Search Results (655)

Autism Spectrum Disorder (ASD) remains significantly underdiagnosed in women, resulting in a persistent gender gap with important clinical, functional, and psychosocial implications. This narrative review explores the multifactorial barriers contributing to diagnostic disparities, including the male-oriented structure of current diagnostic criteria, the prevalence of co-occurring psychiatric conditions, and the phenomenon of social camouflaging shaped by culturally reinforced gender norms. These factors frequently lead to delayed identification, clinical misinterpretation, and suboptimal care. The review synthesizes evidence from clinical, psychological, and sociocultural research to demonstrate how the under-recognition of ASD in women impacts mental health outcomes, access to education, occupational stability, and overall quality of life. Special emphasis is placed on the consequences of missed or late diagnoses for healthcare delivery and the educational needs of clinicians involved in ASD assessment and care. This article concludes with actionable, evidence-based recommendations for enhancing diagnostic sensitivity, developing gender-responsive screening strategies, and integrating training on female autism presentation into medical and allied health education. Addressing these challenges is essential to reducing diagnostic inequities and ensuring timely, accurate, and person-centered care for autistic women throughout their lifespan. Full article

Despite growing recognition of the role that social determinants of health (SDOHs) and health-related social needs (HRSNs) play in chronic disease, limited research has examined their associations with Chronic Obstructive Pulmonary Disease (COPD) in population-based studies. This cross-sectional study analyzed 2022 Behavioral Risk Factor Surveillance System (BRFSS) data from 37 U.S. states and territories to determine how financial hardship, food insecurity, employment loss, healthcare access barriers, and psychosocial stressors influence the prevalence of COPD. Weighted logistic regression models were used to assess the associations between COPD and specific SDOHs and HRSNs. Several individual SDOH and HRSN factors were significantly associated with COPD prevalence, with financial strain emerging as a particularly strong predictor. In models examining specific SDOH factors, economic hardships like inability to afford medical care were strongly linked to higher COPD odds. Psychosocial HRSN risks, such as experiencing mental stress, also showed moderate associations with increased COPD prevalence. These findings suggest that addressing both structural and individual-level social risks may be critical for reducing the prevalence of COPD in populations experiencing financial challenges. Full article

Background/Objectives: Psychosocial (PS) factors and cognitive dysfunction (CD) in patients with atrial fibrillation (AF) may negatively impact treatment compliance. The PS profile covers multiple psychological and socio-economic factors, although research is mostly limited to depression, anxiety, and work stress. This study assessed the prevalence of a broad range of PS factors in patients with AF and their relationship with cognitive decline. Methods: We retrospectively analyzed data from patients referred to a cardiovascular rehabilitation clinic between March 2017 and April 2023 who underwent standardized assessments of PS factors, cognition, and quality of life. Results: Of the 798 included patients, 230 (28.8%) had AF, with a mean age of 68.07 years (SD 9.60 years). Six of nine PS factors were present in more than half of the overall sample. Compared to non-AF patients, those with AF showed significantly higher levels of social isolation, depression, and hostility, whereas low socioeconomic status, family and work-related stress, and other mental disorders were more frequent in the non-AF group. CD was present in 67.4% of the total cohort and was more prevalent in AF patients with a higher PS burden. Patients with permanent AF reported the poorest health status. Conclusions: Integrating assessments of PS factors and cognition in cardiac rehabilitation is feasible and supports a more comprehensive, patient-centred model of care in AF. Full article

Limb–girdle muscular dystrophy (LGMD) encompasses a heterogeneous group disease, genetic and phenotypically. There are more than 30 subtypes divided into two groups: autosomal dominant and recessive. LGMDs are characterised by muscle weakness; however, psychosocial factors seem to be affected too, such as HRQoL. Given the lack of literature in this respect, the present cross-sectional study aimed to create a patient profile comparing both dominant and recessive forms by analysing HRQoL through the INQoL, and sociodemographic data. The LGMD-recessive group had a worse HRQoL compared to the dominant group, specifically in the dimensions of muscle weakness (p = 0.007), emotion (p = 0.046), independence (p = 0.029), and body image (p = 0.022). In addition, in the LGMD-dominant group, 77.9% of the relational indicator was explained by age (B = 0.907, p = 0.012), which can be understood as a limitation in their social role due to the disease progression. In contrast, no sociodemographic variables were found to be predictive of the HRQoL of patients with recessive forms of LGMD. These results are relevant for clinical practice, as they reflect the most affected areas of HRQoL in LGMD patients, differentiating between recessive and dominant forms. Full article

The present study focuses on investigating the contribution of puppetry as a pedagogical and psychosocial tool in special education, addressing the literature gap in the systematic documentation of the experiences of special education teachers, concerning its use in daily teaching practice. The main objective is to capture the way in which puppetry enhances the learning, social and therapeutic support of students with complex educational and psychosocial needs. The study employs a qualitative phenomenological approach, conducting semi-structured interviews with eleven special education teachers who integrate puppetry into their teaching. Qualitative data were analyzed using thematic analysis. The findings highlight that puppetry significantly enhances cognitive function, concentration, memory and language development, while promoting the active participation, cooperation, social inclusion and self-expression of students. In addition, the use of the puppet acts as a means of psycho-emotional empowerment, supporting positive behavior and helping students cope with stress and behavioral difficulties. Participants identified peer support, material adequacy and training as key factors for effective implementation, while conversely, a lack of resources and time is cited as a key obstacle. The integration of puppetry in everyday school life seems to ameliorate a more personalized, supportive and experiential learning environment, responding to the diverse and complex profiles of students attending special schools. Continuous training for teachers, along with strengthening the collaboration between the arts and special education, is essential for the effective use of puppetry in the classroom. Full article

Social adversity is linked to poorer physical health in breast cancer survivors, highlighting the urgency of addressing health equity. Simultaneously, identifying individual-level factors that mitigate these effects may provide more immediate relief for survivors. This study examined whether four modifiable psychosocial factors—emotion dysregulation, physical activity, sleep disturbance, and social support—moderate the relationship between place-based social adversity and physical health in 255 breast cancer survivors (Mage = 56.03, 74.5% non-Hispanic White) within six months post-treatment. Linear regression analyses with 5000 bootstrapped estimates revealed that sleep disturbance significantly moderated the relationship between place-based social adversity and physical health (B = −0.014, SE = 0.001, bootstrapped 95% CI = −0.027, −0.001). Specifically, greater place-based social adversity was associated with poorer physical health at high levels of sleep disturbance (B = −0.22, p = 0.004), but not at low (B = 0.01, p = 0.94) or average (B = −0.10, p = 0.07) levels. Emotion dysregulation, physical activity, and social support did not moderate this relationship. Findings suggest that improving sleep quality may buffer the negative impact of social adversity on physical health, identifying sleep as a potential target for interventions aimed at reducing disparities among breast cancer survivors. Full article

Introduction: Dental caries and molar–incisor hypomineralisation (MIH) are prevalent conditions affecting children’s oral health, with functional, aesthetic, and psychosocial implications. In Spain, previous studies have highlighted geographic and sociodemographic disparities in their distribution, particularly among rural and migrant populations. Objective: To characterise oral health status, in terms of caries and MIH, among 6–7-year-old children from the towns of Palos de la Frontera, Mazagón, and San Bartolomé. Methods: A cross-sectional study was conducted involving 229 children recruited from public primary schools. Sociodemographic, anthropometric, and behavioural data were collected through clinical examination and interview. Statistical analysis included univariate and multivariate logistic regression. The study protocol was approved by the Ethics Committee of Huelva. Results: The prevalence of caries (DMFT ≥ 1) was 53.3%, with mean DMFT and dft indices of 1.78 and 0.31, respectively. MIH affected 32.8% of the cohort, with a predominance in the first permanent molars (teeth 36 and 26). Multivariate analysis identified independent predictors of caries: African (OR = 7.47; 95% CI: 2.84–23.8) and European (OR = 4.56; 95% CI: 1.26–22.3) parental origin, poor oral hygiene (OR = 3.07; 95% CI: 1.60–6.03), and the presence of MIH (OR = 3.20; 95% CI: 1.64–6.42). The municipality of San Bartolomé was associated with a higher risk of MIH (OR = 2.90; 95% CI: 1.21–7.45). Conclusions: The high prevalence of caries and MIH in the Condado-Campiña district, exceeding national averages, reflects oral health inequities linked to social determinants (migrant origin, locality) and clinical factors (MIH, oral hygiene). Targeted preventive interventions are urgently needed in high-risk populations, including culturally tailored education and policies ensuring equitable access to dental care services. Full article

Background: Anhedonia, defined as the diminished capacity to experience pleasure, represents a core negative symptom in first-episode psychosis (FEP) with profound implications for functional outcomes and long-term prognosis. Despite its clinical significance, comprehensive understanding of anhedonia prevalence, underlying mechanisms, and optimal intervention strategies in early psychosis remains limited. Objectives: To systematically examine the prevalence and characteristics of anhedonia in FEP patients, explore neurobiological mechanisms, identify clinical correlates and predictive factors, and evaluate intervention efficacy. Methods: Following PRISMA 2020 guidelines, we conducted comprehensive searches across PubMed, Embase, PsycINFO, and Web of Science databases from January 1990 to June 2025. Studies examining anhedonia and negative symptoms in FEP patients (≤24 months from onset) using validated assessment instruments were included. Quality assessment was performed using appropriate tools for study design. Results: Twenty-one studies comprising 3847 FEP patients met inclusion criteria. Anhedonia prevalence ranged from 30% at 10-year follow-up to 53% during acute phases, demonstrating persistent motivational deficits across illness trajectory. Factor analytic studies consistently supported five-factor negative symptom models with anhedonia as a discrete dimension. Neuroimaging investigations revealed consistent alterations in reward processing circuits, including ventral striatum hypofunction and altered network connectivity patterns. Social anhedonia demonstrated stronger associations with functional outcomes compared to other domains. Epigenetic mechanisms involving oxytocin receptor methylation showed gender-specific associations with anhedonia severity. Conventional antipsychotic treatments showed limited efficacy for anhedonia improvement, while targeted psychosocial interventions demonstrated preliminary promise. Conclusions: Anhedonia showed high prevalence (30–53%) across FEP populations with substantial clinical burden (13-fold increased odds vs. general population). Meta-analysis revealed large effect sizes for anhedonia severity in FEP vs. controls (d = 0.83) and strong negative correlations with functional outcomes (r =·−0.82). Neuroimaging demonstrated consistent ventral striatum dysfunction and altered network connectivity. Social anhedonia emerged as the strongest predictor of functional outcomes, with independent suicide risk associations. Conventional antipsychotics showed limited efficacy, while behavioral activation approaches demonstrated preliminary promise. These findings support anhedonia as a distinct treatment target requiring specialized assessment and intervention protocols in early psychosis care. Full article

As digital transformation progresses, schools are increasingly confronted with psychosocial challenges such as technostress, digital overload, and unequal participation in digital (learning) environments. This article investigates the conceptual relevance of digital well-being for school development, particularly in relation to social inequality. Despite growing attention, the term remains theoretically underdefined in educational research—a gap addressed through a theory-driven review. Drawing on a systematic search, 25 key studies were analyzed for their conceptual understanding and refinement of digital well-being, with a focus on educational relevance. Findings suggest that digital well-being constitutes a multidimensional state shaped by individual, media-related, and socio-structural factors. It emerges when individuals are able to successfully manage the demands of digital environments and is closely linked to digital inequality—particularly in terms of access, usage practices, and the resulting opportunities for participation and health promotion. Since the institutional role of schools has thus far received limited attention, this article shifts the focus toward schools as key arenas for negotiating digital norms and practices and calls for an equity-sensitive and health-conscious perspective on school development in the context of digitalization. In doing so, digital well-being is repositioned as a pedagogical cross-cutting issue that requires coordinated efforts across all levels of the education system, highlighting that equitable digital transformation in schools depends on a critical reflection of power asymmetries within society and educational institutions. The article concludes by advocating for the systematic integration of digital well-being into school development processes as a way to support inclusive digital participation and to foster a health-oriented digital school culture. Full article

Background and Objectives: Resilience and perceived social support are crucial factors influencing the psychological well-being among breast cancer survivors. Understanding their levels and interrelations can inform psychosocial interventions aimed at improving survivorship outcomes. This study aimed to examine the relationship between resilience and perceived social support, evaluate the psychometric properties, and explore their associations with key sociodemographic factors among breast cancer survivors. Materials and Methods: A total of 253 women in clinical remission, at least six months post-primary treatment, were recruited from the University Clinical Center of Vojvodina. Participants completed sociodemographic and clinical questionnaires, the Connor–Davidson Resilience Scale (CD-RISC-25), and the Multidimensional Scale of Perceived Social Support (MSPSS). Results: Participants reported moderate levels of resilience (Mdn = 75, IQR = 19). Among resilience domains, Hardiness (Mdn = 22, IQR = 7) and Coping (Mdn = 14, IQR = 4) scored highest, while Optimism (Mdn = 6, IQR = 3) was the lowest. A significant positive correlation was found between resilience and fertility-related quality of life (ρ = 0.454, p < 0.01), while a negative correlation was observed between resilience and fertility-related stress (ρ = −0.275, p < 0.01). Adaptive coping strategies, particularly from the Practical Management Branch of the CIQ, were positively associated with resilience and quality of life, while avoidance coping was linked to higher stress and lower well-being. Conclusions: Breast cancer survivors in this Serbian cohort reported moderate resilience and social support, with a strong interrelationship between the two. These findings underscore the importance of strengthening social support networks as a potential pathway to enhance resilience and psychological well-being in cancer survivorship care. Full article

With accelerated population aging, the importance of older adults’ self-rated health is constantly increasing. Self-rated health is influenced by complex relationships between the built environment and psychosocial factors. Therefore, this study constructs a pathway framework of “material (housing quality and environmental pollution)–psychological (depression and social capital)–self-rated health” elements to explore the influencing mechanism of older adults’ self-rated health. This study utilized the 2018 China Labor Force Dynamics Survey Database to explore the relationship between built environment factors (housing quality and environmental pollution), depression, social capital, and older adults’ self-rated health, using structural equation modeling. The heterogeneity between urban and rural areas is also analyzed. Better housing quality and less environmental pollution were found to be related to higher levels of self-rated health. Depression and social capital were important mediators in the relationship between housing quality, environmental pollution, and self-rated health. Regarding urban–rural heterogeneity, the direct impact of environmental pollution on self-rated health was only significant among urban older adults. Secondly, the multiple mediating roles of social capital were only reflected among rural older adults. The government and relevant entities should promote improvements in housing quality and reduce environmental pollution to achieve a healthy and livable environment. Full article

Background/Objectives: Cerebral hemorrhage (CH) has physical, cognitive, and emotional consequences. Recovery requires a complex rehabilitation process in which coping strategies play a fundamental role in supporting psychological adaptation. The aim of this study is to investigate and understand the extent and manner in which coping strategies have been assessed in the CH population within the scientific literature. Methods: Studies were identified through searches in the PubMed, Scopus, and Embase databases. Eight studies published between 2014 and 2024 were selected. Results: The most frequently adopted coping strategies include task-oriented coping, avoidance, emotion-focused coping, acceptance, planning, and emotional support. Task-oriented strategies and acceptance are associated with better psychological outcomes. Conversely, avoidant and emotion-focused strategies correlate with higher levels of anxiety, depression, and poorer adaptation. Resilience and social participation emerge as protective factors. Finally, Action/Distraction is associated with a better quality of life, while Trivialization/Resignation is linked to lower levels. Conclusions: Coping seems to represent a modifiable, patient-centered lever that can mitigate the psychosocial sequelae of intracranial hemorrhage when assessed systematically and addressed through tailored rehabilitation programs. Our findings lay the groundwork for evidence-based, coping-focused interventions and highlight critical avenues for future longitudinal and mechanistic research. Full article

About 8% of Ghanaians, including adolescents, have various types of disabilities. Although many legal and constitutional protections for people with disabilities, including adolescents, exist in Ghana, it is widely known that these persons face a variety of psychosocial issues. Several factors have been identified as contributing to the unremitting marginalisation of people with disabilities in general, but the extent to which these can be generalised to adolescents with disabilities is unknown. This study, therefore, sought to document the determinants, manifestations, and consequences of disability-related stigma among differently abled adolescents in three special schools in northern, middle, and southern Ghana. An exploratory descriptive qualitative design was used. Overall, 54 participants were purposively selected for a semi-structured interview and focus group discussions. Braun and Clarke’s procedure for thematic analysis was followed. The findings showed a variety of stigmatising experiences by adolescents with disabilities in their sociocultural context. More broadly, the cause of disability was linked to the ramifications of parental sins against the gods, being a descendant of river gods, and the consequences of bewitchment/curses by family members. Others included the perceived transmissibility of the disability and disability as a visible condition. Stigma manifested in the form of pejorative labelling, ableism, and social exclusion. The consequences of this stigma included negative psychological and emotional effects (i.e., depression, low self-esteem, and a lack of confidence) and suicidal ideation. There is an urgent need for stigma reduction interventions for adolescents with disabilities in Ghana as part of an effort to improve their wellbeing. Full article

Background: Pediatric Crohn’s Disease (CD) affects more than physical health, influencing emotional well-being, social integration, and developmental milestones, with an impact on disease management. This study aimed to explore adolescents’ lived experiences with CD and identify factors influencing their motivation for self-management. Methods: A descriptive, cross-sectional qualitative study was conducted using a semi-structured, self-administered online questionnaire. Participants (n = 10) were adolescents with CD who had been diagnosed for over three years and were recruited from a tertiary pediatric gastroenterology center. Data included demographics, clinical characteristics, IMPACT-III (HRQOL), and PROMIS short forms. Open-ended responses underwent thematic analysis using the framework developed by Braun and Clarke. Results: Participants (80% female, median age 16.2 years, median disease duration 4.6 years) were all in clinical remission (median PCDAI = 2) and with good quality of life (median IMPACT-III = 80.7). Six themes emerged: (1) disease knowledge, (2) emotional responses, (3) coping and adaptation, (4) social support, (5) daily life and school impact, and (6) transition to adult care. Most participants demonstrated strong disease literacy and reported effective coping strategies. Emotional responses to diagnosis ranged from relief (60%) to distress (40%); relapses commonly triggered anxiety and fear. Therapeutic changes and disease monitoring were perceived as beneficial (100%) but with concern. Diagnostic procedures were viewed as burdensome by 70% of respondents. School performance and extracurricular participation were negatively affected in 40% during flares. Concerns regarding the future were reported by 40% of participants, with 30% believing that CD might limit life aspirations. While 60% managed their disease independently, 30% relied on parental support. All acknowledged the need for transition to adult care, though readiness varied. Conclusions: This study illustrates the overall impact of disease on pediatric CD patients. It reports significant emotional challenges and difficulties, as well as an impact on daily life, despite good disease knowledge. The findings underscore the importance of psychosocial well-being, ongoing mental health assessment, non-invasive monitoring, and holistic care, emphasizing the patient perspective, in managing pediatric CD. Full article

Homelessness is characterised by a wide range of risk factors of a multidimensional and unstable nature. The COVID-19 pandemic intensified these risk factors associated with homelessness but also prompted the development of prevention and care actions. This study identified and mapped the intervention programmes carried out for people experiencing homelessness in the wake of the COVID-19 pandemic. To achieve the study purpose, a thematic analysis of the scientific literature was conducted following the search strategy and analysis methodology characteristic of informetrics and scientometrics. The sources of information used were WoS, Scopus, PubMed, PsycINFO and ERIC. The paucity of planned actions, most of which have a local impact, reinforces the need to strengthen research that presents robust evidence on this issue. China and Europe are under-represented compared to other types of studies linked to COVID-19 and the prevalence of homelessness. Several clusters are distinguished among the plans: they are carried out in buildings or in geographical areas and according to the impact on the group (preventive, substance-related disorder support, health care and diagnostic). Among the emerging themes, health and social variables are represented, including communication and trust between health, community and homeless groups. The reduction in the thematic dimensionality shows equal planning between health care actions (81.8%) and psychosocial and prevention support (72.8%), an aspect that confirms the importance of joint actions. In this line, among the various clusters of the network analysis, the relationship between hotel, mental health support, substance-related disorder, social intervention and access to permanent housing was found. The studies analysed also highlight social exclusion, stigma, victimisation, living conditions and the risk of contagion among this group. This situation has not gone unnoticed among the studies analysed, which present proposals for the continuation of the projects. Full article