Search Results (351)

Cardiovascular disease (CVD) remains Europe’s leading cause of mortality, responsible for >45% of deaths. Beyond established risk factors (hypertension, diabetes, dyslipidaemia, smoking, obesity), psychosocial elements—depression, anxiety, financial stress, personality traits, and trauma—significantly influence CVD development and progression. Behavioural Cardiology addresses this connection by systematically incorporating psychosocial factors into prevention and rehabilitation protocols. This review examines the HEARTBEAT model, developed by Greece’s first Behavioural Cardiology Unit, which aligns with current European guidelines. The model serves dual purposes: primary prevention (targeting at-risk individuals) and secondary prevention (treating established CVD patients). It is a personalised medicine approach that integrates psychosocial profiling with traditional risk assessment, utilising tailored evaluation tools, caregiver input, and multidisciplinary collaboration to address personality traits, emotional states, socioeconomic circumstances, and cultural contexts. The model emphasises three critical implementation aspects: (1) digital health integration, (2) cost-effectiveness analysis, and (3) healthcare system adaptability. Compared to international approaches, it highlights research gaps in psychosocial interventions and advocates for culturally sensitive adaptations, particularly in resource-limited settings. Special consideration is given to older populations requiring tailored care strategies. Ultimately, Behavioural Cardiology represents a transformative systems-based approach bridging psychology, lifestyle medicine, and cardiovascular treatment. This integration may prove pivotal for optimising chronic disease management through personalised interventions that address both biological and psychosocial determinants of cardiovascular health. Full article

Psychological stress and dietary behavior are interdependent forces that greatly influence mental and physical health. Thus, both what and how we eat impact our well-being. Maladaptive eating patterns, such as eating in response to emotional cues rather than physiological hunger, have become increasingly common amid modern stressors and an ultra-processed food environment. This narrative review synthesizes interdisciplinary findings from nutritional psychiatry, microbiome science, and behavioral nutrition to explore how stress physiology, gut–brain interactions, and dietary quality shape emotional regulation and eating behavior. It highlights mechanisms (e.g., HPA-axis dysregulation, blunted interoception, and inflammatory and epigenetic pathways) and examines the evidence for mindful and intuitive eating; phytochemical-rich, whole-food dietary patterns; and the emerging role of precision nutrition. Trauma-informed approaches, cultural foodways, structural barriers to healthy eating, and clinical implementation strategies (e.g., interprofessional collaboration) are considered in the context of public health equity to support sustainable mental wellness through dietary interventions. Ultimately, restoring a healthy relationship with food positions nutrition not only as sustenance but as a modifiable regulator of affect, cognition, and stress resilience, central to mental and physical well-being. Full article

Trauma-informed care (TIC) is an increasingly implemented approach in human services, but little research documents implementation within veterinary services. This study explored emotional experiences of veterinary clients and the perceived emotions/behaviors of their pets, studied experiences of TIC, and ascertained the extent to which experiences of TIC predicted client outcomes. Clients (N = 274) were surveyed about their experiences of veterinary care. Clients documented positive and negative emotional experiences, with negative emotions associated with more serious presenting issues. TIC was experienced during veterinary visits. Principal component analyses found that TIC fell into the following five factors: (1) transparent and client-centered communication; (2) client supports and strengths; (3) emotional safety and empowerment; (4) physical safety and comfort; (5) informed consent. Hierarchical regressions revealed that, after controlling for reason for the visit, client-reported emotions and pet emotions/behaviors, 53.9% and 56.3% of the variance in client satisfaction and client disappointment was accounted for by TIC practices, respectively. The results show that although the outcomes for pets receiving veterinary care might not always be positive, which can lead to negative emotional experiences for clients, these can be ameliorated and lead to positive client outcomes through utilizing TIC. Full article

Background and Objectives: Thailand’s demographic shift toward an aging population increases vulnerability among older adults to the long-term mental health effects of childhood trauma. While childhood adversity is linked to heightened risks of late-life depression and PTSD, the moderating role of resilience remains underexplored in Thai older adults. This study investigated whether resilience moderates the association between childhood trauma and depressive or PTSD symptoms in this population. Materials and Methods: A cross-sectional survey was conducted with 201 older patients (mean age 68.6 years) from the Family Medicine and Geriatric Psychiatry Clinics at Maharaj Nakorn Chiang Mai Hospital. Participants completed validated measures on trauma history, resilience, depression, and PTSD symptoms. A moderation analysis was performed, adjusting for covariates including education, family support, and psychiatric history. Results: The findings revealed that resilience significantly buffered the impact of childhood trauma on depression but did not mitigate PTSD symptoms. Conclusions: These results underscore the protective role of resilience against depression following childhood trauma in older adults, yet also point to its limitations in alleviating trauma-specific responses such as PTSD. This study highlights the need for trauma-informed geriatric mental health strategies and calls for further research on resilience, focusing on cultural context and adaptive mechanisms, including emotion regulation and social connectedness, in older populations. Full article

Background: Mass casualty events in conflict-affected regions can lead to the displacement of civilians and are often accompanied by substantial psychological and emotional impact on those affected. While physical activity is known to support mental health, the ways in which it relates to anxiety, resilience, and well-being in conflict-affected populations are still being explored. Objective: This study examined the associations among physical activity, anxiety, resilience, and well-being in evacuees from a conflict-affected zone. We hypothesized that higher levels of intense physical activity would be associated with higher levels of resilience and well-being and lower levels of anxiety. Methods: In this cross-sectional study, 107 evacuees completed an online survey in December 2023. The questionnaire assessed the frequency and intensity of physical activity, generalized anxiety, resilience, and well-being. Participants were categorized by weekly total physical activity levels. Data was analyzed using ANOVA, Pearson correlations, and multiple linear regression. Results: Evacuees engaging in more than three hours of vigorous-intensity physical activity exhibited significantly higher resilience and better well-being compared to those with lower activity levels. Although not statistically significant, the data suggested a possible pattern of lower anxiety among evacuees engaging in higher levels of physical activity. Regression analysis identified higher resilience and lower anxiety as significant predictors of greater mental well-being. Additionally, residing in a community exposed to a higher number of traumatic events was associated with reduced well-being. The overall model explained a substantial portion of the variance in mental well-being. Conclusions: Physical activity, especially intense exercise, is associated with improved mental health and resilience among evacuees, supporting its inclusion in interventions for trauma-affected populations. Full article

This paper examines a previously unknown anonymous Hebrew letter inserted into a postwar edition of Shem HaGedolim, found in the library of the Jewish University in Budapest. The letter, composed in Győr in 1947, consists almost entirely of passages copied from Tiferet Chayim, a hagiographic genealogy of the Sanz Hasidic dynasty. Although derivative in content, the letter’s form and placement suggest it was not meant for transmission but instead served as a private act of mourning and historiographical preservation. By situating the letter within the broader context of post-Holocaust Jewish and Hasidic memory practices, including yizkor books, rabbinic memoirs, and grassroots commemorative writing, this study proposes that the document constitutes a “micro-yizkor”: a bibliographic ritual that aimed to re-inscribe lost tzaddikim into sacred memory. Drawing on theories of trauma, religious coping, and bereavement psychology, particularly the Two-Track Model of Bereavement, the paper examines the letter as both a therapeutic and historiographical gesture. The author’s meticulous copying, selective omissions, and personalized touches (such as modified honorifics and emotive phrases) reflect an attempt to maintain spiritual continuity in the wake of communal devastation. Engaging scholarship by Michal Shaul, Lior Becker, Gershon Greenberg, and others, the analysis demonstrates how citation, far from being a passive act, functions here as an instrument of resistance, memory, and redemptive reconstruction. The existence of such a document can also be examined through the lens of Maurice Rickards’ insights, particularly his characterization of the “compulsive note” as a salient form of ephemera, materials often inserted between the pages of books, which pose unique challenges for interpreting the time capsule their authors sought to construct. Ultimately, the paper argues that this modest and anonymous document offers a rare window into postwar Ultra-orthodox religious subjectivity. It challenges prevailing assumptions about Hasidic silence after the Holocaust and demonstarates how even derivative texts can serve as potent sites of historical testimony, spiritual resilience, and bibliographic mourning. The letter thus sheds light on a neglected form of Hasidic historiography, one authored not by professional historians, but by the broken-hearted, writing in the margins of sacred books. Full article

Background: Post-concussion syndrome (PCS) and Functional Neurological Disorder (FND), including Functional Cognitive Disorder (FCD), are two frequently encountered but diagnostically complex conditions. While PCS is conceptualized as a sequela of mild traumatic brain injury (mTBI), FND/FCD encompasses symptoms incompatible with recognized neurological disease, often arising in the absence of structural brain damage. Yet, both conditions exhibit considerable clinical overlap—particularly in the domains of cognitive dysfunction, emotional dysregulation, and symptom persistence despite negative investigations. Objective: This review critically examines the shared and divergent features of PCS and FND/FCD. We explore their respective epidemiology, diagnostic criteria, and risk factors—including personality traits and trauma exposure—as well as emerging insights from neuroimaging and biomarkers. We propose the “Functional Overlay Model” as a clinical tool for navigating diagnostic ambiguity in patients with persistent post-injury symptoms. Results: PCS and FND/FCD frequently share features such as subjective cognitive complaints, fatigue, anxiety, and heightened somatic vigilance. High neuroticism, maladaptive coping, prior psychiatric history, and trauma exposure emerge as common risk factors. Neuroimaging studies show persistent network dysfunction in both PCS and FND, with overlapping disruption in fronto-limbic and default mode systems. The Functional Overlay Model helps to identify cases where functional symptomatology coexists with or replaces an initial organic insult—particularly in patients with incongruent symptoms and normal objective testing. Conclusions: PCS and FND/FCD should be conceptualized along a continuum of brain dysfunction, shaped by injury, psychology, and contextual factors. Early recognition of functional overlays and stratified psychological interventions may improve outcomes for patients with persistent, medically unexplained symptoms after head trauma. This review introduces the Functional Overlay Model as a novel framework to enhance diagnostic clarity and therapeutic planning in patients presenting with persistent post-injury symptoms. Full article

Background: Borderline personality disorder (BPD) is a severe psychiatric condition characterised by emotional instability, impulsivity, interpersonal dysfunction, and self-injurious behaviours. Despite growing clinical interest, the neuropsychological mechanisms underlying these symptoms are still not fully understood. This review aims to summarise findings from neuroimaging, psychophysiological, and neurodevelopmental studies in order to clarify the neurobiological and physiological basis of BPD, with a particular focus on emotional dysregulation and implications for the treatment of adolescents. Methods: A narrative review was conducted, integrating results from longitudinal neurodevelopmental studies, functional and structural neuroimaging research (e.g. FMRI and PET), and psychophysiological assessments (e.g., heart rate variability and cortisol reactivity). Studies were selected based on their contribution to understanding the neural correlates of BPD symptom dimensions, particularly emotion dysregulation, impulsivity, interpersonal dysfunction, and self-harm. Results: Findings suggest that early reductions in amygdala volume, as early as age 13 predict later BPD symptoms. Hyperactivity of the amygdala, combined with hypoactivity in the prefrontal cortex, underlies deficits in emotion regulation. Orbitofrontal abnormalities correlate with impulsivity, while disruptions in the default mode network and oxytocin signaling are related to interpersonal dysfunction. Self-injurious behaviour appears to serve a neuropsychological function in regulating emotional pain and trauma-related arousal. This is linked to disruption of the hypothalamic-pituitary-adrenal (HPA) axis and structural brain alterations. The Unified Protocol for Adolescents (UP-A) was more effective to Mentalization-Based Therapy for Adolescents (MBT-A) at reducing emotional dysregulation compared, though challenges in treating identity disturbance and relational difficulties remain. Discussion: The reviewed evidence suggests that BPD has its in early neurodevelopmental vulnerability and is sustained by maladaptive neurophysiological processes. Emotional dysregulation emerges as a central transdiagnostic mechanism. Self-harm may serve as a strategy for regulating emotions in response to trauma-related neural dysregulation. These findings advocate for the integration of neuroscience into psychotherapeutic practice, including the application of neuromodulation techniques and psychophysiological monitoring. Conclusions: A comprehensive understanding of BPD requires a neuropsychologically informed framework. Personalised treatment approaches combining pharmacotherapy, brain-based interventions, and developmentally adapted psychotherapies—particularly DBT, psychodynamic therapy, and trauma-informed care—are essential. Future research should prioritise interdisciplinary, longitudinal studies to further bridge the gap between neurobiological findings and clinical innovation. Full article

Background/Objectives: Although eating disorders (EDs) affect a large portion of the population and have a significant impact on health and productivity, they are understudied in the workplace. We assessed the frequency of EDs and studied the relationship between EDs and occupational and individual factors. Methods: All workers undergoing health surveillance were invited to fill in the Eating Disorder Examination Questionnaire, short form (EDE-QS) and, before their routine medical examination that included metabolic tests, measure their level of health literacy, stress, quality of sleep, anxiety, depression, and happiness. Out of a total of 2085 workers, 1912 (91.7%) participated. Results: Suspected EDs affected 4.9% (CI95% 3.9; 5.9) of workers, with no notable difference in gender (5.3% CI95% 4.1; 6.7 in female workers vs. 4.2%, CI95% 2.9; 5.9 in male). Cases were significantly associated with trauma and emotional factors (anxiety, depression, unhappiness), but also with work-related stress and poor sleep quality, and negatively associated with health literacy. Using a hierarchical logistic regression model, suspected cases of EDs were significantly predicted in Model II by life trauma (OR 2.21 CI95% 1.40; 3.48, p < 0.001) and health literacy (OR 0.94 CI95% 0.90; 0.98, p < 0.001), in Model III also by work-related stress (OR 2.57 CI95% 1.68; 3.94, p < 0.001), and in Model IV by depression (OR 1.19 CI95% 1.02; 1.38, p < 0.05) and happiness (OR 0.88 CI95% 0.78; 0.99, p < 0.05). An association was also found between EDs and overweight, obesity, increased abdominal circumference, hypercholesterolemia, hypertriglyceridemia, hyperglycemia, arterial hypertension, atherogenic index of plasma, and metabolic syndrome. Conclusions: The workplace is an ideal setting for the prevention of EDs and their consequences. Occupational health intervention should promote health literacy, improve sleep quality, and reduce work-related stress. Full article

Background: Patients with obesity seeking bariatric surgery often display high rates of depressive symptoms, which are linked to worse clinical and surgical outcomes. A comprehensive evaluation of depression-related features in this population is lacking. Therefore, this study investigated clinical and psychopathological factors associated with depressive symptoms’ severity in 946 outpatients with obesity undergoing pre-surgical evaluation. Methods: The sample (45.1 ± 12 years) was subdivided according to Patient Health Questionnaire-9 (PHQ-9) into ‘absent’, ‘mild’, and ‘moderate-to-severe depression’ groups, which were compared for sociodemographic characteristics, childhood trauma, and emotional dysregulation. Assessments included the Childhood Trauma Questionnaire-Short-Form (CTQ-SF) and Difficulties in Emotion Regulation Scales (DERS). Inflammatory levels were evaluated through the Systemic Immune-inflammatory Index (SII). Multinomial logistic regression and correlations were performed to evaluate predictors of depression severity and their interrelationship. Results: Beyond sociodemographic and clinical differences, patients with moderate-to-severe depression displayed higher childhood trauma, emotional dysregulation, and inflammatory levels. Logistic regression with 95% confidence intervals showed that higher CTQ-SF scores were significantly associated with moderate-to-severe vs. absent depression (p = 0.005, 95% CI: 1.02–1.09), while elevated DERS scores were a risk factor for both moderate-to-severe vs. mild (p < 0.001, 95% CI: 1.04–1.11) and vs. absent depression (p < 0.001, 95% CI: 1.11–1.18). Additionally, PHQ-9 was significantly correlated with CTQ-SF, DERS, and SII. Conclusions: A worse clinical picture was observed in patients with moderate-to-severe depression, and significant interactions were found between psychopathology and inflammatory indexes. Emotional dysregulation was primarily associated with depression severity. These preliminary results support the implementation of rigorous pre-operative screening to identify and deliver targeted psychotherapeutic/pharmacological interventions aimed at improving clinical and post-surgical outcomes. Full article

Background: The onset and persistence of Long COVID can lead to cognitive and functional impairment, contributing to illness-induced employment and work disparities. Understanding how social support influences these issues can inform care strategies and support continued workforce participation. Objectives: This study explored perceptions of social support among patients with Long COVID. Methods: Semi-structured interviews were conducted with 21 patients receiving care at a post-COVID recovery clinic. Patient perspectives on social support in their work and personal lives were analyzed using both inductive and deductive thematic analysis. Findings were organized under the following five dimensions of social support theory: tangible support, emotional support, informational support, appraisal support, and belonging support. Results: Patients received positive tangible, emotional, and informational support from family, friends, and credible sources. However, patients also described receiving negative appraisal support from their personal lives and workplaces when others misunderstood the scope and duration of their limitations due to Long COVID. This negative appraisal support often labeled them as lazy or underperforming, leading to both personal and professional challenges to their self-esteem. Regarding companionship support, participants reported challenges keeping in touch with others and being less social. Conclusions: Social support impacts Long COVID patients’ abilities to cope with the trauma of their experiences. Understanding the sources of and barriers to social support for Long COVID patients may inform strategies to enhance their care and well-being. Future interventions should offer opportunities for family, friends, and employers of Long COVID patients to learn about what it means to live with the illness. Full article

Background: Despite the high incidence of surgical treatment of lower leg fractures in children, there is little research focusing on the emotional consequences of such trauma, particularly the distinction between somatic and cognitive anxiety symptoms. Given the important role of social support and manifest anxiety in emotional recovery, there is a clear need to investigate factors that predict the development of anxiety in this population. Objectives: This study aimed to identify predictors of anxiety and to assess differences between somatic and cognitive anxiety symptoms in children undergoing surgery for lower leg fractures, addressing the need to better understand psychological effects in this vulnerable group. Methods: The research included 63 children with lower leg fractures, of whom 40 were boys (63.5%) and 23 were girls (36.5%), with a mean age of M = 15.174 (SD = 3.701). The instruments used in this research were as follows: the Demographic Data Questionnaire, the Children’s Anxiety Scale, the Beck Anxiety Inventory (BAI), and the Multidimensional Scale of Perceived Social Support. Results: The results showed that the only significant predictor of somatic symptoms of anxiety was the presence of paresthesia, while significant predictors of cognitive symptoms of anxiety were social support from friends and the presence of paresthesia. Conclusions: Paresthesia was identified as a significant predictor of somatic symptoms of anxiety, while social support from friends was associated with lower levels of cognitive anxiety symptoms in children with lower leg and ankle fractures. These results point to the relevance of considering both somatic and psychological factors in the recovery process following pediatric fractures. Full article

Background/Objectives: Borderline personality disorder (BPD) is a complex psychiatric condition marked by emotional dysregulation, interpersonal instability, and impulsivity. Despite the advances in psychotherapy and pharmacotherapy, many patients show a partial or unstable response. Recent research suggests that oxytocin, a neuropeptide involved in social cognition and emotional regulation, may offer novel therapeutic avenues. Methods: We systematically synthesize evidence from PubMed, PsycINFO, Web of Science, and Google Scholar on oxytocin’s role in BPD, prioritizing studies on neurobiology, emotion regulation, clinical interventions, and adjunctive therapy models. Thirty studies were included and critically appraised using PRISMA and Cochrane’s tools. Due to methodological heterogeneity, no meta-analysis was conducted; instead, the findings were integrated through a narrative synthesis approach. Results: Evidence supports oxytocin’s modulatory effects on amygdala reactivity, prefrontal–limbic connectivity, and hypothalamic–pituitary–adrenal axis function. Intranasal oxytocin appears beneficial for emotional regulation and interpersonal sensitivity, particularly in individuals with early trauma. The reported effect sizes ranged from small (Cohen’s d ≈ 0.40) to large (d ≈ 0.83), though some trials reported null or adverse effects, such as increased hypermentalization. Heterogeneous responses were influenced by factors such as sex, trauma history, and OXTR gene variants. Conclusions: Although intranasal oxytocin shows promise in modulating core neurobiological systems implicated in BPD and enhancing emotion regulation and social cognition, its clinical effects remain variable and context-dependent. The evidence supports cautious exploration of oxytocin as an adjunct to psychotherapeutic interventions rather than as a standalone treatment. Future research should focus on biomarker-informed, stratified trials that account for trauma history, genetic variation, and sex differences to clarify its therapeutic potential. Full article

This community-based participatory research (CBPR) study explored, using a Photovoice methodology, the lived expeiences of northeastern Black and/or African American youth and mothers who were currently experiencing the incarceration of their fathers and husbands. Grounded in critical theories of dual consciousness and comparative conflict, the findings provide valuable insights into how this population navigates the intersections of family, school, and community within the context of the criminal legal system, and, in the process, underscore the relevance of Abolitionist practice in capturing their theoretically lived experiences. Participants documented through photography and narrative reflections the multifaceted impacts of incarceration on fathers and husbands, including disrupted family dynamics, social stigma, and barriers to community resources. A focus group with the mothers of these youth highlighted the profound impact of incarceration on their family structure, revealing significant emotional burdens for caregivers as well as personal changes to parenting styles as a result of this project. A central theme that emerged was the development of a “double” or “dual consciousness”—an ability to see humanity and injustice in their circumstances, fueling a desire for systemic change. Overall, this CBPR project amplifies the voices of marginalized youth and mothers, illuminating how the criminal legal system perpetuates cycles of trauma, stigma, and disempowerment. The implications call for a radical reimagining of the role of social work in creating more equitable, restorative, and healing-centered communities, including an immediate embrace of Abolitionist practice concepts and interventions. Full article