Anxiety Research Articles

Quality of Professional Life in Medical Students: The Roles of Psychological Self-care, Anxiety, and Depression

Background: Medical students often experience high levels of psychological stress, which can significantly impact their professional lives. Objectives: This study aimed to investigate the quality of professional life among medical students and the influence of psychological self-care and resilience on both professional quality of life and psychological distress among medical clerks and interns at Babol University of Medical Sciences. Methods: This descriptive-cross-sectional study, conducted from May to September 2022, included 270 medical trainees from Babol University of Medical Sciences (Babol, Iran). Participants had not taken academic leave in the past year nor transferred to another university. They completed online questionnaires covering resilience, psychological self-care, quality of professional life, and psychological distress, along with demographic details such as age, gender, and marital status. Data were analyzed using SPSS software. Results: Results indicated a generally favorable quality of professional life among the students, characterized by low compassion fatigue (mean 17.43 ± 7.87 out of 36) and low psychological burnout (mean 15.34 ± 4.10 out of 24), but moderate compassion satisfaction (mean 34.52 ± 8.13 out of 50). Additionally, mean scores for depression (7.84 ± 3.50 out of 21) and anxiety (7.24 ± 3.76 out of 21) were low. Students demonstrated above-average psychological self-care (mean 127.47 ± 17.97 out of 180) but had low resilience against stress (mean 24.12 ± 5.28 out of 38). Regression analysis revealed that psychological self-care significantly influenced the quality of professional life (P < 0.001, β = 0.318). Furthermore, age (P < 0.001, β = 0.299), female gender (P = 0.013, β = -0.136), and self-care (P < 0.001, β = -0.327) significantly affected levels of anxiety and depression. Conclusions: Psychological self-care plays a crucial role in enhancing the quality of professional life and in mitigating anxiety and depression among medical clerks and interns.

The course of acute low back pain: a community-based inception cohort study.

Acute low back pain (LBP) is increasingly recognized for its potential recurrent nature and long-term implications. This community-based inception cohort study aimed to delineate trajectories of acute LBP over one year and investigate associated biopsychosocial variables. One hundred seventy-six participants with acute LBP were monitored at 5 follow-up time points over 52 weeks. Pain trajectories were identified using a latent class linear mixed model, and their associations with baseline biopsychosocial factors were evaluated through multinomial logistic regression. Four distinct LBP trajectories were discerned: "mild/moderate fluctuating pain" (54.0%), "delayed recovery by week 52" (6.2%), "persistent moderate pain" (33.0%), and "moderate/severe fluctuating pain" (6.8%). Increased baseline pain intensity and history of LBP episodes were significantly linked with less favorable trajectories. Contrary to expectations, psychological variables like stress, anxiety, and depression did not significantly associate with unfavorable trajectories. This study underscores the heterogeneity of acute LBP's course over a year, challenging the conventionally benign perception of the condition. Recognizing these distinct trajectories might enable more tailored, effective clinical interventions for LBP patients. The small sample size of certain trajectories may influence the generalizability of the results. Acute LBP can manifest in different trajectories, with nearly half of the participants experiencing less favorable trajectories. Baseline pain intensity and previous episodes of LBP emerged as key factors, whereas psychological variables had no discernible influence. Recognition of these trajectories may be necessary for improved patient management and targeted interventions.

Diaphragm dysfunction is found in patients with chronic painful temporomandibular disorder: A case-control study

AimTo determine whether patients with chronic painful temporomandibular disorder (TMD) had abnormal diaphragm function compared to healthy controls and to explore the correlation between diaphragm contractility, psychological status, and pain characteristics. MethodsA single-blinded, case-control study was conducted involving 23 chronic painful TMD patients and 22 healthy volunteers. The examination and diagnosis were performed according to the Diagnostic Criteria for Temporomandibular Disorders, and questionnaires were used to evaluate pain, depression, anxiety, and physical symptoms status. B-mode ultrasound was used to measure diaphragm thickness and contractility. The sonographer responsible for measuring the diaphragm was blinded to group membership. Results1. Depression, anxiety, and physical symptoms scores were significantly higher in the patients than in the controls (p < 0.05). 2. The Interference Score of pain was significantly correlated with depression and physical symptoms (p < 0.01). 3. Bilateral diaphragm contractility was significantly smaller in the patients than in the controls (right: P = 0.003; left: P = 0.001). 3. There was no correlation between diaphragm contractility on the left and right sides in the patients (r = −0.112, P = 0.611), while there was a positive correlation in the control group (r = 0.638, P = 0.001). 4. No correlation was found between the degree of diaphragm contractility, psychological status, and pain scores. Conclusions1. Patients with chronic painful TMD have worse psychological status, including depression, anxiety, and physical symptoms. 2. Patients with chronic painful TMD have a smaller degree of bilateral diaphragm contractility and more significant left-right incongruity, which indicated that diaphragm dysfunction may be correlated with chronic painful temporomandibular disorder.

Implementation of the Psychological Scale Depression Anxiety Stress Scale 21 (Dass-21) in the Expert System for Diagnosing Mental Health Disorder

Implementation of the Psychological Scale Depression Anxiety Stress Scale 21 (Dass-21) in the Expert System for Diagnosing Mental Health Disorder

A survey of cancer patients’ interest in undertaking exercise to promote relaxation during radiotherapy for breast cancer and metastatic cancer

BackgroundApproximately 25–50% of patients undergoing radiotherapy (RT) experience psychological distress and anxiety, which can detrimentally affect both their quality of life and treatment outcomes. While previous research has demonstrated that relaxation exercises can enhance the tolerability of RT and alleviate associated stress and anxiety, the specific needs for such therapies in radiation oncology remain under-explored. This study aims to investigate the demand for and preferences toward relaxation exercises among radiotherapy patients, addressing a critical gap in patient-centered care.MethodsA prospective pseudonymized survey study using a one-time paper-based questionnaire was conducted from 2022 to 2023 among patients undergoing curative-intent RT for breast cancer or patients undergoing palliative RT for bone metastases. Patients were asked in a 11-item questionnaire about their anxiety, pre-existing practice of relaxation exercises/interventions, their interest in relaxation exercises, and preferences on the type and format of instruction. Data were analyzed descriptively.Results100 patients (74 female and 26 male) responded, of whom 68 received curative-intent adjuvant RT and 32 palliative RT. Median age was 62 years. 78% of patients indicated a desire to be actively involved in their radiotherapy, but only 27% had used relaxation exercises prior to RT. 44.8% of both curatively and palliatively treated patients who wanted to be actively involved in their therapy desired to learn how to best relax. 56.4% of respondents were willing to spend extra time learning offered exercises.ConclusionThe survey indicates that patients undergoing RT, both for curative or palliative intent, desire relaxation exercises to relieve stress and anxiety from RT. It is therefore important to assess the need for relaxation interventions in individual patients and to develop suitable programs or collaborate with other healthcare professionals to meet these needs.

Mitigating Identity-Related Anxiety through Humor and Immersive Storytelling with 360-Degree Video in Virtual Reality: A Study on Microaggressions' Mental Health Effects.

Background: Microaggressions are subtle slights that can cause significant psychological distress among marginalized groups. Few studies have explored interventions that might mitigate these effects. Objective: This study aimed to investigate if and how humor-infused immersive storytelling via virtual reality (VR) could reduce identity-related psychological distress caused by microaggressions. Methods: Using a community-based participatory research approach, we developed a 7-min 360-degree VR film depicting scenarios of microaggressions across various identities. Forty-six college students participated in a controlled study where they were exposed to this immersive VR experience. We measured identity-related psychological anxiety, character identification, perceived humor, and perceived psychological presence. Results: The findings demonstrated a significant anxiety reduction following the VR intervention, supporting the efficacy of humor-infused storytelling in alleviating the impact of microaggressions. Character identification significantly predicted anxiety reduction, while perceived humor and psychological presence did not directly influence anxiety reduction but indirectly contributed through enhanced character identification. Conclusions: Humor-infused immersive storytelling, facilitated by VR, effectively reduces identity-related psychological distress primarily through character identification. The structural equation modeling results emphasize the importance of integrating humor and psychological presence to enhance character connection, advocating for a balanced approach that combines traditional narrative elements with technological innovations in health interventions aimed at combating the adverse psychological effects of microaggressions.

포용적 리더십이 중장년층 구성원의 내면화된 수치심에 미치는 영향

Middle-aged members experience high psychological anxiety or are alienated from the organization due to rapid changes in the business environment and job insecurity, reduced work and roles, age discrimination, and forced retirement. The anxiety of middle-aged members appears as internalized shame, showing a cynical attitude toward the organization, and has the potential to spread negative emotions to individuals and organizations. In addition, middle-aged members are an area of interest in research in that they have know-how and performance resources through their careers. This study focused on the internalized shame of middle-aged members, and to confirm the psychological mechanisms that alleviate it, the direct effect of inclusive leadership, the controlled role of leader trust and perceived organizational support were verified. The survey was conducted twice by separating the measurement period of the survey from 455 office workers working in various industries. As a result of the study, first, inclusive leadership was found to reduce the internalized shame of middle-aged members. Second, it was found that inclusive leadership was regulated by leader trust and alleviated internalized shame. Third, inclusive leadership was found to alleviate internalized shame as a controlled moderating effect of leader trust and perceived organizational support. Focusing on the status, emotions, and characteristics of middle-aged members, this study deeply verified the relationship between variables, presented theoretical and practical implications, and presented future research tasks and limitations based on the research results.

Psychological burden, anxiety, depression and quality of life in patients with hand eczema: A systematic review and meta-analysis.

Living with hand eczema (HE) has been associated with impaired quality of life (QoL), having anxiety and depression but the magnitude of association is not clear. The aim of this systematic review and meta-analysis was to determine the psychological burden in terms of anxiety, depression and quality of life in patients with HE. Several databases were systematically searched. Weighted means with standard deviation (SD) were calculated for disease severity, QoL, depression and/or anxiety scores among patients with HE. For studies presenting QoL, depression and/or anxiety scores in patients with HE and in controls the weighted means were compared with an unpaired t-test. In studies reporting Hand Eczema Severity Index (HECSI) and Dermatology Life Quality Index (DLQI), the correlation between HECSI and DLQI was estimated using Spearman's rank correlation (rs). In total, 81 studies encompassing 17,835 patients with HE and 31,541 controls were included. The weighted mean DLQI was 10.66 (SD 8.93) corresponding to a moderate-to-large effect on QoL and a strong correlation (rs: 0.76, 95% CI:0.56-0.87) between DLQI and HECSI was observed. The mean EQ-5D-VAS was significantly lower in patients with HE compared with controls (68.03 (SD 10.52) vs. 80.63 (SD 1.17), p < 0.00001). Patients with HE had higher mean HADS (Hospital Anxiety and Depression Scale) anxiety score (7.4 vs. 5.8, p = 0.0008) than controls but not higher HADS depression score (6.5 vs. 5.7, p = 0.32). Only one study assessed risk of anxiety, depression and suicidal ideation showing an increased odds of all diseases among patients with HE compared with controls. Hand eczema has a moderate-to-severe impact on quality of life with a strong correlation between disease severity and impact on quality of life. Patients with hand eczema have an impact on QoL comparable to other chronic diseases when measured with generic QoL scoring systems.

Effect of an 8-Week Mindfulness Meditation Training Program on Psychological Distress in Caregivers and on Behavioral and Psychological Symptoms in People with Alzheimer’s Disease: A Randomized Controlled Trial

ObjectivesMental health problems are highly prevalent in people with Alzheimer’s disease (AD) and their family caregivers. Therefore, this study aimed to examine the effects of the Mindfulness-Based Health Care Program (MBHC) on the psychological distress of family caregivers of people with AD and, indirectly, on the behavioral and psychological symptoms of dementia (BPSD) in people with AD.MethodA sample of 66 caregivers of people with AD was randomly assigned to either 8 weeks of MBHC or treatment as usual (TAU) groups. The psychological distress in family caregivers, measured by the Hospital Anxiety and Depression Scale (HADS), and BPSD in patients, measured by the Neuropsychiatric Inventory Questionnaire (NPI-Q), were evaluated and compared at baseline, post-intervention, and 3-month follow-up.ResultsA total of 50 participants (75.6%) completed the MBHC post-intervention and 30 (50%) at the 3-month follow-up. At post-intervention, compared to TAU, MBHC was associated with significantly greater decreases in psychological distress (β = − 3.86; 95%CI, − 7.67, − 0.04; p = 0.047), specifically in anxiety symptoms (β = − 2.84; 95%CI, − 5.38, − 0.30; p = 0.029), but no significant changes were observed in depressive symptoms. MBHC did not produce a significant change in psychological distress at 3-month follow-up. MBHC did not yield a significant reduction in BPSD in people with AD, neither at post-intervention nor at 3-month follow-up.ConclusionsThe results suggest that 8-week mindfulness training can effectively reduce psychological distress and anxiety symptoms in caregivers of people with Alzheimer’s disease.PreregistrationThis study was preregistered on ClinicalTrials.gov (identifier NCT03858283) on 26 February 2019.

The impact of distance education on the socialization of college students in the Covid-19 era: problems in communication and impact on mental health

BackgroundThe problems of students’ social interaction and psychological well-being associated with online learning dependent on self-directed learning have become an important topic of research in recent years worldwide due to the COVID-19 pandemic, affecting their Social Emotional Learning. This paper aimed to compare the students’ loneliness, social anxiety, social interaction, and general psychological well-being at different stages of online learning (at the beginning and the height of the pandemic), considering their criteria (presence/absence of a job and own family).MethodsFor this, the researchers conducted an electronic survey of students (n = 320) twice, in February and May 2020, using four questionnaires: UCLA loneliness scale-3, Social Anxiety Scale for E-Learning Environments, Social Interaction Scale, and Brief Adjustment Scale. The responses at different stages of online learning were compared using Student’s t-test. Differences between employed and unemployed students with or without their own families were determined using the analysis of variance (ANOVA).ResultsThe findings showed that unemployed students without their families suffered the most from loneliness. Social interaction online was rated higher by students with their own families; psychological well-being at the beginning of the distance period and social anxiety at the height of the distance period were higher among unemployed students.ConclusionsThis research can become a theoretical basis for a phase-by-phase study of social predictors for the psychological well-being of higher education students and is of practical value for teachers and administrators of online learning aimed at students’ socialization. In addition, it provides education officials with information about how students perceive psychological well-being, anxiety, social interaction, and loneliness during distance learning, which can help officials direct their decisions and reforms to improve interaction in the online environment.

Investigating the Relationship Between Insulin Treatment Refusal and Psychosocial Factors in Type 2 Diabetic Patients

Objective: Refusal of insulin therapy is an important barrier in the treatment of type 2 diabetes mellitus (T2DM). The current study aimed to investigate the effect of psychosocial status of diabetic patients on insulin treatment acceptance and refusal. Methods: This cross-sectional study was conducted with age and gender matched 80 diabetic patients who accepted insulin therapy and 80 diabetic patients who refused insulin therapy. Participants were interviewed face-to-face using a questionnaire consisting of five sections: socio-demographic, depression, anxiety, fear of self-injection and adherence to diabetes treatment. Results: There was no significant difference between the two groups in terms of age and gender. The beck depression scale score (p=0.002) and beck anxiety scale score (p&lt;0.001) of the participants who refused insulin treatment were statistically significantly higher than the group who accepted the treatment. The injection fear scale score of the group who refused insulin treatment was statistically significantly higher than those who accepted insulin treatment (p&lt;0.001). There was a significant negative correlation between injection fear score and treatment adherence scale score in both participants who accepted (r:-0.224; p:0.045) and refused insulin treatment (r:-0.309; p:0.005). Conclusion: The current study showed that depressive and anxiety moods of the individuals caused insulin therapy refusal. In addition, fear of injection was another factor causing insulin treatment refusal. Depression and fear of injection were also found to negatively affect adherence to treatment.

Research Progress on the Basic Pharmacodynamic Substance and Mechanism of &lt;i&gt;Citri Sarcodactylis Fructus&lt;/i&gt; in Relieving Anxiety

Anxiety disorder resulting from the interaction of psychological factors-caused anxiety and mood disorder symptoms is one of the clinical mental diseases. Excessive worry, nervousness and fear often bring about several negative outcomes, and seriously impact the physical, mental, and social functioning of patients. What’s worse, with poor treatment, anxiety disorder may develop into mental illnesses such as depression and schizophrenia. The treatment of anxiety has mainly recourse to drug therapy and psychotherapy; however, Western drug therapy represented by 5-hydroxytryptamine reuptake inhibitor often causes evident adverse effects, including nausea and constipation, as well as poor long-term medication compliance of patients. Citri Sarcodactylis Fructus can sooth the liver and regulate qi, which can be applied to alleviate anxiety disorder as an ancillary drug. Modern pharmacological research revealed that bergamot volatile oil, also known as bergamot essential oil (BEO), is the main active chemical component of Citri Sarcodactylis Fructus for anti-anxiety. BEO has been confirmed to exert an anti-anxiety effect through modulating neuronendocrine-immune network, including immunoregulation, suppression of hyperactive hypothalamic-pituitary-adrenal (HPA) axis, enhancement of function of hypothalamic-pituitary-thyroid (HPT) axis, modulation of neurotransmitter, and promotion of neurotrophic effect. The study discusses the current research status regarding the application of Citri Sarcodactylis Fructus for anti-anxiety in recent years, and deeply probes into the mechanism of Citri Sarcodactylis Fructus playing an anti-anxiety role via neuronendocrine-immune network, in an effort to provide references to clinical treatment of anxiety disorder and new ideas for developing drugs targeting anxiety disorders.

Association of OPRM1 rs1799971, HTR1B rs6296 and COMT rs4680 polymorphisms with clinical phenotype among women with fibromyalgia

To investigate the association between three selected pain polymorphisms and clinical, functional, sensory-related, psychophysical, psychological or cognitive variables in a sample of women with fibromyalgia (FMS). One hundred twenty-three (n = 123) women with FMS completed demographic (age, height, weight), clinical (years with pain, intensity of pain at rest and during daily living activities), functional (quality of life, physical function), sensory-related (sensitization-associated and neuropathic-associated symptoms), psychophysical (pressure pain thresholds), psychological (sleep quality, depressive and anxiety level) and cognitive (pain catastrophizing, kinesiophobia) variables. Those three genotypes of the OPRM1 rs1799971, HTR1B rs6296 and COMT rs4680 single nucleotide polymorphisms were obtained by polymerase chain reactions from no-stimulated whole saliva collection. No significant differences in demographic, clinical, functional, sensory-related, psychophysical, psychological and cognitive variables according to OPRM1 rs1799971, HTR1B rs6296 or COMT rs4680 genotype were identified in our sample of women with FMS. A multilevel analysis did not either reveal any significant gene-to-gene interaction between OPRM1 rs1799971 x HTR1B rs6296, OPRM1 rs1799971 x COMT rs4680 and HTR1B rs6296 x COMT rs4680 for any of the investigated outcomes. This study revealed that three single nucleotide polymorphisms, OPRM1 rs1799971, HTR1B rs6296 or COMT rs4680, mostly associated with chronic pain were not involved in phenotyping features of FMS. Potential gene-to-gene interaction and their association with clinical phenotype in women with FMS should be further investigated in future studies including large sample sizes.

Supportive care needs and anxious-depressive symptoms in cancer patients: An interaction effect between emotional competence and the COVID-19 pandemic?

The main objective was to assess the link between emotional competence (EC) and adjustment outcomes such as supportive care needs (SCN) and anxious-depressive symptoms in cancer patients starting chemotherapy. The second objective was to assess the interaction effect between EC and the COVID-19 pandemic (i.e. patients included before or during the pandemic) on these outcomes. At the beginning of care, 255 patients with digestive or hematological cancer, recruited before the pandemic began (n = 156, 61.2%) or during the pandemic (n = 99, 38.8%), completed the Short Profile of Emotional Competence, the Hospital Anxiety and Depression Scale, and the Supportive Care Needs Survey Short Form. Partial correlations and multiple regressions were used. Intrapersonal EC showed negative significant correlations with psychological unmet SCN (r = -.32, p < .001), anxiety (r = -.37, p < .001), and depression (r = -.46, p < .001). Interpersonal EC showed only significant interaction effects (p < .05): it was only associated with fewer unmet physical and daily SCN (p < .002) and fewer depressive symptoms (p < .004) during pandemic. Results show significant associations between intrapersonal EC and better adjustment of cancer patients from the early stage of care. Interpersonal EC seems to be a significant resource to deal with illness only in difficult contexts such as the COVID-19 pandemic.

The relationship between dental anxiety and oral health literacy with oral health-related quality of life

Background and AimDental anxiety is a prevalent issue in society, characterized by an uneasy sensation and anticipation of negative experiences in dental settings. In essence, dental anxiety, oral health literacy, and quality of life may have a relationship with each other, however, there is a shortage of evidence examining the interplay between these factors. Therefore, this study aimed to assess the relationship between dental anxiety and oral health literacy (OHL) with oral health-related quality of life (OHRQOL).MethodsThis is an analytical cross-sectional study conducted on 155 patients referred to the Department of Oromaxillofacial Diseases. Three questionnaires consisting of dental anxiety scale, oral health impact profile- 14, and oral health literacy adult questionnaire were used to measure anxiety, health literacy, and the quality of life-related to oral health. Scores were recorded and analyzed by IBM SPSS 24 software using independent samples T-test and ANOVA. Besides, the confirmatory modeling through the goodness of fit index of the model was applied.ResultsThis study involved 155 participants, with a mean age of 38.44 ± 14 years. The majority were females, comprising 99 individuals (63.9%). In this study, 89 patients (57.4%) had dental anxiety. The mean OHL score in the examined participants was 9.88 ± 3.97. Both factors of anxiety (p < 0.001) and OHL (p = 0.012) had a significant effect on the OHRQOL. There was no significant difference in the mean OHRQOL among the three categories of OHL (p = 0.085). The confirmatory modeling showed that only the fourth (p = 0.065) and fifth (p = 0.146) questions of the OHL questionnaire had no significant effect on the total score of OHL. Besides, both factors of anxiety (p < 0.001) and OHL (p = 0.012) had a significant effect on OHRQOL. With an increase of one unit in anxiety, the OHRQOL score increases by 0.31 and for a one-unit increase in the OHL score, the OHRQOL score decreases by 0.66 units.ConclusionIn conclusion, it seems that considering various dimensions of oral and dental health can help patients to have reduced psychological anxiety. Notably, further multicenter studies assessing diverse variables related to dental anxiety, OHL, and OHRQOL, and considering more comprehensive study designs with longitudinal follow-up could help provide insights into how changes in dental anxiety and OHL over time affect OHRQOL.

Efficacy of Internet-based Cognitive Behavioral Therapy for Hong Kong University Students: A Randomized Controlled Trial

Purpose: This study examined the efficacy of a 10-week internet-based cognitive behavioral therapy (iCBT) program “REST Online” for Hong Kong university students with mild to moderate levels of psychological distress. Method: A total of 206 Hong Kong university students were randomized into: (1) web-based and (2) app-based iCBT, and (3) waitlist control (WLC) groups. Results: Compared with the WLC group, the participants in the two iCBT groups showed a significant reduction in psychological distress, depression and anxiety symptoms, and negative thoughts and emotions, and significant increase in positive thoughts and emotions, with medium to large effect sizes. The positive effects were sustained at the 3-month follow-up test. No significant intervention effects were found between the two iCBT groups except for anxiety symptoms. Discussion: The findings were discussed in terms of program design and service delivery, and suggestions for delivering digital mental health service in Hong Kong universities were proposed.

Your Need for Cognition, Cognitive Flexibility, and Cognitive Emotion Regulation Strategies Matter! The Path beyond a Satisfied Life

This study explored the associations among cognitive flexibility, cognitive emotion regulation (CER) strategies, need for cognition, and life satisfaction, which represents a cognitive component of subjective well-being. Previous studies have shown the importance of adaptive CER strategies for well-being, while maladaptive strategies have been linked to negative outcomes such as psychological distress, depression, and anxiety. Additionally, the need for cognition has been associated with cognitive flexibility and positive outcomes in various domains. However, the specific roles of cognitive flexibility and CER strategies in the relationship between need for cognition and life satisfaction remain relatively unexplored in the existing literature. This study aimed to address this gap by investigating how cognitive flexibility and different CER strategies contribute to the relationship between need for cognition and life satisfaction in a non-clinical sample of 239 adults via a survey consisting of a demographic information form, need for cognition scale, cognitive flexibility inventory, cognitive emotion regulation questionnaire, and satisfaction with life scale. The results demonstrated that when individuals with a high need for cognition had cognitive flexibility, they were more likely to use adaptive cognitive emotion regulation strategies, resulting in elevated life satisfaction. The findings of this study may provide insights into the underlying mechanisms that influence individuals’ cognitive processes, cognitive emotional regulation, and overall life satisfaction. Such understanding can have implications for interventions aimed at enhancing cognitive flexibility, promoting adaptive CER strategies, and ultimately fostering improved life satisfaction.

Parental psychological control and depression, anxiety among adolescents: The mediating role of bedtime procrastination and moderating role of neuroticism

Studies have shown that maladaptive parenting styles, particularly parental psychological control may be an important risk factor for emotional problems in adolescence. However, the potential mechanisms behind this association are still not fully understood. To fill the research gap, this study investigated the relationship between parental psychological control and depression and anxiety among adolescents. It also explored the mediating effect of bedtime procrastination and the moderating effect of neuroticism through a moderated mediation analysis. A sample of 665 adolescents (331 girls) were recruited from two secondary schools in southern China. All participants completed standardized self-report questionnaires measuring the severity of parental psychological control, bedtime procrastination, depression, anxiety, and neuroticism. Data were analyzed using SPSS 25.0 and PROCESS macros. The results indicated that parental psychological control had a positive predictive effect on depression and anxiety among adolescents. Bedtime procrastination partially mediated the relationship between parental psychological control and depression, as well as parental psychological control and anxiety. Neuroticism was found to play a moderating role in the path from bedtime procrastination to depression and from bedtime procrastination to anxiety, with these effects being stronger for adolescents with higher levels of neuroticism. This study advances a deeper understanding of how and when or for whom parental psychological control is related to adolescents' severe depression and anxiety. Our findings suggest that intervention programs or strategies aimed at reducing parental psychological control and assisting adolescents in establishing healthy sleep hygiene practices should be developed to decrease the risk of depression and anxiety in adolescents.

Abstract PS04-07: Associations between Virtual Care Access and Psychological and Mental Health Conditions among Adults with Breast Cancer in the US: A Population-Based Analysis

Abstract Background: Adults with breast cancer (AwBC) often experience psychological and mental health challenges and face many barriers to accessing mental health care and services. Telemedicine can help facilitate access to these care and services and AwBC may benefit uniquely from virtual care. However, little is known about the relationships between virtual care access (VCA) and psychological and mental health conditions in AwBC nationally. Methods: We obtained a population-based sample from the 2021 National Health Interview Survey that used stratified clustering sampling to interview US adults. This study was limited to adults who ever had breast cancer. VCA was defined as having had a virtual (i.e., phone or video) medical visit with a health provider in the past 12 months and was categorized as “yes/no.” Serious psychological distress, measured using the 6-item Kessler scale, was dichotomized based on a cutoff score of 13. Having an anxiety disorder or depression was self-reported as “yes/no.” Weighted proportions and 95% confidence intervals (CI) were tabulated and compared using Rao-Scott chi-square tests. Multivariable logistic regression models were fit to calculate adjusted odds ratios (AOR) and 95% CIs. All statistical analyses accounted for complex sample design and survey weights. Results: The unweighted sample size was 698, representing a weighted sample of 4,379,870 AwBC in the US. The mean age was 67.7 years; 77.6% were White and 9.6% were Black; 53.8% and 38.9% were privately insured and on Medicaid/Medicare, respectively. Of the total, 20.9% (95% CI: 17.3-24.6%) had depression, 17.4% (95% CI: 14.0-20.9%) had an anxiety disorder, and 3.2% (95% CI: 1.7-4.7%) experienced serious psychological distress. Overall, 50.3% (95% CI: 46.1-54.4%) had a virtual visit. White AwBC reported a higher proportion of VCA than Black AwBC (50.6% vs. 38.6%). AwBC on Medicaid/Medicare reported a lower proportion of VCA than those privately insured (47.8% vs. 51.8%). AwBC who experienced serious psychological distress had a higher percentage of VCA than those who did not (78.5% [95% CI: 60.8-96.2%] vs. 48.5% [95% CI: 44.2-52.8%], p=.007). Compared with AwBC who did not have depression, those who did had a higher percentage of VCA (63.9% [95% CI: 54.6-73.2%] vs. 46.6% [42.0-51.3%], p=.002). Similarly, AwBC with an anxiety disorder reported a higher percentage of VCA than those without (60.4% [95% CI: 50.3-70.6%] vs. 48.1% [43.6-52.6%], p=.032). Furthermore, AwBC who frequently felt anxious or depressed were more likely than those who felt less frequently to use telemedicine. In the adjusted regression models, AwBC experiencing serious psychological distress had significantly greater odds of VCA than those not experiencing (AOR=3.79, 95% CI: 1.05-13.7). AwBC with depression had significantly greater odds of VCA than those without (AOR=2.02, 95% CI: 1.25-3.28). Although AwBC with an anxiety disorder also had greater odds of VCA than those without (AOR=1.45, 95% CI: 0.89-2.38), the association was not statistically significant. Conclusions: In this nationally representative sample of US AwBC, more than one in 6 had an anxiety disorder or depression and VCA was prevalent in the past 12 months. AwBC with serious psychological distress, anxiety, or depression were more likely than those without to use telemedicine, indicating a greater need for virtual care among AwBC. Our findings also suggest that to help AwBC improve their psychological and mental health conditions and address their unmet needs, breast cancer support programs would need to ensure equitable access to virtual care and services in this patient population. Citation Format: Jincong Freeman, Ted Akhiwu, Yong Gun Lee, Xinyi Li. Associations between Virtual Care Access and Psychological and Mental Health Conditions among Adults with Breast Cancer in the US: A Population-Based Analysis [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PS04-07.

BOTOX’s Mechanism, Diversity Considerations, and Therapeutic Potential in Cosmetic, Medical, and Dental Practice

This review provides a comprehensive overview of the societal pressures of maintaining a youthful appearance and the increasing popularity of BOTOX injections for aesthetic purposes. It discusses the motivation behind BOTOX use for personal psychological gains, partly driven by social media pressure and societal expectations. Ethical considerations and potential psychosocial consequences of cosmetic BOTOX are also addressed.The article delves into the explanation of what BOTOX is and how it works, emphasizing its use for cosmetic and medical purposes, such as treating spasmodic dysphonia and hyperhidrosis. When used appropriately, it highlights the rarity of complications and adverse effects associated with BOTOX. BOTOX’s historical use and development, from its initial medical applications to its widespread adoption in cosmetic procedures, are outlined. Further explored is the prevalence of BOTOX use among different socioeconomic classes, races/ethnicities, ages, and genders, highlighting disparities and emerging trends. It summarizes the effectiveness and safety of BOTOX injections for facial wrinkles and its non-cosmetic uses (e.g., treating migraines, hyperhidrosis, and pain management). The review describes BOTOX’s uses in dentistry, including its therapeutic benefits and safety considerations.It also discusses the possible therapeutic advantages of BOTOX injections in managing psychological conditions, including depression, anxiety, and body dysmorphic disorder (BDD). The diagnostic applications of BOTOX and its mechanism of action are briefly explained.The article concludes with a summary of BOTOX’s beneficial and adverse effects and the constraints on access to and use of BOTOX treatments. It acknowledges the limitations of BOTOX research and the need for further investigation to address these limitations.Abbreviations: BDD: Body Dysmorphic Disorder; FDA: U.S. Food and Drug Administration; QoL: Quality of Life; ROM: Range of Motion; SES: Socioeconomic Status; SNAP-25: Synaptosomal-Associated Protein 25; TMD: Temporomandibular Joint Disorder