Background: Student mobility carries mental health and well-being risks, particularly when transition-related needs are hidden by formal student categories. Objective: This short communication examines Moldovan students with Romanian citizenship in Romanian higher education. Legally classified as domestic, they may undergo an international-like adjustment involving linguistic, cultural, academic, and relational transition. Methods: We analyzed semi-structured interviews with 24 such students using reflexive thematic analysis and interpreted them through an integrated lens of belonging uncertainty, minority stress, and transactional stress-coping models within a biopsychosocial framework. Four themes were generated: social stressors and belonging difficulties, including accent-based othering and withdrawal; academic and institutional stressors, including educational culture mismatch and help-seeking barriers; mental and physical health costs, including fear of failure, emotional exhaustion, and somatic symptoms; and mixed coping and support strategies. Results: What distinguishes these accounts from generic student adjustment appears to be their configuration: difference attributed to nationality rather than to socioeconomic or regional background, legal contingency, cross-system educational discontinuity, and the absence of any administrative category through which support might be triggered. Because such students are invisible to provision keyed to international status, screening and belonging-based support should be indexed to adjustment need rather than enrollment category, and directed at institutional conduct as well as individual coping. Conclusion: Hidden student mobility may constitute a distinct adjustment context in which substantial cross-border transition is obscured by domestic administrative status. Recognizing adjustment needs independently of formal enrolment categories may help institutions identify otherwise overlooked students and design more equitable, context-sensitive support.
Contemporary AI-mediated platforms systematically narrow the conditions under which authentic agency can be expressed—a process Commentary terms stage compression, operating at two levels: synchronically, constraining the range of identities available in any given interaction; diachronically, foreclosing the developmental windows within which genuine identity exploration can unfold. Existing health psychology frameworks address downstream symptoms without theorising these structural conditions. This Commentary identifies this gap and sketches Dual Agency Theory for Authentic Being (DAT) as one possible direction: drawing on structuration theory, relational autonomy frameworks, and self-determination theory, DAT proposes that self-directed and other-directed agency are mutually constitutive. Platform success, on this account, should be measured not by engagement metrics but by whether users develop stronger capacities for self-regulation and genuine social connectedness.
Background: Tuberculous empyema surgery combines chronic infectious disease stigma with operative stress, yet conventional perioperative nursing rarely addresses illness identity and self-stigma. Narrative nursing may help reconstruct illness narratives, but evidence remains limited. Objective: To evaluate whether structured narrative nursing from admission through three months post–chest tube removal reduces anxiety and depression compared with routine care. Methods: In this single-center, non-randomized quasi-experimental study (December 2022–December 2023), patients admitted during odd weeks received narrative nursing plus routine care; even-week admissions received routine care alone. The intervention comprised eight structured sessions (30–50 min) integrating narrative therapy with perioperative milestones. Primary outcomes were GAD-7 and PHQ-9 scores at baseline and three months after chest tube removal. Analysis of covariance was adjusted for baseline scores, and an E-value sensitivity analysis assessed unmeasured confounders. Results: Of 96 eligible patients, 92 completed follow-up (46 per group). At three months, the narrative nursing group showed significantly lower mean GAD-7 (4.83 ± 2.11 vs. 7.26 ± 2.58; p < 0.001; d = 1.04) and PHQ-9 (5.37 ± 2.46 vs. 8.04 ± 2.93; p < 0.001; d = 0.99) scores. Moderate-to-severe anxiety (10.87% vs. 30.43%, p = 0.018) and depression (13.04% vs. 34.78%, p = 0.015) were also lower. E-values were 2.8 for GAD-7 and 2.7 for PHQ-9. Conclusion: Structured narrative nursing is associated with substantially lower anxiety and depression three months post–chest tube removal. Despite large effect sizes, the non-randomized, single-center design limits causal inference. Randomized controlled trials with active controls and longer follow-up are warranted.
The problematic use of electronic devices among minors is increasing, and specific withdrawal symptoms mark the addictive nature of this use. This Commentary offers a different perspective on the problem, proposing the smartphone as a third actor in the parent–child relationship: the issue involves not only minors but also their parents—how parents use smartphones, and how they mediate the relationship between children and smartphones. Specific constructs have been theorized to explain how this use interferes with the parent–child relationship. Technoference refers to the continuous, daily interruptions of parent–child interactions caused by smartphone use. The type of parent–child attachment is also important to consider, as children have been found to seek satisfaction of certain needs online when parents do not adequately respond to their requests. Active parental mediation is recommended to regulate children’s smartphone use, favoring shared rules and dialogue over restrictive control. Future research should focus on the role of fathers in the intergenerational transmission of problematic smartphone use.
Background: Although ventricular function usually recovers rapidly after Takotsubo syndrome (TTS), little is known about the early evolution of psychological functioning. Objectives: In this study, we examined longitudinal changes across multiple psychological domains during the first month in patients with TTS, patients with acute myocardial infarction (AMI), and healthy controls (HC). Methods: Eighty-five participants (37 TTS, 23 AMI, and 25 HC) completed psychological assessments during the acute phase and 30 days later. The assessment included symptoms of anxiety and depression, anger, coping strategies, emotion regulation, resilience and worry. Longitudinal changes were evaluated using linear mixed-effects models including fixed effects for group, time, and the group × time interaction, with a random intercept for participants. Results: A significant group × time interaction was observed for anger-in control, with patients with AMI showing a greater increase over time than HC; this interaction remained significant after false discovery rate (FDR) correction for multiple testing. An interaction was also observed for cognitive coping in the primary analysis, but it did not remain significant after FDR correction and was therefore considered exploratory. Conclusion: Most psychological outcomes did not show statistically significant longitudinal changes during the first month after TTS. These findings highlight the importance of incorporating psychological assessment into routine follow-up after TTS.
Background: Globally, 44.9% of college students engage in emotional eating. Burdened by academic and life stress, many overeat as a maladaptive coping mechanism. It triggers gastrointestinal troubles, weight swings, low self-esteem, bad moods, and poor grades, meriting exploration of its mechanisms. Objective: This study aims to investigate the association between physical exercise and emotional eating among college students, while examining the mediating role of mindful eating and the moderating role of childhood socioeconomic status (SES) within this relationship. Methods: A total of 1,130 college students participated in the survey, including 606 males with a mean age of 20.54 years. The survey employed the Physical Activity Rating Scale, the Dutch Eating Behavior Questionnaire, the Mindful Eating Questionnaire, and the Childhood Socioeconomic Status Questionnaire. Results: Physical exercise was significantly negatively correlated with emotional eating among college students. Mindful eating partially mediated the relationship between physical exercise and emotional eating. Childhood SES corresponded to varying correlational strengths linking four of the five mindful eating dimensions to emotional eating, while no such differentiated correlational pattern emerged for disinhibition. Specifically, among college students from high childhood SES backgrounds, awareness and external cues showed stronger positive associations with emotional eating, whereas distraction and emotional response showed stronger negative associations with emotional eating. Conclusion: Physical exercise correlated with reduced emotional eating among college students, partly through mindful eating pathways. Childhood SES moderated the second mediation stage in a dimension-specific manner, amplifying both risk-related and protective links depending on the mindful eating facet.
Background: Depressive symptoms are common among people with diabetes and may impair self-management and quality of life. Objective: This study aimed to develop and externally validate an interpretable machine-learning model for depressive symptom screening in Chinese adults aged 50 years or older with diabetes and translate it into an online assessment tool. Methods: Participants with diabetes from Round 4 of the China Health and Retirement Longitudinal Study (n = 2,187) were randomly divided into training and internal validation/model-selection sets at a 7:3 ratio. An independent cohort from Xijing Hospital (n = 695) was reserved for external validation. Depressive symptoms were defined as a Center for Epidemiologic Studies Depression Scale-10 (CESD-10) score of 10 or higher. Least absolute shrinkage and selection operator regression was used for feature selection; nine machine-learning algorithms were compared in the development data, and SHapley Additive exPlanations analysis interpreted the final Extreme Gradient Boosting (XGBoost) model. Results: Sixteen predictors were retained. XGBoost achieved areas under the curve of 0.822, 0.832, and 0.812 in the training, internal validation, and external validation sets, respectively. Major contributors included sleep duration, self-perceived health status, cognitive function, activities of daily living, instrumental activities of daily living, and life satisfaction. An online assessment tool was developed. Conclusions: The XGBoost model showed consistent discrimination but non-ideal calibration and may support concurrent preliminary classification and triage of depressive symptoms in Chinese adults aged 50 years or older with diabetes. The calculator is not diagnostic, should not replace CESD-10 administration or professional assessment when clinically indicated, and requires recalibration and prospective multicenter validation before broader clinical use.
Background: Childbirth is a major transition for both parents. However, few studies have examined the pairwise role of family function in both parents simultaneously. Objective: This study aimed to explore the interconnected effects of family function on maternal perinatal depressive symptoms (MPDS) and paternal perinatal depressive symptoms (PPDS) from the perspectives of both parents. Methods: The cross-sectional study was conducted in a large tertiary hospital. The Edinburgh Postnatal Depression Scale (EPDS) was applied for MPDS and PPDS screening, and the APGAR scale was adopted to evaluate family function. The actor and partner effects of maternal and paternal family function on the risk of MPDS and PPDS were examined using the Actor-Partner Interdependence Model (APIM). Multivariate logistic regression was additionally performed to explore the associations between family function and parental perinatal depressive symptoms. Results: In total, 715 couples were included in this study, and the prevalence of MPDS and PPDS were 24.90% and 14.55%, respectively. Significant actor effects were observed for both mothers (β=0.11, p=0.03) and fathers (β=0.19, p<0.001), and partner effects of maternal family function significantly predicted PPDS (β=0.10, p=0.048). Elevated risk of parental perinatal depressive symptoms was associated with poor or fair maternal family function (OR=2.41, 95% CI: 1.16–4.99) and paternal family function (OR=2.59, 95% CI: 1.41–4.77). Conclusion: The high prevalence rates of MPDS and PPDS underscore the importance of parental depressive symptoms screening. Intervention strategies targeted at family function should be adopted for the management of MPDS and PPDS.
Background: Fertility can be conceptualized as a population-level health outcome. Globally, total fertility rates (TFRs) have persistently fallen below replacement level, signaling a profound transformation in reproductive health behaviors with far-reaching implications for population health and societal well-being. Although economic development, educational expansion, gender equality, and demographic transition are well-established drivers of fertility decline, the role of internet diffusion as a contextual, health-relevant exposure remains insufficiently examined. Objective: Addressing this gap, the present study investigates whether national levels of internet diffusion are associated with TFRs beyond demographic, economic, and gender-related determinants. Methods: Using three publicly available cross-national datasets, we conducted hierarchical regression analyses across 71 nations to examine the association between TFR and internet diffusion, followed by subgroup analyses stratified by development status. Results: Internet diffusion was a significant cross-national correlate of lower TFRs after controlling for economic development, population characteristics, and gender equality indicators. Subgroup analyses revealed a significant negative association between internet diffusion and fertility rates in developing nations, whereas the internet–fertility association was positive but not statistically significant in developed nations. Conclusion: These findings extend fertility research by identifying internet diffusion as a salient macro-level correlate of reproductive outcomes. More broadly, the study adds a digital dimension to current fertility and reproductive health research, which has typically emphasized economic, demographic, and policy determinants over digital environments. Policies and public health research aimed at promoting reproductive well-being in the digital era should explicitly consider the influence of digital environments on reproductive decision-making.
Background: Burnout, anxiety, depression, insomnia, and impaired mentalizing are common among mental health trainees, potentially impacting well-being and quality of care. Mindfulness-based interventions have shown promise in mitigating these issues. Incorporating such programs into postgraduate training may offer proactive support during a critical developmental stage. Objective: This study primarily aimed to assess the feasibility and acceptability of implementing a mindfulness-based stress reduction (MBSR) program among psychiatry and child neuropsychiatry residents. Secondary exploratory aims included assessing preliminary changes in burnout, anxiety, depression, insomnia, and mentalizing outcomes. Methods: This single-center, non-randomized controlled pilot feasibility study included psychiatry and child neuropsychiatry residents. Participation in the intervention group was based on willingness to attend an MBSR program alongside standard institutional support services. A comparison group was identified among residents from the same departments who received standard support only. Feasibility outcomes included recruitment, retention, adherence, and participant satisfaction. Validated scales assessed burnout, anxiety, depression, insomnia, and mentalizing before and after intervention. Results: Thirty-nine participants were included in the final analysis (19 in the intervention group; 20 in the control group). Feasibility outcomes indicated good acceptability and participant satisfaction. Exploratory analyses showed a modest reduction in emotional exhaustion in the intervention group compared to controls (p = 0.0487), while no significant between-group differences emerged for other outcomes. Conclusion: This pilot study supports the feasibility and acceptability of implementing an MBSR program among mental health trainees. Exploratory findings suggest possible effects on emotional exhaustion, although results should be interpreted cautiously. Larger controlled studies are needed to assess clinical effectiveness.
Background: Joint dialogue emotion classification and act recognition aim to simultaneously predict emotional and behavioral labels for each utterance. While existing models leverage discourse context, they largely overlook individual differences in sequential expression patterns. Objective: This paper proposes a personalized model integrating personality for joint dialogue emotion classification and act recognition (PEDR-GAT) to incorporate personality traits into both local semantics and global temporal reasoning, thereby bridging inference gaps caused by neglected individual differences. Methods: First, personality information and label distributions were used to initialize utterance representations, strengthening the association between personality-guided semantics and task labels. Second, graph attention mechanisms extracted global temporal dependencies across utterances and captured cross-task interactions. Finally, a co-attention mechanism integrated personality-guided local and global features to maintain long-term dependencies and supplement short-term contextual information. Results: Experiments on Mastodon, DailyDialog, and CPED datasets show that PEDR-GAT outperforms baselines, achieving F1 improvements of 2.0%/0.6%, 2.3%/1.9%, and 5.3%/2.3% for emotion/act recognition, respectively. Personality-guided semantic label acquisition enhances semantics-label associations, and personality-fused graph attention effectively captures latent temporal patterns, demonstrating the value of incorporating individual differences into joint dialogue modeling. Conclusion: PEDR-GAT effectively integrates personality traits into joint dialogue emotion and act recognition, demonstrating that modeling individual differences significantly enhances performance across multiple datasets.
Background: The burden of chronic pain is high among older adults and is associated with a reduction in health-related quality of life (HRQOL). Pain catastrophizing is a key psychological factor that exacerbates pain-related distress; however, the role of the meaning in life (MIL) in this relationship remains unclear. Objective: This study aimed to examine whether the MIL, a key construct in positive psychology, moderates the relationship between pain catastrophizing and HRQOL among older individuals living with chronic pain. Methods: A cross-sectional online survey was conducted targeting adults aged ≥ 65 years with chronic pain. Of the 400 respondents, 349 (177 women, 172 men) met the inclusion criteria and were included in the analysis. The study used standardized instruments: the catastrophizing scale, the Meaning of Life Questionnaire, pain intensity assessments, and HRQOL measures. Correlation analysis and multiple regression were performed, with statistical significance set at p < 0.05. Results: MIL was identified as a moderator of the relationship between mental quality of life (QOL) and magnification (β = 0.130*). Specifically, higher levels of MIL attenuated the negative association between magnification and mental QOL. In contrast, no such moderating effect was observed for physical QOL. Conclusion: The MIL may serve as a psychological resource that buffers the adverse impact of maladaptive pain-related cognitions on mental QOL in older adults with chronic pain. Interventions aimed at enhancing the MIL may help improve psychological well-being in this population.
Background: Climate change is one of the most pressing global challenges of the 21st century. Climate-related information is widely disseminated through mass media, particularly social media. Exposure to such content can elicit emotional responses and contribute to climate-change–related psychological states, including eco-worry. Objective: This study aims to investigate exposure to climate-change–related information among Italian emerging adults, focusing on information sources, related emotional responses, and the moderating role of problem-focused, de-emphasizing/avoidant, and meaning-focused coping strategies in the relationship between media exposure and eco-worry. Methods: A total of 642 Italian emerging adults aged 18–30 years (mean = 22.84, standard deviation = 3.06; 62.1% female) completed self-report measures assessing exposure to climate-change–related information, information sources, emotional reactions, eco-worry, and coping strategies. Moderation analyses were conducted to evaluate the protective and risk roles of different coping strategies. Results: Exposure to climate-change–related information predominantly elicited negative emotions, particularly anger, guilt, and helplessness, whereas positive emotions were less frequent. Participants generally perceived climate change information as broad and generic, with social media emerging as the primary information source. Compared with traditional media, social media exposure was associated with higher levels of eco-worry and negative affect. Problem-focused and meaning-focused coping strategies attenuated the relationship between information exposure and eco-worry, whereas de-emphasizing and avoidant coping strategies strengthened this association. Conclusion: The findings highlight the role of media exposure in shaping the psychological impact of climate change in the Italian context. They also provide support for interventions promoting adaptive coping strategies and suggest directions for future research.
Background: Social exclusion is a common experience among adolescents, particularly in vocational education settings, and has been linked to various behavioral problems. However, the mechanisms underlying the relationship between social exclusion and internet addiction remain underexplored. Objective: This study investigates the impact of social exclusion on internet addiction among Chinese secondary vocational school students and examines the mediating role of resilience in this relationship. Methods: A total of 1,128 Chinese secondary vocational school students were surveyed using the Social Exclusion Scale, the Resilience Scale for Adolescents, and the Internet Addiction Test. Results: Social exclusion was significantly negatively correlated with resilience (r = –0.608, p < 0.001) and significantly positively correlated with internet addiction (r = 0.468, p < 0.001). Resilience was significantly negatively correlated with internet addiction (r = –0.640, p < 0.001). Resilience partially mediated the relationship between social exclusion and internet addiction (indirect effect = 0.547, accounting for 72.4% of the total effect). Conclusion: Social exclusion increases the risk of internet addiction by eroding psychological resilience.
Background: The high prevalence of depression among adolescents has become a significant public health concern, with relapse rates remaining high even after treatment. While family function is consistently linked to depression, the cross-sectional statistical associations linking family-level contextual factors to individual clinical outcomes remain incompletely characterized. Objective: We aimed to examine the cross-sectional associations of resilience and positive coping within the relationship between family function and depressive symptoms among adolescents with depressive disorder. Methods: A total of 200 adolescents with depressive disorder were recruited from Tianjin Anding Hospital. After screening, 145 valid questionnaires were included for final analysis. Trained investigators administered four widely used standardized scales to measure family function, individual resilience, coping style, and depression. The bootstrap approach was utilized to conduct mediation analysis. Results: The mean BDI-II score was 36.02 (SD = 14.02). Family function was negatively associated with the severity of depression (β = −0.570, p < 0.001). Meanwhile, it also exhibited statistical correlational linkage with depression via the serial associational chain of resilience and positive coping (β = −0.701, p < 0.001). Conclusion: Resilience and positive coping were significant statistical mediators in the cross-sectional association between family function and depression.
Background: Clinically significant depressive symptoms and self-reported mental health-related conditions are increasing among older adults in China. Although socioeconomic status (SES) is an important upstream determinant, nationally representative evidence on its longitudinal association with mental health-related outcomes and related behavioral pathways remains limited. Objective: To examine the longitudinal association between socioeconomic status and incident mental health-related outcomes among older Chinese adults, and to assess whether social participation and sleep duration partly explain this association. Methods: Using data from the China Health and Retirement Longitudinal Study (CHARLS, 2011–2018), this study included 5,465 adults without baseline depressive symptoms or self-reported mental health-related conditions. SES was derived from latent class analysis of household income, educational attainment, and employment status, rather than from employment status alone. Incident mental health-related outcomes were identified during follow-up using Center for Epidemiologic Studies Depression Scale-10 screening results and self-reported physician diagnosis. Cox proportional hazards models, subgroup analyses, and pathway analyses were conducted. Results: Compared with the high-SES class, low SES was associated with a higher risk of incident mental health-related outcomes in the fully adjusted model (hazard ratio: 1.40, 95% confidence interval: 1.15–1.69), with a stronger association among women, while residence- and body mass index-specific patterns were interpreted cautiously. Social activity accounted for 6.1% of the SES–outcome association, whereas sleep duration showed a small suppressor effect (−2.6%). Conclusion: These findings suggest that socioeconomic disadvantage is associated with elevated mental health-related risk in later life, partly through reduced social participation. The role of sleep requires further investigation using more detailed sleep measures.
Background: Nicotine product packaging conveys both branding and health information, yet marketing elements may visually compete with warning labels and weaken risk communication, particularly for novel nicotine products. Objective: This study aims to assess how visual attention is distributed across key packaging features of conventional cigarettes, heated tobacco, e-cigarettes, and nicotine pouches among young adult nicotine users. Methods: We conducted an experimental eye-tracking study with 45 Czech university students, all of whom had used nicotine products in the previous two weeks. Participants physically handled and inspected the packaging of four product types: conventional cigarettes, heated tobacco, e-cigarettes, and nicotine pouches. Visual attention was analyzed across five predefined areas of interest, including warning labels, branding, and product composition. Two eye-tracking indicators were assessed: fixation duration and dwell time within each area of interest. Repeated-measures analysis of variance and post hoc tests were used to determine statistically significant differences both within and across product types. Results: Branding and product composition consistently received more attention than warning labels or general text. Warning labels attracted the most attention, only for conventional cigarettes. In cross-product comparisons, branding was significantly more engaging for e-cigarettes and nicotine pouches, while attention to health warnings remained low. Fixation data supported these trends, suggesting more intensive processing of branding than of health-related information. Conclusion: Warning labels on conventional cigarettes attracted substantially more visual attention than those on novel nicotine products, where branding and composition dominated instead. This suggests that current packaging requirements for e-cigarettes, heated tobacco, and nicotine pouches may not achieve comparable warning salience. Extending established cigarette packaging standards to these categories, alongside clearer communication of relative product risk, could improve consumer engagement with health information.
Nomophobia is an emerging phenomenon with potential effects on mental health and professional performance. In the healthcare field, smartphone use is frequent for both personal and work-related reasons; however, the evidence regarding its prevalence and associated factors is heterogeneous, making it difficult to draw integrated conclusions. This study explores the prevalence of nomophobia and analyzes its relationship with sociodemographic, psychological, and occupational variables among healthcare professionals through a systematic review and meta-analysis. A systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, with the protocol registered with PROSPERO (CRD420261329317). A search was conducted in Web of Science, Scopus, and ProQuest without time restrictions for quantitative observational studies involving healthcare professionals that assessed nomophobia using validated instruments. Data were extracted on sociodemographic characteristics, prevalence, severity, and psychological and occupational associations. A correlational meta-analysis was performed using a random-effects model. Eighteen published studies were included, with sample sizes ranging from 112 to 1,083 participants, mainly nursing professionals. The prevalence of nomophobia was high, generally at mild-to-moderate levels. It was consistently associated with younger age and less professional experience, and showed positive associations with stress, anxiety, fear of missing out, and neuroticism, and negative associations with mindfulness, self-efficacy, well-being, and clinical decision-making. Evidence regarding occupational variables was limited. The meta-analyses indicated a significant association with occupational stress, a negative association with decision-making, and a positive association with well-being. Nomophobia is common among healthcare professionals and is mainly associated with psychological variables relevant to well-being and clinical performance.
Background: Social support has been widely recognized as a psychosocial resource associated with reduced aggressive behavior in adolescence; however, the psychological processes underlying this association remain unclear. Objective: Guided by the general aggression model, this study examines whether control beliefs and self-control are associated with and may mediate the relationship between perceived social support and aggressive behavior among Chinese adolescents. Methods: A cross-sectional survey was conducted with 491 secondary school students in China. Participants completed validated self-report measures of perceived social support, control beliefs, self-control, and aggressive behavior. Pearson correlations and serial mediation analyses were performed, controlling for age and gender. Perceived social support was associated negatively with aggressive behavior. Results: Self-control was found to be a significant mediator of this association. In addition, a sequential association was observed: greater social support was linked to stronger control beliefs, which in turn were associated with greater self-control and less aggressive behavior. The indirect effect of control beliefs alone was not statistically significant. Conclusion: The findings suggest that social support is associated with lower levels of aggressive behavior, partly through control beliefs processes and a self-control pathway. By clarifying how a modifiable psychosocial resource is linked to adolescent behavioral health through interconnected internal processes, this study provides evidence relevant to promoting adolescent behavioral health and early prevention.relevant to promoting adolescent behavioral health and early prevention.
