Search Results (104)

Background/Objectives: The prevalence of orthorexia nervosa (ON) is increasing over time. Additionally, specific social categories seem to be more affected. In the literature, the prevalence of university students suffering from ON is unclear, ranging from 7% to 83%. Nonetheless, ON shares pathological traits with both eating and obsessive–compulsive disorders, making its etiology and therapeutic perspectives complex. This study aimed to investigate the prevalence of ON and explore its psychological characteristics in a sample of university students. Methods: A total of 205 students from the University of Parma were consecutively recruited using a convenience sampling procedure. Participants completed the Orthorexia Nervosa Questionnaire-15 (ORTO-15) to assess ON, the Eating Disorder Inventory-3 (EDI-3) to investigate eating behavior, the Symptom Checklist-90-Revised (SCL-90-R) to detect psychological symptoms, and the P Stress Questionnaire (PSQ) to describe stress-related lifestyle. Based on the scores obtained on the ORTO-15, a group of orthorexic students (ORTO-15 score ≤ 35) was compared with a group of non-orthorexic students (ORTO-15 score > 35). Results: The prevalence of university students with ON was nearly 42% (specifically, 41.95%). Furthermore, orthorexic students reported significantly higher levels of emotional dysregulation, perfectionism, and asceticism on the EDI-3 as well as affective problems and overcontrol in general. Furthermore, although there were no differences between the groups regarding psychological symptoms, an increase in sense of responsibility, vigor, and hyperactivity, as well as decreased free time on the PSQ, characterized the orthorexic student group. Conclusions: The results support that orthorexia nervosa emerged as a concerning phenomenon among university students, with increasing evidence pointing to its psychological correlates. Nonetheless, the fact that ON shares psychological characteristics with eating disorders highlights the clinical importance of implementing multidimensional assessments and multidisciplinary therapeutic approaches for individuals presenting with orthorexic-type eating behavior disorders. Full article

Medical education is inherently demanding, requiring students to balance intense academic workload, clinical training, and emotional resilience. High levels of stress and burnout among medical students have been associated with decreased empathy, poorer academic performance, and increased risk of mental health problems. This cross-sectional, correlational study examined the relationships between emotional intelligence (EI), perceived stress, and burnout among undergraduate medical students at the Alexandria Faculty of Medicine. Participants completed self-report questionnaires: the Mind Tools Emotional Intelligence Test, the Perceived Stress Scale, and the Maslach Burnout Inventory. Descriptive statistics, bivariate correlations, and multivariate regression models were used for analysis. Among the 264 participants (88% response rate), the majority (73.4%) demonstrated average EI with no statistically significant differences across gender and academic year. Higher perceived stress was strongly correlated with emotional exhaustion and depersonalization, and it was also inversely correlated with personal accomplishment. Regression analysis indicated that gender, academic year, and academic grade were not independent predictors of stress or burnout (R² = 0.054). Approximately 30.3% of the students met the criteria for burnout. These findings highlight the complex interplay between emotional functioning and burnout, and they also suggest that interventions targeting emotional regulation and resilience may be beneficial in reducing stress and promoting well-being among medical students. Full article

Background and Objectives: On 6 February 2023, two catastrophic earthquakes struck southeastern Türkiye, affecting over 13 million individuals and causing widespread destruction. While the physical damage was immediate, the psychological consequences—particularly posttraumatic stress disorder (PTSD) and depression—have proven long-lasting. This study aimed to evaluate the severity and course of PTSD symptoms among survivors and to examine the effectiveness of a telepsychiatry-based mental health intervention in a post-disaster setting. Materials and Methods: This naturalistic, observational study included 153 adult participants from the affected regions who underwent at least two telepsychiatry sessions between the first and sixth month post-disaster. Initial screening was conducted using the General Health Questionnaire (GHQ-12), and individuals scoring ≥ 13 were further assessed with the PTSD Checklist—Civilian Version (PCL-C) and the Beck Depression Inventory (BDI). Follow-up evaluations and pharmacological or psychoeducational interventions were offered as clinically indicated. Results: At the one-month follow-up, 94.4% of participants met the threshold for PTSD symptoms (PCL-C > 22) and 77.6% had severe depressive symptoms (BDI > 30). By the sixth month, PTSD symptoms had significantly decreased (mean PCL-C score reduced from 42.47 ± 12.22 to 33.02 ± 12.23, p < 0.001). Greater symptom reduction was associated with higher educational attainment and perceived social support, while prior trauma predicted poorer outcomes. Depression severity emerged as the strongest predictor of chronic PTSD. Conclusions: This study highlights the psychological burden following the 2023 earthquakes in Türkiye and demonstrates the feasibility and potential effectiveness of telepsychiatry in disaster mental health care. Integrating digital mental health services into disaster response systems may help reach vulnerable populations and improve long-term psychological recovery. Full article

Background: Somatic symptom disorder (SSD) in children may be influenced by stress reactivity and psychosocial factors. The glucocorticoid receptor (GR), encoded by NR3C1, is a key mediator of stress responses. However, the relationship between NR3C1 methylation and SSD remains unclear. Methods: We analyzed NR3C1 exon 1F methylation in cell-free DNA from saliva in 34 children with SSD and 29 age- and sex-matched controls using bisulfite amplicon sequencing. Psychological assessments included the Beck Depression Inventory-II (BDI-II) and KINDL questionnaires to evaluate associations with methylation patterns. Results: Methylation levels showed age-related differences. In children under 13, CpG sites displayed mixed methylation, and specific sites correlated with KINDL and BDI-II scores. KINDL physical and total well-being scores negatively correlated with CpG30 and positively with CpG35; BDI-II scores negatively correlated with CpG32 and CpG35. In children aged 13 or older, CpG sites showed uniformly high methylation with no correlation to psychological measures. The SSD group showed significantly higher average methylation across the exon 1F region than controls in the older age group. These children also had more cases of orthostatic dysregulation and longer illness duration. Conclusions: This study suggests age-dependent epigenetic regulation of NR3C1 in SSD. While younger children showed CpG-specific correlations with psychological symptoms, older children demonstrated uniformly high methylation and potentially reduced gene expression, potentially reflecting cumulative stress, autonomic dysfunction, and internalizing disorders such as anxiety and depression. Full article

The field of emergency medicine (EM) is a high-stress medical specialty. We aim to comparatively investigate burnout, work addiction, and stress-related growth between EM physicians and EM residents. Our sample consists of 117 EM professionals, 41 physicians and 76 residents, from 5 out of the 12 EM county departments in Romania that run residency programs. Methods: An online survey was sent to 461 EM professionals (170 physicians and 291 residents), with a response rate of 25.4%. The survey comprised two sections: the first focused on sociodemographic and professional data, with the second consisting of six validated assessment instruments: the Oldenburg Burnout Inventory, Dutch Work Addiction Scale—short version, Stress-Related Growth Scale, Responsive Distress Scale, Self-Discipline Scale, and Zuckerman–Kuhlman Personality Questionnaire. Both EM physicians and residents reported moderate to high levels of burnout, disengagement, and exhaustion, but there was no significant difference between them. However, physicians exhibited significantly higher levels of work addiction, excessive work, compulsive work, and stress-related growth. No significant differences were found in compulsive work behaviors. Conclusions: Burnout levels are comparable between EM physicians and residents. However, physicians demonstrate higher work addiction but also higher stress-related growth. Personality variables and sleep duration appear to be more influential in predicting burnout than in work addiction or stress-related growth. Full article

The B3 transcription factor superfamily, crucial for plant growth and stress adaptation, remains poorly characterized in cucumber (Cucumis sativus), a globally important vegetable crop. Here, we conducted the first genome-wide identification of 52 B3 superfamily genes in cucumber, classifying them into LAV, ARF, RAV, and REM subfamilies through integrated phylogenetic and structural analyses. These genes exhibited conserved B3 domains with lineage-specific motif architectures and diverse exon–intron organizations, particularly within the structurally divergent REM subfamily. Collinearity analysis revealed segmental duplication as a key driver of family expansion, notably between syntenic REM clusters on chromosomes 2 (CsREM5-7) and 6 (CsREM18-20). Promoter cis-element profiling identified enrichment in hormone-responsive and stress adaptation motifs, suggesting functional diversification in signaling pathways. Furthermore, tissue-specific expression divergence was observed across 10 organs, with ARF members displaying broad regulatory roles and REM genes showing apical meristem enrichment. Strikingly, CsRAV8 exhibited glandular trichome-specific expression, a novel finding, given Arabidopsis RAVs’ lack of trichome-related functions. Spatial validation via in situ hybridization localized CsRAV8 transcripts to trichome glandular head cells. Functional investigation using virus-induced gene silencing (VIGS) demonstrated that CsRAV8 suppression caused significant glandular trichome shriveling, implicating its role in maintaining glandular cavity integrity. This study provides the first comprehensive genomic inventory of B3 transcription factors in cucumber, providing evolutionary insights and functional frameworks for future functional genomics studies. Full article

Background and Objectives: This study aimed to evaluate the efficacy and safety of modified laparoscopic Burch intervention over a 24-month follow-up period. Materials and Methods: We performed a retrospective cohort evaluation including all eligible patients, 83 patients, who underwent modified laparoscopic Burch colposuspension for stress urinary incontinence (SUI). Primary outcomes included the presence or absence of SUI on follow-up and the success of index surgery based on responses to validated questionnaires of patient-reported outcomes. Results: Patient-reported outcomes indicated a progressive improvement in perceived well-being over time. At the 6-month follow-up, 50.6% of participants reported their condition as “greatly improved”, increasing cumulatively to 66.7% by 24 months. The severity of urinary incontinence symptoms was markedly reduced following the intervention. The incidence of severe incontinence was notably low, with only 4.8% of patients affected at 6 months, remaining consistent at 5.1% at 24 months. This finding aligns with a high procedural success rate, as the vast majority of patients (≥94.9%) reported no severe symptoms across all follow-up intervals. Dryness, defined as the absence of urinary leakage, demonstrated an upward trend over time. At 6 months, 45.8% of patients reported complete dryness, with this figure rising to 55.1% at 12 months and 62.8% at 24 months. The Urogenital Distress Inventory-6 (UDI-6) served as a critical metric for evaluating the subjective burden of urinary symptoms. Across all follow-up intervals, over 97% of patients achieved scores below the clinically significant threshold (<33), indicating substantial symptom relief and enhanced quality of life. Conclusions: The modified laparoscopic Burch colposuspension demonstrated consistent efficacy, with significant improvements in urinary continence, symptom severity, and quality of life over the 24-month follow-up period. Full article

Human–animal relationships have long been idealized as universally positive, but recent studies highlight the complexities and contradictions inherent in this bond. This study re-analyzes previously published data to examine the nuanced effects of pet ownership on human well-being, particularly under stressful circumstances such as the COVID-19 pandemic. Using a mixed-methods approach, data from three independent surveys (n = 840) were re-analyzed to explore the bio-psychosocial implications of pet companionship. Key instruments included the Quality of Life Questionnaire (WHOQOL-BREF), Beck Depression Inventory (BDI-II), and Lexington Attachment to Pets Scale (LAPS). Results revealed that pet ownership was significantly associated with higher levels of psychosocial stress, challenging the assumption that pets universally improve quality of life. Notably, individuals with current pet ownership reported lower quality of life compared to non-owners. However, qualitative analyses illustrated perceived emotional and social support among pet owners, reflecting the “pet-effect paradox.” Mental health variables such as depression and loneliness emerged as stronger predictors of well-being than pet attachment. This study introduces the “Aunty Phenomenon” as a conceptual framework to describe the idealization of pet relationships, while acknowledging the responsibilities they entail. These findings underscore the importance of a holistic approach to human–animal bond research. Full article

Incarcerated women report extremely high rates of lifetime sexual violence victimization. Survivors Healing from Abuse: Recovery through Exposure (SHARE) is an exposure-based group therapy specifically designed for incarcerated women survivors of sexual violence. SHARE has been continuously delivered in a women’s prison for more than 12 years. However, like many prisons during the COVID-19 pandemic, the prison ceased all in-person programming between March 2020 and July 2021. In response, the SHARE treatment team pivoted to a hybrid telehealth delivery model (i.e., group participants gathering in a facility group room and therapists joining via video, displayed on a computer screen within the group room). Given the lack of evidence for hybrid telehealth in carceral settings, and specifically for group therapy for sexual trauma, the current study compared ratings on internalizing symptoms (Brief Symptom Inventory-18 or BSI-18), posttraumatic stress symptoms (Posttraumatic Checklist-5 or PCL-5), and group cohesion ratings (Inclusion of Self in Other scale, or IOS) for participants who received SHARE in person (n = 21) or through hybrid telehealth (n = 19). The results demonstrated that participants of in-person and hybrid telehealth SHARE groups reported similar significant reductions in BSI-18 (15.21 in person vs. 16.00 in hybrid telehealth) and PCL-5 (30.78 in person vs. 26.40 in hybrid telehealth) scores pre- to post-treatment and comparable IOS ratings (5.06 in person vs. 5.31 in hybrid telehealth). The findings suggest hybrid telehealth is an effective and feasible treatment modality for meeting the need for trauma-focused therapy in prisons. Future studies examining the effectiveness and implementation of trauma-focused hybrid telehealth groups in prisons are warranted. Full article

Background/Objectives: Excess adiposity, affecting 43% of the global adult population, is a major contributor to cardiometabolic diseases. Lifestyle behaviours, specifically dietary habits, play a key role in weight management. Real-time assessment methods such as Ecological Momentary Assessment (EMA) provide context-rich data that reduce recall bias and offer insights into dietary triggers and lapses. This study examines dietary triggers among adults with excess adiposity in Singapore using EMA, focusing on factors influencing dietary adherence and lapses. Methods: A total of 250 participants with a BMI ≥ 23 kg/m² were recruited to track dietary habits for one week, at least three times a day, using the Eating Behaviour Lapse Inventory Survey Singapore (eBLISS) embedded within the Eating Trigger Response Inhibition Program (eTRIP© V.1) smartphone app. Logistic regression analysis was used to identify predictors of dietary adherence. Results: Of the 4708 responses, 76.4% of the responses were indicative of adherence to dietary plans. Non-adherence was primarily associated with food accessibility and negative emotions (stress, nervousness, and sadness). Factors such as meals prepared by domestic helpers and self-preparation were significantly associated with adherence. Negative emotions and premenstrual syndrome were identified as significant predictors of dietary lapses. Conclusions: EMA offers valuable insights into dietary behaviours by identifying real-time triggers for dietary lapses. Future interventions can utilise technology-driven approaches to predict and prevent lapses, potentially improving adherence and weight management outcomes. Full article

Background/Objectives: This is a cross-sectional study designed to explore the contribution of personality factors (the Alternative Five Factor Model) and lower order characteristics (responsive distress and self-discipline) to burnout, work addiction, and stress-related growth among Romanian prehospital emergency healthcare workers. Methods: A total of 266 prehospital professionals (41 physicians, 74 nurses, and 151 paramedics) participated in the study out of the 728 invited (36.5% response rate). The age of participants ranged between 20 and 57 years and 67.3% were men. The participants completed the Oldenburg Burnout Inventory, the Dutch Work Addiction Scale (the short version), the Stress-Related Growth Scale, the Zuckerman–Kuhlman Personality Inventory, the Responsive Distress Scale, and the Self-Discipline Scale. Results: The results show that burnout was predicted by age, gender, impulsive sensation seeking, responsive distress, and self-discipline; work addiction was predicted by aggression–hostility, sociability, and responsive distress, while stress-related growth was predicted by age, activity, and self-discipline. Additionally, we found that emergency healthcare workers displayed lower impulsive sensation seeking, neuroticism–anxiety, and aggression–hostility, but displayed higher levels of activity and sociability in comparison with the general Romanian population, although these differences must be interpreted with caution as the general Romanian population tend to be significantly younger. Conclusions: This study provides new insights into the role of personality traits as risk factors for burnout and work addiction, and as protective factors for stress-related growth in prehospital emergency personnel. It is also among the few studies in this field to employ the Alternative Five Factor Model of personality. Full article

Background and Objectives: Stress is a significant issue among dental students, with both psychological and physiological impacts affecting their academic performance. This cross-sectional study aimed to explore the relationship between academic stress and salivary biochemical markers, specifically cortisol and total antioxidant capacity (TAC), in third- and fifth-year dental students during the 2022/2023 academic year. Materials and Methods: This study included 44 participants from the Faculty of Dental Medicine at Victor Babes University, Romania. Saliva samples were collected during a low-stress period and prior to exams (high-stress period). Results: Cortisol and TAC levels were measured using ELISA and TAC assays, respectively, decreasing from an average of 3.69 (SD ± 1.49) before stress to 2.86 (SD ± 2.28) during high-stress periods (p < 0.05), while salivary cortisol levels showed a non-significant change from 23.69 (SD ± 35.6) ng/mL to 20.44 (SD ± 23.07) ng/mL; additionally, female participants exhibited a mean STAI score of 91.65 (SD ± 5.13) compared to 91.09 (SD ± 9.41) for males, indicating greater stress responses among females. Conclusions: The State-Trait Anxiety Inventory (STAI) scores confirmed elevated anxiety levels during exams. The findings suggest that academic stress negatively impacts TAC while triggering a moderate increase in salivary cortisol, underlining the need for stress management interventions in dental education. Full article

Background: Hwa-Byung is a culturally bound syndrome prevalent in Korea, characterized by intense emotional distress and physical symptoms related to suppressed anger. Patients frequently report experiencing chest tightness, heat sensations, and globus pharyngeus (the sensation of a lump in the throat). These physical symptoms often accompany psychological distress and can exacerbate the sense of frustration and helplessness associated with the condition. The distinctive presentation of these symptoms highlights the necessity for therapeutic interventions that address both the emotional and physical aspects of Hwa-Byung. Conventional therapeutic methods, such as Emotion-to-Emotion Therapy (ETE), have shown efficacy in treating this condition. This study aims to assess the efficacy of Virtual Reality-based Emotion-to-Emotion Therapy (VR-based ETE) compared to conventional ETE, utilizing immersive digital platforms to enhance therapeutic engagement. Methods: This single-center, randomized, assessor-blind, parallel-group clinical trial will enroll 96 participants, evenly divided into two experimental groups and one control group. Over eight weeks, each participant will undergo 12 intervention sessions. Experimental group 1 will receive conventional ETE, experimental group 2 will receive VR-based ETE, and the control group will receive Hwa-Byung management training materials. The primary outcome will be the change in symptoms, measured by the Likert Scale for Major Symptoms of Hwa-Byung from baseline to 8 weeks. Secondary outcomes will include psychometric scales and physiological measures such as the core seven-emotions inventory short form, physical health questionnaire, stress response index, Beck depression inventory, state-trait anger expression inventory, state-trait anxiety inventory, functional near-infrared spectroscopy, and heart rate variability. For economic efficiency assessment, quality-adjusted life-years will be the primary outcome using the EuroQol-5 dimension, and the secondary outcome will be using the EuroQol visual analog scale. Discussion: ETE is a recognized oriental psychotherapy that enhances symptom management, self-regulation, and stress coping. VR is expected to deepen treatment immersion. By combining these strengths, VR-ETE may further improve emotion regulation and alleviate psychosomatic symptoms. If successful, this study will not only advance the treatment of Hwa-Byung but also contribute to the modernization of traditional Korean medicine through the integration of digital therapies. Full article

(1) Background: Dentistry is innately stressful and demanding. However, the extent of perceived chronic stress and the contributing factors within the dental practice at Primary Health Care Corporation (PHCC) in Qatar are largely unknown. (2) Methods: This study is quantitative, hypothesis-testing, correlational, and cross-sectional, using a simple random sample of all PHCC dentists (168 general dentists and 47 specialist dentists). A cross-sectional survey with electronic consent was performed using demographic and professional information, the Perceived Stress Scale (PSS)-10 to evaluate chronic stress, and the Job Stress Inventory (JSI) to assess job stress factors. (3) Results: The response rate was 49.3%. PHCC dentists demonstrated above-average perceived stress (mean = 18.08, SD = 5.84), with a significant relationship with age (p = 0.01). Overall job stress was average (mean = 2.45, SD = 1.18). All job factors demonstrated a significant and positive correlation with perceived stress (r = 0.472–0.555, p < 0.001). (4) Conclusion: About 70% of the dentists experienced high levels of chronic stress that decreased with age; 65.4% of this stress was attributed to job-related factors, primarily those involving patients (β = 0.341, p < 0.001). This study highlights the impact of health system reforms on stress levels among dental professionals in primary care settings. Full article

The occupational environment may affect one’s psychophysical health by leveraging both external workplace stressors and individual psychological responses. We developed a comprehensive questionnaire to assess occupational stress among postgraduate medical trainees, investigating both situational and personal aspects. Exploratory factor analysis was used to identify the constructs captured by the questionnaire, and reliability was assessed by estimating Cronbach’s alpha. Construct-specific scores were computed, and their correlation with established pre-validated scales (criterion validation) was assessed. Four factors—“stress”, “coping”, “empathy”, and “trauma”—explained 50% of data variability and demonstrated satisfactory overall internal consistency (Cronbach’s alpha = 0.76). Significant correlations were found between the “stress” score and the “emotional exhaustion” component of the Maslach Burnout Inventory (MBI) (r = −0.76), the “coping” score and the “positive attitudes” component of the Coping Orientation to Problems Experienced Inventory (COPE) (r = 0.46), and the “empathy” score with the “empathic concern” (r = 0.52), “fantasy” (r = 0.41), and “perspective taking” (r = 0.45) components of the Interpersonal Reactivity Index (IRI). No significant differences in scores were found in terms of gender or medical specialization. This study suggests that the SCOPE questionnaire may be a promising tool for assessing workplace stress and psychological responses among medical residents. Full article