Search Results (1,037)

Background: Depression is highly prevalent among individuals with chronic pain and strongly impacts pain intensity, psychological functioning, and health-related quality of life. Self-efficacy has emerged as a potentially modifiable resilience factor within this interplay, yet large-scale real-world evidence integrating self-efficacy into multidimensional pain–depression models remains limited. Methods: This cross-sectional registry-based analysis evaluated standardized patient-reported measures from chronic pain patients enrolled in the German Pain e-Registry. All variables were directionally harmonized and transformed into standardized deviation scores (hSDSs) relative to patients without depression. Group-level hSDS profiles for five DASS-21 depression severity strata (none, mild, moderate, severe, extreme) were compared across pain intensity, disability, psychological well-being, affective pain processing, quality of life, neuropathic pain features, and pain-related self-efficacy (PSEQ). Correlations and exploratory principal component analysis (PCA) were used to assess multivariate structure. PCA-informed path models were estimated to evaluate directional relationships between pain, function, depression, and self-efficacy. All directional and mediation models represent exploratory, theory-informed statistical frameworks and do not imply causal or mechanistic relationships. Results: Across all domains, hSDS values increased monotonically with depression severity, while self-efficacy showed the strongest inverse gradient. Exploratory PCA revealed a dominant severity component explaining most variance and a secondary affective–self-efficacy axis, supporting the conceptual separation between functional–physical and psychological–affective symptom clusters. In the bottom-up path model (pain → function → self-efficacy → depression), self-efficacy showed the largest indirect statistical contribution within the proposed path models, and the model explained 55% of depression variance (R² = 0.55). In the top-down model (depression → affective pain → self-efficacy → pain), 45% of pain intensity variance was explained (R² = 0.45), again with self-efficacy as a central mediating construct. Associations remained robust after adjustment for age, sex, and BMI, as well as during sensitivity analyses. Conclusions: This large real-world cohort demonstrates a highly coherent pattern of associations across biopsychosocial domains and highlights pain-related self-efficacy as a central statistical construct linking pain, functional impairment, and depressive symptom burden within the applied exploratory models. The findings suggest that self-efficacy occupies a key position in the interplay between pain and mood, and that pharmacological and non-pharmacological treatments traditionally used in chronic pain management may be associated with changes in this construct. Importantly, all directional and mediation analyses are exploratory and do not imply causal or mechanistic relationships. Therapeutic strategies aimed at enhancing self-efficacy may therefore represent promising targets for future research within multimodal pain management frameworks. Full article

Objective: This study aimed to identify distinct dyadic coping profiles among infertile couples undergoing assisted reproductive technologies (ARTs) and to examine the associations between these coping profiles, depressive symptoms, and fertility quality of life (FertiQOL). Methods: A total of 271 infertile couples undergoing ARTs were recruited from a reproductive medicine center in Zhengzhou, China, and completed standardized self-report measures. Latent profile analysis was conducted to identify distinct dyadic coping profiles at the couple level. Multinomial logistic regression was used to examine sociodemographic and infertility-related predictors of profile membership. Differences in depressive symptoms and FertiQoL across profiles were analyzed using the Bolck–Croon–Hagenaars method. Results: Four dyadic coping profiles were identified: high-coping wife and low-coping husband (15.4%), low dyadic coping (20.1%), medium dyadic coping (31.5%), and high dyadic coping (33.0%). Couples in the high dyadic coping profile reported the lowest levels of depression and the highest level of FertiQoL. Women in the low dyadic coping profile reported the highest depressive symptoms, while men in the high-coping wife and low-coping husband profile demonstrated the highest depression among male partners. Sociodemographic factors (household registration, family income) and infertility characteristics (type of infertility, infertility duration) were significant predictors of profile membership. Conclusions: Dyadic coping among infertile couples undergoing ARTs is heterogeneous and differentially associated with depression and FertiQoL. Low and asymmetric dyadic coping represent high-risk profiles linked to poorer outcomes in both partners. These findings suggest that dyadic coping may serve as a protective resource for infertile couples to improve their psychological well-being and quality of life, highlighting the importance of incorporating dyadic coping assessment into routine care and providing couple-centered psychosocial interventions in fertility care practice. Full article

Voluntary turnover represents a critical challenge in essential public services, where workforce attrition affects both employee well-being and service quality. The primary objective of this study was to identify the psychosocial predictors of well-being profiles and turnover intention among public transport workers, using the Job Demands–Resources model as a theoretical framework. A cross-sectional study design was employed, with 131 employees of an Italian public transport company completing a questionnaire assessing turnover intention and key psychosocial factors (job satisfaction, perceived work-related stress, work engagement, meaning of work, and perceived workplace safety). The analytical strategy integrated Latent Profile Analysis (LPA), logistic regression, and path analysis. LPA identified two distinct well-being profiles: a “low well-being profile,” with high perceived stress and low engagement and meaning of work; and a “high well-being profile,” with low stress and high engagement and work meaning. Logistic regression analyses showed that satisfaction with pay and the intrinsic nature of work tasks predicted membership in the high well-being profile. Path analysis indicated that profile membership significantly predicted turnover intention, with employees in the high well-being profile reporting lower turnover intention. Additionally, satisfaction with supervision, perceived workplace safety, and age showed direct effects on turnover intention. These findings highlight the organizational and psychological resources that can increase employee well-being and retention in the public transport sector, offering insights for preventive interventions and for promoting safer and more sustainable public transport systems. Full article

Conventional Heating, Ventilation, and Air Conditioning (HVAC) control systems primarily rely on environmental and physiological parameters, largely ignoring the critical influence of psychological states on thermal comfort. Overlooking this factor often leads to suboptimal occupant satisfaction, energy inefficiency and thus carbon dioxide (CO₂) emissions. To this aim, this study introduces a novel mood-adaptive HVAC control system integrating psychological feedback to decrease CO₂ emissions in office buildings by reducing energy consumption and optimizing comfort. A total of 7000 thermal facial measurement records and high-resolution camera images were collected across seven mood state conditions using video stimuli and the Profile of Mood States (POMS) questionnaire to evaluate mood variations. A dual artificial intelligence system was developed: a Convolutional Neural Network (CNN) for analyzing facial expressions and an Artificial Neural Network (ANN) for processing facial temperatures via thermal imaging. These models collectively predict occupant mood in real-time, and a custom-designed wearable necklace interface transmits this data to dynamically adjust HVAC setpoints. To evaluate system performance, energy consumption was directly measured in real-life operations using an energy analyzer, without relying on simulations. Results indicate that this prototype personalized mood-driven system has the potential to enhance perceived thermal comfort while achieving up to a 20% reduction in carbon emissions compared to conventional systems. This human-centered approach significantly advances intelligent building management and climate change mitigation. Full article

Online social platforms increasingly function as informal self-help environments for individuals experiencing depression, offering spaces for emotional expression and peer support outside traditional clinical settings. However, how coping strategies and psychological engagement states—individuals’ emotional and cognitive involvement in managing their condition—are reflected through online self-disclosure remains poorly understood. We analyzed a large-scale dataset from Reddit depression-related communities to investigate how different psycho-linguistic profiles and coping orientations emerge from users’ language. We collected posts and comments from over 300,000 users across six depression-focused subreddits over two years. User-generated text was characterized through multiple psychological and linguistic dimensions capturing emotions, sentiment, subjectivity, and related features, then aggregated at the user-month level and analyzed using unsupervised clustering techniques. Our analysis identifies four distinct groups characterized by different emotional profiles and dominant coping orientations. These states exhibit meaningful correspondences with established theoretical frameworks, including the Coping Orientations to Problems Experienced model and the Patient Health Engagement model. Our findings demonstrate that large-scale textual data from online communities can provide interpretable insights into coping behaviors and engagement patterns, offering a complementary perspective to traditional approaches for studying mental health. Full article

Background: Understanding diverse psychological factors is crucial for promoting vaccination. This study focuses on psychological factors influencing HZ vaccination attitudes and intentions among older adults who have not yet received the HZ vaccine in China. Methods: We conducted a cross-sectional survey of 12,357 older adults (aged ≥60 years) who had not previously received the HZ vaccine. Latent Profile Analysis (LPA) was performed using the 5C psychological antecedents of vaccination (Confidence, Constraints, Calculation, Complacency, and Collective Responsibility). Multinomial logistic regression and Chi-square tests were used to identify predictors of profile membership and to investigate the nature of reported barriers. Results: An optimal five-profile solution was identified, with the largest group being “Willing but Obstructed” (44.6%). This profile exhibited high vaccination willingness but perceived the most significant constraints. While household income was not a direct predictor of profile membership, low-income individuals were significantly more likely to report ‘high cost’ as a primary barrier (p < 0.01), revealing that socioeconomic status appears to influence vaccination intention through tangible structural obstacles. Conclusions: Vaccination attitudes among previously unvaccinated older adults are heterogeneous. A substantial proportion are willing to be vaccinated but are hindered by socioeconomic barriers, primarily cost. Addressing the intention–behavior gap may require a shift from universal messaging to equity-focused interventions that directly address structural barriers for vulnerable groups, particularly among those who have not yet initiated vaccination. Full article

As classrooms become increasingly diverse, achieving equitable and inclusive education is central to the United Nations Sustainable Development Goals (SDGs), particularly SDG 4.7, and to advancing social sustainability in education. Teachers’ multicultural teaching efficacy is a key psychological resource shaping inclusive classroom practice. This study conceptualizes multicultural teaching efficacy as a multidimensional belief system and adopts a person-centered approach to identify latent efficacy profiles among Korean lower secondary school teachers. Using data from the OECD Teaching and Learning International Survey (TALIS) 2024, latent profile analysis was conducted based on seven efficacy indicators, with teachers’ social and emotional learning self-efficacy (TSEL-SE) and participation in multicultural education-related professional learning included as covariates. Five distinct efficacy profiles were identified, revealing heterogeneity in both level and configuration. TSEL-SE consistently predicted profile membership, whereas the effects of professional learning varied across profiles and were strongest among teachers with high TSEL-SE, indicating a conditional interaction effect between psychological and experiential resources. Notably, over one-third of teachers belonged to a structurally low efficacy profile, indicating systemic vulnerability. These findings highlight the importance of differentiated and emotionally responsive teacher education strategies for advancing inclusive practice and contributing to SDG 4.7 and broader social sustainability goals. Full article

This article examines the attitude–behaviour gap in sustainable consumption among young adults in Poland, focusing on the psychological and contextual mechanisms that hinder the translation of pro-environmental attitudes into everyday practices. The findings show that declared support for sustainable solutions does not translate into behaviour when decision costs are elevated, particularly in terms of price, limited availability of green alternatives and low label readability. Drawing on six focus group interviews and reflexive thematic analysis, this study identifies the dominance of transactional over normative factors, a reliance on simple heuristics (e.g., packaging material) rather than verified certifications, and the central role of habit and convenience in consumption choices. Interpreting these results through the Theory of Planned Behaviour, the analysis shows how price- and supply-related barriers reduce perceived behavioural control and undermine sustainable decision making. This article contributes to behavioural research on sustainable consumption by identifying key mechanisms underlying the attitude–behaviour gap in a Central and Eastern European context. Practical implications include simplifying environmental labels, low-cognitive-load consumer education and interventions that increase the accessibility and visibility of sustainable options. Limitations stem from the qualitative design and the urban profile of the sample, suggesting cautious generalisation and the need for replication using diverse populations and methodological triangulation. Full article

Background: Retrograde cricopharyngeus dysfunction (RCPD) is a recently described upper esophageal sphincter motility disorder caused by the inability of the cricopharyngeus muscle to relax, prohibiting belching. While clinical features and treatment have been reported, early-life experiences remain unclear. This study aimed to explore childhood experiences, comorbidities, and family history in adults reporting symptoms consistent with RCPD. Methods: This cross-sectional survey included adults recruited through an online community focused on RCPD who reported cardinal symptoms consistent with RCPD. The survey collected and descriptively analyzed demographics, symptom profile, family history, neonatal and childhood experiences, psychological factors, and physician visits. Results: Of 225 respondents, 207 met inclusion criteria (mean age 32 years; 69% female). Nearly all experienced abdominal bloating (98%), gurgling noises (98%), flatulence (90%), and inability to belch (100%). Painful hiccupping, a newer described symptom, was reported by 80%. Symptoms began before age 25 in 97%, and 29% reported a first-degree relative affected. Common early-life experiences included emetophobia (39%), anxiety (38%), and difficulty being burped as an infant (20%). No statistically significant crude differences were detected in symptom severity, frequency, gender, or age of onset by presence of experiences. Only 36% felt that any physician understood their condition, and 18% reported their gastroenterologist improved their symptoms. Conclusions: Psychological early-life experiences and family history were common, but exploratory analyses did not detect statistically significant differences in symptom burden by their presence. These findings provide a foundation for future studies investigating the disorder’s pathophysiology. Limited physician recognition highlights the need for greater clinical awareness of this emerging esophageal motility disorder. Full article

This study aimed to explore the efficacy of oral supplementation with 11 probiotic strains, combined in the strain mix Probatech™ (Centro Sperimentale del Latte S.r.l Strada Provinciale per Merlino, 326839 Zelo Buon Persico (LO), Italy) and delivered through the food supplement PROBAFLOR and how it plays a positive role in maintaining normal intestinal function, providing benefits in healthy adult subjects. A 16-week, randomized, double-blind, placebo-controlled clinical study was conducted starting with 60 participants. Participants were randomly assigned to either the probiotic or placebo group. Participants were asked to provide one faecal sample at the beginning of the study, another one after 12 weeks of supplementation and the final one after 16 weeks. Amplicon 16S rRNA gene sequencing and GC-MS Short-Chain Fatty Acid (SCFA) profiling were performed on the faecal samples. Participants filled out questionnaires to assess their gastrointestinal health and psychological well-being. The overall mean GIQLI scores increased in both groups over time. The increases were significant within both groups but not between groups. Following the administration of PROBAFLOR, Shannon and Simpson diversity indices showed a significant increase at day 90 (week 12) (p < 0.05), demonstrating that the intervention effectively enhanced gut microbiota diversity. A shift in the intestinal microbiota towards SCFA-producing families and genera was observed. Moreover, the change in total and single SCFAs was significantly different between probiotic and placebo groups at the end of the supplementation period. Once-daily consumption of the PROBAFLOR probiotics formula regulated gut microbiota balance by modulating SCFA production. It may be beneficial for gut health, improving defecation habits and satisfaction, normalizing stool frequency, and promoting bacterial metabolism. Full article

Ageism—encompassing stereotypes, prejudice, and discrimination across age groups—affects how individuals perceive and experience their own ageing. This study, based on a large sample (N = 1047), compared three age cohorts and explored intra-group variability among older adults (65–75 vs. ≥76 years). Results indicated that attitudes towards ageing were influenced by life stage, knowledge about ageing, perceived ageism, and internalised stereotypes. Participants aged 65–75 years showed more favourable attitudes, greater knowledge, and better emotional wellbeing compared to the ≥76 group, which exhibited higher hostile ageism and lower psychological wellbeing. A forward stepwise logistic regression (explained 35.9% of the variance) identified five predictors of a positive self-perception of ageing: lower perceived age discrimination; generally positive attitudinal profile; endorsement of benevolent stereotypes; absence of hostile ageism; and belonging to the 65–75 group. The findings highlighted the psychosocial complexity of ageing and call for interventions promoting positive ageing and reducing ageism. Full article

Background/Objective: Health is a multidimensional construct shaped not only by clinical conditions but also by psychological, social, environmental and cultural factors. In low- and middle-income countries undergoing rapid epidemiological transition, understanding health requires integrated and culturally informed approaches. However, quality of life, perceived health status and lifestyle behaviors are often investigated separately, limiting the interpretation of well-being in specific local contexts. This study aimed to provide an integrated assessment of quality of life, perceived health status and lifestyle behaviours among adults attending a peri-urban public hospital in Kenya, using internationally validated instruments applied within a specific local cultural context. Methods: A cross-sectional observational study was conducted at Tigoni Level 4 Hospital, Kiambu County, Kenya. Adult outpatients (N = 40) were consecutively recruited. Quality of life was assessed using the WHOQOL-BREF, perceived health status using the EQ-5D-5L and EQ-VAS, and lifestyle behaviours using selected modules of the WHO STEPS instrument. Descriptive statistics were performed, and exploratory associations were examined using Spearman’s rank correlation coefficient. Results: Participants had a mean age of 35.9 ± 11.4 years, with a balanced gender distribution. Lifestyle risk factors were prevalent, including insufficient physical activity (40%) and overweight or obesity (>50%). WHOQOL-BREF scores revealed a heterogeneous profile, with relatively preserved social relationships and lower scores in the psychological and environmental domains. Pain/discomfort and anxiety/depression were the most frequently reported EQ-5D-5L problems. The mean EQ-VAS score was 68.2 ± 15.7. Perceived health was positively associated with physical and psychological quality of life, while higher body mass index was associated with lower physical quality of life. Mental health emerged as a cross-cutting factor across instruments. Conclusions: The findings highlight the multidimensional nature of health in a peri-urban Kenyan context and suggest the importance of considering local social and cultural influences when interpreting standardized health measures. Mental health and environmental conditions play a central role in shaping quality of life and perceived health, while lifestyle risk factors are already prevalent in a relatively young outpatient population. Integrating standardized health measures within a cross-cultural framework may support more holistic and person-centred approaches in primary care and public health in similar settings. Full article

Background/Objectives: Systemic lupus erythematosus (SLE) is frequently accompanied by psychological distress. Alexithymia, an impairment in identifying and describing emotions, has been reported in SLE, but its clinical and serological correlates remain insufficiently characterized. We aimed to estimate the prevalence of clinically significant alexithymia in SLE and to explore its clinical, laboratory, and coping-related correlates. Methods: In this cross-sectional observational study, adult outpatients fulfilling the 2019 ACR/EULAR SLE classification criteria were assessed at a tertiary referral centre (2024–2025). Alexithymia was measured using the Toronto Alexithymia Scale-20 (TAS-20), and clinically significant alexithymia was defined as a total score >60. Coping strategies were assessed with the 60-item COPE inventory (Italian version). Clinical indices (SLEDAI-2K, Lupus Low Disease Activity State (LLDAS), and SLICC/ACR Damage Index (SDI)), organ involvement, antiphospholipid syndrome (APS), selected autoantibodies, complement levels, and treatments were recorded. Group comparisons and exploratory logistic regression were performed. Results: Sixty-eight patients were included (94.1% female). Clinically significant alexithymia was present in 23.5%. In univariate analysis, alexithymia was more frequent among patients with APS. Alexithymic participants reported higher use of emotional venting and lower use of positive reinterpretation. In an exploratory multivariable logistic regression model, APS (adjusted OR 35.79, 95% CI 3.74–341.7), emotional venting (adjusted OR 1.684, 95% CI 1.162–2.44), and positive reinterpretation (adjusted OR 0.514, 95% CI 0.349–0.755) remained associated with alexithymia. Conclusions: Alexithymia was frequent in this SLE cohort and, in exploratory analyses, was associated with APS and specific coping patterns. These findings suggest that assessment of emotional processing and coping may provide complementary clinical information, particularly in patients with APS, but should be interpreted as associative and hypothesis-generating. Full article

Purpose: The purpose of this preliminary study was to investigate the prevalence of Charles Bonnet Syndrome (CBS) among patients attending the National Centre of Service and Research for the Prevention of Blindness and Vision Rehabilitation of the Visually Impaired, Rome, Italy. Furthermore, the research aimed to delineate the psychological profile of these individuals to determine whether significant differences exist compared with visually impaired patients who do not experience hallucinatory phenomena and to identify likely predictors. Methods: A preliminary cross-sectional analysis was conducted on a convenience sample of patients recruited between January 2025 and December 2025. Prevalence was calculated based on structured clinical interviews, while the psychological profile was assessed by comparing the CBS group with a control group (non-CBS) matched for visual acuity. Participants underwent comprehensive ophthalmological and psychological assessments, including best-corrected visual acuity (BCVA), reading acuity (RA), contrast sensitivity (CS), fixation stability, and retinal sensitivity (RS). Psychological status was evaluated using the Symptom Check List-90-Revised (SCL-90-R), the Patient Health Questionnaire (PHQ-9), and the Generalized Anxiety Disorder Questionnaire (GAD-7). Patients experiencing CBS were further interviewed regarding the specific characteristics and patterns of their hallucinations. The association between CBS and both psychological profiles and visual function parameters was evaluated using regression analysis. Results: Out of 385 individuals screened, 120 participants (58% women; mean age 55.4 ± 18.8 years) were included; CBS was detected in 19%. No significant differences were observed between participants with and without CBS in demographic variables or psychological questionnaire scores (p > 0.05). Mean SCL-90-R, PHQ-9, and GAD-7 scores indicated mild psychological distress, depression, and anxiety, with no significant group differences (p > 0.05). Using standard cut-off values, depressive and anxiety symptoms were prevalent in 65% and 88% of participants, respectively, but were not significantly associated with CBS in chi-square or logistic regression analyses (p > 0.05). Logistic regression analysis of SCL-90 scores showed that only anxiety was significantly associated with hallucination occurrence among the visually impaired participants (OR = 0.27; 95% CI = 0.08–0.87; p < 0.05). Among the visual function parameters, poorer RA in the worse eye was significantly associated with CBS (p < 0.05). Conclusions: This study confirms that CBS is a prevalent, yet frequently under-reported, condition within rehabilitation settings. While overall visual function did not differ significantly between patients with and without CBS, reduced reading acuity (RA) in the worse eye emerged as a potential specific risk factor. Characterizing the psychological profile of these patients is essential to differentiate the syndrome from psychiatric disorders and to develop tailored support pathways. Despite its preliminary nature, this research underscores the necessity of systematic screening to enhance clinical management and the emotional well-being of visually impaired individuals. Consequently, integrating psychological support into visual rehabilitation programs is vital to addressing the high prevalence of comorbid anxiety and depression. Full article