ± 9.53 in the control group (t = 7.414, p < 0.001). Low anxiety increased from 2.5% to 62.5% in the study group compared with 7.5% to 12.5% in the control group, and severe anxiety was eliminated from 27.5% to 0.0% in the study group compared with 32.5% to 22.5% in the control group after the intervention. Conclusions: The MBSEL approach effectively enhanced women’s knowledge regarding cervical cancer prevention and significantly reduced anxiety levels. Integrating mindfulness practices with social–emotional learning and health education appears to strengthen cognitive engagement and emotional regulation. Clinical Trial Registration: Registered in accordance with WHO and ICMJE standards (Trial number: PACTR202605512267205). Registration date: 29 May 2026. Full article

Mental health counselors routinely work in emotionally demanding environments that require sustained psychological and occupational functioning. Identifying psychological resources and occupational factors that support adaptive functioning may inform strategies to enhance counselor well-being and reduce burnout. This study examined the relationships among counselors’ clinical service context, emotion regulation, growth mindset, self-compassion, job satisfaction, and burnout. Participants were 152 individuals with graduate degrees who provided counseling services and completed an anonymous online survey. Measures assessed burnout, job satisfaction, self-compassion, growth mindset, cognitive reappraisal, expressive suppression, and workplace and professional characteristics. Group comparisons and hierarchical regression analyses were conducted. Burnout was significantly associated with lower job satisfaction, self-compassion, cognitive reappraisal, and growth mindset. Counselors providing services to children reported greater burnout and lower self-compassion, whereas those providing services to adults reported greater cognitive reappraisal, higher job satisfaction, and lower burnout. Job satisfaction varied across service settings, with the highest levels observed in outpatient community mental health and private practice and the lowest in detention centers and K–12 schools. In hierarchical regression analyses, only job satisfaction and self-compassion independently predicted burnout after controlling for counseling experience, degree characteristics, growth mindset, and emotion regulation. Counselors’ adaptive functioning appears to reflect the combined influence of workplace context and psychological resources. Self-compassion and job satisfaction emerged as key protective factors against burnout. These findings have implications for counselor education, clinical supervision, workforce development, and interventions designed to promote occupational well-being and strengthen the behavioral health workforce. Full article

Introduction: The recognition of Complex Post-Traumatic Stress Disorder (CPTSD) as a distinct diagnosis in ICD-11 has intensified the need to clarify its boundaries with Borderline Personality Disorder (BPD), given their symptom overlap and shared traumatic origins. Therefore, this systematic review aimed to examine whether CPTSD is distinct from BPD, assess their comorbidity and symptom overlap, identify key criteria for differential diagnosis, and explore therapeutic implications. Method: A systematic search was conducted in PubMed, Scopus, and Web of Science following PRISMA 2020 guidelines. Seven empirical studies (2015–2025) were included, comprising 2574 adults (mean age 40.4 years; 73.3% women). Methods included latent class analysis, structural equation modeling, and network analysis. The methodological quality of the included studies was evaluated independently by two reviewers using the JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies. Results: Findings consistently supported that CPTSD and BPD are empirically distinguishable, though substantially correlated, particularly within the ICD-11 framework. High symptom co-occurrence was observed, with affective dysregulation identified as the symptom most centrally connecting the two symptom networks. Self-concept emerged as the most robust differentiator: stable and persistently negative in CPTSD versus unstable and fragmented in BPD. Shame was a key affective marker of more severe presentations, and trauma severity, rather than diagnostic category, was associated with symptom variation across studies. Conclusions: CPTSD and BPD are distinct yet frequently co-occurring conditions. Differential diagnosis should focus on self-concept stability, patterns of behavioral dysregulation, and shame. Treatment requires individualized, trauma-informed, and shame-sensitive approaches, with transdiagnostic emotion regulation strategies across presentations. These conclusions should be interpreted with caution, given the predominantly cross-sectional design and methodological heterogeneity of the available evidence. Full article

Reflecting on emotionally challenging experiences with caregivers is a critical developmental process through which children learn to identify, express, and regulate emotions. However, much of the existing literature on caregiver–child emotion socialization has centered White, middle-class families, limiting understanding of how these processes unfold within culturally and contextually situated interactions among Black families. Guided by Margaret Beale Spencer’s Phenomenological Variant of Ecological Systems Theory and the Integrative Conceptual Model of Adaptive Racial/Ethnic and Emotion Socialization, the present study explored how Black girls (ages 5–11) described experiences of sadness, stress, and anger during caregiver-guided conversations embedded within a culturally grounded shared book reading activity. Fifteen Black girls (M = 8.27 years, SD = 1.71) and their caregivers participated in a novel video-recorded shared reading activity followed by a guided discussion about emotions. Black girls described sadness in relation to separation from loved ones, social exclusion, and witnessing harm; stress primarily in response to academic pressures; and anger in response to perceived unfairness and injustice. They also identified diverse emotion regulation strategies, including deep breathing, solitude, cognitive reframing, imaginative coping, and seeking social support. Across emotional contexts, caregivers consistently encouraged elaboration, validated children’s emotional experiences, and reinforced adaptive coping strategies, creating supportive opportunities for collaborative emotional meaning-making. Our findings highlight shared reading as a culturally affirming context for caregiver-supported emotion socialization and underscore the importance of centering Black girls’ voices in research on socioemotional development. Full article

Violent crime is a widely recognized public health concern. According to emotion regulation theory, aggressive behavior in violent offenders is linked to maladaptive emotion regulation strategies. However, few studies have explored interventions targeting emotional factors to reduce aggression in this population. Expressive arts therapy (EAT), which facilitates emotional expression and release, has shown therapeutic potential, but its effectiveness for violent offenders remains understudied. This randomized controlled trial examined the effects of an 8-week EAT program on emotion regulation and aggressive behavior in male violent offenders from a prison in China. Participants were assigned to either the intervention group (n = 31) or the control group (n = 34). Outcomes were assessed using cognitive reappraisal tasks, the Implicit Association Test, visual analogue mood scales, and the Emotion Regulation Strategies for Artistic Creative Activities Scale. Key findings revealed that, after 4 weeks of intervention, the experimental group demonstrated significantly improved cognitive reappraisal abilities and weakened “violence-positive” implicit associations, suggesting that enhanced cognitive reappraisal may be one key mechanism through which EAT operates. These results suggest that EAT effectively fosters positive psychological resources (i.e., cognitive reappraisal) and promotes non-violent implicit attitudes among violent offenders. This study provides initial quantitative evidence for EAT as a promising intervention for reducing aggression-related cognitive and implicit processes. Future research should further investigate its long-term effects and underlying mechanisms. Full article

While most research on biographical narratives has concentrated on the analysis of the final textual product as a means of understanding the narrative, the present study explores the underlying processes of narrative construction and presentation within peer groups in a teacher education college, drawing on the narrators’ own reflections and accounts. Employing on a qualitative grounded theory design, semi-structured interviews were conducted with 15 current and former special education college students. Participants reflected on the deliberative and interpretive processes, shaping both disclosure decisions and modes of self-presentation. Findings indicate that peer groups constitute a significant force in narrative co-construction. Boundaries of disclosure and degrees of vulnerability were continuously negotiated, through engagement with others’ narratives. Participants employed various narrative strategies, including redemption and normalization frameworks, in order to sustain a coherent and resilient professional self-concept. A key theoretical contribution of the study is the conceptualization of emotional regulation, as an integral component of narrative construction. Participants actively modulated the emotional intensity of their storytelling. Overall, the study suggests that Biographical Narrative practices function as a collaborative and meaning-making process that supports reflective capacity, peer-based scaffolding and resilience, thereby contributing to teacher well-being and professional identity development, in preservice education contexts. Full article

Background: Cyberbullying is a critical public health issue affecting adolescent well-being. This study adopted a socio-ecological framework to examine individual, family, and school-level risk factors associated with three cyberbullying roles—Cyberbullies, Cybervictims, and Cyberbully/Victims—with particular attention to the often-overlooked Cyberbully/Victim subgroup and gender pathways. Methods: A total of 4543 adolescents (Mage = 13.97 years; 52.5% girls) completed the Tabby Improved Checklist. Multinomial logistic regression analyses were conducted separately for boys and girls to identify predictors of involvement in the three cyberbullying roles, including empathy dimensions, moral disengagement, antisocial behavior, aggression toward teachers, and social support, using non-involved adolescents as the reference group. Results: Cyberbully/Victims represented a high-risk profile characterized by elevated moral disengagement, antisocial behavior, and aggression toward teachers, irrespective of gender. Gender-specific patterns also emerged: male Cyberbullies exhibited high cognitive empathy and low affective empathy, whereas female Cybervictims and Cyberbully/Victims reported higher levels of affective empathy. Furthermore, low parental support and monitoring significantly predicted involvement among male Cyberbullies but not among females. Aggression toward teachers emerged as a common risk factor across all cyberbullying roles. Conclusions: These findings underscore the complexity of the Cyberbully/Victim role and support the need for gender-sensitive prevention strategies. Effective prevention efforts should adopt a multi-level approach addressing maladaptive cognitive processes, emotional regulation, and student–teacher relationships to reduce online aggression. Full article

Work-related stress and difficulties in managing the work–life interface represent significant challenges for psychological well-being. While research has increasingly examined coping and recovery processes, less attention has been paid to the role of nature-based leisure activities in supporting these dynamics. This qualitative study explores how adult workers who regularly practice surfing use this activity to cope with work-related stress and how it relates to the development of personal resources and the work–life interface. Semi-structured interviews were conducted with 14 Italian workers, and the data were analyzed using thematic analysis. Three main themes emerged. First, surfing was described as a coping strategy that supports emotional regulation, psychological detachment from work, and recovery, particularly through immersion in a natural environment. Second, participants reported that experiences developed in surfing, such as managing uncertainty, risk, and decision making, were transferable to the work context. Third, surfing played a complex role in the work–life interface, contributing to balance but also generating time-based tensions when not adequately integrated into daily routines. Overall, the findings highlight the active role of individuals in using extra-work activities as resources for coping and recovery and underline the importance of considering nature-based experiences within broader models of occupational well-being and work–life dynamics. Full article

Young women living in urban informal settlements experience intersecting structural and environmental conditions that shape health and well-being. Alcohol environments (the physical, social, and commercial contexts in which alcohol is sold, marketed and consumed) represent an important but understudied social and commercial determinant of health. Young women in these settings face intersecting vulnerabilities, including poverty, unemployment, and gender inequality, that increase their exposure to alcohol-related harm. Although alcohol use and alcohol-related harms are increasingly understood as shaped by social and commercial determinants of health, little is known about how young women experience alcohol environments in low-resource settings. This exploratory, site-specific secondary, qualitative analysis draws on data from a 2022 Photovoice project conducted over several weeks with 15 young women (ages 18–24) living in urban poverty in Kampala. Participants used photography and group discussions to explore how alcohol shapes their lives. Our inductive thematic analysis included all five participants from the Makindye site, where alcohol-related photographs and narratives emerged prominently during the Photovoice discussions. Six key themes were identified from 42 narrative excerpts and two photographs, highlighting alcohol’s dual role as both a source of livelihood and a source of harm. Participants described pervasive exposure to aggressive marketing, unregulated drinking venues, and the normalization of alcohol use, often linked to interpersonal violence, emotional distress, and disruption of household dynamics. Alcohol environments also constrained women’s mobility and safety, limiting their participation in public life. These findings suggest that alcohol environments may shape young women’s exposure to violence, economic precarity, and psychological distress in this setting. They also point to the potential value of gender-responsive policies, stronger regulation, and community-based prevention strategies to address alcohol-related harm and health inequities in low-resource urban settings. Full article

Cannabis use among adolescents and young adults has increased alongside legalization, commercialization, and higher product potency. However, evidence regarding the effectiveness of interventions to prevent or reduce cannabis use remains heterogeneous. To systematically synthesize evidence from randomized controlled trials (RCTs) evaluating behavioral, educational, psychosocial, family-based, and digital interventions targeting cannabis use among adolescents and young adults. Following PRISMA guidelines, MEDLINE, PsycINFO, CINAHL, Embase, and Web of Science were searched for randomized or cluster-randomized controlled trials involving participants aged 12–25 years. Study characteristics, intervention approaches, outcomes, and effectiveness were synthesized qualitatively. Of 973 records, 15 RCTs met the inclusion criteria. Studies varied in setting, intervention characteristics, delivery modality, and follow-up duration (2 months–7 years). School-based cognitive-behavioral interventions demonstrated the most consistent reductions in cannabis use and related harms by strengthening emotional regulation, problem-solving, coping skills, and social competence. Motivational interviewing, family-based, and digital interventions showed beneficial but variable effects. Behavioral interventions, particularly school-based cognitive-behavioral approaches, provide the strongest and most consistent evidence for reducing cannabis use and related harms among adolescents and young adults. However, methodological heterogeneity limits direct comparisons. Future well-powered RCTs with standardized outcome measures, longer follow-up, and implementation evaluations are needed to strengthen evidence-based prevention strategies. Full article

The present study aimed to examine whether self-esteem acts as a mediator in the relationship between problematic internet use (PIU) and well-being among athletes, and to determine the implications of these relationships for educational practice, coaching strategies, and athlete support interventions. A total of 334 Polish athletes participated in the study and completed the Polish versions of the Generalized Problematic Internet Use Scale 2 (GPIUS2), the Rosenberg Self-Esteem Scale (SES), and the Mental Health Continuum-Short Form (MHC-SF). Pearson’s r correlation coefficients and mediation analyses using a bootstrap approach were conducted. The main results showed that PIU was negatively associated with self-esteem and well-being, whereas self-esteem was positively associated with well-being. Statistically significant, although small, indirect associations through self-esteem were observed between PIU and general well-being, as well as between all dimensions of PIU and emotional and psychological well-being. For social well-being, statistically significant indirect associations were observed only for preference for online social interaction and deficient self-regulation. These findings suggest that self-esteem may represent one psychological factor associated with the interrelations between PIU and well-being in athletes. The results may contribute to a more cautious understanding of the links between problematic internet use, self-esteem, and well-being, and may inform psychoeducational and preventive strategies in sport settings while acknowledging the limited practical significance of the observed effects. Full article

The intensification of armed conflicts has forced thousands of women to seek refuge in other countries, exposing them to conditions of heightened vulnerability, characterized by inequality, violence, and mental health challenges. Despite these adversities, refugee women demonstrate resilience through diverse coping strategies. However, qualitative research centring women’s experiences within gender-sensitive and intersectional frameworks remains limited. This study aims to characterize the experiences of forced migration among refugee women in Portugal and to explore the coping strategies they have developed. Semi-structured interviews were conducted with six refugee women residing in Portugal. Based on thematic analysis, the data revealed a trajectory marked by material and symbolic losses, disruption of social bonds, and symptoms consistent with post-traumatic stress. Motherhood emerged both as motivation and as an obstacle to social and professional integration. Participants reported various coping strategies, including social support, self-efficacy, optimism, emotional regulation, religious coping, and contemplative practices. These findings indicate that coping strategies among refugee women are shaped not only by trauma exposure, but also by gendered structural conditions in the host context. These results highlight the need for gender-sensitive and trauma-informed public policies, as well as community-based interventions to promote social integration and well-being. Full article