Search Results (249)

Background: Despite major advances in insulin formulations and delivery systems since 1921, many people with diabetes (PwDs) still fail to achieve recommended glycemic targets. Common reasons include inadequate education, injection errors, and poor adherence due to factors such as needle phobia and pain. Recognition of these barriers has driven the development of improved injection systems, particularly thinner and shorter needles. An experimental study previously identified the Pic Insupen 34 G 3.5 mm needle as high performing. We therefore conducted an observational study to assess its acceptability directly among PwDs. Methods: This multicentre, open-label, real-world study enrolled 300 insulin-treated PwDs who compared their usual pen needle (30–33 G) with the new 34 G × 3.5 mm needle over two two-week periods. The primary outcome was perceived puncture pain. Results: Participants overwhelmingly preferred the 34 G needle, based on the following findings: Pain perception: 62% of 34 G users reported minimal or no pain, compared with only 8% using their previous needle. Conversely, 22% of participants reported the highest pain score with their old needle, compared with just 5% using the 34 G. Ease of use: 77% rated the 34 G needle at the highest level of ease of use, compared with 20% for their previous needle. Complications: The 34 G needle was linked to significantly fewer hypo-/hyperglycemic episodes and local skin complications such as bruising or irritation. Eighty per cent reported no glycemic fluctuations while using the 34 G needle. Robustness: Ninety-four per cent of PwDs never observed the 34 G needle bending during use, compared with 64% using their previous needle, confirming greater robustness despite its thinner profile. Conclusions: The Insupen^® 34 G × 3.5 mm needle substantially reduces puncture pain and improves the overall manageability of insulin injections. Its innovative design—combining reduced thickness with optimised tip geometry—is associated with fewer complications and enhanced injection performance. Because reduced pain and ease of use are critical for improving adherence to insulin therapy, the features of the 34 G needle should inform future prescribing decisions. Full article

Aim of the study: Anxiety about dental treatment is one of the main barriers to accessing dental services and, at the same time, a well-known problem for dentists. The main objective of this observational pilot study was to assess the prevalence and determinants of dental anxiety and severe forms compatible with dental phobia among adult dental patients and to explore their association with psychological distress, as well as patients’ preferences for methods to reduce pain and anxiety during dental treatment. Materials and Methods: We carried out a pilot observational study using two well-established questionnaires, namely the BSI-18 (Brief Symptom Inventory-18), which assesses the psychological distress of patients visiting the dentist, and the DAS (Dental Anxiety Scale), which evaluates dental anxiety toward dental treatment. The questionnaires were administered in independent dental practices in Timisoara, and the study was conducted between August 2024 and January 2025 on a sample of 231 persons. Results: The results of our study revealed a clear link between sources of oral health information, the high prevalence of anxiety as a personality trait, anxiety towards the dentist, and referral to dental services. Conclusions: The intensity of dental anxiety is higher before the therapeutic manoeuvre. It has been found, however, that people who are more educated experience lower levels of anxiety in specific situations. Full article

Background: Patients with dental phobia frequently require intravenous sedation (IVS) to undergo dental treatment; however, some can gradually discontinue IVS through repeated clinical experiences. The physiological and psychological factors influencing successful IVS withdrawal remain unclear. This study aimed to compare physiological (sAA, HR) and subjective (VAS) measures between patients who discontinued IVS and those who remained dependent on IVS. Methods: This prospective cohort study included 51 patients with dental phobia treated under IVS. Participants were classified into a Non-Sedation Group (NSG; n = 25) and a Sedation-Dependent Group (SDG; n = 26) based on their ability to discontinue IVS during the course of treatment. Salivary alpha-amylase (sAA), heart rate (HR), and visual analog scale (VAS) scores for fear, tension, and anxiety were assessed at predefined time points from the waiting room to venous cannulation. Treatment satisfaction and expectations for future treatment were also evaluated. Results: sAA activity was significantly higher in the SDG than in the NSG at T0 and T1 (p < 0.05), indicating higher levels of selected physiological measures during anticipatory phases; however, the difference at T2 was not significant. HR differed significantly only in the waiting room, whereas no between-group differences were observed in self-reported VAS scores for fear, tension, or anxiety at any time point, indicating a dissociation between physiological and subjective stress measures. Treatment satisfaction and expectations for future treatment were significantly higher in the SDG. Conclusions: Patients who remained dependent on IVS showed higher levels in selected physiological measures at the group level during anticipatory stages, whereas no corresponding differences were observed in self-reported subjective measures. These findings are exploratory and descriptive in nature and do not imply predictive or causal relationships. Full article

Social media addiction (SMA) and social phobia (SP) are significant adolescent mental health concerns. In Saudi Arabia, despite high social media penetration, the association between these two constructs remains under-researched, particularly in the Aseer region. This cross-sectional study, conducted from January to March 2025, recruited 384 Saudi adolescents aged 11–19 from schools in the Aseer region using multistage cluster sampling. Participants completed validated self-report measures, including the Social Phobia Inventory (SPIN) and the Al-Menayes Social Media Addiction Scale. A refined “Core SMA” subscale was created based on expert consensus criteria to enhance measurement precision. The prevalence of moderate-to-severe social phobia was 15.6%. A significant, moderate positive correlation emerged between SP and SMA (Spearman’s ρ = 0.294, p < 0.001). After adjusting for age, gender, and family income, adolescents with moderate social phobia had 2.15 times the odds of probable SMA compared to those with no SP (adjusted odds ratio [AOR] = 2.15, 95% CI: 1.15–4.04, p < 0.05), and this effect was more pronounced for those with severe social phobia (AOR = 2.56, 95% CI: 1.04–6.30, p < 0.05). This study demonstrates a clear relationship between social phobia severity and social media addiction among Saudi adolescents in the Aseer region. These findings support the urgent need for integrated mental health and digital literacy interventions that proactively screen for both conditions. Full article

Background and Objectives: Atopic dermatitis (AD) is a prevalent, chronic, relapsing itchy skin disorder, affecting up to 20% of the pediatric population. Topical corticosteroids are the cornerstone of AD treatment, but their use is often limited due to topical corticosteroid phobia among parents. Research on chronic illnesses highlights the significant role of personality traits in treatment adherence, with emotional stability and conscientiousness—within the framework of the Five-Factor Model—emerging as key predictors. The aim of our study was to examine the relationship between parental personality traits and their adherence to the treatment of their children with AD. Materials and Methods: A cross-sectional study was conducted at the Department of Dermatovenereology, University Hospital of Split, involving 90 parents of children diagnosed with AD. Personality traits were evaluated using the abbreviated version of the International Personality Item Pool Big-Five Personality Questionnaire (IPIP 50s). Treatment adherence was assessed through a valid and reliable questionnaire, the Morisky Medication Adherence Scale (MMAS-8). Statistical analyses were performed using JASP v.0.18.1.0. Results: According to MMAS-8, only a small proportion of the sample reported having high adherence (14.4%). The only significant associations between personality traits and adherence were found between conscientiousness and adherence and emotional stability and adherence, where more conscientious participants and more emotionally stable participants reported higher scores. Conclusions: The results suggest that parents of children with AD with higher scores on conscientiousness and emotional stability are more likely to demonstrate better treatment adherence. These insights may encourage a holistic and multidisciplinary approach to the treatment of children with AD, with an emphasis on providing psychological support to both the children and their parents in order to improve treatment adherence and the further clinical course of the disease. Full article

The study investigated the prevalence of gender-based violence, its psychological effects, and coping mechanisms among refugees in Ethiopia’s Kebribeyah Camp, which is believed to be the least recognized issue for female refugees. Owing to the loss of a social network and power, refugee women are the most vulnerable to different forms of gender-based violence and psychosocial challenges. The data collection and analysis were performed using a cross-sectional explanatory, quantitative design. The study involved 357 women refugees who were eligible for the study and found that there was a prevalence of 10.98% for GBV. In this study, it was determined that the most prevalent forms of GBV are psychological, physical, and sexual forms, respectively, which require immediate interventions. Irrational verbal and physical violence against women by men is identified as a signal for sexual violence. The mediation analysis examines the relationship between GBV acts, psychosocial challenges, and survivors’ coping strategies. GBV was found to be a significant predictor of both psychological and social difficulties, accounting for a significant variance in psychological difficulties (71%) and phobias (59%), and a substantial portion of social challenges (35%). GBV accounts for 82% of the variance in coping strategies. The study deduces the multidimensional pathway of the adverse effects of GBV among survivors, and suggests a combination of interventions to address GBV acts, psychological challenges, social challenges, and psychological phobias through an intersectional approach. Full article

Background/Objectives: Physical activity alleviates symptoms and may slow Parkinson’s disease (PD) progression, yet many individuals with PD remain sedentary. Kinesiophobia, the fear of movement, may represent a significant but underexplored psychological barrier to physical activity in this population. Virtual reality (VR), already effective in phobias, may represent a promising approach to address this challenge. This review initially aimed to systematically examine exposure-based interventions in VR (E-IVR) directly targeting kinesiophobia in PD. Methods: Database searches using keywords such as “kinesiophobia,” “fear of movement,” and “VR” combined with “PD” yielded no eligible studies. Consequently, the scope was broadened to include populations with neurological or musculoskeletal conditions, and a narrative review format was adopted to synthesize the available evidence. Furthermore, relevant studies of interventions in VR applied in PD, although not specifically addressing kinesiophobia, are detailed to provide evidence of efficacy and feasibility of VR interventions in PD. Finally, directions are offered to support the creation of E-IVR targeting kinesiophobia in individuals with PD. Results: Meta-analyses in neurological and musculoskeletal populations demonstrate moderate to large reductions in kinesiophobia following VR interventions, although effects vary depending on assessment tools, degree of immersion, and exposure design. In PD, VR has been applied to rehabilitation, anxiety reduction, and quality of life enhancement. These interventions achieved high adherence (≥90%), were well tolerated, and reported no major adverse events. Conclusions: Kinesiophobia is prevalent in PD and could contribute to physical inactivity. E-IVR appears feasible, safe, and innovative for addressing kinesiophobia in people living with PD. Full article

Background and Objectives: Parental fears and misconceptions about topical corticosteroids (TCS), known as TCS phobia, can hinder adherence and lead to poor eczema control in children. Despite its clinical relevance, few instruments capture this phenomenon using modern psychometric principles. This study aimed to develop and validate the Parental Topical Corticosteroid Phobia Scale (PTCPS), a brief tool grounded in Rasch measurement theory. Methods: A cross-sectional survey was conducted among 678 parents of children with eczema in Saudi Arabia. The five-item PTCPS was designed to reflect cognitive, emotional, and behavioral components of corticosteroid phobia. Rasch analysis using WINSTEPS assessed item fit, person and item separation and reliability, unidimensionality, and category functioning. Exploratory factor analysis (EFA) and principal component analysis (PCA) of residuals further evaluated structural validity. Results: All five items fit the Rasch model well (infit/outfit MnSq: 0.8–1.2), with strong item reliability (0.96) and clear item separation (4.67), indicating a well-defined item hierarchy. Person reliability was lower (0.40), suggesting limited precision in distinguishing between respondent levels. The scale showed functioning dichotomous response categories with no disordered thresholds. The eigenvalue of the first residual contrast (1.78) supported unidimensionality. Exploratory factor analysis confirmed a single-factor solution accounting for 53.0% of total variance, with substantial factor loadings (0.68–0.76) across all items, supporting structural coherence of the scale. Conclusions: The PTCPS is a psychometrically robust, unidimensional instrument for assessing TCS phobia in parents. Future research should validate its use across cultures, explore longitudinal stability, and assess its predictive value for treatment adherence. Full article

Dental phobia is a disabling yet underdiagnosed condition that prevents many patients from seeking essential oral healthcare, leading to avoidable pain, disease progression, and reduced quality of life. Cognitive Behavioral Therapy (CBT) is the most widely supported psychological intervention for specific phobias and has demonstrated significant efficacy in reducing dental anxiety and avoidance. This narrative review synthesizes recent evidence on CBT applications for phobia management, with particular emphasis on dental settings. In addition to reviewing established mechanisms of CBT, this paper highlights emerging adjunctive approaches such as virtual reality, eye movement desensitization and reprocessing (EMDR), and hypnosis. Special attention is given to pediatric populations, trauma-exposed individuals, and patients with neurodevelopmental disorders, who are often underrepresented in clinical research. The findings underscore the central role of CBT in addressing dental phobia while identifying gaps in standardized protocols, long-term outcomes, and accessibility across diverse healthcare contexts. Future research should prioritize controlled trials, cultural adaptations, and the integration of psychological training into dental curricula to enhance the translation of evidence into everyday practice. Full article

Background: Anxiety disorders, including panic disorder, agoraphobia, specific phobias, and generalized anxiety disorder, are among the most frequent psychiatric conditions in primary care. They often present with somatic symptoms such as dyspnea, palpitations, chest or gastrointestinal discomfort, sweating, or flushing. Adaptol^® is a non-benzodiazepine anxiolytic with nootropic properties that modulates the limbic-reticular system, hypothalamic emotional centers, and multiple neurotransmitter systems. This study aimed to assess the association between Adaptol^® use and changes in anxiety symptoms, including somatic manifestations, in routine practice. Methods: A noninterventional observational study was conducted in 100 adults diagnosed with anxiety disorders in primary care. All received Adaptol^® 500 mg as prescribed. Patients had to have mild-to-moderate anxiety (5–14 points according GAD-7) to be enrolled. Exclusion criteria ruled out individuals with concomitant psychiatric or severe somatic conditions and those with use of other medications or any interventions that could affect the symptoms. Anxiety severity and somatic symptom burden were assessed at baseline and after treatment. Results: Adaptol^® treatment was associated with reduction in anxiety and somatic complaints. Improvements were reported in palpitations, chest discomfort, gastrointestinal disturbances, and autonomic symptoms. Greater benefit was observed in male patients, though without significance testing, and in those with severe baseline anxiety, as demonstrated by correlation between GAD-7 scores at baseline and changes after the treatment (r = 0.5). No unexpected adverse events occurred. Conclusions: In this real-world study, Adaptol^® showed anxiolytic efficacy and good tolerability, improving both psychological and somatic manifestations of anxiety disorders. These findings support its use in primary care, especially in severe cases of anxiety. Controlled trials are needed to support these results. Full article

Metaverses have been hailed as the next arena for a wide spectrum of technovation and business opportunities. This research (∑ N = 714) focuses on the three underexplored areas of virtual commerce in AI-enabled metaverses: blockchain-powered cryptocurrencies, non-fungible tokens (NFTs), and AI-powered virtual influencers. Study 1 reports the mediating effects of (dis)trust in AI-enabled blockchain technologies and the moderating effects of consumers’ technopian perspectives in explaining the relationship between blockchain transparency perception and intention to use cryptocurrencies in AI-powered metaverses. Study 1 also reports the mediating effects of Neo-Luddism perspectives regarding metaverses and the moderating effects of consumers’ social phobia in explaining the relationship between AI-algorithm awareness and behavioral intention to engage with AI-powered virtual influencers in metaverses. Study 2 reports the serial mediating effects of general perception of NFT ownership and psychological ownership of NFTs as well as the moderating effects of the investment value of NFTs in explaining the relationship between acknowledgment of the nature of NFTs and intention to use NFTs in AI-enabled metaverses. Theoretical contributions to the literature on digital materiality and psychological ownership of blockchain/cryptocurrency-powered NFTs as emerging forms of digital consumption objects are discussed. Practical implications for NFT-based branding/entrepreneurship and creative industries in blockchain-enabled metaverses are provided. Full article

The use of virtual reality (VR) for therapeutic purposes has expanded rapidly; however, few studies have specifically addressed amaxophobia, or driving-related fear, using immersive exposure techniques. This pilot study evaluated the feasibility and preliminary effectiveness of an immersive VR-based exposure intervention for pre-drivers with elevated driving fear. Five participants completed a five-session exposure program within a technically stable VR environment designed to support perceptual continuity and reduce cybersickness risk. Driving fear was assessed before and after the intervention using the Cuestionario para la Evaluación del Miedo a Conducir en Preconductores (CEMICP). Results showed a statistically significant reduction in fear, supported by both a one-tailed paired-samples t-test and the exact Wilcoxon signed-rank test, each revealing a large effect size. Reliable and clinically significant change analyses indicated that all participants experienced meaningful improvement, with 60% achieving clinically significant reduction in driving-related fear. These findings suggest that immersive VR exposure may offer a promising and acceptable approach to mitigate amaxophobia in young adults. Given the small single-group sample, further research is required to establish long-term effects, explore behavioral performance outcomes, and determine the mediating role of presence and emotional engagement. Future controlled trials with larger and more diverse samples are warranted to validate the clinical utility of this VR intervention. Full article

Background: Exposure therapy is an established intervention for treating specific phobias. This study evaluates a Virtual Exposure Therapist (VET), a virtual reality (VR)-based system enhanced with artificial intelligence (AI), designed to reduce spider fear symptoms. Methods: The VET system delivers three progressive exposure scenarios involving interactive 3D spider models and features an adaptive relaxation mode triggered when physiological stress exceeds preset thresholds. AI integration is rule-based, enabling real-time adjustments based on session duration, head movement (degrees/s), and average heart rate (bpm). Fifty-five participants (aged 18–35) with self-reported moderate to high fear of spiders completed seven sessions using the VET system. Participants were not clinically diagnosed, which limits the generalizability of findings to clinical populations. Ethical approval was obtained, and informed consent was secured. Behavioral responses were analyzed using AR(p)–GARCH (1,1) models to account for intra-session volatility in anxiety-related indicators. The presence of ARCH effects was confirmed through the Lagrange Multiplier test, validating the model choice. Results: Results demonstrated a 21.4% reduction in completion time and a 16.7% decrease in average heart rate across sessions. Head movement variability declined, indicating increased user composure. These changes suggest a trend toward reduced phobic response over repeated exposures. Conclusions: While findings support the potential of AI-assisted VR exposure therapy, they remain preliminary due to the non-clinical sample and absence of a control group. Findings indicate expected symptom improvement across sessions; additionally, within-session volatility metrics (persistence/half-life) provided incremental predictive information about later change beyond session means, with results replicated using simple volatility proxies. These process measures are offered as complements to standard analyses, not replacements. Full article

Background: Obesity remains a major global health challenge, and a significant proportion of bariatric surgery patients continue to experience dysfunctional emotional eating and body image concerns after surgery. Neurofeedback training (NFT) has been investigated as a potential intervention for maladaptive eating behaviours, but evidence in post-bariatric populations is still limited. Methods: Thirty-six patients who underwent sleeve gastrectomy were included, divided into an NFT group (N = 18) and a control group (N = 18). Assessments were performed at baseline and after 10 NFT sessions, using the Eating Disorder Inventory (EDI) and the Body Uneasiness Test (BUT). The intervention aimed to enhance alpha and theta waves with real-time feedback. Results: Compared with the control group, the NFT group showed significant improvements; specifically, reductions were observed in EDI subscales such as Drive for Thinness (p = 0.023, d = 0.51), Bulimia (p = 0.008, d = 0.92), Body Dissatisfaction (p = 0.015, d = 0.52), Ineffectiveness (p = 0.002, d = 0.89), Perfectionism (p = 0.006, d = 0.70), Interpersonal Distrust (p = 0.008, d = 0.82), and Interoceptive Awareness (p = 0.001, d = 0.91). Significant reductions were also found in BUT subscales including Weight Phobia (p = 0.041, d = 0.84), Body Image Concern (p = 0.039, d = 0.90), Avoidance (p = 0.027, d = 0.83), Compulsive Self-Monitoring (p = 0.013, d = 0.83), and Depersonalisation (p = 0.033, d = 0.85). Conclusions: The data indicate that NFT may help reduce emotional eating and related psychological factors in post-bariatric patients in the short term. However, studies with larger samples and longer follow-ups are needed to confirm its effectiveness and assess its clinical applicability. Full article

Background: Dental phobia significantly impairs treatment adherence and oral health–related quality of life. While intravenous sedation (IVS) is commonly used to manage anxiety, interest in non-pharmacological alternatives is increasing. Visual color stimuli are known to affect emotional processing and autonomic nervous system activity. This study investigated whether brief exposure to colored goggles (translucent, green, blue, red) influenced physiological and psychological stress markers in patients with dental phobia undergoing IVS. Methods: Twenty patients with dental phobia (CMDAS ≥ 20) participated in a within-subject repeated measures design, experiencing all four color conditions in randomized order via Latin square. Salivary alpha-amylase (sAA), heart rate (HR), and Visual Analog Scale (VAS) scores for pain and satisfaction were measured at four time points. The Friedman test, followed by Wilcoxon signed-rank tests with Bonferroni correction, was used to compare conditions. Results: Prior to peripheral intravenous cannulation (PIC), green goggle exposure significantly reduced median sAA levels compared to the translucent control (p = 0.009). HR was lower in the green and blue conditions than in the red, although not significantly. VAS pain scores were significantly reduced under green and blue conditions; satisfaction scores remained uniformly high across all conditions. Red did not worsen stress responses compared to the control and may promote increased engagement. Conclusions: Cool color stimuli—particularly green and blue—may attenuate acute stress responses in patients with dental phobia prior to PIC. Incorporating such visual cues into preoperative environments may serve as a simple, non-invasive adjunct to managing dental anxiety. Full article