mental health

Generation Alpha (born 2010-2024) and Generation Beta (born 2025-2039) represent an unprecedented developmental archetype defined by total digital integration and ubiquitous artificial intelligence (AI). This empirical study evaluated specialized psychological adaptation mechanisms, parenting models, and mental health intervention frameworks across these cohorts. Utilizing a mixed-methods design, quantitative data were gathered from $N = 300$ parents (Gen Alpha parents and expectant/early Gen Beta parents) using the Modified Parental Stress Scale (PSS) and Child Behavior Checklist (CBCL), supplemented by qualitative interviews with $N = 20$ pediatric mental health experts. Independent samples $t$-tests confirmed that Gen Alpha/Beta display significantly higher digital dependency anxiety ($M = 38.60, p < .001$) alongside superior visual-spatial intelligence ($M = 44.10, p < .001$) relative to normative baselines. Crucially, a proactive "Digital Integration" co-navigation parenting framework yielded significantly lower parental stress ($M = 29.50$) compared to rigid "Digital Detox" restriction models ($M = 42.80, p < .001$). A preventive clinical framework focusing on Social-Emotional Learning (SEL) and cognitive impulse management is proposed.

Abstract The COVID-19 pandemic created social disruptions, leading to high levels of mental health problems for adolescents. Interpersonal stressors, such as lack of familial support, peer victimization, and discrimination, may have further exacerbated teen mental health issues. Yet, the psychological impact of interpersonal stressors and their interactive effects with high levels of loneliness remains unknown. In this pre-registered study , conducted in November and December 2020 (approximately eight months into the COVID-19 pandemic), we used a diverse sample of adolescents from across 43 U.S. states with elevated depressive symptoms (n = 2,452, ages 13–16) to examine how familial support, peer victimization, and discrimination are concurrently associated with mental health outcomes. Results indicated that perceived discrimination was the strongest standardized correlate across continuous internalizing outcomes (depressive symptoms, anxiety symptoms, and hopelessness), whereas lack of familial support was the primary correlate of suicidal ideation; if youth reported a lack of familial support, they were over three times as likely to report suicidal ideation. Loneliness significantly moderated the cross-sectional links between lack of familial support and depressive symptoms, as well as perceived discrimination and hopelessness. Simple slope probing demonstrated a distress ceiling effect: interpersonal stressors were most strongly associated with elevated distress among youth reporting low baseline loneliness, whereas youth experiencing high loneliness exhibited consistently elevated distress regardless of stressor exposure. These findings underscore interpersonal stressors and loneliness as high-priority targets for youth prevention and intervention programs, particularly during periods of widespread social disruption.

The present study investigated the mediating effect of spiritual wellbeing on the relationship between mindfulness and emotion dysregulation among young adults. The sample N=200 were selected for the present research. A cross-sectional correlational research design was used for the present study. Through the convenience sampling technique, data were gathered by using the Five Facet Mindfulness Questionnaire (FFMQ) by Baer et al. (2006), the Spiritual Well-Being Scale (SWBS) by Paloutzian and Ellison (1982) Difficulties in Emotion Regulation Scale (DERS) by Gratz and Roemer (2004). According to the results, spiritual well-being is positively correlated with mindfulness and its dimensions (observing, describing, acting with awareness, non-judging, non-reactivity). Emotional dysregulation is negatively linked to mindfulness. Mediation analysis showed a significant prediction by mindfulness of spiritual well-being and emotional dysregulation. It was also found that spiritual well-being predicts emotional dysregulation. In addition, spiritual well-being was found to be a mediating factor through which emotional dysregulation and mindfulness are linked. According to the study, interventions aimed at enhancing emotional resilience and well-being in people will be of interest for the mental health section.

University students who live away from their families may experience loneliness and depressive symptoms, while perceived social support may alter this relationship. This study examined the associations among loneliness, perceived social support, and depressive symptoms and tested whether perceived social support moderated the loneliness-depressive symptoms relationship. A cross-sectional quantitative design involved 396 university students living in boarding houses in Yogyakarta. Data were analyzed using Pearson correlations and moderated multiple regression. Perceived social support was negatively associated with depressive symptoms. Loneliness was also significantly associated with depressive symptoms, but the direction was negative and therefore did not support the proposed positive hypothesis. The interaction between loneliness and perceived social support was significant, indicating that the loneliness slope differed across levels of support. The findings highlight the relevance of perceived social support for student mental health while also showing that the unexpected loneliness pattern requires cautious interpretation and replication.

This study examined the association between intolerance of uncertainty and psychological distress among emerging adults aged 18-29 years. A quantitative, cross-sectional correlational design was used with online convenience sampling. Of 181 survey submissions, one record was excluded because age was missing and one because the respondent was aged 17 years; a further 18 respondents who reported a previous mental-health diagnosis were excluded. The final analytical sample comprised 161 participants (M age = 23.60, SD = 3.09; 67.1% women). Intolerance of uncertainty was measured with the 12-item Intolerance of Uncertainty Scale (IUS-12), and nonspecific psychological distress with the Kessler Psychological Distress Scale (K10). Mean IUS-12 and K10 scores were 32.11 (SD = 9.44) and 24.31 (SD = 8.09), respectively. Internal consistency estimates were .887 and .913. Pearson's correlation indicated a positive association between IUS-12 and K10 scores, r(159) = .632, p < .001, 95% CI [.529, .717]. Spearman's correlation was also positive and significant (rs = .595, p < .001, 95% bootstrap CI [.475, .699]). Higher intolerance of uncertainty was associated with greater self-reported psychological distress in this sample. The cross-sectional design, convenience sampling, self-report measures, and diagnosis-based screening limit causal inference and generalisability.

Abstract Background Repetitive negative thinking (RNT) is a transdiagnostic process relevant to common mental health problems in primary care. RNT-ACT is a brief acceptance and commitment therapy-based protocol targeting RNT in two sessions. This pilot study assessed the feasibility of RNT-ACT compared with therapist-supported internet-based cognitive behavioural therapy (iCBT) in Swedish primary care. Methods Thirteen participants were randomised: 7 to RNT-ACT and 6 to iCBT. The primary feasibility outcomes were recruitment rate, intervention non-completion, and patient satisfaction measured with the Client Satisfaction Questionnaire (CSQ-8). Symptom and process measures were secondary outcomes. Secondary outcomes were assessed at baseline and at 1- and 3-month follow-ups. Analyses were descriptive and exploratory, based on available observations without imputation of missing data. Results Thirteen of 20 eligible individuals were enrolled (65%), corresponding to 35% of all 37 individuals screened. All participants in the RNT-ACT group completed the intervention, whereas 4 of 6 participants in the iCBT group did not complete the intervention. Mean CSQ-8 scores were 27.8 (SD 3.7; n = 5) in the RNT-ACT group and 23.0 (SD 0.0; n = 2) in the iCBT group. Conclusions The small sample size and high iCBT non-completion limit between-group comparisons. Further investigation of recruitment, treatment engagement, and patient and therapist experiences is needed before determining whether and how to proceed to a full-scale RCT. Trial registration ClinicalTrials.gov NCT05946382 registered July 14, 2023.

The number of depressed Malaysian university students has sharply increased over the past ten years. What started as a localized academic issue has now become a major national mental health crisis, but the true experiences of those affected remain elusive. Therefore, the purpose of the research is to comprehend the authentic experiences of students in Malaysian universities who are experiencing depression. This research employed a qualitative methodology via a phenomenological framework involving five participants female university students who are diagnosed clinically with depression. Information was accessed via semi-structured interviews that were digitally audiotaped, transcribed verbatim and translated to English to analyse the information. The results indicate that there are six major themes that describe the experience of having depression. They are high-achieving students losing their academic identity because they entered the survival mode, a bitter fight between seeking the help of professional assistance and turning to drug use or self-harm in order to cope, the pressure of being a normal, fearing to be seen as a burden, the contradiction between familial beliefs and attributing depression to lack of spirituality, the physically isolated nature of staying in the room because of the need to avoid social interaction, and the impact of past sexual abuse as an underlying factor of psychological trauma. The themes indicate that student depression is not just a medical problem but they are very much influenced by intrapersonal, social, cultural, and spiritual demands. It is thus recommendable to provide necessary support that will alleviate the deep-seated experience of depression, especially in the university.

Background and Purpose: Non-suicidal self-injury (NSSI) is a global concern in adolescent mental health. Rural boarding middle school students, as a unique and vulnerable population, remain understudied regarding the potential heterogeneity and longitudinal trajectories of NSSI. This study aimed to identify latent classes of NSSI among this group, examine their transition patterns over time, and evaluate the effectiveness of an emotion management group intervention. Methods: Study 1 cross-sectionally surveyed 927 adolescents; we split samples into non-NSSI and NSSI subgroups and ran latent profile analysis (LPA) only among participants with NSSI ( n =285). Study 2 conducted a 6-month follow-up of 550 participants and applied latent transition analysis (LTA) to examine class shifts and predictive factors. Study 3 was a randomized controlled trial in which 30 students from the High-NSSI received an 8-week emotion-management group intervention. Intervention effects were evaluated using repeated-measures ANCOVA with demographic covariates. Results: Within the NSSI subgroup ( n = 285), two classes were identified: a High-NSSI class ( n = 21, 7.4%) and a Low-NSSI class ( n = 264, 92.6%). Poor sleep quality and bullying victimization independently predicted High-NSSI membership. Longitudinal analysis revealed high stability in the Low-NSSI class (91%) and high fluidity in the High-NSSI class (83% transitioning to low-risk). The emotion-management intervention significantly reduced both NSSI frequency and negative affect. Discussion: These findings demonstrate that clinically meaningful NSSI subtypes exist among rural boarding adolescents and that sleep quality and bullying are key modifiable risk factors. The results support a stepped-care approach in school settings, where the High-NSSI class requires intensive intervention and the Low-NSSI class may benefit from less intensive, universal supports. The emotion-management group intervention is an effective school-based program for the most severe NSSI subtype. Keywords: non-suicidal self-injury, latent profile analysis, latent transition analysis, emotion management, group intervention

Mental health services are constantly evolving with the gradual introduction of functionalized care, which means medical intervention has become more focused on a particular clinical area or stage of the illness. This has progressed to having designated teams for inpatient psychiatry. Usually, psychiatrists manage their patients both in outpatient and inpatient settings while working in a particular geographical area or sector. Moving away from this model to a functionalized inpatient setting, where other psychiatrists take care of their patients, is seen as a breach in continuity of care. In this context, it was intended to review the current literature for the experience of clinicians and patients in these sectorized (medical continuity) or functionalized models of psychiatric inpatient care. A narrative review of the current literature from multiple databases was conducted. The results suggested that there are positive and negative observations in both models. It appeared that neither met the expectations of patients nor clinicians. Patients preferred to be seen by the same consultant in community and inpatient settings, but clinical outcomes were not significantly different in the two models. The functionalized care was mostly medical continuity rather than multidisciplinary. Any changes in the care models may be driven by local facilities and issues. There is a need to improve the quality of care through existing models before any changes. More studies are needed to improve the evidence on the effectiveness of these service models.

Preparing for the Civil Services Examination is long, costly, and uncertain, yet little research has listened to aspirants in India's Tier 2 cities. This descriptive survey asked 523 aspirants enrolled in coaching in Thiruvananthapuram, Kerala, about their stress, coping, attitudes to professional mental-health support, and the support their institutions offer. More than half (55.8%) called the past month very or extremely stressful, and financial strain, family expectations, and fear of judgement were prominent. Aspirants coped through peers, breaks, and planning, yet 84.3% felt they had not found a strategy that worked. Most (90.6%) thought professional help reasonable, but only 23.9% had used it, mainly held back by fear of peer judgement, cost, and confidentiality worries. Most (84.1%) rated stress-related support from their institutions as inadequate or absent. The findings are descriptive, not causal, and suggest support should change the conditions of preparation as well as strengthen individual coping.

The rapid digitalisation and technological advancements associated with Industry 4.0 are transforming work environments, job demands, and employee expectations across sectors. While these changes create new opportunities for flexibility, innovation, and productivity, they also introduce increased pressures that can affect workers’ psychological well-being in different ways. Emerging literature highlights mental health and well-being as critical concerns in the digital era, yet limited attention has been given to how these changes are experienced differently by men and women. This conceptual paper aims to examine gender differences in psychological well-being within the context of Industry 4.0, with a focus on work demands, work–life balance, and organisational support. Through a critical review of existing empirical and theoretical studies, a conceptual framework is proposed, drawing on the Job Demands–Resources (JD–R) theory and supported by Ryff’s Psychological Well-Being model. This framework provides an understanding of how demands and resources associated with Industry 4.0 shape the well-being of men and women in both similar and different ways. The study offers insights for policymakers, organisations, and researchers in developing more inclusive and gender-sensitive strategies to support employee well-being in technology-driven workplaces and contributes to discussions on sustainable work and mental health in the Fourth Industrial Revolution.

The COVID-19 pandemic brought about consequences extending beyond the health crisis itself, particularly affecting the mental health of the adult population in Latin America—a region where structural inequalities and healthcare deficiencies exacerbated the emotional impact of lockdowns, economic uncertainty, and the fear of infection. This study aimed to identify and analyze the psychological factors linked to stress levels experienced by adults in the region following the health emergency, utilizing a systematic literature review conducted in accordance with PRISMA guidelines. The process began with 543 records identified in databases such as PubMed, SciELO, and Elsevier, from which 30 publications covering the 2022–2026 period were selected. Findings revealed that anxiety, depression, emotional fatigue, and post-traumatic stress were the predominant manifestations, associated with social isolation, economic instability, academic and work-related overload, and low socioeconomic status. Resilience and family support served as protective factors against these manifestations. The study concludes that post-pandemic stress has a multifactorial origin and that its effects can persist over time, highlighting the need to strengthen public mental health policies for the adult population.

Anxiety and depressive symptoms frequently co-occur during adolescence. Physical activity is associated with adolescent mental health at the scale-score level, but its links with individual symptoms and their temporal ordering remain less clear. This study examined contemporaneous and one-year prospective associations between physical activity and individual anxiety/depression symptoms, evaluated the robustness of pooling three annual wave-pair cohorts, and compared network patterns between male and female adolescents. Three adjacent annual wave-pair cohorts (2020–2021, 2021–2022, and 2022–2023) from a Chinese national adolescent health survey were analyzed ( N = 13,785 wave-pair records). Physical activity was measured with the PAQ-A and anxiety/depression symptoms with the SCL-90. Gaussian graphical models and cross-lagged panel networks (CLPNs) were estimated. Annual-cohort invariance, missingness, centrality, bridge centrality, accuracy, stability, and male/female differences were examined. Annual-cohort comparisons showed no detectable network-structure differences (M = 0.07–0.08, p = 0.120–0.270) or global-strength differences (ΔS = 0.12–0.32, p = 0.150–0.320). Little’s test was nonsignificant (χ² = 79.39, df = 89, p = 0.531), providing no evidence against a completely-at-random missingness mechanism. In the pooled contemporaneous network, physical activity had negative partial correlations with low motivation (weight = -0.0732), low energy (-0.0651), and nervousness (-0.0532). Worthlessness (expected influence [EI] = 1.39), tension (EI = 1.38), and nervousness (EI = 1.34) were influential nodes. Panic had the highest reported bridge EI (0.659). In the CLPN, physical activity was prospectively associated with lower low motivation ( β = -0.0602) and low mood ( β = -0.0561), while nervousness was associated with lower subsequent physical activity ( β = -0.0539). Male and female networks differed in structure (M = 0.112, p < 0.001) but not global strength (ΔS = 0.19, p = 0.709). Physical activity occupied a peripheral position in the contemporaneous network but showed small prospective associations with selected anxiety and depressive symptoms. These temporal associations do not establish causality. The stable annual-cohort pattern and male/female-specific edge configuration support further confirmatory work using designs that can address unmeasured confounding and within-person change.

Nurses delivered much of the direct care to COVID-19 patients and were repeatedly exposed to death, infection risk, and shortages of equipment, yet little is known about how Pakistani nurses experienced and managed posttraumatic stress symptoms (PTSS). This qualitative study explored PTSS, experiences of trauma, perceived psychological impact, and coping strategies among nurses who cared for COVID-19 patients during peak pandemic waves. Eight registered nurses working in COVID wards and intensive care units of public hospitals in Islamabad and Rawalpindi were recruited through purposive sampling and took part in individual semi-structured interviews conducted in Urdu and basic English. Data were analysed using Braun and Clarke’s thematic analysis. Four themes were generated: (a) symptoms related to trauma (altered sleep, changes in temperament, emotional reactivity, diminished interest in social life, flashbacks); (b) threats and stress due to COVID-19 (increased workload, direct threat to self and others, sense of isolation, lack of knowledge and equipment); (c) psychological impact of trauma (increased mental health concerns, burnout and compassion fatigue, elevated death anxiety, lack of optimism about the future); and (d) strategies to cope (sharing workload with the team, emotional support from colleagues). Seven of eight nurses described flashbacks, and accounts spanned several DSM-5 symptom clusters, although no diagnostic assessment was used. Peer teamwork and emotional support were the only coping resources reported, and no participant had received formal counselling. Peer solidarity seems to have been an informal resource of resilience where organizational support was absent and institutional psychological services should be built around it.

Despite growing concerns about mental health difficulties among children and youth, limited empirical evidence exists on the extent to which adverse childhood experiences and resilience predict mental health difficulties among school-going children and youth in rural communities. This research explored the prevalence and psychosocial predictors of mental health difficulties among children and youth. The study adopted a correlational and descriptive research design. Respondents consisted of 837 children and youth, who were selected from Johannesburg West Education District. They were assessed using the Strengths and Difficulties Questionnaire (SDQ), the Adverse Childhood Experiences Questionnaire (ACE-Q), and the Child and Youth Resilience Measure (CYRM) as data-collection instruments. Frequencies and percentages, regression analysis, and moderation analysis were conducted using Hayes' PROCESS Macro. Findings revealed that about 44.4%, 18.3%, and 37.3% of the participants were within the normal, borderline, and abnormal ranges of mental health well-being, respectively. Adverse childhood experiences (ACEs) significantly predicted mental health difficulties (β = .238, t = 7.071, p < .001), contributing about 5.6% of the variation in mental health difficulties among youth and children. Resilience is also a significant predictor (β = −.121, t = −3.524, p < .001), accounting for about 1.5% of the variation in mental health problems; higher resilience was associated with lower levels of mental health difficulties. Moderation analyses showed that age and gender did not significantly moderate the relationships between ACEs, resilience, and mental health difficulties. The study concludes that ACEs constitute a significant risk factor, whereas resilience serves as a protective factor. The findings highlight the need for trauma-informed interventions, resilience-building programmes, and comprehensive mental health support services to promote positive mental health outcomes among children and youth.

Many children who experience reading challenges develop co-occurring mental health difficulties, such as reading anxiety. The current study tested the relationships between specific reading skills (decoding, fluency, and comprehension) and reading anxiety symptoms. Participants were 230 twins between 8 and 13 years old. Multi-level linear regression models were used to account for family relationships and covaried for age and sex. Age was positively associated and sex was not associated with reading anxiety. Lower decoding (β = -0.19, p < .001), reading fluency (β = -0.22, p < .001), and reading comprehension skills (β = -0.22, p < .001) were significantly associated with higher reading anxiety symptoms. When testing whether each reading skill contributed to reading anxiety after controlling for others, reading comprehension (β = -0.15, p = .010) remained significantly associated with reading anxiety symptoms, whereas decoding (β = 0.01, p = .90) and reading fluency (β = -0.13, p = .08) were no longer significant. Model comparisons followed a similar pattern indicating that reading comprehension (and to a lesser extent fluency) accounted for significant variance in reading anxiety over and above other reading skills, while decoding did not. Secondary analyses covarying for clinical anxiety and ADHD symptoms showed that the association between reading skills and reading anxiety could not be accounted for by these co-occurring symptoms. This study is among the first to examine relationships between specific reading skills and reading anxiety symptoms and highlights the need for improved identification and treatment of reading anxiety symptoms in struggling readers.

ABSTRACT Introduction Anxiety is central to the psychotherapy process, yet psychotherapists routinely infer a client's anxiety intensity from observable behaviour rather than from formal measurement, with no widely accepted framework to organise which observable markers indicate which levels of anxiety. This exploratory study examined how therapists make such classifications. Method Ninety‐one mental health professionals were randomly assigned to classify 41 text‐described behavioural and physiological markers using either a 5‐level or a simplified 3‐level category system, both derived from an integrated model of state anxiety in psychotherapy. Results Response distributions departed significantly from uniformity for nearly all markers in both formats, and the rank ordering of markers by intensity was highly consistent across formats, suggesting that therapists may share broad intuitions about relative marker intensity. Which markers elicited agreement, however, was far less reproducible, depending substantially on the response format. Convergence also depended on where the agreement criterion was set, declining from 90.2% to 51.2% of markers in the 3‐level format and from 63.4% to 22.0% in the 5‐level format as the criterion rose from > 0.50 to > 0.70. The 3‐level format yielded more classifiable markers at every criterion, although this advantage was not consistent across indices, whereas the 5‐level format elicited fewer ‘Insufficient to Determine’ responses. Markers placed at the highest intensity levels were classified most consistently. Discussion These findings offer preliminary groundwork for research on marker operationalisation, contextualised rating tasks and the development of training materials for psychotherapy process research.

The digital revolution has fundamentally transformed childhood experience across the globe. In Ghana, rapid mobile internet penetration, the proliferation of low-cost smartphones, and COVID-19-induced remote learning have dramatically intensified basic school children's exposure to digital screens. Emerging evidence links digital screen addiction (DSA) to significant impairments in children's psychological well-being encompassing emotional, cognitive, social, and behavioural dimensions. Yet, school management responses in Ghanaian basic schools remain underdeveloped and largely uncoordinated. This narrative literature review synthesizes global and sub-Saharan African evidence on digital screen addiction and its psychological well-being consequences among basic school children (ages 5–15), critically examines existing school management frameworks, and proposes a School-Based Digital Wellness Management Framework (SBDWMF) for Ghanaian basic schools. A narrative synthesis approach was employed. Literature was sourced from PubMed, Google Scholar, Scopus, PsycINFO, African Journals Online (AJOL), and grey literature from the WHO, UNESCO, UNICEF, Ghana Education Service (GES), Ghana Health Service (GHS), and the Ministry of Education. Peer-reviewed empirical studies, systematic reviews, meta-analyses, and policy documents published from 2010 to 2024 were included, with a total of 72 sources forming the evidence base. DSA is prevalent among basic school-age children globally, with pooled prevalence estimates ranging from 19% to 38% depending on measurement tools and contexts. Excessive screen exposure is consistently associated with psychological distress, anxiety, depression, attentional difficulties, emotional dysregulation, impaired self-esteem, peer-relationship deficits, and poor academic well-being. In Ghana, contextual risk amplifiers, including parental digital literacy gaps, absent school mental health services, post-COVID normalization of extended screen use, and fragmented policy, compound the psychological burden. School management frameworks in Ghanaian basic schools are largely inadequate to address DSA, with critical deficits in policy, counselling capacity, teacher training, and parental engagement. DSA poses a mounting psychological well-being challenge for Ghanaian basic school children, demanding an urgent, evidence-informed school management response. The proposed six-pillar SBDWMF offers a practical governance architecture for Ghanaian basic school heads, district education officers, and national policymakers to address DSA comprehensively within the school setting.

In this study, we examine students’ reasons for course non-completion at a large, diverse, public research university in the university system of Georgia. We found these reasons in multiple datasets and used a mixed-methods approach to interpret them. While many studies have framed course withdrawals as rational decisions based on academic or personal factors, this study explores a variety of factors, including both practical and emotional considerations, that shape students’ withdrawal decisions. We analyzed emotional sentiment and reasons for course non-completion cited at the moment of withdrawal (i.e., disclosed on the registrar withdrawal form) as well as at retrospective timepoints (i.e., in a survey and semi-structured interview). At the time of withdrawal, students most frequently cited academic, personal, or mental health struggles as reasons for withdrawal, often expressing negative emotions. In some cases, students indicated the need for immediate crisis intervention. However, retrospective reflections revealed more positive emotions about their decisions and cited poor academic performance and an overall imbalance in their lives as key reasons. These findings highlight the complex interplay between academic challenges and emotional responses in the withdrawal process, suggesting that educators should consider both factors when addressing course non-completion. We also discuss the implications for future research and administrative policy.

Mental health disorders are a major concern with millions of people living with mental illnesses, but only a small fraction of them have access to treatment due to stigma attached, lack of resources and trained personnel. Therefore, the inclusion of mental healthcare services in primary health care (PHC) is essential for improving its accessibility. The present review investigates the effectiveness, the different models, and the barriers in integrating mental health services into primary health care in India. The review was conducted following the PRISMA protocol using database like PubMed and Scopus between January 2016 and January 2026. The systematic search yielded 62 results, of which 23 were selected based on established inclusion criteria and were subsequently analyzed thematically. Successful integration of mental health services into primary healthcare was identified as including, but not limited to, task-sharing, use of digital technologies, use of telepsychiatry, and creating an improved policy-driven system. Task-sharing with lay personnel was found to greatly increase the identification and management of people with mental illnesses, while digital technology and telepsychiatry led to better access to mental health services, especially in rural areas. Barriers to implementing integrated mental health services included a lack of training, stigma, insufficient workforce, and limited infrastructure. Integrated mental health services into primary healthcare exist and demonstrate positive results, but to sustain successful implementation, the identified barriers to integration must be eliminated or mitigated to reduce the existing treatment gap for mental illness in India.

Abstract Less effective emotion regulation abilities during childhood represent a significant factor of risk for healthy child development. However, despite much research into less skilled emotion regulation abilities, findings about the outcomes of emotion regulation ability trajectories in adolescence are inconsistent. This may reflect methodological challenges in undertaking prospective longitudinal research, or a lack of clarity about factors that influence developmental outcomes. Therefore, we conducted a systematic review and meta-analysis to examine the prospective relation between early childhood (ages 3–6) emotion regulation abilities and adolescent outcomes (ages 13–16). Peer reviewed prospective longitudinal research studies published in English since 2015 were included in the review if they examined emotion regulation abilities in early childhood; assessed subsequent outcomes in adolescence; and examined risk, protective, or promotive factors associated with emotion trajectories. Statistical analyses utilized random effects models and reported pooled effect sizes within groups. Of 27,490 records identified, 16 studies were included in the systematic review, and 10 in the meta-analysis. Early emotion regulation abilities that were less adaptive predicted subsequent less adaptive regulation, psychiatric difficulties, academic concerns, and social challenges in adolescence. Risk and promotive factors for early childhood emotion regulation abilities included pregnancy-related factors, parental mental health, socioeconomic status, child characteristics, cognitive and behavioral traits, and family dynamics. This highlighted the complex interplay of biological, psychological, and social factors. There was conflicting evidence about sex, suicidality, and externalizing behaviors, and quantitative analyses revealed high heterogeneity among the studies. The findings offer insights about the identification of youth at risk, and the development of targeted clinical interventions to enhance adolescent developmental outcomes.

Background While the COVID-19 pandemic caused major disruptions to social connections and lifestyles, many countries continued the sale of alcohol as an essential commodity. Evidence on change in alcohol use, and its association with mental health and wellbeing during the pandemic is, however, mixed and limited to initial periods of the pandemic. This study aimed to address these research gaps. Methods Data were drawn from the COVID-19 Risks Across the Lifespan (CORAL) Study, a three-wave longitudinal study conducted between May 2020 and April 2021. The present sample included 2,369 participants (age M = 38.81 ± 16.94 years, range = 11–100; 90% females) from the United Kingdom, United States, and Australia. Measures included pre-pandemic alcohol use and changes in consumption frequency, quantity, drinking behaviours (e.g., drinking earlier in the day), and motivations (e.g., drinking for enjoyment) during the pandemic. General perceived stress, COVID-19-related stress, loneliness, and symptoms of depression and anxiety were also assessed. Findings Drinking frequency and quantity remained stable across the first year of the pandemic; however, non-linear age associations were found. Young individuals aged between 11 to 20 years, and mid-aged individuals aged between 50 to 70 years, had the highest probability of increased alcohol use frequency and quantity. Drinking behaviours and motivations also remained largely stable, although age- and country-specific differences emerged, potentially reflecting policy differences such as alcohol access restrictions and lockdown measures. Finally, loneliness unidirectionally predicted subsequent alcohol use quantity. Conclusions These findings highlight the heterogeneous alcohol use patterns across age groups and countries during the pandemic, and underscore loneliness as an important public health issue with implications for alcohol misuse.

Cyberbullying has become an important concern for adolescent well-being because online harassment can continue beyond school settings and expose young people to repeated social stress. This study examined the relationships between cyberbullying exposure, emotion-regulation strategies, and mental health among adolescents. A quantitative, cross-sectional correlational design was used with 100 secondary-school adolescents aged 13-18 years (M = 15.42, SD = 1.38). Measures included the Cyber-Victimization Scale (CYBVICS), Emotion Regulation Questionnaire (ERQ), and Early Adolescent Mental Health Scale (EAMHS). Descriptive statistics, Pearson product-moment correlations, and simple linear regression analyses were reported. Cyberbullying exposure was negatively correlated with cognitive reappraisal (r = -.42, p < .001) and mental health (r = -.58, p < .001), and positively correlated with expressive suppression (r = .48, p < .001). Cognitive reappraisal was positively associated with mental health (r = .51, p < .001), whereas expressive suppression was negatively associated with mental health (r = -.46, p < .001). Regression analysis indicated that cyberbullying exposure accounted for 33.6% of the variance in mental-health scores, R? = .336, F(1, 98) = 49.68, p < .001. The findings indicate meaningful associations among online victimization, emotion regulation, and adolescent well-being. Because the study is cross-sectional and relies on self-report measures, the findings do not establish causality.

Background: Rural women in India are often confronted with situations that make it difficult for them to access formal mental health services such as inaccessibility, internalized stigma, believing that suffering is due to external causes and gender inequalities. These barriers delay receiving formal care for mental health and make these women resort to informal ways of coping such as community support and local faith healers. Methods: This study aimed to explore the informal coping strategies and beliefs around mental health among 100 rural women over the age of 18 years residing in Amroha district of Uttar Pradesh, India. Being a qualitative study, the method employed for the survey was focused group discussions and the participants were included through a convenience snowball sampling. The discussions were held in Hindi language for the ease of the participants and were recorded for analysis which was done through a thematic analysis approach. Results: The results highlighted six broad themes: (1) burden of responsibilities and emotional burnout, (2) physiological manifestations of psychological distress, (3) normalization of chronic stress, (4) psychological distress arising from marital conflict and gender-based adversity, (5) reliance on spiritual and informal coping strategies in place of formal mental healthcare, and (6) emotional suppression and silent tolerance. Conclusions: The findings suggest the urgent need to design culturally aligned psychotherapeutic interventions that focus on creating awareness through psychoeducation that could reduce stigma as well as helping rural women deal with their unmet mental health challenges.

Abstract Purpose Forced migration increases vulnerability to exploitation. Globally, around 50 million people are affected by human trafficking, which often involves trauma with negative mental health effects. Forced migrants already face elevated risks of PTSD, depression, and anxiety, yet the specific association of trafficking on their mental health remains unclear. Methods Symptoms of posttraumatic stress disorder (PTSD), depression, anxiety, and overall stress were assessed using standardized screening instruments (PC-PTSD-5, PHQ-4, and the Distress Thermometer). Experiences of human trafficking were measured with a modified version of the Adult Human Trafficking Screening Tool (AHTST) among forced migrants in Germany. Missing data were handled using multiple imputation. Logistic regression analyses were conducted to examine the association between human trafficking and positive screenings for the respective mental health conditions. Results A total of N = 1108 forced migrants participated in the study. Depending on the imputation model, between 49% and 56% of all participants screened positive for PTSD, 60% to 71% for depression, and 41% to 52% for an anxiety disorder. Among participants who screened positive for these mental health conditions, a positive screen for human trafficking was associated with a 30–40% higher probability of screening positive for PTSD and a 15% to 20% higher probability of screening positive for depression or anxiety disorder. Conclusions Forced migrants with a history of human trafficking are at elevated risk for PTSD, depression, and anxiety than those without, underscoring the need for early identification and tailored psychosocial support.

Mental health systems face a persistent gap in accessible, continuous, and person-centred support. Conversational AI can expand access to psychoeducation, emotional check-ins, self-management, and service navigation, but may also introduce risks of digital exclusion, cultural mismatch, privacy concerns, unsafe advice, and overreliance on automation. This paper develops a conceptual framework integrating Orange Technology, which promotes emotional wellbeing, cultural sensitivity, social connectedness, and resilience, with empathetic AI for mental health support. An integrative literature review examined peer-reviewed systematic reviews and WHO and UN guidance published from 2021 to 2026. Evidence suggests that conversational AI can improve depression, distress, anxiety, and engagement, although effects are heterogeneous and may decline over time. Personalization and empathic interaction may enhance engagement, while the framework's effects on community resilience, cultural sensitivity, and community resource integration require further empirical validation. The framework therefore positions AI as a supportive, human-in-the-loop layer rather than a replacement for clinicians, families, peers, or communities. It connects emotional sensing, empathetic dialogue, personalized support, escalation pathways, community connection, inclusive access, and governance, while aligning mental health innovation with SDG 3, 9, and 17.

Abstract Subclinical depression among peacekeeping veterans remains understudied despite its prevalence and potential to progress to major depression. This study examined associations between deployment-related traumatic stressors and subclinical depressive symptoms in 2,258 Finnish peacekeeping veterans. Subclinical depression was measured using the Depression Scale (DEPS) and traumatic stressor exposure via a 16-item questionnaire. Frequent traumatic stressor exposure was associated with an increased risk of subclinical depression, with 5 out of 16 stressors showing significant associations. The strongest predictor was feeling powerless to help sufficiently within one’s role as peacekeeper, suggesting moral injury significantly contributes to the development of subclinical depression. These results highlight the importance of developing post-deployment screening to detect non-danger-based stressors and subclinical conditions that carry the risk of progressing into severe mental health disorders.

This quantitative comparative investigation evaluated and contrasted levels of state-trait anxiety and generalized anxiety symptoms between early and late adolescent cohorts (N = 100). A cross-sectional comparative survey design was employed using standardized psychometric instruments: the 40-item State-Trait Anxiety Inventory (STAI) and the Generalized Anxiety Disorder-7 scale (GAD-7). Non-parametric Mann-Whitney U tests and chi-square independence analyses revealed no statistically significant differences in overall anxiety scores between early and late adolescents across all dimensions (p > .26). However, over 47% of participants across both groups met clinical severity cut-offs ?10on GAD-7). State and trait anxiety demonstrated a robust positive association (? = 0.81, p < .001). The findings underscore an urgent imperative for universal, stage-independent psychological screening and preventive mental health frameworks within educational environments.

Abstract Governments and organizations increasingly endorse the importance of mental health in all forms of policy, though emphasis in measurement still remains on indicators such as GDP, depression, and other common disorders. In this study of 92 countries ( n = 53,799), we assess the mental health of individuals around the world alongside measures of financial and social well-being. Findings include a trend of languishing mental health across many groups, particularly among younger adults and within higher-income countries. While positive trends are observed for education and income, a number of concerning trends also emerge, particularly the poor results for young adults and generally moderate results for employed individuals. In sum, we find an alarming but perhaps unsurprisingly low level of positive mental health in a substantial number of countries, but also identify specific economic, social, and other indicators that policymakers could target in improving the well-being of the populations they serve.

Eating disorders are complex mental health conditions that typically develop during adolescence or early adulthood and may have a significant adverse impact on both physical and mental health. The main types of eating disorders include anorexia nervosa, bulimia nervosa, and binge-eating disorder, all of which are characterized by altered eating behaviours and associated health problems (Robatto et al., 2024). Eating disorders may be associated with a range of psychological and somatic complications, including depression, anxiety, cardiovascular and endocrine disorders, as well as an increased risk of mortality (Mushtaq et al., 2023). The effects of these disorders may also manifest in the oral cavity. Therefore, in dental hygiene practice, particular importance should be placed on the early recognition of potential oral health changes, individualized assessment of the patient’s oral health status, and the selection of appropriate preventive measures. Dental hygienists may play an important role not only in the prevention of oral diseases but also in the early recognition of oral manifestations potentially associated with eating disorders and in encouraging patients to seek timely multidisciplinary professional care.

Introduction All children have the right to education; however, school attendance problems represent an increasing global concern. The aim of this meta-synthesis is to explore adolescents’ perceptions of their school attendance problems. Methods A meta-synthesis of qualitative primary studies was conducted in accordance with Sandelowski and Barros's guidelines. Seven databases were systematically searched in November 2025. Thematic analysis was used to analyze the findings. Results The adolescentś perceptions of their school attendance problems included mental health challenges, negative peer- and teacher relationships, and a lack of school connectedness. However, positive relationships with teachers, parental support, and appropriate school accommodation supports adolescents’ re-engagement with school. Discussion The findings highlight the complex and multifaceted nature of school attendance problems, and the importance of collaboration between schools and parents to enable early identification and implementation of interventions. There is also a need to strengthen positive relationships between teachers and peers, increase knowledge about school attendance problems, and foster a positive school environment that supports adolescents’ potential. Systematic Review Registration PROSPERO CRD420251245890.

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.

Developmental Coordination Disorder (DCD) is associated with elevated rates of anxiety and depression, as well as reduced quality of life, yet the mechanisms linking motor difficulties to these outcomes remain incompletely specified. This article presents and critically evaluates the Integrated Stress-Adaptation Framework for DCD (ISAF-DCD), which synthesizes empirical findings on DCD with established stress theories, including the Environmental Stress Hypothesis, the transactional model of stress, and the Conservation of Resources model. Although the framework is presented with reference to comorbid neurodevelopmental conditions broadly, its evidential basis and worked examples concentrate specifically on attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD); generalization to other neurodevelopmental conditions is plausible but has not been evaluated here. ISAF-DCD proposes that motor coordination difficulties influence mental, cognitive, and physical health through interacting environmental demands, primary and secondary stressors, appraisal and response processes, and personal and social factors. The framework is bidirectional and developmentally sensitive, allowing outcomes to feed back into subsequent stress and adaptation processes across the lifespan. I examine the model’s conceptual coherence, empirical support, and potential clinical utility, arguing that ISAF-DCD offers a theoretically grounded heuristic for organizing a fragmented literature while remaining provisional. Its proposed contributions include clarifying the multiple roles of resilience and social support, refining the classification of environmental demands, incorporating neurodevelopmental comorbidity as a cross-cutting factor, and representing reciprocal relationships between stress and motor functioning. To improve falsifiability, I specify the temporal and functional roles of key dual-role constructs and derive five core, empirically distinguishable propositions that differentiate ISAF-DCD from an expanded Environmental Stress Hypothesis. Direct empirical support for some components, particularly the proposed corticolimbic mechanisms, remains limited. ISAF-DCD should therefore be treated as a hypothesis-generating framework, focused primarily on ADHD and ASD as comorbid conditions and on mental health as its central but not exclusive outcome domain, that requires rigorous longitudinal and intervention-based evaluation.

Background Benefit finding may be associated with better mental health after the pandemic, but its longitudinal trajectory and its associations with psychosocial resources and mental health symptoms during recovery remain unclear. Objective This study examined trajectories of benefit finding among Chinese college students from approximately 3 to 15 months after COVID-19 restrictions were lifted. We also examined its associations with emotion regulation, social connectedness, depressive symptoms, and anxiety symptoms, together with indirect association patterns involving benefit finding. Methods A three-wave longitudinal study was conducted among 1,155 Chinese college students. Data were analyzed using parallel-process latent growth curve modeling. Results Social connectedness and benefit finding increased linearly over time, whereas depressive and anxiety symptoms decreased. Cognitive reappraisal was positively associated with the benefit finding intercept but negatively associated with its slope, whereas expressive suppression was not significantly associated with either growth factor. Social connectedness showed stronger associations with benefit finding trajectories than the emotion regulation variables. Benefit finding was negatively associated with depressive and anxiety symptoms at both the intercept and slope levels. Indirect association patterns through benefit finding were supported for social connectedness and both depressive and anxiety symptoms at the intercept and slope levels when inference was based on bias-corrected bootstrap confidence intervals. Conclusions Benefit finding increased during the post-pandemic recovery period and was associated with lower depressive and anxiety symptoms. Social connectedness showed relatively strong associations with benefit finding trajectories, while cognitive reappraisal was associated with higher initial benefit finding but a slower subsequent increase. The indirect association patterns linked social connectedness with both symptom domains through benefit finding at the intercept and slope levels. These findings highlight psychosocial resources that merit further study in campus mental health research, while the observational design does not establish causal direction or temporal precedence.

This study evaluated the implementation and operational viability of the LGU Malay Mental Health Ordinance using the seven-component Project EMBRACE framework. The study addressed a local evidence gap by examining not only whether ordinance activities were implemented but also whether the workforce, referral, infrastructure, monitoring, and partnership conditions required for sustained delivery were present. A convergent parallel mixed-methods design was used. Quantitative data were obtained from 50 program implementers through a validated researcher-developed questionnaire (Cronbach's alpha = 0.962), while qualitative data were collected through Focus Group Discussions with 10 adult mental health service clients from Mainland Malay and Boracay Island. Means and standard deviations summarized five-point viability ratings, and qualitative transcripts were thematically analyzed; the two strands were integrated by comparing convergent, complementary, and divergent findings. The ordinance obtained an overall viable assessment, but component results were uneven. Wellness of Daily Living (M = 3.75), Mental Disorder (M = 3.65), Substance Abuse and Other Forms of Addiction (M = 3.72), and Provision of Services for Mental, Neurologic, and Substance Disorders (M = 3.45) were rated Viable. Extreme Life Experience (M = 3.11), Neurologic Disorders (M = 3.37), and Enhancement of Mental Health Facilities and Partnerships (M = 3.29) were Moderately Viable. Service-user accounts generally supported these patterns and highlighted limited specialist access, psychosocial workforce gaps, dependence on external referrals, and infrastructure constraints. The findings indicate that Malay has established a functional community mental health foundation, but long-term viability requires prioritized investment in crisis-response personnel, neurologic referral capacity, facilities, formal partnerships, continuity-of-care mechanisms, and integrated monitoring.

Recent advances in artificial intelligence (AI) call for a renewed examination of the ontological meaning of the human being and the nature of psychoanalytic treatment.AI-based mental health interventions show potential for improving the accessibility and efficiency of care; however, current AI systems generate verbal responses on the basis of statistical patterns, and it remains difficult to regard them as capable of performing, in the same manner as human therapists, the embodied emotional experience and relational internal transformation that psychoanalytic treatment entails.This paper conceptualizes the persistent delegation of psychological functions to external systems as the "outsourced ego" and examines the possibility that this phenomenon may, over time, lead to a weakening of ego functions and a delay in the formation of subjectivity.It also discusses the structural problems of AI-based treatment, including the lack of explainability, the reinforcement of self-deceptive narratives through hallucination, and the absence of ethical responsibility.In addition, this paper considers the difficulty of implementing, in an AI-mediated environment, core mechanisms of psychoanalytic interaction such as containment, transference and countertransference, and the analytic third.In response, it proposes four practical virtues for preserving humanity in the age of AI: reflexivity, negative capability, relational courage, and responsible subjectivity.In conclusion, the development of AI technology should not remain confined to the question of whether human therapists can be replaced; rather, it should serve as an opportunity to reflect more clearly on the distinctiveness of human existence, which lies in the capacity to endure imperfection and live with others.

Background Simulated interviews could provide behavioral information for young-adult mental-health research, including studies of social-evaluative anxiety. Their value depends on reliable observer impressions and interpretable links to participants’ self-reports. We examined personality expression, affective communication, self-observer correspondence, and competence impressions in emerging adults. Methods Two video-interview protocols were administered to participants aged 18–23 years: an occupationally framed protocol ( n = 55 ) and a broader personality-oriented protocol ( n = 33 ); 30 participants completed both. The protocols covered parallel HEXACO-related domains but differed in both framing and question content. Participants completed HEXACO self-reports and selected one of five valence-arousal categories after each response. Four observers rated personality expression, affective communication, and competence. We distinguished focused domain-matched tests from secondary question-level tests and exploratory correlation matrices, reported 95% confidence intervals, used permutation tests, and controlled the false-discovery rate within analysis families. Results Self-reported HEXACO scores were similar across protocols except for lower Agreeableness in the broader protocol (mean difference = − 0.23 , 95% CI [ − 0.35 , − 0.12 ] , q = 0.004 ). Global valence was more positive in the broader protocol (mean difference = 0.30 , 95% CI [ 0.15 , 0.45 ] , q < 0.001 ), whereas the arousal difference was uncertain. Reliability was heterogeneous: personality and competence ICCs ranged from 0.27 to 0.65 and 0.35 to 0.64 in the occupational protocol and from 0.33 to 0.58 and 0.22 to 0.73 in the broader protocol. Question-level affect ICCs were approximately 0.00 to 0.60 and − 0.91 to 0.03, respectively. Occupational self-observer correlations for Extraversion and Agreeableness survived correction; no broader-protocol personality correlation did. Strong same-observer personality-competence associations survived correction in both protocols, but broader-protocol affect-competence associations did not. Conclusions Affective reports differed between protocols, but question content also differed, precluding a pure context effect. Observer-rating reliability and self-observer correspondence identify conditions for future mental-health studies pairing simulated interviews with validated symptom and functioning measures.

Background The coronavirus disease 2019 (COVID-19) pandemic and Russia’s full-scale invasion of Ukraine represent unprecedented global stressors with substantial consequences for mental health. Objective A repeated cross-sectional study was conducted in three independent Hungarian samples before COVID-19 ( N = 249), after the second wave of COVID-19 ( N = 265), and during the early phase of Russia’s full-scale invasion of Ukraine ( N = 148) to examine differences in meaning in life, coping competencies, and fear of death, as well as in the relationships among these constructs. The outbreak of the invasion during data collection provided a unique opportunity to examine these constructs during its early phase. Results Compared with the post-COVID sample, lower descriptive levels of fear of death were observed following the outbreak of Russia’s full-scale invasion of Ukraine. Lower levels of several coping resources, particularly sense of coherence and social competencies, together with the greater relevance of search for meaning, were among the key findings associated with these unforeseen stressors. Stronger associations between coping and meaning in life were identified, while the association between presence of meaning and search for meaning became stronger following the outbreak of the invasion. Network analyses further suggested a closer integration of meaning-related processes with fear of death and coping resources, although these patterns should be interpreted cautiously given the limited stability of the network estimates. Conclusion The findings suggest that exposure to successive unforeseen large-scale stressors may be associated with the reorganization of meaning-related processes and coping resources. The patterns observed following the outbreak of the war may be interpreted within the framework of distal defense processes described by the terror management theory, although these mechanisms were not directly assessed in the present study. The results suggest that longer-term existential anxiety processes and their delayed psychological and social consequences should be considered when developing mental health interventions. These findings may contribute to the refinement of healthcare interventions across multiple levels and cultural contexts in preparation for current and future crises.

The dance piece “Luka Pulih” (Healing Wounds) is a contemporary dance work that explores the emotional experiences of individuals who have been bullied and subjected to social pressure from their surroundings. This work was created as an effort to visualize the psychological process of a person when facing adversity until they are able to rise again through inner strength. The purpose of this work is to convey the message about the impact of bullying on mental health and to describe the healing process as a form of courage and determination in living life. The creative method in this work includes the stages of idea gathering, movement exploration, concept formation, composition, and evaluation. The movements were developed from observations of human body expressions under emotional pressure, which were then processed into contemporary movements with varying dynamics. The accompanying music, makeup, and costumes were designed to reinforce the emotional character in each part of the work. The results of the creation show that the processing of movement, tempo dynamics, and changes in spatial composition are able to present a representation of the character's emotional transition from a phase of despair and indecision to a phase of awakening. Through the work “Luka Pulih”, the choreographer hopes that the audience can understand that the healing process from the experience of bullying requires time, acceptance, and determination. Keywords: Wound Healing, Bullying, Empirical Experience, Langon Method

Background Psychedelic retreats are increasingly used to promote wellbeing outside clinical settings, yet the psychological processes associated with sustained improvements in wellbeing remain poorly understood. From a public mental health perspective, identifying mechanisms that support positive mental health beyond symptom reduction is of growing importance. Methods This naturalistic longitudinal study followed 173 participants attending guided psilocybin retreats conducted within a structured framework of preparation, dosing, and integration. Mental wellbeing was reported before the retreat and across a 12-month follow-up period. Longitudinal changes were examined using linear mixed-effects models. Mediation analyses investigated whether changes in connectedness, neuroticism (anxiety facet), spiritual transcendence, and absorption were associated with changes in wellbeing. Mystical-type experiences were examined as potential predictors of these psychological changes. Results Participants reported substantial and sustained improvements in mental wellbeing over 12 months, moving from levels below Swedish population norms at baseline toward comparable levels at follow-up. Connectedness showed the strongest statistical association with improvements in wellbeing and accounted for the largest proportion of variance in wellbeing change, followed by reductions in the anxiety facet of neuroticism and absorption. Spiritual transcendence was associated with wellbeing improvements when examined separately but did not retain unique effects in the multiple mediation model. More intense mystical-type experiences predicted greater increases in connectedness, spirituality, and absorption, as well as greater reductions in neuroticism (trait anxiety). The association between mystical experiences and wellbeing was substantially attenuated when connectedness was included in the model, suggesting that connectedness may act as a candidate mediator linking mystical-type experiences to longer-term wellbeing, though the observational design precludes causal inference. Conclusions These findings extend prior work on psychedelic-assisted therapy to naturalistic retreat settings, suggesting that connectedness may represent a key psychological process linking psychedelic retreat experiences to sustained improvements in mental wellbeing. From a public mental health perspective, the results highlight the potential importance of social and relational factors in promoting wellbeing beyond the treatment of mental illness. Future controlled studies are needed to clarify the relative contributions of psychedelic, social, and contextual components.

Introduction: During the first year of the COVID-19 pandemic, the global prevalence of anxiety and depression rose by about 25%, with women and young people most affected. Now that the emergency phase is over, it is necessary to know the mental health status of university students' families, a group that is rarely measured directly. Objective: To describe the levels of anxiety, depression and perceived stress among nursing students and their family members, and to explore their relationship with age, gender, socioeconomic stratum and religion. Methods: Quantitative, descriptive, cross-sectional study with non-probability convenience sampling. Thirty-nine people aged 17 to 79 took part: third-semester nursing students at Universidad Metropolitana de Barranquilla and their family members. The GAD-7, the PHQ-9 and the 10-item Perceived Stress Scale (PSS-10) were administered. Associations were tested with the chi-square test and, because of the small cell counts, with an exact test estimated by Monte Carlo simulation.Results: Of the participants, 67% were women, 31% were aged 17 to 25, 49% belonged to socioeconomic stratum 2 and 87% were Catholic. Absence of symptoms and mild levels predominated. Mild anxiety was the most frequent category among those aged 17 to 25 (66.7%), and 25% of those aged 44 to 52 had severe anxiety. The chi-square test suggested an association between age and anxiety (p = 0.046), but the exact test did not confirm it (p = 0.080). No other variable was significantly associated with anxiety, depression or stress. Conclusions: Participants mostly showed mild or no symptoms, with no significant differences by sociodemographic variables. The cross-sectional design and the sample size do not allow these levels to be attributed to the pandemic, but the cases of severe anxiety and moderately severe depression among middle-aged family members warrant follow-up of family mental health in the post-pandemic period.

Self-harm represents a serious mental health concern in which emotional experiences play a significant role in both its onset and maintenance. This exploratory study examined which emotions were most frequently reported before and after self-harm, how selected emotions changed following self-harm, and how emotional experiences were associated with specific forms of self-harm and demographic factors (gender, religious identification). The sample comprised of 158 university students, of whom 130 reported a history of self-harming behavior and were included in analyses of emotional experiences. Data were collected using a modified Self-Harm Inventory questionnaire and measures assessing the occurrence of emotions before and after self-harm. Anger, feelings of failure, and sadness were the most frequently reported emotions preceding self-harm, whereas sadness, relief, disappointment, guilt, and shame were the most frequently reported emotions following self-harm. The reported frequency of anger, guilt, and sadness decreased following self-harm, whereas negative emotions remained prominent after the behavior. After Benjamini–Hochberg correction for multiple comparisons, religious identification remained negatively associated with self-harm frequency and with the reported frequency of several emotions. Gender was not significantly associated with the examined variables, although this finding should be interpreted cautiously given the gender imbalance and limited sample size. After correction, selected associations between emotions and specific forms of self-harm remained significant, including associations of anger with hitting oneself, disgust with starving oneself, hatred with self-defeating thoughts, guilt following laxative misuse, and changes in anger with hitting oneself and intentionally worsening medical situations. Overall, the findings indicate selective associations between emotional experiences and self-harming behavior while underscoring the need for longitudinal and event-level research to clarify their temporal and causal dynamics.

Background Diabetes frequently co-occurs with depression, anxiety, and diabetes-related distress, and psychological status directly influences glycaemic control and the risk of complications. Traditional mental health assessment relies on subjective scales. With the growth of digital health, digital phenotyping offers a new paradigm for real-time, objective mental health monitoring and prediction. However, the pathways through which these technologies perform monitoring and prediction remain unclear. Objective This scoping review aimed to systematically map the application pathways of digital phenotyping for mental health monitoring and prediction in people with diabetes, and to use machine learning-assisted text mining to analyse the main research themes and hotspots, thereby informing the future development of individualised risk prediction models and monitoring systems. Methods A scoping review search was conducted in six English databases (PubMed, Embase, CINAHL, Web of Science, Scopus, and the Cochrane Library) and four Chinese databases (CNKI, Wanfang, VIP, and China Biomedical Literature Database[CBM]), covering studies published from database inception to 10 September 2026. The search strategy was built around terms related to diabetes, digital phenotyping, and mental health. Machine learning-assisted literature mining was used to identify thematic patterns in the included studies. The study selection process and overall workflow followed the PRISMA extension for scoping reviews (PRISMA-ScR). Results A total of 2,968 records were retrieved. After screening, 10 studies were included. The evidence indicated that digital phenotyping mainly enables real-time monitoring of mental health in people with diabetes through signals such as continuous glucose monitoring (CGM), passive smartphone sensing, voice, and ecological momentary assessment (EMA). Machine learning methods were widely used for risk prediction modelling, but most studies built models at the group level, with only a few adopting n -of-1 analysis or subgroup prediction to achieve individualised risk prediction. External validation of models was generally lacking, and no intervention studies were identified. Conclusions Preliminary evidence suggests that digital phenotyping has exploratory potential for mental health monitoring and prediction in people with diabetes, but research that genuinely achieves individualised risk prediction remains limited. Closed-loop monitoring-intervention design and multicentre external validation are the main directions for future research. Systematic Review Registration https://osf. io/6wsaj/ .

Psychoanalysis occupies a unique position in psychiatry, simultaneously a body of knowledge, a method of clinical investigation, and a form of treatment. Despite its relevance to clinical practice, postgraduate psychiatry residents often encounter the subject with limited structured exposure, resulting in either fascination or dismissal. This primer aims to bridge that gap by providing an accessible, theoretically grounded introduction to psychoanalysis and its derivatives psychoanalytic psychotherapy and psychodynamic psychotherapy for postgraduate psychiatry residents. It outlines the core principles of psychoanalytic theory, the evolution of the field since Freud, key underlying neurobiological concepts, and the common factors shared across various dynamic therapies. The paper does not serve as a training manual, nor does it provide detailed accounts of individual defense mechanisms, models of mind, dream analysis, drive theory, or the historical development of analytic schools. It is intended to sensitize residents to the field and provide a foundation for further independent study.

Bullying victimization is an important public health concern that has been linked to adverse psychological outcomes among adolescents. The study used mental health well-being data collected in the most recent Bangladesh Adolescent Health and Wellbeing Survey (2019–2020) (BAHWS). A total of 9,116 adolescents aged 15–19 years with complete depression data were included in the analysis. A three-level linear mixed-effects model was employed to account for the hierarchical structure of the survey, with adolescents nested within primary sampling units and districts. Additional analyses examined gender and marital status interactions, subgroup differences, and the cumulative association between multiple forms of bullying and depressive symptoms using a composite bullying measure. The findings revealed that verbal bullying (β = 1.39, p < 0.001) and cyberbullying (β = 1.15, p = 0.012) were independently associated with higher depressive symptom scores. The association between physical bullying and depressive symptoms differed significantly by gender, whereas interactions of gender with verbal and cyberbullying were not statistically significant. Exploratory subgroup analyses showed variation in the magnitude of estimated associations across ever-married females, unmarried females, and unmarried males. A graded association was observed for cumulative bullying exposure: compared with adolescents reporting no bullying exposure, those exposed to on (β = 1.25), two (β = 2.61), and three (β = 4.99) bullying types had progressively higher depressive symptom scores (all p < 0.001). Adolescent Age, Current school or college attendance and higher household wealth were associated with lower depressive symptom scores. Bullying victimization, particularly verbal bullying, cyberbullying, and exposure to multiple forms of bullying, was associated with higher depressive symptoms among Bangladeshi adolescents. These findings highlight the need for comprehensive bullying prevention strategies and accessible psychosocial support services, with particular attention to adolescents experiencing multiple forms of bullying and other vulnerable groups.

Background Everyday stress and social inhibition are relevant to mental health during emerging adulthood. Daily psychological richness may help explain the temporal association between perceived stress and subsequent social inhibition. Methods In a 15-day diary study, 186 emerging adults provided 2,790 observations of perceived stress, psychological richness, and social inhibition. Perceived social support was assessed at the person level. Two-level dynamic structural equation modeling (DSEM) was used to examine lagged associations and cross-level moderation. Results Higher perceived stress was associated with lower psychological richness the following day [estimate = −0.588, 95% highest posterior density credible interval (HPD CrI) (−0.672, −0.501)]. Psychological richness was negatively associated with social inhibition on the subsequent day [estimate = −0.093, 95% HPD CrI (−0.108, −0.079)], and perceived stress showed a positive direct association with social inhibition 2 days later [estimate = 0.224, 95% HPD CrI (0.192, 0.257)]. Higher perceived social support was associated with weaker stress–richness and direct stress–inhibition associations. The credible interval for moderation of the richness–inhibition path included zero. The conditional indirect association was smaller at high than low support [difference = −0.040, 95% HPD CrI (−0.065, −0.016)]. Conclusion The findings identify a temporally ordered indirect association involving daily psychological richness and support-related differences in stress-linked pathways. They inform further research on everyday psychosocial experiences and social functioning among emerging adults.

Psychiatric rehabilitation is a crucial aspect of recovery-oriented mental healthcare, yet it remains underdeveloped in Oman. This paper reviews the current state of rehabilitation services, identifying systemic gaps in in-patient, day care and community-based provisions. Services are fragmented, lacking adequate multidisciplinary integration, sufficient community rehabilitation and supported housing, which leads to prolonged hospital stays. Additionally, broader challenges such as stigma and limited intersectoral collaboration hinder service development. The paper suggests practical strategies to enhance rehabilitation services, including the establishment of multidisciplinary teams, expansion of community programmes, provision of supported accommodation and workforce training, all aligned with Oman Vision 2040 and the principles of recovery-oriented mental health care.

The increasing participation of women in the workforce has been accompanied by growing professional and personal demands that may affect the psychological well-being of career women. The World Health Organization (WHO) reports that approximately 15% of the working-age population experiences mental health problems, while work-related pressures contribute to approximately 12 billion lost working days annually. These conditions highlight the importance of resilience as a psychological resource that enables career women to adapt, recover, and function effectively when facing workplace challenges. This study aimed to examine the predictive relationships of self-esteem and emotion regulation with resilience among career women. A quantitative cross-sectional survey design was employed involving 200 career women in Semarang City, Indonesia, selected through purposive sampling. Data were collected using questionnaires measuring self-esteem, emotion regulation, and resilience on a five-point Likert scale. The data were analyzed using Structural Equation Modeling–Partial Least Squares (SEM-PLS) with SmartPLS 4 through the evaluation of the measurement model, structural model, and hypothesis testing using a bootstrapping procedure. The findings showed that self-esteem and emotion regulation were positive predictors of resilience among career women. Self-esteem demonstrated a relatively stronger contribution than emotion regulation, while the overall model explained part of the variance in resilience. These findings indicate that career women with more positive self-esteem and better emotion regulation tend to demonstrate greater resilience. The study highlights the importance of self-esteem and emotion regulation as psychological resources that may be considered in organizational programs aimed at supporting women's resilience, psychological well-being, and sustainable career development. ABSTRAK Meningkatnya partisipasi perempuan dalam dunia kerja diikuti dengan semakin kompleksnya tuntutan profesional dan kehidupan personal yang berpotensi memengaruhi kondisi psikologis wanita karier. Organisasi Kesehatan Dunia (WHO) melaporkan bahwa sekitar 15% penduduk usia produktif mengalami gangguan mental, sementara tekanan kerja menyebabkan hilangnya sekitar 12 miliar hari kerja setiap tahun. Kondisi tersebut menunjukkan pentingnya resiliensi agar wanita karier mampu bertahan, beradaptasi, dan bangkit dari berbagai tekanan. Penelitian ini bertujuan menganalisis hubungan prediktif self-esteem dan regulasi emosi dengan resiliensi pada wanita karier. Penelitian menggunakan pendekatan kuantitatif dengan desain cross-sectional melalui metode survei terhadap 200 wanita karier di Kota Semarang yang dipilih menggunakan teknik purposive sampling. Data dikumpulkan menggunakan kuesioner yang mengukur self-esteem, regulasi emosi, dan resiliensi dengan skala Likert lima tingkat. Data dianalisis menggunakan Structural Equation Modeling–Partial Least Squares (SEM-PLS) dengan bantuan SmartPLS 4 melalui evaluasi model pengukuran, model struktural, dan pengujian hipotesis menggunakan prosedur bootstrapping. Hasil penelitian menunjukkan bahwa self-esteem dan regulasi emosi merupakan prediktor positif terhadap resiliensi pada wanita karier. Self-esteem menunjukkan kontribusi yang relatif lebih kuat dibandingkan regulasi emosi, sedangkan model penelitian secara keseluruhan mampu menjelaskan sebagian variasi resiliensi. Temuan ini menunjukkan bahwa wanita karier dengan penghargaan diri yang lebih positif dan kemampuan regulasi emosi yang lebih baik cenderung memiliki resiliensi yang lebih tinggi. Penelitian ini menegaskan pentingnya self-esteem dan regulasi emosi sebagai sumber daya psikologis yang dapat dipertimbangkan dalam pengembangan program organisasi untuk mendukung resiliensi, kesejahteraan psikologis, dan keberlanjutan karier perempuan.

Depression is a leading cause of illness and disability among adolescents worldwide, yet evidence on its burden among school-going adolescents in rural Kenyan counties remains limited. This study determined the prevalence and socio-demographic factors of depression among secondary school students in Bungoma County, Kenya, to provide baseline evidence for mental health planning. The study was guided by Hopelessness Theory of Depression and Ecological Systems Theory. An analytical mixed methods cross-sectional study design was adopted. The target population consisted of secondary school students, with a sample size of 400 respondents determined using Taro Yamane formula. The respondents were selected through multistage stratified and systematic sampling from three sub-counties of Bungoma County (Mt. Elgon, Kimilili and Bungoma South). Quantitative data were collected using the Patient Health Questionnaire (PHQ-9) and a structured questionnaire, and analyzed using descriptive statistics and ordinal logistic regression in SPSS version 28. Qualitative data were obtained through ten Focus group discussions with students and twelve in-depth interviews with class teachers, and analyzed thematically. The overall prevalence of depressive symptoms (PHQ-9 score ≥ 5) was 55.5% (n = 222), 41.5% (n = 166) had mild depression, 9.5% (n = 38) moderate depression, 3.5% (n = 14) moderately severe depression and 1.0% (n = 4) severe depression, while 44.5% (n = 178) were not depressed. Female students were found to be almost twice as likely to experience higher levels of depression compared to the males (AOR= 1.71, P= 0.04). On the other hand, students in mixed day and boarding schools were 78% less likely to experience higher level of depression, (AOR = 0.22, P<0.001), compared to those in girls’ boarding and day schools. Further, students who live with extended family were more than twice as likely as those with both parents to experience higher depression levels (AOR = 2.10, P= 0.04). The qualitative data pointed to gender and family structure as possible associations of depression. Depression is highly prevalent among secondary school students in Bungoma County, with one in seven students experiencing moderate to severe depression. Routine school-based mental health screening using validated tools such as the PHQ-9 is recommended to enable early identification, counselling and referral of affected students.

Mental healthcare needs are growing, yet awareness of available services remains limited, even in Houston, Texas. This study examined relationships between having experienced or been diagnosed with mental illness and awareness of community-based mental health or crisis services. Approximately 1,000 Houston-area adults were surveyed in 2024 and 2026. Chi-square and multivariable regression analyses showed that experience with mental illness was associated with SGM populations, race/ethnicity, and age after adjustment for sociodemographic characteristics. SGM participants had greater odds of reporting mental illness, whereas Black/African American, Hispanic/Latinx, Asian, and older adults had lower adjusted odds relative to their reference groups. Awareness of community-based services was independently associated with gender, SGM populations, race/ethnicity, age, and annual household income; females had greater odds of awareness, whereas Hispanic/Latinx, Asian, and older adults had lower odds. Findings highlight sociodemographic differences in reported experience with mental illness and awareness of community-based services. Longitudinal research is needed to further examine these relationships.

Traditional diagnostic systems, such as the DSM-5 and ICD-11, suffer from well-documented limitations, including high comorbidity rates, arbitrary diagnostic thresholds, and within-disorder heterogeneity. Consequently, the field is evolving towards hierarchical, transdiagnostic, dimensional models of psychopathology. This study reports on the development and initial validation of the Multidimensional Transdiagnostic Inventory of Psychopathology (MTIP). This new broadband inventory aligns traditional DSM disorders with contemporary dimensional models of psychopathology. We conducted initial development and basic psychometric analyses in a mixed sample of 301 adults. We then validated the MTIP in a second independent sample (N = 826), of which 640 who self-reported no history of past mental health treatment were used as our normative/reference sample. The final MTIP contained 13 clinical scales and seven supplemental scales. All the MTIP scales met core psychometric assumptions at the item, scale, and transdiagnostic levels. A series of exploratory and second-order factor analyses supported the MTIP hierarchical dimensional structure. Concurrent validity correlations with the DSM-5 level 1 cross-cutting symptom measure were strong, ranging from 0.89 (depression) to 0.51 (drug misuse). Regression analyses supported the construct validity of the higher-order transdiagnostic scales. Twelve of the 13 clinical scales differentiated individuals with a history of mental health care from those without past care, with effect sizes ranging from 0.20 (Alcohol Misuse) to 1.06 (Anxiety). Effect sizes for the transdiagnostic scales ranged from 0.33 (Thought Dysregulation) to 1.07 (Emotion Dysregulation). The clinical implications and potential applications of the MTIP are discussed.

This study addresses the process of symbolic grief experienced by mothers of children with Autism Spectrum Disorder (ASD), considering psychological vulnerability and resilience in the face of the deconstruction of the image of the idealized child. It is based on the understanding that an ASD diagnosis may disrupt expectations developed throughout pregnancy regarding the child’s development and future, thereby affecting the maternal experience. The general objective is to analyze the process of symbolic grief experienced by mothers of children with ASD, integrating psychological vulnerability, resilience, and support networks. Specifically, the study seeks to identify factors of psychological vulnerability resulting from maternal overload; discuss the impact of symbolic grief on atypical motherhood; and evaluate the role of support networks and public policies in promoting these women’s mental health. This is a narrative literature review of a qualitative, descriptive, and exploratory nature, conducted using the BVS-Psi and SciELO databases. The results indicate that a diagnosis may trigger psychological distress, frustration, guilt, fear, and emotional overload, contributing to social isolation and mental health problems. However, psychological support, family and community assistance as part of a support network, and effective public policies contribute to strengthening resilience and reframing the experience of atypical motherhood. It is concluded that understanding the impact of symbolic grief on these mothers is essential to broadening the perspective of psychology and public policies regarding their socio-emotional needs, promoting comprehensive care and strengthening mental health.

BACKGROUND: Israel's 2015 mental health reform transferred responsibility for mental health services from the government to community health maintenance organisations (HMOs), aiming to improve accessibility and equity and reduce stigma. However, its implications for different populations remain significantly underresearched. AIMS: To examine trends in mental health service utilisation and psychiatric medication issue rates among Arab and Ultra-Orthodox Jewish populations before and after the 2015 mental health reform. METHOD: = 2 847 184). Participants were classified as either general (non-Ultra-Orthodox Jewish), Ultra-Orthodox Jewish or Arab. The study analysed annual community visits to mental health professionals and dispensed psychiatric prescriptions. RESULTS: Between 2012 and 2019 the number of mental health service users increased across all populations, most prominently among Ultra-Orthodox Jewish and Arab populations (1.94- and 1.91-fold, respectively), compared with 1.55-fold in the general population. Annual community visits increased 2.4-fold in the general population, 2.2-fold in the Ultra-Orthodox Jewish population and 3.7-fold among Arabs, who had the lowest baseline utilisation. Psychiatric medication issue rates increased most in the Ultra-Orthodox Jewish population (2.5-fold), compared with 1.7-fold in the Arab and 1.5-fold in the general population. Women consistently used more services than men, with the greatest relative increase among Arab women. CONCLUSIONS: The findings suggest improved access to mental health services over the study period spanning the 2015 mental health reform, particularly in previously underserved populations. Continued progress requires culturally sensitive, community-tailored interventions for Arab and Ultra-Orthodox Jewish populations.

Entry-level managers are usually promoted for their technical skills and are then expected to meet targets, lead teams and resolve conflicts with little preparation for the role. This study examined the relationship between workplace stress, mental health and job satisfaction among entry-level managers in Indian organizations. Using a quantitative correlational design, data were collected through an online questionnaire from 47 managers with up to five years of managerial experience across finance, manufacturing, IT/ITES, healthcare and service operations. Most participants reported moderate workplace stress (61.7%), while nearly half (46.8%) reported high job satisfaction. Workplace stress was positively correlated with mental health difficulty (r = .641) and negatively correlated with job satisfaction (r = -.477), and mental health difficulty was negatively correlated with job satisfaction (r = -.536), all at p < .01. Stress explained 41% of the variance in mental health difficulty, and mental health explained 29% of the variance in job satisfaction. When both were considered together, only mental health remained a significant predictor of satisfaction. The findings suggest that the mental health of new managers is central to their job satisfaction and point to the need for training, mentoring and psychological support early in a managerial career.

Objectives: The coronavirus disease-2019 (COVID-19) infection has affected the lives of all strata of society since its beginning. To control the spread of the disease, a lockdown was imposed. During this time, there was a substantial increase in the usage of gadgets and reduction in outdoor activities because of online studies that resulted in serious the mental health issues, especially in the paediatric population. Material and Methods: To study the effect of the COVID-19 pandemic on screen time, playtime and behaviour of the students, the study was conducted on 153 subjects of 4–18 years age group attending the outpatient department, over a period of 3 months. A questionnaire format of ten questions was framed that was asked from the children or from their parents/guardians. This study included questions such as time spent on online classes, self-study or study with parents and gadgets used for the online classes. Results: Most of the children were students of classes upper kinder garden and I, comprising 19.0% and 18.3%, respectively. Females outnumbered males in the study. Weight gain was observed in 43.8%, and signs of irritability were observed in 68.0% of the children. Weight gain showed a statistically significant correlation with the duration of online classes, indoor and outdoor playtime with p-values of 0.044, <0.005 and 0.005, respectively. There was also a statistically significant correlation between change in behaviour with outdoor playtime and sleep timings with p < 0.005 and 0.019, respectively. Conclusion: This study concluded that there was a significant increase in screen time and a decrease in outdoor play activities during the time of COVID-19 pandemic with a statistically significant correlation with the weight gain and change in behaviour of the children.

Mental health conditions have become one of the most urgent public health challenges worldwide, affecting nearly one billion people and creating substantial social and economic burdens. Despite increasing demand for psychological services, barriers such as financial costs, shortages of mental health professionals, geographical inequalities, and social stigma prevent many individuals from receiving timely support. This paper examines the biological, psychological, and environmental factors contributing to mental disorders and evaluates the potential role of artificial intelligence (AI) conversational models in mental health support. It argues that AI cannot replace licensed clinicians but can serve as a complementary tool by improving accessibility, providing continuous communication, offering privacy, and delivering personalized psychoeducation. Particular attention is given to autism spectrum disorder (ASD), where AI's predictable communication style may support communication practice and reduce social pressure. The paper also discusses AI-assisted interventions based on cognitive behavioral therapy (CBT) and examines ethical challenges, including privacy, algorithmic bias, and clinical responsibility. Overall, responsible cooperation between AI technologies and healthcare professionals may improve the accessibility and effectiveness of future mental healthcare.

Background Digital mental health platforms routinely deliver self-administered symptom scales on the assumption that users with more severe symptoms are more likely to enter professional care. That assumption is rarely tested with linked participant-level data, and almost never in the Arabic-speaking Gulf. Objective To examine whether symptom severity at a user’s first self-assessment predicts booking a professional session within 90 days, across four symptom domains, on a Saudi commercial digital mental health platform. Methods Retrospective cohort analysis of 10,100 first assessments — depression, generalized anxiety, panic, and obsessive-compulsive scales — contributed by 5,524 unique users of the Talbinah platform and linked to demographic and session-booking records through a pseudonymous (SHA-256 hashed) user identifier. The primary outcome was any session booked within 90 days after the assessment. Severity was banded by the established cut-offs for the PHQ-9 and GAD-7, and by percentage of scale maximum for the panic and obsessive-compulsive measures, for which no severity thresholds are established. Per-scale multivariable logistic regression estimated adjusted odds ratios (aOR) for severity band (reference None/Minimal), adjusting for age, sex, and device type. Pre-specified sensitivity analyses used 30- and 180-day windows, an attended-session outcome, percentage-of-maximum banding applied to all four scales, and a subset with no prior booking (incident help-seeking). Reporting followed STROBE. Results Users were young (mean age 26.7 years, SD 8.1) and predominantly female (78.1%); 16.6% of first assessments were followed by a booking within 90 days. No severity band on any of the four scales was associated with higher odds of booking (severe vs None/Minimal: depression aOR 0.71, 95% CI 0.51–1.01; generalized anxiety 0.76, 0.49–1.16; panic 0.83, 0.52–1.31; obsessive-compulsive 1.01, 0.59–1.74). One severity contrast was statistically significant, in the opposite direction: moderate depression was associated with lower odds of booking (0.66, 95% CI 0.45–0.97). Older age (aOR ~1.2 per decade) and iOS device use (1.4–2.0) were associated with booking across scales. This absence of a positive severity–booking association was consistent across 30-, 90-, and 180-day windows, the attended-session outcome, and percentage-of-maximum banding; a nominal association for moderate anxiety seen under percentage banding did not persist with validated GAD-7 cut-offs. Estimates for the panic and obsessive-compulsive scales, which lack established severity thresholds, are exploratory. Conclusions On a Saudi digital mental health platform, greater self-reported symptom severity at first assessment was not followed by higher subsequent booking of professional care, consistently across specifications, and for moderate depression was associated with lower odds of booking; demographic and access-related attributes showed stronger associations with booking than symptom load did. Self-screening on its own appears insufficient as a pathway into care.

Few events in recent history have forced clinicians and researchers to rethink mental health quite like COVID-19. In this commentary, we reflect on something that struck us while reading the work of Cantone et al. : the pandemic, for all its devastation, created a kind of unplanned observational window, a chance to study, at population scale, what happens when stress and rhythm disruption hit at the same time. Healthcare Workers (HCWs) were at the epicentre of this. They didn't just witness the crisis; they absorbed it, shift after shift, for months. What the data show is that their depressive symptoms and rhythm instability were not random; they appear systematically linked, and at levels one would more typically associate with mood disorder research. We discuss these findings through the lens of DYMERS (Dysregulation of Mood, Energy, and Social Rhythms Syndrome), a heuristic transdiagnostic construct that, in our view, captures something that standard categorical diagnoses tend to miss: the subthreshold, fluctuating psychopathology that sits just below the threshold of formal diagnosis but causes real impairment. The pandemic may not have created these vulnerabilities, but it may well have sharpened our ability to see them.

Pre-adolescence 9-12 years is a critical developmental period characterized by rapid biological, emotional, cognitive, and social changes that influence future mental health and well-being. Indian pre-adolescents increasingly encounter academic pressure, changing family dynamics, peer challenges, and extensive digital exposure, creating potential risks to emotional adjustment. Resilience, defined as the ability to adapt positively to adversity and recover from challenging experiences, is an important protective factor during this formative stage. This article aims to examine the determinants and dimensions of resilience among Indian pre-adolescents and to propose a culturally relevant, integrated framework for promoting resilience across biological, psychological, social, and digital domains. This article highlights key factors that strengthen resilience, including emotional regulation, self-esteem, self-compassion, problem-solving skills, supportive parenting, positive school environments, healthy peer relationships, and community connectedness. Digital resilience is also emphasized, encompassing safe technology use, digital literacy, responsible online behavior, and adaptive coping with cyberbullying, online risks, and excessive screen exposure. Based on existing evidence and contextual insights, the integrated pre-adolescent resilience model (IPARM) is proposed, integrating biological, psychological, social, and digital dimensions. Resilience promotion strategies are discussed at individual, family, school, community, and healthcare levels, with nurses and other health professionals playing an important role in early identification of vulnerable children, mental health promotion, and implementation of resilience-building interventions. Strengthening resilience during pre-adolescence represents a valuable preventive mental health strategy. A holistic and culturally responsive approach can foster emotional competence, psychological well-being, adaptability, and healthy development, enabling Indian children to navigate contemporary challenges and develop into confident and resilient individuals.

This longitudinal study examined the trajectories of healthcare workers’ mental health from the first to the second COVID-19 wave (May 2020–December 2020) in a Swiss tertiary hospital, and their association with individual and organizational factors. For each mental health outcome (depression, anxiety, peritraumatic stress, and well-being), a separate analysis identified two trajectories: one with higher, persistent levels of symptoms and one that was resilient, with low-level symptoms. The persistent trajectory comprised about 25%–30% of participants for anxiety, depression and peritraumatic stress and 47% for well-being; because the classifications were outcome-specific, membership differed across outcomes (about 15% of participants were on a persistent trajectory for all four outcomes and 46% resilient for all four). We found that women, nurses, caregivers, non-managerial employees, and frontline COVID-19 workers were more likely to follow a persistent trajectory. Organizational risk factors were a high workload and an irregular work schedule. These results provide a basis for implementing risk-adapted prevention measures and resilience-promotion programs to protect health workers from the impact of major crises. Future research should address the needs of vulnerable health workers to provide evidence-based health promotion.

Introduction/Objective Depression is a disabling mental health disorder affecting over 300 million people worldwide. In Tunisia, population-level data on its prevalence and determinants remain limited. Our study aimed to estimate the prevalence of depression in the Tunisian population and identify associated socio-demographic and clinical factors. Methods Data were drawn from the mental health component of the Tunisian Health Examination Survey (2016), a nationally representative study conducted among 9,209 individuals aged ≥15 years. Self-reported, physician-diagnosed lifetime depression was the main outcome. Associations with socio-demographic characteristics and clinical conditions, including rheumatoid arthritis, diabetes, and menopause, were examined. Results The study population comprised 4360 men (49.2%) and 4849 women (51.8%), with a mean age of 41.4±17.4 years. The prevalence of self-reported lifetime depression was 4.7%. Multivariate analysis identified female sex (OR=1.53, 95% CI [1.11–2.10]) and age groups 30–64 years (OR=1.81, 95% CI [1.20–2.73]) and ≥65 years (OR=1.82, 95% CI [1.06–3.14]) as factors significantly associated with higher prevalence. Conversely, marriage (OR=0.59, 95% CI [0.42–0.84]) and the absence of rheumatoid arthritis (OR=0.48, 95% CI [0.38–0.60]) were associated with a lower prevalence of the disorder. Discussion The findings indicate that self-reported depression in Tunisia is significantly influenced by gender and aging, consistent with global epidemiological trends. The strong association with physical comorbidities, particularly rheumatoid arthritis, underscores the necessity of integrated mental health screening for patients with chronic illnesses. Furthermore, the protective association of marriage suggests that social and family cohesion remain vital factors in the Tunisian sociocultural context. Conclusion Depression in Tunisia is shaped by gender, aging, and physical comorbidities. Targeted prevention and integrated screening strategies are needed, especially for vulnerable demographic and clinical groups.

Purpose This study examined the global landscape of mental health literacy (MHL) education for health professions students, focusing on publication trends, intervention designs, pedagogical approaches, MHL domains addressed, evaluation methods, and contextual influences. Methods Following PRISMA-ScR guidelines, an Evidence and Gap Mapping (EGM) scoping review was conducted to identify and visually synthesize MHL education interventions. Searches were conducted in PubMed, Embase, Scopus, Web of Science, EBSCOhost (including CINAHL, PsycINFO, and ERIC), and APA PsycArticles (February 1997-May 2025). The included studies involved pre-licensure health professions students and implemented structured educational interventions explicitly targeting MHL domains. The data were extracted using a standardized framework and analyzed through descriptive synthesis and visual mapping to identify research clusters and gaps. PROSPERO registration: CRD420251050891. Results Fifty-five studies met the inclusion criteria for this review. Notably, the number of publications increased significantly after 2016, with most of the evidence coming from Europe, the Western Pacific, and the Americas, while representation from the African and Eastern Mediterranean regions was limited. Quasi-experimental designs were the most common, characterized by short-term, classroom-based interventions primarily targeting specific professions, particularly nursing and medicine. Although traditional didactic teaching methods remained prevalent, experiential strategies such as simulation, role-play, and reflective practices were increasingly adopted. Within the existing body of evidence, interventions predominantly emphasized knowledge, attitudes, and confidence, whereas skills development, behavioral change, self-awareness, and help-seeking were less consistently addressed. Furthermore, evaluations mostly relied on short-term, self-reported outcomes, with few studies examining behavioral change or long-term impacts. Conclusions MHL education for future health professionals is expanding but remains unevenly distributed, pedagogically conservative, and methodologically limited. Advancing the field will require longitudinal, theory-informed, and experiential approaches, stronger evaluation designs, integration of lived-experience perspectives, and targeted capacity-building in low- and middle-income settings.

The increasing accessibility of online pornography has led to earlier exposure among children and adolescents, raising concerns about its potential long-term effects on sexual development, behaviour and mental health. This systematic literature review synthesises current evidence on the relationship between early exposure to pornography and later pornography consumption. A comprehensive search of six electronic databases (MEDLINE, PsycINFO, Sociological Abstracts, Embase, ASSIA, Web of Science) identified 17 studies that met the inclusion criteria, which required individuals to have experienced early exposure to pornography and reported subsequent pornography consumption. Eligible quantitative studies (longitudinal, cohort, case-control, cross-sectional), published in English from 1993 onwards, were identified and screened against inclusion and exclusion criteria. Across studies, earlier age of first exposure was consistently associated with higher frequency of use, greater risk of compulsive or problematic consumption and progression towards more extreme or deviant content in adolescence and adulthood. Developmental and gender differences emerged, with males generally exposed earlier and exhibiting stronger associations between early exposure and problematic use, although similar attitudinal effects were noted among females. Mediating mechanisms included internalisation of sexual scripts, perceived realism, shame and emotional distress, while moderating factors encompassed impulsivity, sensation-seeking, family stability, religiosity and cultural context. Overall, findings indicate that early exposure to pornography may shape enduring behavioural and cognitive trajectories, with outcomes influenced by individual, developmental and social factors. Findings and future directions are discussed in relation to implications for practice, policy and future research.

Benang Merah Bertaut Paku is a dance choreography that addresses psychological violence within the family as one of the main causes of anxiety disorder in children. Psychological violence often leaves no visible physical wounds, yet it has long-term effects on children’s mental health, such as fear, anxiety, pressure, and social isolation. Through the medium of dance, this work seeks to give voice to emotional wounds that are often hidden and rarely discussed openly. The creative process of this work employs dance creation methods consisting of exploration, improvisation, composition, evaluation, and revision. Exploration was conducted to discover movement qualities that represent inner pressure, such as restrained, repetitive, and withdrawn movements. Guided improvisation was used to explore the emotions of children who are ignored and yelled at by their parents. Supporting elements such as tin plates as a symbol of verbal outbursts, white cloth as a symbol of emotional bondage, minimalist music, and dim lighting were used to strengthen the psychological atmosphere of the work. The result of this choreography shows that dance can function not only as entertainment and aesthetic expression, but also as a critical and empathetic language toward social realities. The dancer’s body becomes a medium to convey silence, inner tension, and a child’s fundamental need for love and acceptance from the family. It is hoped that this work will raise public awareness of the importance of children’s mental health and the harmful impact of psychological violence within the family environment

«بنـگ مـرح بـرتـاوت پاکـو» یک رقص‌آرایی است که به خشونت روانی در خانواده به‌عنوان یکی از علل اصلی اختلال اضطراب در کودکان می‌پردازد. خشونت روانی اغلب هیچ زخم فیزیکی قابل مشاهده‌ای بر جای نمی‌گذارد، اما تأثیرات بلندمدتی بر سلامت روان کودکان دارد، از جمله ترس، اضطراب، فشار و انزوای اجتماعی. این اثر از طریق زبان رقص تلاش می‌کند به زخم‌های عاطفی‌ای که اغلب پنهان مانده و به‌ندرت به‌صورت آشکار مورد بحث قرار می‌گیرند، صدا ببخشد. فرآیند خلاقانه این اثر با بهره‌گیری از روش‌های خلق رقص شامل اکتشاف، بداهه‌پردازی، ترکیب، ارزیابی و بازنگری انجام شده است. اکتشاف به‌منظور یافتن کیفیت‌های حرکتی که فشار درونی را نمایان می‌کند، مانند حرکات مهار شده، تکراری و کناره‌گیرانه، صورت گرفته است. بداهه‌پردازی هدایت‌شده برای واکاوی احساسات کودکانی که توسط والدین نادیده گرفته شده و مورد فریاد قرار می‌گیرند، به کار رفته است. عناصری همچون بشقاب‌های حلبی به‌عنوان نماد فوران‌های کلامی، پارچه سفید به‌عنوان نماد اسارت عاطفی، موسیقی مینیمال و نورپردازی کم‌سو برای تقویت فضای روان‌شناختی اثر مورد استفاده قرار گرفته‌اند. نتیجه این رقص‌آرایی نشان می‌دهد که رقص می‌تواند نه‌تنها به‌عنوان سرگرمی و بیان زیبایی‌شناختی، بلکه به‌عنوان زبانی انتقادی و همدلانه نسبت به واقعیت‌های اجتماعی ایفای نقش کند. بدن رقصنده به رسانه‌ای برای انتقال سکوت، تنش درونی و نیاز اساسی کودک به عشق و پذیرش از سوی خانواده تبدیل می‌شود. امید است این اثر آگاهی عمومی نسبت به اهمیت سلامت روان کودکان و پیامدهای زیان‌بار خشونت روانی در محیط خانواده را افزایش دهد.

Suicidal ideation is the consideration of self-inflicted death and has emerged as a serious and rising concern for worldwide public health systems, contributing to over 800,000 deaths annually worldwide. Individuals express intentions, distress, and thoughts of self-harm and death, thereby offering a crucial and unprecedented avenue for timely psychological intervention and surveillance. The core problem addressed by this research is the pronounced global insufficiency in detecting and mitigating suicidal ideation across linguistically diverse environments, specifically focusing on low-resource languages. Previous computational studies have primarily focused on English and other widely used languages, leaving a critical research gap for contexts such as Amharic. The main aim of this study was to investigate and to develop a robust and optimal deep learning model for identifying suicidal ideation in Amharic social media content. A total of 5,428 postings from social media such as Facebook and Telegram were carefully collected, manually annotated, and processed to provide the first publicly available dataset on Amharic suicidal ideation. After preprocessing, Word2Vec, GloVe, and FastText were among the word embedding techniques used for feature engineering. Five deep learning models and four machine learning models were then compared in this study. Based on the experimental results, ensemble learning models achieved slightly higher performance than the individual deep learning models in suicidal ideation detection. Specifically, hard voting ensemble learning models achieved the highest accuracy (83.3%) and precision (86.55%). CNN-BiLSTM achieved an accuracy of 81.45%, while the BiLSTM model achieved an accuracy of 81.4%, indicating that bidirectional sequence learning effectively captures contextual information in Amharic texts. Beyond its strong empirical performance, this study contributes a robust detection framework and introduces a public Amharic dataset, thereby establishing a foundational methodological resource for mental health research. Future studies should focus on developing scalable datasets and context-aware deep learning models that effectively handle multimodal data, multilingual transformer models, fusion-based features, and addressing bias in low-resource computational linguistics.

افکار خودکشی به معنای اندیشیدن به مرگ خودخواسته است و به عنوان یک نگرانی جدی و رو به افزایش برای نظام‌های سلامت عمومی در سراسر جهان مطرح شده است، به طوری که سالانه بیش از ۸۰۰٬۰۰۰ مرگ را در سطح جهانی رقم می‌زند. افراد، نیت‌ها، پریشانی و افکار آسیب به خود و مرگ را ابراز می‌کنند و بدین ترتیب، مسیر مهم و بی‌سابقه‌ای برای مداخله و پایش روان‌شناختی به موقع فراهم می‌شود. مسئله اصلی که این پژوهش به آن می‌پردازد، کمبود چشمگیر جهانی در شناسایی و کاهش افکار خودکشی در محیط‌های زبانی متنوع، به ویژه در زبان‌های کم‌منبع است. مطالعات محاسباتی پیشین عمدتاً بر زبان انگلیسی و سایر زبان‌های پرکاربرد تمرکز داشته‌اند و این امر موجب ایجاد شکاف پژوهشی مهمی در زمینه‌هایی مانند زبان آمهاریک شده است. هدف اصلی این مطالعه، بررسی و توسعه یک مدل یادگیری عمیق قوی و بهینه برای شناسایی افکار خودکشی در محتوای شبکه‌های اجتماعی به زبان آمهاریک بود. در مجموع، ۵٬۴۲۸ پست از شبکه‌های اجتماعی مانند فیس‌بوک و تلگرام با دقت جمع‌آوری، به صورت دستی برچسب‌گذاری و پردازش شدند تا نخستین مجموعه‌داده عمومی درباره افکار خودکشی به زبان آمهاریک فراهم شود. پس از پیش‌پردازش، تکنیک‌های تعبیه واژه مانند Word2Vec، GloVe و FastText برای مهندسی ویژگی‌ها به کار گرفته شدند. در این پژوهش، پنج مدل یادگیری عمیق و چهار مدل یادگیری ماشین با یکدیگر مقایسه شدند. بر اساس نتایج تجربی، مدل‌های یادگیری تجمعی (ensemble learning) عملکردی اندکی بهتر از مدل‌های یادگیری عمیق منفرد در شناسایی افکار خودکشی داشتند. به طور خاص، مدل‌های یادگیری تجمعی با رأی‌گیری سخت (hard voting) بالاترین دقت (۸۳/۳٪) و دقت مثبت (precision) (۸۶/۵۵٪) را به دست آوردند. مدل CNN-BiLSTM به دقت ۸۱/۴۵٪ و مدل BiLSTM به دقت ۸۱/۴٪ دست یافتند که نشان می‌دهد یادگیری دنباله‌ای دوسویه به طور مؤثری اطلاعات زمینه‌ای را در متون آمهاریک استخراج می‌کند. افزون بر عملکرد تجربی قوی، این پژوهش چارچوب شناسایی قابل اعتمادی ارائه داده و مجموعه‌داده عمومی آمهاریک را معرفی می‌کند و بدین ترتیب منبع روش‌شناختی بنیادی برای پژوهش‌های سلامت روان فراهم می‌آورد. مطالعات آتی باید بر توسعه مجموعه‌داده‌های مقیاس‌پذیر و مدل‌های یادگیری عمیق آگاه از زمینه که به طور مؤثر داده‌های چندوجهی، مدل‌های ترنسفورمر چندزبانه، ویژگی‌های مبتنی بر همجوشی و رفع سوگیری در زبان‌شناسی محاسباتی کم‌منبع را مدیریت می‌کنند، تمرکز کنند.

Long-term digital psychological intervention faces issues such as delayed state feedback, observation absence, and scattered individual responses. Static input is difficult to retain cross-period dependencies, and a unified strategy will also widen user differences and cause fluctuations in continuous actions. To address these problems, a personalized intervention system that combines Transformer temporal modeling and proximal policy optimization is constructed. Structured psychological state representation organizes continuous behaviors and subjective feedback into an updateable sequence. The Transformer encoder extracts long-term dependencies and local mutations, the individual embedding absorbs user response deviations, and the Kullback–Leibler (KL) constraint inhibits adjacent strategy jumps. The experiment uses StudentLife data and accompanying simulations, semi-synthetic data. The cumulative reward of the complete model reaches 634.7 ± 21.8, with a 95% confidence interval of 619.11–650.29. The rule strategy, Proximal Policy Optimization (PPO) immediate state model, and the configuration without individual embedding are 412.6 ± 38.4, 528.3 ± 42.7, and 561.9 ± 35.2, respectively. The differences among the three groups, after Holm correction, all reach significant levels ( p < 0.001). The complete model enters the stable range after 1620 rounds, and the variance of the reward after convergence drops to 19.4. The rate of change in emotional intensity, the improvement value of state stability, and the cumulative variance of individual rewards is 0.091, 0.052, and 28.4, respectively. The ablation results show that temporal encoding mainly affects long-term benefits and convergence stability, and individual embedding focuses on reducing the dispersion among users. The existing evidence supports strategy optimization in non-clinical environments, but does not constitute a psychological mechanism explanation, causal effect proof, or clinical effectiveness conclusion.

مداخله روان‌شناختی دیجیتال بلندمدت با مسائلی نظیر بازخورد تأخیری وضعیت، فقدان مشاهده و پاسخ‌های پراکنده فردی مواجه است. ورودی ایستا در حفظ وابستگی‌های میان‌دوره‌ای دشوار عمل می‌کند و راهبرد یکپارچه نیز تفاوت‌های کاربران را افزایش داده و موجب نوسان در اقدامات پیوسته می‌شود. برای رفع این مشکلات، یک سامانه مداخله شخصی‌سازی‌شده که مدل‌سازی زمانی Transformer و بهینه‌سازی سیاست مجاور (Proximal Policy Optimization) را ترکیب می‌کند، طراحی شده است. بازنمایی ساختاریافته وضعیت روان‌شناختی، رفتارهای پیوسته و بازخوردهای ذهنی را به دنباله‌ای قابل به‌روزرسانی سازمان‌دهی می‌کند. رمزگذار Transformer وابستگی‌های بلندمدت و جهش‌های محلی را استخراج می‌کند، تعبیه فردی (individual embedding) انحرافات پاسخ کاربران را جذب می‌کند و قید کولبک–لیبلر (Kullback–Leibler constraint) از جهش‌های راهبردی مجاور جلوگیری می‌کند. آزمایش با داده‌های StudentLife و شبیه‌سازی‌های همراه، داده‌های نیمه‌مصنوعی، انجام شده است. پاداش تجمعی مدل کامل به ۶۳۴٫۷ ± ۲۱٫۸ با فاصله اطمینان ۹۵٪ برابر با ۶۱۹٫۱۱ تا ۶۵۰٫۲۹ می‌رسد. راهبرد قاعده‌مند، مدل وضعیت فوری Proximal Policy Optimization (PPO) و پیکربندی بدون تعبیه فردی به ترتیب ۴۱۲٫۶ ± ۳۸٫۴، ۵۲۸٫۳ ± ۴۲٫۷ و ۵۶۱٫۹ ± ۳۵٫۲ هستند. تفاوت میان سه گروه، پس از اصلاح Holm، همگی به سطح معناداری (p < 0.001) می‌رسد. مدل کامل پس از ۱۶۲۰ دور به بازه پایدار وارد می‌شود و واریانس پاداش پس از همگرایی به ۱۹٫۴ کاهش می‌یابد. نرخ تغییر شدت هیجانی، مقدار بهبود پایداری وضعیت و واریانس تجمعی پاداش فردی به ترتیب ۰٫۰۹۱، ۰٫۰۵۲ و ۲۸٫۴ است. نتایج حذف اجزا (ablation) نشان می‌دهد که رمزگذاری زمانی عمدتاً بر منافع بلندمدت و پایداری همگرایی اثرگذار است و تعبیه فردی بر کاهش پراکندگی میان کاربران تمرکز دارد. شواهد موجود از بهینه‌سازی راهبرد در محیط‌های غیر بالینی حمایت می‌کند، اما تبیین سازوکار روان‌شناختی، اثبات اثر علّی یا نتیجه‌گیری اثربخشی بالینی را فراهم نمی‌کند.

Identifying the perceptions of service users and professionals regarding mental health services is key to understanding the gap between the supply of and demand for care. This systematic review (PRISMA 2020; EBSCOhost, SAGE Journals, Taylor & Francis Online, and SciELO; 2010–2025) identified these perceptions and the accessibility of services. Thirty-three studies were included and synthesized through thematic and narrative analysis, from which five cross-cutting themes and four population groups emerged. Users and professionals converge in an unfavorable perception of access and in identifying structural barriers (cost, waiting times, fragmentation, staff shortages), but diverge in how they situate suffering: individual and psychobiological for professionals, social and cultural for users. Stigma falls less on distress than on the act of seeking consultation, and its institutional dimension is reported almost exclusively by those who experience it, whereas professionals locate it in the community. Despite community-oriented regulatory frameworks, services remain hospital-based and regulated by severity, while community care practices emerge outside the system. These results call for a participatory and culturally situated approach that recognizes users’ knowledge and integrates sociocultural barriers into the design and evaluation of services.

شناسایی ادراک‌های کاربران خدمات و متخصصان نسبت به خدمات سلامت روان، کلید درک شکاف میان عرضه و تقاضای مراقبت است. این مرور نظام‌مند (PRISMA 2020؛ EBSCOhost، SAGE Journals، Taylor & Francis Online و SciELO؛ ۲۰۱۰–۲۰۲۵) به شناسایی این ادراک‌ها و دسترسی‌پذیری خدمات پرداخت. سی‌وسه مطالعه وارد مرور شده و از طریق تحلیل موضوعی و روایی ترکیب شدند که از آن‌ها پنج مضمون مشترک و چهار گروه جمعیتی استخراج شد. کاربران و متخصصان در ادراک نامطلوب از دسترسی و شناسایی موانع ساختاری (هزینه، زمان انتظار، پراکندگی، کمبود نیروی انسانی) هم‌نظر هستند، اما در نحوه تبیین رنج تفاوت دارند: برای متخصصان، فردی و روان‌زیستی و برای کاربران، اجتماعی و فرهنگی است. انگ کمتر متوجه تجربه رنج است تا اقدام به جستجوی مشاوره، و بُعد نهادی آن تقریباً منحصراً توسط تجربه‌کنندگان گزارش می‌شود، در حالی که متخصصان آن را در جامعه می‌بینند. علی‌رغم چارچوب‌های مقرراتی مبتنی بر جامعه، خدمات همچنان بیمارستان‌محور و مبتنی بر شدت باقی مانده‌اند، در حالی که رویه‌های مراقبت اجتماعی خارج از نظام ظهور می‌یابند. این نتایج بر رویکردی مشارکتی و مبتنی بر زمینه فرهنگی تأکید دارد که دانش کاربران را به رسمیت شناخته و موانع اجتماعی‌فرهنگی را در طراحی و ارزیابی خدمات ادغام می‌کند.

This study aimed to investigate the longitudinal relationship between everyday discrimination experienced among 707 lesbian, gay, and bisexual individuals and their substance use over two years, considering age group as a moderator. The findings revealed that higher levels of everyday discrimination and younger age group were linked to increased substance use after two years. The interaction term between everyday discrimination and age group was also significant, demonstrating that the relationship between everyday discrimination and substance use after two years was more pronounced among younger individuals compared to those of the average age group. Implications for counseling professionals are discussed.

هدف این مطالعه بررسی رابطهٔ طولی بین تبعیض روزمره تجربه‌شده در میان ۷۰۷ فرد همجنس‌گرا، دوجنس‌گرا و مصرف مواد آن‌ها طی دو سال، با در نظر گرفتن گروه سنی به عنوان تعدیل‌گر بود. یافته‌ها نشان داد که سطوح بالاتر تبعیض روزمره و گروه سنی جوان‌تر با افزایش مصرف مواد پس از دو سال مرتبط بودند. همچنین، عبارت تعاملی بین تبعیض روزمره و گروه سنی معنادار بود و نشان داد که رابطهٔ بین تبعیض روزمره و مصرف مواد پس از دو سال در میان افراد جوان‌تر نسبت به افراد با میانگین سنی، برجسته‌تر است. پیامدهای این یافته‌ها برای متخصصان مشاوره مورد بحث قرار گرفته است.

Despite the growing literature on first-generation students, limited research has examined how intersecting socioeconomic, cultural, linguistic, and institutional barriers shape the higher education experiences of first-generation Sama Indigenous students in Tawi-Tawi, Philippines. Thus, this study investigated the socioeconomic challenges encountered by first-generation Indigenous Sama students pursuing higher education in Tawi-Tawi and examined how these challenges affect their academic performance and overall well-being. A qualitative case study design was employed. Seven fourth-year first-generation Sama undergraduate students enrolled in higher education institution in Tawi-Tawi were selected through purposive sampling based on ethnicity, first-generation status, final-year enrollment, and residency. Data were gathered through semi-structured interviews lasting 45–58 minutes, audio-recorded with consent, transcribed, cleaned, and analyzed using a four-stage thematic coding process: initial coding, frequency count, categorization, and theme development. Addressing this gap, the study found four major challenges : financial and economic struggles, including poverty, job anxiety, and lack of scholarship support; academic and institutional challenges, such as heavy workloads, teacher-centered instruction, and literacy gaps; social and cultural factors, including language barriers, discrimination, and social comparison; and family and socioeconomic conditions, such as parental loss, limited income, and unstable housing. Impacts included spiritual and emotional strength as the primary coping mechanism, time-management struggles, career aspirations, health decline, and mental health strain. The findings underscore the need for targeted financial assistance, culturally responsive academic support, inclusive teacher training, and stronger collaboration among educational institutions, government agencies, and community leaders to improve retention, academic success, and well-being among first-generation Indigenous students in marginalized island communities.

با وجود افزایش پژوهش‌ها درباره دانشجویان نسل اول، تحقیقات محدودی به بررسی چگونگی تأثیر تلاقی موانع اقتصادی، فرهنگی، زبانی و نهادی بر تجارب آموزش عالی دانشجویان بومی ساما نسل اول در تاوی-تاوی، فیلیپین پرداخته‌اند. بنابراین، این مطالعه به بررسی چالش‌های اقتصادی-اجتماعی پیش‌روی دانشجویان بومی ساما نسل اول که در تاوی-تاوی به تحصیلات عالی می‌پردازند، و تأثیر این چالش‌ها بر عملکرد تحصیلی و بهزیستی کلی آنان پرداخت. این پژوهش با رویکرد کیفی و طرح مطالعه موردی انجام شد. هفت دانشجوی کارشناسی سال چهارم نسل اول ساما که در یک مؤسسه آموزش عالی در تاوی-تاوی ثبت‌نام کرده بودند، با نمونه‌گیری هدفمند بر اساس قومیت، وضعیت نسل اول، ثبت‌نام در سال پایانی و محل سکونت انتخاب شدند. داده‌ها از طریق مصاحبه‌های نیمه‌ساختاریافته به مدت ۴۵ تا ۵۸ دقیقه جمع‌آوری شد که با رضایت شرکت‌کنندگان ضبط صوتی، رونویسی، پاک‌سازی و با استفاده از فرایند کدگذاری چهار مرحله‌ای شامل کدگذاری اولیه، شمارش فراوانی، دسته‌بندی و توسعه تم‌ها تحلیل گردید. این مطالعه با پرداختن به این خلأ، چهار چالش عمده را شناسایی کرد: مشکلات مالی و اقتصادی از جمله فقر، اضطراب شغلی و فقدان حمایت بورسیه؛ چالش‌های تحصیلی و نهادی مانند حجم بالای کار، آموزش معلم‌محور و شکاف‌های سواد؛ عوامل اجتماعی و فرهنگی شامل موانع زبانی، تبعیض و مقایسه اجتماعی؛ و شرایط خانوادگی و اقتصادی-اجتماعی مانند فقدان والدین، درآمد محدود و مسکن ناپایدار. پیامدها شامل قدرت معنوی و عاطفی به عنوان راهبرد اصلی مقابله، مشکلات مدیریت زمان، آرزوهای شغلی، افت سلامت و فشار روانی بود. یافته‌ها بر ضرورت حمایت مالی هدفمند، پشتیبانی تحصیلی متناسب با فرهنگ، آموزش فراگیر معلمان و همکاری قوی‌تر میان مؤسسات آموزشی، نهادهای دولتی و رهبران جامعه برای بهبود ماندگاری، موفقیت تحصیلی و بهزیستی دانشجویان بومی نسل اول در جوامع جزیره‌ای محروم تأکید دارد.

Background Suicidal behaviors among adolescents are a serious global public health concern and are closely linked to both mental health and everyday lifestyle behaviors. Suicidal ideation, planning, and attempts lie along a spectrum of increasing severity. However, how psychological distress and health-related behaviors interact to influence suicide risk is complex and not yet fully understood. This study aimed to identify key mental health and lifestyle factors associated with different stages of adolescent suicidal behaviors using interpretable machine learning methods. Methods Data were obtained from the 2021 Youth Risk Behavior Surveillance System (YRBS), a nationally representative survey of U.S. high school students. After data cleaning and multiple imputation, 16,946 adolescents aged 14–18 years were included in the analysis. Extreme Gradient Boosting (XGBoost) models were developed to predict suicidal ideation, suicide planning, and suicide attempts. Model performance was assessed using the area under the receiver operating characteristic curve (AUC) and related metrics. Feature importance was examined using gain-based measures, while SHapley Additive exPlanations (SHAP) and partial dependence plots were used to explore the direction, strength, and nonlinear effects of key predictors. Results All three XGBoost models showed satisfactory predictive performance. Mental health factors, particularly persistent feelings of sadness and self-rated mental health, were the strongest predictors across all stages of suicidal behaviors. Lifestyle behaviors, including sleep duration, physical activity, diet, screen time, and substance use, also contributed meaningfully to risk prediction, although their relative importance differed by outcome. SHAP analyses indicated that greater sadness and poorer mental health were strongly associated with higher suicide risk, whereas adequate sleep and higher levels of physical activity were associated with lower predicted risk. Substance use, including alcohol, cigarette, and marijuana use, played an important role in predicting suicide attempts than suicidal ideation or planning. Partial dependence analyses showed nonlinear and threshold effects, especially for sadness, mental health status, and sleep duration. Conclusion Mental health factors, especially persistent sadness and overall psychological well-being, were among the most prominent factors associated with suicidal behaviors among adolescents, while lifestyle behaviors showed important and stage-specific associations. Interpretable machine learning approaches help identify complex and nonlinear patterns associated with adolescent suicide risk and offer valuable insights to guide targeted, evidence-based prevention efforts.

زمینه: رفتارهای خودکشی در میان نوجوانان یک نگرانی جدی بهداشت عمومی در سطح جهانی است و ارتباط نزدیکی با سلامت روان و رفتارهای سبک زندگی روزمره دارد. افکار خودکشی، برنامه‌ریزی و اقدام به خودکشی در طیفی با شدت فزاینده قرار دارند. با این حال، نحوه تعامل پریشانی روان‌شناختی و رفتارهای مرتبط با سلامت برای تأثیرگذاری بر خطر خودکشی پیچیده بوده و هنوز به طور کامل درک نشده است. هدف این مطالعه شناسایی عوامل کلیدی سلامت روان و سبک زندگی مرتبط با مراحل مختلف رفتارهای خودکشی در نوجوانان با استفاده از روش‌های یادگیری ماشین قابل تفسیر بود. روش‌ها: داده‌ها از سیستم پایش رفتارهای پرخطر نوجوانان (YRBS) در سال 2021، که یک پیمایش ملی نماینده از دانش‌آموزان دبیرستانی ایالات متحده است، به دست آمد. پس از پاک‌سازی داده‌ها و برآورد چندگانه، 16,946 نوجوان 14 تا 18 ساله در تحلیل وارد شدند. مدل‌های Extreme Gradient Boosting (XGBoost) برای پیش‌بینی افکار خودکشی، برنامه‌ریزی خودکشی و اقدام به خودکشی توسعه یافتند. عملکرد مدل با استفاده از مساحت زیر منحنی مشخصه عملکرد گیرنده (AUC) و معیارهای مرتبط ارزیابی شد. اهمیت ویژگی‌ها با استفاده از معیارهای مبتنی بر gain بررسی شد و برای بررسی جهت، شدت و اثرات غیرخطی پیش‌بین‌های کلیدی از SHapley Additive exPlanations (SHAP) و نمودارهای وابستگی جزئی استفاده گردید. یافته‌ها: هر سه مدل XGBoost عملکرد پیش‌بینی رضایت‌بخشی نشان دادند. عوامل سلامت روان، به ویژه احساسات مداوم غمگینی و ارزیابی ذهنی سلامت روان، قوی‌ترین پیش‌بین‌ها در تمام مراحل رفتارهای خودکشی بودند. رفتارهای سبک زندگی شامل مدت خواب، فعالیت بدنی، رژیم غذایی، زمان استفاده از صفحه نمایش و مصرف مواد نیز به طور معناداری در پیش‌بینی خطر نقش داشتند، اگرچه اهمیت نسبی آن‌ها بسته به پیامد متفاوت بود. تحلیل‌های SHAP نشان داد که غمگینی بیشتر و سلامت روان ضعیف‌تر به طور قوی با افزایش خطر خودکشی مرتبط است، در حالی که خواب کافی و سطوح بالاتر فعالیت بدنی با کاهش خطر پیش‌بینی‌شده همراه بودند. مصرف مواد، از جمله مصرف الکل، سیگار و ماری‌جوانا، نقش مهم‌تری در پیش‌بینی اقدام به خودکشی نسبت به افکار یا برنامه‌ریزی خودکشی داشت. تحلیل‌های وابستگی جزئی اثرات غیرخطی و آستانه‌ای را به ویژه برای غمگینی، وضعیت سلامت روان و مدت خواب نشان داد. نتیجه‌گیری: عوامل سلامت روان، به ویژه غمگینی مداوم و بهزیستی روان‌شناختی کلی، از برجسته‌ترین عوامل مرتبط با رفتارهای خودکشی در نوجوانان بودند، در حالی که رفتارهای سبک زندگی نیز ارتباطات مهم و مرحله‌محور نشان دادند. رویکردهای یادگیری ماشین قابل تفسیر به شناسایی الگوهای پیچیده و غیرخطی مرتبط با خطر خودکشی نوجوانان کمک می‌کنند و بینش‌های ارزشمندی برای هدایت تلاش‌های پیشگیرانه هدفمند و مبتنی بر شواهد ارائه می‌دهند.

Background: Parent–child separations have been associated with adverse health and well-being, with most research focusing on prolonged separations driven by war, famine or disease. Verschickungskinder (‘sent-away children’) – the eight to twelve million German children who, in the decades following World War II, were separated from their families for several weeks to stay in so-called children’s health resorts – represent a largely overlooked case of short-term separation. Despite growing recognition of adverse experiences and abuse in these settings, little is known about the long-term mental health of this population or which characteristics of the sent-away experience are associated with these outcomes.Objective: To examine whether sent-away children show more depressive symptoms, anxiety symptoms, and stress overload compared with peers, and to identify which characteristics of the sent-away experience are associated with these outcomes.Method: An anonymous online survey was conducted with 334 sent-away children and 77 participants in a convenience comparison group (M = 61.1 yrs.; 72.7% female). Linear regression models, adjusting for ACEs and sociodemographics, examined group differences and associations between characteristics of the sent-away experience (age at separation, sex, number of separations, emotional memory) and these outcomes.Results: Sent-away children reported more depressive symptoms, anxiety symptoms, and stress overload than comparison participants (all p < .001). Bivariate comparisons among the sent-away children indicated that younger age at separation was associated with more depressive symptoms, repeated separations with higher stress overload, and very negative memories with all three outcomes; no sex differences were observed. When entered simultaneously in regression models, emotional memory of the event was the only sent-away characteristic associated with depressive (p = .02) and anxiety symptoms (p = .009).Conclusions: Findings highlight the potential long-term mental health relevance of the sent-away experience, particularly among those with very negative memories of their experiences.

زمینه: جدایی والد–کودک با پیامدهای نامطلوب سلامت و بهزیستی همراه بوده است و بیشتر پژوهش‌ها بر جدایی‌های طولانی‌مدت ناشی از جنگ، قحطی یا بیماری تمرکز داشته‌اند. کودکان Verschickungskinder («کودکان فرستاده‌شده») – هشت تا دوازده میلیون کودک آلمانی که در دهه‌های پس از جنگ جهانی دوم برای چندین هفته از خانواده‌های خود جدا شده و در به‌اصطلاح آسایشگاه‌های سلامت کودکان اقامت داشتند – نمونه‌ای عمدتاً نادیده‌گرفته‌شده از جدایی کوتاه‌مدت هستند. با وجود افزایش شناخت نسبت به تجارب نامطلوب و سوءاستفاده در این محیط‌ها، اطلاعات اندکی درباره سلامت روانی بلندمدت این جمعیت یا ویژگی‌های تجربه جدایی که با این پیامدها مرتبط است، وجود دارد. هدف: بررسی اینکه آیا کودکان فرستاده‌شده علائم افسردگی، علائم اضطراب و اضافه‌بار استرس بیشتری نسبت به همتایان خود نشان می‌دهند و شناسایی ویژگی‌های تجربه جدایی که با این پیامدها مرتبط است. روش: یک پیمایش آنلاین ناشناس با ۳۳۴ کودک فرستاده‌شده و ۷۷ شرکت‌کننده در گروه مقایسه‌ای در دسترس (میانگین سنی = ۶۱/۱ سال؛ ۷۲/۷٪ زن) انجام شد. مدل‌های رگرسیون خطی با کنترل ACEs و متغیرهای جمعیت‌شناختی، تفاوت‌های گروهی و ارتباط بین ویژگی‌های تجربه جدایی (سن در زمان جدایی، جنسیت، تعداد دفعات جدایی، حافظه هیجانی) و این پیامدها را بررسی کردند. یافته‌ها: کودکان فرستاده‌شده علائم افسردگی، علائم اضطراب و اضافه‌بار استرس بیشتری نسبت به شرکت‌کنندگان گروه مقایسه گزارش کردند (همه p < ۰/۰۰۱). مقایسه‌های دو متغیره در میان کودکان فرستاده‌شده نشان داد که سن پایین‌تر در زمان جدایی با علائم افسردگی بیشتر، جدایی‌های مکرر با اضافه‌بار استرس بالاتر و خاطرات بسیار منفی با هر سه پیامد مرتبط بود؛ تفاوتی از نظر جنسیت مشاهده نشد. زمانی که این متغیرها به طور همزمان در مدل‌های رگرسیون وارد شدند، حافظه هیجانی رویداد تنها ویژگی تجربه جدایی بود که با علائم افسردگی (p = ۰/۰۲) و علائم اضطراب (p = ۰/۰۰۹) ارتباط داشت. نتیجه‌گیری: یافته‌ها بر اهمیت بالقوه بلندمدت سلامت روانی تجربه جدایی، به‌ویژه در میان افرادی که خاطرات بسیار منفی از این تجربه دارند، تأکید می‌کند.

Depression is a common and disabling condition, yet population-level estimates among Ethiopian and Ethiopian-descendant adults in the Seattle metropolitan area are limited. We conducted a cross-sectional community-based survey from November to December 2024 among adults aged ≥18 years who self-identified as Ethiopian or Ethiopian-descendant. Participants were recruited through social media, community networks, and faith-based organizations and completed anonymous REDCap questionnaires. Clinically significant depressive symptoms were defined as a Patient Health Questionnaire-9 (PHQ-9) score ≥10, a screening threshold rather than a clinical diagnosis. We used logistic regression to examine associations between clinically significant depressive symptoms and the primary exposures of nativity, self-rated physical health, chronic medical conditions, reproductive health history, recreational marijuana or other drug use, and firearm exposure, with adjustment for prespecified sociodemographic covariates. A comprehensive model included the primary full-sample exposures simultaneously, with Benjamini-Hochberg correction for multiple comparisons. Among 474 participants (mean age, 31.6 years; 49.8% male), 178 (37.6%) screened positive for clinically significant depressive symptoms. In the mutually adjusted model, poorer self-rated physical health was associated with higher odds of depressive symptoms: average health (adjusted odds ratio [aOR], 3.83; 95% CI, 2.08–7.36) and poor/somewhat poor health (aOR, 10.73; 95% CI, 4.53–26.80), compared with excellent health. Ever use of recreational marijuana or other drugs (aOR, 3.52; 95% CI, 2.08–6.03) and knowing someone injured or killed by a firearm in the past year (aOR, 2.32; 95% CI, 1.39–3.90) were also associated with higher odds. Among parous women, a history of postpartum depression was associated with current depressive symptoms (aOR, 9.76; 95% CI, 4.31–23.51). Clinically significant depressive symptoms were common in this sample and were associated with poorer physical health, recreational marijuana or other drug use, firearm-related exposure, and prior postpartum depression. Longitudinal research is needed to clarify temporal relationships and inform culturally responsive prevention and care.

افسردگی یک وضعیت شایع و ناتوان‌کننده است، اما برآوردهای جمعیت‌محور در میان بزرگسالان اتیوپیایی و افراد با تبار اتیوپیایی در منطقه کلان‌شهری سیاتل محدود است. ما یک مطالعه مقطعی مبتنی بر جامعه را از نوامبر تا دسامبر ۲۰۲۴ در میان بزرگسالان با سن ≥۱۸ سال که خود را اتیوپیایی یا دارای تبار اتیوپیایی معرفی کردند، انجام دادیم. شرکت‌کنندگان از طریق شبکه‌های اجتماعی، شبکه‌های اجتماعی جامعه‌محور و سازمان‌های مذهبی جذب شدند و پرسشنامه‌های ناشناس REDCap را تکمیل کردند. علائم افسردگی بالینی به‌عنوان نمره ≥۱۰ در پرسشنامه سلامت بیمار-۹ (PHQ-9) تعریف شد که یک آستانه غربالگری است و نه تشخیص بالینی. برای بررسی ارتباط بین علائم افسردگی بالینی و متغیرهای اصلی شامل محل تولد، سلامت جسمانی خودارزیابی‌شده، بیماری‌های مزمن جسمانی، سابقه سلامت باروری، مصرف تفننی ماریجوانا یا سایر مواد مخدر و مواجهه با سلاح گرم، با تعدیل برای متغیرهای جمعیت‌شناختی از پیش تعیین‌شده، از رگرسیون لجستیک استفاده شد. یک مدل جامع، متغیرهای اصلی را به طور همزمان در کل نمونه وارد کرد و اصلاح بنجامینی-هوچبرگ برای مقایسات متعدد اعمال شد. در میان ۴۷۴ شرکت‌کننده (میانگین سنی ۳۱/۶ سال؛ ۴۹/۸٪ مرد)، ۱۷۸ نفر (۳۷/۶٪) از نظر علائم افسردگی بالینی مثبت غربال شدند. در مدل تعدیل‌شده متقابل، سلامت جسمانی خودارزیابی‌شده ضعیف‌تر با احتمال بالاتر علائم افسردگی همراه بود: سلامت متوسط (نسبت شانس تعدیل‌شده [aOR]، ۳/۸۳؛ ۹۵٪ CI، ۲/۰۸–۷/۳۶) و سلامت ضعیف/تاحدی ضعیف (aOR، ۱۰/۷۳؛ ۹۵٪ CI، ۴/۵۳–۲۶/۸۰) در مقایسه با سلامت عالی. مصرف تفننی ماریجوانا یا سایر مواد مخدر (aOR، ۳/۵۲؛ ۹۵٪ CI، ۲/۰۸–۶/۰۳) و شناخت فردی که در سال گذشته توسط سلاح گرم مجروح یا کشته شده است (aOR، ۲/۳۲؛ ۹۵٪ CI، ۱/۳۹–۳/۹۰) نیز با احتمال بالاتر همراه بود. در میان زنان دارای سابقه زایمان، سابقه افسردگی پس از زایمان با علائم فعلی افسردگی مرتبط بود (aOR، ۹/۷۶؛ ۹۵٪ CI، ۴/۳۱–۲۳/۵۱). علائم افسردگی بالینی در این نمونه شایع بود و با سلامت جسمانی ضعیف‌تر، مصرف تفننی ماریجوانا یا سایر مواد مخدر، مواجهه با سلاح گرم و سابقه افسردگی پس از زایمان ارتباط داشت. پژوهش‌های طولی برای روشن شدن روابط زمانی و اطلاع‌رسانی به پیشگیری و مراقبت متناسب با فرهنگ مورد نیاز است.

The Papua New Guinea Psychiatric Association (PNGPA) was inaugurated in 1979. The Association’s objectives are to promote mental health care, advance psychiatric training and transcultural psychiatry, and advocate for the interests of mental health professionals. Psychiatric training started at the University of Papua New Guinea’s undergraduate medical school in 1987. The Master of Medicine in Psychiatry began in 1989 and has produced 11 PNG graduates. Major achievements of PNGPA include improving the training of primary health care workers, publishing a national management guide, and contributing to mental health policy. PNGPA is a member of the World Psychiatric Association. Despite this progress, the psychiatric workforce is still insufficient. Expanding services will require improved recognition and support from government.

انجمن روان‌پزشکی پاپوآ گینه نو (PNGPA) در سال ۱۹۷۹ تأسیس شد. اهداف این انجمن ارتقای مراقبت سلامت روان، پیشبرد آموزش روان‌پزشکی و روان‌پزشکی میان‌فرهنگی و حمایت از منافع حرفه‌ای‌های سلامت روان است. آموزش روان‌پزشکی از سال ۱۹۸۷ در دانشکده پزشکی دانشگاه پاپوآ گینه نو در مقطع کارشناسی آغاز شد. دوره کارشناسی ارشد پزشکی در روان‌پزشکی از سال ۱۹۸۹ شروع شد و تاکنون ۱۱ فارغ‌التحصیل از پاپوآ گینه نو داشته است. از دستاوردهای مهم PNGPA می‌توان به بهبود آموزش کارکنان مراقبت سلامت اولیه، انتشار راهنمای ملی مدیریت و مشارکت در سیاست‌گذاری سلامت روان اشاره کرد. PNGPA عضو انجمن جهانی روان‌پزشکی است. با وجود این پیشرفت‌ها، نیروی انسانی روان‌پزشکی همچنان ناکافی است. گسترش خدمات نیازمند شناسایی و حمایت بیشتر از سوی دولت خواهد بود.

Athletes experience mental health difficulties at rates comparable to or exceeding those of the general population, yet disclosure and help-seeking are often constrained by stigma and performance-oriented norms. This study evaluated a brief, retired-athlete–led, team-embedded mental health literacy (MHL) session and examined changes in MHL, perceived psychological safety, and help-seeking intention among athletes from two Japanese competitive sport teams in the women’s category. Thirty-four athletes (badminton, volleyball) attended a 90-min session integrating psychoeducation and facilitated team dialogue delivered by retired athletes who had completed facilitator training in mental health literacy. Using a single-group pre–post–2-month follow-up design, outcomes were assessed at baseline, immediately post-session, and follow-up. Mixed-effects models estimated change over time, with exploratory stratification by baseline psychological strain measured with the Athlete Psychological Strain Questionnaire (APSQ). MHL improved from baseline to post-session and remained higher at follow-up (standardised mean changes of 0.72 and 0.65, respectively). Perceived psychological safety also increased and was maintained (0.65 and 0.59). Exploratory subgroup estimates varied by baseline strain, although time × strain-group interactions were not statistically significant. The proportion endorsing likely/very likely help-seeking increased descriptively (41%, 53%, 50%) but showed no clear time effects. These preliminary findings support further controlled and implementation-oriented evaluation of retired-athlete–led delivery and downstream help-seeking behaviour.

ورزشکاران با نرخ‌هایی مشابه یا حتی بالاتر از جمعیت عمومی با مشکلات سلامت روان مواجه می‌شوند، اما افشاگری و جستجوی کمک اغلب به دلیل انگ و هنجارهای عملکردمحور محدود می‌شود. این مطالعه یک جلسه کوتاه سواد سلامت روان (MHL) با هدایت ورزشکار بازنشسته و تیم‌محور را ارزیابی کرده و تغییرات در MHL، ایمنی روان‌شناختی ادراک‌شده و قصد جستجوی کمک را در میان ورزشکاران دو تیم ورزشی رقابتی زنانه ژاپنی بررسی کرد. سی‌وچهار ورزشکار (بدمینتون، والیبال) در یک جلسه ۹۰ دقیقه‌ای شرکت کردند که آموزش روانی و گفت‌وگوی تسهیل‌شده تیمی را با هدایت ورزشکاران بازنشسته‌ای که آموزش تسهیل‌گری در سواد سلامت روان را گذرانده بودند، ادغام می‌کرد. با استفاده از طرح تک‌گروهی پیش‌آزمون–پس‌آزمون–پیگیری دوماهه، پیامدها در خط پایه، بلافاصله پس از جلسه و در پیگیری ارزیابی شدند. مدل‌های اثرات مختلط تغییرات در طول زمان را برآورد کردند و طبقه‌بندی اکتشافی بر اساس فشار روانی اولیه با استفاده از پرسشنامه فشار روانی ورزشکار (APSQ) انجام شد. MHL از خط پایه تا پس از جلسه بهبود یافت و در پیگیری نیز بالاتر باقی ماند (تغییرات میانگین استانداردشده به ترتیب ۰٫۷۲ و ۰٫۶۵). ایمنی روان‌شناختی ادراک‌شده نیز افزایش یافت و حفظ شد (۰٫۶۵ و ۰٫۵۹). برآوردهای اکتشافی زیرگروه‌ها بر اساس فشار اولیه متفاوت بود، اگرچه تعاملات زمان × گروه فشار از نظر آماری معنادار نبودند. نسبت افرادی که جستجوی کمک را محتمل/بسیار محتمل اعلام کردند به طور توصیفی افزایش یافت (۴۱٪، ۵۳٪، ۵۰٪) اما اثر زمانی مشخصی نشان نداد. این یافته‌های مقدماتی از ارزیابی‌های کنترل‌شده‌تر و با رویکرد پیاده‌سازی برای ارائه با هدایت ورزشکار بازنشسته و رفتار جستجوی کمک در آینده حمایت می‌کند.

Abstract Resilience and psychological flexibility are protective factors for mental health and well-being in the general population as well as in patients with cancer. Additionally, psychological inflexibility is a risk factor for poor wellbeing and psychopathology. Research suggests that psychological flexibility constitutes a resilience factor and mediates the association between resilience and psychological outcomes across various contexts. However, there is only sparse evidence regarding the mediating role of psychological inflexibility and flexibility processes in the relationship between resilience and psychological outcomes in patients with a chronic health condition. This study examined psychological inflexibility and flexibility processes as mediators of the relationship between resilience and psychological outcomes in patients with cancer. A total of N = 222 patients completed an online survey assessing resilience (Resilience Scale-11), psychological inflexibility (Acceptance and Action Questionnaire-2), distress (National Cancer Center Network distress thermometer), depression (Patient Health Questionnaire-8), anxiety (General Anxiety Disorder-7), and mental health-related quality of life (Short Form Health Survey-12). Across all bootstrapped mediation models, psychological inflexibility mediated the relationship between resilience and all psychological outcomes. Secondary analyses of acceptance of versus struggle with illness and value-based living versus obstruction showed partial mediation, with distinct patterns of association for each process. Our findings highlight psychological (in)flexibility as a key mediator between resilience and psychological outcomes in cancer patients. Obstruction showed the strongest association, suggesting that ACT-based interventions targeting psychological barriers may be particularly effective in enhancing resilience and mental health.

چکیده: تاب‌آوری و انعطاف‌پذیری روان‌شناختی از عوامل محافظت‌کننده برای سلامت روان و بهزیستی در جمعیت عمومی و همچنین در بیماران مبتلا به سرطان به‌شمار می‌روند. علاوه‌براین، عدم انعطاف‌پذیری روان‌شناختی یک عامل خطر برای بهزیستی پایین و آسیب‌شناسی روانی است. پژوهش‌ها نشان داده‌اند که انعطاف‌پذیری روان‌شناختی به‌عنوان یک عامل تاب‌آوری عمل کرده و میانجی ارتباط بین تاب‌آوری و پیامدهای روان‌شناختی در زمینه‌های مختلف است. با این حال، شواهد اندکی در مورد نقش میانجی‌گری عدم انعطاف‌پذیری روان‌شناختی و فرایندهای انعطاف‌پذیری در رابطه بین تاب‌آوری و پیامدهای روان‌شناختی در بیماران مبتلا به بیماری مزمن وجود دارد. این مطالعه، عدم انعطاف‌پذیری و فرایندهای انعطاف‌پذیری روان‌شناختی را به‌عنوان میانجی رابطه بین تاب‌آوری و پیامدهای روان‌شناختی در بیماران مبتلا به سرطان بررسی کرد. در مجموع، ۲۲۲ نفر از بیماران پرسش‌نامه آنلاین شامل سنجش تاب‌آوری (Resilience Scale-11)، عدم انعطاف‌پذیری روان‌شناختی (Acceptance and Action Questionnaire-2)، پریشانی (National Cancer Center Network distress thermometer)، افسردگی (Patient Health Questionnaire-8)، اضطراب (General Anxiety Disorder-7) و کیفیت زندگی مرتبط با سلامت روان (Short Form Health Survey-12) را تکمیل کردند. در تمامی مدل‌های میانجی‌گری بوت‌استرپ‌شده، عدم انعطاف‌پذیری روان‌شناختی رابطه بین تاب‌آوری و تمامی پیامدهای روان‌شناختی را میانجی‌گری کرد. تحلیل‌های ثانویه پذیرش در مقابل مبارزه با بیماری و زندگی مبتنی بر ارزش‌ها در مقابل انسداد، میانجی‌گری جزئی را با الگوهای متمایز برای هر فرایند نشان داد. یافته‌های ما بر نقش کلیدی (عدم) انعطاف‌پذیری روان‌شناختی به‌عنوان میانجی بین تاب‌آوری و پیامدهای روان‌شناختی در بیماران سرطانی تأکید می‌کند. انسداد قوی‌ترین ارتباط را نشان داد و این امر حاکی از آن است که مداخلات مبتنی بر ACT که موانع روان‌شناختی را هدف قرار می‌دهند، ممکن است در ارتقای تاب‌آوری و سلامت روان مؤثرتر باشند.

Electronic cognitive behavioral therapy (e-CBT) is a scalable intervention for anxiety and depressive disorders.While its efficacy against inactive controls is well documented, its comparative effectiveness against first-line pharmacotherapy remains critically underexplored.We conducted a systematic review and meta-analysis (International Prospective Register of Systematic Reviews (PROSPERO): CRD420261413686) of randomized controlled trials (RCTs) comparing e-CBT with waitlist, active psychotherapy, usual care, or medication in adults with anxiety and depression.Effect sizes were pooled using random-effects models with restricted maximum likelihood (REML) and Hartung-Knapp-Sidik-Jonkman (HKSJ) adjustments.Outcomes were assessed using Hedges' g and risk ratios (RR), and evidence certainty was evaluated via the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework.Twenty-two RCTs were included in the analysis.Compared to waitlist/attention controls (k, number of independent contrasts = 11), e-CBT demonstrated a large, statistically significant reduction in depression severity (Hedges' g, standardized mean difference = 0.91; 95% CI: 0.63 to 1.18).However, re-expression onto the Patient Health Questionnaire-9 (PHQ-9) scale yielded an absolute reduction (3.86 points) that fell below the pre-specified minimally important difference (MID) of 5 points.No clear difference was found between e-CBT and active face-to-face or bibliotherapy CBT (k = 3; g = 0.08; 95% CI: -0.59 to 0.75); the wide interval means equivalence could not be established.Adding e-CBT to usual care gave an imprecise, non-significant estimate (k = 3; g = 0.32; 95% CI: -1.41 to 2.05; p = 0.511) that neither confirms nor excludes a benefit.The network geometry revealed zero head-to-head RCTs comparing e-CBT monotherapy directly with antidepressant medication.Nineteen of the 22 trials (86%) were at high overall risk of bias, and funnel-plot asymmetry (Egger's test; p = 0.0056) suggested small-study effects, possibly including publication bias; most GRADE certainty ratings were very low.e-CBT is a scalable option that showed no clear difference from faceto-face CBT in a small number of trials, but its efficacy against inactive controls may be overestimated because of small-study effects and methodological limitations.A critical evidence gap exists regarding its comparative efficacy against pharmacotherapy, necessitating rigorous blinded head-to-head non-inferiority trials.

درمان شناختی-رفتاری الکترونیکی (e-CBT) یک مداخله مقیاس‌پذیر برای اختلالات اضطراب و افسردگی است. در حالی که اثربخشی آن در مقایسه با گروه‌های کنترل غیرفعال به خوبی مستند شده است، اثربخشی مقایسه‌ای آن در برابر دارودرمانی خط اول همچنان به طور انتقادی کمتر مورد بررسی قرار گرفته است. ما یک مرور نظام‌مند و فراتحلیل (ثبت بین‌المللی مرورهای نظام‌مند آینده‌نگر (PROSPERO): CRD420261413686) از کارآزمایی‌های تصادفی کنترل‌شده (RCT) که e-CBT را با لیست انتظار، روان‌درمانی فعال، مراقبت معمول یا دارو در بزرگسالان مبتلا به اضطراب و افسردگی مقایسه کرده‌اند، انجام دادیم. اندازه اثرها با استفاده از مدل‌های اثرات تصادفی با حداکثر درست‌نمایی محدود (REML) و تعدیلات Hartung-Knapp-Sidik-Jonkman (HKSJ) تجمیع شدند. پیامدها با استفاده از g هجز و نسبت خطر (RR) ارزیابی شدند و قطعیت شواهد از طریق چارچوب درجه‌بندی توصیه‌ها، ارزیابی، توسعه و ارزشیابی (GRADE) سنجیده شد. بیست و دو کارآزمایی تصادفی کنترل‌شده در تحلیل وارد شدند. در مقایسه با گروه‌های کنترل لیست انتظار/توجه (k، تعداد تضادهای مستقل = 11)، e-CBT کاهش بزرگ و معناداری در شدت افسردگی نشان داد (g هجز، تفاوت میانگین استاندارد شده = 0.91؛ 95% CI: 0.63 تا 1.18). با این حال، بازنمایی این نتیجه بر روی مقیاس پرسشنامه سلامت بیمار-9 (PHQ-9) کاهش مطلق (3.86 امتیاز) را نشان داد که کمتر از تفاوت حداقل مهم از پیش تعیین‌شده (MID) به میزان 5 امتیاز بود. تفاوت آشکاری بین e-CBT و درمان شناختی-رفتاری حضوری فعال یا کتاب‌درمانی (k = 3؛ g = 0.08؛ 95% CI: ‎-0.59 تا 0.75) یافت نشد؛ بازه وسیع به این معناست که برابری قابل اثبات نبود. افزودن e-CBT به مراقبت معمول، برآوردی غیر دقیق و غیر معنادار ارائه داد (k = 3؛ g = 0.32؛ 95% CI: ‎-1.41 تا 2.05؛ p = 0.511) که نه تأیید و نه رد کننده سودمندی بود. هندسه شبکه هیچ کارآزمایی تصادفی کنترل‌شده سر به سر را که درمان e-CBT را مستقیماً با داروی ضدافسردگی مقایسه کند، نشان نداد. نوزده مورد از ۲۲ کارآزمایی (۸۶٪) در معرض خطر کلی بالای سوگیری بودند و عدم تقارن نمودار قیفی (آزمون Egger؛ p = 0.0056) نشان‌دهنده اثرات مطالعات کوچک، احتمالاً شامل سوگیری انتشار بود؛ اغلب رتبه‌بندی‌های قطعیت GRADE بسیار پایین بودند. e-CBT گزینه‌ای مقیاس‌پذیر است که در تعداد کمی از کارآزمایی‌ها تفاوت آشکاری با درمان شناختی-رفتاری حضوری نشان نداد، اما اثربخشی آن در برابر گروه‌های کنترل غیرفعال ممکن است به دلیل اثرات مطالعات کوچک و محدودیت‌های روش‌شناختی بیش از حد برآورد شده باشد. شکاف شواهدی مهمی در خصوص اثربخشی مقایسه‌ای آن با دارودرمانی وجود دارد که نیازمند کارآزمایی‌های سر به سر کور شده و غیر برتری دقیق است.

Disasters pose a formidable challenge for mental health support services in terms of resources and timely response. This study evaluated the effects of different types of events on the Mexico City population during the first year of the COVID-19 pandemic, under the assumption that high-resolution time-scale data analysis performed on ICT-based and telehealth systems could contribute to understanding psychological needs and to identifying events associated with short-term outbursts in support demands, estimating their time of occurrence, and the characteristics of calls for service. The study evaluated the effects of public announcements of quarantine measures, mental health press conferences, festivities during 2020, and earthquakes with public early warnings between 2020 and 2023 reported through national public institutions’ databases, the “Screening Tool for Mental Health Problems” and the “Lifeline Emergency Phone Call Service (LEPCS),” comprising 138,471 interactions. The analysis used qualitative and quantitative methods, including principal component analysis, correlations, and one-way ANOVA. The study successfully identified patterns in responses associated with acute stress, depression, and anxiety, as well as possible times of maximum demand associated with different types of events. Complex scenarios with multiple threats were associated with significant short-term outbursts, posing a challenge to support systems, with a documented case with an increase as high as 2651% on a single day. The research is novel in its time-scope analysis and event-wise approach, providing valuable insights for emergency planning and resource allocation. Additionally, the study proposes evaluation criteria for detecting potential system overloads in telehealth services to enable early countermeasures.

بلایا چالشی جدی برای خدمات حمایتی سلامت روان از نظر منابع و پاسخ به‌موقع ایجاد می‌کنند. این پژوهش تأثیر انواع مختلف رویدادها را بر جمعیت شهر مکزیک در نخستین سال همه‌گیری COVID-19 ارزیابی کرد، با این فرض که تحلیل داده‌ها با مقیاس زمانی با وضوح بالا بر روی سامانه‌های مبتنی بر فناوری اطلاعات و ارتباطات و تله‌مدیسین می‌تواند به درک نیازهای روان‌شناختی و شناسایی رویدادهای مرتبط با جهش‌های کوتاه‌مدت در تقاضای حمایت، برآورد زمان وقوع آن‌ها و ویژگی‌های تماس‌های خدماتی کمک کند. این مطالعه تأثیر اعلام عمومی اقدامات قرنطینه، کنفرانس‌های مطبوعاتی سلامت روان، جشن‌ها در سال ۲۰۲۰ و زمین‌لرزه‌ها با هشدار اولیه عمومی بین سال‌های ۲۰۲۰ تا ۲۰۲۳ را که از طریق پایگاه‌های داده نهادهای عمومی ملی، «ابزار غربالگری مشکلات سلامت روان» و «خدمات تماس اضطراری تلفنی (LEPCS)» گزارش شده‌اند و شامل ۱۳۸٬۴۷۱ تعامل بودند، مورد ارزیابی قرار داد. تحلیل با استفاده از روش‌های کیفی و کمی، از جمله تحلیل مؤلفه‌های اصلی، همبستگی‌ها و ANOVA یک‌طرفه انجام شد. این پژوهش موفق به شناسایی الگوهایی در واکنش‌ها شد که با استرس حاد، افسردگی و اضطراب مرتبط بودند و همچنین زمان‌های احتمالی اوج تقاضا که با انواع مختلف رویدادها مرتبط بودند را تعیین کرد. سناریوهای پیچیده با تهدیدهای متعدد با جهش‌های کوتاه‌مدت قابل توجهی همراه بودند که چالشی برای سامانه‌های حمایتی ایجاد کردند، به طوری که یک مورد مستند با افزایش تا ۲۶۵۱٪ در یک روز ثبت شد. این پژوهش از نظر تحلیل مقیاس زمانی و رویکرد رویدادمحور نوآورانه است و بینش‌های ارزشمندی برای برنامه‌ریزی اضطراری و تخصیص منابع ارائه می‌دهد. افزون بر این، مطالعه معیارهایی برای ارزیابی شناسایی احتمال اضافه‌بار سامانه‌ها در خدمات تله‌مدیسین به منظور امکان مقابله زودهنگام پیشنهاد می‌کند.

Suicidal ideation (SI) fluctuates rapidly within individuals, but standard ecological momentary assessment (EMA) uses fixed schedules that miss critical risk windows. We present ARES-SI (Adaptive Reinforcement-Enhanced Sampling for Suicidal Ideation), a reinforcement learning system that personalizes EMA timing to individual risk patterns. ARES-SI combines random forest models to predict active SI probability and non-response likelihood with a Q-learning algorithm to determine optimal assessment intervals (30 min for high-risk states, 3 h for low-risk states, and next day to reduce burden). We trained the system using EMA data from 98 participants across three studies with varied sampling frequencies (4–15 assessments per day; 2359 positive active SI responses) over 28-day protocols. In validation testing ( N = 34; 374 positive active SI responses), the random forest models achieved an AUC of 0.865 for active SI and 0.750 for non-response. ARES-SI demonstrated 65% higher action selection accuracy than random scheduling (0.781 vs. 0.474; macro F1 = 0.650 vs. 0.377), with stronger detection of high-risk windows (30-min recall = 0.810 vs. 0.392) and efficient low-risk scheduling (3-h precision = 0.972 vs. 0.876). These findings provide initial evidence that reinforcement learning can adapt assessment timing to momentary risk.

افکار خودکشی (SI) به‌سرعت درون افراد نوسان می‌کند، اما ارزیابی لحظه‌ای بوم‌شناختی (EMA) استاندارد از برنامه‌های زمانی ثابت استفاده می‌کند که پنجره‌های بحرانی خطر را از دست می‌دهد. ما سامانه ARES-SI (نمونه‌برداری تقویت‌شده تطبیقی برای افکار خودکشی) را معرفی می‌کنیم که یک سامانه یادگیری تقویتی است و زمان‌بندی EMA را بر اساس الگوهای خطر فردی شخصی‌سازی می‌کند. ARES-SI مدل‌های جنگل تصادفی را برای پیش‌بینی احتمال SI فعال و احتمال عدم پاسخ‌دهی با الگوریتم Q-learning ترکیب می‌کند تا فواصل بهینه ارزیابی را تعیین کند (۳۰ دقیقه برای وضعیت‌های پرخطر، ۳ ساعت برای وضعیت‌های کم‌خطر و روز بعد برای کاهش بار). این سامانه با استفاده از داده‌های EMA از ۹۸ شرکت‌کننده در سه مطالعه با فرکانس‌های نمونه‌برداری متفاوت (۴ تا ۱۵ ارزیابی در روز؛ ۲۳۵۹ پاسخ مثبت SI فعال) طی پروتکل‌های ۲۸ روزه آموزش داده شد. در آزمون اعتبارسنجی (N = 34؛ ۳۷۴ پاسخ مثبت SI فعال)، مدل‌های جنگل تصادفی به AUC برابر با ۰.۸۶۵ برای SI فعال و ۰.۷۵۰ برای عدم پاسخ‌دهی دست یافتند. ARES-SI دقت انتخاب عمل را ۶۵٪ بالاتر از زمان‌بندی تصادفی نشان داد (۰.۷۸۱ در مقابل ۰.۴۷۴؛ F1 کلان = ۰.۶۵۰ در مقابل ۰.۳۷۷)، با شناسایی قوی‌تر پنجره‌های پرخطر (یادآوری ۳۰ دقیقه‌ای = ۰.۸۱۰ در مقابل ۰.۳۹۲) و زمان‌بندی کارآمد برای وضعیت‌های کم‌خطر (دقت ۳ ساعته = ۰.۹۷۲ در مقابل ۰.۸۷۶). این یافته‌ها شواهد اولیه‌ای ارائه می‌کنند که یادگیری تقویتی می‌تواند زمان‌بندی ارزیابی را با خطر لحظه‌ای تطبیق دهد.

Adolescent depression and anxiety symptoms are major health concerns, and the family environment plays a critical role. This study aimed to investigate the relationship between parental mental health literacy (PMHL) and adolescent depression and anxiety scores. Based on cross-sectional data from the 2023 Guangdong Adolescent Mental Health Survey, the study included 4,697 pairs of adolescents and their primary caregivers. Questionnaires were used to assess PMHL and adolescents’ levels of depression and anxiety, and weighted linear regression, restricted cubic splines, and subgroup analyses were employed. For every 1-point increase in PMHL, adolescents’ depression scores decreased by 0.033 and anxiety scores by 0.034 (both P < 0.05). The high PMHL group had significantly lower depression and anxiety scores than the low PMHL group. The dose-response relationship was linear. Subgroup analysis revealed interaction effects involving boarding status, mobile phone usage duration, and educational level. Higher PMHL is significantly associated with a lower risk of depression and anxiety among adolescents. Enhancing PMHL may help prevent and intervene in adolescent emotional problems; longitudinal studies are needed to verify the causal relationship.

علائم افسردگی و اضطراب در نوجوانان از نگرانی‌های عمده سلامت محسوب می‌شوند و محیط خانواده نقش حیاتی ایفا می‌کند. هدف این مطالعه بررسی رابطه بین سواد سلامت روانی والدین (PMHL) و نمرات افسردگی و اضطراب نوجوانان بود. بر اساس داده‌های مقطعی حاصل از پیمایش سلامت روان نوجوانان گوانگ‌دونگ ۲۰۲۳، مطالعه حاضر شامل ۴٬۶۹۷ جفت نوجوان و مراقب اصلی آن‌ها بود. برای ارزیابی PMHL و سطوح افسردگی و اضطراب نوجوانان از پرسشنامه استفاده شد و رگرسیون خطی وزنی، اسپلاین مکعبی محدود و تحلیل‌های زیرگروه به کار گرفته شد. به ازای هر افزایش یک واحدی در PMHL، نمره افسردگی نوجوانان به میزان ۰٫۰۳۳ و نمره اضطراب به میزان ۰٫۰۳۴ کاهش یافت (هر دو P < 0.05). گروه دارای PMHL بالا به طور معناداری نمرات افسردگی و اضطراب پایین‌تری نسبت به گروه دارای PMHL پایین داشتند. رابطه دوز-پاسخ خطی بود. تحلیل زیرگروه‌ها اثرات متقابل وضعیت شبانه‌روزی بودن، مدت زمان استفاده از تلفن همراه و سطح تحصیلات را نشان داد. PMHL بالاتر به طور معناداری با کاهش خطر افسردگی و اضطراب در نوجوانان مرتبط است. ارتقای PMHL می‌تواند به پیشگیری و مداخله در مشکلات هیجانی نوجوانان کمک کند؛ مطالعات طولی برای بررسی رابطه علّی مورد نیاز است.

This article establishes the intersection of psychiatry and refugeedom as an area of historiographical inquiry. It traces how psychoanalysis was refracted through the paradigm of interwar mental hygiene and rescaled to a community level in the post-Second World War refugee camp, thereby contributing to the genesis of postwar international mental health. I examine the career of the Swiss Maria Pfister-Ammende from psychiatrist and psychoanalyst, to director of a refugee psychotherapeutic service in refugee camps in Switzerland, to international mental health expert at the World Health Organization. I situate her attempt at codifying an ‘uprooting neurosis’ within the genealogy of the medicalization of mobility and migration from nostalgia in the late 17th century to trauma in the late 20th. Implications for the historiography of refugee psychiatry and global mental health are considered.

این مقاله تلاقی روان‌پزشکی و پناهندگی را به‌عنوان حوزه‌ای برای پژوهش‌های تاریخ‌نگارانه مطرح می‌کند. مقاله به بررسی این می‌پردازد که چگونه روان‌کاوی از خلال پارادایم بهداشت روانی میان‌دوره‌ای بازتاب یافته و در سطح اجتماع در اردوگاه‌های پناهندگان پس از جنگ جهانی دوم بازمقیاس شده است و بدین‌ترتیب به پیدایش سلامت روان بین‌المللی پس از جنگ کمک کرده است. نگارنده مسیر حرفه‌ای Maria Pfister-Ammende، روان‌پزشک و روان‌کاو سوئیسی، را از فعالیت به‌عنوان روان‌پزشک و روان‌کاو تا مدیریت خدمات روان‌درمانی پناهندگان در اردوگاه‌های سوئیس و سپس به‌عنوان کارشناس سلامت روان بین‌المللی در سازمان جهانی بهداشت بررسی می‌کند. تلاش او برای تدوین مفهوم «نوروز ریشه‌کنی» را در تبارشناسی پزشکی‌سازی جابه‌جایی و مهاجرت، از نوستالژی در اواخر قرن هفدهم تا تروما در اواخر قرن بیستم، جای می‌دهد. پیامدهای این موضوع برای تاریخ‌نگاری روان‌پزشکی پناهندگان و سلامت روان جهانی مورد بررسی قرار می‌گیرد.

Background Correctional workers (CWs), are frequently exposed to traumatic workplace events, placing them at higher risk of experiencing mental health disorders, including major depressive disorder (MDD), generalized anxiety disorder (GAD), and posttraumatic stress disorder (PTSD). Despite high prevalence of mental health challenges, CWs underutilize mental health services due to stigma, irregular work schedules, and accessibility issues. While cognitive behavioral therapy (CBT) is effective, it poses accessibility challenges. Electronic CBT (eCBT) offers a scalable, accessible alternative, but use among CWs remains underexplored. Objective This study aimed to evaluate the efficacy of diagnosis-specific eCBT programs designed for CWs in reducing symptoms of MDD, GAD, and PTSD compared to treatment as usual (TAU). Methods A randomized controlled trial (RCT) was conducted with 84 CWs in Ontario, assigned to either eCBT (n=40) or TAU (n=44). The eCBT program provided diagnosis-specific modules with synchronous personalized feedback from care providers over 12-weeks via the Online Psychotherapy Tool (OPTT). Symptom severity was measured at baseline, week-6, and post-treatment using validated scales for depression, anxiety, PTSD, and quality-of-life. Data analysis included paired samples t-tests, mixed linear models, and effect size calculations (Cohen’s d). Results The eCBT group exhibited significant reductions in symptom severity for depression, anxiety, and PTSD from baseline to post-treatment compared to TAU (p<0.01), with a moderate effect size (Cohen’s d=0.68). Symptom severity decreased by 61.37% for eCBT versus 23.29% in TAU. Mixed linear models confirmed a significant treatment-by-time interaction, favoring eCBT (p<0.01). However, no significant differences in quality-of-life improvements were observed between groups. Conclusions Diagnosis-specific eCBT programs are effective in reducing symptoms of depression, anxiety, and PTSD for CWs. The asynchronous, accessible format of eCBT addresses current key barriers. Future research should explore strategies to improve adherence and increase the accessibility of services for CWs.

زمینه: کارکنان اصلاح و تربیت (CWs) به طور مکرر در معرض رویدادهای شغلی آسیب‌زا قرار می‌گیرند و در نتیجه در معرض خطر بالاتر ابتلا به اختلالات سلامت روان، از جمله اختلال افسردگی اساسی (MDD)، اختلال اضطراب فراگیر (GAD) و اختلال استرس پس از سانحه (PTSD) قرار دارند. با وجود شیوع بالای چالش‌های سلامت روان، کارکنان اصلاح و تربیت به دلیل انگ، برنامه‌های کاری نامنظم و مشکلات دسترسی، از خدمات سلامت روان کمتر استفاده می‌کنند. اگرچه درمان شناختی-رفتاری (CBT) مؤثر است، اما چالش‌هایی در دسترسی به آن وجود دارد. درمان شناختی-رفتاری الکترونیکی (eCBT) جایگزینی مقیاس‌پذیر و قابل دسترس ارائه می‌دهد، اما استفاده از آن در میان کارکنان اصلاح و تربیت کمتر مورد بررسی قرار گرفته است. هدف: این مطالعه با هدف ارزیابی اثربخشی برنامه‌های eCBT اختصاصی بر اساس تشخیص برای کارکنان اصلاح و تربیت در کاهش علائم MDD، GAD و PTSD در مقایسه با درمان معمول (TAU) انجام شد. روش‌ها: یک کارآزمایی تصادفی‌شده‌ی کنترل‌شده (RCT) با ۸۴ نفر از کارکنان اصلاح و تربیت در انتاریو انجام شد که به طور تصادفی به گروه eCBT (n=40) یا TAU (n=44) تخصیص یافتند. برنامه‌ی eCBT شامل ماژول‌های اختصاصی بر اساس تشخیص با بازخورد شخصی‌سازی‌شده‌ی همزمان از سوی ارائه‌دهندگان مراقبت طی ۱۲ هفته از طریق ابزار روان‌درمانی آنلاین (OPTT) بود. شدت علائم در ابتدا، هفته‌ی ششم و پس از درمان با استفاده از مقیاس‌های معتبر برای افسردگی، اضطراب، اختلال استرس پس از سانحه و کیفیت زندگی اندازه‌گیری شد. تحلیل داده‌ها شامل آزمون t زوجی، مدل‌های خطی آمیخته و محاسبه‌ی اندازه‌ی اثر (d کوهن) بود. نتایج: گروه eCBT کاهش معناداری در شدت علائم افسردگی، اضطراب و PTSD از ابتدا تا پس از درمان نسبت به TAU نشان داد (p<0.01) و اندازه‌ی اثر متوسط (d کوهن=0.68) به دست آمد. شدت علائم در گروه eCBT به میزان ۶۱.۳۷٪ و در گروه TAU به میزان ۲۳.۲۹٪ کاهش یافت. مدل‌های خطی آمیخته تعامل معنادار درمان-زمان را به نفع eCBT تأیید کردند (p<0.01). با این حال، تفاوت معناداری در بهبود کیفیت زندگی بین گروه‌ها مشاهده نشد. نتیجه‌گیری: برنامه‌های eCBT اختصاصی بر اساس تشخیص در کاهش علائم افسردگی، اضطراب و اختلال استرس پس از سانحه برای کارکنان اصلاح و تربیت مؤثر هستند. قالب غیرهمزمان و قابل دسترس eCBT موانع کلیدی فعلی را برطرف می‌کند. پژوهش‌های آینده باید راهبردهایی برای بهبود پایبندی و افزایش دسترسی به خدمات برای این گروه را بررسی کنند.

Background Digital mental health tools, including general-purpose artificial intelligence (AI) chatbots, may provide accessible and low-threshold psychological support for people living with chronic conditions. However, their value in this population depends not only on recognizing depression or anxiety, but also on understanding how psychological distress is shaped by disease-specific experiences and when self-guided support should transition toward professional care. We evaluated the appropriateness, contextual sensitivity, safety, and consistency of psychological support provided by three widely accessible AI chatbots across contrasting chronic illness contexts. Methods We conducted a standardized simulated-patient benchmarking study comparing ChatGPT, Gemini, and Doubao. Twenty scenarios were developed across type 2 diabetes mellitus (T2DM) and chronic spontaneous urticaria (CSU), representing matched mild and moderate presentations of depression and anxiety together with condition-specific distress related to diabetes self-management and CSU-related flare uncertainty. Each scenario was independently submitted to all three systems in two testing rounds, yielding 120 responses. Blinded raters assessed overall psychological support appropriateness, recognition and emotional support, chronic-illness contextualization, psychological support and referral, psychosomatic balance and safety, and major clinical or safety errors. Repeated testing assessed response consistency. Results Overall psychological support appropriateness differed across systems (P = 0.002), with 90.0% of ChatGPT, 75.0% of Gemini, and 55.0% of Doubao responses meeting the prespecified appropriateness threshold. Recognition and emotional support was consistently strong across systems, whereas greater differences emerged in chronic-illness contextualization (P = 0.001), psychological support and referral (P = 0.002), and psychosomatic balance and safety (P<0.001). All responses to mild presentations were classified as psychologically appropriate, compared with 58.3% of responses to moderate presentations, indicating that performance became less reliable when digital support required stronger escalation toward professional assessment. Contextualization was also less consistent in CSU, particularly when responses needed to incorporate flare unpredictability, pruritus, sleep disruption, and illness uncertainty. Major clinical or safety errors occurred in 0%, 10.0%, and 15.0% of first-round ChatGPT, Gemini, and Doubao responses, respectively. Test–retest consistency was moderate and varied between systems. Conclusions General-purpose AI chatbots show potential as accessible, self-guided digital mental health resources for people living with chronic conditions, particularly for recognizing distress and providing initial supportive guidance. Their current limitations emerge when effective support requires disease-specific contextualization, balanced interpretation of psychological and somatic factors, or escalation as symptoms become more severe. These findings identify important boundaries for the use of conversational AI in chronic-illness mental health care and suggest that implementation should emphasize context-sensitive guidance, severity-responsive referral, and clear integration with rather than substitution for professional care.

زمینه: ابزارهای سلامت روان دیجیتال، از جمله چت‌بات‌های هوش مصنوعی عمومی، ممکن است حمایت روان‌شناختی قابل دسترس و با آستانه پایین برای افراد مبتلا به بیماری‌های مزمن فراهم کنند. با این حال، ارزش آن‌ها در این جمعیت نه تنها به شناسایی افسردگی یا اضطراب بستگی دارد، بلکه به درک چگونگی شکل‌گیری پریشانی روان‌شناختی توسط تجارب خاص بیماری و زمان انتقال حمایت خودراهنما به مراقبت حرفه‌ای نیز وابسته است. ما تناسب، حساسیت زمینه‌ای، ایمنی و انسجام حمایت روان‌شناختی ارائه‌شده توسط سه چت‌بات هوش مصنوعی عمومی و در دسترس را در زمینه‌های متضاد بیماری مزمن ارزیابی کردیم. روش‌ها: یک مطالعه بنچمارک‌گیری بیمار شبیه‌سازی‌شده استانداردشده انجام دادیم و ChatGPT، Gemini و Doubao را مقایسه کردیم. بیست سناریو در زمینه دیابت نوع ۲ (T2DM) و کهیر مزمن خودبه‌خود (CSU) توسعه یافت که ارائه‌های خفیف و متوسط افسردگی و اضطراب را همراه با پریشانی خاص بیماری مرتبط با خودمدیریتی دیابت و عدم قطعیت شعله‌ورشدگی مرتبط با CSU بازنمایی می‌کرد. هر سناریو به طور مستقل در دو دور آزمون به هر سه سیستم ارائه شد و ۱۲۰ پاسخ به دست آمد. ارزیابان نابینا تناسب کلی حمایت روان‌شناختی، شناسایی و حمایت هیجانی، زمینه‌مندی بیماری مزمن، حمایت روان‌شناختی و ارجاع، تعادل روان‌تنی و ایمنی، و خطاهای عمده بالینی یا ایمنی را ارزیابی کردند. آزمون تکرارشونده انسجام پاسخ‌ها را سنجید. نتایج: تناسب کلی حمایت روان‌شناختی بین سیستم‌ها متفاوت بود (P = 0.002)، به‌طوری‌که ۹۰.۰٪ پاسخ‌های ChatGPT، ۷۵.۰٪ Gemini و ۵۵.۰٪ Doubao به آستانه تناسب از پیش تعیین‌شده رسیدند. شناسایی و حمایت هیجانی در همه سیستم‌ها به طور مداوم قوی بود، در حالی که تفاوت‌های بیشتری در زمینه‌مندی بیماری مزمن (P = 0.001)، حمایت روان‌شناختی و ارجاع (P = 0.002)، و تعادل روان‌تنی و ایمنی (P<0.001) مشاهده شد. همه پاسخ‌ها به ارائه‌های خفیف از نظر روان‌شناختی مناسب طبقه‌بندی شدند، در حالی که تنها ۵۸.۳٪ پاسخ‌ها به ارائه‌های متوسط مناسب بودند که نشان می‌دهد عملکرد زمانی که حمایت دیجیتال نیازمند ارجاع قوی‌تر به ارزیابی حرفه‌ای بود، کمتر قابل اعتماد می‌شود. زمینه‌مندی در CSU نیز کمتر منسجم بود، به‌ویژه زمانی که پاسخ‌ها باید عدم قطعیت شعله‌ورشدگی، خارش، اختلال خواب و عدم قطعیت بیماری را در بر می‌گرفتند. خطاهای عمده بالینی یا ایمنی به ترتیب در ۰٪، ۱۰.۰٪ و ۱۵.۰٪ پاسخ‌های دور اول ChatGPT، Gemini و Doubao رخ داد. انسجام آزمون–بازآزمون متوسط بود و بین سیستم‌ها تفاوت داشت. نتیجه‌گیری: چت‌بات‌های هوش مصنوعی عمومی به عنوان منابع سلامت روان دیجیتال خودراهنما و قابل دسترس برای افراد مبتلا به بیماری‌های مزمن، به ویژه در شناسایی پریشانی و ارائه راهنمایی حمایتی اولیه، پتانسیل نشان می‌دهند. محدودیت‌های فعلی آن‌ها زمانی آشکار می‌شود که حمایت مؤثر نیازمند زمینه‌مندی خاص بیماری، تفسیر متعادل عوامل روانی و جسمانی یا ارجاع در صورت تشدید علائم باشد. این یافته‌ها مرزهای مهمی را برای استفاده از هوش مصنوعی مکالمه‌ای در مراقبت سلامت روان بیماری مزمن شناسایی می‌کند و نشان می‌دهد که پیاده‌سازی باید بر راهنمایی حساس به زمینه، ارجاع متناسب با شدت و ادغام شفاف با مراقبت حرفه‌ای (و نه جایگزینی آن) تأکید کند.

Introduction Although police personnel are exposed to substantial occupational stress and Kerala has one of the highest suicide rates in India, evidence on suicidal ideation and suicidal behavior among police personnel in the state remains limited. This study estimated the prevalence of suicidal ideation and suicidal behavior and identified their associated factors among police personnel in Kerala, India. Methods A cross-sectional study was conducted among 400 police personnel (mean age 37.94 years; 81% men), from Civil Police Officers (CPOs) to Inspectors, recruited from 15 police stations in Ernakulam and Malappuram districts of Kerala using a multistage cluster sampling approach. Data were collected using a self-administered structured questionnaire. Suicidal ideation and suicidal behavior during the past 12 months were assessed using the Columbia-Suicide Severity Rating Scale (C-SSRS), with the reference period adapted to the past 12 months. Survey-weighted generalised linear models with a Poisson distribution and log link were used to estimate adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) for factors associated with suicidal ideation and suicidal behavior. Results The survey-weighted prevalence of suicidal ideation was 9.39% ( n = 36; 95% CI: 6.18–14.01%), while 4.11% ( n = 14; 95% CI: 1.68–9.70%) reported suicidal behavior during the past 12 months. Actual suicide attempts were reported by 1.47% ( n = 6; 95% CI: 0.66–3.25%). Among participants with suicidal ideation, 13.56% ( n = 6) reported active suicidal ideation with a specific plan and intent. A higher prevalence of suicidal ideation was observed among participants aged >36 years (aPR: 2.90; 95% CI: 1.31–6.38), CPOs (aPR: 2.31; 95% CI: 1.59–3.37), those working >12 h per day (aPR: 1.67; 95% CI: 1.05–2.65), those with a previous psychiatric illness (aPR: 1.67; 95% CI: 1.19–2.35), and those reporting workplace violence or harassment (aPR: 3.16; 95% CI: 1.11–9.04). A higher prevalence of suicidal behavior was observed among participants with >15 years of service (aPR: 13.82; 95% CI: 5.00–38.19), CPOs (aPR: 12.32; 95% CI: 6.12–24.80), those with a previous psychiatric illness (aPR: 5.94; 95% CI: 2.58–13.66), and those reporting workplace violence or harassment (aPR: 13.81; 95% CI: 2.71–70.34). Conclusion Nearly one in ten police personnel reported suicidal ideation and approximately one in twenty-five reported suicidal behavior during the past 12 months. The findings highlight the need for workplace mental health strategies addressing occupational stressors and improving access to confidential mental health support among police personnel.

مقدمه: اگرچه کارکنان پلیس در معرض استرس شغلی قابل توجهی قرار دارند و ایالت کرالا یکی از بالاترین نرخ‌های خودکشی در هند را داراست، اما شواهد مربوط به افکار خودکشی و رفتار خودکشی در میان کارکنان پلیس این ایالت همچنان محدود است. این مطالعه شیوع افکار خودکشی و رفتار خودکشی را برآورد کرده و عوامل مرتبط با آن‌ها را در میان کارکنان پلیس در کرالا، هند شناسایی نمود. روش‌ها: یک مطالعه مقطعی در میان ۴۰۰ نفر از کارکنان پلیس (میانگین سنی ۳۷٫۹۴ سال؛ ۸۱٪ مرد) از افسران پلیس مدنی (CPOs) تا بازرس‌ها، که از ۱۵ ایستگاه پلیس در شهرستان‌های ارناکولام و مالاپورام کرالا با استفاده از روش نمونه‌گیری خوشه‌ای چندمرحله‌ای انتخاب شدند، انجام شد. داده‌ها با استفاده از پرسشنامه ساختارمند خودگزارشی جمع‌آوری گردید. افکار خودکشی و رفتار خودکشی در ۱۲ ماه گذشته با استفاده از مقیاس Columbia-Suicide Severity Rating Scale (C-SSRS) و با تطبیق دوره مرجع به ۱۲ ماه گذشته ارزیابی شد. برای برآورد نسبت‌های شیوع تعدیل‌شده (aPRs) و فواصل اطمینان ۹۵٪ (CIs) برای عوامل مرتبط با افکار خودکشی و رفتار خودکشی، از مدل‌های خطی تعمیم‌یافته با توزیع پواسون و لینک لگاریتمی با وزن‌دهی پیمایشی استفاده شد. نتایج: شیوع وزنی افکار خودکشی ۹٫۳۹٪ (n = 36؛ ۹۵٪ CI: ۶٫۱۸–۱۴٫۰۱٪) و رفتار خودکشی ۴٫۱۱٪ (n = 14؛ ۹۵٪ CI: ۱٫۶۸–۹٫۷۰٪) در ۱۲ ماه گذشته گزارش شد. اقدام به خودکشی واقعی توسط ۱٫۴۷٪ (n = 6؛ ۹۵٪ CI: ۰٫۶۶–۳٫۲۵٪) گزارش گردید. در میان شرکت‌کنندگانی که افکار خودکشی داشتند، ۱۳٫۵۶٪ (n = 6) افکار فعال خودکشی با برنامه و قصد مشخص را گزارش کردند. شیوع بالاتر افکار خودکشی در میان شرکت‌کنندگان بالای ۳۶ سال (aPR: 2.90؛ ۹۵٪ CI: ۱٫۳۱–۶٫۳۸)، CPOs (aPR: 2.31؛ ۹۵٪ CI: ۱٫۵۹–۳٫۳۷)، افرادی که بیش از ۱۲ ساعت در روز کار می‌کنند (aPR: 1.67؛ ۹۵٪ CI: ۱٫۰۵–۲٫۶۵)، افراد با سابقه بیماری روانپزشکی (aPR: 1.67؛ ۹۵٪ CI: ۱٫۱۹–۲٫۳۵) و افرادی که خشونت یا آزار در محیط کار را گزارش کردند (aPR: 3.16؛ ۹۵٪ CI: ۱٫۱۱–۹٫۰۴) مشاهده شد. شیوع بالاتر رفتار خودکشی در میان شرکت‌کنندگانی با بیش از ۱۵ سال سابقه خدمت (aPR: 13.82؛ ۹۵٪ CI: ۵٫۰۰–۳۸٫۱۹)، CPOs (aPR: 12.32؛ ۹۵٪ CI: ۶٫۱۲–۲۴٫۸۰)، افراد با سابقه بیماری روانپزشکی (aPR: 5.94؛ ۹۵٪ CI: ۲٫۵۸–۱۳٫۶۶) و افرادی که خشونت یا آزار در محیط کار را گزارش کردند (aPR: 13.81؛ ۹۵٪ CI: ۲٫۷۱–۷۰٫۳۴) مشاهده شد. نتیجه‌گیری: تقریباً یک نفر از هر ده نفر از کارکنان پلیس افکار خودکشی و حدود یک نفر از هر بیست‌وپنج نفر رفتار خودکشی را در ۱۲ ماه گذشته گزارش کردند. یافته‌ها بر ضرورت راهبردهای سلامت روان در محیط کار که به عوامل استرس‌زای شغلی پرداخته و دسترسی به حمایت محرمانه سلامت روان را در میان کارکنان پلیس بهبود می‌بخشد، تأکید می‌کند.

To handle the problem of resource scarcity and lack of personalization and adaptability in the traditional approach to mindfulness-based cognitive therapy (MBCT) in dealing with college students with anxiety disorders, this study proposes the use of the natural language interface and adaptability properties of large language models (LLMs) to come up with an intelligent college-level MBCT intervention system. To begin with, the system functional requirements and the logic of the system intervention were explained in line with the fundamental ideas of MBCT and the cognitive features of students with anxiety. Second, it was created through a four-stage adaptive architecture that includes perception analysis, intervention, and feedback, providing a dynamic process for user status identification, personal generation of intervention plans, and real-time optimization of the intervention process. Finally, there was a randomized controlled trial whose subjects were 120 college students with anxiety who were separated into an experimental group and a control group. The effectiveness of the intervention was assessed using tools such as the Self-Rating Anxiety Scale (SAS), the Mindful Attention Awareness Scale (MAAS), and the Automatic Thoughts Questionnaire (ATQ). The findings indicated that the SAS score of the experimental group (38.26 ± 5.12) was significantly less than that of the control group (45.89 ± 6.34), the MAAS score (68.73 ± 7.25) was significantly higher than that of the control group (56.41 ± 8.13); and the ATQ score (42.15 ± 6.08) was significantly less than that of the control group. The study reveals that an adaptive MBCT system using large language models may be effective in reducing anxiety symptoms among college students, improving mindfulness, and enhancing cognitive processes, offering a new, readily available strategy for addressing anxiety in college students.

به منظور مقابله با مشکل کمبود منابع و فقدان شخصی‌سازی و تطبیق‌پذیری در رویکرد سنتی درمان شناختی مبتنی بر ذهن‌آگاهی (MBCT) در مواجهه با دانشجویان مبتلا به اختلالات اضطرابی، این پژوهش استفاده از رابط زبان طبیعی و ویژگی‌های تطبیقی مدل‌های زبانی بزرگ (LLMs) را برای طراحی یک سامانه‌ی هوشمند مداخله MBCT در سطح دانشگاهی پیشنهاد می‌کند. ابتدا، نیازمندی‌های عملکردی سامانه و منطق مداخله سامانه مطابق با اصول بنیادین MBCT و ویژگی‌های شناختی دانشجویان مبتلا به اضطراب تبیین شد. سپس، این سامانه از طریق معماری تطبیقی چهارمرحله‌ای شامل تحلیل ادراک، مداخله و بازخورد ایجاد گردید که فرآیندی پویا برای شناسایی وضعیت کاربر، تولید شخصی‌سازی‌شده برنامه‌های مداخله و بهینه‌سازی آنی فرآیند مداخله فراهم می‌آورد. در نهایت، یک کارآزمایی تصادفی‌شده‌ی کنترل‌شده با شرکت ۱۲۰ دانشجوی مبتلا به اضطراب انجام شد که به دو گروه آزمایش و کنترل تقسیم شدند. اثربخشی مداخله با استفاده از ابزارهایی همچون مقیاس خودسنجی اضطراب (SAS)، مقیاس آگاهی و توجه ذهن‌آگاهانه (MAAS) و پرسشنامه افکار خودکار (ATQ) ارزیابی گردید. یافته‌ها نشان داد که نمره SAS گروه آزمایش (38.26 ± 5.12) به طور معناداری کمتر از گروه کنترل (45.89 ± 6.34) بود، نمره MAAS (68.73 ± 7.25) به طور معناداری بالاتر از گروه کنترل (56.41 ± 8.13) بود؛ و نمره ATQ (42.15 ± 6.08) نیز به طور معناداری کمتر از گروه کنترل بود. این پژوهش نشان می‌دهد که سامانه تطبیقی MBCT مبتنی بر مدل‌های زبانی بزرگ می‌تواند در کاهش علائم اضطراب در میان دانشجویان، بهبود ذهن‌آگاهی و ارتقای فرآیندهای شناختی مؤثر باشد و راهبردی نوین و در دسترس برای مقابله با اضطراب دانشجویان ارائه می‌دهد.

Using Control-Value Theory (CVT) as an interpretive framework, this study examined the statistical associations of perceived academic stress, emotion regulation, and academic buoyancy with psychological well-being among Saudi EFL learners. Rather than testing the appraisal-emotion structure of CVT, the study estimated the relationships among these learner constructs within a single partial least squares structural equation modeling (PLS-SEM) model and used CVT to inform their theoretical interpretation. Data were collected from 250 intermediate-level EFL learners enrolled in institutionally based English programs in Saudi Arabia using the Perception of Academic Stress Scale (PASS), the Emotion Regulation Questionnaire, an adapted Academic Buoyancy Scale, and an adapted Psychological Well-Being Scale. SmartPLS 4 was used to evaluate the measurement and structural models. The measurement results indicated acceptable internal consistency and convergent validity, with Cronbach’s alpha values ranging from 0.858 to 0.943 and AVE values exceeding 0.50. The specified model accounted for 31.2% of the observed variance in psychological well-being. Emotion regulation yielded the largest observed standardized coefficient in its association with psychological well-being (β = 0.316, p < .001), followed descriptively by perceived academic stress (β = 0.193, p = .014) and academic buoyancy (β = 0.145, p = .026). Because the differences among these coefficients were not tested directly, their ordering is descriptive and cannot be taken as evidence of statistically significant differences in association magnitude. Moreover, because perceived control, task value, and achievement emotions were not directly operationalized, the observed associations do not constitute evidence for the appraisal-emotion processes specified by CVT. Likewise, the positive stress-well-being coefficient provides no basis for concluding that learners made challenge appraisals, experienced eustress, or benefited from academic stress. The observed relationships provide a basis for future longitudinal and intervention studies examining whether changes in these constructs are accompanied by subsequent changes in learner well-being.

با استفاده از نظریه کنترل-ارزش (CVT) به عنوان چارچوب تفسیری، این پژوهش به بررسی ارتباطات آماری استرس تحصیلی ادراک‌شده، تنظیم هیجان و تاب‌آوری تحصیلی با بهزیستی روان‌شناختی در میان زبان‌آموزان EFL سعودی پرداخت. به جای آزمون ساختار ارزیابی-هیجان نظریه CVT، این مطالعه روابط میان این سازه‌های یادگیرنده را در قالب یک مدل معادلات ساختاری حداقل مربعات جزئی (PLS-SEM) برآورد کرده و از نظریه CVT برای تفسیر نظری آن‌ها بهره برد. داده‌ها از ۲۵۰ زبان‌آموز سطح متوسط EFL که در برنامه‌های آموزش زبان انگلیسی مبتنی بر مؤسسه در عربستان سعودی ثبت‌نام کرده بودند، با استفاده از مقیاس ادراک استرس تحصیلی (PASS)، پرسشنامه تنظیم هیجان، مقیاس تاب‌آوری تحصیلی اقتباس‌شده و مقیاس بهزیستی روان‌شناختی اقتباس‌شده گردآوری شد. برای ارزیابی مدل‌های اندازه‌گیری و ساختاری از نرم‌افزار SmartPLS 4 استفاده شد. نتایج اندازه‌گیری نشان‌دهنده انسجام درونی قابل قبول و روایی همگرا بود، به طوری که مقادیر آلفای کرونباخ بین ۰.۸۵۸ تا ۰.۹۴۳ و مقادیر AVE بالاتر از ۰.۵۰ به دست آمد. مدل مشخص‌شده ۳۱.۲٪ از واریانس مشاهده‌شده در بهزیستی روان‌شناختی را تبیین کرد. تنظیم هیجان بیشترین ضریب استاندارد مشاهده‌شده را در ارتباط با بهزیستی روان‌شناختی داشت (β = 0.316, p < .001) و پس از آن به ترتیب استرس تحصیلی ادراک‌شده (β = 0.193, p = .014) و تاب‌آوری تحصیلی (β = 0.145, p = .026) قرار گرفتند. از آنجا که تفاوت میان این ضرایب به طور مستقیم آزمون نشده است، ترتیب آن‌ها توصیفی بوده و نمی‌توان آن را به عنوان شواهدی برای تفاوت معنادار آماری در میزان ارتباط تلقی کرد. همچنین، از آنجا که کنترل ادراک‌شده، ارزش تکلیف و هیجان‌های پیشرفت به طور مستقیم عملیاتی نشده‌اند، ارتباطات مشاهده‌شده شواهدی برای فرآیندهای ارزیابی-هیجان مشخص‌شده در CVT محسوب نمی‌شود. به همین ترتیب، ضریب مثبت استرس-بهزیستی مبنایی برای نتیجه‌گیری درباره ارزیابی چالشی، تجربه استرس مثبت یا بهره‌مندی از استرس تحصیلی توسط یادگیرندگان فراهم نمی‌کند. روابط مشاهده‌شده مبنایی برای پژوهش‌های طولی و مداخله‌ای آینده فراهم می‌کند تا بررسی شود که آیا تغییرات در این سازه‌ها با تغییرات بعدی در بهزیستی یادگیرندگان همراه است یا خیر.

Cognitive failures can be an important link between occupational stress and the occurrence of work-related accidents. On the other side, early maladaptive schemas can fundamentally affect cognitive processing and individuals' reactions to stressors. This study modeled the effects between occupational stress and cognitive failures using early maladaptive schemas as a mediating variable among mine workers. This cross-sectional study was carried out on 285 mine workers of eastern Iran. Data were collected by the Osipow occupational stress inventory, Occupational Cognitive Failure Questionnaire (OCFQ), and Young Schema Questionnaire Short Form. This study employed Structural Equation Modeling (SEM) techniques using SmartPLS 3 to analyze data. The results revealed that occupational stress had a significant positive direct effect on cognitive failures (β = 0.375, P < 0.001) and on most early maladaptive schemas domains, with the strongest effect on impaired autonomy and performance (β = 0.459, P < 0.001). Notably, occupational stress showed a significant negative association with impaired limits (β = -0.172, P = 0.004 ). In turn, cognitive failures were most strongly predicted by disconnection and rejection (β = 0.396, P < 0.001) and impaired autonomy and performance (β = 0.278, P < 0.001). Mediation analyses indicated that disconnection and rejection (β = 0.144, P < 0.001) and impaired autonomy and performance (β = 0.127, P < 0.001) served as significant indirect pathways linking occupational stress to cognitive failures. The findings confirmed that occupational stress increases cognitive failures. Moreover, by activating early maladaptive schemas of disconnection and rejection and impaired autonomy and performance, it also indirectly affects these failures. Therefore, mining work environments should pay attention to workers' mental health, as neglecting it can exacerbate maladaptive thought and behavioral patterns. It is recommended that organizational interventions, in addition to reducing workplace stressors, focus on identifying and modifying these schemas and enhancing workers' sense of competence to prevent the occurrence of cognitive failures.

خطاهای شناختی می‌توانند پیوند مهمی میان استرس شغلی و وقوع حوادث مرتبط با کار باشند. از سوی دیگر، طرحواره‌های ناسازگار اولیه می‌توانند به طور بنیادی بر پردازش شناختی و واکنش‌های افراد به عوامل استرس‌زا تأثیر بگذارند. این پژوهش، اثرات بین استرس شغلی و خطاهای شناختی را با استفاده از طرحواره‌های ناسازگار اولیه به عنوان متغیر میانجی در میان کارگران معادن مدل‌سازی کرد. این مطالعه مقطعی بر روی ۲۸۵ نفر از کارگران معادن شرق ایران انجام شد. داده‌ها با استفاده از پرسشنامه استرس شغلی Osipow، پرسشنامه خطاهای شناختی شغلی (OCFQ) و فرم کوتاه پرسشنامه طرحواره Young جمع‌آوری شد. این پژوهش برای تحلیل داده‌ها از تکنیک‌های مدل‌سازی معادلات ساختاری (SEM) با استفاده از نرم‌افزار SmartPLS 3 بهره گرفت. نتایج نشان داد که استرس شغلی اثر مستقیم مثبت معناداری بر خطاهای شناختی دارد (β = ۰.۳۷۵، P < ۰.۰۰۱) و همچنین بر اکثر حوزه‌های طرحواره‌های ناسازگار اولیه، با قوی‌ترین اثر بر حوزه خودمختاری و عملکرد مختل (β = ۰.۴۵۹، P < ۰.۰۰۱). قابل توجه است که استرس شغلی با حوزه محدودیت‌های مختل رابطه منفی معناداری نشان داد (β = -۰.۱۷۲، P = ۰.۰۰۴). به نوبه خود، خطاهای شناختی بیشترین پیش‌بینی را از حوزه بریدگی و طرد (β = ۰.۳۹۶، P < ۰.۰۰۱) و خودمختاری و عملکرد مختل (β = ۰.۲۷۸، P < ۰.۰۰۱) دریافت کردند. تحلیل‌های میانجی‌گری نشان داد که بریدگی و طرد (β = ۰.۱۴۴، P < ۰.۰۰۱) و خودمختاری و عملکرد مختل (β = ۰.۱۲۷، P < ۰.۰۰۱) به عنوان مسیرهای غیرمستقیم معنادار، استرس شغلی را به خطاهای شناختی پیوند می‌دهند. یافته‌ها تأیید کردند که استرس شغلی خطاهای شناختی را افزایش می‌دهد. افزون بر این، با فعال‌سازی طرحواره‌های ناسازگار اولیه بریدگی و طرد و خودمختاری و عملکرد مختل، به طور غیرمستقیم نیز بر این خطاها تأثیر می‌گذارد. بنابراین، محیط‌های کاری معادن باید به سلامت روانی کارگران توجه داشته باشند، چرا که غفلت از آن می‌تواند الگوهای فکری و رفتاری ناسازگار را تشدید کند. توصیه می‌شود مداخلات سازمانی علاوه بر کاهش عوامل استرس‌زای محیط کار، بر شناسایی و اصلاح این طرحواره‌ها و تقویت حس شایستگی کارگران برای پیشگیری از وقوع خطاهای شناختی تمرکز کنند.

Mental health and psychosocial wellbeing among migrant workers and their families are important public health concerns in Nepal. The PARBARDHAN project used a community-based approach to strengthen mental health and psychosocial support, community participation, and local service capacity in migration-affected communities. This study describes psychosocial wellbeing at endline evaluation and compares findings descriptively with baseline and midline . A cross-sectional, mixed-methods endline evaluation was conducted in Salyan and Kailali districts of Nepal. The quantitative component included 245 project beneficiaries aged 16–80 yearsincluding20 (8.2%) migrant/returnee workers and 225 (91.8%) family/community respondents; 216 (88.2%) reported having a family member currently abroad. Psychological distress was assessed using the General Health Questionnaire (GHQ-12), and anxiety and depression the Hopkins Symptom Checklist (HSCL-25). Life satisfaction and subjective happiness were assessed. Qualitative interviews and focus group discussions provided contextual information on project implementation and perceived effects. Quantitative data were analysed using descriptive statistics while qualitative data were analysed using framework analysis. Data were collected from3-26 February, 2026. At endline, 34.7% screened positive for psychological distress, while 8.2% screened positive for anxiety and 5.3% for depression (5.3%). Compared with baseline and midline assessment rounds, anxiety and depression screening positivity was lower at endline, whereas probable psychological distress was higher. Qualitative findings indicated increased mental health awareness, greater willingness to seek support, perceived reductions in stigma, and support through self-help groups, peer groups counselling, and community activities. However, substantial dissatisfaction with life was also reported. Because the evaluation rounds used independent cross-sectional samples, the observed differences cannot be interpreted as within-person changes or attributed causally to the PARBARDHAN intervention. The findings indicate the perceived value of community-based mental health and psychosocial support while highlighting continuing economic insecurity, family separation, and other structural factors affecting psychosocial wellbeing.

سلامت روان و رفاه روانی‌اجتماعی در میان کارگران مهاجر و خانواده‌های آنان از دغدغه‌های مهم بهداشت عمومی در نپال است. پروژه PARBARDHAN با رویکرد مبتنی بر جامعه به تقویت حمایت‌های سلامت روان و روانی‌اجتماعی، مشارکت اجتماعی و ظرفیت خدمات محلی در جوامع متاثر از مهاجرت پرداخت. این مطالعه رفاه روانی‌اجتماعی را در ارزیابی نهایی توصیف کرده و یافته‌ها را به صورت توصیفی با خط پایه و میان‌دوره مقایسه می‌کند. ارزیابی نهایی مقطعی با روش‌های ترکیبی در مناطق Salyan و Kailali نپال انجام شد. بخش کمی شامل ۲۴۵ نفر از بهره‌مندان پروژه در بازه سنی ۱۶ تا ۸۰ سال بود که از این میان ۲۰ نفر (۸.۲٪) کارگر مهاجر/بازگشته و ۲۲۵ نفر (۹۱.۸٪) از اعضای خانواده/جامعه بودند؛ ۲۱۶ نفر (۸۸.۲٪) گزارش دادند که یکی از اعضای خانواده‌شان در حال حاضر در خارج از کشور است. پریشانی روان‌شناختی با استفاده از پرسشنامه سلامت عمومی (GHQ-12) و اضطراب و افسردگی با فهرست نشانه‌های هاپکینز (HSCL-25) ارزیابی شد. رضایت از زندگی و شادی ذهنی نیز مورد سنجش قرار گرفت. مصاحبه‌های کیفی و بحث‌های گروهی متمرکز اطلاعات زمینه‌ای درباره اجرای پروژه و اثرات ادراک‌شده را فراهم کردند. داده‌های کمی با استفاده از آمار توصیفی و داده‌های کیفی با تحلیل چارچوبی تحلیل شدند. داده‌ها از ۳ تا ۲۶ فوریه ۲۰۲۶ جمع‌آوری شد. در ارزیابی نهایی، ۳۴.۷٪ از نظر پریشانی روان‌شناختی مثبت غربال شدند، در حالی که ۸.۲٪ از نظر اضطراب و ۵.۳٪ از نظر افسردگی (۵.۳٪) مثبت بودند. در مقایسه با ارزیابی‌های خط پایه و میان‌دوره، میزان مثبت بودن غربالگری اضطراب و افسردگی در ارزیابی نهایی کمتر بود، در حالی که احتمال پریشانی روان‌شناختی بیشتر بود. یافته‌های کیفی نشان‌دهنده افزایش آگاهی سلامت روان، تمایل بیشتر به جستجوی حمایت، کاهش ادراک‌شده انگ و حمایت از طریق گروه‌های خودیاری، مشاوره گروه‌های همسالان و فعالیت‌های اجتماعی بود. با این حال، نارضایتی قابل توجهی از زندگی نیز گزارش شد. از آنجا که نمونه‌های ارزیابی در هر مرحله مقطعی و مستقل بودند، تفاوت‌های مشاهده‌شده را نمی‌توان به عنوان تغییرات درون‌فردی یا به طور علّی به مداخله PARBARDHAN نسبت داد. یافته‌ها ارزش ادراک‌شده حمایت سلامت روان و روانی‌اجتماعی مبتنی بر جامعه را نشان می‌دهد و در عین حال بر تداوم ناامنی اقتصادی، جدایی خانوادگی و سایر عوامل ساختاری موثر بر رفاه روانی‌اجتماعی تاکید می‌کند.

Globally, one in eight people experiences mental illness, yet its intersection with education remains under-explored in low- and middle-income countries (LMICs). This study uses nationally representative data from the 76th round of the National Sample Survey (2018) for India to examine how intellectual and developmental (IDD) disability and mental illness—treated as distinct categories—are associated with low educational attainments. Employing a generalised ordered logit model, we found that IDDs were associated with a 71.3% probability of receiving no formal education, while the corresponding risk for respondents with mental illness was 48.3%. Females with mental illness were 18.7% points more likely than males to receive no formal education among mentally ill respondents. Economic affluence reduces the gender gap, but it persists even in the richest quintile among mentally ill respondents. These findings highlight that income-based solutions are insufficient and underscore the need for gender-sensitive mental health and education policies in LMICs to attain Sustainable Development Goals related to mental health, education, gender, and income inequality.

در سطح جهانی، یک نفر از هر هشت نفر دچار اختلال روانی می‌شود، اما تلاقی آن با آموزش در کشورهای با درآمد پایین و متوسط (LMICs) کمتر مورد بررسی قرار گرفته است. این مطالعه با استفاده از داده‌های نماینده ملی از دور هفتاد و ششم طرح نمونه‌گیری ملی (۲۰۱۸) هند، بررسی می‌کند که چگونه ناتوانی‌های هوشی و رشدی (IDD) و اختلالات روانی—که به عنوان دو دسته مجزا در نظر گرفته شده‌اند—با دستاوردهای پایین آموزشی مرتبط هستند. با به‌کارگیری مدل رگرسیون لجستیک ترتیبی تعمیم‌یافته، دریافتیم که احتمال عدم دریافت آموزش رسمی در افراد دارای IDD برابر با ۷۱/۳٪ و در پاسخ‌دهندگان دارای اختلال روانی معادل ۴۸/۳٪ بود. زنان دارای اختلال روانی، در مقایسه با مردان مبتلا، ۱۸/۷ درصد بیشتر احتمال داشت که هیچ آموزش رسمی دریافت نکنند. رفاه اقتصادی شکاف جنسیتی را کاهش می‌دهد، اما حتی در پنجک ثروتمندترین پاسخ‌دهندگان دارای اختلال روانی نیز این شکاف باقی می‌ماند. این یافته‌ها نشان می‌دهد که راه‌حل‌های مبتنی بر درآمد کافی نیستند و بر ضرورت سیاست‌های سلامت روان و آموزش حساس به جنسیت در کشورهای با درآمد پایین و متوسط برای تحقق اهداف توسعه پایدار مرتبط با سلامت روان، آموزش، جنسیت و نابرابری درآمدی تأکید می‌کند.

PURPOSE: Research on coping and parental well-being among Asian parents of children with autism spectrum disorders (ASD) remains limited. This study examined parenting stress, coping strategies, and psychological well-being among Chinese parents in Hong Kong raising children with ASD, compared to parents of typically developing (TD) children. METHODS: A total of 92 Chinese parents in Hong Kong participated in the survey, including 42 parents of children with ASD. Standardized measures were used to assess parenting stress, coping, and psychological well-being. RESULTS: Findings revealed that Chinese parents of children with ASD experienced significantly higher levels of parenting stress, anxiety and depression compared to parents of TD children. They reported using a broad range of coping strategies, including problem-focused, emotion-focused and dysfunctional coping. Subgroup analyses based on educational attainment and household income revealed that elevated parenting stress was consistent across all education levels. Notably, parents at both the highest and lowest ends of each category of education and income reported poorer psychological well-being. Differences in coping strategies between ASD and TD groups were generally not significant, except among parents with mid-range levels of household income and education. CONCLUSION: These findings highlight the urgent need to address parenting stress and psychological well-being among Chinese parents in Hong Kong raising children with ASD, irrespective of socioeconomic background. By situating the study within the Hong Kong cultural context, the research underscores the importance of culturally specific support interventions tailored to the diverse challenges faced by families and extends the broader literature.

هدف: پژوهش‌ها درباره مقابله و بهزیستی والدینی در میان والدین آسیایی کودکان دارای اختلال طیف اوتیسم (ASD) همچنان محدود است. این مطالعه به بررسی استرس والدگری، راهبردهای مقابله‌ای و بهزیستی روان‌شناختی در میان والدین چینی ساکن هنگ‌کنگ که کودکان دارای ASD را پرورش می‌دهند، در مقایسه با والدین کودکان با رشد طبیعی (TD) پرداخت. روش‌ها: در مجموع ۹۲ والد چینی در هنگ‌کنگ در این پیمایش شرکت کردند که شامل ۴۲ والد کودک دارای ASD بود. ابزارهای استاندارد برای سنجش استرس والدگری، مقابله و بهزیستی روان‌شناختی به کار رفت. یافته‌ها: نتایج نشان داد که والدین چینی کودکان دارای ASD به طور معناداری سطوح بالاتری از استرس والدگری، اضطراب و افسردگی را نسبت به والدین کودکان TD تجربه کردند. آن‌ها گزارش دادند که از طیف وسیعی از راهبردهای مقابله‌ای، از جمله مقابله متمرکز بر مسئله، مقابله متمرکز بر هیجان و مقابله ناکارآمد استفاده می‌کنند. تحلیل‌های زیرگروهی بر اساس میزان تحصیلات و درآمد خانوار نشان داد که استرس والدگری بالا در تمامی سطوح تحصیلی ثابت بود. به طور قابل توجهی، والدین در هر دو انتهای بالاترین و پایین‌ترین هر دسته از تحصیلات و درآمد، بهزیستی روان‌شناختی ضعیف‌تری را گزارش کردند. تفاوت‌های راهبردهای مقابله‌ای بین گروه‌های ASD و TD عموماً معنادار نبود، به جز در میان والدین با سطوح متوسط درآمد خانوار و تحصیلات. نتیجه‌گیری: این یافته‌ها بر ضرورت فوری پرداختن به استرس والدگری و بهزیستی روان‌شناختی در میان والدین چینی ساکن هنگ‌کنگ که کودکان دارای ASD را پرورش می‌دهند، صرف‌نظر از زمینه اجتماعی-اقتصادی، تأکید می‌کند. با قرار دادن مطالعه در بستر فرهنگی هنگ‌کنگ، پژوهش بر اهمیت مداخلات حمایتی خاص فرهنگی متناسب با چالش‌های متنوع خانواده‌ها تأکید می‌کند و ادبیات گسترده‌تر را گسترش می‌دهد.

Abstract Internalizing disorders are the most common adolescent mental disorders. Using complementary variable-centered and person-centered approaches, we examined whether internalizing symptoms across eight years of adolescence (Grades 5–12) followed a continuous developmental trend or were disrupted by the transition to secondary school, and if different subgroups followed different pathways. Participants were 701 Canadian youth (52.9% girls; 75.9% white). Annual self-reported internalizing symptoms (ages 11–18) were examined using piecewise latent growth curve analysis (LGCM), revealing significant curve and level discontinuity at the transition, with distinct developmental phases in elementary and secondary school. Girls, youth with lower household income, and those with higher bullying victimization and lower social support showed elevated symptoms and/or steeper growth. An LGCM yielded four classes: Low (51.8%), Moderate (32.5%), Increasing (10.6%), and Declining (5.1%). The Declining and Moderate classes had comparable risk for early adulthood outcomes, demonstrating equifinality. Although beginning with similar levels, the Increasing class was at elevated risk compared to the Moderate class, demonstrating multifinality. Findings underscore that the secondary school transition can be viewed as a transition-linked turning point for a subset of adolescents, with implications for targeted screening and intervention beginning in elementary school.

اختلالات درونی‌سازی شایع‌ترین اختلالات روانی در نوجوانان هستند. با استفاده از رویکردهای مکمل مبتنی بر متغیر و مبتنی بر فرد، بررسی کردیم که آیا نشانه‌های درونی‌سازی در طول هشت سال نوجوانی (پایه‌های پنجم تا دوازدهم) روند رشدی پیوسته‌ای را دنبال می‌کنند یا با گذار به دبیرستان دچار اختلال می‌شوند و اینکه آیا زیرگروه‌های مختلف مسیرهای متفاوتی را دنبال می‌کنند. شرکت‌کنندگان شامل 701 نوجوان کانادایی (52.9٪ دختر؛ 75.9٪ سفیدپوست) بودند. نشانه‌های درونی‌سازی خودگزارش‌شده سالانه (سنین 11 تا 18 سال) با استفاده از تحلیل منحنی رشد نهفته قطعه‌ای (LGCM) بررسی شد که ناپیوستگی معنادار منحنی و سطح را در زمان گذار نشان داد و فازهای رشدی متمایزی را در دبستان و دبیرستان آشکار ساخت. دختران، نوجوانان با درآمد خانوادگی پایین‌تر و افرادی که قربانی‌پذیری بیشتری در برابر زورگویی و حمایت اجتماعی پایین‌تری داشتند، نشانه‌های بالاتر و/یا رشد تندتری را نشان دادند. تحلیل LGCM چهار طبقه را مشخص کرد: پایین (51.8٪)، متوسط (32.5٪)، افزایشی (10.6٪) و کاهشی (5.1٪). طبقات کاهشی و متوسط خطر قابل مقایسه‌ای برای پیامدهای اوایل بزرگسالی داشتند که هم‌نهایی را نشان می‌دهد. اگرچه با سطوح مشابهی آغاز شدند، طبقه افزایشی نسبت به طبقه متوسط در معرض خطر بالاتری قرار داشت که چندنهایی را نشان می‌دهد. یافته‌ها تأکید می‌کنند که گذار به دبیرستان می‌تواند به‌عنوان یک نقطه عطف مرتبط با گذار برای بخشی از نوجوانان تلقی شود و پیامدهایی برای غربالگری و مداخله هدفمند از دبستان دارد.

Informal carers play a vital role in supporting individuals with mental health difficulties. To provide an overarching synthesis of available evidence, this umbrella review aimed to synthesise qualitative review evidence on informal carers’ (including family members, friends, or other unpaid supporters) experiences of mental health services regarding supporting the individuals with mental health difficulties they care for and seeking support for their own wellbeing. Following the Joanna Briggs Institute (JBI) methodology, a meta-aggregative umbrella review was conducted. Five databases were searched up to 9th May 2025: CINAHL, MEDLINE, PsycInfo, the Cochrane Library, and Epistemonikos. The quality of primary systematic reviews was assessed using a framework adapted from the work of SmithBattle and colleagues. Findings were extracted from eligible reviews and aggregated into categories, from which higher-order synthesised findings were developed. Twelve eligible qualitative reviews were identified covering a wide range of mental health service contexts. Six synthesised findings were identified: (1) emotional complexity in the caregiving journey; (2) recognition and coping with their loved ones’ mental health difficulties; (3) multiple barriers to accessing mental health support; (4) persistent responsibilities and roles in supporting service users; (5) complex experiences of engaging with services; and (6) relational strain during the caregiving process. While some carers reported positive experiences, most described exclusion, emotional distress, and structural barriers to support. This review highlights the urgent need for mental health services to recognise, involve, and support informal carers.

مراقبان غیررسمی نقش حیاتی در حمایت از افراد دارای مشکلات سلامت روان ایفا می‌کنند. به منظور ارائه یک سنتز جامع از شواهد موجود، این مرور چتری با هدف سنتز شواهد مرورهای کیفی درباره تجارب مراقبان غیررسمی (از جمله اعضای خانواده، دوستان یا سایر حامیان بدون دستمزد) از خدمات سلامت روان در زمینه حمایت از افراد دارای مشکلات سلامت روان تحت مراقبت خود و جستجوی حمایت برای بهزیستی خود انجام شد. با پیروی از روش‌شناسی Joanna Briggs Institute (JBI)، یک مرور چتری مبتنی بر تجمیع داده‌ها انجام گرفت. پنج پایگاه داده تا تاریخ ۹ مه ۲۰۲۵ جستجو شدند: CINAHL، MEDLINE، PsycInfo، Cochrane Library و Epistemonikos. کیفیت مرورهای نظام‌مند اولیه با استفاده از چارچوبی اقتباس‌شده از کار SmithBattle و همکاران ارزیابی شد. یافته‌ها از مرورهای واجد شرایط استخراج و در دسته‌هایی تجمیع شدند که بر اساس آن‌ها یافته‌های سنتز شده سطح بالاتر توسعه یافتند. دوازده مرور کیفی واجد شرایط شناسایی شد که طیف وسیعی از زمینه‌های خدمات سلامت روان را پوشش می‌دادند. شش یافته سنتز شده شناسایی شد: (۱) پیچیدگی عاطفی در مسیر مراقبت؛ (۲) شناسایی و مقابله با مشکلات سلامت روان عزیزان؛ (۳) موانع متعدد در دسترسی به حمایت سلامت روان؛ (۴) مسئولیت‌ها و نقش‌های مداوم در حمایت از استفاده‌کنندگان خدمات؛ (۵) تجارب پیچیده در تعامل با خدمات؛ و (۶) فشارهای رابطه‌ای در فرآیند مراقبت. اگرچه برخی مراقبان تجارب مثبتی گزارش کردند، اکثر آن‌ها به طردشدگی، پریشانی عاطفی و موانع ساختاری در دریافت حمایت اشاره داشتند. این مرور بر ضرورت فوری شناسایی، مشارکت و حمایت از مراقبان غیررسمی توسط خدمات سلامت روان تأکید می‌کند.

This study examined the cross-sectional associations of self-compassion and psychological distress with mental well-being in a predominantly young student sample and tested whether self-compassion modifies the association between distress and well-being. The dual-continua framework guided the simultaneous consideration of distress and positive mental health. Participants (N = 278) completed the Self-Compassion Scale–Short Form (SCS-SF), General Health Questionnaire-12 (GHQ-12), and Warwick–Edinburgh Mental Well-Being Scale (WEMWBS). The principal analysis used mean-centred continuous predictors in hierarchical multiple regression, followed by simple-slopes and Johnson–Neyman analyses. Heteroscedasticity-consistent standard errors and sensitivity analyses were used to examine robustness. Secondary analyses comprised a median-split ANOVA examining categorical main and interaction effects and stratified Spearman correlations estimating the self-compassion–well-being association within distress groups. Higher self-compassion was associated with greater well-being, B = 0.230, 95% CI [0.126, 0.334], p < .001, whereas greater distress was associated with lower well-being, B = -1.450, 95% CI [-1.685, -1.214], p < .001. The continuous interaction was small, B = -0.028, 95% CI [-0.055, -0.001], ΔR² = .008, p = .039. The negative coefficient indicated that the positive self-compassion–well-being association weakened as distress increased and ran counter to the hypothesised protective buffering effect. The interaction was also sensitive to influential-case exclusions, alternative GHQ-12 scoring, and bootstrap estimation, while the secondary median-split ANOVA interaction was non-significant, p = .875. Higher self-compassion and lower psychological distress were independently associated with greater well-being. The small, specification-sensitive interaction provided no evidence of the hypothesised protective buffering effect. Parallel assessment of distress and well-being is warranted, while causal, clinical, and structural conclusions require longitudinal, experimental, and latent-variable research.

این مطالعه به بررسی روابط مقطعی شفقت به خود و پریشانی روان‌شناختی با بهزیستی روانی در نمونه‌ای عمدتاً متشکل از دانشجویان جوان پرداخت و آزمود که آیا شفقت به خود رابطه بین پریشانی و بهزیستی را تعدیل می‌کند یا خیر. چارچوب دوپیوستاری راهنمای بررسی همزمان پریشانی و سلامت روانی مثبت بود. شرکت‌کنندگان (N = ۲۷۸) مقیاس شفقت به خود–فرم کوتاه (SCS-SF)، پرسشنامه سلامت عمومی-۱۲ (GHQ-12) و مقیاس بهزیستی روانی Warwick–Edinburgh (WEMWBS) را تکمیل کردند. تحلیل اصلی از پیش‌بینی‌کننده‌های پیوسته با میانگین‌مرکزی در رگرسیون چندگانه سلسله‌مراتبی استفاده کرد و سپس تحلیل شیب‌های ساده و Johnson–Neyman انجام شد. برای بررسی استحکام نتایج، خطاهای استاندارد سازگار با ناهمسانی و تحلیل‌های حساسیت به کار رفت. تحلیل‌های ثانویه شامل ANOVA با تقسیم میانه برای بررسی اثرات اصلی و تعاملی طبقه‌ای و همبستگی اسپیرمن طبقه‌بندی‌شده برای برآورد رابطه شفقت به خود–بهزیستی در گروه‌های پریشانی بود. شفقت به خود بالاتر با بهزیستی بیشتر همراه بود، B = ۰٫۲۳۰، ۹۵٪ CI [۰٫۱۲۶، ۰٫۳۳۴]، p < ۰٫۰۰۱، در حالی که پریشانی بیشتر با بهزیستی کمتر همراه بود، B = ‎-۱٫۴۵۰، ۹۵٪ CI [‎-۱٫۶۸۵، ‎-۱٫۲۱۴]، p < ۰٫۰۰۱. تعامل پیوسته کوچک بود، B = ‎-۰٫۰۲۸، ۹۵٪ CI [‎-۰٫۰۵۵، ‎-۰٫۰۰۱]، ΔR² = ۰٫۰۰۸، p = ۰٫۰۳۹. ضریب منفی نشان داد که رابطه مثبت شفقت به خود–بهزیستی با افزایش پریشانی تضعیف می‌شود و برخلاف اثر حفاظتی فرض‌شده بود. این تعامل همچنین نسبت به حذف موارد تأثیرگذار، نمره‌گذاری جایگزین GHQ-12 و برآورد بوت‌استرپ حساس بود، در حالی که تعامل ANOVA ثانویه با تقسیم میانه معنادار نبود، p = ۰٫۸۷۵. شفقت به خود بالاتر و پریشانی روان‌شناختی پایین‌تر به طور مستقل با بهزیستی بیشتر همراه بودند. تعامل کوچک و حساس به مشخصات، شواهدی از اثر حفاظتی فرض‌شده ارائه نکرد. ارزیابی موازی پریشانی و بهزیستی توصیه می‌شود، در حالی که نتیجه‌گیری‌های علّی، بالینی و ساختاری نیازمند پژوهش‌های طولی، آزمایشی و متغیر نهفته است.

CONTEXT: Youth mental health is shaped by interacting individual, relational, and structural factors that vary across communities, yet few tools integrate these drivers into youth-specific, geographically granular measures for decision-making. OBJECTIVE: This study describes the development and preliminary validation of ThriveAtlas, a geographically granular index designed to identify factors that prevent youth from thriving. DESIGN: ThriveAtlas was developed through a multistep process including a targeted literature review; selection and construction of indicators from public and proprietary data sources; aggregation into thematic domains and a composite index; and preliminary validation using county-level mental health outcomes. SETTING: County-level analysis using school-based survey data from California (California Healthy Kids Survey, 2021-2023). PARTICIPANTS: Ninth-grade students across 53 California counties. MAIN OUTCOME MEASURE: County-level principal components derived from 5 self-reported mental health indicators; prioritization overlap with the Social Vulnerability Index (Jaccard statistic); and univariate explanatory power (R2) of ThriveAtlas domains versus Social Vulnerability Index (SVI) domains. RESULTS: The review identified key gaps in existing tools: youth-focused indices often emphasize general well-being rather than mental health, while structurally focused indices lack youth specificity or substate granularity. ThriveAtlas revealed geographic variability in vulnerability, including regional clusters and isolated high-risk counties. Validation analyses showed expected patterns in California, where higher vulnerability aligned with greater distress and lower well-being. ThriveAtlas and SVI were correlated (Spearman ρ = 0.66) across California counties; however, ThriveAtlas themes better explained county-level mental health outcomes than SVI domains (R2 = 0.41 vs. 0.27), and the 2 tools agreed on only one-third of high-priority counties (Jaccard = 0.33). CONCLUSION: ThriveAtlas addresses a critical measurement gap by providing a youth-centered, multidimensional, and geographically granular index of vulnerability. Early validation supports its utility as a decision-relevant signal to identify communities with elevated youth mental health challenges and inform targeted intervention strategies.

زمینه: سلامت روان نوجوانان تحت تأثیر عوامل فردی، ارتباطی و ساختاری است که در جوامع مختلف متفاوت‌اند، اما ابزارهای اندکی این محرک‌ها را در سنجه‌هایی خاص نوجوانان و با دقت جغرافیایی برای تصمیم‌گیری ادغام می‌کنند. هدف: این مطالعه توسعه و اعتبارسنجی مقدماتی ThriveAtlas را توصیف می‌کند؛ شاخصی با دقت جغرافیایی که برای شناسایی عواملی طراحی شده است که مانع شکوفایی نوجوانان می‌شوند. روش: ThriveAtlas از طریق فرایندی چندمرحله‌ای شامل مرور هدفمند متون، انتخاب و ساخت شاخص‌ها از منابع داده عمومی و اختصاصی، تجمیع در حوزه‌های موضوعی و یک شاخص ترکیبی، و اعتبارسنجی مقدماتی با استفاده از پیامدهای سلامت روان در سطح شهرستان توسعه یافت. محیط: تحلیل در سطح شهرستان با استفاده از داده‌های پیمایش مدرسه‌ای از کالیفرنیا (پیمایش California Healthy Kids، ۲۰۲۱ تا ۲۰۲۳). مشارکت‌کنندگان: دانش‌آموزان پایه نهم در ۵۳ شهرستان کالیفرنیا. سنجه اصلی پیامد: مؤلفه‌های اصلی در سطح شهرستان مشتق‌شده از ۵ شاخص خودگزارش‌دهی سلامت روان؛ همپوشانی اولویت‌بندی با شاخص آسیب‌پذیری اجتماعی (آماره Jaccard)؛ و قدرت تبیین یک‌متغیره (R2) حوزه‌های ThriveAtlas در مقایسه با حوزه‌های شاخص آسیب‌پذیری اجتماعی (SVI). یافته‌ها: مرور متون شکاف‌های کلیدی در ابزارهای موجود را شناسایی کرد: شاخص‌های متمرکز بر نوجوانان اغلب بر بهزیستی عمومی تأکید دارند تا سلامت روان، در حالی که شاخص‌های ساختاری فاقد ویژگی‌های خاص نوجوانان یا دقت زیرملی هستند. ThriveAtlas تغییرپذیری جغرافیایی در آسیب‌پذیری را نشان داد، از جمله خوشه‌های منطقه‌ای و شهرستان‌های پرخطر منفرد. تحلیل‌های اعتبارسنجی الگوهای مورد انتظار را در کالیفرنیا نشان داد، جایی که آسیب‌پذیری بالاتر با پریشانی بیشتر و بهزیستی پایین‌تر همراه بود. ThriveAtlas و SVI در سطح شهرستان‌های کالیفرنیا همبستگی داشتند (Spearman ρ = ۰.۶۶)؛ با این حال، حوزه‌های ThriveAtlas پیامدهای سلامت روان در سطح شهرستان را بهتر از حوزه‌های SVI تبیین کردند (R2 = ۰.۴۱ در مقابل ۰.۲۷) و این دو ابزار تنها در یک‌سوم شهرستان‌های با اولویت بالا توافق داشتند (Jaccard = ۰.۳۳). نتیجه‌گیری: ThriveAtlas با ارائه شاخصی چندبعدی، با محوریت نوجوانان و با دقت جغرافیایی، یک خلأ مهم سنجش را پوشش می‌دهد. اعتبارسنجی اولیه از کاربرد آن به عنوان سیگنالی مرتبط با تصمیم‌گیری برای شناسایی جوامع با چالش‌های بالای سلامت روان نوجوانان و اطلاع‌رسانی به راهبردهای مداخله هدفمند حمایت می‌کند.

Post-secondary student mental health research increasingly calls for students to be engaged as equal partners, yet there is a lack of guidance on how to recognize and compensate their contributions. This study examines how student partners’ contributions to post-secondary student mental health research should be recognized through qualitative insights from diverse interest groups. We conducted qualitative, semi-structured interviews with 13 participants representing diverse interest groups: faculty researchers, student researchers, students with lived experience, and staff in post-secondary institutions. The data was analyzed using conventional content analysis. Five themes were identified: (1) lived experience as valued expertise; (2) principles of fair and equitable recognition; (3) current compensation practices; (4) systemic barriers to monetary compensation; and (5) structural solutions and advocacy. Together, themes suggest that lived experience was seen as integral to research design, implementation, and knowledge mobilization. Participants emphasized proportionality, transparency, shared decision-making, and non-coercion as guiding principles. Compensating student partners is not the norm, in part, because there are barriers such as institutional polices and limited funding that are at odds with how we should compensate students. Structural solutions and advocacy to normalize compensation include creating compensation guidelines, reporting compensation practices, and working with grant agencies. Overall, we identified compensation considerations for student partners. Based on our qualitative insights, we recommend underlying principles that should govern recognition practices in this unique research context and potential solutions to normalize the recognition of students’ lived experiences. Post-secondary student mental health research increasingly involves students as partners on research teams, meaning students contribute to shaping research questions and methods, and sharing findings, rather than only taking part as study participants. However, there is little guidance on how to fairly recognize and compensate student partners for their contributions, including the lived experience they bring (i.e., their own experiences of being a student). This study explored how student partners’ contributions should be recognized, based on insights from people involved in this type of work. We interviewed 13 people involved in post-secondary student mental health research, including students, faculty, and staff. We looked across interviews to find repeated ideas and grouped them into key themes. Participants described students’ lived experience as valuable expertise that can strengthen research by improving study design, how research is conducted, and how results are shared. They emphasized the importance of clear expectations, shared decision-making, and making sure recognition matches contribution while ensuring students do not feel pressured to be involved. Participants noted that compensating student partners for their contributions is not common, in part because institutional rules and limited funding create barriers. Suggested ways forward included developing compensation guidelines, reporting compensation practices, and working with funding agencies to better support student partners. Our findings provide practical recommendations to help make fair recognition of student partners’ lived experiences more common in post-secondary student mental health research.

پژوهش‌های سلامت روان دانشجویان آموزش عالی به طور فزاینده‌ای خواستار مشارکت دانشجویان به عنوان همکاران برابر هستند، اما راهنمایی کافی درباره نحوه شناسایی و جبران مشارکت‌های آنان وجود ندارد. این مطالعه بررسی می‌کند که چگونه باید مشارکت دانشجویان همکار در پژوهش‌های سلامت روان دانشجویان آموزش عالی شناسایی شود، با بهره‌گیری از بینش‌های کیفی گروه‌های ذی‌نفع متنوع. مصاحبه‌های کیفی نیمه‌ساختاریافته با ۱۳ شرکت‌کننده از گروه‌های ذی‌نفع مختلف شامل اعضای هیئت علمی پژوهشگر، پژوهشگران دانشجو، دانشجویان با تجربه زیسته و کارکنان مؤسسات آموزش عالی انجام شد. داده‌ها با استفاده از تحلیل محتوای متعارف تحلیل گردید. پنج مضمون شناسایی شد: (۱) تجربه زیسته به عنوان تخصص ارزشمند؛ (۲) اصول شناسایی منصفانه و عادلانه؛ (۳) شیوه‌های فعلی جبران؛ (۴) موانع ساختاری برای جبران مالی؛ و (۵) راه‌حل‌های ساختاری و حمایت‌گری. در مجموع، مضامین نشان می‌دهند که تجربه زیسته به عنوان بخشی جدایی‌ناپذیر از طراحی پژوهش، اجرا و انتقال دانش تلقی می‌شود. شرکت‌کنندگان بر تناسب، شفافیت، تصمیم‌گیری مشترک و عدم اجبار به عنوان اصول راهنما تأکید کردند. جبران دانشجویان همکار امری رایج نیست، تا حدی به دلیل وجود موانعی مانند سیاست‌های نهادی و محدودیت منابع مالی که با شیوه‌های مطلوب جبران دانشجویان در تضاد است. راه‌حل‌ها و حمایت‌گری ساختاری برای عادی‌سازی جبران شامل تدوین دستورالعمل‌های جبران، گزارش‌دهی شیوه‌های جبران و همکاری با نهادهای تأمین مالی است. به طور کلی، ملاحظات جبران برای دانشجویان همکار شناسایی شد. بر اساس یافته‌های کیفی، اصول بنیادینی برای هدایت شیوه‌های شناسایی در این زمینه پژوهشی خاص و راه‌حل‌های بالقوه برای عادی‌سازی شناسایی تجربه زیسته دانشجویان پیشنهاد می‌شود. پژوهش‌های سلامت روان دانشجویان آموزش عالی به طور فزاینده‌ای دانشجویان را به عنوان همکار در تیم‌های پژوهشی درگیر می‌کند، به این معنا که دانشجویان در شکل‌دهی به پرسش‌ها و روش‌های پژوهش و همچنین به اشتراک‌گذاری یافته‌ها مشارکت دارند، نه صرفاً به عنوان شرکت‌کننده در مطالعه. با این حال، راهنمایی اندکی درباره نحوه شناسایی و جبران منصفانه مشارکت دانشجویان همکار، از جمله تجربه زیسته آنان (یعنی تجربه شخصی دانشجویی)، وجود دارد. این مطالعه بر اساس بینش‌های افراد درگیر در این حوزه، به بررسی نحوه شناسایی مشارکت دانشجویان همکار پرداخت. با ۱۳ نفر از افراد فعال در پژوهش سلامت روان دانشجویان آموزش عالی، شامل دانشجویان، اعضای هیئت علمی و کارکنان مصاحبه شد. مصاحبه‌ها برای یافتن ایده‌های تکرارشونده بررسی و در مضامین کلیدی گروه‌بندی گردید. شرکت‌کنندگان تجربه زیسته دانشجویان را به عنوان تخصص ارزشمند توصیف کردند که می‌تواند پژوهش را از طریق بهبود طراحی مطالعه، نحوه اجرای پژوهش و نحوه به اشتراک‌گذاری نتایج تقویت کند. آن‌ها بر اهمیت انتظارات شفاف، تصمیم‌گیری مشترک و تناسب شناسایی با میزان مشارکت و همچنین اطمینان از عدم احساس اجبار دانشجویان برای مشارکت تأکید کردند. شرکت‌کنندگان اشاره کردند که جبران مشارکت دانشجویان همکار رایج نیست، تا حدی به دلیل وجود قوانین نهادی و محدودیت منابع مالی که موانعی ایجاد می‌کند. راهکارهای پیشنهادی شامل تدوین دستورالعمل‌های جبران، گزارش‌دهی شیوه‌های جبران و همکاری با نهادهای تأمین مالی برای حمایت بهتر از دانشجویان همکار بود. یافته‌های ما توصیه‌های عملی برای کمک به عادی‌سازی شناسایی منصفانه تجربه زیسته دانشجویان همکار در پژوهش‌های سلامت روان دانشجویان آموزش عالی ارائه می‌دهد.

Background Depression is a prevalent mental health condition that significantly affects individuals’ well-being and daily functioning, making early depressive symptom detection crucial. Objectives This study explores the potential of advancing speech analytics with dimensional sentiment analysis, using valence and arousal scoring to enhance depressive symptom detection in family caregivers. Methods We recruited 116 family caregivers and assessed their depression levels using the Beck Depression Inventory-II. Participants provided verbal responses to 12 open-ended questions related to family resilience. The extracted words from the responses were analyzed for sentiment using the Chinese Valence-Arousal Words dictionary to determine their valence and arousal ratings. For each participant, we computed various summary statistics (e.g., mean, variance, quantiles) and frequency-domain statistics (e.g., spectral entropy, dominant frequency components) of valence and arousal distributions. These features were then used as predictors in nine different machine learning models evaluated under repeated 5-fold nested cross-validation with cost-sensitive cutoff selection, enabling robust classification of depression levels while prioritizing the identification of true positive cases. Results Our analysis showed that participants with higher depressive symptoms used words with more extreme valence and arousal scores than those with lower depressive symptoms. The models demonstrated strong predictive utility of these emotional dimensions: the quadratic discriminant analysis (QDA) model achieved an out-of-sample sensitivity of 0.725, a specificity of 0.563, and an AUC of 0.7. These findings support that valence and arousal analysis provides meaningful discriminative power for identifying depressive symptoms. Importantly, the high sensitivity achieved by these models ensures that individuals with elevated symptoms are more reliably detected, thereby reducing the risk of missed cases. Overall, the results suggest strong potential for automated depressive symptom detection based on emotional signal analysis, with cost-sensitive optimization reducing false negatives while maintaining clinically relevant specificity. Conclusions This study offers proof-of-concept evidence that emotional sentiment analysis of speech using valence and arousal scoring can capture linguistic markers associated with depressive symptoms among family caregivers. With further refinement and validation, this approach lays an important foundation for the development of more robust machine learning models and ultimately contributes to non-intrusive mental health screening tools.

زمینه و هدف: افسردگی یکی از اختلالات شایع سلامت روان است که به طور قابل توجهی بر بهزیستی و عملکرد روزانه افراد تأثیر می‌گذارد و شناسایی زودهنگام نشانه‌های افسردگی را ضروری می‌سازد. هدف: این پژوهش به بررسی قابلیت ارتقای تحلیل گفتار با استفاده از تحلیل احساسی بُعدی و امتیازدهی والنس و برانگیختگی جهت بهبود شناسایی نشانه‌های افسردگی در مراقبان خانوادگی می‌پردازد. روش‌ها: تعداد ۱۱۶ مراقب خانوادگی جذب شدند و سطح افسردگی آن‌ها با استفاده از پرسشنامه افسردگی بک-نسخه دوم (Beck Depression Inventory-II) ارزیابی شد. شرکت‌کنندگان به ۱۲ پرسش باز مرتبط با تاب‌آوری خانواده به صورت شفاهی پاسخ دادند. واژه‌های استخراج‌شده از پاسخ‌ها با استفاده از فرهنگ واژگان چینی والنس-برانگیختگی از نظر احساسات مورد تحلیل قرار گرفت تا امتیازهای والنس و برانگیختگی آن‌ها تعیین شود. برای هر شرکت‌کننده، آمارهای خلاصه مختلف (مانند میانگین، واریانس، صدک‌ها) و آمارهای حوزه فرکانس (مانند آنتروپی طیفی، مؤلفه‌های فرکانسی غالب) توزیع والنس و برانگیختگی محاسبه شد. این ویژگی‌ها به عنوان متغیرهای پیش‌بین در نه مدل مختلف یادگیری ماشین که با اعتبارسنجی متقاطع تودرتوی ۵-تایی تکرارشونده و انتخاب نقطه برش حساس به هزینه ارزیابی شدند، مورد استفاده قرار گرفتند تا طبقه‌بندی قوی سطوح افسردگی با اولویت شناسایی موارد مثبت واقعی فراهم شود. نتایج: تحلیل ما نشان داد شرکت‌کنندگانی که نشانه‌های افسردگی بیشتری داشتند، واژه‌هایی با امتیازهای والنس و برانگیختگی افراطی‌تر نسبت به افراد با نشانه‌های افسردگی کمتر به کار بردند. مدل‌ها سودمندی پیش‌بینی قوی این ابعاد هیجانی را نشان دادند: مدل تحلیل ممیز مربعی (QDA) حساسیت خارج از نمونه ۰.۷۲۵، ویژگی ۰.۵۶۳ و سطح زیر منحنی (AUC) برابر با ۰.۷ را به دست آورد. این یافته‌ها نشان می‌دهد که تحلیل والنس و برانگیختگی قدرت تمایز معناداری برای شناسایی نشانه‌های افسردگی فراهم می‌کند. مهم‌تر آنکه حساسیت بالای این مدل‌ها تضمین می‌کند که افراد با نشانه‌های بالا با اطمینان بیشتری شناسایی می‌شوند و در نتیجه خطر موارد از دست رفته کاهش می‌یابد. به طور کلی، نتایج نشان‌دهنده پتانسیل قوی برای شناسایی خودکار نشانه‌های افسردگی بر اساس تحلیل سیگنال‌های هیجانی است که با بهینه‌سازی حساس به هزینه، موارد منفی کاذب را کاهش داده و در عین حال ویژگی بالینی مرتبط را حفظ می‌کند. نتیجه‌گیری: این مطالعه شواهد اثبات مفهومی ارائه می‌دهد که تحلیل احساسات هیجانی گفتار با استفاده از امتیازدهی والنس و برانگیختگی می‌تواند نشانگرهای زبانی مرتبط با نشانه‌های افسردگی در میان مراقبان خانوادگی را شناسایی کند. با اصلاح و اعتبارسنجی بیشتر، این رویکرد می‌تواند پایه‌ای مهم برای توسعه مدل‌های یادگیری ماشین قوی‌تر و در نهایت ابزارهای غربالگری سلامت روان غیرتهاجمی فراهم آورد.

BACKGROUND: Preventing episodes involving aggression and reducing coercive measures are important goals in in-patient mental health settings. Antecedents may provide insight into how episodes are described to develop. However, most studies reflect staff perspectives, and often describe and temporally specify antecedents inconsistently. AIMS: This scoping review mapped reported antecedents to episodes involving aggression and episodes involving coercive measures, and identified which appeared shared or specific to either phenomenon. METHOD: This review followed the Joanna Briggs Institute methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidance, and included 39 studies from systematic searches across Ovid Medline, APA PsycINFO and Scopus. Reported antecedents were extracted, standardised and mapped to six analytical domains. RESULTS: The review mapped 240 antecedents, many of which appeared shared across the phenomena. Patient studies emphasised experiences of restrictive care, loss of autonomy and poor interaction quality. Staff studies emphasised immediate, observable situations related to risk management, such as patient aggression, denied requests and interpersonal conflict. Most studies did not specify the temporal boundaries of antecedents. CONCLUSIONS: The perspectives represented in studies and the ways antecedents are conceptualised influence which antecedents become visible in the literature. Overlapping antecedents indicate that episodes involving aggression and episodes involving coercive measures are often described as part of the same escalation process, although patient and staff studies seem to highlight different stages. Prevention efforts therefore require attention to the entire trajectory, and to the point at which staff perceive intervention as necessary. Future studies should incorporate both perspectives, prioritise patient involvement, and more clearly define and temporally specify antecedents.

زمینه: پیشگیری از اپیزودهای مرتبط با پرخاشگری و کاهش اقدامات اجباری از اهداف مهم در بخش‌های بستری سلامت روان هستند. پیشایندها می‌توانند بینشی درباره نحوه توصیف فرایند شکل‌گیری این اپیزودها فراهم کنند. با این حال، اکثر پژوهش‌ها دیدگاه کارکنان را منعکس می‌کنند و اغلب پیشایندها را به‌صورت ناسازگار توصیف و از نظر زمانی مشخص می‌کنند. اهداف: این مرور گستره‌ای، پیشایندهای گزارش‌شده برای اپیزودهای مرتبط با پرخاشگری و اپیزودهای مرتبط با اقدامات اجباری را ترسیم کرده و مشخص نمود که کدام پیشایندها مشترک یا خاص هر پدیده هستند. روش: این مرور از روش‌شناسی مؤسسه Joanna Briggs و راهنمای PRISMA-ScR پیروی کرده و ۳۹ مطالعه را از جستجوهای نظام‌مند در Ovid Medline، APA PsycINFO و Scopus وارد کرد. پیشایندهای گزارش‌شده استخراج، استانداردسازی و در شش حوزه تحلیلی ترسیم شدند. یافته‌ها: این مرور ۲۴۰ پیشایند را ترسیم کرد که بسیاری از آن‌ها در هر دو پدیده مشترک بودند. مطالعات مبتنی بر بیماران بر تجربه مراقبت محدودکننده، از دست دادن خودمختاری و کیفیت پایین تعامل تأکید داشتند. مطالعات مبتنی بر کارکنان بر موقعیت‌های فوری و قابل مشاهده مرتبط با مدیریت ریسک مانند پرخاشگری بیمار، رد درخواست‌ها و تعارضات بین‌فردی تأکید داشتند. اکثر مطالعات مرزهای زمانی پیشایندها را مشخص نکرده بودند. نتیجه‌گیری: دیدگاه‌های منعکس‌شده در مطالعات و نحوه مفهوم‌سازی پیشایندها بر قابل مشاهده شدن آن‌ها در ادبیات تأثیر می‌گذارد. پیشایندهای همپوشان نشان می‌دهد که اپیزودهای مرتبط با پرخاشگری و اقدامات اجباری اغلب به عنوان بخشی از یک فرایند تشدید توصیف می‌شوند، اگرچه مطالعات بیماران و کارکنان به نظر می‌رسد مراحل متفاوتی را برجسته می‌کنند. بنابراین تلاش‌های پیشگیرانه نیازمند توجه به کل مسیر و نقطه‌ای است که کارکنان مداخله را ضروری می‌دانند. مطالعات آینده باید هر دو دیدگاه را وارد کنند، مشارکت بیماران را در اولویت قرار دهند و پیشایندها را به‌طور واضح‌تر تعریف و از نظر زمانی مشخص نمایند.

Statelessness affects an estimated 4.3 to 10 million people worldwide, denying them access to fundamental rights including education, employment, healthcare, and freedom from arbitrary detention. While stateless individuals are recognised as a marginalised group at elevated risk of human rights violations, discrimination, and trauma, the psychological impact of statelessness remains under-researched. This study aimed to explore how adults with lived experience of statelessness in the UK make sense of its impact on their mental health, and how they access support for any psychological difficulties. A qualitative design using Interpretative Phenomenological Analysis was used. Seven adults affected by statelessness were recruited through non-governmental organisations using purposive sampling. Participants varied in the reasons why they had been affected by statelessness, country of origin, and current immigration status in the UK. Four group experiential themes were generated. Trapped in a Kafkaesque System captured participants’ experience of draconian, discriminatory, and self-perpetuating bureaucratic structures that stripped autonomy, security, and time. Erosion of Self and Belonging described feeling administratively reduced to a non-person, dual legal and relational abandonment, and severed connections. Psychological and Embodied Harm located anxiety, depression, suicidality, post-traumatic stress disorder (PTSD), and somatic symptoms unambiguously within structural conditions, with two participants reporting that UK procedures damaged their mental health more than prior experiences of incarceration; intergenerational effects of the impacts of statelessness were also identified. Survival Strategies and Systemic Limits captured the protective role of community, faith, activism, and equipped services, while emphasising that resilience was bounded and could not substitute for rights. The findings articulate a pathway in which Kafkaesque systems produce entrapment, erode the person’s sense of identity, belonging and connection to others, and generate psychological and embodied harm only partially mediated by coping. Implications include the need for policy reform (reduced waits, restored and adequate Legal Aid funding, the right to work and healthcare access during protracted legal processes), clinician training, and services that recognise statelessness-related distress as legitimate clinical territory rather than deflecting responsibility to immigration authorities.

بدون تابعیت بودن حدوداً بین ۴٫۳ تا ۱۰ میلیون نفر را در سراسر جهان تحت تأثیر قرار می‌دهد و آن‌ها را از دسترسی به حقوق اساسی از جمله آموزش، اشتغال، مراقبت‌های بهداشتی و آزادی از بازداشت خودسرانه محروم می‌کند. اگرچه افراد بدون تابعیت به عنوان گروهی به حاشیه رانده‌شده با خطر بالاتر نقض حقوق بشر، تبعیض و تروما شناخته می‌شوند، اما تأثیر روان‌شناختی بدون تابعیت بودن همچنان کمتر مورد پژوهش قرار گرفته است. هدف این مطالعه بررسی نحوه درک بزرگسالان دارای تجربه زیسته بدون تابعیت بودن در بریتانیا از تأثیر آن بر سلامت روان و نحوه دسترسی آن‌ها به حمایت برای مشکلات روان‌شناختی بود. این پژوهش با رویکرد کیفی و با استفاده از تحلیل پدیدارشناختی تفسیری انجام شد. هفت بزرگسال تحت تأثیر بدون تابعیت بودن از طریق سازمان‌های غیردولتی و با نمونه‌گیری هدفمند جذب شدند. شرکت‌کنندگان از نظر دلایل بدون تابعیت بودن، کشور مبدأ و وضعیت مهاجرتی فعلی در بریتانیا متفاوت بودند. چهار مضمون تجربی گروهی استخراج شد. «گیر افتادن در یک سیستم کافکایی» تجربه شرکت‌کنندگان از ساختارهای بوروکراتیک سختگیرانه، تبعیض‌آمیز و خودتداوم‌بخش را که خودمختاری، امنیت و زمان را از آن‌ها سلب می‌کرد، توصیف می‌کند. «فرسایش خود و تعلق» به احساس تقلیل اداری به یک غیرشخص، رهاشدگی دوگانه حقوقی و ارتباطی، و قطع پیوندها اشاره دارد. «آسیب روان‌شناختی و جسمانی» اضطراب، افسردگی، تمایلات خودکشی، اختلال استرس پس از سانحه (PTSD) و علائم جسمانی را به طور آشکار در شرایط ساختاری جای می‌دهد؛ دو شرکت‌کننده گزارش دادند که رویه‌های بریتانیا سلامت روان آن‌ها را بیش از تجربیات قبلی زندان آسیب زده است؛ همچنین آثار بین‌نسلی بدون تابعیت بودن شناسایی شد. «راهبردهای بقا و محدودیت‌های نظام‌مند» نقش حمایتی جامعه، ایمان، کنشگری و خدمات مجهز را نشان داد، در حالی که تأکید شد تاب‌آوری محدود بوده و جایگزین حقوق نمی‌شود. یافته‌ها مسیر تولید گرفتاری توسط سیستم‌های کافکایی، فرسایش هویت، تعلق و ارتباط با دیگران، و ایجاد آسیب روان‌شناختی و جسمانی را که تنها تا حدی با مقابله تعدیل می‌شود، تبیین می‌کند. پیامدها شامل نیاز به اصلاح سیاست (کاهش زمان انتظار، بازگرداندن و تأمین کافی بودجه کمک حقوقی، حق کار و دسترسی به مراقبت‌های بهداشتی در طول فرایندهای حقوقی طولانی)، آموزش بالینی و خدماتی است که پریشانی مرتبط با بدون تابعیت بودن را به عنوان حوزه بالینی مشروع به رسمیت بشناسند و مسئولیت را به مقامات مهاجرتی واگذار نکنند.

Background: Workplace stress, anxiety, burnout and psychological distress are important concerns affecting employee well-being and organisational performance. The increasing use of artificial intelligence (AI) in digital mental health support offers opportunities for accessible and timely assistance, while raising concerns regarding privacy, informed consent, algorithmic bias, clinical safety, accountability and human oversight. This study aims to examine the potential role and responsible integration of AI-based psychiatric counselling for managing employee stress and supporting workplace mental health by 2030. Materials and Methods: A mixed-methods research design will be used, combining quantitative survey data with qualitative interviews. The quantitative component will include approximately 350–450 employees, while the qualitative component will involve approximately 25–35 interviews with HR professionals, organisational leaders, EAP professionals and mental health practitioners. Data will assess perceived stress, anxiety, burnout, psychological safety, trust, confidentiality, privacy concerns, AI counselling acceptance and willingness to use AI-based mental health support. Quantitative data will be analysed using descriptive statistics, reliability testing, correlation, regression, t-tests, ANOVA and appropriate mediation or moderation analyses. Qualitative data will be analysed thematically. Results: The study is expected to identify factors influencing employee acceptance and trust in AI-based psychiatric counselling and to examine the role of privacy, human oversight, psychological safety and organisational support in its responsible adoption. Conclusion: AI-based psychiatric counselling may serve as a supportive component of workplace mental health systems, particularly for early support, psychoeducation, self-help and triage. However, it should complement rather than replace qualified mental health professionals. Responsible implementation will require privacy safeguards, informed consent, clinical oversight, transparency, fairness, accountability and clear referral pathways.

زمینه: استرس محیط کار، اضطراب، فرسودگی شغلی و پریشانی روان‌شناختی از دغدغه‌های مهمی هستند که بهزیستی کارکنان و عملکرد سازمانی را تحت تأثیر قرار می‌دهند. افزایش استفاده از هوش مصنوعی (AI) در حمایت دیجیتال سلامت روان، فرصت‌هایی برای دسترسی و کمک به‌موقع فراهم می‌کند، در حالی که نگرانی‌هایی درباره حریم خصوصی، رضایت آگاهانه، سوگیری الگوریتمی، ایمنی بالینی، مسئولیت‌پذیری و نظارت انسانی ایجاد می‌کند. هدف این مطالعه بررسی نقش بالقوه و ادغام مسئولانه مشاوره روان‌پزشکی مبتنی بر هوش مصنوعی برای مدیریت استرس کارکنان و حمایت از سلامت روان محیط کار تا سال ۲۰۳۰ است. مواد و روش‌ها: از طرح پژوهشی آمیخته استفاده خواهد شد که داده‌های پیمایش کمی را با مصاحبه‌های کیفی ترکیب می‌کند. بخش کمی شامل حدود ۳۵۰ تا ۴۵۰ نفر از کارکنان خواهد بود و بخش کیفی شامل حدود ۲۵ تا ۳۵ مصاحبه با متخصصان منابع انسانی، رهبران سازمانی، متخصصان EAP و درمانگران سلامت روان خواهد بود. داده‌ها میزان استرس ادراک‌شده، اضطراب، فرسودگی شغلی، ایمنی روان‌شناختی، اعتماد، محرمانگی، نگرانی‌های مربوط به حریم خصوصی، پذیرش مشاوره مبتنی بر هوش مصنوعی و تمایل به استفاده از حمایت سلامت روان مبتنی بر هوش مصنوعی را ارزیابی خواهند کرد. داده‌های کمی با استفاده از آمار توصیفی، آزمون پایایی، همبستگی، رگرسیون، آزمون t، ANOVA و تحلیل‌های میانجی‌گری یا تعدیل‌گری مناسب تحلیل می‌شوند. داده‌های کیفی به صورت مضمون‌محور تحلیل خواهند شد. نتایج: انتظار می‌رود مطالعه عوامل مؤثر بر پذیرش و اعتماد کارکنان به مشاوره روان‌پزشکی مبتنی بر هوش مصنوعی را شناسایی کند و نقش حریم خصوصی، نظارت انسانی، ایمنی روان‌شناختی و حمایت سازمانی را در پذیرش مسئولانه آن بررسی نماید. نتیجه‌گیری: مشاوره روان‌پزشکی مبتنی بر هوش مصنوعی می‌تواند به عنوان بخشی حمایتی از نظام‌های سلامت روان محیط کار، به ویژه برای حمایت اولیه، آموزش روانی، خودیاری و ارجاع اولیه مورد استفاده قرار گیرد. با این حال، باید مکمل و نه جایگزین متخصصان واجد شرایط سلامت روان باشد. اجرای مسئولانه نیازمند تضمین‌های حریم خصوصی، رضایت آگاهانه، نظارت بالینی، شفافیت، انصاف، مسئولیت‌پذیری و مسیرهای ارجاع روشن خواهد بود.

Franco Basaglia's centenary, celebrated on March 11, 2024, invites reflection on the historical significance of his legacy. His work in defense of people with mental disorders represents his fight for the protection of human dignity and the value of life. Pejoratively called “the philosopher Basaglia,” he transformed psychiatric practices by pushing the boundaries of medicine to address profound human rights issues. Basaglia adopted an existential-analytical stance that underpinned his commitment to psychiatric reform and the management of mental health practice, inspiring changes in public policies around the world. This commemorative editorial presents a historical overview of Franco Basaglia's contributions to psychiatric reform and their implications for mental health care.

صدمین سالگرد تولد فرانکو بازالیا که در ۱۱ مارس ۲۰۲۴ گرامی داشته شد، فرصتی برای تأمل بر اهمیت تاریخی میراث او فراهم می‌کند. فعالیت‌های او در دفاع از افراد مبتلا به اختلالات روانی، نمایانگر تلاش وی برای حفاظت از کرامت انسانی و ارزش زندگی است. بازالیا که به طعنه «فیلسوف بازالیا» نامیده می‌شد، با گسترش مرزهای پزشکی و پرداختن به مسائل عمیق حقوق بشری، شیوه‌های روان‌پزشکی را متحول ساخت. او با اتخاذ رویکردی وجودی-تحلیلی، تعهد خود به اصلاحات روان‌پزشکی و مدیریت عمل سلامت روان را پایه‌گذاری کرد و الهام‌بخش تغییراتی در سیاست‌های عمومی در سراسر جهان شد. این سرمقاله‌ی یادبود، مروری تاریخی بر دستاوردهای فرانکو بازالیا در اصلاح روان‌پزشکی و پیامدهای آن برای مراقبت از سلامت روان ارائه می‌دهد.

AIMS AND METHOD: An analysis of coronial inquest data provides contextual information rarely available in routine surveillance systems, including a nuanced understanding of proximal circumstances preceding death of value to mental health services. Inquest records of more than 750 suicides occurring within the South Wales Central Coroner's jurisdiction between 2016 and 2023 were reviewed, including the COVID-19 pandemic years, to assess the effects of lockdown and social isolation. Detailed information was extracted, including medical records, toxicology, police reports, witness statements and suicide notes. RESULTS: Several patterns emerged relating to age, gender, method of death, trigger factors, local authority area, and engagement with mental health services. Hanging was the predominant method, particularly among men. Depression was the most common trigger factor, followed by relationship problems, alcohol/drug misuse, health concerns, psychotic illness and bereavement. CLINICAL IMPLICATIONS: Key structural and psychosocial risk factors identified highlighted the need for tailored, context-specific suicide-prevention strategies, with circumstances preceding suicide integrated into public health planning.

اهداف و روش: تحلیل داده‌های تحقیقات پزشکی قانونی اطلاعات زمینه‌ای را فراهم می‌کند که به ندرت در سامانه‌های پایش معمول در دسترس است و شامل درک دقیق‌تری از شرایط نزدیک به مرگ است که برای خدمات سلامت روان ارزشمند است. سوابق تحقیقات بیش از ۷۵۰ مورد خودکشی که در حوزه قضایی پزشکی قانونی مرکز ولز جنوبی بین سال‌های ۲۰۱۶ تا ۲۰۲۳ رخ داده بود، از جمله سال‌های همه‌گیری COVID-19، به منظور ارزیابی اثرات قرنطینه و انزوای اجتماعی مرور شد. اطلاعات دقیقی از جمله سوابق پزشکی، نتایج سم‌شناسی، گزارش‌های پلیس، اظهارات شاهدان و یادداشت‌های خودکشی استخراج گردید. نتایج: چندین الگو مرتبط با سن، جنسیت، روش مرگ، عوامل محرک، منطقه تحت پوشش شهرداری و میزان ارتباط با خدمات سلامت روان مشاهده شد. حلق‌آویز کردن رایج‌ترین روش بود، به ویژه در میان مردان. افسردگی شایع‌ترین عامل محرک بود و پس از آن مشکلات روابط، سوءمصرف الکل/مواد مخدر، نگرانی‌های سلامت، اختلالات روان‌پریشی و داغدیدگی قرار داشتند. پیامدهای بالینی: عوامل خطر ساختاری و روانی‌اجتماعی کلیدی شناسایی‌شده، بر ضرورت تدوین راهبردهای پیشگیری از خودکشی متناسب با زمینه و شرایط خاص تأکید می‌کند، به گونه‌ای که شرایط پیش از خودکشی در برنامه‌ریزی سلامت عمومی ادغام شود.