Search Results (1,304)

Rehabilitation in long-term conditions requires not only clinical capacity but also sustained patient engagement, yet retention is commonly reduced to crude completion metrics. This theory-informed conceptual mini-review used a purposive, non-systematic synthesis of literature identified from the authors’ existing knowledge base, targeted PubMed/MEDLINE searches last updated on 9 August 2026, and backward reference checking; the final article cites 76 sources. Retention is reframed as six related phases comprising referral and eligibility, uptake or initiation, early attendance, ongoing attendance or dose, completion or planned discharge, and post-program maintenance, while time to dropout is treated as a longitudinal metric. Across these phases, disengagement may reflect interactions among clinical severity, symptom interpretation, illness beliefs, distress, motivational climate, therapeutic relationships, social context, and structural access. Four author-generated hypotheses concern psychological flexibility and acceptance, illness coherence and rehabilitation self-efficacy, autonomy-supportive care and therapeutic alliance, and social support and peer belonging. Direct evidence is concentrated in selected rehabilitation settings, whereas several stage-specific and cross-condition pathways remain theoretical extrapolations. Rehabilitation resilience is therefore proposed as a provisional interaction between patient adaptive resources and responsive care systems, not as a validated trait or a synonym for observable retention. Structural barriers may prevent participation directly, and discontinuation may be appropriate when treatment is unsafe, ineffective, burdensome, or inconsistent with informed patient goals. The framework is intended to guide prospective, condition-specific testing rather than imply causal validation or scientific consensus. Full article

High-altitude hypoxia is associated with sleep disruption, affective fluctuation, and changes in cognitive performance, yet prior findings remain markedly heterogeneous in both direction and magnitude. To clarify this variability, this structured narrative review synthesizes evidence from systematic reviews, meta-analyses, and key empirical studies on psychological and cognitive adaptation to high-altitude hypoxia, with a particular focus on personality and related traits. The review is organized along three axes: exposure context and characterization (real-altitude field/residential exposure, hypobaric chambers, normobaric hypoxia, expedition settings, and dose alignment), exposure duration and time course, and outcome domains spanning sleep/fatigue, affective adaptation, and cognitive performance. Across the literature, cognitive effects appear domain-specific and strongly conditioned by exposure dose, temporal stage, and task characteristics, whereas sleep disturbance during the early acclimatization period emerges as one of the more consistent findings and appears closely intertwined with anxiety-related responses. Although direct personality-related evidence remains limited and uneven, the available findings can be organized into a testable trait–process–outcome framework that distinguishes candidate associations with relatively more direct evidence from mechanism-informed hypotheses. Neuroticism/emotional stability and anxiety-related traits have received comparatively more direct empirical investigation than other personality domains, but the available evidence is insufficient to regard them as established predictors of high-altitude adaptation. The roles of conscientiousness, resilience/hardiness, extraversion, agreeableness, and openness remain more tentative and are better treated as targets for prospective testing. We therefore propose that personality-related dispositions may influence adaptation-relevant outcomes through candidate processes involving threat appraisal, coping, resource regulation, and social interaction. We conclude that future research should strengthen exposure dose characterization, specify the boundary conditions for generalizing across real-altitude, hypobaric-chamber, normobaric hypoxia, and expedition settings, and adopt longitudinal, multilevel, and ecologically valid designs to test personality-related pathways more rigorously. Full article

Background: Transitional age youth aged 18–25 years are more likely to engage in risky behaviors, displaying significantly higher alcohol and illicit drug use levels than adolescents and older adults. College students are particularly vulnerable at this critical life juncture as transitioning to adulthood may impact emotional health and well-being, contributing to anxiety, depression, and feelings of hopelessness, all of which are linked to increased risk of substance use and disorders. Objective: This study characterizes the design and status of the MAPme Project, a prospective project centered on substance use and emotional wellness during and beyond college. Herein, we describe the 2018–2024 pilot cohort that was followed during the first two years of college, remotely during the COVID-19 pandemic, and upon the return to campus. We also describe our latest 2025+ cohort with ongoing data collection. Participants: The 2018–2024 cohort comprised 301 college freshmen who completed online assessments at baseline (Wave 1). The 2025+ cohort has currently enrolled 618 students and counting. Methods: We provide descriptive information on both cohorts, along with preliminary associations of pre- and early collegiate substance use outcomes, psychopathology, sleep patterns, and personality traits. Results: Approximately 64% of first-year students reported use of a substance in the 90 days leading up to college in 2018. Alcohol and cannabis were the most prevalent substances used in both cohorts with males consuming more alcohol than females. Females reported greater levels of daily stressors and mood symptoms. Other health and personality characteristics and observed associations between psychosocial risk and protective factors are described. Prior studies demonstrate the ability to test research hypotheses in the social, health, and clinical areas of psychology with robust statistical power. Conclusions: Substance use and emotional well-being vary considerably upon entry into college/university and at any particular moment in time. The MAPme Project encourages the engagement of students to address challenges associated with lack of awareness, inclusivity, and acceptance of scientific research. Overcoming barriers of inclusivity and empowering the community is key to the successful adoption and implementation of campus health and community-oriented research programs and systematically enhancing research training. Full article

Background/Objectives: Ageing populations face complex challenges, yet many older adults maintain well-being despite adversity. Understanding resilience offers critical direction for health promotion. This integrative review takes a conceptual and methodological approach to resilience in older adults, with clear implications for geriatric care. The review addresses: (1) how resilience is conceptualised and measured; (2) individual, social, and contextual factors linked to resilience; and (3) the effectiveness of interventions that aim to promote resilience. Methods: Following Whittemore and Knafl’s framework, a systematic search of six databases (PubMed, CINAHL, MEDLINE, Scopus, Web of Science, and Cochrane CENTRAL; 2016–2025) identified 42 empirical studies across 18 countries of diverse designs. Quality was assessed using the Mixed Methods Appraisal Tool, and thematic analysis identified five convergent themes. Results: Most studies explicitly defined resilience using trait-, process-, or outcome-based frameworks and employed validated instruments, most commonly the CD-RISC. Self-efficacy, spirituality, sense of coherence, and gratitude were consistently associated with resilience. Family relationships, social networks, and community participation were important relational correlates. Health status, education, economic security, and digital literacy were key contextual factors. Six longitudinal studies linked higher resilience to reduced mortality, slower cognitive decline, and attenuated frailty progression. Seven intervention studies, including five randomised controlled trials, supported physical activity, mindfulness, positive thinking training, Tai Chi, and technology-supported exercise as promising intervention modalities, though one web-based programme yielded null findings. Conclusions: Resilience in older adults is a multifaceted and potentially modifiable construct. Growing longitudinal evidence extends its relevance beyond psychological well-being to physical health outcomes, though cross-sectional designs predominate and limit causal inference. Measurement heterogeneity across more than twenty instruments underscores the need for international consensus and culturally valid tools. Larger longitudinal studies and adequately powered trials are needed to guide definitive practice and policy for ageing populations worldwide. Full article

Background: Psychological distress has been frequently reported in individual autoimmune diseases, but evidence regarding shared psychological characteristics across heterogeneous autoimmune conditions remains limited. Objective: This study compared stress vulnerability, exposure to major life events, state and trait anxiety, and Type A behavioral characteristics between adults with autoimmune diseases and controls. Methods: This cross-sectional case–control study included 389 adults: 204 patients with autoimmune diseases and 185 controls. Participants completed the Stress Vulnerability Scale, Holmes–Rahe Life Stress Inventory, State–Trait Anxiety Inventory, and Jenkins Activity Survey. Between-group differences, effect sizes, and correlations among psychometric variables were examined. Results: Patients with autoimmune diseases had significantly higher stress vulnerability scores (Cohen’s d = 0.39) and Holmes–Rahe life-event burden (d = 0.54) than controls. State anxiety (d = 0.52) and trait anxiety (d = 0.68) were also higher (all p < 0.001). Type A behavioral characteristics did not differ significantly between groups. State and trait anxiety showed the strongest correlation (r = 0.755, p < 0.001). Disease duration was positively associated with Holmes–Rahe scores but not with stress vulnerability or anxiety. Conclusions: Adults with autoimmune diseases showed a higher psychological burden across several complementary psychometric dimensions. These findings support consideration of psychological screening within multidisciplinary autoimmune disease care. Longitudinal and disease-specific studies integrating biological, psychological, and social factors are required to clarify temporal and potentially bidirectional relationships. Full article

Background/Objectives: Nurses are frequently exposed to emotionally demanding situations, placing them at risk of adverse psychological outcomes such as secondary traumatic stress (STS) and burnout. Personality traits, particularly perfectionism, may influence these outcomes. Submissive compassion, characterized by caring behavior motivated by a desire for approval or avoidance of rejection, may play an explanatory role in these relationships. Methods: This study examined whether submissive compassion was statistically associated with the relationship between perfectionism and professional quality of life (ProQOL) among hospital nurses, while accounting for potential confounding and moderating factors. A cross-sectional online survey was conducted among ward nurses working in hospitals in Japan. Participants completed measures of perfectionism, submissive compassion, and ProQOL. Data from 218 nurses were analyzed using structural equation modeling. Results: Socially prescribed perfectionism was positively associated with submissive compassion and STS. Submissive compassion was significantly associated with the indirect relationship between socially prescribed perfectionism and STS. Age moderated the association between submissive compassion and STS, with stronger indirect effects observed among older nurses. Additionally, self-oriented perfectionism showed a relationship with stress-related outcomes, whereas socially prescribed perfectionism was associated with burnout. Conclusions: The findings suggest that submissive compassion may contribute to the association between perfectionism and adverse psychological outcomes among nurses. These results underscore the potential importance of maladaptive compassion motives in understanding how perfectionism relates to STS in this population and may help inform interventions aimed at supporting nurses’ psychological well-being. Full article

Background/Objectives: The mental health of university students is a global public health priority. While pathological narcissism is increasingly recognized as a source of significant psychological suffering, its developmental and somatic correlates remain insufficiently explored. This study examines the sociodemographic, familial, and health-related correlates of pathological narcissism and its association with global psychological distress. Methods: A cross-sectional study was conducted with 888 university students (M = 21.3 years; 78.5% female) recruited from three faculties—Humanities and Social Sciences, Civil Engineering, and Medicine. Participants completed the Pathological Narcissism Inventory (PNI), Brief Symptom Inventory (BSI), and sociodemographic, familial, and health-related characteristics, including trauma exposure. Multivariable linear regressions and hierarchical regression analyses were conducted. Results: Pathological narcissism was robustly and positively associated with global psychological distress (r = 0.636, p < 0.001). Multivariable regression models identified chronic fatigue as the strongest somatic correlate of narcissistic pathology, consistent with an ego-depletion account of self-regulatory failure. Additional significant correlates included trauma history, insomnia, and prior use of psychological services. Students from the Faculty of Humanities and Social Sciences reported significantly higher narcissism scores than medical students. Poorer perceived family relationship quality was associated with higher narcissism scores. The full models accounted for 14.4% to 16.9% of the variance in narcissistic dimensions. Conclusions: These cross-sectional findings suggest that pathological narcissism is not merely a personality trait but a clinically relevant construct deeply intertwined with psychological distress and somatic exhaustion. The strong association between narcissism and chronic fatigue points to a substantial physiological cost of sustained self-regulatory effort. Findings highlight the need for integrated screening protocols in university counseling services that account for somatic symptoms (fatigue, insomnia), traumatic experiences, and family dynamics, alongside efforts to destigmatize help-seeking, given that fewer than 1% of students turn to faculty for support. Full article

Intentional deceptive responding under laboratory instructions provides an experimental model for investigating the cognitive mechanisms involved in producing false responses, although it does not fully capture the complexity of real-world deception. Although deception has important implications for social functioning and has been widely studied, identifying reliable indicators that cannot easily be concealed remains a major challenge. In the present study, we investigated frontal EEG activity during intentional instructed deception and examined its association with stress-related and affective traits. The study included 86 healthy adults (M age = 26.97 years, SD = 9.42) who completed standardized self-report measures assessing depression (BDI), anxiety (BAI), perceived stress (PSS), and everyday deceptive behavior (LiES). A subsample of 48 participants subsequently completed a controlled truth–deception task while EEG activity was recorded from frontal scalp electrodes, providing an indirect measure of frontal electrophysiological activity. Absolute spectral power was analyzed across beta, alpha, theta, and delta frequency bands. The findings indicated that anxiety was positively associated with self-reported deceptive behavior, whereas depression and perceived stress were not significantly related to deception tendencies. EEG analyses suggested an increase in right-frontal scalp theta power during instructed deceptive responding, particularly through significant modulation of theta activity in the right hemisphere; however, later multilevel analysis showed it is a rather less specific activation appearing irrespective of the hemisphere. The increase remained significant when relative power was analyzed, indicating that the finding was robust to normalization of spectral power. Together, these findings suggest that instructed deceptive responding was associated with changes in frontal EEG oscillatory activity that are broadly consistent with mechanisms previously linked to executive control and conflict monitoring; however, because recordings were obtained using a low-density consumer EEG device during overt verbal responding, these interpretations should be considered exploratory. In this view, our study investigates habitual deceptive tendencies with affective traits and state-dependent EEG modulation during instructed deception, and our results could contribute to the understanding of emotion–cognition interactions in decisions involving uncertainty, social evaluation, and strategic information control. Full article

Positionality refers to a researcher’s stance within the social context of their research study. It can include information such as gender, race and class, and other characteristics like location. In addition, positionality statements can also include researchers’ personal traits, such as their thoughts, feelings and behaviors. They convey a researcher’s position and are incorporated within research articles to make readers aware of the beliefs and assumptions that a scholar may be bringing into the study. Describing one’s positionality can be particularly beneficial within health professions education (HPE) research, where complex power dynamics often exist between the researcher and participants. However, there is currently limited literature on how positionality statements should be written for HPE research. This paper aims to present an introductory guide on how a novice researcher can write a positionality statement within HPE research, including elements such as reflexivity, location and context, power dynamics, and insider–outsider positioning, as well as the potential risks tied to positionality statements. Additionally, this paper provides readers with a practical step-by-step guide and a real-life example to follow when developing their own positionality statement. By practicing reflexivity and considering how their location and presence impact the research process and participants, a scholar can articulate how their identity and context shape their research approach. Consequently, adding a positionality statement can increase trustworthiness and enhance transparency of a study when they are reflexive, context-specific, ethically constructed and integrated into the research process. Full article

Phishing attacks exploit human vulnerabilities through social engineering techniques; therefore, a multidimensional framework integrating personality and cognition is crucial for tailoring personalized defenses against phishing threats. To prevent phishing attacks, focusing on psychological mechanisms has become the primary approach to address the human-centric nature of these threats. In response, we propose an integrated framework that synthesizes dimensions from the Five-Factor Model (FFM) and the Myers–Briggs Type Indicator (MBTI), grounded in Dual Process Theory to explore the cognitive drivers underlying decision-making under threat. To operationalize this framework, we developed a decision tree classifier to quantify the predictive significance of various personality traits and their hierarchical interactions. The results indicate that the personality types associated with the highest phishing risk profiles are ENFP, ESFP, ESTP, and ENFJ. These hierarchical classification results are projected onto the C.O.R.E. Quadrant (Cognition Orientation Risk Evaluation Quadrant) which enables the systematic representation of risk patterns across all 16 personality types. By providing a structured visualization of personality-driven risk patterns, the C.O.R.E. Quadrant offers a practical foundation for developing personalized defense mechanisms and tailored cybersecurity training strategies, moving beyond one-size-fits-all security protocols. Full article

Research on autistic features and identity development has indicated that autistic traits are positively associated with disturbances in identity development. Characteristic attributes of autism, such as circumscribed interests and differences in social relatedness, align with self-rumination and challenges in navigating the components of identity formation. Nonetheless, research on this topic remains scarce. The present study examined the association between autistic features and identity formation processes in a non-clinical population while accounting for sociocultural factors, specifically social camouflaging and gender conformity. The sample consisted of college students enrolled in a large metropolitan city (N = 427) who completed an anonymous online survey battery. Autistic features were positively associated with both ruminative identity exploration and identity distress. Social camouflaging mediated these relationships, suggesting that the concealment of autistic traits may contribute to maladaptive identity formation rather than autistic traits themselves. Gender conformity further moderated the effect, with higher levels of conformity to traditional gender roles weakening the relationship between autistic features and social camouflaging. These findings signify the relevant role of social camouflaging in the relationship between autistic features and identity disturbances, highlighting the need for interventions and assessments that consider its prevalence and manifestation. Full article

Background: Internet Gaming Disorder has drawn more attention as a public health problem in young adults; however, there are insufficient data regarding problematic gaming behaviour (PGB). This study explored the prevalence and predictors of PGB in students from a Romanian medical university. Methods: We implemented a cross-sectional survey of 243 Romanian and international undergraduate students from the University of Medicine and Pharmacy “Carol Davila” Bucharest. PGB was measured using the Internet Gaming Disorder Scale—Short Form. Personality traits, depressive symptoms, anxiety symptoms, perceived social support and prosocial behaviour were assessed by standardised instruments. Hierarchical multiple regression was used to identify predictors of the IGDS9-SF scores. Results: Based on a cut-off score of 24 on the IGDS9-SF, 10.3% of the participants were classified as having PGB (mean IGDS9-SF = 14.99, SD = 6.03). The final regression model accounted for 28.9% of the variance in IGDS9-SF scores (R² = 0.289, p < 0.001), with gaming-related variables accounting for the largest incremental variance. Higher daily gaming time (β = 0.292, p = 0.001), competitive preferred game type (β = −0.232, p = 0.006), and lower conscientiousness (β = −0.201, p = 0.017) were significant independent predictors. IGDS9-SF scores were greater for competitive games. Perceived social support and prosocial behaviour did not show significant independent associations to PGB. Equally, depressive and anxiety symptoms improved model fit, but were not independent predictors. Conclusions: Among medical students, PGB demonstrates significant associations with gaming engagement and self-regulation, suggesting that screening and preventive approaches targeting these domains may represent relevant strategies for early identification and risk reduction. Full article

Sexual selection theory provides a unifying framework for understanding how cognitive traits, reproductive strategies, and molecular mechanisms coevolve to maximize fitness. Across species, evidence shows that cognitive performance predicts reproductive success through both male–male competition and female mate choice, with individuals displaying superior problem-solving, social dominance, or courtship skills achieving greater mating success. Sexual selection also favors alternative strategies, including sexual mimicry and socially induced sex change, which allow individuals to navigate competitive mating environments and optimize reproductive output. At a mechanistic level, the close evolutionary coupling of cognition and reproduction is reflected in shared cellular, molecular, and genetic architectures between the brain and reproductive tissues, particularly sperm. Conserved genes and pathways involved in signaling, metabolism, epigenetic regulation, and stress responses link neural function to gamete performance across species. We hypothesized that natural selection on cognitive or reproductive traits drives coordinated evolution of shared genetic and molecular pathways between the brain and reproductive tissues, resulting in conserved mechanisms that support both behavioral and fertilization success. To test this hypothesis, we investigated the extent to which the brain and reproductive tissues share conserved genes and molecular pathways, and whether these shared mechanisms provide evidence for coordinated evolution between cognitive and reproductive functions. Full article

Suicidal ideation may fluctuate over short periods, yet cross-sectional or long-interval study designs offer limited insight into day-level variation and same-day associations. This 7-day diary study examined same-day associations among perceived stress, social connectedness, self-disgust, and suicidal ideation in college students, with a particular focus on indirect association patterns involving self-disgust and social connectedness. Sixty-eight Chinese college students were recruited online; 61 provided valid data, yielding 427 daily observations. Multilevel structural equation modeling showed that, at the within-person level, daily perceived stress was associated with higher same-day self-disgust (B = 0.574, SE = 0.065, p < 0.001), which was associated with higher same-day suicidal ideation (B = 0.403, SE = 0.089, p < 0.001). The indirect association through self-disgust was significant (B = 0.232, 95% CI [0.123, 0.341]). Daily perceived stress was also associated with lower same-day social connectedness (B = −0.471, SE = 0.044, p < 0.001), and daily social connectedness was negatively associated with same-day self-disgust (B = −0.503, SE = 0.045, p < 0.001). The serial indirect association was significant (B = 0.081, 95% CI [0.043, 0.118]). These findings highlight a within-person association pattern in which higher daily perceived stress was associated with same-day suicidal ideation in relation to lower social connectedness and higher self-disgust. By contrast, the corresponding indirect associations at the between-person and trait levels were not statistically significant, suggesting that the findings should be interpreted primarily as within-person patterns of same-day associations. Full article

This narrative review critically summarizes the literature on the associations of Type A and Type D personality, together with related personality traits, with cardiovascular disease (CVD) onset, prognosis, cardiac surgery, and rehabilitation outcomes. For the past half a century, there has been a consistent interest in the question of whether or not there is a connection between personality qualities and CVD. At the same time as individuals with a Type A personality who were angry, competitive, and excessively motivated were overrepresented among patients seeking treatment for CVD, it was also noted that these individuals were more likely to acquire coronary artery disease or syndrome. Anger and animosity were among the unfavorable impacts that were found to be connected with worse cardiovascular outcomes, according to the findings of research. After that, a new personality entity was brought into existence, which was referred to as the type D “distressed” personality. This personality type coupled negative affectivity and social inhibition. Type D personality subsequently became a major focus of research, and several studies reported associations with poorer patient-reported health and adverse cardiac outcomes. However, these findings have not been consistently replicated, and the stability, incremental predictive value, and independence of Type D personality from depression, disease severity, and other psychosocial factors remain debated. As a result, there are a number of criticisms that pertain to the current knowledge of the connection between personality construct and the risk of developing cardiovascular diseases as well as the outcome of these diseases. This review provides a critical narrative synthesis of supportive and conflicting evidence and highlights the methodological limitations that currently prevent definitive causal or prognostic conclusions. Full article