Interpersonal problems as predictors of anxiety symptom trajectories in PTSD: A retrospective multilevel modeling study.

Racial trauma is a growing mental health concern among ethnoracially minoritized college students. Limited research has examined campus-level promotive factors that may mitigate suicidal ideation (SI) in this population. This study explored whether student perceptions of antiracist campus climate and campus involvement in cultural/racial student organizations moderated the relationship between racial trauma symptoms and SI. We conducted a cross-sectional analysis of 23,414 ethnoracially minoritized students (ages 18-26) from 135 U.S. colleges using data from the 2022-2023 Healthy Minds Study. Multilevel logistic regression models assessed associations between racial trauma symptoms, campus-level promotive factors, and past-year SI, controlling for sociodemographic and institutional variables. Higher racial trauma symptoms scores were significantly associated with greater odds of SI (OR=1.11, 95% CI=1.09-1.12, p<0.001). Students who perceived their campuses as actively combating racism (OR=0.71, p<0.001) or were involved in cultural/racial organizations (OR=0.79, p<0.01) were significantly less likely to report SI. However, these factors did not significantly moderate racial trauma and SI. Gender diverse students as well as students in Southern and East South-Central regions were noted to face higher SI risk. Although antiracism climate and campus involvement did not buffer the psychological toll of racial trauma, they were associated with lower SI risk. Institutions should prioritize multilevel antiracism mental health promotion strategies to support these students.

The October 7, 2023 events exposed both Israelis, Palestinians, and the entire middle east to unprecedented complex trauma. Guided by theoretical considerations and expert panel discussions, we identified seven distinct exposure domains: missile attacks, physical violence, evacuation, combat participation, hostage involvement, media exposure, and group-based marginalization. We examined actual exposure, that of self and significant others, to these domains alongside subjective stress and major stressful life events. Outcomes included PTSD, depression, anxiety, and somatic symptoms. A representative sample of Israeli-Jewish adults (N=928) surveyed for political stress prior to the October 7th 23 events were assessed again in December 2023. They completed a newly developed measure capturing the above seven exposure domains, a measure of major stressful events, and measures of the above outcomes. Hierarchical Regression Analysis was employed to identify both linear and curvilinear effects of exposure, moderated by life stress. Self and significant others' exposure were unrelated to subjective stress (rs: 0.09 and 0.14, ns) but differentially predicted all symptom types. Subjective stress was the strongest predictor of outcomes overall (βs: 0.18-0.35). Curvilinear effects and interactions between trauma exposure and major life stress were documented, although the latter interactions were substantially trimmed by sensitivity analyses. A comprehensive conceptualization and assessment mass-casualty armed conflict is essential for identifying stress-distress profiles and guiding personalized care and preventive interventions worldwide.

This study examines the associations between perceived institutional change and service innovation in Taiwan's School-Based Health Centers (SBHCs), with particular attention to the mediating role of organizational professionalism. A cross-sectional survey was conducted with 298 school nurses managing SBHCs across multiple educational levels. Using validated measures of institutional change, organizational professionalism, and service innovation, hierarchical regression analysis tested the hypothesized mediation model. Results indicate that institutional change is positively associated with both organizational professionalism (β=0.40, p<0.001) and service innovation (β=0.38, p<0.001), with moderate effect sizes. Furthermore, organizational professionalism demonstrates a substantial partial mediating effect, accounting for approximately 52% of the total effect, indicating that it is significantly associated with the relationship between institutional change and service innovation in SBHCs. Strengthening organizational professionalism through leadership, training, and resource alignment may enhance SBHCs' adaptive capacity and sustain innovation under conditions of institutional reform and resource constraint. This study integrates institutional theory, professionalism, and service innovation research to advance understanding of how meso-level professionalism functions as an internal mechanism linking systemic change to organizational innovation in hybrid healthcare-education settings.

To examine the relationship between nurse managers' empowering leadership, nurses' resilience and organisational learning from incidents. Cross-sectional observational study. Secondary data from a study conducted in June-July 2022 was used. The sample included 1049 nurses working in three special-functioning hospitals. The self-administered questionnaires assessed nurse managers' empowering behaviours, nurses' resilience and attitudes and behaviours fostering organisational learning from incidents. The analysis employed multilevel analysis with hierarchical linear modelling. Nurse managers' empowering behaviours and nurses' resilience were significantly positively associated with attitudes and behaviours fostering organisational learning from the following incident subscales: make efforts to identify the problem, discuss safety in the workplace, identify and give feedback to address the at-risk behaviour. The interaction of empowering behaviours and resilience was not significant. Nurse managers' empowering behaviours and nurses' resilience can contribute to attitudes and behaviours that foster organisational learning, even when nurses face stressful incidents. Fostering empowering leadership in nurse managers and resilience in nurses enhances organisational learning and improves safety and care quality. The reporting is based on the STROBE guidelines. This study did not include patient or public involvement in its design, conduct or reporting.

Effects of basic psychological needs on Chinese youth athlete burnout under coach burnout: Using hierarchical linear modeling.

The aim of this study was to determine the relationships between physical activity (PA) and fitness and mental health in persons with spinal cord injury (PwSCI) living with chronic pain. This cross-sectional baseline data analysis included n = 43 people PwSCI ≥ 18years reporting chronic pain. We administered the Satisfaction with Life Scale, EuroQol anxiety/depression, ICEpop CAPability Measure for Adults (ICECAP-A) enjoyment and pleasure and achievement and progress, Spinal Cord Injury Quality of Life Satisfaction with Social Roles and Activities scale, Leisure-Time PA Questionnaire for PwSCI, the 36-Item Short-Form Health Survey, and an arm-crank fitness test. Hierarchical multiple regressions, controlling for age, gender, injury level, fatigue, and pain, revealed that moderate to vigorous PA and fitness explained variance in enjoyment and pleasure (ΔR2 = .133, R2 = .344, p = .002), anxiety/depression (ΔR2 = .125, R2 = .258, p = .023), Satisfaction with Life Scale (ΔR2 = .036, R2 = .240, p = .030), achievement and progress (ΔR2 = .084, R2 = .260, p = .020), and Satisfaction with Social Roles and Activities (ΔR2 = .074, R2 = .444, p = .005). Future studies should test whether interventions that increase PA and fitness improve mental health in PwSCI living with chronic pain.

The association between generative artificial intelligence use and foreign language classroom anxiety.

Chronic Obstructive Pulmonary Disease (COPD) is associated with reduced physical activity, negatively affecting prognosis and quality of life. According to Self-Determination Theory (SDT), the quality of motivation plays a key role in sustaining active behavior, but evidence in COPD remains limited. The objective of this study was to examine the associations between different types of exercise motivation and objectively measured physical activity and sedentary behavior in individuals with COPD. This cross-sectional study included 50 community-dwelling individuals with COPD (GOLD stages 2-3; mean age 69.4 ± 7 years). Motivation was assessed using the Behavioral Regulation in Exercise Questionnaire (BREQ-3) and the Self-Determination Index (SDI). Physical activity was objectively measured with the ActiGraph GT3X accelerometer. Associations were examined using Spearman's correlations and hierarchical multiple linear regression models. Integrated regulation was positively correlated with light physical activity (rho = 0.43, p < 0.05), total physical activity (rho = 0.40, p < 0.05), and daily step count (rho = 0.43, p < 0.05). Intrinsic motivation was positively correlated with light physical activity (rho = 0.37, p < 0.05), total physical activity (rho = 0.37, p < 0.05), and daily step count (rho = 0.35, p < 0.05). The Self-Determination Index was positively associated with light physical activity (rho = 0.28, p < 0.05) and daily step count (rho = 0.33, p < 0.05), but showed no significant association with sedentary time. In hierarchical regression analyses, higher levels of integrated regulation were independently associated with higher daily step count, with each one-unit increase associated with 687 additional steps per day. For total physical activity, integrated regulation showed a borderline independent association with the outcome after adjustment for clinical covariates (β = 0.279, p = 0.054), whereas FEV1 (% predicted) remained independently associated with total physical activity (β = 0.304, p = 0.027). For sedentary behavior, higher self-determination was independently associated with lower sedentary time; specifically, each one-unit increase in the Self-Determination Index corresponded to approximately 13 fewer sedentary minutes per day (β = -0.327, p = 0.026). Self-determined motivation was associated with more favorable physical activity profiles in individuals with COPD. Integrated regulation was independently associated with daily step count, while higher self-determination was associated with lower sedentary time. These findings suggest that autonomous forms of motivation may be important factors to consider when promoting active lifestyles in people with COPD.

Utopian or dystopian? A mixed-methods study of nursing and midwifery students' perceptions of artificial intelligence and robot-assisted person-centred care in education.

Morbid curiosity refers to a stable tendency to engage with aversive, threatening, or taboo stimuli, yet its psychological correlates remain insufficiently understood. This study investigated the associations between morbid curiosity, personality traits, impulsivity, and human values in a Brazilian sample. A total of 367 undergraduate students completed measures of morbid curiosity, dark and prosocial traits, impulsivity, and basic human values. Correlational analyses and hierarchical regressions indicated that morbid curiosity was positively associated with dark personality traits - particularly psychopathy - and impulsivity, and negatively associated with prosocial traits such as forgiveness. Regarding motivational values, experimentation and suprapersonal values were positively related to morbid curiosity, whereas interactive values showed a negative association. Impulsivity emerged as a central predictor, suggesting that self-regulatory processes may facilitate the behavioral expression of morbid curiosity. Together, these findings conceptualize morbid curiosity as a multidetermined construct shaped by dispositional, motivational, and self-regulatory factors, extending previous accounts beyond sensation seeking and highlighting its relevance for understanding individual differences in engagement with violent or taboo content.

Predicting structure- and control-based parental feeding practices among families with low-income: An ecological approach.

Decision-making readiness is essential for effective patient participation in treatment decisions, especially for lung cancer patients receiving chemotherapy who face repeated complicated treatment choices. However, existing research investigating their level of decision-making readiness and its associated influencing factors remains inadequate. This study aimed to investigate the level of decision-making readiness among hospitalized lung cancer patients undergoing chemotherapy, and further explore the influencing factors of their decision-making readiness. A cross-sectional observational design was adopted. A total of 452 hospitalized lung cancer patients receiving chemotherapy were recruited using convenience sampling. Data were collected via multiple questionnaires: the Chinese Version of the Preparation for Decision Making Scale, Decisional Conflict Scale, Patient Attitude Toward Treatment Decision-Making Scale, Decision Regret Scale, and a self-designed questionnaire covering sociodemographic and clinical characteristics. Descriptive statistics, correlation analysis, and hierarchical multiple linear regression were applied for data analysis. The median score of participants' decision-making readiness was 62.00 (56.00, 70.00), representing a moderate overall readiness level. Correlation analysis demonstrated that decision-making readiness was positively associated with patients' willingness to participate in treatment decision-making and negatively associated with decisional conflict. Hierarchical regression revealed that demographic variables could explain 9.2% of the total variance of decision-making readiness, and the inclusion of decisional conflict and decision participation attitude raised the explanatory power to 31.1%. Economic status, residential location, decisional conflict and participation attitude were identified as significant predictive factors of decision-making readiness. Lung cancer patients undergoing chemotherapy only possess moderate decision-making readiness. Compared with demographic characteristics, psychosocial factors (decisional conflict and decision participation attitude) exert a stronger impact on patients' decision-making readiness. These findings also support the applicability of the Common Sense Model of Self-Regulation in the field of cancer treatment decision-making research. Targeted nursing decision-support interventions are urgently needed to assess and elevate lung cancer patients' decision-making readiness, which can further promote the practice of patient-centered treatment decision-making.

Compensatory cognitive training for unstably housed, post-9/11 veterans in residential mental health treatment: A randomized controlled trial.

Objective Alliance ruptures are common in psychotherapy, and their clinical impact depends on how they are recognized and responded to. Little empirical work has examined rupture processes in psychotherapy for schizophrenia-spectrum disorders. The present study investigated whether therapists’ adherence to Metacognition Insight Reflection Therapy (MERIT) elements is associated with clients’ session-quality evaluations and whether adherence moderates the association between therapist-perceived alliance ruptures and client-perceived session quality. Method Data included 610 therapy sessions from a randomized controlled trial, including 37 clients diagnosed with schizophrenia or schizoaffective disorder. Following each session, therapists rated their adherence to MERIT elements and their perceived intensity of alliance ruptures, while clients independently rated session quality. Multilevel models were used to examine within-client associations across sessions. Results Therapists’ adherence to MERIT elements was positively associated with clients’ perceptions of session quality. Higher therapist-perceived rupture intensity was negatively associated with clients’ session evaluations. Adherence to MERIT content elements moderated this association: when content adherence was high, therapist-perceived rupture intensity was no longer associated with poorer client-rated session quality, whereas under low adherence conditions, greater rupture intensity predicted worse session evaluations. Conclusion Therapists experienced rupture was negatively related to clients’ satisfaction, in sessions characterized by weaker therapist-rated adherence to content elements.

Effectiveness of the Botvin High School LifeSkills Training Intervention on Adolescent Substance Use: A Cluster Randomized Trial.

Construct validity, reliability, and sensitivity of proxy-reported pain interference in individuals with cerebral palsy.

Empirical research has suggested the association between interpersonal dysfunctions and anxiety disorders. However, no previous meta-analysis has estimated the extent to which these relational issues are related to negative mental health in anxiety disorders. This study aimed to conduct a systematic review and meta-analysis to evaluate the correlation between interpersonal distress and negative mental health outcomes in people with a diagnosed anxiety disorder. We performed a systematic search in PsycINFO and PubMed, based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria, including studies reporting estimates of the associations between interpersonal distress and negative (non-relational) mental health outcomes in people with diagnosed anxiety disorders. Using multilevel meta-analytic models, we estimated a pooled correlational (r) effect size, accounting for variability at the within-effect-size, between-effect-size, and between-study level. We identified 18 eligible articles, reporting 43 effect sizes from 2,998 subjects. The multilevel models showed a significant association between interpersonal distress and mental health in people with a diagnosed anxiety disorder (r=0.37, 95% confidence interval [CI] [0.28, 0.52], d=0.84). We found significant heterogeneity around the estimations (Q(42)=463.29, p<.001) but failed to find significant moderators of the association. Interpersonal distress has a moderate-to-large correlation with non-relational mental health outcomes in people with diagnosed anxiety disorders. More research would be necessary to determine putative moderators of this association.

18F-Fluorodeoxyglucose Positron Emission Tomography as a Marker of Extraocular Muscle Function.

Disentangling girls' chronic absenteeism: Integrating menstrual, parental, and school influences in China.