Search Results (338)

This article systematically analyzes the problems of various social groups at many levels, studying the importance of culture in education and the social environment, and identifying research trends among world scientists over the past 5 years (2022–2026). A systematic literature review was conducted in January 2026 using the PRISMA 2020 methodology, as a result of which 109 peer-reviewed, indexed publications from Scopus, Web of Science, and ERIH+ were selected and analyzed. As a result, the most current research trend was identified to use cultural intelligence theory, measurement tools, scales, and concepts in the analysis of multi-level problems of various social groups. The main conclusion: culture in education and its social environment in the context of social groups has not been studied systematically enough; therefore, cultural intelligence measurements can contribute to the understanding of the causes of problems of various social groups involved in the educational process in four dimensions: (1) metacognitive, (2) cognitive, (3) motivational, and (4) behavioral. The development of cultural intelligence in an individual person promotes a dialogue between different social groups that is constructive, open, and based on mutual empathy. Originality of the study: a systemic analysis of multi-level problems of social groups in the context of education, culture, and social environment was carried out, determining theoretical and empirical aspects and their contradictions. Full article

Background/Objectives: Postpartum depression (PPD) is a clinically important perinatal mental health condition affecting maternal functioning and early mother–infant interaction. Prospective studies using clinically diagnosed PPD outcomes while jointly assessing antenatal psychosocial resources and obstetric context remain limited. This study examined antenatal psychosocial and obstetric factors associated with clinically diagnosed PPD at 6 weeks postpartum. Methods: This prospective cohort study included 85 pregnant women assessed at ≥24 weeks of gestation in a tertiary university hospital. Women receiving psychiatric treatment during pregnancy or meeting DSM-5 criteria for current depressive disorder at baseline were excluded; women with elevated antenatal depressive symptom scores but no current clinical depressive disorder were retained. Antenatal depressive symptoms, perceived stress, perceived social support, psychological resilience, pain catastrophizing, and clinician–patient relational empathy were assessed using standardized measures. Obstetric and neonatal data were extracted from medical records. PPD was assessed at 6 weeks postpartum using a structured DSM-5-based psychiatric interview. Group comparisons, univariable logistic regression analyses, and an exploratory two-domain adjusted logistic regression model were performed. Results: PPD was diagnosed in 25 women (29.4%). Women who developed PPD had higher parity, more frequent maternal obstetric comorbidity, lower infant birth weight and head circumference, higher depressive symptom severity, perceived stress, and pain catastrophizing, and lower perceived social support and psychological resilience. In the exploratory adjusted model, greater perceived social support was associated with lower odds of PPD (adjusted odds ratio [aOR] = 0.58, 95% confidence interval [CI]: 0.35–0.96), whereas higher parity was associated with higher odds (aOR = 2.24, 95% CI: 1.17–4.28). Conclusions: Clinically diagnosed PPD was associated with antenatal psychosocial vulnerability and obstetric context. Antenatal assessment of perceived social support, parity, and broader psychosocial vulnerability indicators may help identify women requiring closer postpartum monitoring. Full article

Background/Objectives: Perinatal loss is a profoundly distressing life event associated with grief, depression, anxiety, post-traumatic stress symptoms, and long-term psychosocial challenges among bereaved parents who experience miscarriage, stillbirth, or neonatal death. Although psychotherapeutic interventions are increasingly used to address these adverse outcomes, there is limited synthesis on how characteristics consistent with a patient-centered care perspective are reflected in such interventions and how they may relate to psychosocial well-being. This umbrella review aimed to synthesize evidence on psychotherapeutic interventions following perinatal loss and to examine patient-centered care–related dimensions reported across the included reviews, including therapeutic communication, patient engagement, therapeutic relationships, emotional validation, and meaning-making processes. Methods: An umbrella review was conducted in accordance with the Joanna Briggs Institute methodological guidance. Systematic reviews and meta-analyses published between 2019 and 2025 were identified through searches of PubMed, CINAHL, PsycINFO, and the Cochrane Library from database inception to 31 May 2026. Eligible reviews examined psychotherapeutic, psychosocial, and psychological support interventions designed to improve grief, depression, anxiety, post-traumatic stress symptoms, psychological distress, coping, and psychosocial well-being among bereaved parents following perinatal loss. In accordance with the predefined secondary exploratory objective, a secondary interpretive synthesis examined patient-centered care–related dimensions described within the included reviews. Results: Five systematic reviews and meta-analyses met the inclusion criteria. Interventions included cognitive behavioral therapy, mindfulness-based approaches, bereavement counseling, psychosocial support programs, narrative interventions, supportive counseling, and digitally delivered psychological therapies. Across reviews, psychotherapeutic interventions were generally associated with beneficial effects on grief, depression, anxiety, post-traumatic stress symptoms, and broader indicators of psychosocial well-being. Communication-, support-, and engagement-related characteristics consistent with a patient-centered care perspective, including empathy, therapeutic alliance, individualized support, emotional validation, and continuity of communication, were identified through secondary interpretive synthesis as recurring features of beneficial interventions. Digital modalities, such as internet-based cognitive behavioral therapy and telephone-delivered counseling, were consistently described as supporting accessibility, engagement, and continuity of care. Conclusions: Psychotherapeutic interventions following perinatal loss appear to improve a range of psychosocial outcomes. A patient-centered care perspective may help interpret how communication, emotional validation, patient engagement, and supportive therapeutic relationships are described in relation to psychological adaptation after loss. These dimensions should be understood as interpretive characteristics identified across the included reviews rather than as directly measured mechanisms of intervention effectiveness. Future research should examine communication processes, therapeutic alliance, and patient engagement using validated measures, assess how these factors relate to intervention effectiveness, and support the development of integrated, patient-centered models of perinatal bereavement care. Full article

Eco-labels communicate environmental information to consumers, yet evidence regarding their effectiveness remains mixed. Drawing on the Stimulus–Organism–Response (S-O-R) framework, this study examines relationships among empathy, environmental behavior, willingness to pay for eco-labeled products, product preferences, and visual attention to environmental cues. Data were collected from 121 participants in Istanbul, Türkiye, using questionnaires and eye-tracking measurements. Participants evaluated six beverage categories presented in neutral, eco-label logo, and environmental-message conditions while fixation and saccade metrics were recorded. Empathy was positively associated with environmental behavior (r = 0.585, p < 0.001) and willingness to pay for eco-labeled products (r = 0.699, p < 0.001), but not with product preferences. Differences in product preferences according to environmental behavior emerged only in the green smoothie and coffee categories, where participants with higher environmental behavior scores were more likely to prefer environmental-message products. Eye-tracking analyses indicated that the relationship between environmental behavior and visual attention varied across product categories and areas of interest. Heatmap analyses showed that eco-label logos and environmental messages redirected visual attention toward sustainability-related information. The findings indicate that consumer responses to eco-labels depend on individual characteristics and product context. The results provide practical implications for firms and policymakers seeking to improve eco-label design and environmental communication strategies. Full article

Universities increasingly compete through value propositions, service processes, and communication ecosystems rather than through program supply alone. Yet evidence remains limited on how students’ perceptions of the educational marketing mix are associated with satisfaction in non-metropolitan higher education settings in Latin America. This study examines a private university branch campus in a Latin American emerging economy using a quantitative, cross-sectional, non-experimental design and a probabilistic stratified sample of 287 complete student responses. Educational marketing was operationalized as students’ perceived evaluation of the educational marketing mix—product, price, place, and promotion—whereas satisfaction was measured with SERVQUAL-informed, performance-oriented service-evaluation items. The findings show a strong positive association between the perceived educational marketing mix and student satisfaction, with promotional communication emerging as the most closely related dimension. Descriptively, both constructs were concentrated at intermediate levels, indicating an acceptable but non-distinctive institutional experience and pointing to service weaknesses in security, empathy, and responsiveness. The article contributes by problematizing the use of marketing-mix logic in higher education, clarifying that satisfaction is not a proxy for educational quality or belonging, and showing how perceived value communication and service delivery are connected with students’ satisfaction judgments in an emerging-economy context. Full article

Background: Anorexia Nervosa (AN) is a severe eating disorder. Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) are two Neurodevelopmental Disorders (NDDs), frequently co-occurring with each other (ADHD+ASD). The present study aimed to clarify cognitive and behavioral profiles, with a specific focus on emotional regulation, executive functions and empathy, in three groups of female adolescents. Methods: A total of 102 female adolescents aged 12–18 years were recruited. Participants were divided into three groups (AN: n = 30, ADHD: n = 47, ADHD+ASD: n = 25). All participants underwent a psychometric and a multidimensional clinical assessment. Group differences were analyzed through ANOVA with Bonferroni corrections. Results: Adolescents with ADHD+ASD scored significantly higher than the ADHD group in verbal comprehension. The AN group performed significantly better than both the ADHD and ADHD+ASD groups in working memory, and significantly better than the ADHD+ASD group in processing speed. Both the AN and ADHD+ASD groups were characterized by significantly greater impairment in global functioning than the ADHD group. No significant differences were found among the three groups on the Attention Switching, Attention to Detail, and Imagination subscales of the Autism Spectrum Quotient. Behaviorally, AN participants exhibited higher internalizing symptoms (anxiety and depression), the ADHD group presented more prominent externalizing behaviors (aggressive, rule-breaking, and attention problems), and the comorbid ADHD+ASD group demonstrated significantly more pronounced social problems. Most measures used to assess emotional dysregulation did not reveal significant differences among the three groups. Both the ADHD and ADHD+ASD groups showed significantly greater impairment in executive functioning than the AN group. Regarding empathic abilities, mixed results emerged. Conclusions: Findings suggest the coexistence of condition-specific features and shared vulnerabilities in female adolescents with AN, ADHD, and ADHD+ASD. These data underscore the importance of investigating the female phenotype from a transdiagnostic perspective to facilitate early detection and tailored interventions. Full article

Background/Objectives: Emotion processing has increasingly been conceptualized as a transdiagnostic mechanism underlying psychological adaptation and psychopathology. From an attachment perspective, individual differences in emotion perception may be rooted in internal working models shaped by early relationships. This systematic review synthesized the literature on the relationship between adult attachment representations and intrapersonal emotion perception (Impathy) and interpersonal emotion perception (Empathy). Methods: The review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic search was conducted on 9 February 2026, in PsycINFO, PsycArticles, and PubMed. Studies were included if they investigated adolescents or adults, assessed attachment representations using narrative-based measures (Adult Attachment Interview (AAI) or Adult Attachment Projective Picture System (AAP)), and examined intrapersonal and/or interpersonal emotion perception. Findings were synthesized narratively, and a random-effects meta-analysis examined the association between attachment security and reflective functioning. Results: Thirty-eight studies, including 2736 participants, met the inclusion criteria. Across studies, attachment representations were systematically associated with intrapersonal and interpersonal emotion perception. The strongest evidence emerged for reflective functioning, the Impathy dimensions Perceiving and Understanding, and cognitive-empathic processes. Secure attachment representations were consistently associated with higher reflective functioning and more adaptive emotion perception, whereas insecure and especially unresolved attachment representations were linked to impairments in emotional self-awareness, alexithymia-related processes, differentiated emotional understanding, and cognitive-empathic processing. The meta-analysis showed a large positive association between secure attachment representations and reflective functioning (k = 8; r = 0.64, 95% CI [0.50, 0.74]). Conclusions: Attachment representations appear systematically associated with the perceptual foundations of emotion processing. Intrapersonal and interpersonal emotion perception may therefore represent attachment-sensitive processes relevant to psychological adaptation, psychopathology, caregiving, and therapeutic change. Full article

Background: Empathy, compassion, self-compassion, and resilience are essential to medical practice and education. While some evidence shows that these traits may decline during medical school, few studies have examined all these capacities in the same cohorts or trends within an academic year. This study examines first-year longitudinal findings on cohort and within-year changes in these constructs among medical students. Methods: 98 students (58.2% female; M_age = 26.34 (2.86); 37.8% White; MS1 25.5%, MS2 25.5%, MS3 20.4%, MS4 26.5%) from a large US school participated in at least one wave of an online survey distributed 4 times during the 2023–2024 academic year. Validated measures assessed empathy (IRI), compassion (SCBCS), self-compassion (Neff SCS), and resilience (CD-RISC-10). Linear mixed models analyzed between-cohort differences over time with gender and race/ethnicity as covariates. Results: Compared to MS4 students, MS2 and MS3 students had significantly lower cognitive empathy and self-compassion, with marginally lower compassion and higher resilience (p = 0.06). Women reported higher compassion toward others but lower self-compassion and resilience than men. Conclusions: Lower empathy and compassion were observed as early as the second year of medical school, suggesting erosion factors, such as academic pressure and standardized testing, may impact trainees earlier than previously reported. Full article

Sexual violence against young girls is a complex phenomenon encompassing multiple forms of abuse and leading to numerous negative outcomes. Therefore, rehabilitation measures play a critical role in reducing recidivism and enhancing victims’ safety. This study examined preliminary results of a 25-session individual intervention program (the INSIGHT Program) designed for individuals who sexually offended in Portugal, in both prison and community settings. In this pilot clinical trial, 19 participants were assigned to one of two conditions: INSIGHT plus treatment as usual (TAU) or TAU alone. Data was collected at baseline and at the end of the intervention. Proximal outcomes (e.g., attitudes toward child sexual abuse, victim empathy, interpersonal problems, and early maladaptive schemas) were assessed. The Reliable Change Index (RCI) was computed. Results indicated that participants receiving INSIGHT plus TAU evidenced greater clinical improvements in empathy toward victims and interpersonal problems compared with participants receiving TAU alone. Overall, the intervention demonstrates potential to reduce some risk factors among individuals who perpetrated sexual violence against young girls. However, we highlight the need to reconsider the work carried out on EMSs, particularly regarding the techniques used. Full article

Background: Socio-cognitive deficits constitute a core and persistent feature of adolescent-onset schizophrenia, significantly impairing functional outcomes. However, the interplay between genetic metabolic markers such as CYP2D6 and specific socio-cognitive phenotypes remains poorly understood. Methods: This cross-sectional study included 73 adolescents with schizophrenia and 58 matched healthy controls. Theory of Mind (ToM) was evaluated using the Reading the Mind in the Eyes Test (RMET), while empathy was assessed with the Cambridge Empathy Quotient. Symptom severity was measured via the Positive and Negative Syndrome Scale (PANSS). CYP2D6 polymorphisms were genotyped using RT-PCR, classifying participants as Normal or Reduced (Intermediate) metabolizers. Hierarchical multiple regression analyses were performed, controlling for sex, IQ, and psychosocial factors. Results: Patients demonstrated significantly lower RMET and empathy scores compared to controls. Reduced CYP2D6 metabolizers exhibited poorer ToM performance and more severe negative symptoms. The final RMET model accounted for 88.8% of variance (p < 0.001), with CYP2D6 status emerging as a significant independent predictor (β = 0.178, p = 0.005), alongside IQ and negative symptoms. In contrast, the empathy model explained 49.0% of variance, with CYP2D6 effects fully mediated by negative symptom severity. Conclusion: Adolescents with reduced CYP2D6 metabolic activity exhibit greater negative symptom burden and impaired social-cognitive functioning. Our findings reveal a double dissociation: ToM functions as a stable, biologically anchored trait, while empathy serves as a state-dependent construct primarily driven by the negative syndrome. These insights advocate for the integration of pharmacogenetic stratification in the treatment of early-onset schizophrenia. Full article

Empathy toward animals has received increasing attention because of its relationship to prosocial attitudes, conservation engagement, and environmental concern. Despite growing interest, the way empathy toward animals is measured varies widely across disciplines and applied contexts, making it difficult to compare findings or assess the strength of existing instruments. This paper examines the measurement landscape of empathy toward animals by identifying and describing tools used in both academic research and conservation practice. A search of Web of Science yielded 2155 unique records, resulting in a final sample of 65 peer-reviewed studies with empathy assessment instruments published between 2000 and 2025. These were supplemented by 42 instruments shared by members of the Advancing Conservation through Empathy for Wildlife (ACE for Wildlife^®) Network, one of the largest known networks of professionals focused on enhancing and evaluating empathy toward animals. Across these sources, we observe substantial variation in how empathy is operationalized, including differences in construct emphasis, focal species, intended audiences, and attention to reliability and validity. Academic studies primarily use surveys emphasizing affective empathy toward mammals, whereas practitioner-developed tools are more diverse and often assess cognitive and motivational dimensions across cohort groups. In mapping differences in approaches, we identify persistent gaps and provide suggestions to better align scholarly and applied assessment tools. Full article

Background and Objectives: Schizophrenia in adolescence severely impairs quality of life (QoL) and disrupts critical social, academic, and neurodevelopmental periods. Beyond symptom remission, functional recovery and subjective well-being have become central therapeutic goals; however, the specific contributions of pharmacogenetic, social–cognitive, and residual clinical factors to QoL in early-onset schizophrenia remain largely unexplored. This study investigated the contribution of CYP2D6 metabolizer status, social cognition (theory of mind and empathy), residual psychopathology, and family factors to subjective QoL in adolescents with schizophrenia. Materials and Methods: A cross-sectional study of 52 adolescents with DSM-5 schizophrenia (PAT-SCZ) and 51 matched healthy controls. QoL was measured with the Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire (PQ-LES-Q). Social cognition was assessed using the revised Reading the Mind in the Eyes Test (RMET). Residual symptoms were rated with the Positive and Negative Syndrome Scale (PANSS). CYP2D6 genotyping classified patients as normal metabolizers (NMs) or reduced-function metabolizers (RM: intermediate/poor). Two multivariable OLS regression models examined predictors of QoL. Results: Patients showed markedly lower QoL, impaired theory of mind, lower empathy, and higher residual symptoms than controls (all p < 0.0001). Within patients, reduced-function metabolizer (RM) status was associated with poorer QoL, weaker social cognition, higher negative/general psychopathology, and lower IQ. Two multivariable regression models explained 84.2–84.3% of the variance in QoL (adjusted R²). Social cognition (RMET scores) and CYP2D6 reduced-function metabolizer status emerged as the strongest predictors (β = 0.363 and β = −0.362, respectively, both p < 0.0001), followed by negative symptom severity and dysfunctional family relationships (all p < 0.05). Conclusions: Pharmacogenetic (CYP2D6), social–cognitive, and clinical factors strongly determine QoL in adolescent schizophrenia. Routine CYP2D6 genotyping, social-cognition remediation, and family interventions should be integrated into early treatment to improve long-term well-being. Full article

Background/Objectives: Growing concern about narcissistic traits in younger generations and their effects on empathy, communication, and mental health underscores the need for focused research on medical students as future healthcare professionals. Medical training carries a substantial psychological burden that can compromise students’ well-being, professional development, and the future quality of patient care. Personality traits, including grandiose and vulnerable narcissistic dimensions, may shape susceptibility to such psychological distress. Therefore, this study aimed to examine narcissistic traits and their associations with psychological distress among Croatian medical students across study years and trait levels. Methods: In this cross-sectional study, 413 medical students from the University of Split completed self-administered questionnaires during mandatory classes. Narcissistic traits were assessed using the Pathological Narcissism Inventory (PNI) and psychological distress was measured with the Brief Symptom Inventory (BSI). High pathological narcissistic traits were operationally defined as scores within the highest quartile. Statistical analyses included correlation, comparative, and regression analyses. Results: Overall, pathological narcissistic traits were expressed at low to moderate levels and did not differ across academic years. High narcissistic traits were identified in 35% of students, with 15% exhibiting elevated levels of both grandiose and vulnerable dimensions, suggesting an overlap between the two dimensions. Gender differences emerged across both narcissistic dimensions, with women scoring higher on vulnerable and men scoring higher on grandiose narcissism. One-quarter of students met the criteria for clinically significant psychological distress, which was more prevalent in the earlier years of study. High levels of pathological narcissistic traits, particularly vulnerable traits, were significantly associated with clinically significant distress and elevated symptoms across nearly all BSI domains, most notably interpersonal sensitivity and paranoid ideation. Despite this burden, only a minority of distressed students reported seeking psychological help. Conclusions: Elevated pathological narcissistic traits are significantly associated with psychological distress in medical students. The high prevalence of distress, combined with low help-seeking rates, underscores the need for early identification strategies and structured mental health support within medical education. Addressing personality-related vulnerability factors may improve student well-being, enhance professional development, and, ultimately, elevate the quality of healthcare delivery. Full article

Alexithymia has been associated with deficits in social cognition, although findings are inconsistent and often limited by methodological constraints. This study aimed to clarify this relationship using ecologically valid and traditional standardized measures across multiple social-cognitive domains. A total of 163 adults from the general population completed a series of measures, including the Toronto Alexithymia Scale (TAS-20), Questionnaire of Cognitive and Affective Empathy (QCAE), Reading the Mind in the Eyes Test (RMET), Movies for the Assessment of Social Cognition (MASC), and Amsterdam Dynamic Facial Expression Set—Bath Intensity Variations (ADFES-BIV). Results of hierarchical regression analyses revealed that alexithymia facets significantly predicted performance on affective and cognitive empathy (QCAE), and Theory of Mind (MASC total and “No ToM” scores). The only exceptions were affective Theory of Mind (RMET) and recognition of others’ emotions (ADFES-BIV), for which none of the alexithymia facets emerged as significant predictors. The findings suggest that alexithymia is associated with poorer performance in cognitive and affective empathy and contextual Theory of Mind, whereas no significant association emerged for emotion recognition. The results suggest that integrating dynamic and context-rich tasks may be useful for detecting subtle social-cognitive difficulties in individuals with alexithymic traits. Full article

Background/Objectives: Therapeutic communication is a core competency in mental health nursing, yet clinical placements often offer limited opportunities for undergraduate students to practise relational skills in a safe and structured way. Simulation, particularly when aligned with the Healthcare Simulation Standards of Best Practice™ (INACSL), may provide a useful context for fostering empathy, emotional presence, and professional communication. This study aimed to evaluate undergraduate nursing students’ satisfaction and self-confidence following participation in a standardised-patient simulation designed to address therapeutic relationship competencies. Methods: A descriptive cross-sectional study was conducted with 142 third-year nursing students at a public university. Participants completed two INACSL-aligned simulation encounters involving psychiatric scenarios that required therapeutic engagement. After the sessions, students completed a questionnaire based on the Student Satisfaction and Self-Confidence in Learning Scale, adapted to the context of the simulation. Data were analysed using descriptive statistics. Results: Students reported high levels of satisfaction and self-confidence following the simulation experience. Between 88.0% and 92.9% of participants agreed or strongly agreed with items related to realism, relevance, and motivation. High levels of agreement were also observed for items related to therapeutic communication, critical thinking (98.6%), clinical competence (95.8%), and teamwork (93.6%). Lower levels of agreement were found for the usefulness of video-based debriefing (61.9%) and the adequacy of material resources (57.1%), suggesting areas for improvement in future implementation. Conclusions: Standardised-patient simulation was positively evaluated by nursing students and was associated with high levels of satisfaction and self-confidence in learning. The findings suggest that this type of educational strategy may support students’ perceived development of therapeutic communication and relational skills in mental health nursing education. However, these results are based on self-reported data collected using an adapted measurement approach and should be interpreted with caution. Further research using validated instruments and performance-based measures is needed to assess competence development more directly. Full article