General Distress Research Articles

Occurrence of potentially traumatic events, type, and severity in undergraduate students

ABSTRACT Background Trauma exposure can have significant mental health impacts on students that impair academic performance and engagement. It is therefore important to describe the occurrence of trauma experiences and associated symptoms among undergraduate students. Objective This study aimed to 1) assess the rates of potentially traumatic experiences, 2) examine the frequency of different trauma experience types, and 3) compare post-traumatic stress (PTS) symptom severity across experience subtypes in a large sample of undergraduate students. Methods Participants were 806 undergraduate students from three Australian universities who completed online self-report measures of trauma exposure, psychological distress, and PTS symptoms. Results Approximately two-thirds of students (64%) reported having experienced at least one potentially traumatic event. The most common experience types were the unexpected death of a loved one and accidents. Students reporting exposure to potential trauma had significantly higher general distress than non-exposed students. Events involving interpersonal violence were associated with greater PTS symptom severity. Conclusions This study provides evidence that the occurrence of potentially traumatic events is high among university students and may carry negative effects for mental health and functioning. Results highlight the need for trauma-informed educational approaches and robust counselling services to support students managing trauma histories.

The Couples Coping Enhancement Training – Sexual Minority Stress (CCET-SMS) Relationship Education Program: Feasibility, Acceptability, and Preliminary Evidence of Effectiveness

Individuals with diverse and traditionally underrepresented sexual orientations – those who identify as lesbian, gay, or bisexual (LGB) – experience compounded stress due to their marginalized identity in a heteronormative society. Such stressors, which include but are not limited to discrimination and internalized heterosexism, increase risks for various affective disorders and negatively impact relationship functioning. Empirically supported relationship education programs, including the Couples Coping Enhancement Training (CCET), have been found efficacious in increasing psychological and relationship well-being; however, the original CCET and related education programs do not specifically target how couples can identify, communicate, and cope with sexual minority stressors. The purpose of this pilot study was to test the feasibility, acceptability, and preliminary evidence of effectiveness of the Couples Coping Enhancement Training – Sexual Minority Stress (CCET-SMS) relationship education program. Results from nine couples showed trends in decreased reports of sexual minority stress and general distress, and significant increases in reports of positive dyadic coping and relationship satisfaction. Additional results based on the program feasibility and acceptability along with limitations and suggestions for future directions are presented.

Specificity of attentional control deficits in predicting symptoms of social anxiety

BackgroundThe extent to which individuals can flexibly allocate their attention towards adaptive cues in the social environment may play an important role in the maintenance of social anxiety. Attentional control (AC) describes the top-down ability to regulate one's attention and cognitive resources. Although low AC has been linked to psychopathology broadly, the specific relation between AC and social anxiety disorder (SAD) remains poorly understood. The present study aimed to clarify the role of AC in SAD by examining unique associations between AC and several facets of social anxiety, above and beyond general psychological distress. MethodsAdults endorsing elevated SAD symptoms (n = 123) were assessed for levels of AC, inhibitory control, social anxiety severity, social anxiety sensitivity, social avoidance/safety behaviors, stress, and depression. ResultsPartial correlations revealed that self-reported AC was negatively associated with all dimensions of SAD (rs = −0.20 to −0.29, ps < 0.05) after controlling for symptoms of stress and depression. Similarly, structural equation models showed that latent AC negatively predicted latent social anxiety (β = −0.21, p < .05), even after controlling for latent psychological distress. LimitationsThe study used a cross-sectional design, an analogue sample, and solely self-report measures in structural equation models. ConclusionsResults converge to suggest that subjective (but not objective) deficits in AC have a unique relation with several mechanisms involved in the development and maintenance of SAD. These findings partially support the applicability of Attentional Control Theory to SAD and point to AC as a potential treatment target.

Exploring therapist effectiveness across multiple domains over time.

Despite the common assumption that increased therapist experience correlates with improved client outcomes, studies reveal inconsistent relationships between therapist experience and therapy effectiveness. Some studies have demonstrated a slight worsening of client outcomes as therapists gain more experience. Yet, there are few studies that have examined how therapists change in their client outcomes over time, especially across different outcomes (e.g., depression, life functioning, anxiety). The present study used the Behavioral Health Measure-17 to investigate therapist effectiveness over time on multiple treatment outcomes (e.g., general distress, life functioning, anxiety, alcohol/drug use) using a large naturalistic sample of 613 professional therapists and 42,690 clients over approximately 12 years of psychotherapy data. Our results show a significant decrease in client outcomes over time in three domains: general distress, life functioning, and anxiety, albeit small-sized effects. Our findings also indicate that therapist caseload and baseline severity were not associated with predicting client outcomes and that, unexpectedly, the severity of therapist caseloads decreased over time. These findings underscore the importance of a nuanced understanding of therapist effectiveness, challenging the assumption of universal improvement with experience. Furthermore, we believe that these findings may offer preliminary support for matching therapists with clients based on domain-specific strengths. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Barbie Deformity after Edge Labiaplasty: Classification and Repair Algorithm.

Influenced by the popularity of "Barbie" shape of labia minora, edge labiaplasty has become the preferred option among patients and surgeons alike. However, excessive or inappropriate resection of labial free edges may lead to morphological deformities and dysfunctional symptoms termed as "Barbie deformity". This study aims to report a classification of Barbie deformity and a repair algorithm to help surgeons select appropriate surgical methods. A total of 216 patients with Barbie deformity were classified into 3 degrees. Among these, 119 patients underwent repair surgeries by different methods corresponding to the degree of deformity. The surgical outcomes of 87 patients were assessed via follow-up questionnaires. Preoperative and postoperative levels of general psychological distress and self-esteem were compared for 46 patients using standard scales. Barbie deformity was identified on 338 sides: 158 were Grade I, 106 were Grade II, 74 were Grade III, and 187 had vestibular mucosa exposure. Repair surgeries were performed on 189 sides: 53 via edge trimming, 99 via wedge excision, 32 with an island clitoral hood flap, and 5 with Gress's composite method. The complication rate was 4.8%. Genital appearance was improved in 96.6%, preoperative discomfort was resolved or significantly reduced in 74.2%, and overall satisfaction was 86.2%. The general psychological distress and self-esteem scores also improved significantly after surgery. The goal of repairing Barbie deformity is not only to improve the appearance of the genitals but to also restore the position and function of the mucosa. Preventing Barbie deformity is much more important than repairing it.

Psychometric properties of the Depression Anxiety Stress Scales (DASS-21) in women with breast cancer

Breast cancer impacts the psychological well-being of women, leaving them at risk of developing depression, anxiety, and other stress-related disorders. The Depression Anxiety Stress Scales (DASS-21) is a widely used measure, although empirical evidence regarding its psychometric properties in the breast cancer population is limited. The purpose of this study was to conduct an exhaustive analysis of the psychometric properties of the DASS-21 in a sample of Spanish women diagnosed with breast cancer. Participants were 289 breast cancer patients who completed the DASS-21 and other questionnaires measuring life satisfaction, positive and negative affect, flourishing, perceived stress, and breast cancer-specific stressors. In terms of validity evidence based on the internal structure of the DASS-21, adequate fit indices were obtained for the model based on three first-order factors (depression, anxiety, stress) and one second-order factor (general psychological distress). Reliability coefficients (McDonald’s omega) ranged from .84 to .95. Validity evidence based on relationships with other variables was also provided by moderate and strong correlations with well-being indicators and stress measures. The results support the use of the DASS-21 for measuring general psychological distress in the breast cancer context, where it may provide useful information for the design of psychological interventions with patients.

Hardiness predicts mental health recovery during the COVID-19 pandemic.

The COVID-19 pandemic has elicited wide-scale general psychological distress; however, longitudinal investigations are required to identify the critical resources that support individuals' adaptation to this type of unique situation over time. Hardiness, a cognitive trait that facilitates adaptation in the context of adversity and possible posttraumatic growth, may be particularly influential on mental health recovery during health disasters when other resources are not available or effective. We tested the hypothesis that greater psychological hardiness prior to the pandemic would predict lower traumatic stress symptoms (TSSs) and loneliness early into the pandemic and decreases in TSSs and loneliness between early 2020 and late 2021. Predominantly ethnic minority (77% Latina/o/x or Asian American) female young adults (N = 80; Mage = 25 years; 88% female) attending a minority-serving public university completed a measure of hardiness in January 2020 as well as measures of pandemic-related TSSs and loneliness in April 2020, October 2020, and December 2021. Latent growth curve analyses indicated that hardiness was associated with lower initial loneliness as well as decreases in TSSs and loneliness over time. Consistent with previous research on adaptation to other potentially traumatic stressors, the current findings suggest that psychological hardiness may play a critical protective role during a global health disaster, both in terms of initial distress and changes in distress over time. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Enhancing quality of life in epilepsy with a digital intervention (emyna): Results of the ELAINE randomized controlled trial.

Despite the availability of pharmacological treatment for seizures, people with epilepsy (PwE) commonly experience impairments in quality of life (QoL). Given the limited access to psychosocial treatments for PwE, digital interventions could bridge treatment gaps and help improve QoL. The objective of this study was to examine the effectiveness of emyna, a fully automated digital intervention based on cognitive behavioral therapy (CBT) techniques, in improving health-related QoL among PwE who reported impairments in QoL. A previous trial showed that emyna was effective in improving depressive symptoms among PwE with a comorbid depressive disorder, but its effects on QoL among PwE without comorbid depression remain unknown. A pragmatic randomized controlled trial was conducted with N = 438 PwE (mean age = 37.5, 70.3% women, physician-verified diagnoses) who were assigned to the intervention group (n = 216), which used emyna alongside treatment as usual (TAU), or the control group (n = 222), which received TAU only. QoL and secondary outcomes such as general self-efficacy, medication adherence, general distress, and epilepsy-related work and social adjustment were assessed at baseline, 3 months, and 6 months. The primary outcome was QoL assessed with the Quality of Life in Epilepsy [QOLIE-31] total score at 3 months post-randomization. Findings from the intent-to-treat analyses showed that after 3 months, participants in the intervention group experienced significant and clinically relevant improvements in health-related QoL compared to the control group (baseline-adjusted group difference = 4.5; 95% CI = [2.0, 6.9], p < 0.001; Cohen's d = 0.32). Effects on secondary outcomes did not reach statistical significance. This study extends previous research by demonstrating that emyna facilitates improvements in QoL in a diverse group of PwE treated in routine care settings. This CBT-based digital intervention therefore presents a convenient and cost-effective addition to healthcare providers' treatment repertoire. In our study, we tested a digital program called emyna, which conveys cognitive behavioral therapy (CBT) techniques to help improve the quality of life for people living with epilepsy. We found that those who used emyna alongside their usual treatments felt better about their quality of life compared to those who did not use the program. Emyna offers a new, convenient way for people with epilepsy to manage their condition, which can be used alongside currently available treatments.

Identifying impaired mental health in diabetes: a cross-sectional study in general practice.

Type two diabetes (T2D) is linked to impaired mental health. International guidelines emphasise the importance of including psychological aspects in diabetes care. Yet, no systematic approach has been implemented to assess mental health in patients with T2D in general practice. To evaluate the mental health of patients with T2D in general practice, and to investigate the effectiveness of asking patients about their well-being by using a single-item question compared to the WHO five-item Well-being Index (WHO-5). Cross-sectional study, including 230 patients with T2D in Danish general practice from 1 May 2023 to 31 January 2024. Eligible patients were recruited at the annual chronic care consultation. They answered a single-item question on well-being and four validated measures of general well-being (WHO-5), depression (PHQ-9), anxiety (GAD-7), and diabetes distress (PAID-5). Overall, 32% of patients expressed symptoms of impaired mental health. Notably, the WHO-5 identified 53% of these patients, whereas only 12% was identified through the single-item question. Importantly, among the patients exhibiting symptoms of impaired mental health, those identified by the WHO-5 displayed statistically significantly lower mental health scores across all measures (except PAID-5) compared to those not identified by the WHO-5. A significant proportion of patients with T2D in general practice are affected by mental health issues. Our findings indicate that a single-item question may not sufficiently detect these issues, highlighting the importance of incorporating tools like the WHO-5 to offer a more comprehensive approach in diabetes care.

The effects of shared, depression-specific, and anxiety-specific internalizing symptoms on negative and neutral episodic memories following post-learning sleep.

Emotional memory bias is a common characteristic of internalizing symptomatology and is enhanced during sleep. The current study employs bifactor S-1 modeling to disentangle depression-specific anhedonia, anxiety-specific anxious arousal, and the common internalizing factor, general distress, and test whether these internalizing symptoms interact with sleep to influence memory for emotional and neutral information. Healthy adults (N = 281) encoded scenes featuring either negative objects (e.g., a vicious looking snake) or neutral objects (e.g., a chipmunk) placed on neutral backgrounds (e.g., an outdoor scene). After a 12-hour period of daytime wakefulness (n = 140) or nocturnal sleep (n = 141), participants judged whether objects and backgrounds were the same, similar, or new compared with what they viewed during encoding. Participants also completed the mini version of the Mood and Anxiety Symptom Questionnaire. Higher anxious arousal predicted worse memory across all stimuli features, but only after a day spent being awake-not following a night of sleep. No significant effects were found for general distress and anhedonia in either the sleep or wake condition. In this study, internalizing symptoms were not associated with enhanced emotional memory. Instead, memory performance specifically in individuals with higher anxious arousal was impaired overall, regardless of emotional valence, but this was only the case when the retention interval spanned wakefulness (i.e., not when it spanned sleep). This suggests that sleep may confer a protective effect on general memory impairments associated with anxiety.

Psychometric properties of the Arabic version of the Nightmares Distress Questionnaire (NDQ-AV) in a community sample of adolescents

BackgroundThe Nightmare Distress Questionnaire (NDQ), known and commonly used for its adequate psychometric properties, is the most widely used instrument for the measurement of nightmare distress. This study aimed to assess the psychometric properties of a newly translated Arabic version of the Nightmare Distress Questionnaire (NDQ-AV).MethodsA total of 546 Lebanese adolescents was recruited for this study and completed the NDQ-AV, the Insomnia Severity Index (ISI), and the eight-item Depression, Anxiety and Stress Scale (DASS-8).ResultsThe results of the exploratory factor analysis (EFA) and the confirmatory factor analysis (CFA) supported both a one-factor model and a two-factor model of the NDQ-AV, with the latter consisting of seven items within both factors. The first factor was referred to as the “general nightmare distress and coping” while the second was named “nightmare impact and perception”. The reliability of the scale was excellent (α = 0.930 and ω = 0.915). Moreover, measurement invariance was shown across gender, demonstrating that this measure performs consistently for both men and women. Additionally, the NDQ-AV scores exhibited excellent reliability alongside factorial and concurrent validity.ConclusionIn conclusion, these results support the psychometric validity of the Arabic version of the NDQ. The availability of the NDQ-AV is expected to facilitate the understanding of nightmare distress within the Lebanese context.

Effects of mindfulness and movement on affect and vitality.

Increasing levels of distress and barriers to healthcare have coincided with increasing use of Complementary and Alternative Medicine (CAM). While mindfulness and movement interventions may improve wellbeing, little research has compared the effectiveness of these two approaches. This single intervention study aimed to (1) explore the effects of two brief, online, self-administered mindfulness and movement interventions on affect and vitality, and (2) establish whether changes in affect and vitality could be predicted by age, gender, general distress, previous CAM experience and enjoyment of the intervention. Participants (n = 62) were randomly allocated to follow a brief online mindfulness or movement intervention. Levels of affect (using PANAS) and subjective vitality (using the Subjective Vitality Scale) were measured pre and post intervention. Demographics, experience with CAM and general distress (using the DASS-21) were collected pre intervention, while level of enjoyment (using the ENJOY scale) was measured post intervention. Open-text responses gathered qualitative data on participant experience. Participants completing the mindfulness intervention reported increased vitality and decreased positive and negative affect. Those completing the movement intervention reported increased vitality and positive affect and decreased negative affect. Higher DASS-21 levels were predictive of greater reductions in negative affect. Higher levels of enjoyment were predictive of greater increases in positive affect and vitality. Differences between mindfulness and movement interventions may indicate that they could have targeted applications. While further research is necessary, these brief, online interventions may provide a sustainable, accessible self-management and wellbeing intervention.

Inpatient’s, therapist’s and staff’s expectations regarding treatment and their effects on placebo response in the psychiatric ward – results from an add-on oxytocin RCT

ObjectivesPatient’s and therapist’s expectations are considered an important factor influencing placebo response in experimental and therapeutic settings. Nevertheless, the placebo effects of common neurological facilitators that promote treatment efficacy have not been explored. In the present study we examined the estimations of patients, therapists, and staff members, regarding their treatment type and assessed their influence on the facilitating effects of oxytocin.MethodsPatients (N = 87) were randomized and double-blindly allocated to receive either oxytocin or placebo, twice daily for a period of four weeks, as part of a larger randomized, double-blind, placebo-controlled trial. Patient’s, therapist’s and staff’s expectations were assessed based on their estimation of treatment type (agent or placebo). Multilevel modeling and univariate and multivariate regression analysis were performed to assess the effects of patient’s, therapist’s, and staff’s estimations on treatment outcome beyond the effects of treatment type.ResultsStaff’s, therapist’s, and patient’s estimations were significantly associated with treatment outcomes. Nevertheless, only therapist’s and patient’s estimations significantly predicted improvement beyond actual administration, with therapist’s and patient’s estimations associated with improvement in trait anxiety (STAI-T, B=-1.80, p < .05, and B=-2.02, p < .05, respectively); therapist’s estimations were associated with improvement in general distress (OQ-45, B=-3.71, p < .05), and patient’s estimations were associated with symptom relief (HSCL-11, B=-0.13, p < .05). Overall, patient’s estimations had a higher relative contribution to treatment success, with standardized coefficients across scales ranging from − 0.06 to -0.26.ConclusionsThe neurobiological factors that promote treatment success are also influenced by patient’s and therapist’s expectations. Future studies should consider these effects when examining their impact in inpatient settings.

Psychopathy, psychological distress, and treatment history among perpetrators of intimate partner femicide, homicide, and other violent crimes in Buenos Aires, Argentina

Intimate partner femicide—the killing of women based on their gender by their former or current partners—is a global long-standing manifestation of violence against women. Despite the enactment of femicide-specific laws in Latin America, femicide rates have remained relatively constant throughout the last decade. Often perpetrators are pathologized as suffering from mental illness, yet the data on their mental health status is still relatively unknown. Thus, more research is needed to understand the extent of poor mental health among these individuals. The purpose of this study was to compare levels of psychopathy, psychological distress, and treatment history among an all-male sample of intimate partner femicide perpetrators, male-male homicide perpetrators, and offenders convicted of other violent crimes in Buenos Aires, Argentina. This study utilized a cross-sectional survey based on data derived from a two-stage sampling strategy. The questionnaire included two standardized instruments for the measurement of psychopathy (revised Psychopathy checklist and the Levenson Self-Report Psychopathy scale) and one for general distress (Spanish version of 12-item General Health Questionnaire). The final sample included 205 prisoners including 68 intimate partner femicide perpetrators, 73 homicide perpetrators, and 64 individuals convicted of other violent crimes. There were no significant differences across these groups based on their socio-demographic characteristics. Participants did not differ in terms of their psychopathology; however, femicide perpetrators were statistically more likely to experience psychological distress. In addition, femicide perpetrators self-reported more prior episodes of mental and substance use treatments. The findings of increased psychological distress and prior mental health and substance use treatment among femicide perpetrators suggest that there may be missed opportunities for femicide prevention within the public health subspecialties of mental health and substance use disorders. This study suggests that femicide perpetrators likely require distinctive interventions, including self-assessments and harm mitigation tactics, to prevent their potential for femicide perpetration.

Impulsivity as a predictor of clinical and psychological outcomes in a naturalistic prospective cohort of subjects at ultra-high risk (UHR) for psychosis from Tunisia

BackgroundImpulsivity is associated with serious detrimental consequences on physical, mental, behavioral and social aspects of health among patients with psychosis. The present prospective 12-month follow-up study aimed to determine the prevalence of highly impulsive individuals among Ultra High Risk (UHR) patients, how impulsivity evolves over the follow-up period, and whether impulsivity impacts clinical, psychological and functional outcomes in this population. MethodUHR patients were invited to complete a battery of measurements at three-time points: at baseline, and at 6 and 12 months of follow-up. Impulsivity was assessed using both behavioral (the Wisconsin Card Sorting Test, WCST) and self-report (the Barratt Impulsiveness Scale, BIS-11) measures. ResultsFindings showed that at 6 months of follow-up, higher 6-month BIS-11 attentional and motor impulsivity were significantly associated with lower quality of life and greater general psychological distress. In addition, higher baseline BIS-11 motor impulsivity significantly predicted more severe positive psychotic symptoms at 12 months of follow-up. However, WCST scores did not show any significant associations with study variables at the different times of follow-up. ConclusionInterventions targeting impulsivity in UHR individuals could help decrease psychological distress and positive psychotic symptoms’ severity, as well as improve quality of life in UHR individuals.

Our lifestyles are back to 'normal', but is our mental health? Longitudinal assessment of psychological distress during the COVID-19 pandemic among Spanish adults: April 2021 to August 2022.

The COVID-19 pandemic had a detrimental effect on mental health since its start in 2020 and current data on mental health is limited. This study provides recent longitudinal data on psychological distress among a country-wide sample of adults. We recruited and surveyed 1,956 adults in Spain in April 2021 and August 2022 on sociodemographic- and pandemic-related psychological distress using the General Distress 21-item version of the Depression, Anxiety, and Stress Scale (DASS). Paired sampled t-tests assessed DASS scores by sex from April 2021 to August 2022; and one-way ANOVAs assessed DASS scores across sociodemographic characteristics. Results showed that psychological distress slightly improved across the total sample from April 2021 to August 2022; though females, young adults, students, and individuals with lower income experienced more psychological distress. Increases in severe stress scores were found particularly among men. Our data provides an overview of the psychological distress of Spanish adults 2.5 years into the pandemic and provides novel evidence that though life has resumed a sense of normalcy after the COVID-19 pandemic, the mental health of key populations (e.g., females, young adults, students, low-income) is still suffering and further intervention and resources are needed.

Finding the precise distance: Self-differentiation, marital relationship and trauma among ex-combatants’ spouses

BackgroundSpouses of ex-combatants often experience psychological distress due to sharing their lives with a partner who endured traumatic experiences, a phenomenon known as “secondary traumatization”. Self-differentiation is the emotional distance one takes, while keeping an amount of togetherness with significant others. The couple's relationship and self-differentiation can impact the manner and expanse of secondary traumatization experienced by the spouse. ObjectiveThis study aimed to examine the role of marital adjustment and self-differentiation (an enmeshed vs detached differentiation style), in secondary traumatization among spouses of ex-combatants. MethodsThis study is part of a longitudinal study examining psychological implications of war among Israeli ex-combatants and their spouses. Overall, 267 spouses have been assessed three times (2003;2011;2016). Participants completed self-report questionnaires evaluating secondary PTSD (SPS), general psychiatric distress (GPD), self-differentiation and dyadic adjustment (DAS). Cross-path models were used to assess associations between the variables longitudinally. ResultsAssociations were found between both self-differentiation and dyadic adjustment and SPS and GPD. Path models showed that fusion\\cutoff differentiation predicted more SPS\\GPD over time and vice-versa. Furthermore, dyadic adjustment mediated the association between fusion\\cutoff differentiation and SPS\\GPD. In other words, fusion\\cutoff differentiation in time 1 predicted dyadic adjustment in time 2, which in turn predicted SPS\\GPD in time 3. ConclusionsOur results can be interpreted in conjunction with original theories about secondary traumatization, emphasizing the importance of keeping a balanced emotional distance in the marital relationship as a way of reducing distress and PTSD symptoms following traumatic events.

Effects of resilience, social support, and academic self-efficacy, on mental health among Peruvian university students during the pandemic: the mediating role of digital inclusion.

Mental health of university students has been impacted during the pandemic, highlighting the importance of understanding its psychosocial determinants. Nevertheless, there has been limited exploration into whether the digital inclusion conditions for remote education could mediate the effects that variables such as resilience, social support, and academic self-efficacy may have on mental health. Considering the above, there is evidence that shows a consistent relationship between resilience, social support and academic self-efficacy on mental health, to the extent that these are psychological variables. On the other hand, digital inclusion, which comprehends a contextual variable, not a psychological one, related to ICT access opportunities and mainly focused on the quality of Internet access, should be analyzed in a differential manner. This study seeks to analyze the effect of resilience, social support and academic self-efficacy, on the mental health of a group of Peruvian university students; in addition, it seeks to analyze the mediating role of digital inclusion. A cross-sectional study was conducted with 3,147 undergraduate students from a private university in Lima, Perú. From August to October 2020, data were collected online through questionnaire, this include The Depression, Anxiety and Stress Scale 21 (DASS-21), The 10-item version of the Connor-Davidson Resilience Scale (CD-RISC10), The Multidimensional Scale of Perceived Social Support (EMASP), The Perceived Self-Efficacy Specific for Academic Situations Scale (EAPESA) and to measure digital inclusion, the Perceived Quality of Internet Access reported by the students. The levels of participants' anxiety, depression and stress were described using frequency and percentage. Pearson Correlation test was used to measure the correlation between the variables and a Path analysis was conducted. Finally, The PROCESS macro for SPSS (Model 4) was applied to examine the mediating effect of the model controlling gender variable. The results revealed significant levels of extremely severe symptoms of anxiety (36.8%), depression (33.4%) and stress (18.1%) among the participants. A path analysis, which indicated that resilience (β = -0.346), social support (β = -0.189), academic self-efficacy (β = -0.060) and digital inclusion (β = -0.089) had significant impact on students' General Distress. In addition, digital inclusion plays a partial mediation role with low but significant effect size in the relationship between resilience, social support and self-efficacy with mental health. Mental health of university students during the pandemic shows alarming levels of general or emotional distress. The findings indicate that resilience, social support and self-efficacy protect college students' mental health by reducing general distress. However, the study shows that when there is a digital divide around internet quality the impact of these factors is affected.

Shared trauma: Examining the moderating role of parental psychological flexibility and self-compassion on PTSD and distress in refugee families

BackgroundRussia's 2022 assault on Ukraine caused widespread destruction and displacement, affecting families. War and displacement heighten the risk of mental health issues, particularly when both parents and children are exposed to trauma. Resilience factors such as parental self-compassion and psychological flexibility might play a crucial role in moderating the symptoms. ObjectiveThis study aimed to investigate the mental health issues among parent-child refugees and assess their association with parental self-compassion and psychological flexibility. Method50 parent-child refugees who arrived in Israel after fleeing the war in Ukraine participated in the study. Parents completed self-report questionnaires assessing mental health issues and resilience factors regarding them and their children. Results56% of parents and 2% of children met the PTSD cutoff, while 56% of parents and 50% of children met the criteria for general psychological distress. Associations were found between children's PTSD, general distress, and those of their parents. High levels of parental psychological flexibility, self-kindness, and common humanity eliminated the association between parent and child symptoms. While in low and medium levels of these factors, children's PTSD and distress were linked to their parents. ConclusionsRefugee parents and children mutually influence each other's mental health difficulties. Parental psychological flexibility and self-compassion may moderate these dynamics, offering potential assistance in managing and alleviating children's symptoms. Targeting these parental resilience factors in treatment can enhance outcomes, improving the overall mental well-being of both children and parents.

Digital empowerment in mental health: A meta-analysis of internet-based interventions for enhancing mental health literacy

BackgroundPoor mental health literacy (MHL) in the global population significantly contributes to the treatment gap associated with mental disorders. In the digital age, leveraging Internet-based MHL interventions offers scalability and broader accessibility. This meta-analysis aimed to evaluate the effects of Internet-based interventions in improving MHL and mental health. MethodUp to Feb 2024, seven databases were searched for Internet-based interventions on MHL (knowledge, stigma, help-seeking attitudes and intentions) and mental disorders (general distress, anxiety, and depressive symptoms). The random-effects meta-analyses at post-intervention and long-term follow-up assessments were performed. ResultsTwenty-nine eligible studies involving 11,582 participants were included. Significant positive effects were observed across various domains: knowledge increase (immediate: g = 0.459, 95 %CI: 0.285 to 0.634; follow-up: g = 0.487, 95 %CI: 0.348 to 0.626), immediate stigma reduction (g = -0.332, 95 %CI: -0.479 to -0.186), immediate enhancement of help-seeking attitudes (g = 0.168, 95 %CI: 0.046 to 0.3291) and help-seeking intentions (g = 0.135, 95 %CI: 0.072 to 0.198), as well as immediate mental health improvements (g = -0.074, 95 %CI: -0.115 to -0.033). ConclusionOverall, these findings underscore the promising effects of internet-based interventions in improving MHL and mental health, while maintaining these effects over time remains challenging, particularly in reducing stigma and promoting long-term help-seeking behaviors. Addressing methodological limitations, adopting a more interactive approach, and implementing targeted interventions are crucial to maximizing the effectiveness and advancing mental health care worldwide.