Search Results (1,594)

Background: This study aimed to compare a limited set of predefined diet-, lifestyle-, knowledge-, and psychosocial indicators across school youth, students, and adults in Poland, and to examine their associations with three predefined outcomes: BMI ≥ 25 kg/m², poorer mental well-being, and high stress/overload. Diet quality, daily health-related practices, psychosocial well-being, and stress/overload may co-occur across different life stages, but online survey data require a focused analytical framework to avoid overinterpretation. Methods: This cross-sectional anonymous online survey included 360 respondents: 154 school youth aged 15–19 years, 127 students aged 20–29 years, and 79 adults aged 30 years or older. Dietary assessment was based on the KomPAN questionnaire and included the pro-healthy diet index, non-healthy diet index, and Diet Quality Index. Study-specific scores were used for knowledge, healthy practices, psychosocial well-being, and stress/overload. Analyses were restricted to predefined group comparisons, selected correlations, and three whole-sample adjusted logistic regression models. Results: Adults had the highest BMI and waist/hip circumference, whereas school youth showed the highest non-healthy diet index and more frequent high processed-food intake. Among the knowledge and psychosocial indicators, only obesity knowledge differed significantly between groups, with the highest mean value among students. Stress/overload was inversely associated with psychosocial well-being, and DQI was positively associated with psychosocial well-being after adjustment for age, sex, and group. In adjusted whole-sample models, BMI ≥ 25 kg/m² was positively associated with age and DQI and inversely associated with physical activity frequency and regular meals; the positive DQI–BMI association was interpreted cautiously as potentially reflecting reverse causality, reporting bias, or compensatory dietary modification among respondents with excess body weight. Poorer mental well-being was associated with higher stress/overload and inversely associated with DQI, physical activity frequency, and family meals. High stress/overload was positively associated with highly processed food intake and inversely associated with regular meals. Conclusions: The findings suggest that diet quality, behavioral regularity, and psychosocial burden may be more informative than knowledge alone when describing health-related profiles across age-defined groups. Because the study was cross-sectional, self-reported, anonymous, and based on a modest sample, the results should be interpreted as preliminary and hypothesis-generating rather than causal. Full article

Psychological distress is increasing among university students, especially sexual minority individuals in Malaysia, who face stigma and challenges within a sociocultural and dual legal system. This study examined the relationship between sexual minority status and both negative (psychological strain, distress, suicidality) and positive (self-esteem, purpose in life, social support, religiosity) mental health indicators among Malaysian undergraduates. A cross-sectional, multi-institutional survey was conducted utilizing an existing dataset, yielding a final analytical sample of 2244 participants (1870 heterosexual and 374 sexual minority students). Data were analyzed using Welch’s ANOVA and multiple logistic regression, controlling for demographic variables. Heterosexual students reported significantly lower depressive symptoms, anxiety, stress, and suicidality compared to gay, bisexual, and participants with other sexual orientation. In the fully adjusted model, sexual minority identity remained significantly associated with higher deprivation strain (aOR: 1.043), depression (aOR: 1.025), and suicidality (aOR: 1.117). Conversely, identifying as a sexual minority was linked to lower religious commitment (aOR: 0.961) and lower perceived family support (aOR: 0.943). Self-esteem and purpose in life lost statistical significance in the fully adjusted model. Sexual minority undergraduates in Malaysia face heightened psychological distress and suicidality, underscoring the need for comprehensive campus mental health interventions. Full article

Background: As understanding of addiction extends beyond substance misuse, various behavioral disorders may emerge as recognized mental health conditions, including social media use disorder (SMUD). To date, however, empirical research supporting SMUD as a distinct disorder is limited and inconsistent. The present study set out to compare the relative prevalence of elevated symptoms suggestive of SMUD between those with no mental health history and affective disorders (both unipolar depression and bipolar disorder). Methods: Participants were recruited online and completed questionnaires measuring social media use (SMU), symptoms of SMUD, depression and various psychosocial factors associated with social media use (i.e., loneliness, social support). Among those with affective disorders, we set out to identify sociodemographic and clinical features that distinguish those with comorbid SMUD (i.e., above the cut-off on the SMUD screening measure). Results: Five main findings emerged from our analyses: (1) SMUD appears unrelated to known forms of SMU; (2) Among those with no mental health history, SMUD does not present independently of elevated depressive symptoms; (3), No sociodemographic or clinical features distinguish those with clinical depression reporting comorbid SMUD; (4), Among those with bipolar disorder (BD), symptoms of hypo/mania do not distinguish those also reporting elevated SMUD symptoms; (5) And SMUD symptoms no longer differ across clinical groups after adjusting for depressive symptoms. Conclusions: Our findings suggest that SMUD is unrelated to active or passive SMU. Symptoms suggestive of SMUD may instead be a contemporary manifestation of depressive symptomology. These findings do not support the existence of SMUD as a bona fide mental health condition. Full article

Background: Adolescent mental health is a global concern, with lifestyle factors such as diet and physical activity (PA) playing a crucial role. While the Mediterranean Diet adherence (MDA) is known for its neuroprotective benefits on mental health, the mechanisms by which they are related remain unclear. Therefore, the aim of this study was twofold: (1) to examine the associations between MDA, PA, and screen time (ST) with anxiety symptoms, depression, stress, and total psychological distress in Chilean adolescents; and (2) to determine whether PA mediates the relationship between MDA and anxiety symptoms. Methods: A cross-sectional study was conducted with 322 Chilean school-aged adolescents 158 males and 164 females (14.98 ± 1.96 years). Mental health outcomes (depression, anxiety, and stress) and lifestyle behaviors, including MDA, PA, and ST, were comprehensively assessed using validated self-reported questionnaires. Results: After adjusting for age and sex, multiple linear regression models showed that higher MDA was significantly and inversely associated with anxiety (b = −0.23, p = 0.044), stress (b = −0.25, p = 0.022), and total psychological distress (b = −0.72, p = 0.022). Conversely, ST was identified as a consistent risk factor, positively predicting higher levels of anxiety (b = 0.45, p = 0.008), stress (b = 0.42, p = 0.008), and total distress (b = 1.11, p = 0.014). Furthermore, PA was inversely linked to anxiety (b = −0.35, p = 0.013) and successfully mediated the relationship between MDA and anxiety symptoms (Indirect Effect = −0.047, 95% CI: −0.10 to −0.01). No significant mediation effects were observed for depression or stress. Conclusions: The present study identifies robust inverse associations between MDA and symptoms of anxiety, depression, and stress in Chilean adolescents. A key finding is the specific pattern of relationships observed: while higher MDA is directly linked to lower levels of depression and stress, its association with anxiety is shared with levels of PA. Despite these findings, the cross-sectional nature of the study limits the establishment of causal relationships, and further longitudinal research is needed to confirm these directional pathways. Full article

Background/objectives: Long COVID is associated with persistent, multi-system symptoms, yet little is known about how it affects individuals with intersecting vulnerabilities, such as a racialized identity and pre-existing mental health conditions. This study aimed to descriptively characterize the symptom burden, functional outcomes and mental health in this population. Methods: A cross-sectional, exploratory study was conducted among 51 adults in Canada who self-identified as racialized and as having a pre-existing mental health condition and reported long COVID symptoms. Participants completed an online survey, including validated measures of symptoms, fatigue, post-exertional malaise, cognitive function, mental health and disability. Descriptive statistics were used to summarize outcomes. Results: Participants reported a slight to moderate overall symptom burden, with the highest scores in respiratory and psychological domains. Functional impairment was moderate across work, social and daily activities (Work and Social Adjustment Scale mean = 17.35; World Health Organization Disability Assessment Schedule 2.0 mean = 16.61; Post COVID-19 Functional Status Scale mean = 2.20). Fatigue and post-exertional malaise were notable (Modified Fatigue Impact Scale mean = 43.39; DePaul Symptom Questionnaire—Post-Exertional Malaise mean = 22.47), and cognitive difficulties were commonly reported (Perceived Deficits Questionnaire mean = 33.43). Anxiety and depression scores were in the mild to moderate range respectively (General Anxiety Disorder-7 mean = 9.27; Patient Health Questionnaire-9 mean = 11.43). Conclusions: Clinically relevant fatigue, post-exertional malaise, and depression were found, alongside moderate functional limitations across life domains. The findings support the conceptualization of long COVID as a syndemic condition and underscore the need for equity-informed research, rehabilitation and public health strategies. Full article

Population-based evidence on sleep quality in Kazakhstan remains limited. This study describes sleep quality as a multidimensional construct among adults in Kazakhstan using data collected during the first national survey wave after the adoption of a single national time zone. The survey was designed as a national post-transition baseline assessment and not as an evaluation of the causal impact of the time-zone reform. Associations with socio-demographic, behavioural, clinical, and regional factors were examined. We conducted a nationally representative cross-sectional survey of adults aged 18–69 years in Kazakhstan from May to October 2025 using a multistage stratified cluster design. Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI). Poor sleep quality was defined as a global PSQI score > 5. Complete PSQI data were available for 5872 participants. Descriptive analyses examined the global PSQI score and the seven component scores. Survey-weighted multivariable logistic regression was used to identify factors independently associated with poor sleep quality. The weighted prevalence of poor sleep quality was 28.1%, and the weighted mean global PSQI score was 4.43. The greatest component burden was attributable to sleep latency (mean 0.87), subjective sleep quality (0.82), and sleep disturbances (0.80), whereas use of sleep medication contributed minimally (0.11). Poor sleep quality was more common among women, older adults, urban residents, and participants with diabetes, current smoking, heavy episodic drinking, and depressive symptoms. In the adjusted model, female sex (aOR 1.37, 95% CI 1.19–1.57), age 55 years or older versus 18–24 years (1.98, 1.53–2.55), diabetes (1.47, 1.22–1.78), current smoking (1.28, 1.10–1.50), heavy episodic drinking (1.43, 1.16–1.76), and depressive symptoms (4.26, 3.52–5.15) were independently associated with higher odds of poor sleep quality. Rural residence was inversely associated with the outcome (0.71, 0.61–0.84). Compared with the North, higher odds were observed in the Central region (2.00, 1.46–2.74), East (1.94, 1.48–2.53), West (1.48, 1.17–1.88), and Almaty city (2.18, 1.72–2.76). Poor sleep quality is common among adults in Kazakhstan and is characterized primarily by difficulties with sleep initiation, perceived sleep quality, and nocturnal disturbances. The findings provide national post-transition baseline evidence and suggest that sleep health surveillance in Kazakhstan should prioritize demographic, mental health, behavioural, and regional inequalities while avoiding causal interpretation of the time-zone reform itself. Full article

Adolescents with LGBTQ+ parents and LGBTQ+ adolescents navigate unique social and identity-related challenges as compared to those without minoritized sexual and/or gender identities. Adolescents with LGBTQ+ parents (regardless of their own sexual or gender identity) and adolescents who personally identify as LGBTQ+ are distinct populations, though they sometimes overlap. Research on adolescents with LGBTQ+ parents has often focused on parent–adolescent relationships and family structures. How do friends help youth cope with identity-based minority stressors, like peer microaggressions, bullying, and exclusion, common for those with minoritized identities? Friendships are developmentally pivotal during adolescence, shaping social competence, identity exploration, and psychological adjustment. Grounded in ecological systems, social learning, and minority stress theories, we sought to understand how friendships relate to mental health and coping in adolescents with LGBTQ+ parents. This cross-sectional quantitative study included 98 adolescents (ages 12–19) with LGBTQ+ parents in the U.S., recruited via community sampling and Prolific. Higher-quality peer attachment, conceptualized by trust, communication, and alienation in close friendships, was associated with lower depression and greater social competence, but not associated with anxiety or adaptive coping (after accounting for avoidant coping). Avoidant coping was most strongly associated with poorer mental health. This study, with implications for practice, emphasizes the importance of peer relationships for adolescents with LGBTQ+ parents—particularly how high-quality friendships offer important possible protection via social competence and against depression—while also highlighting the complex interplay between friendships, coping, and adjustment. Full article

Background and Clinical Significance: “Hikikomori”—a state of prolonged social withdrawal affecting an estimated 2% of Japan’s working-age population—is frequently associated with underlying anxiety disorders, such as gaze phobia, and contributes to the socio-economic burden known as the “8050 problem,” in which aging parents support their socially isolated adult children. While Morita therapy is effective for such conditions, nursing support has historically lacked a systematic theoretical framework. This case report presents a novel nursing model analyzing the transformation process from toraware (mental preoccupation) toward mokuteki-hon-i (purpose-driven action). It proposes the ‘side-by-side’ nursing approach as a potentially important element in supporting patient autonomy in similar clinical settings. Case Presentation: A man in his 20s, diagnosed with gaze phobia and experiencing long-term withdrawal following traumatic bullying, was referred to our specialized short-care program. After initial preparation through structured psychoeducation regarding Morita therapy principles (toraware, sei-no-yokubo, mokuteki-hon-i), he participated in a 14-month Morita therapy-based short-care program combining individual and group interventions. Initially, the patient exhibited severe social avoidance and was trapped in a cycle of seishin-kogo-sayo (psychic interaction). Nurses applied ‘Strategic Inattention to Symptoms’ (shojo-fumon) and provided specific role suggestions, such as serving as a secretary in group discussions, to elicit his sei-no-yokubo (desire for life). Through the reframing of his anxiety as a constructive drive, the patient shifted to a purpose-driven stance. Outcomes showed improved self-adjustment skills in public spaces and successful social reintegration through sustained part-time employment. Conclusions: Nursing care characterized by ‘intentional non-intervention’—which involves waiting in a ‘side-by-side’ manner within a minimally structured environment—may contribute to fostering patient autonomy in similar clinical contexts. This ‘experience-oriented’ approach appeared to elicit inner strengths and support self-regulation in this case, warranting further investigation in multi-case designs. The relative contributions of individual nursing support and group therapeutic milieu cannot be disentangled in a single-case design. Full article

Background/Objectives: Mild cognitive impairment (MCI) may precede dementia, and safe nutritional strategies able to support cognitive function are of clinical interest. Dietary nucleotides may contribute to membrane phospholipid synthesis, synaptic function, and neuroprotective pathways; however, clinical evidence in older adults with MCI remains limited. This randomized placebo-controlled trial evaluated the efficacy and tolerability of nucleotide-rich yeast extracts from Kluyveromyces fragilis and Saccharomyces cerevisiae. Methods: Seventy-two participants (mean age 73.5 ± 7.7 years; range 60–85) were randomly assigned (1:1:1) to receive K. fragilis extract, S. cerevisiae extract, or placebo once daily for 180 days. Cognitive outcomes were assessed using the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) at baseline (T0), 90 days (T1), and 180 days (T2); quality of life was assessed using the SF-12 questionnaire at T0 and T2. Treatment effects were analyzed using linear mixed-effects models adjusted for age and sex. Results: After 180 days, MoCA scores increased by 4.42 points in the K. fragilis group and 3.92 points in the S. cerevisiae group, compared with 0.58 points in the placebo group (time × treatment p < 0.001; T0–T2 within-group p < 0.001 for both active groups and p = 0.14 for placebo). MMSE scores increased by 1.62 and 3.11 points in the K. fragilis and S. cerevisiae groups, respectively, compared with 0.25 points in the placebo group (time × treatment p < 0.001; T0–T2 within-group p < 0.001 for both active groups and p = 0.57 for placebo). The SF-12 mental component score increased by 7.50 and 9.16 points in the two active groups, respectively (time × treatment p = 0.022; T0–T2 p = 0.0013 and p < 0.001, respectively), while physical quality-of-life scores did not change significantly (PCS time × treatment p = 0.11). No adverse events were reported. Conclusions: Nucleotide-rich K. fragilis and S. cerevisiae yeast extracts were well tolerated and were associated with improved cognitive scores over six months in older adults with MCI. Larger multicenter trials are needed to confirm these findings. Full article

Background: Insomnia is common among people with mental health conditions and can exacerbate symptoms, impair functioning and negatively impact treatment outcomes. Community mental health services require practical data to quantify the burden of insomnia in routine care and to identify groups at a higher risk of experiencing clinically significant insomnia. Methods: We conducted a retrospective analysis of anonymized routinely collected clinical data from adult psychiatric outpatients attending the Community Mental Health Center in Bra (Department of Mental Health, Asl Cuneo 2, Italy). Consecutive patients were included over a three-month period (1 September to 30 November 2025). Insomnia severity was assessed using the Insomnia Severity Index (ISI). Diagnoses were established by psychiatrists using the Structured Clinical Interview for DSM-5 (SCID-5). Results: The sample included 506 patients (mean age: 45.1 ± 16.7 years; 265 women, 52.4%). The mean ISI total score was 12.18 ± 6.99. Clinically significant insomnia (ISI ≥ 15) was present in 205 out of 506 patients (40.5%), while severe insomnia (ISI ≥ 22) was present in 55 out of 506 patients (10.9%). The ISI score differed across diagnostic groups (ANOVA, F(8, 497) = 2.82, p = 0.0046, η² = 0.043). Post hoc comparisons revealed higher ISI scores in patients with depressive disorders than in those with anxiety disorders (Tukey, p = 0.0056). In a multivariable logistic regression model (outcome: ISI score of at least 15), adjusted for age, sex, education and the complexity of concurrent psychotropic medication (number of medication classes), depressive disorders were associated with clinically significant insomnia (OR: 1.99; 95% CI: 1.07–3.73). Attention deficit hyperactivity disorder (ADHD) also showed higher odds (OR: 3.64; 95% CI: 1.26–10.55). Medication complexity was also associated with an ISI score of at least 15 (OR: 1.43 per additional class; 95% CI: 1.16–1.77). In a sensitivity model additionally adjusting for benzodiazepine prescription (yes/no), benzodiazepine prescription was associated with ISI ≥ 15 (OR 1.82; 95% CI 1.13–2.95), while the estimate for medication complexity was attenuated using this association (OR 1.17; 95% CI 0.90–1.53). The eating disorders group was excluded from multivariable models due to the very small sample size (n = 4). Conclusions: Clinically significant insomnia was prevalent among this sample of psychiatric outpatients, with modest differences in insomnia severity across diagnostic groups. Sensitivity analyses suggested that the signal of medication complexity may be partly accounted for by benzodiazepine prescribing, supporting the cautious interpretation of medication-related correlates in routine cross-sectional data. These findings support routine insomnia screening in psychiatric outpatient care, while prospective studies are needed to clarify directionality and clinical implications. Full article

Background/Objectives: Several randomized controlled trials have found that dietary interventions promoting self-guided shifts away from ultra-processed foods (UPFs) and toward minimally processed, nutrient-dense foods may alleviate depressive symptoms. However, translating these interventions into scalable and sustainable real-world approaches remains a key challenge. Adopting a minimally processed dietary pattern requires sustained effort (e.g., meal planning, shopping, and preparation) within environments where UPFs are pervasive and convenient. These demands may be especially burdensome for individuals experiencing depressive symptoms. Consequently, interventions that rely heavily on individual effort may be difficult to maintain. Commercial meal delivery services may offer a structural solution by reducing logistical and cognitive barriers to dietary change, yet little is known about how individuals with depressive symptoms experience this approach. Methods: In a parent study, we conducted a randomized pilot study of a meal delivery service designed to provide minimally processed meals to adults with moderate to moderately severe depressive symptoms; here we report qualitative findings from post-intervention interviews with participants assigned to the meal delivery condition (n = 20). Results: Participants appreciated reductions in preparatory effort and mental load, which supported adherence. Dietary changes were also linked to improved mood through increased energy, mood stability, and more positive self-evaluation. However, social settings were a near-universal barrier, and acceptability depended on palatability, compatibility with personal preferences, and perceived autonomy. Several participants also described a temporal adjustment process (early cravings/withdrawal followed by adaptation). Conclusions: Overall, these findings suggest participant-informed priorities for future testing and refinement of scalable meal delivery interventions for depression, including personalization and choice, quality control, and support for social and withdrawal-related challenges. Full article

The South-to-North Water Diversion Project (SNWDP) in China involves a vast number of resettlers with far-reaching impacts. As a crucial carrier of resettlers’ daily lives, the indoor thermal comfort of resettlement housing directly affects their physical and mental health. However, existing empirical and field studies have paid limited attention to the thermal comfort and thermal adaptation of the resettlers. This study focuses on resettlers of the SNWDP, employing a combination of questionnaires and on-site measurements to analyze thermal benchmarks and thermal adaptation behavior data. The study introduces the concept of relative deprivation theory from social psychology, compares the correlations between vertical and horizontal deprivation and thermal perception across different relocation modes, and validates the predictive performance of commonly used thermal comfort models. The results show that as the relocation distance increases, the summer indoor thermal neutral temperature rises sequentially, and both the sensitivity to temperature changes and the width of the comfort zone also increase. Regarding thermal adaptation behaviors, the short-distance group primarily relies on passive adjustments such as using electric fans and reducing clothing, while the long-distance group significantly shifts toward active mechanical cooling like air conditioning. The sense of relative deprivation has a significant impact on the thermal comfort of medium- and long-distance resettlers, and its correlation even exceeds that of physical factors such as air temperature and black globe temperature. Among all groups, the ePMV and ePTS models modified by the expectancy factor exhibit the best predictive performance, with the smallest average deviation from the actual Thermal Sensation Vote (TSV), making them the optimal evaluation models for indoor thermal comfort of resettlers in the SNWDP. The findings provide theoretical guidance for creating healthy and comfortable indoor thermal environments in resettlement areas and for the sustainable development of subsequent phases of the SNWDP. Full article

Background: Armed conflict and geopolitical instability increasingly affect mental health beyond directly exposed populations through continuous media exposure and digital information dissemination. Nursing students may be particularly vulnerable because of high academic demands, emotional sensitivity to human suffering, and intensive engagement with social media and online news platforms. This study examined the association between conflict related news exposure and depression, anxiety, and stress among nursing students in Saudi Arabia during the February 2026 regional military escalation involving Iran, and explored the role of perceived safety concern and the potential indirect associations involving sleep difficulty and study disruption. Methods: A multi-center cross sectional study was conducted among nursing students from different public universities across five regions of Saudi Arabia. Psychological distress was assessed using the Depression Anxiety Stress Scale. A composite conflict exposure index was developed from conflict news following frequency and exposure intensity measures. We used Gamma generalized linear models, interaction analyses, and structural equation modeling to evaluate associations, moderation by information source, and mediation pathways. Results were reported as arithmetic mean ratios (AMRs) with 95% confidence intervals, representing the relative change in mean psychological distress scores associated with each predictor. Models were adjusted for sociodemographic, academic, and living-related factors. Results: A total of 247 nursing students were included. Moderate to severe depression, anxiety, and stress were reported by 50.2%, 59.9%, and 32.4% of participants, respectively. Our findings showed that higher conflict exposure was associated with increased stress levels (AMR = 1.17, 95% CI: 1.02–1.34), while associations with depression (AMR = 1.14, 95% CI: 0.99–1.30) and anxiety (AMR = 1.13, 95% CI: 0.99–1.28) were weaker. Associations between conflict-related exposure and depression, anxiety, and stress were substantially attenuated after accounting for perceived safety concern, which remained strongly associated with all psychological distress outcomes (AMR = 1.32, 95% CI: 1.19–1.47), anxiety (AMR = 1.31, 95% CI: 1.18–1.44), and stress (AMR = 1.36, 95% CI: 1.24–1.51). Compared with television news users, students relying on online news demonstrated substantially higher depression (AMR = 1.92, 95% CI: 1.32–2.78), anxiety (AMR = 1.84, 95% CI: 1.29–2.64), and stress scores (AMR = 1.88, 95% CI: 1.29–2.74). Structural equation modeling identified significant indirect associations involving sleep difficulty and study disruption, whereas direct associations between exposure and psychological distress were comparatively weak. Conclusions: Conflict-related media exposure was associated with poorer mental health among nursing students, with perceived insecurity, sleep difficulties, and study disruption showing strong associations with psychological distress and patterns consistent with indirect relationships. Universities and nursing education programs should consider implementing mental health support, media literacy interventions, sleep health promotion, and psychosocial support strategies during periods of regional geopolitical instability. Full article

The objective of the study was to examine longitudinal associations between cybervictimization and mental health and suicidal behavior among youth. Data for 4930 youth were drawn from the Canadian Health Survey on Children and Youth (CHSCY), a nationally representative cohort survey with collection waves in 2019 and 2023. Logistic regression models predicted self-reported mental health outcomes in 2023 (depression, anxiety, suicidal ideation and suicide attempt) from cybervictimization in 2019, adjusting for baseline mental health, socio-demographic covariates, frequency of online activities, and experience of traditional bullying victimization. Fully adjusted models suggested that cybervictimization in 2019 was significantly associated with youth depression (OR: 2.41, 95%CI: 1.68, 3.45), anxiety (OR: 1.33, 95%CI: 1.05, 1.68), and suicidal ideation (OR: 1.95, 95%CI: 1.12, 3.39) four years later. The association with suicide attempt was positive but not statistically significant in adjusted models (OR: 1.77, 95%CI: 0.99, 3.16). These results suggest that youth who experience cybervictimization in adolescence are at elevated risk of mental health problems lasting into young adulthood, an association which appears to be independent of the experience of traditional face-to-face victimization. Bullying prevention programs targeted towards reducing cybervictimization may warrant further study, with the aim of informing approaches to improve adolescent mental health. Full article

Assessing task workload during military En Route Critical Care (ERCC) and other high-risk clinical operations remains challenging. This study evaluated heart rate variability (HRV) and body motion as digital biomarkers of task workload among Critical Care Air Transport (CCAT) teams during simulated ERCC missions. Seventy-two U.S. Air Force clinicians participated in 26 high-fidelity simulations. HRV and body motion were continuously captured via a chest-strap wearable sensor, and the NASA Task Load Index (NASA-TLX) was used to assess self-reported workload. Results demonstrated high feasibility (>90% HRV, 100% motion retention) with high wearable comfort ratings. Both HRV and Motion metrics showed strong construct validity, significantly differentiating resting baseline from active simulation (all p < 0.001, effect sizes d = 0.54–1.22 for HRV, r = 0.92–1.00 for motion). Convergent validity was selective: only baseline-adjusted root mean square of successive differences (RMSSD) demonstrated significant associations with NASA-TLX mental demand (β = −0.250, p = 0.005) and temporal demand (β = −0.233, p = 0.003). Baseline-adjusted RMSSD effectively indexes perceived workload, while Motion metrics provide complementary information about physical task demands. These findings support multimodal approaches integrating physiological reactivity, motion patterns, and self-reported ratings for comprehensive workload assessment in complex operational settings. Full article