Search Results (407)

(1) Background: Rapid population aging in China intensifies physical and mental health challenges, including negative emotions and social barriers. Physical activity (PA) fosters resilience, adaptability, and successful aging through emotional and social benefits. This study examines the relationship between square-dancing exercise and psychological capital (PsyCap) in middle-aged and elderly individuals using cross-validation, subgroup analysis, and a cross-sequential design. (2) Methods: A cross-sectional study with 5714 participants employed a serial mediation model. Online questionnaires assessed square-dancing exercise, cognitive reappraisal, prosocial behavior tendencies, PsyCap, and interpersonal relationships. Statistical analyses were conducted using SPSS 27.0 and Mplus 8.3, incorporating correlation analysis, structural equation modeling, and subgroup comparisons. (3) Results: (a) Cognitive reappraisal and prosocial behavior mediated the link between square-dancing and PsyCap through three pathways; (b) model stability was confirmed across two random subsamples; (c) cross-group differences emerged in age and interpersonal relationships. Compared with secondary data, this study further validated PsyCap’s stability over six months post-pandemic. (4) Conclusions: The study, based on China’s largest square-dancing sample, establishes a robust serial mediation model. The findings strengthen theoretical foundations for PA-based interventions promoting psychological resilience in aging populations, highlighting structured exercise’s role in mental and social well-being. Full article

This article examines the theological trajectories of Watchman Nee (1903–1972) and Witness Lee (1905–1997) on sanctification, union with Christ, and deification, situating their contributions within recent reappraisals of the doctrine of theosis in the academy. Though deification was universally affirmed by the early church and retained in various forms in medieval and early Protestant theology, post-Reformation Western Christianity marginalized this theme in favor of juridical and forensic soteriological categories. Against this backdrop, Nee and Lee offer a theologically rich, biblically grounded, and experientially oriented articulation of deification that warrants greater scholarly attention. Drawing from the Keswick Holiness tradition, patristic sources, and Christian mysticism, Nee developed a soteriology that integrates justification, sanctification, and glorification within an organic model of progressive union with God. Though he does not explicitly use the term “deification”, the language he employs regarding union and participation closely mirrors classical expressions of Christian theosis. For Nee, sanctification is not merely moral improvement but the transformative increase of the divine life, culminating in conformity to Christ’s image. Lee builds upon and expands Nee’s participatory soteriology into a comprehensive theology of deification, explicitly referring to it as “the high peak of the divine revelation” in the Holy Scriptures. For Lee, humans become God “in life and nature but not in the Godhead”. By employing the phrase “not in the Godhead”, Lee upholds the Creator–creature distinction—i.e., humans never participate in the ontological Trinity or God’s incommunicable attributes. Yet, in the first portion of his description, he affirms that human beings undergo an organic, transformative process by which they become God in deeply significant ways. His framework structures sanctification as a seven-stage process, culminating in the believer’s transformation and incorporation into the Body of Christ to become a constituent of a corporate God-man. This corporate dimension—often overlooked in Western accounts—lies at the heart of Lee’s ecclesiology, which he sees as being consummated in the eschatological New Jerusalem. Ultimately, this study argues that Nee and Lee provide a coherent, non-speculative model of deification that integrates biblical exegesis, theological tradition, and practical spirituality, and thus, present a compelling alternative to individualistic and forensic soteriologies while also highlighting the need for deeper engagement across global theological discourse on sanctification, union with Christ, and the Triune God. Full article

Background/Objectives: Academic stress is a major factor affecting university students’ psychological well-being and overall functioning. This study examined whether three active coping strategies—positive reappraisal, social support seeking, and strategic planning—mediate the relationship between academic stressors and self-reported stress responses. Methods: A quantitative, cross-sectional, non-experimental design was employed. The sample comprised 1014 students from the University of Extremadura (M_age = 20.56, SD = 3.50). Three subscales of the Academic Stress Questionnaire (CEA) were administered: Academic Stressors (E-CEA), Stress Responses (R-CEA), and Coping Strategies (A-CEA). Descriptive statistics, correlation analyses, and a multiple mediation model using structural equation modeling (SEM) tested direct and indirect effects, controlling for gender, study year, and academic field. Results: (1) Academic stressors were inversely related to positive reappraisal (β = −0.34, p < 0.001), planning (β = −0.12, p < 0.001), and social support seeking (β = −0.09, p < 0.01). (2) All three coping strategies were significantly associated with fewer stress symptoms, with positive reappraisal showing the strongest effect (β = −0.13, p < 0.001), followed by social support seeking (β = −0.06, p < 0.05) and planning (β = −0.03, p < 0.05). (3) Stressors had a strong positive direct effect on stress responses (β = 0.54, p < 0.001). (4) Coping strategies partially mediated the stressor–symptom link (total indirect effect: β = 0.12, p < 0.001, 95% CI [0.08, 0.16]). Conclusions: Active coping partially buffers the negative effects of academic stressors on perceived distress. Findings underscore the importance of enhancing students’ coping skills and implementing institutional policies that reduce structural stress and support psychological well-being. Full article

Emerging adulthood is a critical phase for emotional development and mental health. Psychological well-being has been associated with using emotion regulation strategies as well as high self-esteem and high optimism. The objective of this study was to examine the mediating role of self-esteem and optimism in the relationship between emotion regulation and psychological well-being in the context of the challenges associated with emerging adulthood. The study was conducted with the participation of 771 university students (M = 20.38, SD = 2.01, 73.3% female), who completed questionnaires, including the Psychological Well-Being Scales (PWBS), the Cognitive Emotion Regulation Questionnaire (CERQ-18), Rosenberg’s Self-Esteem Scale and the Optimism Questionnaire (COP). The results indicate a positive correlation between the adaptive strategies of emotion regulation and the dimensions of psychological well-being, as well as a positive correlation with self-esteem and optimism. A mediation model was tested with an adequate model fit, examining both direct and indirect effects. The model identifies planning, positive reappraisal, and catastrophizing as the most significant emotion regulation strategies, while also emphasizing the importance of some dimensions of well-being, such as self-acceptance, mastery of the environment, and life purpose. Furthermore, the findings illustrate the role of self-esteem and optimism as mediators in these relationships. The study concludes with an analysis of the theoretical and practical implications of the findings in the context of the difficulties associated with emerging adulthood where individuals define their identity, goals and purposes in life and their personality becomes more consistent. Full article

Background and Objectives: Adolescence is a critical yet vulnerable developmental stage, characterized by increased exposure to stressful life events (SLEs), which are strongly linked to the onset and progression of depression. Although mindfulness has been consistently associated with lower depressive symptoms, the mechanisms underlying this relationship—particularly in adolescents—remain underexplored. Prior research suggests that mindfulness operates through cognitive mechanisms, such as reduced rumination, enhanced emotional regulation, and greater cognitive flexibility. However, much of this work is cross-sectional, limiting causal interpretation and often overlooking distinctions between direct and indirect effects. This study aimed to clarify two proposed pathways through which trait mindfulness may reduce depressive symptoms in adolescents: (1) a direct pathway involving core cognitive–emotional processes, and (2) an indirect pathway, where mindfulness supports more adaptive stress appraisal. A secondary objective was to assess whether these indirect effects vary across different types of stressful life events. Materials and Methods: We analyzed longitudinal data from 3897 adolescents (M_age = 15.9; 51.2% female) across four waves spaced approximately six months apart. Structural equation modeling (AMOS) was used to evaluate both direct and indirect effects of trait mindfulness on depression, with stress domains included in separate analyses. Results: Trait mindfulness was strongly negatively correlated with depression (r = –0.39 to –0.56). The direct effect of mindfulness on depression was substantial (β = –0.60 to –0.74), while indirect effects via cognitive reappraisal were smaller (β = –0.10 to –0.26 for stress reduction; up to –0.17 for depression). Indirect effects varied across stress domains and were generally modest. Conclusions: Mindfulness appears to reduce adolescent depressive symptoms through both direct and indirect pathways. The more pronounced direct effect likely reflects underlying mechanisms, such as reduced rumination and enhanced emotional regulation. Although weaker, the indirect pathway—mediated by more adaptive stress appraisal—adds meaningful explanatory value. Together, these findings underscore mindfulness as a key protective factor and highlight its potential for informing targeted, resilience-based interventions in adolescent mental health. Full article

Background: Binge eating is a disordered eating behavior implicated in eating disorders such as binge eating disorder (BED) and bulimia nervosa; it significantly affects an individual’s physical and mental health. Recent studies suggest shared neurobiological mechanisms between binge eating and addictive behaviors. Comorbid addiction (e.g., substance use disorders and behavioral addictions) is also frequently reported in binge-eating patients. However, it is still unclear whether binge-eating individuals with comorbid addictions differ in their cognitive and mental health characteristics from those without comorbid addictions. Objectives: The present study aimed to examine the cognitive and mental health profiles of binge-eating individuals with and without co-occurring addictions. We hypothesized that binge-eating individuals with comorbid addictions would show greater impairments in impulsivity and self-control, as well as elevated depression and emotion dysregulation. Methods: In the present study, we assessed psychometric scales on various cognitive and mental health domains (e.g., impulsivity, behavioral inhibition, self-control, emotion regulation, mood, and anxiety) across 30 binge-eating individuals with co-occurring addictive behaviors (i.e., alcohol, nicotine, gambling, and video games), 32 binge-eating individuals without addiction, and 180 healthy control subjects with neither binge-eating tendencies nor addiction. Results: Both binge-eating groups showed a significant increase in punishment sensitivity, perceived stress, and state/trait anxiety compared to healthy controls, but there was no difference between the two binge-eating groups. Higher impulsivity and lower self-control were observed in both binge-eating groups to a significantly greater degree in the group with comorbid addiction. Notably, significantly increased depression and impaired emotion regulation (reduced use of cognitive reappraisal) were observed only in the binge-eating group with comorbid addiction when compared to the healthy controls. Conclusions: Our findings demonstrated the commonalities and differences in binge-eating populations with and without comorbid addiction. It will help to elucidate cognitive and mental health aspects of comorbid addiction in the binge-eating population and to develop more tailored diagnoses and treatments. Full article

Beyond developing new agents, cancer treatment can also be optimized by modifying the dosing regimen of approved drugs. Academic teams have experimented with different ways of improving drug regimens, leading to off-label practices for therapeutic and/or economic purposes, and currently, drug regulatory agencies have begun to reappraise this often-neglected topic. This concept also considers the patient’s perspective in terms of quality of life and convenience, including the concept of time toxicity. Overall, the optimization of drug dosing of anticancer agents may be viewed on three sides: the improvement of the benefits/risks balance (patient), the improvement of the convenience of the treatment (patient, healthcare professionals), and the mitigation of the financial impact (health insurance, patient). Examples of dose reassessments of targeted therapies (approved since 1997) are chosen to illustrate the context. Suboptimal/overdosed regimens are found for certain molecularly targeted agents, mostly based on the ancient concept of maximum tolerated dose in oncology. This underlines the lack of comparative effective dose trials before approval. Fortunately, dosing regimens of newly approved molecularly targeted agents is going to evolve with the hope of more convenient and better tolerated treatments. This optimization will bring greater benefit to patients and to healthcare professionals but without addressing the economic issue. Full article

Although the benefits of regular physical activity are widely recognized, many university students fail to sustain consistent exercise behaviors. This phenomenon may be attributed to cognitive and motivational barriers, particularly perceptions of goal attainability and attribution styles, which are believed to significantly influence students’ health beliefs and intentions to engage in physical activity. This research aimed to examine the independent and combined effects of goal attainability and attribution style on Chinese university students’ health beliefs and willingness to exercise. The study also investigated how shifts in attribution style may influence these outcomes under different levels of goal attainability. Two between-subjects experiments were conducted. In Experiment 1 (N = 146), a 2 (goal attainability: high vs. low) × 2 (attribution style: internal vs. external) design was used. Participants were exposed to tailored exercise advertisements and completed standardized questionnaires measuring health beliefs and exercise intentions. Experiment 2 (N = 130) adopted a 2 (goal attainability: high vs. low) × 2 (attributional shift: external-to-internal vs. internal-to-external) design, utilizing visual priming and short video interventions to manipulate attributional orientation. In Experiment 1, both high goal attainability and internal attribution independently enhanced participants’ health beliefs and exercise willingness. A significant interaction effect was observed only for exercise willingness, with the highest intentions found in the high attainability × internal attribution group. In Experiment 2, shifting attribution from external to internal significantly increased both health beliefs and exercise willingness, while shifting from internal to external resulted in substantial decreases. An interaction effect was again found only for exercise willingness, suggesting that the effectiveness of attributional shift depended on goal attainability. By integrating the Health Belief Model with Attribution Theory, this study offers a deeper understanding of how cognitive and motivational factors influence exercise behavior, and provides a theoretical foundation for developing adaptive interventions. Full article

Drawing on Antonovsky’s salutogenic model, this study investigated how stressful life events relate to university students’ sense of coherence (SOC), focusing on the potential mediating roles of coping style and general self-efficacy, and the moderating role of stress mindset. An analysis of data collected from 2454 Chinese college students (63.6% males, 36.4% females) revealed that stressful life events negatively predicted SOC, with coping style and general self-efficacy significantly sequentially mediating this relationship. Furthermore, stress mindset moderated the relationship between stressful life events and coping style, such that a more positive mindset was associated with more adaptive coping under stress. These findings support the dual-pathway structure of the salutogenic model by illustrating both behavioral and perceptual mechanisms. Importantly, they also underscore the idea that stress, when cognitively reappraised and effectively managed, may contribute to the development of SOC—rather than simply undermining it. This highlights the potential value of stress itself within salutogenic processes. The study offers theoretical insights and preliminary directions for strength-based mental health promotion in higher education settings. Full article

Informed by multiple theoretical frameworks, our study examined multilevel models of homework motivation management among middle-schoolers in China. At the individual level, homework motivation management was positively associated with managing time, managing emotion, cognitive reappraisal, time on extracurricular activities, homework effort, and deep approach. In addition, there was a positive correlation between homework motivation management and homework time at both individual and class levels. Our study expands previous research by revealing that homework motivation management was positively associated with homework effort and deep approach after accounting for other relevant constructs. The implications of these findings are discussed relating to homework practices and further investigations. Full article

Background: Oral bisphosphonates (BPs) are the standard therapy for osteoporosis and skeletal metastases, and exhibit anti-tumor properties in preclinical models. Observational studies assessing their impact on colorectal cancer (CRC) risk have yielded inconsistent results. We aimed to systematically review and meta-analyze the association between oral bisphosphonate use and CRC risk, applying a unified exposure definition. Methods: A systematic search was conducted in PubMed, Embase, and Scopus (January 1966–April 2025) to identify cohort, nested case–control, or population-based case–control studies reporting adjusted estimates of relative risk, odds ratios (ORs), or hazard ratios (HRs) for CRC among oral bisphosphonate users. Two reviewers independently screened studies, extracted data, and assessed quality using the Newcastle–Ottawa Scale. Random-effects meta-analyses pooled risk estimates for “any use” of bisphosphonates, with subgroup analyses by duration of use (<1, 1–3, >3 years). We assessed publication bias through Egger’s test and the trim-and-fill method. Results: A total of eight studies published between 2010 and 2020, including 29,169 CRC cases, fulfilled the inclusion criteria. Any bisphosphonate use was not significantly associated with CRC risk (pooled OR 0.97; 95% C.I., 0.90–1.03). However, 1–3 years of use conferred a protective effect (OR 0.86; 95% C.I., 0.73–0.99), as did >3 years (OR 0.91; 95% C.I., 0.85–0.97). Heterogeneity was moderate, and no significant publication bias was detected. Conclusions: While overall oral bisphosphonate exposure is not significantly linked to CRC risk, prolonged use (≥1 year) appears to reduce risk. Prospective studies and randomized trials are needed to confirm these chemo-preventive effects and guide clinical recommendations. Full article

Background/Objectives: Acute heart failure (AHF) is a common cause of emergency department (ED) referral. Different guidelines aim to optimise this condition, but the evidence is poor for most indications regarding AHF. In this paper, we aim to (i) identify the five most interesting topics in AHF management, (ii) compare guidelines, and (iii) give the reader the best advice on how to manage AHF in each topic. Methods: The working group (WG) identified ten critical topics in AHF management using a Delphi method and submitted them to ITEMS, a national group of ED physicians that ranked them. The WG selected the five highest-ranked topics and performed a critical reappraisal of guidelines. Lastly, the WG prepared the answers for ED physicians according to the guidelines and comparisons of studies. Results: The WG identified five topics for ED patients with AHF: (i) what is the optimal oxygen and ventilatory support, (ii) what is the optimal dose and administration modality of diuretics, (iii) what is the role of inotropes and vasopressors, (iv) what therapeutic strategies are suggested for diuretic refractoriness, and (v) what is the diagnostic role of lung ultrasound. For each topic, the WG identified, summarised, and compared the indications provided by each guideline, generating advice for ED management of AHF after a critical literature reappraisal. Conclusions: We highlighted the differences among guidelines dealing with AHF and developed the five best recommendations to assist ED physicians in determining the optimal approach for the ED management of AHF and to suggest future research directions. Full article

Background: Depression is one of the leading causes of disability worldwide. Among pharmacological treatments, fluvoxamine—an early SSRI with a distinct pharmacological profile—has been recently reappraised for its broader clinical relevance. Objective: To assess the efficacy of fluvoxamine in the treatment of depression compared to placebo and other antidepressants through a comprehensive overview of systematic reviews and meta-analyses. Methods: A systematic search was conducted in MEDLINE and the Cochrane Central Register of Controlled Trials, including systematic reviews and meta-analyses of randomized controlled trials evaluating fluvoxamine’s efficacy. Reviews were eligible if they included adults diagnosed with depressive disorders based on the DSM or ICD criteria. Reviews focusing on other psychiatric disorders, comorbidities, tolerability, or economic evaluations were excluded. Data extraction included effect size measures and methodological quality assessments using the AMSTAR-2 tool. Results were synthesized by comparing fluvoxamine to placebo, tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and other antidepressants. Results: A total of 74 reviews were identified, of which 14 systematic reviews met the inclusion criteria after screening and full-text analysis. These reviews, published between 1994 and 2021, predominantly involved nine pairwise meta-analyses and five network meta-analyses, comparing fluvoxamine with placebo and various antidepressants. Fluvoxamine demonstrated consistent superiority over placebo in achieving treatment response and remission outcomes. Comparisons with imipramine, clomipramine, amitriptyline, dothiepin, paroxetine, fluoxetine, citalopram, mianserin, nortriptyline, and moclobemide generally revealed no significant differences in efficacy. However, some reviews indicated that venlafaxine and mirtazapine were superior to fluvoxamine in certain outcomes, while fluvoxamine demonstrated greater efficacy than desipramine in one review. Sertraline and milnacipran showed mixed or review-quality-dependent results, with one low-quality review favoring milnacipran. Most reviews assessed outcomes over a median follow-up of six weeks using standardized depression rating scales. Conclusions: Fluvoxamine is a robust and effective antidepressant, demonstrating consistent efficacy comparable to other antidepressants and superior to placebo. While no single antidepressant was universally superior, fluvoxamine’s unique pharmacological profile and favourable safety characteristics support its clinical utility. Further research is needed to explore its role in personalized treatment strategies and emerging therapeutic contexts, such as comorbid anxiety and post-traumatic stress disorder. Full article

Emotion regulation (ER) strategies, such as reappraisal and suppression, have been linked to psychological well-being. The available evidence points to the differential impact of ER strategies on resilience and post-traumatic growth (PTG), as factors related to well-being, as well as to sex differences in the link between ER preference and well-being. However, previous studies are mixed regarding these links. To address this issue, college students (N = 1254) recruited between 2020 and 2023 reported their habitual use of ER strategies, resilience and PTG during the COVID-19 pandemic, which, as a global health crisis, has raised not only severe physical health concerns but also mental distress. First, reappraisal was positively associated with both resilience and PTG, whereas suppression was negatively correlated with these measures. Second, female participants had lower suppression scores and higher PTG scores than male participants. Third, a moderation analysis showed that the positive relationship between reappraisal and PTG was stronger in female participants, whereas the negative relationship between suppression and PTG was stronger in male participants. Overall, these findings shed light on the links among ER strategies, resilience, and PTG and have relevance for customized training in the use of reappraisal to increase well-being in women and men. Full article

Background: Stress affects 45% of NHS staff. More research is needed to explore how to develop resilient mental health nurses who face multiple workplace stressors, including interacting with distressed clients. Higher Education Institutions are uniquely placed to introduce coping skills that help reduce anxiety and increase confidence for pre-registration nurses entering placements for the first time. Methods: A convenience sample of first year mental health student nurses (whole cohort), recruited before their first clinical placement, were invited to participate. Following a mixed methods design, we developed a 360-degree virtual reality (VR) video, depicting a distressed service user across three scenes, filmed in a real-life decommissioned in-patient ward. Participants followed the service user through the scenes, as though in real life. We used the video alongside a cognitive reappraisal/solution-focused/VERA worksheet and supportive clinical supervision technique to explore students’ experiences of VR as an educative tool and to help build emotional coping skills. Results: N = 21 mental health student nurses were recruited to the study. Behavioural responses to the distressed patient scenario were varied. Students that had prior experience in health work were more likely to feel detached from the distress of the service user. Although for some students VR provided a meaningful learning experience in developing emotional awareness, other students felt more like a ‘fly on the wall’ than an active participant. Empathetic and compassionate responses were strongest in those who perceived a strong immersive effect. Overall, the supportive supervision appeared to decrease the anxiety of the small sample involved, but confidence was not affected. Conclusion: The use of 360-degree VR technology as an educative, classroom-based tool to moderate anxiety and build confidence in pre-placement mental health nursing students was partially supported by this study. The effectiveness of such technology appeared to be dependent on the degree to which ‘immersion’ and a sense of presence were experienced by students. Our cognitive reappraisal intervention proved useful in reducing anxiety caused by ‘the patient in distress scenario’ but only for students who achieved a deep immersive effect. Students with prior exposure to distressing events (in their personal lives and in clinical settings) might have developed other coping mechanisms (e.g., detachment). These findings support the idea that ‘presence’ is a subjective VR experience and can vary among users. Full article