Background: In psychotherapy, the mirroring of nonverbal behaviour (mimicry) has been linked to more favourable patient evaluations of the therapeutic relationship. Because video recordings are commonly used in clinical supervision, it is important to understand how nonverbal mimicry is perceived by third-party observers. Across two experiments, we investigated the accuracy of mimicry perception and examined associations with observer characteristics (emotional competence and mindfulness) as well as task instructions. Method: In Experiment 1, 132 participants (70% female; mean age = 30.12 years, SD = 11.92; 80% psychology students) were randomly assigned to view a video of a patient-therapist interaction that either included 10 instances of movement mimicry or a digitally edited version in which these instances were removed. Participants were instructed to watch the video attentively but were not informed about the presence of mimicry. In Experiment 2, 94 participants (56% female; mean age = 24.97 years, SD =7.64; 80% psychology students) viewed the mimicry video with explicit instructions to attend to nonverbal behaviour. Results: Experiment 1 indicated that the presence of mimicry did not affect observers' ratings of the working alliance. The number of perceived instances ofmimicry varied substantially across participants and was positively associated with self-reported emotion regulation abilities. Observers underestimated the number of mimicry instances in the mimicry video. In Experiment 2, participants slightly overestimated mimicry. In this experiment, perceived mimicry frequency was positively correlated with working alliance ratings. Conclusion: These findings highlight the importance of both observer characteristics and task instructions in the assessment of nonverbal mimicry in psychotherapy contexts. However, the observed effects were small and based on a specific instance of mimicry within a single dyad evaluated by psychology students. Future research should seek to replicate these findings using a broader range of interaction dyads (e.g., patients with different mental disorders), as well as evaluators with varying levels of expertise and professional backgrounds (e.g., psychotherapists).
Introduction: Alexithymia, characterized by difficulties in identifying and describing feelings and externally oriented thinking, is conceptualized as a multidimensional construct of personal functioning and a transdiagnostic construct. There is a paucity of research on the link between cultural context, alexithymia, and health. Most studies were conducted in Western individualistic countries. The scientific community generally considers that a more Eastern and/or more collectivist cultural orientation (interdependence) explains higher levels of alexithymia. More specifically, higher interdependent self-construal has been associated with higher alexithymia, while higher independent self-construal has been associated with lower alexithymia. No study has investigated this topic in the Italian context or assessed individual cultural orientation distinguishing horizontal-vertical individualism-collectivism. This preliminary study aimed to fill this gap by exploring the relationship between alexithymia and individual cultural orientation in an Italian community sample. Moreover, anxious and depressive symptoms, psychological well-being, and quality of life were taken into account. Methods: Participants (N = 80) were recruited from a region in southern Italy, with ages ranging from 18 to 79 years (M = 42.82; SD = 17.18). Participants completed the Toronto Alexithymia Scale (TAS-20), the Horizontal-Vertical Individualism-Collectivism Scale (INDCOL), and measures of emotional distress (depression [EDD] and anxiety [EDA]), psychological well-being (PWB), and quality of life (WHOQOL-BRIEF). Results: No significant sex differences emerged for any measured variables. All alexithymia dimensions showed positive associations with anxious and depressive symptoms and negative associations with psychological well-being and quality of life. Contrary to findings in individualist cultures, no associations emerged between alexithymia and individualist orientation. Moreover, negative correlations were found between collectivist orientation (horizontal and vertical) and alexithymic traits, particularly difficulty identifying feelings. Conclusion: Findings suggest the relationship between cultural orientation and alexithymia might depend on person-environment fit, whereby alignment between individual orientation and cultural values might promote emotional awareness. Given southern Italy's collectivistic culture, results support the "person-environment fit" and "personality-culture clash" concepts, highlighting the need to distinguish cultural and individual levels when examining cultural influences on emotional functioning. Limitations include cross-sectional design, small sample size, and gender imbalance. Future research should employ larger, gender-balanced, cross-cultural samples.
Background: Neurodiverse students face significant challenges in higher education, where institutional structures often reflect predominantly neurotypical norms. Based on Self-Determination Theory (SDT) and Minority Stress Theory (MST), this study aimed to explore how neurodiverse students experience and negotiate their basic psychological needs in an Italian university context, identifying barriers, resources, and protective factors. Methodology: Eight neurodiverse students (six with autism spectrum disorder and two with attention-deficit/hyperactivity disorder) enrolled in an Italian university participated in semi-structured interviews. Data was analyzed using reflexive thematic analysis, guided by SDT and MST as interpretive frameworks. Results: Four main themes emerged: (1) Negotiated autonomy, reflecting how students co-construct agency within institutional and relational constraints; (2) Competence in tension, highlighting how efficacy depends on recognition and dialogical feedback rather than individual ability alone; (3) Relatedness between invisibility and recognition, describing the oscillation between concealment, exclusion, and authentic connection; and (4) Health and adverse pathways, illustrating how relational misattunement generates distress, while self-acceptance and advocacy foster resilience. Across themes, participants emphasized that both structural barriers and interpersonal dynamics shape their experience of inclusion. Discussion: Findings suggest that well-being and distress among neurodiverse students are shaped by the relational negotiation between individual agency and institutional environments. Unmet needs and minority stress appear to intersect in generating emotional strain, while recognition, pride, and advocacy may support processes of resilience. The findings point to the potential value of a more systemic approach in higher education, moving beyond accommodation-based models toward universal design practices that may support autonomy, competence, and relatedness.
Background: Fibromyalgia is associated with chronic pain, affective burden, and limited response to pharmacological treatment alone; emerging evidence suggests psychological interventions, including Eye Movement Desensitization and Reprocessing, may be beneficial. Chronic pain associated with fibromyalgia represents a complex clinical challenge due to its multifaceted symptomatology and its substantial impact on quality of life. This study evaluated the effect of Eye Movement Desensitization and Reprocessing therapy combined with a multimodal treatment, compared to an active control group, on pain perception, anxiety and depressive symptoms, and quality of life in adults aged 18 to 65 years diagnosed with fibromyalgia. Methods: An experimental pretest-posttest design with an active control group was implemented, comprising 33 randomized participants, with a final analytic sample of 28 participants. Results: The findings revealed significant reductions in pain perception and depressive symptoms in the experimental group (Eye Movement Desensitization and Reprocessing + multimodal treatment), whereas anxiety and quality of life showed no clinically meaningful changes. In contrast, the active control group maintained stable values, with only a slight improvement observed in the psychological component of quality of life. Conclusion: These findings suggest that integrating Eye Movement Desensitization and Reprocessing into multimodal management may constitute a promising adjunctive strategy for fibromyalgia treatment, particularly for reducing pain intensity and depressive symptomatology. However, larger samples and longer follow-up periods are necessary to confirm its efficacy.
Background. The rapid growth of TikTok has emphasized the need for assessment tools specifically designed to capture the psychological and behavioral characteristics of platform use. Most existing measures adapt scales developed for other social media, limiting their ability to reflect TikTok's unique affordances and usage patterns. Objective. This study aimed to develop and evaluate the psychometric properties of the TikTok Use Scale (TTUS), a self-report instrument designed to assess multiple dimensions of TikTok engagement along an adaptive-maladaptive continuum. Methods. An initial pool of 68 items was generated based on the literature and expert review. Following item reduction procedures, 25 items were administered to a sample of 210 Italian adult TikTok users. Participants also completed the Bergen Social Media Addiction Scale to assess convergent validity. Exploratory factor analysis (EFA) using maximum likelihood extraction was conducted, followed by confirmatory factor analysis (CFA). Internal consistency, concurrent validity, and score distributions were examined. Results. EFA supported a four-factor structure including Involvement, Intrusiveness, Temporality, and Dissociation, with strong sampling adequacy (KMO = 0.89) and a significant Bartlett's test of sphericity. CFA indicated acceptable fit indices for the proposed model. Internal consistency was satisfactory across subscales (alpha = .84-.89) and excellent for the total scale (alpha = .93). Evidence of concurrent validity emerged through moderate-to-strong correlations with social media addiction symptoms and with both self-reported and objectively recorded time spent on TikTok. Score distributions suggested that a small proportion of users may exhibit potentially problematic patterns of use. Conclusions. The TTUS demonstrates promising psychometric properties and represents a concise, multidimensional instrument for assessing TikTok use. It may be a valuable tool for research investigating behavioral processes and adaptive versus maladaptive engagement with TikTok.
Introduction: Emerging adulthood (ages 18-29) is a key period of emotional and social development, and cross-cultural research is essential to understanding how these processes manifest in diverse Latin American contexts. Given the need for brief, culturally valid tools to assess affect during this stage, this study focuses on the validation of the 10-item Positive and Negative Affect Scale in emerging adults from Chile and Ecuador and evaluate its measurement invariance across country and sex groups. Methods: A psychometric cross-sectional design was used to assess a sample of 1693 emerging adults (61.7% women) aged 18-29 years (M = 21.94, SD = 2.81). The sample included 983 participants from Chile (M = 22.52, SD = 2.57) and 710 from Ecuador (M = 21.13, SD = 2.94). Results: The results indicate that the Positive and Negative Affect Scale demonstrates adequate structural validity in both countries and both sexes. Strict invariance was achieved across Chile and Ecuador, as well as by sex, supporting the comparability of scores across groups. Regarding latent means, Chilean participants reported lower levels of both positive and negative affect compared to their Ecuadorian counterparts. Additionally, men reported higher levels of positive affect, whereas women reported higher levels of negative affect. Conclusions: The findings are consistent with theoretical models of subjective well-being that conceptualize positive and negative affect as related but distinct dimensions. Although the results cannot be directly generalized to clinical or public health settings, they suggest that the Brief Positive and Negative Affect Scale may serve as a brief tool for assessing affect in both research and applied contexts, including initial screening and large-scale assessments. However, the use of non-probabilistic sampling may limit generalizability, and future studies should include more diverse populations and longitudinal designs to further examine the robustness of these findings.
Background: Although the COVID-19 pandemic has passed, its impact on university students’ mental health remains evident, with lasting increases in anxiety, depression, and eating disorder symptoms. A repeated cross-sectional comparison was conducted to understand the role of weight concerns, emotion regulation, stress, anxiety and depression in the expression of eating disorders (ED) symptoms among two independent cross-sectional university samples collected in 2019, before COVID-19, and in 2022, after the pandemic. Method: A total of 845 students completed the Depression, anxiety, stress questionnaire-21, the Difficulties in emotion regulation scale and the Weight concerns scale as part of a campus-wide campaign that aimed to raise awareness on psychological well-being among students, conducted before and after the pandemic. Multiple regression with interactions was run to test the effects of emotion regulation, stress, anxiety, depression and weight concerns on ED symptoms, controlling for participants’ age and sex. Results: Results showed significant increases in students’ levels of stress, anxiety, depression as well as higher emotion regulation difficulties at post-pandemic. There were also, significant effects of anxiety and emotion regulation on ED symptoms across both years whereas students who experienced higher stress and weight concerns in 2022, towards the end of the pandemic, were more likely to report ED symptoms as compared to students at pre-pandemic. Conclusion: These findings indicate that significant changes were noted in students’ emotional well-being while students with higher stress and weight concerns were more prone to disordered eating after the pandemic. Further evaluation of these factors is necessary to better understand the impact of COVID-19 on ED risk among university students and to inform universities efforts to revise and adapt prevention and screening programs to the post-COVID-19 era.
Background: Health anxiety (HA) can cause significant distress in patients, leading to preoccupation with perceived illness and symptoms. Objective: This study examines the mediating roles of cognitive-emotional processes such as need for Method: The cross-sectional study sampled 276 participants from diverse backgrounds, with ages ranging from 18-80 years. Participants completed a 40-minute survey which consisted of standardized scales assessing these factors. Results: Results demonstrated that while NFC does not directly predict HA, it exerts its influence through cognitive and emotional mechanisms. IU and NIB emerged as key independent mediators, while NIB and ES were associated with HA through serial paths involving somatic symptom severity. Conclusions: Thus, our results suggest that interventions for HA may benefit from targeting constructs such as NFC, IU, NIB, and ES, which are associated with health anxiety, rather than focusing exclusively on health anxiety symptoms themselves.
Objective: Emotion regulation is psychological process playing a key role in affective, social, and cognitive development. Poor emotion regulation is related to psychological problems while high emotion regulation is related to adaptive functioning in children. The present pilot study aimed at testing the relationship between emotion regulation and emotional and behavioral problems in a community sample of school-aged children. Methods: A convenience community sample of 65 children from 6 to 13 years of age (M=8,6; SD= 1.87) were assessed on emotion regulation, emotional and behavioral problems, and prosocial behaviors. Statistical analyses were performed to test age and gender differences, associations between emotion regulation and emotional and behavioral problems, and predictors of psychological difficulties in children. Results: Age and gender differences were not found in emotion regulation, psychological problems and prosocial behaviors, although girls showed higher emotion regulation, higher prosocial behaviors and lower externalizing behaviors than boys. As expected, emotion regulation was positively associated with prosocial behaviors and negatively associated with emotional and behavioral problems. Conversely, emotional lability/negativity was associated with psychological problems, particularly those related to externalizing behaviors. Both emotion regulation and emotional lability/negativity were independent predictors of psychological difficulties in children. Conclusion: Our findings confirm that the capacity to regulate emotions is essential in promoting psychological well-being in children. Because of its transdiagnostic nature, it is important to deeply investigate how specific components of emotion regulation impact on children's mental health. Despite evident research advances, the lack of a valid and reliable measure that integrates the assessment of both implicit and explicit components of emotional regulation in children remain an important gap that must be filled by future research.
Introduction: Systemic Sclerosis (SSc) is a rare autoimmune connective tissue disease affecting the skin and internal organs, significantly impacting quality of life (QoL). Alexithymia and insecure romantic attachment may hinder coping and influence pain perception in chronic illness. This study aims to explore the associations among alexithymia, romantic attachment, pain perception, quality of life, and age in women with SSc, and to examine the predictive role of alexithymia, attachment dimensions and age on perceived physical quality of life using multiple linear regression analyses. Methods: Fifty women with SSc were recruited from a hospital in Rome. Participants completed a sociodemographic questionnaire, the 20-item Toronto Alexithymia Scale (TAS-20), the Experiences in Close Relationships-Revised (ECR-R), the Pain Visual Analogue Scale (pVAS), and the WHO Quality of Life Questionnaire-Brief Version (WHOQOL-BREF). Results: Participants had a mean age of 52.98 years (M = 52.98; SD = 12.87) and a mean SSc duration of 10.31 years (M = 10.31; SD = 8.84). TAS-20 scores negatively correlated with all QoL domains and total QoL (r =-0.303 to-0.672, all p < .01). Difficulty in Describing Feelings correlated positively with pain VAS (r = .312, p < .05). ECR-R Avoidance and Anxiety were negatively associated with several QoL dimensions. Difficulty in Describing Feelings emerged as a significant predictor of physical QoL dimension (B = -0.56, beta = -.68, p < .001). Overall, 18% scored above the TAS-20 clinical cut-off. Overall, 18% scored above the TAS-20 clinical cut-off. Conclusions: The findings suggest that higher levels of alexithymia and insecure attachment are associated with poorer quality of life and greater pain perception in women with Ssc. In particular, difficulties in describing feelings appear to play a key role in the physical dimension of quality of life, pointing to the clinical relevance of emotion verbalization processes in this population. These results support the relevance of affective regulation processes as potential targets for psychological assessment and intervention in Ssc patients and highlight the importance of multidisciplinary care.
Depression is a psychiatric construct, most commonly operationalised as a sustained period of low mood and/or loss of interest/pleasure in activities (APA, 2013). Depression is considerably overrepresented among people living with physical illness, long-term disability and mobility-impairing conditions, with the prevalence of major depressive disorder (MDD) consistently 2-3 times higher than in the general population (Moussavi et al., 2007; Read et al., 2017).
Background: Research on depressive symptoms and interpersonal issues in foreign university students (FS) remains limited. This study assessed interpersonal problem areas, depressive symptoms, and adult separation anxiety (ASA) in Latin-American FS enrolled at an Italian university. We aimed to explore the relationship between these psychological dimensions and how interpersonal stressors - common in the acculturation process - may impact emotional wellbeing. Methods: Participants (N=31; 15 males, 16 females; mean age: 26.9 +/- 3.3) completed an online survey including the Zung Self-Rating Depression Scale (ZSDS), the Work and Social Adjustment Scale (WSAS), the Separation Anxiety Disorder Severity Scale (SAD-A), and the Interpersonal Problem Results: The most described interpersonal problem areas were role transition (74.2%) and interpersonal deficits (51.6%). Clinically significant adult separation anxiety (ASA) was present in 54.8% of participants, and was associated with significantly higher scores in depression (ZSDS: 50.0 +/- 6.3 vs. 36.9 +/- 6.1; p=0.0001), functional impairment (WSAS: 17.4 +/- 8.4 vs. 7.5 +/- 8.6; p=0.003), and number of Conclusions: ASA and interpersonal problem areas may contribute to depressive symptoms in FS, underscoring the clinical relevance of interpersonal dimensions in this population. These findings are preliminary, given the small sample size and reliance on self-report measures.
Background: To investigate the anatomical and psychological characteristics of Central Serous Chorioretinopathy (CSCR) using a multimodal approach combining spectral-domain optical coherence tomography (OCT) and psychometric profiling. The study aims to explore potential correlations between personality traits and disease features to inform future risk stratification and management. Methods: A case-control observational study involving 44 participants (22 patients with CSCR and 22 age-and sex-matched healthy controls). Participants underwent high-resolution OCT to assess choroidal thickness, subretinal fluid, and photoreceptor integrity. Psychological profiles were evaluated using the Personality Inventory for DSM-5-Brief Form (PID-5-BF) and the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Brief (TEMPS-A-brief). Data were statistically analyzed using Python 3.11, with significance set at p < 0.05. Results: CSCR was more prevalent in males (male:female ratio of 10:1), with a mean age of 50.6 years. OCT revealed increased choroidal thickness, photoreceptor disruption, and subretinal fluid in affected individuals. A positive correlation was found between age and choroidal thickness (rho = 0.41; p < 0.05). No significant association was found with corticosteroid use. Although group comparisons in psychological traits were not statistically significant, a trend toward elevated negative affectivity was observed in the CSCR group. Conclusions: CSCR appears to result from a multifactorial interaction between anatomical and psychological components. While no definitive psychological markers were identified, elevated negative affectivity may serve as a vulnerability trait in susceptible individuals. Further longitudinal and larger-scale studies are necessary to validate these findings and investigate the utility of psychological screening in CSCR care.
Objective: This study aimed to examine the latent associations among negative body image (NBI), negative eating attitudes (NEA), and depressive symptoms in adult Ecuadorian women. Specifically, it sought to assess the predictive value of NBI and NEA on depression, and to explore the mediating role of NEA in the relationship between NBI and depressive symptoms through Structural Equation Modelling (SEM). Method: A cross-sectional design was employed with a non-probabilistic sample of 964 Ecuadorian women (M = 29.74, SD = 11.93). Participants completed three validated self-report measures: the Body Shape Questionnaire (BSQ-21), the Eating Attitudes Test (EAT-18), and the Beck Depression Inventory-II (BDI-II). CFA and SEM analyses were conducted using R, employing the DWLS estimation method due to the ordinal nature of the data and non-normal multivariate distribution. Results: NBI and NEA were found to be significant positive predictors of depressive symptoms, jointly explaining 40.1% of the variance. NEA partially mediated the relationship between NBI and depression. Notably, the mediation was identified as competitive/suppressor in nature, whereby the indirect effect acted in the opposite direction to the direct effect, enhancing the explanatory power of the model. Conclusion: The findings contribute to theoretical, methodological, and practical understanding of depressive symptomatology in women, especially within under-researched Latin American populations. The results emphasise the relevance of addressing distorted body image and maladaptive eating attitudes in preventive and clinical interventions and demonstrate the value of SEM in revealing complex psychological mechanisms.
Introduction: Psychotic experiences (PEs), such as hallucinations and delusions, are transdiagnostic phenomena that can range from subclinical manifestations in the general population to more severe and distressing forms in the psychiatric populations. The Questionnaire for Psychotic Experiences (QPE) is a trans-diagnostic tool to explore the diverse and nuanced phenomenology of psychotic experiences from a quali-quantitative perspective. This study presents the preliminary validation of the Italian version of the Questionnaire for Psychotic Experiences (QPE-I), assessing its psychometric properties in a general population sample. Methods: A preliminary validation study was conducted with 87 adults from the general population (M = 29.33, SD = 7.30). Participants completed the Italian version of the QPE (QPE-I) and additional self-report measures. Psychometric analyses included principal component analysis (PCA), internal consistency (Cronbach's alpha), convergent and divergent validity, and inter-scale correlations. Results: The results indicate that the QPE-I largely retains the core structure of the original instrument while adapting to the Italian context. The QPE-I shows good cross-cultural adaptation, internal consistency, reliability, and convergent and divergent validity. As expected for a non-clinical sample, frequencies of hallucinations and delusions were low but detectable. Conclusion: The QPE-I facilitates the transdiagnostic exploration of psychotic experiences by distinguishing qualitative differences in hallucinations and delusions among individuals. The QPE-I also has potential clinical applications in psychotherapy by providing a means of monitoring symptomatic change and therapeutic outcomes. However, this preliminary study is limited by its small sample size and inclusion of only non-clinical participants. Future research with larger and clinical samples is essential to complete the validation process.
Background: Animal-assisted services (AAS) have emerged as a promising approach to complementing the care of pediatric cancer patients and improving their physical and psychosocial well-being. This approach is based on the therapeutic use of the human-animal bond. This study analyzed trends and changes in research examining the impact of AAS on the quality of life of children with cancer. Methodology: We conducted a bibliometric analysis of scientific output and a citation network analysis using the Bibliometrix and Tree of Science platforms. Results: Our findings underscore the emotional and physical advantages of AAS, such as alleviating symptoms of anxiety, pain, and depression, facilitating hospital adaptation, and promoting socialization among children. Three clusters reflecting research trends in canine cancer, emerging cancer therapies, and AAS in pediatric oncology were identified. The latter is the focus of this study. Conclusions: We discuss the gaps in protocol standardization, limited hospital implementation, Conclusions. and lack of conclusive evidence in some studies. Overall, the study concludes that AAS is a complementary alternative for comprehensive psychosocial care in pediatric oncology, though more research is needed for its effective application.
Introduction. Eco-anxiety has gained attention in recent years. While anxiety is typically viewed as a disorder, eco-anxiety may also be seen as a rational response to environmental threats, potentially driving pro-environmental behavior. The present study aimed to develop and validate a new brief tool, the Eco-Anxiety Questionnaire (EAQ), to assess psychological symptoms, intrusive thoughts, and a sense of responsibility associated with eco-anxiety. Methods. An online survey collected data from 228 Italian adults (Mean age= 31.29, SD = 13.71; age range: 18-60; 77% women). The EAQ was developed from an initial pool of 50 items and refined through Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) to a final set of 25 items across three factors, rated on a 5-point Likert scale. Convergent validity was assessed with measures of climate change anxiety, climate change worry, generalized anxiety, and depressive symptoms. Results. EFA supported a three-factor structure explaining 62% of the variance, with good sampling adequacy (Bartlett's test p < .001). The EAQ showed excellent internal reliability (alpha = .95 for the total scale; alpha = .89-.94 for subscales). CFA confirmed the model's adequacy (CFI = .966; TLI = .963; NFI = .95; GFI = .969; IFI = .97; SRMR = .07; RMSEA = .09). Strong correlations emerged with the Climate Change Anxiety Scale and the Climate Change Worry Scale, while moderate associations with GAD-7 and PHQ-9 confirmed the distinctiveness of eco-anxiety from general distress. Conclusions. The EAQ demonstrates strong psychometric properties and offers a multidimensional assessment of eco-anxiety. Its brevity and conceptual breadth represent key strengths. However, the study's non-representative and relatively young sample limits generalizability. Future research should validate the tool in broader populations and explore its predictive value for behavioral and psychological outcomes.
Background: University students have been recognized as a population vulnerable to mental health problems. This study explored the direct and indirect effects of academic stress on psychological distress and suicidal ideation in Colombian university students, emphasizing the mediating role of adaptive coping strategies. Methods: A total of 1,170 undergraduates (M age = 24; SD = 7.77) from a private university completed validated self-report instruments assessing academic stress (SISCO), coping strategies (ACEA), depression, anxiety, and stress (DASS-21), and suicidal ideation (PANSI). Path analysis was conducted using AMOS with bias-corrected bootstrapping (5,000 resamples). Results: Results showed that academic stress symptoms were positively associated with perceived stress, depressive symptoms, and suicidal ideation, while negatively associated with adaptive coping. Seeking social support and positive reappraisal partially mediated the relationship between academic stress and psychological outcomes. The strongest mediation effect was found between academic stress and depression (VAF = 65.4%), followed by suicidal ideation (VAF = 22.3%) and perceived stress (VAF = 2.18%). Moreover, perceived stress served as a key intermediary, reinforcing its role as a transdiagnostic mechanism linking academic stress to emotional vulnerability. The model demonstrated excellent fit (CMIN/DF = 0.089; RMSEA = 0.000; CFI = 1.00), supporting the proposed mediation structure. Conclusions: Findings underscore the importance of enhancing students’ coping capacities—especially social support and cognitive reappraisal—to reduce psychological distress and suicide risk in academic settings. Interventions targeting stress appraisal and adaptive coping may improve emotional well-being and resilience among university students.
