Biopsychosocial Perspective Research Articles

Relationship Between Training Frequency and Training Session Duration on Vitality in Recreational Runners: A Cross-Sectional Study

Background: Running can improve health status from a biopsychosocial perspective. However, isolation strategies, like the COVID-19 pandemic-induced lockdown, produce deleterious effects on both health status and sport performance. The aim of our study was to investigate recreational runners’ sporting habits, subjective vitality (SV), and well-being after the COVID-19 pandemic-induced lockdown. Methods: After data filtration, 5542 recreational runners (74.5% men and 25.5% women, >18 years) were selected for further analyses. The participants answered preliminary questions regarding sporting habits and completed the validated Spanish version of the Subjective Vitality as a Dynamic Reflection of Well-Being questionnaire for assessing their SV after lockdown. Results: Subjective vitality scores did not differ between men and women, nor between age groups (p = 0.41 and p = 0.11, respectively). Subjective vitality was greater with weekly training frequency up to 5 days/week, where this enhancement plateaued, while average training session duration was positively related to SV, stabilizing at 91–120 min/session (p < 0.001 for both). Conclusions: There is a dose–response relationship between both weekly training frequency and training session duration, and mental health benefits in recreational runners. Further longitudinal studies are needed in order to determine the optimal dose–response relationship for simultaneously enhancing mental health outcomes and running performance in recreational runners, especially regarding weekly training frequency, training session duration, and exercise intensity.

‘It's something that people don't have the knowledge of’: Perceived participation of pupils with Prader‐Willi syndrome in specialist schools and staff preparedness

AbstractThere is an abundance of literature on health‐related outcomes for children and young people with Prader‐Willi syndrome and on their lived experiences as well as on their caregivers'. However, little is known about the experiences of education practitioners when providing for them. This study gathered in‐depth evidence of the lived experience of school staff in two secondary specialist schools, on (1) perceptions of functioning and participation of young people with Prader‐Willi syndrome in the setting and (2) how prepared they felt to support them in achieving full participation, including challenges faced. Semi‐structured interviews were conducted with six school staff and transcripts were analysed both deductively (using the ICF classification system) and inductively. School staff perceive the needs of these pupils as mostly related to their body functions, in alignment with a medicalised understanding of disability. However, they recognise the key role of environmental modifications to address these. Staff feel mostly unprepared and perceive their training as limited. Despite wide recognition of the need to conceive disability holistically, medicalised understandings are still present. Training from a biopsychosocial perspective is needed. Future research should address the development of core sets of ICF codes for people with Prader‐Willi syndrome.

Beyond Depression and Anxiety in IBD: Forging a Path Towards Emotional Healing.

Inflammatory Bowel Diseases (IBD) are chronic, often debilitating diseases characterized by inflammation of the digestive tract. IBDs affect up to 1% of the world's population and tend to be diagnosed in the second and third decades of life. In addition to physical burdens, IBDs have significant psychological manifestations stemming from bidirectional inflammatory and coping pathways and thus, are best understood from a biopsychosocial perspective. Though previous IBD literature has predominantly focused on traditional psychological comorbidities, such as anxiety and depression, recent studies have uncovered adjustment disorders, post-traumatic stress, and disordered eating as prevalent manifestations of the disease. This review will summarize the rates and postulated biopsychosocial mechanisms underlying these conditions to frame how cultivating resilience can protect against IBD symptoms and help forge a path towards emotional healing. We will also provide guidance to aid clinicians in screening for these conditions and creating a trauma-informed healthcare environment.

Exploring patient perspective: using narrative DIPEx interviews and the ICF model for interprofessional learning.

The International Classification of Functioning, Disability, and Health (ICF) has been widely adopted in academic health profession education and is part of bachelor curricula since its introduction by the WHO in 2001. In this context, interprofessional exchange among health professionals from a biopsychosocial perspective has become increasingly important and is now a key part of bachelor's program curricula to learn with, about, and from each other regarding students' curiosity about interprofessional collaboration (IPC). This pilot study describes initial teaching experiences within an interprofessional elective module for health professions focused on patient-centeredness. It uses the ICF model to exemplify interprofessional exchange based on real patient experiences from the "DIPEx" database, which stands for "Database of Individual Patients' Experiences." Bachelor students from four healthcare professions learned in small interprofessional groups and selected case-related content from excerpts of real patient narratives from qualitative interviews in the DIPEx database. In a peer-to-peer process, students structured, analyzed, and reflected on selected patient experiences and presented their findings using the ICF model. Develop a shared understanding of the case from a biopsychosocial perspective using the ICF model to communicate and reflect on patient-centeredness in interprofessional groups for a common care strategy rooted in patient-centeredness. This study illustrates how the shared analysis of a patient's experience of illness can lead to different perspectives on professional concepts for practice. The ICF model serves as a guiding structure and analysis tool. The core of the IPC, patient-centeredness, becomes the focus of the collaborative actions of the health professions.

Prevalence of Painful Temporomandibular Disorder Symptoms Among Professional and Student Musicians: An Online Survey.

Within the fields of medicine and music, increasing attention is given to evidence indicating music performance being an occupational risk factor for temporo-mandibular disorders (TMD). Assessment of self-reported painful TMD symptoms among student and professional musicians. Using Survey Monkey software, the German version of the 'TMD-Pain-Screener' was distributed electronically to professional and student musicians in Europe. Supplementary questions addressed age, gender, daily playtime, instrument type and type of professional practice. Results are presented as median [interquartile range]. The TMD-pain-screener was completed by 492 participants. Among them, 96 (19.5%) reported painful TMD (Pain_pos) and 396 did not experience pain (80.5%, Pain_neg). Pain_pos participants were significantly younger (Pain_pos: 34 years [26; 46], Pain_neg: 44 years [30; 56], p = 0.0003), had less work experience (Pain_pos: 15.5 years [6; 25], Pain_neg: 20 years [10; 32], p = 0.009), had fewer performances/year (Pain_pos: 20/year [10; 45], Pain_neg: 30/year [12; 53.5], p = 0.03) and were predominantly female (OR = 3.22 [1.87, 5.74], p < 0.0001). Comparisons among music performance types revealed no statistical significance in the overall test (p = 0.13), although 'keyboard' (OR = 2.99 [0.58, 30.12]), 'upper string' (OR = 2.31 [0.43, 23.63]) and 'singer' (OR = 2.14 [0.44, 20.75]) stood out compared to the reference group 'lower string' (OR 1.00). Organ players formed the largest group and showed a comparatively low prevalence of Pain_pos (16%), compared to other keyboard instruments (Pain_pos 30.2%). Prevalence of TMD pain was highest among young inexperienced female musicians. Playing keyboard instruments (other than organ) or upper strings instruments were frequently associated with painful TMD screening. An improved understanding of causes, implementation of preventive measures, professional guidance and a biopsychosocial health care perspective may decrease this occupational risk while maintaining the health benefits of music.

Quality of life and associated factors among primary caregivers of children and adolescents with neurodevelopmental disorders attending public hospitals in Addis Ababa, Ethiopia: a cross-sectional study.

Neurodevelopmental disorders are a set of disorders that negatively affect the acquisition of skills in a variety of developmental domains, including motor function, learning, socialization, language and cognition. However, there is no information available on the standard of living of Ethiopian primary caregivers of children and adolescents with neurodevelopmental disorders. Therefore, this study aimed to assess the quality of life (QOL) and associated factors among primary caregivers of children and adolescents with neurodevelopmental disorders in Addis Ababa, Ethiopia. A cross-sectional study was conducted during 1-30 May 2022. Systematic random sampling was used to obtain 352 samples. QOL was measured using the WHO Quality of Life Brief. The gathered information was coded, entered into EpiData 4.6.0.2 and analyzed with SPSS version 26. Multiple linear regression analysis was used to identify the correlates of QOL and the strength of the correlation was measured by β coefficient with 95% CI. The mean score of the overall QOL was 62.61 with a SD of 5.17. The mean (±SD) scores for the physical health, psychological, environmental and social relationship domains of primary caregivers were 57.36±9.98, 66.98±9.39, 66.06±12.91 and 60.02±9.14, respectively. Age was significantly associated with physical domain (β=-0.25, 95% CI -0.43 to -0.07) and with environmental domain (β=-4.57, 95% CI -9.06 to -0.09). Being divorced/widowed was negatively associated with psychological health (β=-2.99, 95% CI -5.82 to -0.17) and social health (β=-0.62, 95% CI -1.33 to -0.10). The presence of medical illness was negatively associated with the physical health domain (β=-4.32, 95% CI -7.64 to -2.91) and the environmental domain (β=-3.11, 95% CI -5.71 to -0.51). Poor social support was negatively associated with psychological health (β=-3.25, 95% CI -5.89 to -0.61) and the social health domain (β=-3.39, 95% CI -11.3 to 4.6), and moderate social support (β=8.62, 95% CI 3.15 to 14.09) was positively associated with physical health. Depression (β=-6.32, 95% CI -11.96 to -0.67) and anxiety (β =-3.07, 95% CI -5.80 to -0.34) were negatively associated with physical health and the psychological health domain, respectively. The findings from this study indicate that all dimensions of QOL of primary caregivers of children and adolescents with neurodevelopmental disorders in this study setting were compromised. Being divorced or widowed, lack of formal education, age, average monthly income, poor social support, depression, anxiety and the presence of medical illness were factors associated with QOL in all domains. This requires integrating a bio-psychosocial perspective, a positive mental health strategy and pharmaceutical therapies to enhance QOL for caregivers of children and adolescents with neurodevelopmental disorders.

Scoping review of the role of social support in women veterans’ psychosocial and health outcomes

Women veterans are a steadily growing population and have unique military experiences (e.g., report high rates of sexual harassment and assault) that are impactful across the lifespan. High levels of positive social support have been linked to a range of positive outcomes in both civilian and military populations. However, research has not consistently explored social support and interpersonal functioning in women veterans, or as potential mechanisms of change within interventions for women veterans. This is a scoping review of peer-reviewed articles that evaluated social support. Articles with at least 10% women or formally evaluated sex or gender in reference to social support were included. A total of 69 studies evaluated social support in relation to women veterans’ health outcomes. From a biopsychosocial perspective, social support is an important construct to examine relative to health care engagement and response. Limited research considered aging women veterans needs or focused on the intersectional identities of women veterans. Positive social support can have major physical and mental health benefits, yet limited research and disparate methodological approaches minimize the ability to draw conclusions on how social support can best be leveraged to support women veterans. Women veterans’ roles and military experiences (e.g., increased likelihood of combat exposure) are changing and this population is aging. Research is needed to inform best practices for this growing segment of the veteran population.

Contributions of the ELENA Cohort to Study Autism Spectrum Disorder in Children and Adolescents from a Biopsychosocial Framework.

Autism spectrum disorder (ASD) is a complex neurodevelopmental condition influenced by a myriad of developmental, biological, psychological, and socio-demographic factors. The ELENA cohort seeks to delineate the intricate interplay of these factors, facilitating the identification of risk factors and the development of targeted interventions. This paper emphasizes the clinical profiles of children and outlines key findings from a biopsychosocial perspective. The ELENA cohort, a multicenter initiative across French regional centers, conducted a systematic prospective analysis on children newly diagnosed with DSM-5 ASD between 2012 and 2019. This encompassed direct assessments and parent-reported questionnaires covering a broad spectrum of developmental, biological, psychological and socio-demographic measures. Embedded case-control studies further examined risk and protective factors, alongside specific environmental and psychosocial influences during pregnancy and early childhood. A subset of participants also contributed biospecimens, with data enhancement via linkage to French National Administrative Healthcare Databases. The study unveils baseline clinical characteristics for 876 children, average age 6 (SD ± 3.3) previously unreported in protocol descriptions. It highlights the study's developmental biopsychosocial approach and its novel findings on children's socio-adaptive functioning, ASD severity, comorbidities, quality of life and interventions. Employing developmental biopsychosocial insights offers a promising pathway to integrating health, social care, and experiential insights, ultimately aiming to enhance the future well-being and outcomes for children with ASD. This approach underscores the need of a holistic, interdisciplinary strategy in encouraging and supporting the ASD community.

A qualitative exploration of the lives lived by Irish centenarians

Centenarians are of particular importance to aging research as they represent the living architype of exceptional longevity and as such studying their attributes is expected to contribute to one's understanding of survivorship. While much centenarian research to date recognizes the biological and genetic determinants in achieving advanced age, there is a lack of understanding regarding the influence of social factors and their role in aging. As centenarian populations continue to grow at an unprecedented rate, the heterogeneity among centenarian cohorts together with current aging trends highlights the intrinsic need to better understand centenarian aging from a biopsychosocial perspective. A key challenge for research concerning centenarians is understanding their personal experiences of reaching this momentous age as such information could help to identify the sociodemographic and psychosocial factors that enable people to live such extraordinarily long lives. To address this, this study focused on the lived experience of Irish centenarians and explored their understanding of their aging in a rapidly modernized sociocultural Ireland. Documenting the psychosocial profiles of centenarians will assist key stakeholders including researchers, practitioners, and policymakers in the development of policies and strategies to support the growing population of older adults in Ireland. Furthermore, this research will also map Irish centenarians who have not previously been explored onto the international nexus of centenarian research.

The new (ab)normal: the participation of children attending preschool and elementary school during confinement

ABSTRACT Humans’ participation positively impacts society and individuals, suggesting that children's participation in activities carried out in supportive environments promotes positive health and the development of key capacities. Covid-19 abruptly changed the daily lives of children and their caregivers due to the general duty of home confinement with consequences for participation. This study focused on the participation of children attending preschool and elementary school during Covid-19 confinement in Portugal. Participants (175 caregivers) completed an online survey based on Picture My Participation! (PmP; Imms et al. 2014). Three case studies with children were conducted using PmP. Results showed good levels of participation in daily activities, with the school-aged children participating more (frequency and involvement) than the preschool-aged children; girls were more involved than boys. The caregivers and children had different perceptions of participation, with caregivers justifying these levels based mainly on the children’s characteristics, while the children reinforced the importance of the environment in their participation. These results are used to enhance a discussion about different perspectives of participation, highlight the importance of listening to different participants, and emphasise the relevance of the biopsychosocial and transactional perspectives to explain behaviour and human development.

The extent of implementation and perceptions of maternity and social care professionals about two interprofessional programs for care for pregnant women: a mixed methods study

BackgroundIn 2018, the Dutch government initiated the Solid Start program to provide each child with the best start in life. Key program elements are a biopsychosocial perspective on pregnancy and children’s development and stimulating local collaborations between social and health domains, with a specific focus on (future) families in vulnerable situations. Two programs for interprofessional collaboration between maternity and social care professionals to optimize care for pregnant women in vulnerable situations were developed and implemented, in Groningen in 2017 and in South Limburg in 2021. This paper describes the extent of implementation of these programs and the perceptions of involved professionals about determinants that influence program implementation.MethodsWe conducted a mixed-methods study in 2021 and 2022 in two Dutch regions, Groningen and South Limburg. Questionnaires were sent to primary care midwives, hospital-based midwives, obstetricians (i.e. maternity care professionals), (coordinating) youth health care nurses and social workers (i.e. social care professionals), involved in the execution of the programs. Semi-structured interviews were held with involved professionals to enrich the quantitative data. Quantitative and qualitative data were collected and analyzed using Fleuren's implementation model.ResultsThe findings of the questionnaire (n = 60) and interviews (n = 28) indicate that professionals in both regions are generally positive about the implemented programs. However, there was limited knowledge and use of the program in Groningen. Promoting factors for implementation were mentioned on the determinants for the innovation and the user. Maternity care professionals prefer a general, conversational way to identify vulnerabilities that connects to midwives’ daily practice. Low-threshold, personal contact with clear agreements for referral and consultation between professionals contributes to implementation. Professionals agree that properly identifying vulnerabilities and referring women to appropriate care is an important task and contributes to better care. On the determinants of the organization, professionals indicate some preconditions for successful implementation, such as clearly described roles and responsibilities, interprofessional training, time and financial resources.ConclusionsAreas for improvement for the implementation of interprofessional collaboration between maternity care and social care focus mainly on determinants of the organization, which should be addressed both regionally and nationally. In addition, sustainable implementation requires continuous awareness of influencing factors and a process of evaluation, adaptation and support of the target group.

Exploring Older Adults' Subjective Views on Aging Positively: Development and Validation of the Positive Aging Scale.

Historically, aging research has focused primarily on health deterioration and negative aspects associated with aging. This has limited the scope of our understanding of the experience of aging and the relationships between aging and well-being from an integrative biopsychosocial perspective. In the same vein, there is a lack of reliable and valid assessments of aging that capture the positive aspects that characterize and improve the subjective experience of this period of life, particularly one that focuses on psychosocial well-being, including meaningful experiences and activities, group memberships, and general abilities. This study presents the development and validation of the Positive Aging Scale (PAS), a novel self-report assessment. This was an online cross-sectional study conducted on 501 UK residents aged ≥60 years. A number of self-reported items and measures of positive aging, general health, well-being, and cognitive functioning were administered to the sample. We used exploratory and confirmatory factor analyses and assessed the dimensionality, reliability, and concurrent criterion-related validity of the PAS. The results suggested that a unidimensional solution represents the data well, with the positive aging factor adequately loading on 8 items, and the solution showing factorial invariance between young-old and old participants (i.e., ≥75 years). Total PAS scores positively correlate with general health, well-being, and cognitive functioning. The PAS demonstrated strong psychometric properties and the findings highlight correlations between the PAS and key outcomes of positive aging, including general health. Implications for research and interventions are discussed.

Music therapy during weaning from mechanical ventilation in the intensive care unit: Study protocol for a randomised control trial

ABSTRACT Introduction People admitted to the intensive care unit (ICU) who require mechanical ventilation (MV) must complete the weaning process as soon as possible to reduce associated risk factors. Previous research suggests that music therapy may be beneficial for improving breathing capacity and relaxation, but studies related to weaning are limited. This article presents a music therapy protocol for a randomised controlled trial (RCT). Method ICU patients aged 18–80 who meet the clinical criteria for initiating weaning are eligible for this RCT with two parallel groups. Participants (n = 100) are randomly assigned to a control group (receiving standard treatment during weaning) and an intervention group (receiving daily music therapy intervention combined with standard treatment). The outcome measures are (1) duration of weaning in hours, (2) dosage of sedatives and analgesia, (3) agitation, (4) delirium, (5) perception of pain, and (6) perceived stress at 90 days follow-up. During music therapy, (7) blood pressure, heart rate, respiratory rate and oxygenation level are only measured in the intervention group. The flexible music therapy protocol addresses patient needs from a humanistic biopsychosocial perspective. It includes an assessment of individual music preferences (adapted from the Musical Life Story Questionnaire) and methods such as entrainment, clinical instrumental improvisation, songwriting, and receptive music therapy to reinforce breathing capacity and promote relaxation, stimulation, communication, and emotional regulation. Discussion The findings of this study may offer relevant implications for healthcare delivery and the application of music therapy during weaning in the ICU.

THE ROLE OF PSYCHOLOGY IN PEDIATRIC PALLIATIVE CARE: A participant observation experience report

Hospitalization in childhood can be characterized as a stressful and distressing event for patients and families, especially in cases of illnesses or chronic conditions that require pediatric palliative care (PPC). The hospital psychologist who works in PPC contributes, among other things, to minimize the suffering resulting from illnesses. The purpose of this article was to report the experience of participant observation, as a field activity of a Psychology guided research practice discipline, about the work in PPC of a psychologist in a public hospital in the South of Brazil. This is an observational study, of a qualitative and descriptive nature, of six episodes of participant observation recorded by a Psychology undergraduate in a field diary and analyzed through categorical content analysis. During the observations, the psychologist worked with nine companions and eleven children in hospitalized PPC. It was found that the most required activities for the psychologist were the following categories: listening and supporting family members, to express emotions and encourage self-care; mediation between family members and the healthcare team, for better communication; playful activities with children, to distract and form bonds; and doing records in medical records, to inform and guide the team. In the field of PPC, the psychologist's work must be based on a biopsychosocial perspective of individuals, with the purpose of promoting comprehensive and humanized care. However, considering the complexities present in PPC and the tensions inherent to the hospital context, the psychologist must also be aware of his self-care needs during his professional practice.

Community Based Rehabilitation in People With Lower Limb Amputation: A Systematic Review

The purpose of this paper is to identify the intervention components, key actors and models of social innovation that can contribute to the improvement of health rehabilitation services from a biopsychosocial perspective, aimed at people with lower limb amputation in a situation of disability. Likewise, it aims to analyze the ways in which Community Based Rehabilitation (CBR) facilitates the elimination of barriers in rehabilitation services and promotes a better quality of life for people with disabilities. A systematic review of scientific literature for the period 2001 to 2019 was carried out, starting with a bibliometric analysis of publications found in the Web of Science and Scopus databases; followed by content analysis with NVivo 12 software. Among the findings, it was identified that the optimization of health services for the population with disabilities in emerging countries requires investment and training. In addition, the success and deficiencies in CBR programs were analyzed, since according to the systematic review, these are limited to the care of people with lower limb amputation in contexts of armed conflict.

The 22q11.2 Deletion Syndrome from A Biopsychosocial Perspective: A Series of Cases with an ICF-Based Approach.

A descriptive, cross-sectional case series study with seven 22q11.2DS children. A questionnaire with an ICF checklist for 22q11.2DS was completed using a structured interview. The Wechsler Abbreviated Scale of Intelligence (WASI) was used to determine the Intelligence Quotient (IQ). Seven participants from 7 to 12 years old, presented some level of IQ impairment. It was observed that 22q11.2DS children experience significant intellectual, cognitive, and speech impairments across ICF Body Function domains. Impairments related to nose and pharynx were found in only one patient. The most relevant categories considered limitations in the Activity and Participation components pertained to producing nonverbal messages, communication, handling stress, and social interaction. Family, health professionals, and acquaintances were perceived as facilitators in the component Environmental Factors. The sample has its functioning affected by aspects that go beyond impairments in body structure and function. The organization of information from the perspective of the ICF is a different approach that helps clinical reasoning.

(077) WOMEN'S SEXUAL HEALTH: AN INTRODUCTION TO A BIOPSYCHOSOCIAL LECTURE FOR EARLY HEALTHCARE TRAINING

Abstract Introduction In 2009, The International Consultation in Sexual Medicine called for the implementation of a greatly expanded, national standard on sexual health education across the nation within medical schools (E Coleman et al. 2013). Yet, over half of medical students throughout the United States and Canada feel that their medical school education left them inadequately prepared to address their patients’ sexual health concerns (Shindel AW et al. 2010). A 2022 study illustrates that outside of basic female anatomy, over half of the Chicago area medical schools failed to address female sexual functioning in their curriculum (N Codispoti et al 2022). Furthermore, today's physicians share similar qualms, as they cite lack of education and training on sexual health as leading to barriers to care and a decrease in screening for sexual dysfunction (Parish SJ et al 2009). Our study delineates a proposed curriculum, analyzing for efficacy as well as the students perceived comfort with addressing this topic in clinic and their perspectives on its importance to their education. Objective Assess the need for curriculum supplementation based on student baseline knowledge and comfort with the topic of women's sexual health. Establish the supplemental curriculum, analyzing for efficacy of education and improved student comfort with addressed topics. Integration of supplemental curriculum into study location medical school curriculum and standardization to all area medical school curriculums. Methods This self controlled, cross-sectional, survey study investigates first year medical students' initial education level and perspectives on womens’ sexual function (WSF) and womens’ sexual dysfunction (WSD), and their post education knowledge level and perspective. The study team recruited 50 students for our study, approximately one third of the class. The study outcomes were assessed for the efficacy of each of the teaching materials through content based quiz questions, as well as the students perceived comfort with addressing this topic in clinic and their perspectives on its importance to their education as compared to the pre-education survey. Results The study resulted in statistically significant improvement from the pretest knowledge in subjects of postmenopausal atrophic vaginitis, perimenopausal risk factors and preventative care, and female HPG axis-based pubertal development. Notably within the demographic assessment, all medical specialties were selected as “of interest” by at least one participant. The participants also assessed that overall women’s sexual health should be taught in their preclinical curriculum and is valuable to their future career, despite the widely varied fields of medicine within interest. Conclusions With statistically significant improvement in knowledge of women’s sexual development and function through our proposed curriculum, we aim to advocate for implementation of a standardized preclinical women’s sexual health curriculum. Furthermore, our ongoing studies focus on the development of a curriculum directed at the pathology and treatments of female sexual dysfunction from a biopsychosocial perspective, resulting in a comprehensive curriculum. Disclosure No.

Self-construal and attentional biases in cognitive processing: Insights from Chinese college students for mental health contexts

This study integrates Markus and Kitayama’s self-construal theory with the Biopsychosocial Model to examine the effects of self-construal on cognitive biases and their implications for mental health among Chinese college students. It investigates how independent (IndSC) and interdependent (InterSC) self-construals influence cognitive biases towards positive and negative stimuli, emphasizing the mediating roles of attentional control, self-esteem, cognitive reappraisal, and the need to belong. The research utilizes a hybrid sampling strategy, engaging 748 undergraduate students from diverse majors and universities in Chongqing, China. Participants completed assessments measuring self-construal, attentional control, self-esteem, cognitive reappraisal, need to belong, and cognitive biases. Employing structural equation modeling, the study uncovers that IndSC is positively associated with cognitive biases, favoring positive over negative information, with attentional control and self-esteem serving as significant mediators. InterSC, however, promotes a balanced attention to both positive and negative information, with cognitive reappraisal and the need to belong acting as mediators. These findings underscore the significant role of self-construal within the broader biopsychosocial framework in shaping cognitive processes and highlight the importance of considering these factors in mental health interventions. By leveraging a comprehensive sampling approach, the study ensures a representative sample, enhancing the generalizability of its findings to the broader Chinese college student population. This research not only contributes to the understanding of the complex interplay between cultural psychology and mental health but also suggests the need for mental health interventions that are culturally and individually tailored. Future research should extend to other cultural settings and employ longitudinal designs to further explore the dynamic interactions between self-construal, cognitive biases, and mental health from a biopsychosocial perspective.

Exploring Biopsychosocial Stress Markers in Women With Fibromyalgia

Identification of fibromyalgia has been a challenge for healthcare professionals due to the lack of a clinical biomarker. A well-supported integrative hypothesis holds that this condition is a chronic pain problem partly caused by long-term dysregulation of stress response. Therefore, stress assessment from a biopsychosocial perspective may be a useful approach to recognizing fibromyalgia. A cross-sectional case-control study was conducted to explore stress markers from a multidimensional perspective, including heart rate variability (as a biomarker of stress) as well as psychological distress and social stress. Forty-seven women with fibromyalgia were recruited from support groups and another 47 were recruited as matched pain-free controls. Comparison and discriminant function analyses were performed. The data support the goodness of biopsychosocial stress markers in women with fibromyalgia, resulting in the identification of between 70% and 74.5% of fibromyalgia cases (sensitivity) and 85%-87% pain-free controls (specificity), with medium-high levels of fit (λ = 0.58 and λ = 0.59; p < .00). Women with fibromyalgia were characterized by high levels of psychological distress, social stress (disorder levels), and autonomic dysregulation. Although distress and social stress had a greater weight in discriminant functions, dysregulation in terms of low parasympathetic activity and high sympathetic activity at rest was also relevant. A biopsychosocial approach to stress with an objective biomarker such as heart rate variability may be a useful tool to identify and manage FM.

Clinic-Based Characterization of Adolescents and Young Adults With Migraine: Psychological Functioning, Headache Days, and Disability.

This cross-sectional observational study retrospectively examined clinical data collected from adolescents and young adults (AYAs) seeking care in a specialty headache clinic. We characterized participants' headache characteristics and psychological functioning and examined the association between self-reported anxiety and depressive symptoms and headache frequency, severity, and disability. During their clinic visit, AYAs (M age = 18.36; range = 14-32, 79.5% female) completed an intake questionnaire and reported about their headache characteristics (i.e., frequency, severity, and duration of symptoms in months), mental health history (i.e., previous diagnosis of an anxiety or depressive disorder), and utilization of emergency department (ED) services for migraine. AYAs also completed psychometrically validated screening tools for anxiety and depressive symptoms (i.e., the GAD-7 and PHQ-9). We computed descriptive statistics and examined associations among scores on psychological measures and headache characteristics, including migraine-related disability. We also tested whether individuals with clinically elevated GAD-7 and PHQ-9 scores had higher levels of disability relative to those with fewer/subclinical levels of anxiety and depressive symptoms. Participants (N = 283) reported more than 19 headache days per month on average, with more than 90% describing their average headache intensity as moderate or severe. Nearly half of AYAs reported severe headache-related disability. Approximately one-quarter of AYAs reported a previous diagnosis anxiety or depressive disorder diagnosis, and more than one-third scored above clinical cutoffs on the PHQ-9 and GAD-7. Higher scores on both psychological screening instruments were associated with greater headache frequency. More than 10% of patients endorsed current suicidal ideation; this was not related to headache-related disability. Participants reported a high degree of ED utilization for headache; these rates were unrelated to endorsement of psychological comorbidities. In this sample of AYAs, headache characteristics were generally unrelated to scores on measures on psychological functioning. However, the observed rates of clinically elevated anxiety/depressive symptoms and suicidality in this sample of AYAs underscore the importance of screening for psychological comorbidities in neurology clinics that serve this age group, irrespective of self-reported disability. Results also emphasize the need to expand access to behavioral health services for AYAs with headache disorders and the importance of incorporating a biopsychosocial perspective to the transition of health care from pediatrics to adult neurology practice.