Aim and background: Sleep is a biological necessity essential for physical and mental well-being, yet many young adults, particularly college students, experience sleep disruptions due to major life changes and poor sleep hygiene.This study aimed to identify the determinants of insomnia among undergraduate female students in a rural area of Haryana.Materials and methods: A mixed-method study was conducted between May 2024 and May 2025 involving 340 undergraduate female students.Quantitative data were collected using a semi-structured socio-demographic questionnaire and the insomnia severity index (ISI).Qualitative insights were gathered through in-depth interviews (IDI) with 15 students identified with clinically significant insomnia.Statistical analysis was performed using SPSS software version 26, with significance set at p < 0.05.Results: The prevalence of clinically significant insomnia in the cohort was 5.6% (n = 19).Quantitative analysis revealed that the participant's state of origin was the only statistically significant socio-demographic determinant (p = 0.031).Students from states other than Haryana reported a significantly higher insomnia prevalence (12.5%) compared to those from Haryana (4.2%).Factors such as age, socio-economic status, and type of occupancy showed no significant correlation.Qualitative themes highlighted academic performance, overuse of electronic devices, social environment, and psycho-social stress as primary triggers.Conclusion: While the prevalence of insomnia is relatively low, it is significantly driven by academic transitions, excessive screen time, and communal living challenges.A notable awareness-action gap exists, as students recognize the importance of sleep but prefer self-management or mindfulness over professional clinical help.
Abstract We investigated public beliefs about the extent to which mental disorders are perceived to be part of the true self, that is, the set of traits and behaviors that compose one’s core character. We conducted three quantitative vignette-based studies (total n = 601) in UK general public samples, considering seven disorders (attention deficit hyperactivity disorder (ADHD), anorexia nervosa, autism spectrum disorder (ASD), bipolar disorder, major depressive disorder, schizophrenia, and obsessive-compulsive disorder (OCD)). For each disorder, participants rated how much the disorder reflects the vignette character’s true self, along with perceived causes of the disorders (studies 1 and 2), perceived severity, age of onset, duration, probability of recovery (study 2), and stigmatization (study 3). Disorders differed sharply in the extent to which they were judged to be part of the true self: ADHD, ASD, and OCD received higher true self ratings than major depressive disorder, anorexia nervosa, and schizophrenia, with bipolar disorder intermediate. A disorder was rated more ‘true self’ when it was: perceived as more “biologically” caused; less “psychologically” caused; less severe; and recovery was perceived as less likely. Although the extent of stigmatization also varied across disorders, true self ratings did not predict stigmatization. Our results show that the public thinks about different mental disorders in quite different ways, suggesting that different disorders should not be lumped together when considering attitudes and their consequences.
This study develops an approach to predict personality traits based on the Big Five model through essay text by combining global and contextual information using a Vocabulary Graph Convolutional Network (VGCN) and Bidirectional Encoder Representations from Transformers (BERT). VGCN is used to capture global relationships between words through a vocabulary graph representation built based on NPMI weights, while BERT plays a role in producing richer and more contextual text representations. Experimental results show that the integration of structural and contextual features can provide good performance in multi-label classification tasks. Based on the grid search process and 5-fold cross-validation, the best model configuration obtained a macro F1 score of 0.6827 and a weighted F1 score of 0.6829 in out-of-fold prediction. The evaluation results for each feature show that the recall value is close to 1.0, while the precision value ranges from 0.50 to 0.56. This condition indicates a tendency for the model to produce more positive predictions. Furthermore, the results of the study highlight the importance of optimizing the prediction threshold value to obtain a more optimal compromise between precision and recall. Overall, the integration of graph-based semantic information with contextual representations from BERT shows that the VGCN-BERT approach has good potential for application in multi-label personality classification
Background Trans, non-binary and gender diverse (TNBGD) sexual function has historically been narrowly defined as physical capacities following medical and surgical gender affirming (GA) interventions; and this population's sexual health has been researched more in terms of external influences considered risky rather than being founded in individuals' desires and needs. This can produce discrepancies between services and people who access them. This study explores the service-related barriers, facilitators and compensatory strategies for TNBGD people seeking healthcare related to sexual function. Methods Based on qualitative interview data from n = 19 TNBGD adults in the UK, the dataset was deductively analyzed using Levesque's framework of healthcare access. Results TNBGD people face barriers in distance and transport to appropriate sexual health services, overlaps between sexual healthcare and GA services, and limits in professionals' TNBGD specific knowledge and cultural competence. To navigate these TNGBD people pursued independent knowledge acquisition, were selective during clinical interactions and access, and sought to meet their needs outside clinical settings. The analytical themes demonstrate varied barriers and their interrelatedness. For example, acceptability of a service was informed by the appropriateness of clinician's knowledge and interactions. In turn, TNBGD people's anticipation of un (der) met needs motivated compensatory measures, such as seeking information online or from peers before approaching formal services or sometimes instead of approaching them. Conclusions Healthcare services' design and delivery can present significant barriers to TNBGD adults seeking healthcare to support their sexual function. Providers' ways of interacting may offset some of the barriers and TNBGD adults may deploy strategies that enable them to access care that leads to satisfactory health outcomes. However, while significant barriers persist, TNBGD adults are liable to have unmet needs and consequent health inequalities.
The article examines how prolonged wartime risks transform the marketing value of Facility Management (FM) in the corporate B2B segment of the office property market. It shows that customer value increasingly extends beyond routine service delivery, price and SLA compliance toward business continuity, responsiveness, risk reduction, transparency and organizational resilience. The study combines services marketing, perceived value, relationship marketing, business continuity and resilience approaches with qualitative analysis of recurring FM practices in Ukraine. A four-level model of FM value evolution is proposed: Operational FM, Integrated FM, Risk-oriented FM and Resilience-oriented FM. The findings support a shift from service-list and price-based positioning toward differentiation based on measurable business outcomes, adaptability and continuity support.
Abstract Objectives We hypothesized that benzodiazepine/z-drug (BZRA) dose, insomnia symptoms, and obstructive sleep apnea (OSA) risk are associated with cognitive performance above and beyond other modifiable dementia risk factors. Methods In this cross-sectional study, we used baseline data from recruited patients without dementia from one VA site and one academic site to analyze regression models based on previously published risk factors for cognitive impairment, adapted to include sleep and benzodiazepine usage interactions. Changes in R 2 and model fit (F-tests) were examined for four nested regression models predicting Mini-Mental State Examination (MMSE), Trail Making Test (TMT)-A, TMT-B, and Digit Symbol Substitution Test (DSST). Base Models included common dementia risk factors. Model-2 = Base + Insomnia Severity Index; Model-3 = Model-2 + dose; Model-4 = Model-3 + OSA risk; and Model-5 = Model-4 + OSA-BZRA. Results R 2 for the base model predicting MMSE was 0.139 (n = 313), 0.241 for TMT-A (n = 298), 0.229 for TMT-B (n = 287), and 0.189 for DSST (n = 285). Model-5 R 2 was 0.142 for MMSE, 0.246 for TMT-A, 0.238 for TMT-B, and 0.190 for DSST, with all F-test p-values >.145. Conclusions Sleep disorder variables did not significantly explain additional variation in cognition performance. Studies with a wider range of cognitive performance are needed.
Human well-being has received increasing attention as an indicator of individual and social health and as a consideration in public policy. Gender differences in subjective well-being (SWB), a widely accepted indicator of human well-being, have long been documented. However, explanations of these gender differences remain varied and inconclusive. This study utilizes Gallup World Poll data comprising 1,911,212 observations from 2009 to 2022. Employing advanced machine-learning techniques within an Exogenous Switching Treatment Effect Model (ESTEM) framework, we decompose the gender gap in SWB into differences in characteristics and differences in regime-specific returns. Conditional on observed characteristics and under a common predictive regime, the model predicts higher SWB for men. In contrast, the regime-specific returns component is associated with lower predicted well-being under the male regime. This component also increases over time, widening the estimated gender gap in SWB, while its magnitude varies across countries. The results suggest the potential relevance of institutional flexibility and reduced gender-role pressures for addressing gender disparities in human well-being.
Background: Brief psychological treatment programmes in primary care are increasingly used to address common mental disorders (CMDs), yet patient outcomes remain heterogeneous. Routine symptom measures may help identify patients who are more or less likely to achieve clinically meaningful change and may support treatment planning within stepped-care systems. This study examined associations between baseline depressive and anxiety symptom severity predicted reliable improvement and reliable recovery following brief psychological treatment in a real-world primary care programme. Methods: This secondary analysis used routinely collected data from 512 adults treated in a real-world primary care psychological intervention programme. Participants were assessed with the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) before and after brief psychological treatment. Baseline demographic and clinical variables, including age, sex, number of sessions, and PHQ-9 and GAD-7 scores, were examined according to reliable improvement and reliable recovery status. Logistic regression analyses examined associations between baseline variables and treatment outcomes. Results: Reliable improvement was observed in 73.6% of participants, whereas 53.3% achieved reliable recovery. Higher baseline anxiety severity was associated with reliable improvement (odds ratio [OR] = 1.16, 95% confidence interval [CI]: 1.08–1.23), whereas lower depressive severity predicted reliable recovery (OR = 0.92, 95% CI: 0.88–0.96). Fewer treatment sessions were associated with both reliable improvement and reliable recovery. Age and sex were not significantly associated with outcomes. Conclusions: Baseline anxiety and depressive symptom severity may be relevant for understanding variability in clinically meaningful outcomes following brief psychological interventions in primary care. Patients presenting with greater depressive symptom burden may benefit from closer monitoring and more intensive or extended treatment pathways within stepped-care models.
In corridors shared by humans and robots, mobile robots should follow paths that are comfortable for passengers and observers. Previous studies have examined straight corridors with uniform width; however, actual environments include varying-width corridors, such as hallways connected to open spaces or containing static obstacles. Comfortable path design in such environments is unclear, and differences between passenger and observer preferences remain underexplored. This study provides initial, context-specific empirical evidence on comfort preferences among robot paths in varying-width corridors from passenger and observer perspectives. Through experiments (n = 35), three paths were examined: a straight wall-following path, a center path with a small heading change, and a wall-following path with a larger heading change. Each path was evaluated in two perspectives (passenger and observer) and two environments with sudden or gradual width changes. Comfort was measured by ranking the three paths. A Plackett–Luce model was used to test within-condition path preferences, the effects of perspective and environment, and their interaction. Across all conditions, the straight wall-following path was mainly preferred. In the sudden-change environment, path preference differed significantly between perspectives: passengers preferred the center path over the path with the larger heading change, whereas observers showed no such preference and rated the latter relatively higher. No significant effect of environment or interaction was detected. These findings suggest that, within the scenarios tested, smaller heading changes are associated with comfort, whereas less center-aligned motion may be particularly relevant when observer comfort is prioritized.
Stress is a major contributor to physical and mental health disorders, underscoring the need for reliable and interpretable detection systems. We present an interpretable multimodal deep learning framework that integrates electrocardiogram (ECG), electrodermal activity (EDA), and respiration signals using modality-specific neural architectures complemented by feature-based classical models. To ensure robustness and generalizability, the framework was evaluated under both subject-independent and subject-dependent protocols. Results show that multimodal fusion consistently outperformed single modalities, achieving 94.8% accuracy, 93.9% F1-score, and 0.97 AUC under subject-independent validation, compared with 86–91% accuracy for individual signals. In subject-dependent experiments, performance reached 97.2% accuracy and 96.8% F1-score. Comparative analysis with recent state-of-the-art methods demonstrated the competitiveness of our approach, while ablation studies confirmed the contribution of each modality and fusion strategy. Statistical significance testing with ( p < 0.05) further validated the reliability of these gains. Importantly, interpretability analyses using Grad-CAM and attention visualization provided physiological insights, revealing that the model emphasizes clinically meaningful regions such as ECG R-peaks and phasic EDA fluctuations. By uniting high performance, robustness, and interpretability, this work advances stress detection research and offers a physiologically grounded framework for continuous mental health monitoring.
Introduction This cross-sectional, exploratory study investigated the association between physical exercise (PE) and social anxiety (SA) among 862 left-behind adolescents in China. It examined emotion regulation abilities (ERA) and peer relationships (PR) as potential mediators and gender as a moderator in this association. Methods A cross-sectional exploratory design was adopted. Participants were 862 Chinese left-behind adolescents. Path analysis was used to test the hypothesized sequential mediation model and gender moderation effect. Results Path analysis revealed that PE was negatively associated with SA. Each separate path of the hypothesized sequential chain (PE → ERA, ERA → PR, PR → SA) was statistically significant, while the overall sequential mediation effect (PE → ERA → PR → SA) was non-significant (95% CI included zero). This indicated that the significant PE–ERA association had a small effect size and could not propagate fully through the chain to SA. The direct path from PE to PR was also non-significant. The data favoured independent mediation pathways rather than a sequential mediation process. Gender moderated the pathway: the positive PE–ERA association was significant for females but non-significant for males. Discussion The findings are hypothesis-generating rather than confirmatory and require replication via longitudinal research. For vulnerable adolescents, PE may help build emotional competence, which contributes to improved peer bonds. Interventions could integrate emotion-regulation skill training into physical activity programmes, particularly targeting female adolescents. Due to the cross-sectional nature of the study, causal conclusions cannot be drawn.
Perceptual expertise is widely assumed to refine multisensory perception, yet the empirical literature appears inconsistent. Trained musicians show narrower audiovisual temporal integration windows and quicker segregation, whereas experienced wine tasters seem more influenced by a wine's color in their aroma and flavor judgments than novices are. We argue that the inconsistency arises from a conflation of two formally distinct quantities: the prior probability that concurrent signals arise from a common source, and the coupling between the values of signals that share one. We present a generative model in which both are free parameters, along with channel precision and a decision criterion, that contains causal-inference and coupling-prior models as special cases. The model shows that the correlation between the values of two signals across an environment reflects only the product of the two priors, so that a correlation-tracking learner acquires the coupling when the signals always share a source, whereas separating the two priors requires representing causal structure; that binary common-source reports confound the common-cause prior with the decision criterion; that the coupling trades off against the measurement noise of the influencing channel unless its precision is measured independently; and that the two priors leave distinct signatures in how cross-modal influence varies with disparity. When the source is fixed, as for the color and odor of a wine, tighter coupling alone produces the conjunction of greater displacement by color and better discrimination between wines reported for experienced tasters, which no change in odor precision can produce. Simulations of a test battery combining continuous estimates, common-source reports and discrimination thresholds show that the parameters can be recovered, that a within-subject dissociation can be detected with conventional sample sizes under illustrative effect sizes, and that recovery fails in certain cases. The account yields a rule classifying environments by their base rate of common causation and their coupling strength, and the same ambiguity attends claims about altered multisensory processing in autism and aging. We also show that the most cited demonstration of expert susceptibility to color contains no expertise manipulation, and suggest that apparent expert biases may reflectwind calibration to real-world statistics.
Aim and background: Excessive daytime sleepiness (EDS) is reported far less often than poor nocturnal sleep quality in Indian medical students.We aimed to estimate EDS prevalence and its independent correlates (primary), and to compare these with poor sleep quality correlates in the same cohort and relate both to examination performance (secondary).We hypothesized that sleep hygiene behavior, not global sleep quality category, would dominate.Materials and methods: Prospective cross-sectional study of 354 of 450 eligible MBBS students (78.7%) at a Southern Indian college, sampled by stratified proportional randomization.Under supervised standardized administration, they completed the Epworth Sleepiness Scale (ESS; EDS >10), Pittsburgh Sleep Quality Index (PSQI), and Sleep Hygiene Index (SHI), with screen time, stress, mood, lifestyle, clinical covariates, and the latest university examination percentage.Excessive daytime sleepiness correlates were examined by logistic regression with a pre-specified confounder-adjusted sensitivity model.Results: Excessive daytime sleepiness affected 21.5% [95% confidence interval (CI) 17.5-26.0],more often among poor than good sleepers (27.7% vs 18.6%).Adjusted [area under the receiver operating characteristic curve (AUC) 0.773, 0.714-0.832],only poorer sleep hygiene remained independent [odds ratio (OR) 1.12 per point, 1.07-1.18],unchanged after adjustment for all measured confounders (1.12, 1.06-1.17).Examination percentage did not differ by sleep status (67.33 ± 5.16 vs 68.07 ± 5.72; p = 0.229); academic stage and sex, not sleep, predicted marks (R² = 0.152).Conclusion: In this cross-sectional sample, EDS was associated more closely with sleep hygiene behavior than with global sleep quality category, and the two had distinct correlation profiles.Screening for sleepiness alongside sleep quality, and addressing bedtime device use, merit consideration in student health services.These are associations only; no direction of effect can be inferred.Clinical significance: Measuring EDS alongside global sleep quality identifies a partly distinct at-risk group, for whom brief counselling on bedtime device use may be more specific than generic sleep hygiene advice.
Introduction In Japan, noriuchi refers to a collaborative gambling practice in which multiple players pool money used for betting and later split the final net profit or loss. This cross-sectional online study aimed (a) to estimate the prevalence of noriuchi among adult Japanese gamblers and (b) to examine how the frequency of noriuchi participation relates to gambling involvement and problem gambling severity. Methods In February 2022, an online survey was administered via Rakuten Insight, Inc. to adults aged 20 years or older. Participants were eligible if they reported gambling at least monthly in at least one of nine gambling activities during the past 12 months ( N = 2,000). Noriuchi participation frequency was assessed on a four-point scale (never, less than monthly, monthly or more, weekly or more). Outcomes included monthly gambling days, monthly gambling expenditure, and problem gambling severity measured with the Japanese version of the Problem Gambling Severity Index (PGSI). Results Overall, 498 participants (24.9%) reported noriuchi experience in the past 12 months; among them, 198 (39.76%) met the PGSI criterion for problem gambling. After adjustment for demographic covariates, noriuchi participation was associated with greater problem gambling severity across several gambling activities. Associations with monthly gambling days and expenditure were more limited and varied across gambling activities, with significant increases primarily observed among those engaging in noriuchi weekly for certain gambling activities. Discussion These findings suggest that noriuchi is associated with problem gambling severity, whereas its associations with gambling frequency and individual gambling expenditure are less consistent.
Bullying remains a concern at SDN Sindangsono because teasing and name-calling occur in student interactions, while students’ understanding of the forms of bullying is still limited. This community service activity aimed to describe bullying prevention education through a participatory approach for third- and fourth-grade students. The activity involved 64 students, consisting of 34 third-grade and 30 fourth-grade students, and included an initial question-and-answer session, presentation of learning materials, an educational video, discussion, sharing session, written reflection, oral evaluation, and a joint commitment. Evaluation was conducted through the initial question-and-answer session and oral evaluation. At the beginning of the activity, students’ responses were more focused on physical bullying. Fifteen students (23.4%) voluntarily stated that they had engaged in actions they understood as bullying, while all participants stated that they had experienced feeling bullied, mainly through teasing and name-calling. After the activity, students’ responses began to include verbal, social, and social media-related forms of bullying, accompanied by reflective responses regarding peer interactions. All participants also took part in a joint commitment to prevent bullying. The activity indicated a broader understanding of bullying, the emergence of reflection, and student participation in bullying prevention.
Introduction This simulation-based computational study develops a non-linear state-space framework for stress-related negative cognitive bias and multivariate EEG/ERP observations. Methods A three-state model represents negative bias, cognitive control, and arousal, while symptom load and normalized model stress input reshape a quartic bias potential. N2, P3, late positive potential, frontal theta, frontal alpha asymmetry (FAA), and frontoparietal phase locking provide complementary observation channels. Additional checks distinguish the non-linear benchmark from additive and interaction-only competing generators, examine equilibria of the full coupled system, and perturb the observation model. Results We establish bounded stochastic dynamics, a conditional scalar multistability boundary, stable-branch stress sensitivity, and a sufficient local state-observability condition. A seeded benchmark with 180 simulated participants yields model-implied stress-by-symptom slopes of 66.83 ms for response time, 1.12 μV for LPP, 0.775 dB for frontal theta, 0.133 for FAA, and 0.0769 for frontoparietal PLV. Under a non-linear generating process, mean held-out RMSE was 0.060 for the pre-specified quartic candidate vs. 0.436 for the interaction-only candidate. State-reconstruction RMSE increased from 0.152 under the nominal loading matrix to 0.232 under 15% loading perturbations. Discussion These results demonstrate implementation consistency and characterize model sensitivity; they are not clinical effect estimates or evidence of empirical parameter identifiability.
Academic motivation in physically demanding university programmes may be better understood by considering motivational quality rather than motivation quantity alone. This cross-sectional observational survey supplemented by structured content analysis examined relationships among basic psychological need satisfaction and frustration, autonomous motivation, controlled motivation, amotivation, continuation intention, and career commitment in first- and second-year students enrolled in Physical Education and Mountain Sports at Transilvania University of Brașov. Data were collected from 6 to 30 October 2025 after ethics approval, yielding a final analytical sample of 237 students. Participants completed the Academic Motivation Scale-College/University version, the Basic Psychological Need Satisfaction and Frustration Scale, contextual and sport-related items, continuation and career indicators, and two open-ended prompts. Original open-ended answers were standardized into 50 motivation and 50 demotivation formulations and independently coded by both authors. Autonomous motivation averaged 5.04 (SD = 1.05), amotivation 2.40 (SD = 0.95), overall need satisfaction 3.72 (SD = 0.73), and overall need frustration 2.21 (SD = 0.76). Need satisfaction correlated strongly with autonomous motivation (Spearman ρ = 0.704), whereas need frustration correlated strongly with amotivation (ρ = 0.661). In adjusted models, need satisfaction was positively associated with autonomous motivation (β = 0.539, p < 0.001), and need frustration was positively associated with amotivation (β = 0.569, p < 0.001). Human coding agreement was high for motivation (92.0%, κ = 0.898) and demotivation (94.0%, κ = 0.927). Teaching/prosocial impact was the most frequent motivation category (33.8%), while curriculum/teaching/assessment was the most frequent demotivation category (23.6%). Overall, self-reported need satisfaction and frustration were differentially associated with motivational quality in this cohort, but the cross-sectional, single-faculty design precludes causal or population-level conclusions.
Abstract Importance Bullying is increasingly understood as a social process in which peers influence whether it persists. Anti-bullying policies and programs often encourage bystanders to intervene directly, yet direct defending can carry social costs for defenders, and evidence that it reduces later victimization is mixed. Some interventions already target the peer rewards that sustain bullying, but participant-role classifications tend to absorb deliberate non-reinforcement into outsider behavior or passive bystanding. Objective This paper argues that withdrawing social reinforcement, the deliberate withholding of social rewards that peers confer on bullying, such as attention, approval, amplification, or audience participation, should be conceptualized as a distinct bystander response. Methods This conceptual analysis draws on the social-ecological framework, participant role theory, social cognitive theory, and evidence that the outsider category is internally heterogeneous. Results Withdrawing social reinforcement is functionally positive when it reflects a refusal to endorse bullying and reduces the social rewards available to the student who bullies. It differs from uninvolved passivity in intent and social function, and from indirect defending in primary target, because these responses act on different points in the social process of bullying. When enacted collectively, it may also signal reduced peer endorsement of bullying and shift perceived peer norms. Conclusions Helpful bystander responding should not be defined only by direct intervention. Bystanders can also target the social rewards that sustain bullying, and responses grouped as passive bystanding differ in whether they sustain or withhold those rewards. Future research should test whether withdrawing social reinforcement can be reliably distinguished from uninvolved passivity and indirect defending, and whether it reduces reinforcement for students who bully. Implications for Practice Withdrawing social reinforcement requires less public confrontation than direct defending, offering students who cannot or will not confront the student who bullies another way to respond. Schools can teach this method as an explicit option alongside upstanding.
Abstract Court-Ordered Treatment (COT) is used to address treatment non-adherence and psychiatric readmission in individuals with serious mental illness (SMI), who are at risk for treatment non-adherence and recurrent psychiatric hospitalization. Evidence regarding clinical outcomes associated with COT remains mixed, partly due to differences in legal frameworks and program implementation. To compare psychiatric readmission, outpatient appointment attendance, and long-acting injectable (LAI) medication adherence during COT and during the year following COT expiration in Arizona’s public behavioral health system. This exploratory, retrospective chart review identified 94 patients placed on COT between 2020 and 2021. Paired within-subject analyses included 29 patients whose COT expired and who completed a full one-year follow-up after COT expiration. Outcomes during COT were compared with outcomes during the year after COT expiration. Among the 29 patients analyzed, psychiatric hospital admission rates rose significantly from 10.3% (3/29) during COT to 34.5% (10/29) post COT expiration ( p = .039). Missed psychiatric appointments increased from 24.1% (7/29) during COT to 37.9% (11/29) after COT expiration, but this change was not statistically significant (p =.219). Among 19 patients with complete LAI follow-up data, 1 missed at least one scheduled LAI dose during COT compared with 4 after COT expiration ( p =.250). In this exploratory cohort, psychiatric readmissions were less frequent during COT than during the year following COT expiration. Both missed outpatient appointments and LAI doses were also more frequent after COT expiration, although these differences were not statistically significant, and the small sample limited the ability to detect meaningful differences. These findings should be interpreted cautiously given the small, selected cohort and retrospective observational design. Larger prospective studies are needed to further evaluate outcomes following COT expiration.
Developing effective therapeutic protocols for LGBTQIA+ individuals requires a commitment to practices that do not perpetuate suffering. Addressing negative internalizations and minority stress are two common transdiagnostic aspects within this population. Therapeutic models, such as Schema Therapy (ST), have emerged as a promising strategy; however, research in this area is scarce. This study aimed to evaluate an Affirmative ST program for LGB individuals. The program was tested in a pilot study involving nine participants. A total of 10 sessions were conducted, and the evaluation focused on: positive and negative affect, anxiety, stress (including minority stress), and depression. The effects of the intervention were analyzed using the Hageman-Arrindell approach and GEE. Significant differences were found for: reduction in depression; stress; anxiety; negative affect; and an increase in positive affect and stigma perception. This research represents a pioneering effort in the field of ST with LGBTQIA+ individuals, and further studies are encouraged.
