Search Results (411)

Objectives: This study assessed the effectiveness of a cognitive behavioral therapy (CBT)-based fine dust education program, grounded in the Health Belief Model (HBM), on elementary students’ fine dust knowledge, related behaviors, and mental health (depression, anxiety, stress, sleep quality). Methods: From September to November 2024, 95 students (grades 4–6) living near a coal-fired power plant in midwestern South Korea were assigned to either an intervention group (n = 44) or a control group (n = 51). The intervention group completed a three-session CBT-based education program; the control group received stress management education. Assessments were conducted at weeks 1, 2, 4, and 8 using standardized mental health and behavior scales (PHQ: Patient Health Questionnaire, GAD: Generalized Anxiety Disorder Assessment, PSS: Perceived Stress Scale, ISI: Insomnia Severity Index). Results: A chi-square test was conducted to compare pre- and post-test changes in knowledge and behavior related to PM2.5. The intervention group showed significant improvements in seven fine dust-related knowledge and behavior items (e.g., PM2.5 awareness rose from 33.3% to 75.0%; p < 0.05). The control group showed limited gains. Regarding mental health, based on a mixed-design ANCOVA, anxiety scores significantly declined over time in the intervention group, with group and interaction effects also significant (p < 0.05). Depression scores showed time effects, but group and interaction effects were not significant. No significant changes were observed for stress, sleep, or group × PM2.5 interactions. Conclusions: The CBT-based education program effectively enhanced fine dust knowledge, health behaviors, and reduced anxiety among students. It presents a promising, evidence-based strategy to promote environmental and mental health in school-aged children. Full article

Temporomandibular disorders (TMDs) encompass a heterogeneous group of musculoskeletal and neuromuscular conditions affecting the temporomandibular joint (TMJ) and masticatory system. Due to academic stress and parafunctional habits, dental students may be particularly vulnerable to TMD. Objective: To determine the prevalence of TMD symptoms and their psychosocial and functional correlates among students at the Faculty of Dental Medicine, UMPh Iasi, Romania, using the diagnostic criteria for TMD (DC/TMD) self-report axis and axis II instruments. Methods: In this cross-sectional survey, 356 volunteer students (66.0% female; mean age, 22.9 ± 3.6 years) out of a total population of 1874 completed an online DC/TMD–based questionnaire. Axis I assessed orofacial pain, joint noises, and mandibular locking. Axis II instruments included the Graded Chronic Pain Scale (GCPS), Jaw Functional Limitation Scale (JFLS-20), Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Oral Behaviors Checklist (OBC). Descriptive statistics summarized frequencies, means, and standard deviations; χ² tests and t-tests compared subgroups by sex; Pearson correlations explored relationships among continuous measures (α = 0.05). Results: A total of 5% of respondents reported orofacial pain in the past 30 days; 41.6% observed TMJ noises; 19.7% experienced locking episodes. Mean JFLS score was 28.3 ± 30.5, with 4.8% scoring > 80 (severe limitation). Mean PHQ-9 was 5.96 ± 5.37 (mild depression); 15.5% scored ≥ 10. Mean GAD-7 was 5.20 ± 4.95 (mild anxiety); 16.0% scored ≥ 10. Mean OBC score was 12.3 ± 8.5; 30.1% scored ≥ 16, indicating frequent parafunctional habits. Symptom prevalence was similar by sex, except temporal headache (43.4% females vs. 24.3% males; p = 0.0008). Females reported higher mean scores for pain intensity (2.09 vs. 1.55; p = 0.0013), JFLS (32.5 vs. 18.0; p < 0.001), PHQ-9 (6.43 vs. 5.16; p = 0.048), and OBC (13.9 vs. 9.7; p = 0.0014). Strong correlation was observed between PHQ-9 and GAD-7 (r = 0.74; p < 0.001); moderate correlations were observed between pain intensity and PHQ-9 (r = 0.31) or GAD-7 (r = 0.30), between JFLS and pain intensity (r = 0.33), and between OBC and PHQ-9 (r = 0.39) (all p < 0.001). Conclusions: Nearly half of dental students reported TMD symptoms, with appreciable functional limitation and psychosocial impact. Parafunctional behaviors and psychological distress were significantly associated with pain and dysfunction. These findings underscore the need for early screening, stress-management interventions, and interdisciplinary care strategies in the dental student population. Full article

Climate change disrupts lives globally and poses significant challenges to mental health. Although several scales assess climate anxiety, many either conflate symptoms with coping responses or fail to adequately capture the core symptomatology of anxiety. Hence, this study aimed to develop and validate the Brief Anxiety Scale for Climate Change (BACC), a self-report measure designed to assess symptoms of climate anxiety. A preliminary pool of 21 items was generated based on the diagnostic criteria for generalized anxiety disorder and climate-related stress. Study 1 (n = 300) explored the factor structure via an exploratory factor analysis while Study 2 (n = 400) independently validated the structure via a confirmatory factor analysis (CFA). Analyses of the internal consistency, content validity, and discriminant validity helped refine the scale to a final 13-item version with two factors: cognitive and functional impairment. The CFA results indicated that all the fit indices met the recommended thresholds, and the final version demonstrated excellent internal consistency (Cronbach’s α = 0.92). Additionally, latent correlations revealed that climate anxiety was moderately associated with generalized anxiety and depression. The BACC was developed to identify individuals in the community who experience climate anxiety beyond an adaptive level, thereby promoting sustainable mental health in the context of climate change. These findings suggest that the BACC is a promising tool for assessing climate anxiety. With better identification, mental health professionals, community practitioners, and policymakers can utilize the scale to develop climate-sensitive public health programs and tailored intervention strategies. Full article

This research aims to establish the prevalence of imposter syndrome among Sultan Qaboos University (SQU) undergraduate students while assessing its association with depression symptoms and anxiety symptoms. A cross-sectional design recruited 504 undergraduate students selected through stratified random sampling. Data collection employed the Clance Imposter Phenomenon Scale (CIPS), the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7). Data analysis included Pearson’s correlation, chi-square tests, and logistic regression analyses. In total, 56% of participants had imposter syndrome. The CIPS scores showed a moderate relationship with depression (r = 0.486, p < 0.001) and anxiety (r = 0.472, p < 0.001). Students who experienced imposter syndrome showed a higher probability of developing depressive symptoms (χ² = 45.63, p < 0.001, OR = 3.49) and anxiety symptoms (χ² = 32.96, p < 0.001, OR = 2.86). The logistic regression analysis showed that depression (B = 0.096, p < 0.001) and anxiety (B = 0.075, p = 0.003) acted as significant predictors for imposter syndrome. This study reveals a strong link between imposterism, depression, and anxiety among students. This highlights the need for university counseling programs to address imposter feelings and the role of clinical psychology in managing this phenomenon in academic and clinical settings. Full article

Background/Objectives: Neurofibromatosis type 1 (NF1) and Noonan syndrome spectrum disorders (NSSD) are the most common RASopathies, resulting from germline mutations that affect the RAS-MAPK signaling pathway. Both are associated with increased risk for neurodevelopmental and psychiatric conditions, yet few studies have used structured diagnostic interviews to compare their psychiatric comorbidities. Methods: We conducted clinician-administered DSM-5 diagnostic assessments (KSADS) in 123 children with RASopathies (NF1 = 29, NSSD = 94; ages 5–15). Diagnosis prevalence was compared within each group and to population-based estimates. Results: Psychiatric diagnoses were highly prevalent, at 79.3% in NF1 and 76.6% in NSSD, with ADHD (NF1 = 72.4%, NSSD = 51.1%) and anxiety disorders (NF1 = 37.9% and NSSD = 43.6%) being the most common, rates substantially higher than those reported in general population estimates. Behavioral and sleep disorders were identified in approximately 25% of both groups. Notably, social anxiety disorder was identified in 14.9% of NSSD but not in NF1. Full-scale IQ did not significantly differ by diagnosis status. Specific anxiety disorders, elimination disorders, obsessive–compulsive disorder, and post-traumatic stress disorder were characterized, expanding the known psychiatric phenotype of RASopathies. Conclusions: Children with NF1 and NSSD demonstrate similarly high rates of ADHD, anxiety, and behavioral disorders compared to the general population; in addition, we report sleep disorders in NSSD and characterize psychiatric disorders not previously described in RASopathies. The shared psychiatric profiles may reflect the common effect of RAS-MAPK pathway dysregulation on psychiatric outcomes. These findings highlight the need for early, syndrome-informed mental health screening and intervention in the clinical care of individuals with RASopathies. Full article

Background: Food addiction (FA) is an emerging construct that mirrors the behavioral and neurobiological characteristics of substance use disorders. Despite growing interest, its association with specific psychiatric disorders among bariatric patients remains understudied. Objective: Our aim was to examine the prevalence and strength of associations between FA and seven major psychiatric disorders in individuals who underwent bariatric surgery. Methods: In a sample of 100 post-bariatric patients referred for psychiatric evaluation, FA was assessed using the modified Yale Food Addiction Scale 2.0 (mYFAS 2.0), and psychiatric disorders were diagnosed using the Mini International Neuropsychiatric Interview (MINI). Logistic regression models were used to estimate adjusted odds ratios (aORs) for the association between FA and each psychiatric disorder, controlling for sex, age, body mass index (BMI), employment status, the number of children, clinical comorbidities, physical activity, family psychiatric history, and region of residence. Results: FA was present in 51% of the sample. Descriptive analyses revealed a significantly higher prevalence of major depressive disorder, panic disorder, generalized anxiety disorder, social anxiety disorder, agoraphobia, obsessive–compulsive disorder, and bulimia nervosa among individuals with FA. Multivariate models showed robust associations between FA and bulimia nervosa (aOR = 19.42, p < 0.05), generalized anxiety disorder (aOR = 2.88, p < 0.05), obsessive–compulsive disorder (aOR = 6.64, p < 0.05), agoraphobia (aOR = 3.14, p < 0.05), social anxiety disorder (aOR = 4.28, p < 0.05) and major depressive disorder (aOR = 2.79, p < 0.05). Conclusions: FA is strongly associated with a range of psychiatric comorbidities in post-bariatric patients, reinforcing the need for comprehensive mental health screening in this population. These findings underscore the potential role of FA as a clinical marker for stratified risk assessment, supporting more personalized approaches to mental health monitoring and intervention following bariatric surgery. Full article

Objective: This study aims to investigate the feasibility of an online music therapy protocol for individuals previously diagnosed with COVID-19, focusing on their perceptions of their respiratory symptoms and the intervention’s impact on psychosocial measures. Methods: A within-subject experimental design was applied to examine an eight-week weekly online music therapy protocol, including singing, wind instrument playing, and music visualizations. All self-report data were collected bi-weekly throughout the 16-weeks study period, including baseline and post-tests. The measures for respiratory symptoms included the Medical Research Council’s Dyspnea Scale (MRC Dyspnea), Chronic Respiratory Questionnaire-Mastery Scores (CRQ Mastery), and Visual Analogue Scale for breathlessness. The measures for the secondary psychosocial outcomes were the Beck Depression Inventory-Short Form, the Generalized Anxiety Disorder 7-item, the Hospital Anxiety and Depression Scale, the Fatigue Severity Scale, the Epworth Sleepiness Scale, the EuroQol 5-Dimension 5-Level, and the Connor-Davidson Resilience Scale. Results: Twenty-four participants were enrolled. The participants perceived a reduction in respiratory symptoms, and shortness of breath (MRC Dyspnea). Planned comparisons showed significant decreases in MRC from baseline to post-treatment (p = 0.008). The mixed-effects model, including pre-baseline and post-treatment, was significant (p < 0.001). Significant changes in Breathing VAS were consistent with improvements in MRC Dyspnea, showing a significant baseline-to-post difference (p = 0.01). The CRQ Mastery showed significant improvements from baseline to Week 12 (p < 0.001). No significant changes were observed in other secondary measures. Conclusions: Our preliminary findings suggest that this protocol is feasible, and as a result, may help individuals previously diagnosed with COVID-19 to cope with lasting respiratory symptoms and improve their perception of shortness of breath. Live music-making, including playing accessible wind instruments and singing, may contribute to an increase sense of control over breathing. As this was a feasibility study, we conducted multiple uncorrected statistical comparisons to explore potential effects. While this approach may increase the risk of Type I error, the findings are intended to inform hypotheses for future confirmatory studies rather than to draw definitive conclusions. Full article

Exposure to fine particulate matter (PM2.5) has become an increasing public health concern, particularly in urban areas facing severe air pollution. In response, individuals are increasingly turning to real-time tracking systems and self-monitoring tools. This study aimed to examine the association between PM2.5 risk perception, self-monitoring behaviors, and anxiety levels in the general population of Thailand. A cross-sectional survey was conducted during the dry season using an online questionnaire, which included the 7-item Generalized Anxiety Disorder (GAD-7) scale. A total of 921 participants residing in Bangkok and Chiang Mai were included. Binary logistic regression analysis, adjusted for sex, age, marital status, monthly income, and years of residence, revealed a significant association between anxiety and perceived health risks of PM2.5 exposure (OR = 1.09; 95% CI: 1.06–1.13). Daily self-monitoring of air quality over the past two weeks was also significantly linked to higher anxiety levels compared to non-monitoring individuals: OR = 1.92 (95% CI: 1.11–3.33) for websites, OR = 1.65 (95% CI: 1.01–2.72) for mobile apps, OR = 1.72 (95% CI: 1.12–2.64) for air purifiers, and OR = 3.34 (95% CI: 1.77–6.31) for air quality detectors. Monitoring 4–6 days per week using apps and air detectors was similarly associated with increased anxiety (OR = 1.64 and 2.30, respectively). Heightened perception of PM2.5 health risks and frequent self-monitoring behaviors are associated with increased anxiety among urban residents in Thailand. Public health interventions should consider implementing targeted alert systems during high-pollution periods and prioritize strategies to reduce PM2.5 emissions to alleviate public anxiety. Full article

Opioid use disorder (OUD) and posttraumatic stress disorder (PTSD) frequently co-occur. However, there are no psychotherapy treatments intentionally designed for this comorbidity, nor designed to be augmented with medications for OUD. In this open-label pilot trial, we tested Helping Opioid Use Disorder and PTSD with Exposure (HOPE), a novel integrated, trauma-focused treatment for individuals (N = 6) with OUD/PTSD who were stabilized on medications for OUD. HOPE was delivered weekly for 10–12 sessions, and one follow-up visit was conducted ~1-month post-treatment. Primary outcomes included urine drug screens, the Timeline Followback, Desire for Drugs Questionnaire, Clinician-Administered PTSD Scale-5 (CAPS-5), and PTSD Checklist-5 (PCL-5). Boot-strapped linear mixed effect models and generalized estimating equations showed that PTSD symptoms (CAPS-5: B = −7.16, SE = 1.24, p < 0.01; PCL-5: B = −2.04, SE = 0.26, p < 0.01), desire for opioids (B = −0.56, SE = 0.15, p < 0.01), depression symptoms (B = −0.43, SE = 0.09, p < 0.01), and anxiety symptoms (B = −0.50, SE = 0.08, p < 0.01) decreased significantly over time. Client satisfaction increased throughout the study (B = 0.18, SE = 0.08, p = 0.02), and 83.3% of participants completed the therapy and follow-up visit. There were no significant changes in opioid or other substance use from baseline to follow-up. Although preliminary, results show high acceptability and feasibility of the HOPE therapy and demonstrate significant improvements in PTSD and associated symptoms with an integrated, trauma-focused treatment. Full article

Migraine is a common disabling primary headache disorder with significant personal and socio-economic impacts. A combination of medication and non-pharmacological therapies is essential for migraine management. Outpatient multidisciplinary headache therapy has not yet been evaluated in Switzerland. This study evaluates the effectiveness of the headache management program at Inselspital, Bern University Hospital, in improving headache-related disability in migraine patients. This open-label pilot study used prospectively assessed routine data from our headache registry. Participants aged 18 years or older with a diagnosis of migraine, confirmed by a headache specialist, were included. The program consisted of seven weekly sessions, each with a 50 min educational lecture and a 30 min progressive muscle relaxation (PMR) exercise. Primary outcomes were headache-related impact and disability, measured by the Headache Impact Test 6 (HIT-6) and Migraine Disability Assessment (MIDAS). Secondary outcomes included symptoms of anxiety, measured by the Generalized Anxiety Disorder 7-item scale (GAD-7), and symptoms of depression, assessed using the eight-item Patient Health Questionnaire depression scale (PHQ-8). Data were analysed using paired t-test and Wilcoxon signed rank tests. Significant improvements were observed in HIT-6 scores (pre-program: 65.2; post-program: 61.9; p = 0.012) and MIDAS scores (pre-program: 38; post-program: 27; p = 0.011), while PHQ-8 also showed a statistically significant reduction. Although the GAD-7 scores improved numerically, this change was not statistically significant. These findings suggest that the headache management program may reduce headache burden and disability; however, further research with larger samples is needed to confirm these preliminary results. Full article

Background: Dental anxiety and generalized anxiety are common psychological conditions and can lead to poor oral health and avoidance behavior. This research aims to study the complex interplay between dental anxiety, generalized anxiety, dental neglect, and oral health-related quality of life (OHRQoL) in the general public. Methods: This is an online survey study that was conducted between August to September 2024 in Saudi Arabia and Jordan. Four previously validated instruments were used in this study. This study made use of the Modified Dental Anxiety Scale, the General Anxiety Disorder-7, dental neglect scale, and the Oral Health Impact Profile-14. Mediation analysis was conducted using the PROCESS macro (Model 4) to explore whether dental anxiety and dental neglect mediates the relationship between generalized anxiety and OHRQoL. Results: This study had 2704 participants in total. Higher anxiety levels were associated with slightly lower dental neglect and significantly poorer OHRQoL. Generalized anxiety significantly predicted dental anxiety, with a coefficient of b = 0.275 (p < 0.001). Both generalized anxiety and dental anxiety were significant predictors of OHRQoL, with generalized anxiety showing stronger effect. Dental anxiety partially mediates the impact of generalized anxiety on oral health-related quality of life, while a strong direct effect remains. Conclusions: Dental neglect served as a minor mediator, and the primary relationship between anxiety and oral health-related quality of life is direct. Moreover, dental anxiety partially mediates the impact of generalized anxiety on oral health-related quality of life, while a strong direct effect remains. Full article

This study explored whether sleep duration, insomnia, social jetlag, and circadian preference predicted adolescents’ risk of anxiety and depression two years later. High school students initially aged 16–17 years were, in 2019 and 2021, invited to a web-based survey assessing sleep patterns, insomnia, circadian preference, anxiety, and depression. Sleep duration, insomnia, circadian preference, depression, and anxiety were assessed using the Munich ChronoType Questionnaire, the Bergen Insomnia Scale, the reduced Morningness–Eveningness Questionnaire, the Patient Health Questionnaire-9, and the Generalized Anxiety-Disorder 7, respectively. Analyses were conducted using logistic regression analyses. The analytic longitudinal sample comprised 1456 students (initial mean age 16.4 years; 61.4% girls). Short school night sleep duration, chronic insomnia, and more severe insomnia symptoms at baseline predicted greater risk of anxiety and depression at follow-up when controlled for anxiety and depression at baseline. Neither free night sleep duration nor social jetlag at baseline were related to the risk of anxiety and depression at follow-up. When circadian preference was investigated continuously, greater morningness at baseline predicted lower risk of anxiety and depression at follow-up. When circadian preference was investigated categorically, evening preference type was associated with higher risk of depression at follow-up than intermediate preference type, while the prospective risk of anxiety and depression otherwise did not differ in relation to circadian preference. The results attest to prospective associations between adolescent sleep problems at baseline and later risk of anxiety and depression. Full article

Background: Perinatal depression and anxiety can be experienced simultaneously and change over time. This study aimed to explore the independent and joint developmental trajectories and predictors of perinatal depression and anxiety. Methods: From January 2022 to December 2023, a total of 1062 pregnant women from Affiliated Women’s Hospital of Jiangnan University were surveyed for depression and anxiety symptoms using the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Scale (GAD-7) in early pregnancy (T1, 0–13⁺⁶ weeks), mid-term pregnancy (T2, 14–27⁺⁶ weeks), late pregnancy (T3, 28–41 weeks), and 42 days postpartum (T4). Parallel-process latent class growth model (PPLCGM) was performed to identify the joint developmental trajectories of perinatal depression and anxiety, and logistic regression was used to analyze factors of joint trajectories. Results: Perinatal depression and anxiety each showed four heterogeneous developmental trajectories, and three joint developmental trajectories were identified: “high–slightly decreasing depression and high decreasing anxiety group” (3%), “low–stable depression and low–stable anxiety group” (71%), and “moderate–slightly increasing depression and moderate–decreasing anxiety group” (26%). Adverse maternal history, history of anxiety and depression, and work stress were risk factors for the joint developmental trajectory of perinatal depression and anxiety, while regular exercise, paid work and social support were protective factors. Conclusions: Three joint developmental trajectories for perinatal depression and anxiety were identified, demonstrating group heterogeneity. Perinatal healthcare providers should pay attention to the mental health history of pregnant women, conduct multiple assessments of perinatal anxiety and depression, prioritize individuals with risk factors, and advocate for regular exercise, work participation, and provide greater social support. Full article

Background: The Iowa Infant Feeding Attitude Scale (IIFAS) is widely used to assess breastfeeding attitudes, which are linked to positive breastfeeding practices. However, its psychometric validation in Southeast Asian healthcare students remains limited. Objectives: To investigate the reliability and validity of the IIFAS among Vietnamese healthcare students. Methods: A cross-sectional study was conducted at three medical universities in Vietnam. A total of 542 healthcare students, including medical, nursing, and midwifery students, participated. The students completed the Iowa Infant Feeding Attitude Scale, Breastfeeding Knowledge Scale, and Generalized Anxiety Disorder Scale. The reliability was assessed through the internal consistency and test–retest reliability. The construct validity was tested using exploratory and confirmatory factor analysis. The divergent validity, convergent validity, and known-group comparison were also assessed. Results: The IIFAS showed an excellent internal consistency (Cronbach’s α = 0.94) and test–retest reliability (intraclass correlation = 0.91). A two-factor structure of the Vietnamese IIFAS was identified using exploratory and confirmatory factor analysis with satisfactory fit indices (χ²/df = 1.318, comparative fit index = 0.985, Tucker–Lewis Index = 0.983, and Root Mean Square Error of Approximation = 0.034). Breastfeeding attitudes positively correlated with breastfeeding knowledge (r = 0.74, p < 0.001) and negatively correlated with anxiety symptoms (r = −0.13, p = 0.04). Students who were older, in a higher academic year, and majoring in medicine had significantly higher breastfeeding attitude scores (ps < 0.05). Conclusions: The Vietnamese version of the IIFAS demonstrates excellent reliability and validity, making it a robust tool for assessing breastfeeding attitudes and informing tailored educational programs among healthcare students. Full article

Purpose/Objective: Children with disabilities are at a greater risk of being bullied and experience mental health and academic problems that may persist in adulthood. This study examined the association of childhood bullying experiences with current mental health (anxiety and depression) among adults with disabilities, and whether academic satisfaction mediated the relationship between childhood bullying and adult mental health outcomes. Research Method/Design: A sample of 409 adult participants with disabilities who had had their disabilities while attending school, and currently, completed an online survey assessing bullying experiences (California Bullying Victimization Scale-Retrospective), academic satisfaction (Academic Satisfaction Scale), depression (Patient Health Questionnaire-9), and anxiety (Generalized Anxiety Disorder-7). Bivariate correlations and two mediation analyses were conducted to identify the direct and indirect effects of school bullying experiences on current mental health outcomes, via academic satisfaction. Results: Participants reported a moderate amount of childhood bullying and relatively high levels of depression and anxiety symptomology (with averages close to or exceeding clinical cutoffs of 10). Bivariate correlations among the four variables were all significantly moderately or strongly correlated. Bullying and academic satisfaction had direct associations with depression and anxiety. Academic satisfaction partially mediated the relationships between bullying and both mental health outcomes. Conclusions/Implications: Bullying prevention interventions and programs, especially geared toward preventing bullying in students with disabilities, are critical to stop the likely long-term impacts of bullying on mental health outcomes in disabled communities. Full article