Depression Anxiety Stress Scale Research Articles

Mental health and social trust: Age and religiosity as moderators among young people in Croatia and Slovenia

This study explored the moderating effects of age and religiosity on the relationship between social trust and mental health among young people aged 16–29 in Croatia (N = 1,177) and Slovenia (N = 1,227). Mental health was evaluated using two distinct measures: the Burnout Assessment Tool (BAT) and the Depression Anxiety Stress Scale (DASS-9). Social trust was assessed as trust in close family members and generalised trust. Religiosity was measured by religious service attendance, the importance of God in daily life, and support received from religious organisations. The findings indicate that age moderates the relationship between trust in close family members and BAT in both countries, and the relationship between trust in close family and DASS in Croatia. In terms of religiosity, all three dimensions significantly moderated the relationship between generalised trust and DASS in Croatia, while only one of them did so when BAT was used as the dependent variable. No significant moderation effects of religiosity were found in Slovenia. In summary, the results suggest that the negative psychological impact of low social trust can be mitigated through various mechanisms. The moderating effect of age implies that psychosocial maturation during adolescence may buffer the impact of low trust in close family on mental health. Religiosity, on the other hand, may act as an emotional substitute for generalised trust, especially in highly religious contexts. Additionally, the study highlights the importance of the chosen mental health indicator, as moderating effects varied depending on whether BAT or DASS-9 was applied.

The mediating role of resilience and sleep quality between self-efficacy and prenatal anxiety: A mediational analysis.

During pregnancy, prenatal anxiety is one of the most common mental disorders that women experience. This study aims to assess the prevalence of prenatal anxiety among Chinese pregnant women and explore the parallel mediating role of resilience and sleep quality in the relationship between self-efficacy and prenatal anxiety. Between February and June 2023, a total of 1071 pregnant women were recruited from three hospitals in Nantong, Jiangsu Province, China, using a convenience sampling method. The participants completed general survey questionnaires and were assessed using the Depression Anxiety Stress Scale-21, the Pittsburgh Sleep Quality Index, the 10-item Connor-Davidson Resilience Scale, and the Chinese version of the General Self-Efficacy Scale. In addition, a hierarchical multiple regression analysis was employed to investigate the relevant and mediating factors of prenatal anxiety. This study utilized a structural equation model to examine the mediating role of resilience and sleep quality in the relationship between self-efficacy and prenatal anxiety. Multivariate regression analysis showed that self-efficacy, resilience, and sleep quality were associated with prenatal anxiety (P < 0.05). The results of the mediation analysis indicated that resilience and sleep quality acted as fully mediators between self-efficacy and prenatal anxiety. The mediating effect of resilience was -1.8970 (95% CI -2.5259 to -1.3145), accounting for 72.07% of the total effect, and the mediating effect of sleep quality was -0.5482 (95% CI -0.7450 to -0.3726), accounting for 20.83% of the total effect. While self-efficacy accounted for 7.10% of the total effect (P = 0.5625), resilience, and sleep quality fully mediated prenatal anxiety. In Chinese pregnant women, the study revealed that sleep quality and resilience played a fully mediating role in the impact of self-efficacy on symptoms of prenatal anxiety. This suggests that enhancing resilience, improving sleep quality, and promoting self-efficacy may help alleviate symptoms of prenatal anxiety.

Validity and Reliability of the Turkish Version of the Maternal Ambivalence Scale.

The aim of this study was to adapt the Maternal Ambivalence Scale (MAS) to Turkish culture and to conduct validity and reliability studies. The sample of the methodological type consisted of women (n = 302) who applied to the outpatient clinics of a university hospital in the north of Türkiye. The data of the study were collected with the Personal Information Form, Depression Anxiety Stress Scale-21 and MAS. Explanatory and confirmatory factor analysis was used to analyse the data, and Cronbach's alpha coefficient and item-total correlation were used to analyse internal consistency. Language validity of the scales was ensured by the translation-back-translation method and content validity according to expert opinions. It was found that MAS consists of three sub-dimensions as the original structure, factor loadings are above 0.30 and the explained variance is 55.219%. It was found that the fit index values of the scale were x2/SD value 2.74, CFI 0.895, RMSA 0.0761 and SRMR 0.0679 and the model was acceptable. Cronbach's alpha reliability coefficient of MAS was found to be 0.824, and the mean score was 23.04 ± 6.96. It was determined that Turkish MAS is valid and reliable measurement tool.

Effectiveness of 4 weeks of electrical vestibular stimulation in the management of temporomandibular pain

Background: The non-surgical therapies prevail over surgical therapies in the management of temporomandibular disorders pain. Vestibular stimulation was known to relieve pain through its connections with analgesic brain areas. Although there is literature that supports the analgesic effect of vestibular stimulation, the research studies in this area are comparatively less in Indian settings. Hence, the present study was undertaken. Aims and Objectives: The present study was undertaken to observe the effectiveness of 4 weeks of electrical vestibular stimulation in managing temporomandibular pain. Materials and Methods: Sixty male and female participants who reported temporomandibular pain were recruited. They were then randomly assigned into two groups. The intervention group received electrical vestibular nerve stimulation for 4 weeks and regular treatment as an adjunctive therapy. Placebo stimulation was administered to the control group along with the regular treatment. The numerical pain rating scale, the Jaw functional limitation scale-8, and depression anxiety stress scales-21 were used in the study. Results: Pain score, jaw function score, and psychological parameters before intervention in the study and control groups were not significantly different. However, the pain score, jaw function score, and psychological parameters after intervention in the study group were significantly lower than in the control group. Conclusion: The study results support the analgesic effects of electrical vestibular nerve stimulation in pain management in patients with temporomandibular pain. The study recommends more studies in this area to recommend the implementation of electrical vestibular stimulation in the management of temporomandibular pain.

Mental Health in Adolescents at Telkom Purwokerto Junior High School

Adolescence is a critical phase characterized by rapid physical, psychological, and intellectual development. According to WHO (2018), adolescents are individuals aged 10–19 years, but in Indonesia, this age range is extended to 24 years due to varying regulations. Adolescents' curiosity and impulsive behavior often result in health challenges, especially mental health issues such as anxiety, stress, and depression. This study, conducted at Telkom Junior High School in Purwokerto, explores the mental health status of adolescents aged 11– 13 years, focusing on stress, anxiety, and depression levels. Using a descriptive quantitative survey design, data were collected from 114 seventh-grade students through validated instruments, namely the Depression Anxiety Stress Scales (DASS) and the Kessler Psychological Distress Scale (K-10). Results revealed that moderate levels of stress and anxiety were prevalent among the respondents, while depression was generally within the normal range. Gender differences were observed, with males exhibiting higher levels of stress and anxiety, whereas females were more susceptible to severe depression due to hormonal and socio-cultural factors. The full-day school system significantly contributed to emotional tension, emphasizing the need for supportive mental health interventions. The study recommends implementing school-based programs to enhance mental resilience and calls for further research on the influence of socio-economic and familial factors on adolescent mental health.

Using natural language processing to identify patterns associated with depression, anxiety, and stress symptoms during the COVID-19 pandemic.

Combining data-driven natural language processing techniques with traditional methods using predefined word lists may offer greater insights into the connections between language patterns and depression and anxiety symptoms, particularly within specific stressful contexts. Between 2020 and 2021, 1106 participants wrote narrative responses describing their experiences during the COVID-19 pandemic and completed the Depression Anxiety Stress Scale-21 (DASS). We investigated language patterns associated with DASS symptoms using established categories from Linguistic Inquiry and Word Count (LIWC) and sentiment analysis, as well as exploratory natural language processing techniques. Finally, we constructed machine learning regression models in order to assess how much of the variance in DASS symptoms is related to language use. We found significant positive bivariate correlations between total DASS symptoms and hypothesized LIWC categories: first-person singular pronouns, absolute language, and negative emotion words. These results remained largely similar when using negative sentiment scores and when statistically controlling for gender, age, and education. Exploratory n-gram analyses also revealed new individual words and phrases correlated with total DASS symptoms. Lastly, our regression models demonstrated a significant association between language use and total DASS symptoms (R2 = 0.36-0.62). The current study is one of the first to examine associations between language use and DASS symptoms during the pandemic using both traditional and data-driven techniques. These results replicate and extend prior findings regarding negative emotion and absolute language and identify unique correlates of DASS symptoms during pandemic-related stress, contributing to the literature on language and mental health more broadly.

Plant-based eating pattern and psychological symptoms: a cross-sectional survey among patients with migraine

ABSTRACT Objectives: The present study evaluated the association between plant-based diet index (PDI) and psychological symptoms, including depressive symptoms, stress, and anxiety among Iranian women diagnosed with migraine headaches. Methods: A cross-sectional study was conducted on 262 patients with migraine (aged 20–50 years; body mass index, 18.5–30 kg/m²). Three versions of the PDI were calculated: overall PDI, healthy PDI (hPDI), and unhealthy PDI (uPDI) based on dietary data collected via a 168-item food frequency questionnaire (FFQ). Psychological symptoms, including depressive symptoms, anxiety, and stress, were assessed using the Depression, Anxiety, Stress Scale-21 (DASS-21) questionnaire. Results: After adjustment for potential confounders, patients in the highest tertile of the PDI showed a lower risk of depressive symptoms [odds ratio (OR) = 0.41, 95% confidence interval (CI): 0.22, 0.77]. Furthermore, inverse associations were evident between the PDI score and the risk of stress (OR = 0.46, 95% CI: 0.24, 0.85). Discussion: Higher adherence to a plant-based eating pattern is associated with a reduced risk of psychological symptoms. However, future longitudinal studies and clinical trials should replicate our observations and delineate the underlying mechanisms driving these associations.

Grooming Risk Factors in Adolescents with Abuse Histories: Insights from Chilean Reparative Programs

The increasing use of digital platforms by adolescents has brought to light critical vulnerabilities related to online grooming. This study explores the risk factors associated with grooming among adolescents aged 12 to 17 years enrolled in a Reparative Program for Abuse in Chile. Using a non-experimental, quantitative, exploratory cross-sectional design, a sample of 50 adolescents was evaluated. Data collection employed validated instruments, including the Okasha Scale for Suicidality (EOS), the Depression Anxiety Stress Scale-21 (DASS-21), the Subjective Well-being Scale (EBS-8), and the Online Grooming Risk Scale (OGR-S). Findings revealed significant associations between grooming and variables such as excessive cellphone use, number of virtual social networks, lack of social connections, economic hardships, and depressive symptoms. Regression analysis highlighted that adolescents with unrestricted internet access, poor social interaction skills in face-to-face contexts, and exposure to environmental risk factors exhibit a heightened likelihood of experiencing grooming. These results underscore the necessity for targeted preventive interventions and policy enhancements to safeguard adolescents in vulnerable circumstances.

The Depression, Anxiety, Stress Scales-21: Principal component analysis and evaluation of abbreviated versions in young adults with temporomandibular disorders.

The Depression, Anxiety, Stress Scales-21 (DASS-21) contain three subscales measuring depression, anxiety, and stress. Several abbreviated DASS-21 versions have been developed, demonstrating better clinical utility and measurement properties than the original instrument. This study explored the factor structure of various abbreviated DASS-21 versions and identified/validated the optimal one for assessing young adults with temporomandibular disorders (TMDs). A total of 974 university-attending young adults were recruited in two waves (wave 1: 519; wave 2: 455). Demographic information, the DASS-21, and quintessence five TMD symptoms (5Ts) of the Diagnostic Criteria for TMDs were collected. Principal component analysis (PCA) was employed to condense the DASS-21 (wave 1 data), while confirmatory factor analysis (CFA) was used to determine maximum likelihood estimates and compare different abbreviated DASS-21 versions (wave 2 data). Known-group, concurrent (criterion) validity and reliability were subsequently evaluated. The mean age of the study participants was 21 (SD = 0.1) years and 80.4% were women. Twelve DASS-21 items were identified from the PCA. However, the Korean DASS-12 provided the best-fit model (χ2/df = 2.07, CFI = 0.975, TLI = 0.960, RMSEA = 0.049, SRMR = 0.033) among the seven abbreviated versions in the CFA. The Korean DASS-12 showed good known-group and concurrent (rs = 0.959) validity and reliability when contrasted to the DASS-21. The Korean DASS-12 possessed a good fit, known-group, as well as concurrent (criterion) validity and reliability, and was the best abbreviated DASS-21 version for screening young adults with TMD symptoms for psychological distress.

Depression Anxiety Stress Scales (DASS-21) for Finnish-speaking adults: Validation and normative data.

We conducted the first validation of the Depression Anxiety Stress Scales (DASS-21) in Finnish. DASS-21 is a short public domain questionnaire, which presents a way to quickly and effectively screen for mental ill health. We recruited two large samples, one aged 24-45 (N = 3,101 [2,488 women]), and the other aged 60-82 (N = 5,462 [4,473 women]), all employees of the city of Helsinki at inclusion (2017 and 2000-2002). DASS-21 measured depression, anxiety, stress, and general distress reliably among Finnish-speaking adults. It appeared invariant with age and gender as evinced by invariance analyses, latent mean comparisons, and an examination of psychometric properties for the subscales and individual items. The subscales negatively correlated with the Emotional Well-being subscale of the RAND-36, as expected. A comparison of five structural models using confirmatory factor analyses and a robust estimation method (weighted-least-squares method) showed a good fit for a one-factor solution. We discuss the use and interpretation of the DASS-21 as both a measure of specific affective symptoms and unidimensional general distress. We provide future researchers and clinicians with norms and estimates of measurement error among Finnish-speaking adults. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The Validation of the Perinatal Post-Traumatic Questionnaire in the Italian Population: Risk and Protective Factors

Background: Postpartum Post-Traumatic Stress Disorder (P-PTSD) symptoms develop after experiencing childbirth as traumatic. Several individual and environmental factors influence the childbirth experience. However, in Italy, this phenomenon remains unexplored due to the lack of screening tools. This project aims to validate the Italian version of the Perinatal PTSD Questionnaire (PPQ-II) and to identify maternal, pregnancy, childbirth, and postpartum risk and protective factors associated with P-PTSD. Methods: A total of 702 women (6–24 months postpartum) participated in an online cross-sectional study. They completed the PPQ-II, Depression Anxiety Stress Scales-21 (DASS-21), Big Five Inventory-10 (BFI-10), and a questionnaire to assess sociodemographic and perinatal factors. Factor structure was estimated with an exploratory (EFA) and confirmatory factor analysis (CFA). Internal consistency of the scale, convergent and divergent analyses were computed. Associations between perinatal factors and P-PTSD were also investigated. Results: The EFA revealed a two-factor structure: “Arousal and Mood alteration” and “Avoidance and Intrusion”. CFA supported the factor structure, showing a good fit of the data. The validity was confirmed by a significant association between the PPQ-II and the DASS-21 and a lower correlation with the BFI-10. Significant associations were found between P-PTSD symptoms and factors across the maternal, pregnancy, childbirth, and postpartum periods. Conclusions: The Italian PPQ-II is a valid screening tool to include in maternity care protocols for the early identification of P-PTSD. This study also contributes to identifying perinatal factors for symptom detection and the promotion of maternal well-being.

Psychometric Properties of the Coping Strategy Indicator (CSI) in a South African Male Incarcerated Offender Sample

This study examined the psychometric properties of the coping strategy indicator (CSI) among incarcerated male offenders in South Africa. Using a cross-sectional design, 968 participants were recruited through non-probability convenience sampling and completed four measurement scales, namely the CSI, multidimensional scale of perceived social support (MSPSS), prison adjustment questionnaire (PAQ), and depression anxiety stress scale (DASS). Five factor models were investigated, namely (i) a unidimensional model, (ii) a correlated three factor model, (iii) a bifactor model with uncorrelated three dimensions, (iv) a correlated four factor model, and (v) a bifactor model with uncorrelated four dimensions. Confirmatory factor analysis revealed that a bifactor model with four dimensions showed the best fit. This finding suggests that incorporating a general factor along with four specific dimensions (i.e., problem-solving, seeking social support, avoidance withdrawal, avoidance distraction) most accurately reflects the multidimensional structure of coping strategies in this population. Cronbach's alpha coefficients confirmed the internal consistency of the four factor model. The results also demonstrated good convergent and divergent validity for the CSI, confirming its reliability and validity in this context.

Facebook addiction among medical students: prevalence and consequences

BackgroundSocial media addiction, mainly Facebook, is a common emerging behavior, particularly among teens and young adults. The current study’s primary goal is to determine the prevalence of Facebook addiction and assess its influence on academic performance and mental health among medical students.MethodsSix-hundred twenty-seven students from the Faculty of Medicine, Zagazig University, at Egypt were included at this cross-sectional study. A semi-structured questionnaire designed by authors was used to collect sociodemographic data and data about academic performance and sleep. Facebook addiction was investigated using a scale which is Bergen Facebook Addiction Scale (BFAS). The Depression Anxiety Stress Scale-21 (DASS-21) was utilized to screen for anxiety, depression, and stress.ResultsBetween medical students, 16.6% had score above 24 and considered to have Facebook addiction. Facebook addiction had a substantial association with uncontrollable Internet use, affection of study hours, and decrease in academic scores. There is statistically considerable relation between Facebook addiction and anxiety, depression, and stress.ConclusionsFacebook addiction is common among medical students and had a negatory impact on both their academic achievement and mental health.

Supplemental Material for Depression Anxiety Stress Scales (DASS-21) for Finnish-Speaking Adults: Validation and Normative Data

Supplemental Material for Depression Anxiety Stress Scales (DASS-21) for Finnish-Speaking Adults: Validation and Normative Data

The impact of sociodemographic, psychological, and quality of life factors on dual-task performance in elderly individuals: a cross-sectional study in Iraq

Objective This study aims to explore how sociodemographic, psychological, and quality of life factors impact dual-task performance among elderly individuals in Iraq. Methods This cross-sectional study included 384 healthy community-dwelling participants aged 60 years and over, recruited from Najaf, Iraq. Data were collected using the Depression Anxiety Stress Scales-21 (DASS-21), Mindful Attention Awareness Scale (MAAS), and the World Health Organization Quality of Life Brief Form (WHOQOL-BREF). Dual-task performance was assessed using the Nine-Hole Peg Test (NHPT) combined with a cognitive task of counting backward by threes. Correlation and multivariate regression analyses were conducted to determine the predictors of cognitive dual-task performance. Results Among the WHOQOL domains, only physical health significantly predicted dual-task performance for both dominant and non-dominant hands (β = 0.234, p = 0.041; β = 0.263, p = 0.025, respectively), underscoring the importance of physical well-being in cognitive-motor functions. Psychological factors (depression, anxiety, and stress) measured by DASS-21 did not significantly predict dual-task performance. The model explained a small part of the variance in dual-task performance, suggesting that other factors may influence these abilities in elderly individuals. Conclusion While psychological factors measured by DASS-21 did not significantly impact dual-task performance, the overall quality of life remained essential. These insights can inform the design of elderly care programs.

Exploring the psychometric properties of the Persian Depression Anxiety Stress Scale for Youth (DASS-Y): factor structure and reliability in Iranian children and adolescents.

The Depression Anxiety Stress Scale for Youth (DASS-Y) is a self-report instrument recently developed to evaluate negative emotional states in children and adolescents. However, the Persian version's factor structure and psychometric properties have yet to be investigated in Iranian youth. The study aimed to assess the factor structure and reliability of the Persian DASS-Y in a sample of Iranian children and adolescents. The study recruited 1,277 children and adolescents, 703 (55.1%) being girls and 574 (44.9%) being boys (aged 7-18 years), from schools in Tehran, Iran. Confirmatory factor analysis (CFA) was conducted to evaluate structural validity and test the fit of three-factor models. Internal consistency reliability was examined using Cronbach's alpha and McDonald's omega coefficients for the DASS-Y total and subscale items. Convergent and discriminant validity were also assessed. The CFA results supported the original 3-factor structure of the DASS-Y, consisting of Depression, Anxiety, and Stress subscales in both groups of Iranian children and adolescents. Subsequently, the Pearson correlation coefficient assessed the scale's convergent and discriminant validity, which was relatively appropriate. Also, the DASS-Y's internal consistency reliability was satisfactory. The Persian DASS-Y is a reliable and valid Instrument for measuring depression, anxiety, and stress in Iranian children and adolescents. It can be helpful for both research and clinical work, helping to assess psychological distress in children and adolescents.

Factors correlating work engagement among Palestinian emergency nurses during Gaza war in the West Bank.

Work engagement among emergency nurses is a critical issue that adversely affects the quality of patient care and productivity. Psychological reactions (e.g., stress, anxiety, and depression) and resilience correlated with work engagement. This study addresses the gap in understanding the factors correlating work engagement among. emergency nurses in the West Bank during the Gaza War. A descriptive correlational design was used. The data were collected from 378 emergency nurses from governmental and private hospitals in the West Bank using a self-reported questionnaire from December 2023 to February 2024. Depression Anxiety Stress Scales-21 (DASS-21), the Connor-Davidson Resilience Scale (CD-RISC), and the Utrecht Work Engagement Scale (UWES) were used to assess the study variables. The findings demonstrated that 71.7%, 52.9%, 42.5%, 55.6%, and 40.0% of the emergency nurses reported severe to extremely severe stress, moderate to extremely severe levels of anxiety, severe to extremely severe levels of depression, low resilience, and low to extremely low levels of job engagement, respectively. A positive relationship existed between work engagement and age (r=0.407, p<0.01), years of experience (r=0.385, p<0.01), and resilience (r=0.419, p<0.01). While, work engagement negatively correlated with stress (r=-0.486, p<0.01), anxiety (r=-0.616, p<0.01), and depression (r=-0.632, p<0.01). The findings indicated that policymakers and healthcare professionals should promote initiatives that enhance nurses' resilience and mitigate psychological responses to improve work engagement. Therapeutic programs should consider the situational variations of Palestinian society, encompassing resilience, coping mechanisms, and psychological management approaches.

Correlates Between Temporomandibular Disorder Symptom Severity, Psychological Distress, Well-Being, and Oral Health-Related Quality of Life: Insights From Chinese Young Adults.

There is limited understanding of how temporomandibular disorder (TMD) symptoms, psychological distress, and well-being are related to each other and to OHRQoL in Chinese young adults. This study aimed to identify correlations between TMD symptom severity, psychological status, and OHRQoL while also examining factors associated with low OHRQoL. Participants, recruited from a major university in the capital city, completed a survey that included demographics, the Chinese versions of the expanded five TMD symptoms (5Ts) screener, Depression, Anxiety, Stress Scales-21 (DASS-21), Ryff's Scales of Psychological Well-being-18 (SPWB-18), and Oral Health Impact Profile for TMDs (OHIP-TMD). Data were analysed using Chi-square and Kruskal-Wallis/Mann-Whitney U tests, Spearman's correlation, and logistic regression (α = 0.05). The study sample consisted of 414 individuals (mean age 22.0 years [SD 2.1], 77.8% female). Among them, 23.4%, 22.2%, 15.7%, and 38.6% had no (NT), intra-articular (IT), pain-related (PT), and combined (CT) TMD symptoms, respectively. Significant differences were observed in global TMD severity (CT>IT, PT>NT), global distress (CT>IT, NT), and OHRQoL (CT>IT, PT, NT), but not global well-being. Global TMD severity was significantly, albeit weakly, correlated with global distress (rs = 0.32) and global well-being (rs = -0.12). Global distress, in turn, showed a significant but weak negative association with global well-being (rs = -0.34). Both global TMD severity and global distress exhibited moderate correlations with global OHIP (rs = 0.63/0.42). Global TMD severity, incorporating symptom duration, frequency, intensity, and interference, was the main determinant of low OHRQoL in Chinese young adults.

The Effects of Gain-Versus-Loss Messages Following the Dietary Approaches to Stop Hypertension (DASH) Diet and Low-Glycemic-Index Diet on Stress, Anxiety, Depression, and Fatigue in People with Multiple Sclerosis: A Protocol Study

Background: The global prevalence of multiple sclerosis (MS) is rising, and there is currently no cure. The dietary approaches to stop hypertension (DASH) and low glycemic load diets have demonstrated benefits in improving mood and physical function among adults with MS. Objectives: This study aimed to evaluate the effects of gain- versus loss-framed messages on stress, anxiety, depression, and fatigue in patients with relapsing-remitting MS who follow DASH and Low-Glycemic-Index diets. Methods and Results: This open-label, 12-week randomized controlled trial was conducted at the MS Association of Ahvaz. The study included men and women aged 18 - 55 with an Extended Disability Status Scale (EDSS) score below 4.5. A total of 96 participants were randomly assigned to receive either gain-framed or loss-framed messages. Educational messages, presented in graphical or textual formats, were tailored to participants based on their responses. Outcomes were assessed using the Modified Fatigue Impact Scale (MFIS), the Depression Anxiety Stress Scale-21 (DASS-21), and measures of pain intensity, physical activity, dietary intake, and adherence to the recommended interventions. Data were analyzed using both per-protocol and intention-to-treat methods. SPSS version 26.0 was used for statistical analysis, with significance set at P &lt; 0.05. Conclusions: If this study demonstrates the effectiveness of gain- and loss-framed messages, these approaches can be utilized to enhance knowledge and awareness among individuals with MS. Furthermore, they can promote adherence to DASH and low Glycemic Index diets, potentially improving stress, anxiety, fatigue, and pain intensity in this population.

From breast cancer diagnosis to survivorship: analyzing perioperative biopsychosocial phenotypes and their relationship to pain on long term.

Persistent breast cancer treatment-related pain affects up to 40% of patients, decreasing their quality of life (QoL). While current research typically utilizes correlation and regression analysis to identify biopsychosocial phenotypes contributing to this pain, this study employs cluster analysis to identify qualitatively different phenotypes based on somatosensory and psychosocial characteristics both before and one week post-breast cancer surgery. Further, it investigates how these phenotypes are related to pain intensity one year post-surgery and examines the evolution of phenotype membership from pre- to post-surgery. Somatosensory and psychosocial functioning was evaluated pre- and post-surgery in 184 women undergoing unilateral breast cancer surgery. Eight different quantitative sensory testing (QST) methods including mechanical detection and pain thresholds, pressure pain thresholds, thermal detection and pain thresholds, and conditioned pain modulation were performed at the surgical area (trunk, arm, major pectoral muscle) and a distant location (quadriceps muscle). Psychosocial functioning was assessed using the Central Sensitization Inventory, Pain Catastrophizing Scale, Depression Anxiety Stress Scale-21, and the McGill Quality of Life Questionnaire. Pain intensity was evaluated one year post-breast cancer surgery using the Visual Analogue Scale. Latent class analysis identified five distinct phenotypes before and post-surgery, characterized by differences in mechanical and pain thresholds alongside psychosocial factors. Moreover, higher psychosocial distress and lower QoL correlated with elevated pain intensity one year post-surgery. These findings underscore the importance of addressing breast cancer patients' mental health perioperatively. Therefore, future research should explore whether psychological interventions perioperatively can reduce long-term pain intensity. PerspectiveThis secondary analysis, utilizing cluster analysis, reveals five distinct phenotype based on somatosensory and psychosocial characteristics both before and post breast cancer surgery. Higher psychosocial distress and lower quality of life correlated with elevated pain intensity one year post-surgery, emphasizing the need to address patients' mental health perioperatively. Trial registrationclinicaltrials.gov (NCT03351075)