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Keywords = mindfulness-acceptance interventions

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14 pages, 959 KiB  
Systematic Review
Effectiveness of Acceptance and Commitment Therapy (ACT) in Patient with Cardiovascular Disease: A Systematic Review
by Alessandro Grimaldi, Isabella Veneziani, Laura Culicetto, Angelo Quartarone, Rocco Salvatore Calabrò and Desirèe Latella
Healthcare 2025, 13(15), 1831; https://doi.org/10.3390/healthcare13151831 - 27 Jul 2025
Viewed by 367
Abstract
Background/Objectives: Cardiovascular diseases (CVDs) encompass a wide range of heart and vascular conditions and remain the leading cause of death worldwide. Acceptance and Commitment Therapy (ACT) is a psychotherapeutic approach that integrates acceptance, mindfulness, and commitment to value-based actions. This systematic review aims [...] Read more.
Background/Objectives: Cardiovascular diseases (CVDs) encompass a wide range of heart and vascular conditions and remain the leading cause of death worldwide. Acceptance and Commitment Therapy (ACT) is a psychotherapeutic approach that integrates acceptance, mindfulness, and commitment to value-based actions. This systematic review aims to explore the current evidence on the potential role of ACT interventions in supporting psychological well-being among individuals with CVDs. Methods: A systematic review was conducted in accordance with PRISMA guidelines. A search of the literature was conducted through Scopus, PubMed, Web of Science, Cochrane, and PsycINFO databases. Six studies met the inclusion criteria. Results: The reviewed studies suggest that ACT may promote psychological flexibility, emotion regulation, and self-care behaviors in patients with CVDs. Reported outcomes include improved mindfulness, reduced distress, and enhanced quality of life. However, the evidence base is limited in both size and methodological rigor, with included studies varying in design and population. Conclusions: While preliminary findings indicate that ACT shows promise in addressing psychological aspects of CVDs, the current evidence remains insufficient to draw definitive conclusions. Further high-quality, large-scale studies are needed to evaluate the effectiveness and clinical applicability of ACT in cardiovascular populations. Full article
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13 pages, 438 KiB  
Study Protocol
A Smartphone Application Based on Dialectical Behavior Therapy Skills for Binge Eating Episodes: Study Protocol for a Randomized Controlled Trial
by Telma Cruz, Tiago B. Ferreira, Debra L. Safer, Cristiana Duarte and Mariana V. Martins
Healthcare 2025, 13(14), 1749; https://doi.org/10.3390/healthcare13141749 - 19 Jul 2025
Viewed by 369
Abstract
Background/Objectives: With the rapid progression of technology, applications have been proposed as a promising alternative to conventional psychotherapeutic treatment. Nonetheless, research on unguided self-help applications for binge eating remains scarce, with most existing studies utilizing cognitive behavioral therapy (CBT) principles. Therefore, this [...] Read more.
Background/Objectives: With the rapid progression of technology, applications have been proposed as a promising alternative to conventional psychotherapeutic treatment. Nonetheless, research on unguided self-help applications for binge eating remains scarce, with most existing studies utilizing cognitive behavioral therapy (CBT) principles. Therefore, this paper presents the protocol for a randomized controlled trial designed to evaluate the efficacy and acceptability of eMOTE, a standalone application designed specifically for women in Portugal who binge eat. eMOTE, adapted from dialectical behavior therapy (DBT), is unique in that it focuses on teaching emotion regulation skills while also integrating core CBT strategies. Methods: At least 68 females who self-report binge eating episodes will be randomized into an intervention group with access to eMOTE for eight weeks or a delayed waitlist, which will have access to eMOTE after the T1 assessment. Assessments will be conducted at baseline (T0), post-intervention (T1), and at 2-month follow-up (T2). The primary outcomes will include objective and subjective binge eating frequency and binge eating symptomatology, while secondary outcomes will assess global levels of ED psychopathology, shape concern, weight concern, eating concern, dietary restraint, compensatory behaviors, mindfulness, emotion regulation difficulties, intuitive eating, psychological distress, and body mass index. Conclusions: This study will contribute to the limited literature on the use of smartphone technology as an alternative to traditional psychotherapy. Furthermore, this standalone application will offer insights into the use of emotion regulation and food monitoring components designed for adult females experiencing binge eating episodes. Full article
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25 pages, 324 KiB  
Article
Psychological Flexibility and Inflexibility of University Students: An In-Depth Qualitative Study
by Wendy Cervantes-Perea, Jone Martínez-Bacaicoa and Manuel Gámez-Guadix
Int. J. Environ. Res. Public Health 2025, 22(7), 1141; https://doi.org/10.3390/ijerph22071141 - 18 Jul 2025
Viewed by 304
Abstract
In the Hexaflex model of Acceptance and Commitment Therapy (ACT), psychological flexibility refers to the ability to openly embrace difficult thoughts and emotions while acting in alignment with personal values. In contrast, psychological inflexibility involves rigid avoidance and control strategies that hinder adaptive [...] Read more.
In the Hexaflex model of Acceptance and Commitment Therapy (ACT), psychological flexibility refers to the ability to openly embrace difficult thoughts and emotions while acting in alignment with personal values. In contrast, psychological inflexibility involves rigid avoidance and control strategies that hinder adaptive functioning. Although previously studied, more culturally relevant evidence is needed to inform interventions that promote well-being and mental health among Latin American students. This study explored manifestations of psychological flexibility and inflexibility in 15 undergraduate students from the University of Magdalena in Colombia (mean age = 20.13 years; 53.33% female) through semi-structured, face-to-face interviews (~45 min each). Data were analyzed using Interpretative Phenomenological Analysis (IPA), focusing on how participants described and made sense of their experiences. A total of 25 emergent themes were identified and grouped into 12 subordinate themes, mapped onto the 6 core ACT processes. The participants reported efforts to control or avoid distressing internal experiences, often resulting in difficulty acting in accordance with their values. The findings highlight a recurring ambivalence between avoidance and acceptance, and barriers to committed action, underscoring the dynamic interplay between flexibility and inflexibility. These results support the relevance of ACT-based interventions, such as structured group sessions that foster acceptance, mindfulness, and values-based behavior. Integrating this training into counseling and academic support services could enhance students’ well-being and performance. Future research should examine these dynamics longitudinally and across diverse contexts. Full article
(This article belongs to the Section Behavioral and Mental Health)
24 pages, 3687 KiB  
Systematic Review
The Role of Acceptance and Commitment Therapy in Improving Social Functioning Among Psychiatric Patients: A Systematic Review
by Desirèe Latella, Giulia Marafioti, Caterina Formica, Andrea Calderone, Elvira La Fauci, Angela Foti, Rocco Salvatore Calabrò and Giuseppa Filippello
Healthcare 2025, 13(13), 1587; https://doi.org/10.3390/healthcare13131587 - 2 Jul 2025
Viewed by 600
Abstract
Background and Objectives: Acceptance and commitment therapy (ACT) enhances psychological flexibility by fostering acceptance of thoughts and emotions, promoting mindfulness practices, and encouraging engagement in value-based actions. These processes have been associated with improvements in mental health and social functioning, with accumulating evidence [...] Read more.
Background and Objectives: Acceptance and commitment therapy (ACT) enhances psychological flexibility by fostering acceptance of thoughts and emotions, promoting mindfulness practices, and encouraging engagement in value-based actions. These processes have been associated with improvements in mental health and social functioning, with accumulating evidence supporting ACT’s efficacy across various psychiatric disorders. This systematic review aimed to evaluate current evidence on ACT interventions for reducing psychiatric symptoms and enhancing social functioning and interpersonal relationships in adults with psychiatric conditions. Materials and Methods: A comprehensive search was conducted across PubMed, Web of Science, the Cochrane Library, and Embase for studies published between 2014 and 2024. The review protocol was registered on the Open Science Framework (OSF; registration ID: 2ZAGT). Results: Seventeen studies met the inclusion criteria; however, the evidence base remained fragmented, with most psychiatric diagnoses represented by only one or two studies. The reviewed studies exhibited several methodological limitations, including small sample sizes, lack of randomization and blinding, high risk of bias, reliance on subjective outcome measures, and inadequately designed or absent control groups. Despite these limitations, ACT was associated with beneficial effects in conditions such as post-traumatic stress disorder (PTSD), insomnia, psychosis, and autism spectrum disorder, particularly in reducing experiential avoidance, enhancing mindfulness, and promoting long-term improvements in emotional regulation and life satisfaction. Conclusions: Due to the limited number of studies per diagnosis, significant methodological weaknesses, and the lack of high-quality controlled trials, this review cannot provide strong evidence for the efficacy of ACT in improving social functioning among adults with psychiatric disorders. The heterogeneity and overall low quality of the available literature highlight the urgent need for further large-scale well-controlled studies. Full article
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40 pages, 3199 KiB  
Systematic Review
Mend the Gap: Online User-Led Adjuvant Treatment for Psychosis: A Systematic Review on Recent Findings
by Pedro Andrade, Nuno Sanfins and Jacinto Azevedo
Int. J. Environ. Res. Public Health 2025, 22(7), 1024; https://doi.org/10.3390/ijerph22071024 - 27 Jun 2025
Viewed by 280
Abstract
Background/Objectives: Schizophrenia Spectrum Disorders (SSDs) carry a debilitating burden of disease which, even after pharmacological and psychological treatment are optimized, remains difficult to fully target. New online-delivered and user-led interventions may provide an appropriate, cost-effective answer to this problem. This study aims to [...] Read more.
Background/Objectives: Schizophrenia Spectrum Disorders (SSDs) carry a debilitating burden of disease which, even after pharmacological and psychological treatment are optimized, remains difficult to fully target. New online-delivered and user-led interventions may provide an appropriate, cost-effective answer to this problem. This study aims to retrieve the currently gathered findings on the efficacy of these interventions across several outcomes, such as symptom severity, social cognition, functioning and others. Methods: A systematic review of the current available literature was conducted. Of 29 potentially relevant articles, 26 were included and assigned at least one of four intervention types: Web-Based Therapy (WBT), Web-Based Psycho-Education (WBP), Online Peer Support (OPS) and Prompt-Based Intervention (PBI). Results: The findings were grouped based on outcome. Of 24 studies evaluating the effects of symptom severity, 14 have achieved statistically significant results, and 10 have not. WBT (such as online-delivered Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, social cognition training and Mindfulness Training) seemed to be the most effective at targeting symptoms. Of 14 studies evaluating functioning, seven achieved significant results, four involving a form of social or neurocognitive training, suggesting a potential pathway towards functional improvements through interventions targeting cognition and motivation. Regarding social cognition, all seven studies measuring the effects of an intervention on this outcome produced significant results, indicating that this outcome lends itself well to remote, online administration. This may be linked with the nature of social cognition exercises, as they are commonly administered through a digital medium (such as pictures, videos and auditory exercises), a delivery method that suits the online-user led model very well. Conclusions: Online user-led interventions show promise as a new way to tackle functional deficits in SSD patients and achieve these improvements through targeting social cognition, a hard-to-reach component of the burden of SSDs which seems to be successfully targetable in a remote, user-led fashion. Symptomatic improvements can also be achievable, through the combination of these interventions with treatment as usual. Full article
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18 pages, 279 KiB  
Article
Relationship Between Hybrid Arts-Based CBT-CP Intervention and Personality Dimensions in Patients with Non-Malignant Chronic Pain: Evidence from a Non-Randomized Control Trial
by Asimina Kalmanti, Vasiliki Yotsidi, Athanasios Douzenis, Vasiliki Moraiti, Aikaterini Malafanti and Ioannis Michopoulos
Healthcare 2025, 13(12), 1440; https://doi.org/10.3390/healthcare13121440 - 16 Jun 2025
Viewed by 399
Abstract
Background: Optimal coping with chronic pain (CP) has a positive impact on minimizing the barriers to patients’ quality of life. Mindfulness-based approaches have been shown to improve emotional regulation and coping strategies in CP management, promoting a greater acceptance of pain and [...] Read more.
Background: Optimal coping with chronic pain (CP) has a positive impact on minimizing the barriers to patients’ quality of life. Mindfulness-based approaches have been shown to improve emotional regulation and coping strategies in CP management, promoting a greater acceptance of pain and reducing psychological distress. Given that personality traits may influence the adjustment to chronic pain, this study aimed to investigate whether specific personality dimensions, based on Cloninger’s model of temperament–character dimensions, affect the enrolment and the response to pain treatment in an innovative hybrid arts-based CBT-CP group intervention for patients with non-malignant CP. Methods: A pre-and-post assessment design was implemented in a non-randomized control trial. A total number of 100 outpatients at a University Pain Management Unit were allocated through self-selection in either an arts-based CBT-CP group intervention (N = 50) or a treatment-as-usual (TAU) control group (N = 50). All participants completed the Brief Pain Inventory (BPI), the Orbach and Mikulincer Mental Pain Scale (OMMP), the Tolerance for Mental Pain Scale (TMPS), and the Temperament and Character Inventory (TCI-140). The assessment took place at baseline and at the end of the intervention, after a 10-week period. The statistical analyses included a t-test for independent samples, Chi-square, and linear regression analyses. Results: At baseline, the arts-based CBT-CP intervention group had a higher score in the novelty seeking character dimension (M = 64.04; SD = 9.56), whereas the TAU group was found to have higher scores in self-directedness (M = 74.34; SD = 11.22) and self-transcendence (M = 51.42; SD = 6.61). The arts-based CBT-CP group reported a lower loss of control (M = 22.94; SD = 6.70) and higher belief in the ability to cope with pain (M = 21.10; SD = 3.76) after the intervention, compared to the control group. Self-transcendence was found to be a significant predictor of average pain as well as of patients’ belief in their ability to cope with pain. Conclusions: The current study provides practice-based evidence suggesting that an arts-based CBT-CP group intervention is a promising treatment for non-malignant CP. Personality dimensions affect patients’ enrolment and response to pain treatment. Furthermore, integrating mindfulness-based strategies within such interventions may further enhance treatment outcomes by fostering acceptance, improving coping mechanisms, and reducing the emotional burden associated with chronic pain. Full article
(This article belongs to the Special Issue Mindfulness-Based Intervention for People with Psychiatric Disorders)
35 pages, 8088 KiB  
Systematic Review
Mind over Malignancy: A Systematic Review and Meta-Analysis of Psychological Distress, Coping, and Therapeutic Interventions in Oncology
by Ana Maria Paslaru, Alina Plesea-Condratovici, Lavinia-Alexandra Moroianu, Oana-Maria Isailă, Laura Florentina Rebegea, Liliana Lacramioara Pavel and Anamaria Ciubară
Medicina 2025, 61(6), 1086; https://doi.org/10.3390/medicina61061086 - 13 Jun 2025
Viewed by 769
Abstract
Background and Objectives: Psychological distress is a pervasive yet often undertreated aspect of the cancer experience, contributing to reduced quality of life, poorer treatment adherence, and worse health outcomes. This systematic review and meta-analysis evaluated the efficacy of non-pharmacological, evidence-based psychological interventions on [...] Read more.
Background and Objectives: Psychological distress is a pervasive yet often undertreated aspect of the cancer experience, contributing to reduced quality of life, poorer treatment adherence, and worse health outcomes. This systematic review and meta-analysis evaluated the efficacy of non-pharmacological, evidence-based psychological interventions on distress, depression, anxiety, coping capacity, and quality of life in adult cancer patients. Interventions were grouped into three domains: structured psychotherapeutic therapies (e.g., Cognitive Behavioral Therapy [CBT], Acceptance and Commitment Therapy [ACT], Meaning-Centered Psychotherapy [MCP]); mindfulness and stress reduction programs (e.g., Mindfulness-Based Stress Reduction [MBSR], Mindfulness-Based Cognitive Therapy [MBCT]); and coping and resilience-enhancing modalities (e.g., Promoting Resilience in Stress Management [PRISM], expressive writing). Materials and Methods: Following PRISMA guidelines, 42 randomized controlled trials published between 2015 and 2025 were included. A stratified meta-analytic approach calculated pooled standardized mean differences for each intervention class and outcome. Heterogeneity, subgroup, and moderator analyses explored drivers of effect variability. Results: Structured psychotherapeutic interventions yielded the largest effects, especially for depression. Mindfulness-based interventions produced moderate but significant improvements in distress and emotional regulation. Coping and resilience programs provided smaller yet statistically significant gains in adaptive coping. Between-study heterogeneity was moderate, partly explained by intervention type, delivery modality, and cancer subtype. Conclusions: These findings support integrating psychosocial care into standard oncology protocols and endorse its routine implementation as a core component of comprehensive cancer treatment. Full article
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18 pages, 278 KiB  
Article
Aging Attitudes Among Middle-Aged and Older Adults with Disabilities: Gender Differences and Predictors
by Muna Bhattarai, Gloria K. Lee and Hung Jen Kuo
Geriatrics 2025, 10(3), 77; https://doi.org/10.3390/geriatrics10030077 - 5 Jun 2025
Viewed by 632
Abstract
Background/Objectives: Research suggests that attitudes toward aging significantly impact health and well-being outcomes in older adults and are influenced by various factors. Our study aims to identify gender differences in attitudes toward aging among aging individuals with disabilities while also examining the influence [...] Read more.
Background/Objectives: Research suggests that attitudes toward aging significantly impact health and well-being outcomes in older adults and are influenced by various factors. Our study aims to identify gender differences in attitudes toward aging among aging individuals with disabilities while also examining the influence of demographic and psychological factors on these attitudes. Methods: For this cross-sectional study, we collected data from 393 middle-aged and older adults with disabilities via an online Qualtrics survey administered through the Prolific platform in the United States. Participants completed the Attitudes Towards Aging Questionnaire Short Form, Purpose in Life Test Short Form, Mindfulness Attention Awareness Scale, Acceptance of Chronic Health Conditions Scale, and Three-Item Loneliness Scale. Descriptive and correlation analyses, t-tests, and multiple regression analyses were performed. Results: The independent t-test findings reveal significant differences in physical change and psychological growth between men and women, with men scoring higher in physical change and women in psychological growth. In multiple regression analyses, purpose in life significantly predicted all three domains of attitudes toward aging in men, while both purpose in life and acceptance were predictors across all domains in women. Additionally, age, employment, and financial stability contributed to aging attitudes only among women. Conclusions: Attitudes toward aging, specifically physical change and psychological growth, were found to vary by gender, with purpose in life, acceptance, and loneliness influencing these attitudes among both groups, while certain demographic factors influenced aging attitudes only among women. These findings underscore the need for gender-specific interventions addressing these substantial factors. Full article
26 pages, 2221 KiB  
Article
A Culinary-Based Intensive Lifestyle Program for Patients with Obesity: The Teaching Kitchen Collaborative Curriculum (TKCC) Pilot Study
by Auden C. McClure, Meredith Fenn, Stephanie R. Lebby, John N. Mecchella, Hannah K. Brilling, Sarah H. Finn, Kimberly A. Dovin, Elsa Chinburg, Jennifer Massa, Kate Janisch, David M. Eisenberg and Richard I. Rothstein
Nutrients 2025, 17(11), 1854; https://doi.org/10.3390/nu17111854 - 29 May 2025
Viewed by 1218
Abstract
Background: This study assessed the feasibility, acceptability, and preliminary effectiveness of a teaching kitchen intervention that synergistically provided nutrition education, culinary skills/techniques, mindfulness, physical activity, and behavior change strategies. Methods: Non-randomized pilot study of 16 weekly 2 h hands-on virtual culinary [...] Read more.
Background: This study assessed the feasibility, acceptability, and preliminary effectiveness of a teaching kitchen intervention that synergistically provided nutrition education, culinary skills/techniques, mindfulness, physical activity, and behavior change strategies. Methods: Non-randomized pilot study of 16 weekly 2 h hands-on virtual culinary sessions. Curbside grocery pickup assured food access/consistency. Qualitative interviews and pre/post-anthropometrics (BMI, waist circumference), labs (fasting glucose, insulin, lipids, HbA1c, ALT), and health habits surveys assessed program impact. Results: The program was successfully implemented from January to May of 2022. Of 56 participants screened, 13 (23%) enrolled, and 12 (92%) completed the program (mean age 51 years; 92% female; 92% white) with an average of 15.4 of 16 (96%) sessions attended and 100% completing assessments. Satisfaction with the program and with virtual cooking was high (100% and 92% satisfied-very satisfied). Days/week main meal was prepared from scratch increased from 3.8 to 5.9 (p < 0.05). Sense of well-being and three core mindfulness items (satiety, snacking, and food appreciation) improved (p ≤ 0.05). Confidence in 13 culinary skills/techniques improved (p < 0.05), as did diet recall and daily exercise, with variable significance. Labs improved LDL significantly (p < 0.05); anthropometrics did not. Conclusions: This teaching kitchen program was feasible, very well accepted, and suggested potential efficacy in improving health habits and metrics. Larger studies with randomization are needed. Full article
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25 pages, 592 KiB  
Article
Beyond the Unitary: Direct, Moderated, and Mediated Associations of Mindfulness Facets with Mental Health Literacy and Treatment-Seeking Attitudes
by Matea Gerbeza, Kelsy Dąbek, Katelyn Lockinger, Isabelle M. Wilkens, Mia Loarca-Rodriguez, Katimah Grogan and Shadi Beshai
Healthcare 2025, 13(10), 1201; https://doi.org/10.3390/healthcare13101201 - 20 May 2025
Viewed by 660
Abstract
Background and Objectives: Psychological disorders are prevalent and distressing. Early treatment initiation can prevent adverse outcomes and reduce healthcare system impacts. Improving mental health literacy (MHL)—one’s knowledge regarding psychological disorders—and treatment-seeking attitudes (TSAs) is key in early treatment initiation. Examining the facets of [...] Read more.
Background and Objectives: Psychological disorders are prevalent and distressing. Early treatment initiation can prevent adverse outcomes and reduce healthcare system impacts. Improving mental health literacy (MHL)—one’s knowledge regarding psychological disorders—and treatment-seeking attitudes (TSAs) is key in early treatment initiation. Examining the facets of dispositional mindfulness—the capacity to pay attention to present-moment experiences with acceptance—may offer more granular insights into understanding MHL and TSAs. This study examined (a) associations between mindfulness facets and MHL and TSAs, (b) facets’ prediction of MHL and TSAs beyond demographics, (c) moderation of the MHL–TSA relationship by mindfulness facets, and (d) mediation of mindfulness–TSA relationships via general self-efficacy (GSE). Methods: A community sample of 299 adults was recruited online (TurkPrime) and completed demographic questions and self-report measures: Five-Facet Mindfulness Questionnaire-15, Mental Health Literacy Scale, Mental Help-Seeking Attitudes Scale, and General Self-Efficacy Scale. Results: Describe, Non-Judgment, and Act with Awareness were modestly associated with MHL; all five facets correlated with TSAs. Hierarchical regressions controlling for demographics showed that Describe and Non-Reactivity predicted MHL, while Act with Awareness uniquely predicted TSAs. Non-Reactivity moderated the MHL–TSA relationship, with higher Non-Reactivity amplifying the relationship. GSE fully mediated relationships between Observe and Non-Judgment with TSAs, suggesting self-efficacy is a key mechanism of these facets. Conclusions: Interventions cultivating Non-Reactivity, Describe, and Act with Awareness may improve the translation of mental health knowledge into treatment-seeking behaviors. Future research should explore how mindfulness facets independently and interactively foster early intervention and treatment engagement. Full article
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16 pages, 1875 KiB  
Article
Effects of Acoustically Screened Five-Element Music Combined with Traditional Chinese Mind–Body Exercises on Emotion Regulation, Working Memory, and Functional Brain Connectivity in Older Adults: A Randomized Repeated-Measures Study
by Junya Zhao, Haojie Li and Xiaoyan Wang
Behav. Sci. 2025, 15(5), 699; https://doi.org/10.3390/bs15050699 - 19 May 2025
Viewed by 723
Abstract
This study aimed to investigate the effects of acoustically screened Five-Element Music combined with traditional Chinese mind–body exercises (Taijiquan and Baduanjin) on emotion regulation, working memory, and functional brain connectivity in older adults. A randomized repeated-measures design was employed, recruiting 42 healthy older [...] Read more.
This study aimed to investigate the effects of acoustically screened Five-Element Music combined with traditional Chinese mind–body exercises (Taijiquan and Baduanjin) on emotion regulation, working memory, and functional brain connectivity in older adults. A randomized repeated-measures design was employed, recruiting 42 healthy older adults aged 60–70 years. Participants were assigned to five groups: Five-Element Music alone (FE), Taijiquan (TJ), Baduanjin (BDJ), Five-Element Music combined with Taijiquan (FE+TJ), and Five-Element Music combined with Baduanjin (FE+BDJ). Emotion regulation, working memory, and functional brain connectivity were assessed using an emotion regulation choice task, the N-back task, and functional near-infrared spectroscopy (fNIRS), respectively. Five-Element Music was selected using computational acoustic methods to identify music with therapeutic effects. Significant differences were observed in the acceptance rate of emotion regulation for high-intensity unpleasant pictures across different conditions (p = 0.001). Compared to baseline, the acceptance rate was significantly higher in the FE and FE+TJ conditions (p = 0.027, p = 0.021). Moreover, the acceptance rate in the FE+TJ condition was significantly higher than in the FE condition alone (p = 0.007). Significant differences were found in the average accuracy of the 2-back task across conditions (p = 0.001), with the FE+TJ condition showing significantly higher accuracy than baseline (p = 0.005). The average reaction time in the 2-back task also differed significantly across conditions (p = 0.001), with the FE condition demonstrating a significantly lower reaction time compared to baseline and the FE+BDJ condition (p = 0.003, p = 0.001). Significant differences in functional connectivity (FC) were observed between conditions. Specifically, the FC between CH45 and CH9 and between CH29 and CH6 was significantly higher in the FE+TJ condition than in other conditions (p < 0.02). The combination of Five-Element Music and Taijiquan significantly improved emotion regulation, working memory, and prefrontal–parietal connectivity in older adults. These findings underscore the synergistic benefits of integrating auditory stimulation with mind–body exercise, offering a promising intervention for cognitive and emotional health in aging populations. Future research should investigate long-term effects and broader applications. Full article
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23 pages, 816 KiB  
Article
Workplace Stressors and the Intention to Quit: The Role of Psychological Distress and Psychological Flexibility Among Hospitality Employees
by Asier Baquero, Hazem Ahmed Khairy and Bassam Samir Al-Romeedy
Tour. Hosp. 2025, 6(2), 72; https://doi.org/10.3390/tourhosp6020072 - 25 Apr 2025
Cited by 2 | Viewed by 1237
Abstract
This study investigates how workplace stressors influence the intention to quit among male employees working in five-star hotels in Egypt, with a focus on the mediating role of psychological distress and the moderating role of psychological flexibility. A cross-sectional survey was conducted with [...] Read more.
This study investigates how workplace stressors influence the intention to quit among male employees working in five-star hotels in Egypt, with a focus on the mediating role of psychological distress and the moderating role of psychological flexibility. A cross-sectional survey was conducted with 334 full-time male hospitality workers. Using partial least squares structural equation modeling (PLS-SEM), the study examined the relationships between workplace stressors, psychological distress, the intention to quit, and psychological flexibility. The results showed that higher levels of workplace stressors were significantly associated with increased psychological distress and a stronger intention to quit. Psychological distress partially explained (mediated) the link between stressors and quitting intentions. Moreover, psychological flexibility acted as a buffer (moderator), reducing the negative impact of workplace stress on distress and, in turn, on quitting intentions. These findings highlight the unique contribution of the study in applying the transactional model of stress and coping within a Middle Eastern hospitality context, focusing exclusively on male workers—an understudied group in the existing literature. To address these challenges, hospitality managers are encouraged to adopt evidence-based interventions such as mindfulness-based stress reduction (MBSR) and acceptance and commitment therapy (ACT) to strengthen employees’ psychological flexibility and reduce the turnover risk. The study offers valuable insights for researchers, organizational leaders, and HR practitioners aiming to improve employee well-being and retention in high-pressure service environments. Full article
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23 pages, 984 KiB  
Article
Awakened Awareness Online: Results from an Open Trial of a Spiritual–Mind–Body Wellness Intervention for Remote Undergraduate Students
by Elisabeth J. Mistur, Abigail A. Crete, Suza C. Scalora, Micheline R. Anderson, Amy L. Chapman and Lisa Miller
Psychol. Int. 2025, 7(2), 32; https://doi.org/10.3390/psycholint7020032 - 5 Apr 2025
Cited by 1 | Viewed by 1994
Abstract
This study aimed to assess the feasibility and acceptability of the online delivery of a spiritual–mind–body (SMB) wellness intervention previously delivered and validated in person, Awakened Awareness for Adolescents (AA-A), designed for spiritual individuation among emerging-adult undergraduates. Undergraduates aged 18–25 (N = [...] Read more.
This study aimed to assess the feasibility and acceptability of the online delivery of a spiritual–mind–body (SMB) wellness intervention previously delivered and validated in person, Awakened Awareness for Adolescents (AA-A), designed for spiritual individuation among emerging-adult undergraduates. Undergraduates aged 18–25 (N = 39) participated in an open trial study. Enrollment, retention, and engagement rates were calculated to assess the feasibility of delivering AA-A online. Thematic analysis on qualitative feedback was conducted to assess acceptability. Clinical and spiritual well-being were assessed before and after AA-A delivery using self-report measures and pre-to-post-intervention changes examined. Results were compared to previous findings from AA-A delivered in person. Interactions between sexual and gender minority (SGM) status and AA-A delivery method on spiritual well-being change scores were explored. Significant improvements were seen in anxiety and post-traumatic stress symptoms and spiritual well-being. Affordances and constraints of the online format were identified across three themes. SGM students showed significantly greater improvements than non-SGM students in depression and anxiety symptoms and spiritual well-being. AA-A is feasible and acceptable in an online format and can support students’ spiritual individuation and mental health in a way that is comparable to its in-person format. Furthermore, the online format may be particularly beneficial for SGM students to actively participate and engage. Full article
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27 pages, 2646 KiB  
Article
Feasibility of Augmented Reality-Based Cognitive Training for Older Adults: The MarketMind AR Approach
by Konstantinos Kakoutopoulos, Emmanouil Drakakis, Anastasia Papadopoulou and Christos Goumopoulos
Sensors 2025, 25(7), 2081; https://doi.org/10.3390/s25072081 - 26 Mar 2025
Viewed by 1480
Abstract
The aging population increases the need for accessible interventions for cognitive training of the elderly to preserve cognitive health. Serious games have been widely used for this purpose, with many existing applications leveraging virtual reality (VR) technology. In contrast, this study explores the [...] Read more.
The aging population increases the need for accessible interventions for cognitive training of the elderly to preserve cognitive health. Serious games have been widely used for this purpose, with many existing applications leveraging virtual reality (VR) technology. In contrast, this study explores the potential of augmented reality (AR) for cognitive training. The literature review shows that cognitive training interventions typically employ supermarket-themed serious games that are used extensively in such interventions. MarketMind AR is a supermarket-themed serious game that was created to train memory, attention, and executive function using mobile phone sensors such as cameras, accelerometers, and gyroscopes to interact and recognize the environment. Fifteen older adults participated in a three-attempt trial and completed the System Usability Scale (SUS), the in-game Game Experience Questionnaire (iGEQ), and an adapted version of the Unified Theory of Acceptance and Use of Technology (UTAUT) questionnaires. Qualitative interviews and in-game data (e.g., completion times, PIN recall) were also examined. The results indicated that participants had a positive experience, confirming ease of use, immersive appeal, and perceived cognitive benefits, despite some difficulties with environment scanning and object detection. The results provide evidence that an AR supermarket game leveraging mobile sensors has the potential to be an effective cognitive training tool for older adults. Full article
(This article belongs to the Section Intelligent Sensors)
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32 pages, 562 KiB  
Review
Non-Pharmacological Interventions for Managing the Symptoms of Depression in Women with Breast Cancer: A Literature Review of Clinical Trials
by Mayra Alejandra Mafla-España and Omar Cauli
Diseases 2025, 13(3), 80; https://doi.org/10.3390/diseases13030080 - 11 Mar 2025
Viewed by 2039
Abstract
Symptoms of depression represent a significant burden to patients with breast cancer, not only because of the psychological stress associated with their diagnosis, but also because of the adverse effects of its treatment. We reviewed the clinical trials examining the management of the [...] Read more.
Symptoms of depression represent a significant burden to patients with breast cancer, not only because of the psychological stress associated with their diagnosis, but also because of the adverse effects of its treatment. We reviewed the clinical trials examining the management of the symptoms of depression in breast cancer patients through different non-pharmacological interventions in different databases (PubMed, Embase, Scopus, and the American Psychological Association). Cognitive behavioural therapy, interpersonal psychotherapy or psychodynamic psychotherapy, as well as acceptance and commitment therapy have been effective in improving symptoms of depression in cancer patients with moderate to severe symptoms. Physical exercise, yoga, mindfulness, and support groups have been shown to benefit patients with mild depressive symptoms. These interventions not only showed positive results in interventions in women with breast cancer in terms of the symptoms of depression, but also highlighted their benefits for comorbid anxiety, stress, and poor sleep quality; moreover, it is suggested that these interventions should be leveraged to manage mental health issues in breast cancer patients. The molecular effects of these interventions, such as the reduction in inflammatory cytokines and cortisol levels, have seldom been reported and need further studies. Full article
(This article belongs to the Section Neuro-psychiatric Disorders)
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