Search Results (2,648)

Background: Population aging is driving a convergent rise in three disorders historically managed in isolation: cardiovascular disease, neurocognitive decline, and osteoporotic bone loss. Mechanistic data indicate that these systems are coupled through shared regulators of calcium trafficking, inflammation resolution, vascular integrity, and inflammaging. On this basis, a “Heart–Brain–Bone” axis has been proposed; it should be understood as an integrative conceptual framework that organizes evidence drawn from three separate studies, not as a validated physiological entity with agreed diagnostic criteria or demonstrated modifiability. Three lipid-soluble nutrients—long-chain omega-3 polyunsaturated fatty acids (EPA/DHA), vitamin D3 (cholecalciferol), and vitamin K2 (menaquinone-7 [MK-7])—act on overlapping nodes of this network. Methods: We performed a structured narrative review. PubMed/MEDLINE, Embase, the Cochrane Library, and Web of Science were searched from database inception to 25 June 2026 using predefined term blocks for each nutrient, each organ domain, and each candidate mechanism, and the search was updated on 7 August 2026. Records were screened against prespecified inclusion and exclusion criteria by two authors independently, with disagreements resolved by a third. The strength of evidence for each nutrient–organ relationship was graded with an explicitly defined four-level scheme ((−) to (+++)) applied separately to preclinical, observational, randomized and meta-analytic evidence. Results: Vitamin K2-dependent gamma-carboxylation of matrix Gla protein (MGP) and osteocalcin has been proposed to influence whether calcium is incorporated into the bone matrix or deposited in the arterial wall, offering a candidate mechanistic account of the “calcium paradox” associated with isolated vitamin D3 supplementation; EPA/DHA-derived specialized pro-resolving mediators may support resolution of endothelial and neuronal inflammation; and bone-, vascular- and brain-derived signals (osteocalcin, FGF23, the neurovascular unit) interconnect the three organs. These mechanisms are biologically plausible but remain insufficiently confirmed in humans. The clinical evidence is heterogeneous, formulation- and population-dependent, and comprises positive, neutral and null results: cardiovascular omega-3 trials are discordant (REDUCE-IT, which used icosapent ethyl [an EPA ethyl ester], positive; VITAL/STRENGTH/ASCEND null, predominantly in lower-risk or replete cohorts); cognitive trials are largely null or subgroup-dependent (MAPT, DO-HEALTH, VITAL); and MK-7 improves surrogate bone and calcification biomarkers and slowed coronary artery calcification in one recent randomized imaging trial (VitaK-CAC), whereas combined MK-7 plus vitamin D3 did not slow aortic valve or coronary calcification in AVADEC and MK-7 did not reduce bone loss in early menopausal women. Recognized safety signals include a dose-dependent increase in atrial fibrillation with high-dose omega-3, adverse skeletal effects of high-dose or bolus vitamin D, and clinically relevant interference of even low-dose MK-7 with vitamin K antagonist therapy. Conclusions: No adequately powered randomized trial has demonstrated that the combination of long-chain omega-3, vitamin D3 and MK-7 is superior to its individual components or to placebo for any clinical endpoint. The combined regimen is therefore mechanistically rational and hypothesis-generating rather than clinically established; benefit appears most plausible in individuals with elevated risk or demonstrable nutritional insufficiency, and least in replete, low-risk populations. Findings should be interpreted within a broader healthy-aging context that includes lifestyle and psychosocial factors. Adequately powered factorial randomized controlled trials stratified by baseline Omega-3 index, 25(OH)D and vitamin K status, with prespecified mechanistic biomarkers and hard endpoints, are required. Full article

Psychosocial working conditions are important determinants of employee health, work ability, and organizational sustainability, yet existing instruments often assess job demands, job resources, psychosocial risks, or well-being outcomes separately. This study examined the structural validity of the Multidimensional Psychosocial Work Experience Scale for Employed Persons (MPWES), an instrument designed to assess a multidimensional occupational psychosocial profile comprising workplace conditions and demands, psychosocial resources, adverse exposures, health-related experiences, and subjective functioning. A cross-sectional validation study was conducted among 1631 employees from the pharmaceutical, energy, healthcare, and administrative sectors in Latvia. Confirmatory factor analysis with the robust WLSMV estimator was used to test the predefined measurement model. The refined eight-factor model demonstrated acceptable fit in the calibration subsample (N = 400; CFI = 0.930, TLI = 0.922, RMSEA = 0.066, SRMR = 0.078) and was replicated in the held-out validation subsample (N = 1231; CFI = 0.911, TLI = 0.901, RMSEA = 0.068, SRMR = 0.067). Reliability indices were acceptable for several domains, although some factors showed modest or borderline values. Discriminant validity was supported, with all HTMT values below 0.85, and measurement invariance testing supported configural, metric, scalar, and strict invariance across samples. The findings provide initial evidence of the MPWES’s structural validity and measurement stability in the present sample. However, further studies using external validity criteria, longitudinal designs, and culturally diverse samples are needed before the scale can be considered fully validated for broader occupational and public health applications. Full article

Background: Life satisfaction and psychological distress are associated with multiple lifestyle, sleep-related, psychosocial, and sociodemographic factors. However, multinational evidence simultaneously examining these positive and negative psychological dimensions within a comprehensive Mediterranean lifestyle framework remains limited. This study examined correlates of life satisfaction and psychological distress among adults from Mediterranean and neighbouring countries participating in the MEDIET4ALL survey. Methods: Data were collected from 4010 adults (59.5% female) across 10 Mediterranean and neighbouring countries using a standardized multilingual e-survey. Life satisfaction was assessed as the primary outcome using the Short Life Satisfaction Questionnaire (SLSQ), whereas psychological distress (depression, anxiety, and stress) was assessed as the secondary outcomes using the Depression Anxiety Stress Scales (DASS-21). Mediterranean lifestyle adherence was assessed using the validated MEDLIFE index, integrating dietary habits with brief indicators of physical activity, rest, and social/convivial habits, while complementary validated measures provided more detailed assessments of physical activity, sedentarily, sleep, insomnia and social participation. Hierarchical multiple linear regression analyses were conducted to identify correlates of the primary and secondary outcomes. Bootstrapped exploratory cross-sectional indirect-association analyses were conducted to examine selected indirect statistical associations involving Mediterranean lifestyle adherence, physical activity, social participation, insomnia severity, life satisfaction, and psychological outcomes. Results: Higher life satisfaction was associated with greater Mediterranean lifestyle adherence, better subjective sleep quality, higher social participation, higher education, marital or cohabiting status, and better self-reported health status (β ≈ 0.06–0.18). Conversely, lower life satisfaction was associated with higher body mass index, greater physical activity expenditure, higher insomnia severity, and regional differences between Mediterranean and neighbouring/non-Mediterranean countries (β ≈ −0.05 to −0.19). Insomnia severity showed the strongest negative association with life satisfaction (β = −0.19). Across psychological distress outcomes, insomnia severity emerged as the strongest positive correlate of depression, anxiety, and stress (β ≈ 0.43–0.47), followed by alcohol consumption (β ≈ 0.12–0.15) and residence in Mediterranean countries (β ≈ 0.05–0.08). Older age, analysed as a continuous variable, better self-reported health status, and higher physical activity levels were consistently associated with lower distress levels (β ≈ −0.03 to −0.14). Exploratory cross-sectional indirect-association analyses identified statistically significant indirect associations involving insomnia severity among Mediterranean lifestyle adherence, life satisfaction, and psychological distress. Additional indirect statistical associations involving life satisfaction were observed among physical activity, social participation, and psychological distress outcomes, although their magnitudes were small. Conclusions: Mediterranean lifestyle adherence, social participation, physical activity, sleep-related characteristics, and sociodemographic and health-related factors were associated with life satisfaction and psychological distress. Sleep-related variables, particularly insomnia severity and subjective sleep quality, emerged as the most consistent correlates across the psychological outcomes. These cross-sectional findings, including the exploratory indirect statistical associations, should be interpreted as hypothesis-generating and not as evidence of temporal ordering, causal mediation, or behavioural mechanisms. Full article

Early parental loss may increase depression risk among orphaned university students, yet evidence from low- and middle-income countries such as Thailand remains limited. This cross-sectional study examined depressive symptoms and their associations with attachment insecurity, resilience, inner strength, and perceived social support among 226 Thai university students aged ≥20 years who had lost one or both biological parents before age 18. Participants completed validated Thai versions of the Outcome Inventory–Depression subscale, the Experiences of Close Relationships–Revised 10-item version, the 9-item Resilience Inventory, the Inner Strength-Based Inventory, and the revised Thai Multidimensional Scale of Perceived Social Support. Multiple linear regression identified factors associated with depressive symptoms. The mean depression score was 6.62, with no significant difference between single and double orphans. Attachment anxiety (β = 0.176, p = 0.002) was significantly and positively associated with depressive symptoms, whereas resilience (β = −0.322, p < 0.001), inner strength (β = −0.192, p < 0.003), and perceived social support (β = −0.156, p = 0.022) were significantly and negatively associated with depression. In contrast, attachment avoidance (β = 0.110, p = 0.068) did not reach statistical significance. Among orphaned students, depressive symptoms were more closely linked to psychosocial factors than to the specific type of parental loss (single vs. double orphanhood). Full article

Introduction: Intensive care units are characterized by a high level of clinical and psychosocial demands. Previous research indicates that the work environment plays a significant role in shaping nurses’ occupational well-being; however, analyses that simultaneously consider organizational factors, perceived occupational exposure, and job satisfaction are still limited, particularly in the context of Central and Eastern European countries. Objectives: The aim of the study was to assess the relationships between psychosocial and organizational factors in the work environment and the level of perceived occupational exposure as well as job satisfaction among nursing staff working in intensive care units. Methods: The study was cross-sectional in design and was conducted in Poland among 226 nurses employed in intensive care units. Data were collected using an anonymous online survey that included an author-designed questionnaire and the standardized “Working Conditions” instrument developed by the Central Institute for Labor Protection—National Research Institute. Data analysis was performed using descriptive statistics, chi-square (χ²) tests, and binary logistic regression. The study was conducted and reported in accordance with the STROBE guidelines (Strengthening the Reporting of Observational Studies in Epidemiology). Results: A high psychosocial burden was observed in 49.6% of the participants, while a high organizational risk was found in 69.9%. Higher organizational risk was associated with a more than threefold increase in the odds of high perceived occupational exposure (OR = 3.47; 95% CI: 1.54–7.81). Conclusions: Psychosocial and organizational factors in the work environment play an important role in shaping perceived occupational exposure and job satisfaction among intensive care nursing staff. The results highlight the importance of organizational interventions, such as ensuring adequate nurse staffing, strengthening supportive leadership, and developing psychosocial support programs for staff. Full article

Background/Objectives: Termination of pregnancy (TOP) following a prenatal diagnosis of congenital heart disease (CHD) is a complex decision shaped by clinical, ethical, and psychosocial factors. This study evaluated the clinical factors associated with parental acceptance of TOP after prenatal diagnosis of CHD in a multidisciplinary counselling setting. Methods: This retrospective cohort study was conducted at a tertiary referral center where fetal CHD cases are evaluated in a multidisciplinary perinatology council. Pregnancies with a prenatal CHD diagnosis for which TOP was medically recommended between December 2023 and February 2026 were included. Maternal, fetal, and genetic data were analyzed. Cardiac severity was classified using the fetal cardiovascular disease severity scale. Because the cohort included only 62 pregnancies, a simplified multivariable logistic regression model with three clinically prespecified variables (four parameters: gestational age, cardiac severity, and genetic-evaluation status) was used to identify variables associated with termination acceptance. Results: Sixty-two pregnancies were included; 41 (66.1%) accepted termination and 21 (33.9%) continued the pregnancy. Maternal characteristics and gestational age at diagnosis were similar between groups. In the multivariable model, genetic-evaluation status was the only variable independently associated with termination acceptance. Compared with cases without genetic testing, both major chromosomal/pathogenic anomalies (aOR 4.97; 95% CI 1.29–19.11; p = 0.020) and a normal genetic-evaluation status (aOR 4.71; 95% CI 1.07–20.77; p = 0.041) were associated with higher termination acceptance. Cardiac severity and gestational age were not independently associated with parental decision. Conclusions: Genetic-evaluation status was associated with parental acceptance of termination after prenatal CHD diagnosis in a multidisciplinary counselling setting; given the small sample size and the selected, council-recommended cohort studied, this association should be interpreted as hypothesis-generating rather than as evidence of a causal or independent predictive effect. Full article

Acne vulgaris is a chronic inflammatory skin disease associated with a substantial psychological burden that may extend beyond visible lesions and objective disease severity. Psychological factors such as stress, coping strategies, quality-of-life impairment, self-esteem, psychiatric symptoms, and treatment adherence are associated with disease perception, self-reported exacerbation, and treatment-related outcomes. This narrative review examines psychological stress and proposed biological mechanisms, coping strategies, treatment adherence, quality of life, self-esteem, sleep disturbance, and psychiatric comorbidity in people with acne. Relevant literature was identified through MEDLINE/PubMed, Scopus, Web of Science, and PsycINFO; the final literature search was conducted on 29 May 2026. Acne-specific studies were prioritized, with broader psychodermatology evidence used where acne-specific data were limited. The psychosocial burden of acne is individualized and only partly aligned with clinician-rated severity, supporting person-centered assessment. For each domain, the review outlines brief, commonly used screening instruments that may be feasible in routine dermatology. Incorporating psychological assessment and targeted supportive strategies into acne care may contribute to quality of life, adherence to therapy, and patient-centered care. The evidence is predominantly cross-sectional and derives from heterogeneous populations, instruments, and study designs, limiting causal inference. Full article

Background: School bullying represents a major public health challenge associated with adverse emotional and psychosocial outcomes during childhood. Self-esteem and perceived emotional intelligence may be relevant factors associated with bullying involvement. This study aimed to examine the relationships among school bullying, self-esteem, and perceived emotional intelligence in Primary Education students and to explore the indirect statistical associations between emotional intelligence dimensions and bullying involvement through self-esteem. Methods: A multicenter cross-sectional pretest study was conducted among 507 students from five educational centers in Madrid, Spain. School bullying was assessed using the Peer Harassment Questionnaire (PHQ), self-esteem using the Self-Esteem Questionnaire for Primary Education (A-EP), and perceived emotional intelligence using the Trait Meta-Mood Scale-24 (TMMS-24). Descriptive analyses, group comparisons, Pearson correlations, multiple linear regression, and exploratory mediation analyses were performed. Regression and mediation analyses were based on complete matched records. Results: Moderate bullying involvement was the predominant profile (51.3%), while 12.8% of students were classified as having high bullying involvement. School bullying was negatively correlated with self-esteem (r = −0.42, p < 0.001), emotional attention (r = −0.18, p = 0.002), emotional clarity (r = −0.37, p < 0.001), and emotional repair (r = −0.41, p < 0.001). In the adjusted regression model, self-esteem was the strongest variable independently associated with bullying involvement (β = −0.407, p < 0.001). Significant indirect effects through self-esteem were identified for emotional attention (B = −0.080, 95% CI: −0.133 to −0.027), emotional clarity (B = −0.188, 95% CI: −0.259 to −0.125), and emotional repair (B = −0.193, 95% CI: −0.270 to −0.125). Conclusions: School bullying involvement was associated with lower self-esteem and poorer perceived emotional competencies. Self-esteem statistically accounted for part of the associations between the three emotional intelligence dimensions and bullying involvement within the proposed exploratory models. Given the cross-sectional design, these findings should not be interpreted as evidence of causal or temporal relationships. Full article

Gestational hypertension (GH) imposes physiological and psychosocial burdens that reduce maternal well-being. Health literacy (HL) and health-related quality of life (HRQoL) are important factors influencing self-care and perceived health. This study compared HL and HRQoL between pregnant women with and without GH during the second and third trimesters of pregnancy and examined the relationship between them. A prospective longitudinal comparative study was conducted involving 378 pregnant women. HL and HRQoL were assessed during the second and third trimesters using the 12-item Health Literacy Scale (HLS-12) and the 36-Item Short Form Health Survey (SF-36), respectively. Women with GH had lower median HRQoL and HL scores in the second and third trimesters (p < 0.05). Within the GH group, HRQoL declined from 80 (65–90) to 55 (40–65) in the physical functioning domain, with similar reductions in role limitation and general health domains. The percentage of women with low or moderate HRQoL increased markedly in the GH group (p < 0.001). HL differed significantly between groups; women with GH were more frequently classified as having inadequate or problematic HL (p < 0.001). Compared to normotensive women, pregnant women with GH have lower HL and HRQoL during the second and third trimesters. The two variables were moderately correlated. There is a further need to assess HL and HRQoL in women with high-risk pregnancies and to implement effective strategies to improve the affected domains. Full article

Background/Objectives: Disordered eating behaviours are increasingly common among young adults, yet nutrition-focused, region-specific data from Romania and Central and Eastern Europe (CEE) remain scarce. We characterised nutritional patterns, weight-control practices, disordered-eating indicators, body image, and psychosocial factors among Romanian young adults and tested how these differed across body mass index (BMI) categories. Methods: In a cross-sectional online survey (March–April 2026), 753 Romanian adults aged 18–30 years (93.5% female) completed a 30-item questionnaire. Self-reported anthropometric measurements were classified using WHO BMI cutoffs. Prevalences (with Wilson 95% confidence intervals [CIs]) were compared across BMI categories using the chi-square test, and multivariable logistic regression, adjusted for age and sex, estimated odds ratios (ORs). Results: Most participants were normal weight (59.1%); 11.6% were underweight, 29.3% were overweight or obese, and 86.3% were omnivorous. Dietary restriction (57.4%) and physical exercise (46.7%) were the leading weight-control methods; self-induced vomiting (6.4%) and medication (4.5%) were less frequent. Lifetime compulsive/emotional eating was reported by 50.1%, current stress-related eating by 49.1%, and guilt after eating by 66.1%. Lifetime night eating reached 31.9% (current, 12.9%). Body dissatisfaction (36.1% “not at all satisfied”), difficulty looking in the mirror (66.7%) and self-reported stress (82.2%) were widespread. In adjusted models, dietary restriction, emotional eating and guilt after eating rose steeply and monotonically with BMI (overweight/obesity vs. normal weight: aOR 2.34, 2.49 and 2.73, respectively; all p < 0.001), whereas current night eating and frequent self-weighing did not differ across BMI categories (p = 0.92 and p = 0.82). Dietary restriction increased from 24.1% in underweight to 55.5% in normal-weight and 74.2% in overweight/obesity participants; corresponding gradients were also observed for emotional eating and food-related guilt. Conclusions: In this predominantly female, largely urban online convenience sample of Romanian young adults, self-reported behavioural risk indicators related to disordered eating were common. Restriction, emotional eating and food-related guilt increased with BMI, whereas night eating and self-weighing showed no clear BMI gradient. These findings should be interpreted cautiously and should not be generalised to Romanian young men or rural populations without confirmation in more representative samples. Full article

Persistent racial and ethnic disparities in type 2 diabetes mellitus (T2DM) are incompletely explained by genetic susceptibility, obesity, lifestyle, and socioeconomic factors, suggesting that additional biological mechanisms may link environmental exposures to metabolic disease risk. Increasing evidence indicates that the exposome, encompassing environmental exposures across the life course, may influence long-term metabolic health through molecular mechanisms that integrate environmental signals with host biology. This Review synthesizes epidemiological, experimental, and mechanistic evidence on the gut microbiota–host epigenetic axis and its potential role in linking environmental exposures to population differences in T2DM susceptibility. Gut microbial dysbiosis alters the production and metabolism of short-chain fatty acids, bile acids, and tryptophan-derived metabolites. These microbial metabolites can modulate host signaling and epigenetic processes, including DNA methylation, histone modifications, and non-coding RNA activity, which may influence the expression of genes involved in glucose homeostasis, inflammation, and insulin sensitivity. Conversely, host epigenetic programs may influence intestinal barrier integrity and immune responses, thereby potentially affecting the gut microbial ecosystem, highlighting the reciprocal nature of host–microbiota interactions. We further examine how diet, psychosocial stress, environmental pollutants, and socioeconomic conditions may shape the microbiota–epigenetic axis across diverse populations, providing a framework for understanding differences in metabolic susceptibility without attributing disparities to intrinsic biological variation. However, direct human evidence linking the gut microbiota–host epigenetic axis to racial and ethnic disparities in T2DM risk remains limited, and much of the current framework is based on mechanistic studies, animal models, and associative human data rather than direct causal evidence. Further research in diverse human populations is needed to validate these pathways and establish their contribution to T2DM disparities. This framework may inform biomarker discovery, stratification, precision nutrition, and microbiome-targeted interventions and generate hypotheses for equitable prevention and personalized management of T2DM across diverse populations. Full article

This study investigates how social crowding (e.g., overcrowded environments) influences individuals’ preferences for different modes of shared consumption (sharing-in vs. sharing-out). While existing research has predominantly explored shared consumption through the perspective of non-psychosocial environmental factors (e.g., time scarcity), this study shifts the focus to psychosocial environmental factors by analyzing the underlying mechanism through which social crowding shapes preferences for these modes of shared consumption. We conducted one field experiment and three scenario-based laboratory experiments to manipulate social crowding (vs. non-social crowding) across three distinct contexts: (1) restaurant-based social scenarios, (2) shopping mall consumption contexts, and (3) beach tourism settings. Across these experiments, diverse categories of shared goods were employed to examine participants’ preferences for sharing-in versus sharing-out. The findings demonstrate that social crowding increases individuals’ preference for sharing with close friends (i.e., sharing-in), whereas non-social crowding enhances their preference for sharing with strangers (i.e., sharing-out). This relationship is mediated by psychological distance. Furthermore, resource mindset (scarcity vs. abundance) moderates this effect. Specifically, under a scarcity mindset, social crowding strengthens preferences for sharing-in, whereas under an abundance mindset, it promotes preferences for sharing-out. By conceptualizing shared consumption from a psychosocial environmental perspective, this research extends current understanding of how environmental social cues shape interpersonal consumption decisions and provides practical implications for collaborative consumption platforms, hospitality services, retail environments, tourism destinations, and public service design. Specifically, platform managers and service designers can strategically optimize spatial layouts and perceived crowding levels to strengthen social connectedness among close friends or foster positive interactions between strangers. Full article

Advances in healthcare have led to substantial growth in the global population of cancer survivors, yet young adult cancer survivors (YACS) aged 18–39 years remain an underrepresented population in cancer survivorship research. This review examines the health challenges and psychosocial factors that shape nutritional status in YACS, with the aim of informing age-appropriate nutritional care. YACS face significant financial and psychosocial demands unique to this life stage, balancing education, early careers and family responsibilities. They report greater unmet nutritional and health needs than other age cohorts, in addition to concerns regarding long-term side effects, financial strain, fear of cancer recurrence and increased responsibility for managing their own care. Cancer treatment can cause nutrition impact symptoms (e.g., nausea, taste changes, fatigue, dysphagia and gastrointestinal (GI) disturbances) that may persist for years, and YACS are vulnerable to late effects such as endocrine dysfunction, cardiometabolic disease, chronic pain and osteoporosis, all of which can be influenced by diet. Poor dietary patterns have been observed in YACS, indicating low intakes of fruits, vegetables, fibre and dairy, and higher consumption of saturated fat, sodium and processed foods. This narrative review evaluated fourteen nutritional intervention studies targeting YACS aged 18–39. Most existing interventions demonstrate minimal recruitment and retention rates, small sample sizes, and a reliance on self-report methods rather than objective nutritional measures. These limitations highlight the need for a deeper understanding of YACS’ specific nutritional needs and more effective strategies to engage this cohort. Future research should prioritise larger, more representative samples, incorporate objective nutritional and clinical measures, and explicitly address psychosocial and age-related barriers to healthy eating in young adulthood. Full article

Background: Sports injuries in children and adolescents may affect physical health, emotional well-being, sleep, quality of life, confidence, sport participation, and readiness to return to sport. Objective: This systematic review synthesized evidence on the relationship between sports-related injuries and mental health in athletes aged 19 years or younger, considering both psychological factors associated with injury vulnerability and psychosocial outcomes following injury. Methods: The review was conducted in accordance with the PRISMA 2020 guidelines. PubMed, Web of Science, Scopus, and Google Scholar were searched from inception to 8 July 2026, with eligibility restricted to studies published between 2021 and 2026. Risk of bias was assessed using Joanna Briggs Institute critical appraisal tools, and findings were synthesized narratively. Results: Twenty-one studies were included. Lower well-being, anxiety, stress, fatigue, sleep disturbance, kinesiophobia, and reduced psychological readiness were associated with injury occurrence, symptom burden, recovery, or reinjury. Conversely, injuries were associated with anxiety, depressive symptoms, sleep problems, reduced health-related quality of life, lower confidence, disrupted athletic identity, and return-to-sport difficulties. Conclusions: The findings suggest a potentially bidirectional association between sports injury and mental health within a broader biopsychosocial context. However, heterogeneity and predominantly observational designs limit causal inference. Full article

Background/Objectives: Adolescent sexuality is multidimensional, yet brief instruments assessing attitudes, experiences, and contextual influences from a biopsychosocial perspective remain limited. This study aimed to develop the Comprehensive Questionnaire on Attitudes, Experiences, and Contexts of Adolescent Sexuality (CIAECSA) and examine its content validity, comprehensibility, feasibility, internal consistency, and exploratory internal structure. Methods: A cross-sectional methodological study comprised three phases: theoretical delimitation and generation of 30 initial items; content evaluation by nine experts and semantic validation with 26 adolescents; and pilot administration to 51 adolescents from educational settings in Toledo, Spain. The pilot sample included 35 females (68.6%), 15 males (29.4%), and one gender-fluid participant (2.0%), aged 12–17 years (mean = 14.41; SD = 1.72). Content validity, perceived clarity, feasibility, Cronbach’s alpha, and principal component analysis with Varimax rotation were examined. Results: The final questionnaire comprised 18 items across three domains: sexuality/gender/anatomy, emotional/physical pain, and self-care/environment. The scale-level Content Validity Index (S-CVI/Ave) was 0.955, and mean perceived clarity was 4.53/5. The mean completion time was 5.52 min. Cronbach’s alpha was 0.800, 0.780, and 0.740 for the three domains and 0.715 for the total scale. The KMO was 0.659, Bartlett’s test was significant (p < 0.001), and an exploratory three-component solution, examined against the prespecified domains, explained 51.4% of the variance. Conclusions: The findings provide favorable evidence of content validity, comprehensibility, feasibility, and internal consistency. The CIAECSA may help identify educational needs and psychosocial factors related to adolescent sexuality, although its internal structure and additional measurement properties require examination in larger, balanced, and independent samples. Full article