Search Results (427)

Background: Emotional abuse is both prevalent and underrecognized particularly in culturally complex settings like India. Adolescents, being in a critical developmental phase, are especially vulnerable to the long-lasting psychological effects of emotional abuse. This qualitative literature review aims to synthesize findings from primary studies that explore the lived experiences of emotional abuse among Indian adolescents and identify emerging patterns across sociocultural contexts. Method: Electronic databases, including DOAJ, Google Scholar, ProQuest, JSTOR, Pubmed, PsycNet, and SCOPUS, were searched for peer-reviewed articles published in English up to March 2025. Inclusion criteria comprised qualitative or mixed-methods research focusing on emotional abuse among adolescents aged 12–20 in Indian contexts. The Critical Appraisal Skills Programme (CASP) was used for quality assessment. Results: Five major thematic domains were identified across the included studies: (1) Family as a primary site of emotional abuse; (2) Gendered experiences of abuse; (3) Cultural normalization and silence; (4) Psychological and emotional consequences; and (5) Coping and resilience among adolescents. These themes reflect shared experiences of emotional abuse shaped by cultural, familial, and gender-based expectations. Conclusions: This review highlights the urgent need for increased awareness and culturally sensitive interventions addressing emotional abuse in Indian adolescents. The findings suggest that parents, educators, and policymakers must recognize emotionally harmful behaviors and implement prevention-oriented strategies, particularly through non-violent communication and adolescent mental health support frameworks. Full article

Healthcare abuse is a critical human rights and public health issue, particularly impacting medical interns and trainees who are vulnerable to mistreatment during their formative professional years. This cross-sectional study, conducted from February to June 2024, evaluated the prevalence and psychological impact of harassment and discrimination among 463 healthcare interns in Saudi Arabia from various specialties, including medicine, nursing, pharmacy, and dentistry. Using a self-administered online questionnaire, we found that mistreatment was widely reported, with female interns experiencing significantly higher rates of sexual harassment and gender-based discrimination. Common perpetrators included residents, lecturers, professors, nurses, and patients, with incidents most frequently occurring in surgical and internal medicine departments. Despite high prevalence, only 9% of interns reported the abuse due to mistrust in reporting systems or failure to recognize the behavior as abuse. These experiences were associated with significant psychological distress, including frustration, reduced motivation to learn, and higher DASS scores, particularly among female interns. The study underscores the need for institutional reforms, including policy development, cultural change, and effective reporting systems to ensure a safe and supportive learning environment for future healthcare professionals. Addressing abuse in medical training is essential for individual well-being and the sustainability and integrity of healthcare systems. Full article

This paper presents the development and validation of the Transgender Health, Resilience, Inner Well-Being, Vitality, and Empowerment (THRIVE) Scale. It offers insights into the well-being of transgender and gender-diverse (TGD) individuals, by considering their unique experiences and challenges. TGD individuals often experience significant health disparities, including mental health issues, substance abuse, physical health problems, and difficulty with providers knowing about their needs. A comprehensive quality-of-life assessment could aid in identifying contributions to poor quality of life (QOL) and knowing which resources are needed to address this effectively. Assessments attempting to address these challenges often have not been studied adequately and/or have limitations of being for one-time use, surgery-focused, lengthy, emotionally taxing, and not inclusive of non-binary individuals’ specific needs. Validated among a sample of TGD individuals (N = 61), the THRIVE scale displayed good internal consistency reliability (α = 0.87), as well as convergent and divergent validity. It had significant negative correlations with measures of psychological symptoms and identity distress and positive correlations with measures of life satisfaction and well-being. The THRIVE scale represents a critical advancement in assessing the QOL of TGD individuals and could be an effective tool for individualized care, research, and conversation with these populations. Full article

Background and Objectives: The worldwide shift toward psychiatric deinstitutionalization has aimed to enhance patient autonomy, social integration, and overall quality of life. However, limited studies have examined how concurrent substance use—particularly alcohol, marijuana, and inhalable drugs—affects clinical outcomes in these populations. This study aimed to evaluate psychiatric patients with varying degrees of institutionalization and investigate whether substance use complicates or exacerbates treatment outcomes. We hypothesized that individuals using substances would demonstrate worse psychosocial functioning, higher healthcare costs, and increased readmission rates. Methods: We performed a cross-sectional study of 95 participants recruited from long-term care facilities. Participants completed the SF-36 survey validated in Romanian. Financial data were collected to gauge direct and indirect healthcare expenditures. Results: Results indicated that 34.7% of participants reported alcohol use, 12.6% used marijuana, and 9.5% used inhalable substances. Substance-using patients experienced higher mean hospitalization costs of approximately USD 3251.8, compared to non-users (USD 2743.6, p = 0.032). Quality-of-life scores were significantly lower among substance users (mean SF-36 score 58.4 vs. 66.7, p = 0.027). Rates of relapse and readmission were also notably higher in the substance-using cohort (42.1%) relative to non-users (29.8%, p = 0.041). Conclusions: To our knowledge, this is the first Romanian study—and one of only a handful in Europe—to quantify how specific substance-use profiles simultaneously alter quality of life and direct healthcare costs in a deinstitutionalized psychiatric population. Our findings highlight the need for integrated interventions targeting both mental health and substance abuse. Full article

Background and objectives. Symptoms of Attention Deficit Hyperactivity Disorder (ADHD) are frequently present in university students, even without a clinical diagnosis, and may be aggravated by various factors. This study analyzes the relationship between these symptoms and the use of alcohol, tobacco, cannabis, and other drugs by young university students. Materials and methods. A cross-sectional study was conducted with 397 university students using an anonymous online questionnaire. ADHD symptoms were assessed with the Adult ADHD Self-Report Scale (ASRS), alcohol use with the Alcohol Use Disorders Identification Test (AUDIT-C), nicotine dependence with the Fagerström test, cannabis use with the Cannabis Abuse Screening Test (CAST), and the use of other substances with an adaptation of the latter. Results. The mean age was 21.4 years, and most participants (76.6%) were women. Of the participants, 46.1% presented symptoms compatible with ADHD according to the ASRS. The most frequent items were difficulty maintaining attention during boring tasks (77.3%), avoiding tasks that require mental effort (76.8%), and being easily distracted by noise or external activity (73.8%). Significant differences were found between ASRS scores and gender, with scores being higher and more consistent among those students who identified themselves as non-binary gender (male or female) (p < 0.01). A significant association was also found between smoking and a higher ASRS score (p < 0.01). Although no significant associations with body mass index were detected, a trend toward greater symptomatology was observed in obese individuals. In multivariate analysis, still gender and smoking significantly (p = 0.12 and p = 0.031, respectively) predicted ADHD symptoms (ASRS score). The model R = 0.228 (R squared = 0.052, F = 1.62, p = 0.077). No statistically significant differences were found between ADHD symptoms and the use of alcohol, cannabis, or other substances in either bivariate or multivariate analyses. Conclusions. This study underscores the importance of early detection of ADHD symptoms in the university setting, considering factors such as gender and smoking habit. Future research should focus on aggravating factors such as academic stress and problematic technology use. Full article

Νurses often experience abusive behavior, such as gaslighting, which has a negative impact on their mental health and leads them to quit their jobs. Background/Objectives: We evaluate the impact of workplace gaslighting on nurses’ job burnout and turnover intention. Methods: We conducted a cross-sectional study with a convenience sample of 410 nurses in Greece. We used the Gaslighting at Work Scale (GWS) to measure levels of workplace gaslighting in our sample. Also, we used the single-item burnout measure to measure job burnout and a six-point Likert scale to measure turnover intention. We constructed multivariable regression models to estimate the independent effect of workplace gaslighting on job burnout and turnover intention. Results: We found positive correlations between GWS and job burnout (r = 0.298, p-value < 0.01) and turnover intention (r = 0.385, p-value < 0.01). We found that workplace gaslighting was associated with job burnout in our sample. Our multivariable linear regression model identified a positive association between the score on the GWS (adjusted b = 0.653, 95% CI = 0.436 to 0.869, p < 0.001) and burnout. Similarly, we found that a higher score on the GWS was associated with a higher turnover intention (adjusted b = 0.616, 95% CI = 0.466 to 0.765, p < 0.001). Conclusions: This study findings indicate that nurses encounter gaslighting behaviors that adversely impact their job burnout and turnover intentions. Healthcare institutions are urged to implement policies that raise awareness about this conduct, facilitate avenues for staff to report it, and exhibit zero tolerance for abusive behaviors, including gaslighting. Full article

Education-to-work transition among war-affected youth in post-conflict settings is fraught with challenges, not least compounded by the little attention placed on individual agency and mental health. This review examines the debate on war-affected youth skilling programmes in post-conflict settings, which neglect the roles of individual agency and mental health in the education-to-work transition. Building on Albert Bandura’s Self-Efficacy Theory (SET) and the Cumulative Stress Hypothesis (CSH), the review presents an integrated approach to skills development for improving education-to-work transition among war-affected youth. According to SET, the development of self-efficacy is anchored on enactive mastery, vicarious experience, verbal persuasion, and physiological arousal. Moreover, individual agency factors such as motivation, aspiration, goal orientation, active efforts, and alignment of intentions with skills are protective factors for effective education-to-work transition, but they are also eroded by the adverse consequences of violent conflicts. Similarly, the CSH also suggests that the effects of exposure to protracted violent conflicts are cumulative and may lead, in turn, to a plethora of mental health problems in the aftermath of violent conflicts. Mental health problems like depression, anxiety, and PTSD are linked to, inter alia, behaviours such as aggression, substance abuse, and apathy, all related to poor employment outcomes. To increase the employability of young people affected by war, skills training institutions and work settings need to prioritise the mental health and individual agency of the youth, as well as skills acquisition for specific trades. Consequently, we propose an integrated model of reintegrating war-affected and vulnerable youth anchored on professional technical and vocational skills training; recognition of individual agency; provision of mental and psychosocial support; and life skills training, all nested within the local economic realities. Full article

The COVID-19 pandemic is considered a potentially traumatic event, as it introduced new challenges and threats to people around the world, disrupting daily life due to the restrictions imposed. The psychological defenses of individuals mobilized to deal with stress reactions are influenced by a set of factors, including previous traumatic experiences, which can amplify the current trauma. Recognizing that people exposed to adverse childhood experiences (ACEs) have increased risks of an array of adverse mental and physical health outcomes throughout life, the present study aimed to investigate the relationship between ACEs—more specifically, child abuse and child neglect—and PTSD symptoms in a sample of European adults during the pandemic. A sample of 8459 participants (67.1% female and 32.9% male, with a mean of 43.95 years old) was evaluated. The survey questionnaire included questions on sociodemographic and clinical characteristics, the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5), and the Adverse Childhood Experiences (ACEs) questionnaire. According to our findings, younger women who have suffered from child abuse or child neglect are more likely to develop PTSD symptoms. The most significant factor influencing the PTSD risk was child neglect, contrary to many studies that indicate that child abuse is the most impactful adverse childhood experience. Full article

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

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

Background The COVID-19 epidemic had a deleterious impact on mental health and substance abuse and led to an increase in several forms of violence, including self-harm and interpersonal violence among youth from low- and middle-income countries. Nevertheless, the relationship between the variables and their directionality has not been recognized. This study describes the relationship directionality between these variables among 18- to 20-year-old Mexican youths during the COVID-19 pandemic. Methods The longitudinal cohort study comprises an evolving group of young Mexican adults: 1390 participants aged 18 in 2021, 654 aged 19 in 2022, and 442 aged 20 in 2023. Proportions by sex—50% were matched in every cohort, and the evolution–age sample accomplishment accounted for 47% in 2022 and 32% in 2023. Results According to a structural equation model, which fit the data from 195 iterations with 246 parameters (X²[2722] = 8327.33, p < 0.001), yielding a CFI of 0.946, a TLI of 0.943, and an RMSEA of 0.029 [0.028–0.029]), perpetrating intimate violence, preceded by suffering intimate violence, combined with suffering anxiety symptoms, was associated with self-harm–suicide thoughts and behaviors (ShSTB), marked distress, dysfunction, and somatization symptoms. The relationship was stronger in women and 20-year-old Mexicans. In men, this pathway was exclusively associated with ShSTB. Suffering from intimate violence has been associated with depression, anxiety, and PTSD symptoms, as well as harmful alcohol use. Conclusions During an epidemic, prevention programs should be designed to warn about self-harm–suicide thoughts and behaviors, not only to ensure the safety of the victims of intimate personal-violence but also to prevent the suicidal behavior of perpetrators. Full article

In the news media, there are regular reports of family caregivers killing the people for whom they care, but scholarly research on this phenomenon is fragmented, and there has been little effort to predict or prevent future deaths. The aim of this study was to develop a typology of caregiver-perpetrated homicides that could provide a framework for more rigorous research and targeted responses in policy and practice. Ideal Type Analysis was applied to sixty-four homicides and homicide–suicides perpetrated by family caregivers in England and Wales between January 2015 and December 2019. The cases clustered into seven clear types: Ending Suffering; Genuine Burden of Care; Pre-existing Mental Illness; Neglect; Exploitation; Caregiver as Victim of Domestic Violence, Abuse or Coercive Control; and Caregiver as Perpetrator of Domestic Violence, Abuse, or Coercive Control. Each type was characterised by a distinct motive, context, or course of events leading to the homicide. This is the first typology of homicides and homicide–suicides perpetrated by caregivers. The Caregiver-Perpetrated Homicide Typology challenges previous claims that caregiver-perpetrated homicides are isolated events and provides a framework for the development of evidence-based prediction and prevention initiatives. Full article

Background: Benzodiazepines (BZDs), commonly used to treat insomnia and anxiety, are increasingly used in Spain, raising concerns due to their potential for abuse and dependence. This study investigates the use of BZDs and other psychotropic medications among healthcare workers, exploring their prevalence, associated factors, and their relationship with mental health issues following the COVID-19 pandemic. Methods: An anonymous online survey was conducted among healthcare workers at the Salamanca University Healthcare Complex (CAUSA) from March 2023 to January 2024. Of 1121 participants, 685 provided complete responses, which were analysed. Insomnia, anxiety, and depression were assessed using the Insomnia Severity Index (ISI) and Patient Health Questionnaire-4 (PHQ-4). Results: Of the respondents, 23.8% reported using sleep medication, with 27.8% doing so without a prescription. Additionally, 14.7% used medication for depression or anxiety, with only 0.6% without a prescription. Hypnotic medicine use was associated with older age, insomnia, anxiety, depression, psychological or psychiatric treatment, COVID-19 after-effects, and diagnosed sleep disorders. Night-shift work was associated with increased hypnotic medication use in men but not in women. The use of these medications was linked to a reduced quality of life and impaired work performance. Conclusions: The use of BZD and self-medication are prevalent among healthcare professionals, exceeding the rates observed in the general population. These findings highlight the urgent need for targeted interventions to address psychotropic medication use, promote other pharmacological and non-pharmacological alternatives for insomnia, and enhance mental health support for this vulnerable population. Full article

Background: In Japan, new challenges are emerging, such as declining birth rates, an increase in age at childbirth, postpartum depression, and child abuse. Methods: This study examines the factors influencing maternal consultation behavior at public institutions using some of the data from the Japan COVID-19 and Society Internet Survey (JACSIS). A total of 6227 women (1380 pregnant and 4847 postpartum) were analyzed through logistic regression. Results: The results showed different factors influencing consultations between pregnant women and postpartum women. Among pregnant women, different trends were observed between primigravidae and multigravidae, indicating that primigravidae aged ≥40 years and multigravidae with multiple childbirths tend to seek consultations more frequently. In postpartum women, psychological distress (K6), adverse childhood experiences (ACEs), and social support networks significantly influenced consultation behavior. Postpartum women with extensive support networks (≥3 confidants) exhibited higher consultation rates. In contrast, those with elevated Edinburgh Postnatal Depression Scale (EPDS) and Mother-to-Infant Bonding Scale (MIBS-J) scores were less likely to seek help, potentially due to mental health stigma. Conclusions: This study showed that pregnant and postpartum women facing physical, mental, family, or relationship issues are seeking consultations and receiving thorough support. On the other hand, since some pregnant and postpartum women refrained from seeking consultation, it is necessary to further consider support measures that make it easier for all pregnant and postpartum women to seek advice in the future. Full article

Introduction: Cannabis use disorder (CUD) is being increasingly diagnosed in the United States, but access to treatment remains unequal, particularly in New York. Identifying the factors that contribute to disparities in receiving treatment for CUD among different population groups is essential for ensuring effective and targeted interventions. This study explores the sociodemographic factors influencing treatment utilization for CUD in New York. Methods: Data for this study were retrieved from the 2018 Treatment Episode Data Set—Discharges (TEDS-D) of the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA). Sample size for the study is 422,319 people with CUD. Logistic regression analysis was performed to examine the odds of receiving treatment for CUD based on demographic and socioeconomic factors, as well as the type of treatment setting. Results: The results revealed significant disparities in treatment utilization. Asians/Pacific Islanders and Hawaiian Natives had lower odds of receiving treatment compared to African Americans (OR = 0.367, 95% CI 0.341–0.394). Similarly, Caucasians had the lowest odds of receiving treatment (OR = 0.270, 95% CI 0.266–0.275). Females were less likely to receive treatment compared to males (OR = 0.756, 95% CI 0.744–0.768). Those with higher educational attainment (over four years of college) had the lowest odds of receiving treatment, while individuals with 9–11th grade education had the highest odds. Employment status also influenced treatment access, with the unemployed having the highest odds, and full-time employees having the lowest. Additionally, individuals with no source of income had significantly lower odds of receiving treatment. Conclusions: This study highlights significant disparities in the provision of treatment for CUD in New York, influenced by sociodemographic factors such as race, gender, age, education, and employment status. These findings emphasize the need for targeted interventions to reduce these disparities and improve treatment access for underserved populations. Full article