This study aimed to examine the mediating role of illness perception and maladaptive cognitive emotion regulation strategies in the relationship between social support and fear of cancer recurrence (FCR). This multi-center cross-sectional study recruited 857 female breast cancer patients from four tertiary hospitals in Jilin and Shanxi Provinces, China (mean age = 47.18 ± 9.86; within five years after surgery). Participants completed the Social Support Rating Scale, the Brief Illness Perception Questionnaire, the 16-item maladaptive cognitive emotion regulation strategy composite from the Cognitive Emotion Regulation Questionnaire (self-blame, rumination, catastrophizing, and other-blame), and the Fear of Cancer Recurrence Inventory–Short Form. Chain mediation was tested using PROCESS Model 6 with 5,000 bias-corrected bootstrap samples, adjusting for age and relevant clinical covariates. FCR was positively correlated with illness perception and maladaptive cognitive emotion regulation strategies, and negatively correlated with social support. Social support was negatively related to illness perception and maladaptive cognitive emotion regulation strategies. Chain mediation analysis indicated that illness perception and maladaptive cognitive emotion regulation strategies jointly mediated the association between social support and FCR, with a total indirect effect of b = − 0.153 (48.88
This study developed and validated the Virtuous Moral Character Scale (VMCS), a brief instrument grounded in the Aristotelian–Thomistic framework of the cardinal virtues (prudence, justice, fortitude, and temperance). Two studies were conducted with university students (N = 1,044). Exploratory analyses supported a four-factor structure (KMO = .88), with adequate internal consistency across dimensions (ω = .68–.77). Confirmatory bifactor analysis showed excellent model fit (CFI = .999, TLI = .999, RMSEA = .005, SRMR = .029). A general factor accounted for a substantial proportion of the common variance (ECV = .58, PUC = .79), and omega hierarchical indicated that reliable variance in total scores was attributable to the general factor (ωH = .76). Specific factors retained limited reliable variance (ωHS = .25-.36). Associations with honesty, prudence, and grit supported convergent validity. Overall, the VMCS shows promising evidence of internal structure and internal consistency in Argentine university students, supporting its use as a brief, theoretically grounded measure of general moral character pending replication in other samples.
Physician Associates (PAs) are increasingly embedded within UK surgical teams, yet little is known about their psychological safety, occupational wellbeing, risk orientation, exposure to online hostility, or career aspirations. Surgical PAs represent a small specialist subgroup within the wider PA workforce, working in high-acuity, hierarchical environments where role clarity, supervision and team integration are central to safe practice. This study examined the psychological and occupational experiences of PAs working in UK surgical specialties. We conducted an exploratory mixed-methods cross-sectional study of PAs working in UK surgical roles. Participants were recruited through an identified specialist register of 70 surgical PAs held by the College of Medical Associate Professionals. Structured interviews collected demographic, occupational and qualitative data. Psychological safety was assessed using the Neuroception of Psychological Safety Scale, anxiety using the Generalised Anxiety Disorder-7, and risk orientation using the Risk Propensity Scale. Quantitative data were analysed descriptively and through exploratory correlations. Open-ended responses underwent thematic analysis. Fifty PAs completed the study. Participants reported high confidence in supervised perioperative support roles, with 98
Eating disorder symptoms frequently co-occur with mood, obsessive–compulsive, trauma-related, and stress-related psychopathology. Emerging evidence suggests that perceived stress, insomnia, and cognitive–behavioral avoidance may represent transdiagnostic mechanisms contributing to maladaptive eating behaviors. However, their relative contributions across psychiatric diagnostic groups remain poorly understood. This study investigated differences in eating disorder symptoms, avoidance behaviors, insomnia severity, and perceived stress among university students with self-reported Bipolar Disorder (BD), Major Depressive Disorder (MDD), Obsessive–Compulsive Disorder (OCD), Post-Traumatic Stress Disorder (PTSD), and non-clinical comparison group (HCG). In this cross-sectional study, 879 university students were allocated to Bipolar Disorder (BD, n = 114), Major Depressive Disorder (MDD, n = 225), Obsessive–Compulsive Disorder (OCD, n = 184), Post-Traumatic Stress Disorder (PTSD, n = 156) and non-clinical comparison group (HCG, n = 200) groups based on self-reported psychiatric diagnoses obtained through an online self-report questionnaire. Participants completed the Eating Disorder Examination Questionnaire-13 (EDE-Q-13), Cognitive Behavioral Avoidance Scale–Turkish Version (CBAS-TR), Bergen Insomnia Scale (BIS), and Perceived Stress Scale (PSS) during a single time-point assessment conducted between March and May 2026. Sociodemographic and clinical variables including body mass index, psychotherapy history, psychiatric medication use, and sleep duration were additionally evaluated using self-reported survey measures. Group differences were examined using one-way ANOVA, associations were evaluated using Pearson correlation analyses, and diagnostic-group-specific predictors of eating disorder symptoms were investigated using multiple linear regression models. Significant between-group differences were observed across all dimensions of eating disorder psychopathology, cognitive–behavioral avoidance, insomnia severity, and perceived stress (all p < .001). Participants with MDD and PTSD exhibited the highest levels of eating disorder symptoms, whereas HCG group consistently demonstrated the lowest scores. Avoidance behaviors, insomnia severity, and perceived stress were markedly elevated across all psychiatric groups compared with controls. Correlation analyses revealed strong positive associations within theoretically related domains, particularly among eating disorder symptoms, avoidance behaviors, insomnia indicators, and perceived stress dimensions. Multiple regression analyses demonstrated that perceived stress was the only variable independently associated with EDE-Q total scores, and this association was observed exclusively in the BD group (β = .276, p = .005). Neither insomnia severity nor cognitive–behavioral avoidance independently predicted eating disorder symptoms in any diagnostic category. University students with psychiatric diagnoses exhibit substantially greater eating pathology, avoidance tendencies, insomnia symptoms, and perceived stress than HCG group peers. Among the examined psychological factors, perceived stress was independently associated with eating disorder symptom severity only in individuals with BD group. Because of the cross-sectional design, the direction and causal nature of this association cannot be determined. These findings provide limited support for a transdiagnostic interpretation, as the independent association between perceived stress and eating disorder symptom severity was observed exclusively in the BD group. The results therefore suggest a potentially diagnosis-specific role of perceived stress rather than a consistent effect across psychiatric diagnostic groups.
School-based screening can identify adolescents who show elevated attention-deficit/hyperactivity disorder (ADHD) symptom risk and may benefit from further psychological assessment or support. However, screening studies are difficult to interpret when risk classification procedures, informant sources, and analytic workflows are not fully described. This study examined psychological markers associated with high ADHD symptom-risk classification among adolescents in Uzbekistan, an underrepresented Central Asian school context. A cross-sectional school-based study was conducted in three state general education schools in Tashkent, Uzbekistan. The final analytic sample included 1,512 adolescents aged 12–14 years in grades 7–8. ADHD symptom risk was classified using a study-specific multi-informant screening procedure based on adolescent, parent/legal guardian, and teacher forms. The classification was used for research screening only and was not a clinical ADHD diagnosis. Adolescents completed self-report measures of emotional intelligence, self-regulation, coping strategies, and perceived social support. Descriptive statistics, χ² tests, transparent candidate-variable comparisons, and binary logistic regression were used. The primary regression compared adolescents currently classified as high risk with those classified as medium risk. Low ADHD symptom risk was identified in 1,152 adolescents (76.19
Despite the rapid global growth of amateur marathon participation, evidence on the motivational factors that initiate and sustain participation remains fragmented and has yet to be systematically reviewed and synthesized. To synthesize empirical evidence on participation motivation among amateur marathon runners and to examine how motivational patterns vary across runner characteristics, participation contexts, and stages of engagement. This systematic review was conducted in accordance with the PRISMA 2020 statement. Searches of Web of Science, PubMed, Scopus, SPORTDiscus, and the Psychology Behavioral Sciences Collection, supplemented by manual citation searching, identified 415 records. After duplicate removal, title and abstract screening, and full-text eligibility assessment, 16 empirical studies met the inclusion criteria. Sixteen studies of amateur runners aged 18–72 years were included in this review. Most studies were conducted in Europe. Overall, the methodological quality of the included studies was moderate according to the MMAT assessment, with only two studies meeting all appraisal criteria. Four main categories of participation motives emerged and were divided into: health-related motives (n = 16), achievement motives (n = 14), psychological motives (n = 13), and social motives (n = 10). Health motives were consistently the strongest motivations for participation, and achievement, psychological, and social motives varied by gender, age, experience level, and race. Based on the above data, motivations often shift over time, with initial participation commonly driven by health or weight control, and long-term engagement increasingly supported by psychological well-being, habit formation, and social connection. Motivation among amateur marathon runners is multidimensional and appears to evolve across participation stages and life circumstances. Sustained participation depends not only on health and performance goals but also on psychological and social processes that support long-term engagement. To facilitate future research synthesis, subsequent systematic reviews or meta-analyses must focus on four critical pillars: (1) need for higher-quality studies; (2) larger and more diverse samples to capture a broader runner population; (3) standardization of methods and measurements to facilitate cross-study comparability; and (4) examination of understudied variables or populations. Not applicable.
Learning motivation is a pivotal determinant of academic success in second language acquisition. However, prior research on the motivation of international students learning Chinese in China has mainly relied on traditional variable-centered methods, with little attention to a person-centered approach. This study identifies level-based latent profiles of Chinese learning motivation among international students in Zhejiang Province, China, examines learner characteristics as predictors of profile membership, and compares academic self-efficacy and class engagement across the identified profiles. Using latent profile analysis, data from 648 international students were analyzed across six motivation subdimensions. Multinomial logistic regression examined learner characteristics associated with profile membership, while the modified BCH method compared academic self-efficacy and class engagement across profiles. Participants completed validated scales for Chinese learning motivation, academic self-efficacy, and class engagement. Three profiles emerged: moderate-motivation, moderate-high-motivation, and high-motivation. Male students showed lower odds of belonging to the higher distinct motivational profiles in this sample. Academic self-efficacy and class engagement scores were incrementally higher across the moderate-motivation, moderate-high-motivation, and high-motivation profiles. Study duration and proficiency showed no statistically detectable associations with profile membership. The findings demonstrate that Chinese learning motivation in an immersion context coalesces into quantitatively distinct intensity tiers rather than divergent qualitative configurations. Students belonging to higher motivational intensity profiles exhibited systematically higher levels of academic self-efficacy and class engagement. These concurrent profile differences provide baseline empirical evidence for designing differentiated pedagogical support in international Chinese education.
Survival outcomes for childhood cancer in China have improved significantly; nevertheless, long-term psychosocial consequences among childhood cancer survivors (CCSs) remain poorly delineated. A comprehensive synthesis is needed to guide survivorship practice and policy. This scoping review synthesized evidence on psychosocial late outcomes among CCSs in China, outlining outcome domains, study features, geographic distribution, and methodological gaps. Chinese and English databases were searched for studies published between 2015 and October 2025 using terms related to childhood cancer and psychosocial outcomes. Two reviewers independently conducted title/abstract and full-text screening, with disagreements resolved by a third reviewer. Studies involving survivors diagnosed before age 18 were included. Data were extracted using a predefined framework covering study design, population characteristics, cancer type, treatment, and psychosocial outcomes. Thirty-six studies met the inclusion criteria. Most were cross-sectional and geographically concentrated in more developed regions, with small samples and short follow-up periods. Psychological outcomes were most frequently reported, particularly anxiety and depression, followed by cognitive difficulties involving attention, memory, and executive functioning. Across six domains identified in the review—cognitive outcomes, psychological outcomes, social adaptation, post-traumatic stress symptoms, resilience, and fear of cancer recurrence substantial psychosocial challenges were reported. Leukemia was the most frequently studied diagnosis, with chemotherapy the most commonly reported treatment. The evidence was limited by short follow-up, small sample sizes, restricted representation of cancer diagnoses, and underrepresentation of rural populations. CCS in China experience psychosocial challenges extending beyond active treatment across six domains: cognitive outcomes, psychological outcomes, social adaptation, post-traumatic stress symptoms, resilience, and fear of cancer recurrence. These experiences may be influenced by contextual factors, including educational demands, sociocultural expectations, and regional disparities, and should be considered within the broader context of survivors’ developmental stages. However, younger children remain underrepresented in the existing evidence, and the limited availability of age-stratified analyses constrains the ability to draw definitive conclusions regarding developmental variations in psychosocial outcomes. Future research should prioritize longitudinal, multicenter studies incorporating standardized and developmentally appropriate assessment tools, prespecified age-stratified analyses, and broader geographic representation. Such efforts should be complemented by comprehensive, survivor-centered psychosocial care tailored to the evolving developmental and psychosocial needs of CCSs. Novelty and Impact:sfsd First scoping review of psychosocial late effects among Chinese CCSs Anxiety, depression, and cognitive impairment are most frequently reported Evidence is largely cross-sectional and geographically concentrated in developed regions Findings support integrating psychosocial care in pediatric oncology
Bullying and peer mistreatment in health-professions education may undermine psychological safety, wellbeing, and professional learning. This study examined the association between agreeableness and self-reported bullying-related perpetration behaviors among health-professions undergraduates in the United Arab Emirates (UAE). Other Big Five domains and age-band modification of the openness association were secondary or exploratory. This single-institution cross-sectional survey used a non-probability sample of 307 undergraduates from medicine, dentistry, pharmacy, and nursing. The outcome was the mean of the six perpetration-oriented items of the Bullying Prevalence Questionnaire (range 1–4), interpreted as behavior frequency rather than a bullying diagnosis or prevalence estimate. Personality was assessed with the English 44-item Big Five Inventory (BFI-44). Age band, year, and college were modeled categorically. Welch’s analysis of variance was used when variances were unequal. Hierarchical linear regression used HC3 heteroskedasticity-consistent standard errors; bootstrap, Huber M-estimation, and fractional-logit analyses assessed robustness. The mean bullying-related behavior score was 1.56 (SD 0.66); 109 participants (35.5
Teacher well-being is closely connected to teachers’ classroom experiences, yet limited research has examined how perceived student engagement and discrete teacher emotions are associated with the well-being of novice male English teachers. This study therefore investigated the associations among perceived student engagement, teacher enjoyment, anxiety, boredom, and well-being in the context of Chinese senior high school English education. A two-wave time-lagged design was adopted. Using convenience sampling, 339 novice male English teachers from Chinese senior high schools completed measures of perceived student engagement and teacher emotions at Time (1) Four weeks later, they completed a measure of teacher well-being at Time (2) Structural equation modeling (SEM) was used to examine the hypothesized direct and indirect associations. Perceived student engagement was positively associated with subsequent teacher well-being. It was also indirectly associated with well-being through higher teacher enjoyment and lower teacher anxiety and boredom. These findings indicate that teachers who perceived their students as more actively engaged tended to report more positive emotional experiences, fewer negative emotional experiences, and higher well-being four weeks later. The findings extend current understanding of how teachers’ perceptions of student classroom engagement are associated with their emotional experiences and subsequent well-being. Schools may benefit from combining engagement-oriented instructional practices with emotion-focused professional development to support the well-being of novice male English teachers.
Transference is defined as the possibility for the patient to relive, during the psychotherapy process, unconscious impulses and fantasies awakened in the relationship with a person from the patient’s earlier life and it plays an essential role in psychoanalytic treatments. This systematic review aimed to identify and describe the main instruments found in the literature used to assess and measure transference in psychoanalytic psychotherapy, especially with self-reported measures (PROSPERO CRD42024596027). Searches were conducted across the central databases (PubMed/Medline, PsycInfo, Scopus, Scielo, Cochrane, Web of Science, BVS, and Embase) using descriptors such as “Transference,” “Psychotherapy,” “scale,” and “instruments,” along with related terms. No language or publication date restrictions were applied. A total of 1,812 articles were identified, 31 met the inclusion criteria and 12 different instruments were identified: none of the studies were published in Latin America, Oceania and Africa, and only two instruments considered the patients’ perspective. Regarding the two self-report instruments, although one had a more robust statistical analysis regarding the quality of the proposed instrument, neither achieved high levels of psychometric quality across the evaluated criteria. Future research should develop scientifically rigorous tools to better demonstrate the transferential process in psychotherapy.
Although older age is dominantly associated with cognitive complaints or mistakes, such failures are also prevalent but much less studied in the young population. Importantly, they might impact academic or occupational performance, sleep, or general affect and well-being. Therefore, the aim of the present study was to identify variables potentially contributing to cognitive failures in healthy young adults, including objective cognitive performance, sleep, and affective factors. 125 young adults (mean age: 21 years, SD = 2.29) completed a series of self-report questionnaires and performed neurocognitive tasks targeting memory and executive functions. Variables associated with cognitive failures were identified by correlation analysis and hierarchical multiple linear regression. We demonstrated that although the amount of self-reported cognitive failures was not associated with objective cognitive performance, it was significantly related to subjective sleep quality and depression. Our results indicate the importance of examining affective and sleep-related factors in the case of subjective cognitive complaints, as cognitive failures reflect worries about one’s cognitive ability rather than actual cognitive functioning, even at a younger age. Not applicable.
This study examines the influence of brain hemisphere preference on the learning and thinking styles of undergraduate students in the Malappuram district, Kerala, India. The primary aims were to identify students’ hemispheric preference using SOLAT test, assess their learning and thinking styles, and compare these styles across hemispheric preference, and specific components of learning and thinking. A descriptive survey design was employed, involving 400 undergraduates. Data were collected using standardized instrument and analyzed through descriptive statistics (percentages, means, and standard deviations) and inferential statistics (independent-samples t-test, one-Way ANOVA, Welch ANOVA, Tukey HSD and Games-Howell post hoc tests), with appropriate effect-size measures (Cohen’s d, η2 and ω2). Among participants, 248 students exhibited right-hemisphere preference and 144 exhibited left-hemispheric preference. Key findings include that most students in both groups exhibited moderate levels of learning and thinking styles. Students with left-hemispheric preference tended to favour structured, sequential, and verbal learning approaches, while students with right-hemispheric preference tended to exhibit inclination towards interactive, creative, and imaginative learning and thinking styles. The study found no significant difference in overall learning styles between students with left- and right-hemispheric preferences. However, a significant difference was observed in thinking styles, with students with a right-hemispheric preference demonstrating higher scores than those with a left-hemispheric preference, accompanied by a moderate effect size. Notable differences were identified within the components of learning and thinking styles for both hemispheric groups, particularly among students with a right-hemispheric preference, with creativity and imaginative thinking emerging as salient components. Effect sizes ranged from small to moderate, indicating meaningful but non-deterministic hemispheric influences. The study establishes that hemispheric preference exerts a nuanced, component-specific influence, operating alongside integrative and overlapping cognitive processes rather than as a rigid functional divide, unlike prior studies depicting hemispheric preference as a fixed or deterministic predictor of learning and thinking styles. The findings reinforce contemporary perspectives that view hemispheric preference as reflecting relative cognitive tendencies rather than rigid functional divisions. The study underlines adopting balanced and inclusive pedagogical approaches addressing diverse cognitive orientations in higher education.
Undergraduate health science students experience academic, clinical, and social demands that may affect psychological well-being and influence self-care practices, including self-medication. Religiousness and spirituality may be associated with how students experience and interpret psychological distress, although the direction and independence of these associations remain uncertain. This study aimed to estimate the prevalence of self-medication and compare anxiety and depressive symptom scores across undergraduate programs; associations with sociodemographic, academic, clinical, and religious/spiritual variables were treated as secondary, exploratory analyses given the cross-sectional design and non-probabilistic sampling. This cross-sectional analytical observational study, conducted between May and December 2025, included 163 Dentistry, Psychology, and Nursing students from a private higher education institution in Jundiai, Sao Paulo, Brazil. Participants completed a sociodemographic questionnaire, a structured self-medication questionnaire, the Beck Anxiety Inventory (BAI), the Beck Depression Inventory-II (BDI-II), and the Brief Multidimensional Measure of Religiousness/Spirituality. Because one BAI item was structurally absent from the electronic dataset, the 20 administered BAI items were prorated to the conventional 0–63 metric; this limitation is reported explicitly. Multivariable Poisson regression with robust variance estimated adjusted prevalence ratios for self-medication outcomes, and multivariable linear regression with HC3 robust standard errors estimated adjusted coefficients for anxiety and depression. Final complete-case samples were n = 162 for each Poisson model, n = 159 for anxiety, and n = 150 for depression. Linear-model diagnostics included VIFs, residual assessment, leverage, Cook’s distance, and heteroscedasticity testing. The mean age was 30.0 years (SD 11.7; median 27; IQR 20–39; range 18–68; n = 162). Lifetime self-medication was reported by 132 students (81.0
Abstract Background A diagnosis of vestibular schwannoma (VS) confronts patients with complex treatment decisions under conditions of uncertainty. While previous research has focused on treatment outcomes, symptom trajectories, and predictors of treatment choice, less is known about how patients psychologically process the diagnosis and construct meaning before surgery. This study explored how patients experience uncertainty, regain agency, and negotiate responsibility during the preoperative period. Methods We conducted semi-structured interviews with twelve patients who underwent surgical resection of a VS within the previous five years. Interviews explored emotional, cognitive, and relational experiences following diagnosis and during treatment decision-making. Data were analyzed using qualitative content analysis. Results Four interconnected themes described a process of reconstructing certainty and agency after diagnosis: (1) Diagnosis as biographical disruption, as patients experienced VS as a sudden event challenging their sense of normality, identity, and future expectations; (2) Meaning-making as an attempt to regain control, involving information-seeking, peer exchange, and reinterpretation of previous experiences; (3) Healthcare interactions as regulators of uncertainty, with communication quality, empathy, and consistency shaping confidence and emotional stability; and (4) Surgical decision-making as emotional, relational, and moral work, requiring patients to negotiate fear, trust, responsibility, and the burden of irreversible choices. Conclusion The preoperative experience of patients with VS extends beyond symptom burden and treatment selection. Patients engage in complex processes of meaning-making and uncertainty management before deciding on treatment. Patient-centered care should integrate clear information with empathetic communication and support patients in navigating the emotional and moral dimensions of decision-making.
The cultural adaptation of cognitive behavioral therapy (CBT) oriented school-based programs is essential to ensure contextual relevance, ecological validity, and implementation feasibility, particularly in low-resource settings. The feasibility trial of the Super Skills for Life Program (SSL—Children Version) involves its translation and adaptation in the cultural context of Pakistan. The trial also examined the fidelity, acceptability, feasibility and preliminary within-group changes of SSL intervention in reducing anxiety and depressive symptoms and enhancing self-esteem, social skills, and quality of life. The SSL program was translated and culturally adapted using the Planned Adaptation (PA) approach and subsequently evaluated in a mixed-methods feasibility trial. Feasibility, implementation fidelity, and acceptability were assessed using a mixed-methods approach, while preliminary within-group changes were evaluated through pre- and post-intervention assessments of 18 primary school children recruited from a private school system. The findings provided evidence that the intervention was delivered with high implementation fidelity with satisfactory markers of inter-rater reliability (κ = 0.99**). The feasibility outcomes demonstrated acceptability across children, parents, and teachers. The findings also suggested the practical feasibility of conducting a future cluster randomized controlled trial (cRCT), with only minor procedural changes in the methodology of SSL. The preliminary within-group changes indicated a significant reduction in anxiety (t = 5.87, p < .001) and depressive symptoms (t = 4.93, p < .001) at the post-assessment level. Furthermore, the findings provided evidence of improvements in self-esteem (t = 4.04, p < .001), social skills (t = 5.64, p < .001), and quality of life (t = 3.25, p < .001) following the intervention. The culturally adapted SSL program demonstrated high implementation fidelity, high acceptability and feasibility alongside promising preliminary within-group changes for reducing anxiety and depressive symptoms as well as enhancing self-esteem, social skills and quality of life among primary school children in Pakistan. Trial Registration No: Trial is registered at Registry of Efficacy and Effectiveness Studies with ID is 12720.1v1 during the study on 28 May 2022. It has also been registered retrospectively at ClinicalTrials.gov with ID NCT07162402 on 18 august 2025.
Researchers’ observations as academics in higher institutions have shown that the university environment in the Nigerian context has a lot of stressors and such have the potential of impeding the work effectiveness of university staff. In the ideal situation, academics’ target is to discharge their duties diligently, devoid of any limiting factor. However, when the environment is not conducive to achieving such a target, the expected result will be hampered. Studies on the management of stressful conditions abound, but few studies have specifically focused on these academic disciplines in Nigeria. In other words, there is a dearth of research with respect to the effectiveness of REBT on stress management among academics in higher education. Thus, this research explored the effect of rational emotive behaviour therapy (REBT) on stress management among higher education lecturers using a randomized controlled trial group experimental design. A randomised controlled trial evaluation lasted for 12 weeks, and data were analysed using Quade's analysis of covariance test. The study involved 183 eligible volunteers from federal universities in Southeast Nigeria who were conveniently recruited and then randomly allocated to the intervention and non-intervention groups. Out of the 183 participants, 92 were assigned to the REBT group, while 91 were assigned to the non-intervention group. Their perceptions of stress were measured using an adopted perceived stress scale (α = .87). Academics in the fields of Agriculture, Science, and Vocational Education who participated in an 8-week REBT intervention showed significantly lower mean stress scores than those in the non-intervention group, F (1, 181) = 254.215, p < .001, η_p^2 = .584. It is interesting to note that following a 3-month follow-up, the REBT group members were still able to maintain their reduced levels of work-related stress, F (1, 181) = 258.815, p < .001, η_p^2 = .588. Therefore, this finding is indicative of the effectiveness of REBT on the management of work stress among academics in the fields of agriculture, science, and vocational education. For university academics, REBT may be a useful tool for managing work-related stress. Therefore, it is advised that the management of the university in southeast Nigeria make the necessary preparations to guarantee that the REBT intervention is applied to the university's faculty. University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR). Trial Number: UMIN000061069. Date of registration: 12/01/2026 (Retrospectively registered).
Treatment adherence is a critical challenge in managing both physical and mental health conditions. For psychiatric patients, enhancing adherence significantly lowers readmission rates, thereby reducing healthcare costs and improving satisfaction levels among both patients and caregivers. This study aimed to evaluate the impact of a specifically designed discharge program on improving treatment adherence in severely ill psychiatric inpatients at an Iranian teaching psychiatric hospital during 2022. This pre-post case-control study, conducted as a pre- and post-intervention design at the Psychiatric Teaching Hospital in Sanandaj, Iran, involved designing (based on literature review, hospital assessment, and an evidence-based model) and implementing a discharge program. It included adults (≥ 18 years) with schizophrenia, schizoaffective disorder, or bipolar disorder, divided into a control group (n = 133) and an intervention group (n = 136). The control group was sampled in the first quarter of 2022, and the intervention group was sampled in the third quarter of the same year. Participants were followed for six months post-discharge, with outcomes measured including treatment adherence (using the MMAQ-8 via phone at one month), attendance at the first scheduled follow-up visit (dichotomous, via phone at one month), and the number of readmissions (determined via hospital records within six months). Data analysis was performed using Stata version 16, employing independent t-tests, chi-square tests, and Fisher’s exact tests. Following the discharge plan implementation, the intervention group demonstrated significantly higher treatment adherence, a considerably higher rate of attendance at the first scheduled post-discharge visit, and a significantly lower readmission rate within six months compared to the control group (p < 0.001 for all outcomes). Overall, the discharge program—rooted in patient and family education and implemented through collaboration between the treatment team and families—proved highly effective, significantly improving treatment adherence, boosting attendance at the first post-discharge visit, and reducing patient readmissions. IRCT20180114038350N4. Registration date: 2026-08-20.
Camera use in synchronous online teaching determines whether instructors are visually observable, yet experimental evidence on how this visibility affects instructors’ immediate stress and performance remains limited. This study compared perceived stress and expert-rated performance under camera-on and camera-off conditions during online microteaching among teacher-education students. In a parallel-group randomized experiment, 70 participants were randomized to camera-on or camera-off conditions. Sixty-six attended the laboratory session and provided outcome data (camera-on n = 35; camera-off n = 31). Perceived stress was assessed immediately after teaching on a 5-point scale. Three experienced teacher educators rated teaching performance from the recordings using a prespecified rubric. Neuroticism and conscientiousness were examined in exploratory moderation analyses, and primary comparisons were supplemented with covariate-adjusted robustness models. Perceived stress was higher in the camera-on condition than in the camera-off condition (M = 3.40 vs. 2.10, d = 1.67, p < 0.001). Expert-rated performance was also higher in the camera-on condition (M = 90.67 vs. 86.55, d = 1.32, p < 0.001). Covariate-adjusted robustness models yielded similar estimates. Neuroticism showed a small positive association with perceived stress, whereas the exploratory analyses provided no evidence that neuroticism or conscientiousness moderated the camera-condition effects. These findings suggest that the camera-on configuration operates as a double-edged situational cue, yielding higher perceived stress alongside more favorable evaluations. Notably, performance ratings may partly reflect visual information available to raters rather than purely enacted teaching behavior. Future research should examine whether these effects extend to more interactive teaching contexts and diverse participant populations. This study was retrospectively registered at the Chinese Clinical Trial Registry (ChiCTR2600123389) on 26 April 2026. Chinese Clinical Trial Registry, ChiCTR2600123389; registered on 26 April 2026; retrospectively registered.
Emotional and uncontrolled eating are common in obesity and may persist despite pharmacological or surgical treatment. Automatic thoughts and metacognitive beliefs may contribute to maladaptive eating, but have rarely been examined together while accounting for depression, anxiety, and stress. We examined whether metacognitive beliefs were associated with eating behaviors in adults with obesity and whether these associations differed from healthy-weight controls. This cross-sectional study included 67 adults with obesity (body mass index [BMI] ≥ 30 kg/m²) from a psychiatric outpatient clinic and 70 healthy-weight hospital employees (BMI ≤ 25 kg/m²). Current DSM-5 psychiatric disorders were excluded using the Structured Clinical Interview for DSM-5. Participants completed the Three-Factor Eating Questionnaire-21, Automatic Thoughts Questionnaire, Metacognitions Questionnaire-30, and Depression Anxiety Stress Scales-21. Multi-group path analysis assessed direct and indirect associations, adjusting for age and sex. Indirect effects used 5,000 bootstrap samples, and selected coefficients were compared with Wald-type z tests. Because sample size was calculated for the primary group comparison rather than the structural model, path analyses were exploratory. Participants with obesity had higher emotional eating (d = 1.05), uncontrolled eating (d = 1.10), automatic thoughts (d = 0.58), metacognitive beliefs (d = 0.55), and depression, anxiety, and stress scores (d = 0.69–0.96), whereas cognitive restraint did not differ (d = − 0.07). In the obesity group, metacognitive beliefs were associated with emotional eating independently of emotional symptoms (β = 0.46, p = .006); the corresponding association was not statistically significant in controls (β = −0.06, p = .688), and the between-group difference was significant. In controls, automatic thoughts were indirectly associated with uncontrolled eating through anxiety, although indirect effects were not formally compared. The principal finding remained after adjustment for education. Metacognitive beliefs showed a selective association with emotional eating in adults with obesity. Most other associations were non-significant, and the cross-sectional design precludes causal inference. These findings require confirmation in larger longitudinal and interventional studies and do not establish metacognitive beliefs as a causal treatment target or the effectiveness of metacognitive therapy for obesity.
