This study examined whether playing soccer in high school was associated with higher rates of mental health problems in early to middle adulthood. Longitudinal cohort study. The National Longitudinal Study of Adolescent to Adult Health ("Add Health") databases were analyzed. There were 221 individuals (53.8% women) who participated in high school soccer (without participating in football) and 2388 (67.2% women) who denied participating in soccer or any contact sports during high school. N/A. This study includes longitudinal data from individuals assessed at Wave I (n = 6503; median age = 15), Wave III (median age = 22), Wave IV (median age = 29), and Wave V (n = 4196; median age = 38). We compared those who played soccer with those who did not engage in contact sports on several mental health outcomes. When comparing those who played high school soccer with those who did not play contact sports, there were no differences in the proportion who had a lifetime diagnosis of depression, lifetime diagnosis of anxiety or panic disorders, suicidal ideation in the past year, psychological counseling in the past year, or current depressed mood at Waves III, IV, or V (all P -values > 0.05). In addition, we matched soccer players to control participants on biologic sex, race, and educational attainment to control for potential confounds; the results were similar and nonsignificant. Individuals who played soccer in high school did not have an increased rate of mental health difficulties at multiple follow-up time points during early to mid-adulthood.

Digital self-harm among adolescents in China: Latent profiles, correlates, and its relationship with suicidal behaviors.

Motivational interviewing (MI) is an effective counseling approach for promoting health behavior change, but its scalability is constrained by the need for highly trained human counselors. Large language models (LLMs) may provide a scalable way to support MI counseling, but evidence remains limited, especially for Chinese MI resources and evaluations based on standardized MI fidelity frameworks. This study aimed to develop Chinese large language models for motivational interviewing (MI-LLMs) and evaluate whether MI-focused fine-tuning could improve their ability to generate counseling responses consistent with MI principles. We first curated 5 publicly available Chinese psychological counseling datasets and assessed sampled conversations in terms of comprehensiveness, professionalism, authenticity, and safety. The 2 highest-scoring datasets, CPsyCounD and PsyDTCorpus, were selected for MI-style data construction. Using GPT-4 with a structured MI-informed prompt, we transformed 2040 multiturn counseling conversations into MI-style dialogs. Among these, 2000 dialogs were used for training and 40 for testing. Three Chinese-capable open-source LLMs (Baichuan2-7B-Chat, ChatGLM-4-9B-Chat, and Llama-3-8B-Chinese-Chat-v2) were fine-tuned with low-rank adaptation on the training dataset and were referred to as MI-LLMs. Automatic evaluation was conducted on the testing dataset using Bilingual Evaluation Understudy-4 (BLEU-4) and Recall-Oriented Understudy for Gisting Evaluation (ROUGE) metrics. Manual evaluation was conducted using the Motivational Interviewing Treatment Integrity Coding Manual 4.2.1. Thirty simulated counseling dialogs generated by the MI-LLMs were compared with 30 real MI dialogs sampled from AnnoMI and translated into Chinese. Two trained graduate student raters coded global scores and behavior counts, from which summary scores were subsequently calculated. In automatic evaluation, fine-tuning substantially improved BLEU-4 and ROUGE scores across all 3 models compared with the base models. In manual evaluation, the MI-LLMs achieved technical and relational global scores, as well as total MI-adherent ratios that approached those of real MI dialogs. The MI-LLM based on ChatGLM-4-9B-Chat showed the strongest overall global performance. However, MI-LLMs produced fewer complex reflections and had lower reflection-to-question ratios than real MI dialogs. This study provides preliminary evidence that MI focused fine-tuning can help Chinese LLMs acquire core counseling behaviors consistent with MI principles. It also offers a scalable approach for constructing MI style dialog resources in Chinese. Nevertheless, current MI-LLMs should be regarded as early-stage tools for supporting, rather than replacing human counselors. Future work should expand real MI training data and strengthen the complex reflective skills of MI-LLMs. Further studies are needed to evaluate their effectiveness, acceptability, and safety in health behavior change settings in the real world.

Young and middle-aged breast cancer patients suffer not only from physical pain but also from great psychological distress. Therefore, there is an urgent need to understand the factors influencing psychological distress in young and middle-aged breast cancer patients with the aim of reducing such distress. Cross-sectional descriptive study. To explore the current status and factors influencing psychological distress in young and middle-aged breast cancer patients. In this cross-sectional survey, relevant evaluations of the research subjects were conducted using a general information questionnaire, the Self-Rating Anxiety Scale, the Self-Rating Depression Scale and the Psychological Stress Thermometer. A total of 262 patients completed the survey, and anxiety and depression were positively correlated with psychological distress. Multiple linear regression analysis revealed that anxiety, depression, age, and fertility were factors influencing psychological distress among young and middle-aged breast cancer patients. Young and middle-aged breast cancer patients experience a high level of psychological distress. The mental health of these patients should be addressed, and such patients should be provided with timely emotional and psychological counseling to reduce their psychological distress.

ABSTRACT Oocyte cryopreservation (OC) is an increasingly utilized fertility preservation strategy, particularly for women with diminished ovarian reserve or those facing gonadotoxic treatments, yet its impact on quality of life (QoL) remains incompletely understood. This prospective cross-sectional study evaluated QoL in women undergoing OC using the validated FertiQol questionnaire and investigated demographic and reproductive factors associated with QoL outcomes. A total of 102 women aged 22–49 years who underwent OC between September and December 2023 at the Assisted Reproductive Technology Unit of Zeynep Kamil Women’s and Children’s Hospital were included. Participants completed detailed sociodemographic questionnaires alongside the FertiQol assessment, and data were analyzed using appropriate statistical methods. The mean age of the cohort was 36.3 ± 5.5 years, with 62.7% of participants being single. Women reporting irregular menstrual cycles had significantly lower total FertiQol scores compared with those with regular cycles (61.4 vs. 68.5, p = 0.044). Similarly, participants whose mothers experienced menopause before the age of 40 demonstrated reduced QoL scores relative to others (60.9 vs. 69.2, p = 0.026). Higher educational attainment and socioeconomic status were positively associated with QoL measures, indicating a protective effect on emotional and psychosocial well-being. These findings suggest that menstrual cycle characteristics, maternal reproductive history, and socioeconomic factors play a significant role in shaping QoL among women undergoing OC. Early identification of individuals at risk for impaired emotional well-being and the integration of structured psychological counseling into fertility preservation services may enhance patient-centered care, while further longitudinal studies are warranted to clarify the long-term psychological and reproductive consequences of OC.

Exploring the clinical supervision that Black men trainees in psychology receive can illuminate whether these trainees are being prepared to provide culturally responsive clinical services to individuals and communities of color. However, there are limited studies on Black men's clinical supervision experiences, particularly those that are perceived as growth-promoting and attentive to racial issues. Using semistructured interviews from 27 Black men enrolled in counseling psychology doctoral programs, this study examined Black men's perceptions of growth-promoting, race-inclusive multicultural supervision that they received in their training. Findings revealed one overarching theme of race matters in supervision, with three subthemes of (a) identity congruence contributes to shared racial understanding, (b) supervisor's race and race-inclusive multicultural competence matter, and (c) overcoming cultural/racial mistrust. Regardless of the racial background of the supervisor, multiple themes were consistently identified in participants' descriptions of growth-promoting, race-inclusive multicultural supervision. These elements included (a) positive perceptions of race talk quality, (b) integration of supervisees' salient identities, (c) integration of supervisors' salient identities, and (d) connection to professional resources and opportunities. These findings suggest that there are specific strategies that clinical supervisors can implement when supervising Black men to enhance their race-inclusive multicultural competence. Implications for research and training are discussed to improve Black men's experiences in clinical settings. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Caring for a child with a rare condition can significantly impact parents' emotional health, yet research on the emotional impact is limited. This qualitative interview study sought to investigate the lived experiences of parents who are experiencing higher psychological burden. Participants were parents of undiagnosed children undergoing whole genome sequencing (WGS) through the Genomic Medicine Service (GMS) across multiple NHS sites in England. Parents were purposively sampled to select those scoring poorly on validated measures of anxiety, family impact and/or resilience (GAD-7, PedsQL family functioning, BRS). We interviewed 24 parents after testing but prior to the return of WGS results. Questions focused on understanding their lived experience, in particular the emotional impact of their child's condition and how they coped day-to-day. Semi-structured interviews were transcribed and analysed using reflexive thematic analysis, leading to the generation of the central organising concept: "The construction of a caregiver identity: Torn between being a 'hero(ine)' and being a parent." Parents' experiences as caregivers often involved a significant re-evaluation of their parental role, as they sought to provide love and support while also adjusting to changes in their envisioned family life. Societal expectations, along with the complex challenges of navigating the health and social care systems, contributed to emotional strain. In particular, mothers often adapted their personal identities to embody a 'heroic' caregiving role. The anxiety caused by the uncertainty surrounding their child's condition was also found to affect parents' mental health. Areas for psychological interventions and recommendations to support parents' mental health are identified. Further research is needed to explore how the return of genomic sequencing results impacts parents' emotional wellbeing, and whether and which psychological counselling modalities throughout the journey might reduce emotional distress. Not applicable.

The aim of this research is to explore the self-soothing skills of adolescents and to develop a valid and reliable measurement tool for assessing these skills. The research was conducted using an exploratory sequential mixed-methods design. In the qualitative phase, semi-structured interviews were conducted with middle school students aged 11 to 14 in order to identify the self-soothing strategies adolescents use in emotionally distressing situations. The interview data were analyzed through content analysis, and five sub-themes related to adolescents’ self-soothing skills were identified. Based on the qualitative findings, relevant literature, and expert opinions, an item pool for the Self-Soothing Skills Scale for Adolescents was created. In the quantitative phase, the draft scale was administered to middle school students to examine its psychometric properties. Exploratory factor analysis revealed a multidimensional structure, and confirmatory factor analysis supported the construct validity of the scale. Reliability analyses were conducted using internal consistency coefficients and the test-retest method. The findings demonstrated that the scale has validity and reliability evidence for measuring adolescents’ self-soothing skills. The developed scale is expected to contribute to the assessment of adolescents’ emotional regulation capacities and to support preventive and intervention studies in school counseling and psychological counseling settings. In addition, the scale may provide researchers and practitioners with a comprehensive tool for identifying adolescents’ self-soothing tendencies and planning appropriate support programs.

Unmet needs of heart failure patients across the different domains of palliative care - a qualitative interview study.

BackgroundTransgender youth face multiple ethical and social challenges that significantly impact their mental health, dignity, and overall well-being. These challenges are influenced by social, cultural, and religious norms in a middle eastern country, and little is known about the ethical dimensions of their lived experiences.Research question/aim/objectivesThis study aimed to explore the ethical challenges and human vulnerability experienced by transgender youth in a middle eastern country, focusing on care, dignity, and social justice.Research designA qualitative study employing conventional content analysis was conducted to capture in-depth insights from participants' lived experiences.Participants and research contextEighteen transgender youth from the western region of the study setting participated in semi-structured, in-depth interviews. Participants were recruited via purposeful and snowball sampling, and interviews were conducted in private settings, lasting approximately 45 min each.Ethical considerationsThe ethical approval was obtained from the relevant institutional ethics committee. Confidentiality was ensured, written informed consent was obtained, and participants were free to withdraw at any time without consequences.Findings/resultsParticipants reported pervasive experiences of physical and sexual abuse, social rejection, discrimination in education and employment, stigma, rumination, anxiety about the future, family rejection, poverty, engagement in high-risk behaviours including substance use and criminality, and limited access to psychological, sexual health, and therapeutic counselling. These factors significantly affected their mental health, social integration, and overall quality of life, highlighting ethical concerns regarding care, vulnerability, and social justice.ConclusionsTransgender youth in a middle eastern country experience significant ethical and psychosocial challenges that threaten their mental health and well-being. There is an urgent need for culturally sensitive interventions, inclusive policies, and comprehensive counselling services to promote dignity, social justice, and mental health support for transgender individuals.

The students from key universities face a higher risk of depression and anxiety than those from non-key universities. However, the utilization rate of on-campus counseling services remains very low. Working from the theory of perceived affordances, this study investigates the reasons why some college students with emotional distress at a Chinese key university avoid using the provided on-campus psychological counseling services. This study employed Braun and Clarke's reflexive thematic analysis method to code and extract themes from the texts obtained through in-depth interviews. It was conducted at a key Chinese university, where 13 participants were recruited using purposive sampling and took part in interviews lasting between 30min and two hours. The study revealed that perceived affordances of the campus mental health education and counseling center (MHECC) among this group of college students exhibited three characteristics: surveillant services, counseling without empathy, and cautious peer support. Although these negative perceived affordances of the MHECC may be inconsistent with its real affordances, they led this group of college students to make a decision to refuse help-seeking without accessing the counseling services. To enhance the usability of the MHECC, the perceived information regarding the Center's affordances should be optimized based on college students' experiences and cultural backgrounds.

This study aimed to investigate the relationship between fatalism, death anxiety, and compliance with type 2 diabetes mellitus (T2DM) treatment in patients who had undergone limb amputation due to diabetic complications. A mixed-method design was used, combining quantitative and qualitative data. The sample consisted of 93 patients with diabetes who had undergone amputation and who completed surveys, and 20 who participated in in-depth interviews. Qualitative data were analyzed using a phenomenological approach. Scales included the Fatalism Scale, Thorson-Powell Death Anxiety Scale, and the T2DM Treatment Compliance Scale. Significant differences were observed across education levels in death anxiety, treatment compliance, and fatalism (P<.05). The quantitative analysis revealed a significant positive effect of fatalism on treatment compliance (β=0.427, P<.001). Because higher scores on this scale indicate lower adherence, this result suggests that higher fatalism is associated with reduced treatment compliance. Death anxiety did not have a statistically significant direct effect on treatment compliance (β=-0.177, P=.072). Qualitative findings supported these results and identified 3 main concepts: challenges in adapting to amputation, managing diabetes treatment, and psychological and belief-based challenges. Three themes were identified: issues with adapting to the condition, treatment adherence, and fatalism, death anxiety, and psychological effects. Fatalism plays a crucial role in treatment compliance for diabetic foot and amputation-related DM, whereas the impact of death anxiety is less direct. To improve compliance, addressing fatalistic beliefs and providing psychological support is essential. Tailored interventions, including psychological counseling and patient-specific educational programs, could significantly enhance adherence in amputated diabetic patients.

There is little evidence about the susceptible exposure window of maternal depression during pregnancy and preterm birth in China. We aimed to assess the trimester-specific association of depression during pregnancy with preterm birth, and the effect modification of social support. In 2021-2023, a prospective cohort study was conducted in Hangzhou, China. Depression was measured using the Edinburgh Postnatal Depression Scale (EPDS) during three trimesters of pregnancy. The Social Support Rating Scale (SSRS) and Life Events Scale for Pregnant Women (LESPW) were adopted to evaluate the social support and stress exposure of pregnant women. Binary logistic regression models were used to evaluate the associations of SSRS, LESPW, and EPDS with preterm birth, presenting as odds ratio (OR) and 95% confidence interval (CI). Stratified analysis by SSRS was performed. Of 3692 pregnant women, 190 (5.1%) had a preterm birth, and the prevalence of depression was 12.1%, 10.2%, and 7.4% for the 1st, 2nd, and 3rd trimester, respectively. High EPDS in the 1st trimester contributed to an increased OR of preterm birth (1.60, 95% CI 1.03, 2.40) after adjusting for potential confounders. Although stratified analyses suggested a significant association only among women with low social support (1.58, 95% CI 1.00, 2.50), the formal interaction test was not significant. Maternal depression during the first trimester seemed to elevate the odds of preterm birth. The association was not modified by social support in our study. It is recommended to establish an early screening system for depression during pregnancy and seek professional psychological counseling and treatment when necessary, to reduce the risk of preterm birth.

Prevalence, associated disorders and treatment of joint hypermobility syndrome; A systematic review.

The gender paradox of infertility: a comparative study of marital adjustment and sexual dysfunction in Bangladesh

Interrelationships Among Psychological Conditions, Oral Health-related Quality of Life, and Clinical Characteristics in Chinese Patients with Minor Recurrent Aphthous Stomatitis.

This qualitative study explores the integration of Artificial Intelligence (AI) in group psychological counselling within wellness education through an ethical and interdisciplinary framework.Drawing on 30 in-depth interviews with educators and mental health professionals, the research examines perceptions of ethical digitalisation, the application of knowledge graphs for personalised emotional mapping, the role of outcome-based education (OBE) in structuring measurable psychological goals, and the impact of industry-education collaboration in co-developing AI tools.Thematic analysis identified five overarching domains: ethical governance, data-driven personalisation, outcome alignment, collaborative innovation, and cultural responsiveness.Findings reveal both enthusiasm for AI's potential to enhance support and significant concerns regarding privacy, algorithmic bias, institutional barriers, and the need for human-centred design.The study concludes that effective implementation requires robust ethical frameworks, continuous stakeholder engagement, and adaptive educational structures.These insights offer a conceptual foundation for designing AI-supported counselling systems that align with psychological development goals while safeguarding ethical integrity in diverse educational environments.

ABSTRACT This qualitative study analyzes fifty anonymized posts from Palestinian Facebook support groups to understand how women rebuild identity and assert agency after divorce. Thematic analysis revealed six key themes: the need for self care, catalysts for separation, verbal and emotional abuse, conflicted love, supportive communities, and financial autonomy. The findings show that digital solidarity and economic empowerment facilitate decision making and self determination. This research highlights the need for accessible psychological counseling, legal advocacy recognizing emotional abuse, and tailored financial services, showing how women in conservative societies manage severe social stigma to reclaim their dignity and build independent new lives.

BackgroundAutism spectrum disorder is a complex neurodevelopmental disorder marked by difficulties in social interaction, communication impairments and repetitive behaviours. Depending on the degree of the illness and each person’s particular strengths and problems, autism can have a variety of effects on both individuals and families. Caring for a child with autism is complex and demanding, placing considerable emotional and social burdens on parents.AimThis study explored the lived experiences of parents caring for children living with autism spectrum disorder at the Greater Accra Regional Hospital.MethodAn explorative qualitative research approach was employed in this study. A purposive sampling technique was used to interview 10 parents of children with autism spectrum disorder. Data were collected with an interview guide and analysed using thematic content analysis.ResultsThe findings of this study underscore the profound emotional, social, psychological and financial challenges faced by parents caring for children with autism. Many participants reported experiences of stigma, spiritual accusations and marital difficulties associated with caregiving. Despite these adversities, parents demonstrated resilience by adopting various coping strategies, including behavioural and lifestyle adaptations, reliance on faith and spiritual support and importantly, consciously disregarding negative societal attitudes.ConclusionThese findings highlight the urgent need for comprehensive and coordinated support systems, including psychological counselling, marital therapy and rehabilitation support services, to assist parents in navigating the complex challenges of caring for children with autism spectrum disorder. Implementing such interventions has the potential to reduce parental burden, mitigate stigma and enhance the overall well-being of both children with autism and their caregivers.

To address the limitations of traditional physical education (PE) approaches that rely heavily on manual observation for psychological assessment, this study integrates Natural Language Processing techniques with sports psychology education. A psychological education model incorporating the pre-trained Bidirectional Encoder Representations from Transformers (BERT) model was developed to enable intelligent and precise evaluation of students' psychological states. First, a text sentiment analysis model was constructed to extract emotional features. The BERT model was then fine-tuned for sports-specific contexts to capture deep semantic features of the text. Together, these components formed a four-dimensional feature extraction framework-semantic, emotional, thematic, and psychological. Experiments were conducted on two publicly available datasets, Emotional First Aid Dataset 1 and Psy-Insight 2. The proposed BERT-LDA-Psych model achieved average accuracy, precision, recall, and F1 scores of 91.5%, 91.0%, 90.3%, and 90.6%, respectively, on sentiment analysis tasks. It also outperformed mainstream ensemble models in psychological state recognition and feature fusion efficiency. The proposed model exhibits stable performance on general psychological counseling text corpora, establishing a reference computational framework for subsequent psychological state recognition tasks within PE contexts. The current results indicate functional feasibility in controlled textual environments; however, transferability to authentic PE classroom discourse remains uncertain.