Mental health research has increasingly moved beyond linear risk models that view adversity as having uniform effects on psychological outcomes, toward identifying protective factors that shape responses to stress. This study examined social support as one such factor in the relationship between perceived stress and PTSD among South African university students. Participants ( n = 491) completed the Perceived Stress Scale, the PTSD Checklist for DSM-5, and the Multidimensional Scale of Perceived Social Support. Moderation analysis found no significant direct effect of social support on PTSD. However, overall support, support from significant others, friends, and family, each moderated the relationship between perceived stress and PTSD. Specifically, the association between perceived stress and PTSD was stronger at low levels of social support and weaker at high levels. These findings highlight the buffering role of perceived social support and suggest that interventions strengthening support from multiple sources may reduce the impact of stress on PTSD symptoms.
Background: Body self-concept is vital to psychological well-being, yet little is known about how women living with obesity in non-Western contexts, particularly Iran, negotiate their bodily identities amidst familial and gendered expectations. Methods: This descriptive phenomenological study explored body self-concept among 48 Iranian women with obesity using purposive maximum-variation sampling, including 24 treatment-seeking and 24 non-treatment participants. Semi-structured interviews were analyzed via Colaizzi’s method, supported by reflexive and validation procedures. Results: Body self-concept emerged as a continuously negotiated, relational, and multilayered process. It is shaped by inner disruptions of the lived body, social visibility, life-course bodilychanges, psychobehavioural dynamics, and intergenerational influences. Participants experienced identity negotiation, self-surveillance, and stigma management within familial and social contexts, often marked by moral judgment and ambivalence toward change. Conclusions: Body self-concept is co-constructed through culturally embedded relational processes. Findings highlight the need for context-sensitive, stigma-reducing, and family-aware approaches in obesity care.
The nature and causes of neuropsychiatric symptoms in children and young people (CYP) with Long Covid are debated in current research. This study explored CYP perceptions of their mental health difficulties in association with Long Covid diagnoses. Nine CYP were interviewed, asking about their experiences of Long Covid and mental health. Data was analysed using Interpretive Phenomenological Analysis. There were two principal findings in this research. (1) Participants related their mental health difficulties to difficulties associated with having Long Covid and wider system pressures. (2) Participants spoke about the impact of stigma in healthcare services delaying access to specialist medical professionals. Findings suggest that healthcare services need to be better informed, and to reduce barriers to access healthcare services. These measures would reduce the pressure on families to fight for services.
Adolescents in low-resource settings hold positive attitudes toward sexual and reproductive health (SRH) services, yet fail to use them. This study presents a theoretical reinterpretation of mixed-methods data (N = 408 adolescents, aged 13–19) from Uganda’s Busoga region, through Festinger’s Cognitive Dissonance Theory. Quantitative findings showed health-seeking attitudes predicted SRH service utilization (β = 0.910, p < .001) and future intentions (β = 1.976, p < .001), but 52% of adolescents had no SRH service contact in past year, and mean uptake scores remained below 2.0 on a 5-point scale. Qualitative analysis of focus group discussions identified three dissonance-reduction strategies: avoidance of health facilities, rationalization through misinformation, and selective information-seeking from peers. The reinterpretation proposes four intervention strategies: barrier reduction, community norm campaigns, cues to action with immediate access, and targeted messaging for working and rural adolescents. Addressing psychological discomfort and structural barriers may help close the attitude-behaviour gap.
Weight stigma during preconception, pregnancy, and postpartum undermines women’s wellbeing and health behaviours, yet little is known about how women protect body image within weight-stigmatising environments. This qualitative study explored how women develop body image resilience in response to weight stigma across reproductive stages. Semi-structured Zoom interviews were conducted with 20 Australian women aged 25-42 years. Deductive content analysis identified sources of weight stigma, while reflexive thematic analysis explored resilience strategies. Women experienced stigma from their own mothers, older adults (including healthcare professionals), social and digital media, and self-stigma. Three resilience themes were generated: strategising self-protection through boundary-setting, asserting autonomy, and cultivating supportive relationships; breaking intergenerational cycles by recognising inherited body criticism and modelling body positivity for children; and embodying self-acceptance through age-related perspective, health prioritisation, and reproductive body appreciation. These findings position the reproductive period as integral to strengthening body image resilience and shaping healthier body attitudes across generations.
Pain is often underreported and undertreated among individuals with mental illness receiving health care services. Few studies have reported on prevalence of pain and pain management within psychiatric settings; this study aims to fill that gap. Secondary analysis of cross-sectional anonymized population-level data from the Ontario Mental Health Reporting System (N = 315,934 unique individuals) was conducted to identify associations between psychiatric diagnoses and recognition of pain management needs while controlling for factors previously linked to pain. Approximately 22% reported pain, yet only 49% had recognized pain management needs. Age under 65, financial trade-offs, heavy drinking, opiate use, self-reported trauma, PTSD, substance use disorder, and cognitive impairment were associated with increased odds of recognition of pain management needs, while admission from an institution or homelessness, repeated psychiatric admissions, substance use, health instability, and several psychiatric diagnoses were associated with decreased odds. These findings highlight the need for systematic recognition of identified pain within psychiatric care.
Background: Physicians in oncology face emotionally demanding conditions that increase psychological distress, but whether this exposure promotes posttraumatic growth (PTG) remains unclear. Objective: To compare distress and PTG among physicians in paediatric and adult oncology and examine their relationship. Methods: In this cross-sectional study, 265 physicians from four groups were assessed using HADS, DASS-21, and PTGI. Group differences were analysed with ANOVA/ANCOVA adjusting for age, experience, and hospital type; correlations were examined with Pearson analysis. Results: Paediatric physicians showed higher DASS-21 stress, anxiety, depression ( p ≤ 0.033). Department was associated with HADS-D ( p = 0.047) but not HADS-A. PTGI scores did not differ across groups ( p > 0.05). Distress measures were strongly correlated (r = 0.67–0.83), whereas associations with PTG were weak and negative (r = −0.10 to −0.15). Conclusion: Paediatric oncology physicians experience greater psychological distress, but this does not translate into higher PTG, suggesting that growth depends on contextual and organisational factors rather than distress severity alone.
Chronic physical illnesses and mental disorders usually do not occur in isolation, but rather within a social context. The course of a disease is influenced not only by medical treatment but also by close relatives, friends, and especially partners, who themselves are affected by illness-related restrictions or care-giver burden. However, to date, the social context is not been adequately considered, with the social component of the biopsychosocial model often receiving only limited attention. With the We-Disease Model (WDM), we promote a systemic/interpersonal view of mental disorders and somatic illnesses with a particular focus on the couple relationship and joint coping efforts. To address processes over time, we propose the Trajectory Model of We-Disease (TMWD) to consider the factors that influence we-disease processes and propose various trajectories over time. Finally, we address the significance of this perspective, which is conceptualized in the term “we-disease”, for health interventions.
To identify factors associated with higher levels of anxiety and poorer quality of life in women with abnormal results in a cervical screening programme. A cross-sectional study was conducted among 140 women aged 25–65 years with abnormal cervical screening results referred to the Cervical Pathology Clinic at Donostia University Hospital between May and November 2022. Anxiety and quality of life were assessed using the State-Trait Anxiety Inventory (STAI) and the Human Papillomavirus-related Quality of Life (HPV-QoL) questionnaire, respectively. Multivariable linear regression models were used to identify factors independently associated with emotional outcomes. Higher state anxiety (STAI-S) was independently associated with greater baseline trait anxiety (STAI-T) ( p < 0.001), a first positive HPV result ( p = 0.05), and low-to-medium educational level ( p = 0.03). Among HPV-positive women, poorer HPV-related quality of life was independently associated with higher baseline trait anxiety ( p = 0.008) and lower educational level ( p = 0.032). Baseline anxiety is the strongest determinant of emotional impact after an abnormal cervical screening result, followed by first-time HPV positivity and lower educational level , highlighting the multifactorial nature of emotional responses in cervical screening.
ObjectivesThe feasibility of a fatigue Cognitive Bias Modification training was evaluated in women on treatment for breast cancer in a multi-center waitlist-control design assessing feasibility criteria, such as recruitment, retention, and completion rates, as well as effects on fatigue bias.MethodsFive hospitals were each asked to recruit 30 patients, who were sequentially divided in active and delayed treatment groups. Fatigue bias and self-reported outcomes (fatigue, vitality, avoidance, and all-or-nothing behavior) were measured in baseline, training, and follow-up phases.ResultsFeasibility results were mixed with recruitment and retention not meeting predetermined criteria, but completion and variability were judged positively. Training effects on fatigue bias compared to control were found.ConclusionsThis study evaluated a promising novel fatigue intervention. Continuation with an RCT is encouraged with recruitment and retention strategies reconsidered.Trial registryThis study's protocol (Geerts, et al., 2024) was preregistered at the Open Science Framework on October 31st, 2023.
The Health-Esteem Model identifies four health-behavior motivational variables that involve thinking about self-determined ideals: health-esteem, goal alignment, goal feasibility, and goal investment. This study provides a psychometric foundation for using this model to understand motivation for exercise. A sample of 401 participants considering or pursuing exercise goals completed an online survey containing a new questionnaire assessing the four Health-Esteem Model variables, along with three measures of exercise and eight existing scales assessing types of personal motivation for exercise. The new scales each produced robust correlations with exercise, explained variance that could not be explained by existing scales, and demonstrated unique associations with scales involving similar types of evaluation. The sales had bell-shaped distributions with high ceilings, adequate test-information curves, and good fit to an expected factor structure. This study provides strong psychometric support for Health-Esteem Model variables which are theoretically important for health intervention research and distinct from existing scales.
Although self-efficacy beliefs are an important predictor of physical activity, the origins of self-efficacy beliefs remain unclear, and a comprehensive joint perspective regarding the sources of self-efficacy is lacking. The present study investigates whether distinct profiles emerge in the sources of self-efficacy regarding physical activity. In a sample of 324 participants, latent profile analysis revealed that a five-profile solution fitted the data best. Significant differences were observed between these profiles concerning self-efficacy and physical activity. Discriminant analysis substantiated the profile assignments. Findings of this study suggest that multiple configurations of self-efficacy sources yield commendable levels of self-efficacy and physical activity. However, elevated levels of negative affect seem to have a detrimental effect on self-efficacy and physical activity, nearly irrespective of the other sources of self-efficacy. Implications of these findings for promoting self-efficacy in a person-centered manner to address the issue of physical inactivity and the concomitant health restrictions are discussed.
Holographic Memory Resolution ® (HMR ® ) is a mind-based intervention without somatic movement used to treat individuals with conditions including depression, anxiety, post-traumatic stress disorder, and chronic pain. No studies on the lived experiences of HMR exist. This phenomenological study explored the perspectives of a subset of participants undergoing HMR in a larger open-label trial for chronic pain, dysphoric memory, and accompanying biopsychosocial symptoms. Eighteen participants were interviewed one-month post-HMR regarding their lived experiences. Thematic analysis revealed HMR facilitated: (1) Awareness of Coping Strategies and personal creation of a safe place, visualization of color, and use of a metaphorical lockbox to store traumatic memories, (2) Reframing of the Memory , (3) Relief and Release of Pain , and (4) Life Integration , which involved getting their voice back and feeling empowered to strengthen connections with others. Findings highlight HMR as an impactful mind-based tool to control chronic pain and provide relief for associated biopsychosocial symptoms.
Living with long-term conditions requires adaptation and coping. It is unclear how young adults - often still in unstable social relationships - and their partners or friends cope with the challenges of a long-term condition. Our study aimed to explore how young adults and their friends or partners arrange themselves with this situation. In a comparative design, we interviewed 24 young adults with differing long-term conditions and 30 of their friends or partners in episodic interviews, which we analyzed with thematic coding. We identified four patterns of dyadic arrangements of coping for both sides: Joint Management and Supportive Arrangement show congruence and cooperation in dealing with the condition. Divergence and Diffusiveness illustrate conflicts and tensions. Our results show the importance romantic partners or close friends can have for dyadic disease management in young adulthood and suggest including friends and partners in training courses on long-term conditions and in professional support.
Background and Objective: Artificial Intelligence (AI) has the potential to influence social behavior and public well-being. This study investigates AI’s role in promoting kindness and identifies ethical strategies to foster empathy, support, and compassionate communities. Materials and Methods: This qualitative content analysis involved purposive sampling of 30 participants, including AI experts, social scientists, religious leaders, developers, and users. Semi-structured interviews were conducted until theoretical saturation was reached. Data were analyzed using Granheim and Lundman’s method. Trustworthiness was ensured using Lincoln and Guba’s criteria: credibility (via member checking), transferability (detailed contextual descriptions), dependability (audit trail), and confirmability (researcher reflexivity and documentation). Results: Five key themes emerged: emotional well-being, social justice, behavioral change, ethical responsibility, and education. AI fosters prosocial behavior, enhances social inclusion, and promotes sustainable relationships. Conclusion: When ethically and thoughtfully applied, AI can support and complement, but not replace, human relationships, particularly in promoting kindness and prosocial behaviors. This approach can strengthen social cohesion, enhance public health, and improve community well-being. Explicitly acknowledging AI’s supportive role reinforces the manuscript’s ethical positioning and conceptual clarity.
Our study aims to understand the barriers and facilitators surrounding continuous glucose monitors (CGMs) in adolescents experiencing diabetes distress from type 1 diabetes through a biopsychosocial lens. We qualitatively analyzed interviews of 21 adolescents and coded their emotional experiences. Findings show that biologically, adolescents noted improved mood with healthier glucose ranges and future health prospects. Psychologically, adolescents preferred a sense of control over when to use, and take a break from, their CGM. Socially, they described mixed feelings surrounding how CGM use impacts relationships with friends, with family, and at school. The biopsychosocial framework captures the complexity and interplay among these factors, highlighting the desire for identity exploration, sense of belonging, and good health as important themes in adolescent diabetes management with a CGM. Clinicians can play a crucial role by bringing a biopsychosocial understanding of the CGM experience into care conversations for adolescents and families to consider.
Background: The Russian-Ukranian war (RUW) broke in 2022. Finland is a neighboring country of Russia. People in Finland could be assumed to be especially vulnerable to war-related stress. We examined the relationship between time spent following the RUW from media, sleep problems and psychological distress in university students. Methods: The participants were university students who responded anonymously to a questionnaire. They reported their age, gender, time spent following RUW, anxiety, depressive symptoms, and sleep problems. Statistical analyses were conducted using SPSS and Mplus for structural equation modeling. Results: The time spent following RUW from media was associated with greater psychological distress, and more sleep disturbances. Sleep disturbances accounted for more than 12% of the association between time spent following RUW and psychological distress. Conclusions: Present findings suggest that sleep problems should be taken into account when supporting students. Support programs should emphasize the importance of sleep in psychological well-being.
In romantic relationships, gratitude promotes positivity, satisfaction and maintenance behaviour. However, little is known about specific domains of and ways of expressing gratitude in long-term relationships, particularly, as studies so far relied on pre-formulated self-report questionnaires that may fail to capture expressions of gratitude beyond direct verbal expressions. The research questions were: How do individuals experience gratitude in their current romantic relationship and how do they describe their partner’s expressions of gratitude? Forty-three older couples were interviewed separately by phone. Interview data were analysed with qualitative content analysis. Overall, a strong sense of gratitude was mentioned for the partner’s personality, the relationship quality, the partner’s support, their joint achievements and the life they have created together. Gratitude was expressed verbally, but also in idiosyncratic ways through love expressions, signs of affection, or gifts. To conclude, gratitude seems to be an integral part of long-term relationships and may be beneficial for healthy aging.
This study aimed to explore the challenges that patients faced when severely ill with COVID-19 and during their rehabilitation journeys following the first wave in Sweden. Eight patients that were treated in an intensive care unit were interviewed using semi-structured interviews. Three themes were generated through thematic analysis: “transition into illness” (with subthemes: underestimated severity, uncertainty and worry); “to be cared for in a hospital setting” (with subthemes: loss of responsibility, loss of memory and time, contradictory feelings of being hospitalized, physical impact as frustrating); and “after care: managing on your own” (with subthemes: appreciation for care, care gaps and insufficient care, compromised ability, mental health, and self-efficacy for self-managed rehabilitation and post-traumatic growth). The findings indicated that the Swedish open strategy may be beneficial in other countries as it facilitated post-traumatic growth and that there should be a structured rehabilitation strategy in place in case of future pandemics.
Epidermolysis bullosa (EB) comprises a group of genetically and clinically heterogeneous disorders characterized by skin fragility and blistering. It is currently incurable, and care is complex because of the rarity of the disease. Epidermolysis bullosa has a major impact on the lives of people living with it and on their families. In this study, we aimed to explore health care professionals’ (HCPs) experiences of treating and following up on children with EB and their families. Nine HCPs from several health care disciplines participated in semi-structured interviews, which were analyzed through reflexive thematic analysis. Two main themes were identified: caring as an act of balance and facilitating collaboration. All participants experienced the following as challenging: (a) balancing between professional decisions and the provision of guidance to parents and (b) dealing with their own emotions. More systematic research is needed on the psychological impact of caring for children with EB and their families on HCPs.
