To identify symptom phenotypes among breast cancer survivors using latent profile analysis (LPA) and examine differences in fear of cancer recurrence (FCR) and social support levels across phenotypes. A multicenter cross-sectional study recruited 357 breast cancer survivors through convenience sampling from three university-affiliated tertiary hospitals in Beijing between November 2024 and January 2025. Symptoms were assessed using the Memorial Symptom Assessment Scale (MSAS), while the Fear of Cancer Recurrence Inventory-Short Form and Social Support Rating Scale measured FCR severity and perceived social support. LPA was performed using severity scores of nine MSAS symptoms to determine the optimal symptom profile model. Three symptom phenotypes were identified: Emotion-reactive (33.9%), Somatic-burden fatigue-pain (13.2%), and Regulated low-symptom (52.9%). Significant differences among these phenotypes were observed in medical burden, treatment method, activities of daily living, and illness cognition (P < 0.05). FCR levels were significantly higher in the Emotion-reactive and Somatic-burden phenotypes compared with the Regulated low-symptom phenotype (p < 0.001, η2p = 0.199), with no difference between the two high-symptom phenotypes. After adjusting for covariates, differences in perceived social support across symptom phenotypes were not significant (p = 0.119, η2p = 0.012). Breast cancer survivors exhibit substantial heterogeneity in symptom phenotypes: those with Emotion-reactive and Somatic-burden fatigue-pain phenotypes experience higher FCR levels, whereas individuals with the Regulated low-symptom phenotype show better symptom control and comparatively lower FCR levels. Integrating symptom phenotypes with FCR may aid rapid identification of high-risk subgroups and support precision nursing in survivorship care.

ABSTRACTBackgroundAdvanced ovarian cancer patients face profound psychosocial challenges in maintaining hope amidst terminal illness and treatment uncertainty. Understanding mechanisms supporting adaptive hope could inform psychosocial interventions.MethodsPhenomenological qualitative study of 16 women with advanced ovarian cancer receiving platinum‐based and/or targeted therapies at a tertiary center in southern China. Semi‐structured interviews conducted across 11‐month observation period; thematic analysis guided by Leventhal’s Common‐Sense Model (CSM).ResultsParticipants demonstrated a triphasic psychosocial adjustment process organized around three interdependent themes: (1) Cognitive Reappraisal of Chronicity: Patients progressively reconceptualized ovarian cancer from acute crisis to manageable chronic condition, anchored in biomedical evidence (stable disease scans) and analogized to familiar chronic illnesses (diabetes). This cognitive restructuring enabled milestone‐based temporal orientation replacing survival countdown framing; (2) Therapeutic Alliance as Hope Anchor: Quality of patient–clinician relationships functioned as relational scaffolding enabling cognitive reappraisal through shared decision‐making, emotional attunement, continuity of care, and hope‐framed honest prognostic communication. Family members facilitated this process through co‐construction of illness identity, milestone tracking, and selective information mediation (81.3% of participants); (3) Strategic Information Management: Patients actively regulated illness‐related information engagement, prioritizing actionable biomarkers over distressing epidemiological statistics, protecting the chronic illness cognitive framework while maintaining decision‐making capacity. The triphasic trajectory progressed from Phase 1 Crisis Cognition (0–3 months) through Phase 2 Cognitive Negotiation (4–10 months) to Phase 3 Adaptive Integration (11+ months). Platinum‐resistant cases reverted to Phase 1, indicating dynamic rather than stable cognitive achievement. All themes directly mapped onto CSM regulatory dimensions (identity, timeline, consequences, controllability, emotional representation), demonstrating empirical alignment between data‐derived constructs and established theoretical architecture.ConclusionsHope maintenance in advanced ovarian cancer depends on integrated cognitive reappraisal, relational security, and behavioral information management—mechanisms actionable through targeted psychosocial intervention. Family‐centered communication and milestone‐based temporal scaffolding warrant clinical implementation pending prospective validation.

Physical symptoms severely impair quality of life (QoL) in patients with gastrointestinal cancers (GICs). Althoughillness acceptance is recognized asa key mediator, the distinct rols of its twodimensions-active acceptanceand negative acceptance-remain underexplored in the symptom-QoL pathway. This study aimed to explore their parallel mediating roles. In this cross-sectional study, 301 inpatients with GICscompleted the MD Anderson Symptom Inventory (MDASI), the 12-item Short Form Health Survey (SF-12), the Illness Cognition Questionnaire-Acceptance subscale (ICQ-A, measuringactive acceptance), and the Medical Coping Modes Questionnaire (MCMQ, measuringnegative acceptance). Parallel mediation analysiswas performed using PROCESS Model 4 with bootstrap resampling (5,000 iterations). Symptom severity was negatively correlated with QoL (r = -0.69, P < 0.01) and active acceptance (r = -0.47, P < 0.01), and positively correlated with negative acceptance (r = 0.56, P < 0.01). Active acceptance was positively (r = 0.60) and negative acceptance negatively (r = -0.60) correlated with QoL (both P < 0.01). Mediation analysis revealed two significant indirect pathways: symptoms → reduced active acceptance → lower QoL, accounting for23.92% of total effect(95% bootstrap CI [-0.068,-0.033]), and symptoms → increased negative acceptance → lower QoL, accounting for25.36% of total effect(95% bootstrap CI [-0.074, -0.035]). Neither confidence interval contained zero. Both active acceptance and negative acceptance independently mediate the relationship between physical symptoms and QoL in patients with GICs. Active acceptance buffers the impact of symptoms, whereas negative acceptance exacerbates it. These findings support integrating psychological interventions that foster active acceptance and mitigate negative acceptanceas a core component of symptom managementto optimize QoL in this population.

To explore the stress adaptation experiences of young and middle-aged couples with colorectal cancer (CRC), specifically examining the interaction between illness cognitions and dyadic coping. Using purposive sampling, semi-structured interviews were conducted with eight pairs of young and middle-aged CRC couples, along with eight patients and five spouses, at a tertiary hospital in Guangzhou from October 2023 to February 2024. Data were analyzed following the six-stage process outlined in the interpretative phenomenological analysis research guidelines, with coding and organization supported by Nvivo 12.0 software to extract hierarchical themes reflecting the interaction process between illness cognitions and dyadic coping in CRC couples. Three themes emerged: (1) Intrapersonal dynamics: positive illness cognitions facilitated adaptive coping strategies, whereas negative cognitions triggered maladaptive coping behaviors. (2) Dyadic mechanisms: a cross-partner influence was observed where one partner's illness cognitions affected the other's coping through specific pathways, including negative resonance, reverse activation, and compensatory adaptive coping. (3) Key moderators: relationship intimacy, communication quality, family resilience, social support, family role identity, and division of labor significantly moderated these interactions. The findings reveal complex bidirectional influences between CRC couples, including compensatory and reverse activation mechanisms. Relationship intimacy, communication quality, family role identity, resilience, and social support play crucial moderating roles in facilitating or hindering adaptive coping. These results underscore the necessity of psychosocial interventions adopting a family systems perspective, focusing on enhancing communication skills, clarifying role division, and strengthening support networks to improve psychological adjustment in cancer-affected families.

Breast cancer imposes substantial psychosocial challenges, with helplessness being a key determinant of reduced quality of life (QoL). Acceptance and Commitment Therapy (ACT) has shown promise in improving psychological flexibility, but its role in targeting helplessness and enhancing QoL in breast cancer patients has not been fully established. This randomized controlled trial (RCT) examined the effects of ACT on helplessness, QoL, and their domains. This two-arm, parallel, single-blind RCT recruited 80 breast cancer patients from a tertiary care center and randomly assigned them to either ACT (n = 40) or treatment-as-usual (TAU, n = 40). Participants completed the Malay Illness Cognition Questionnaire (ICQ-M) and the Functional Assessment of Cancer Therapy (General and Breast Cancer modules) at baseline (T1), post-intervention at 4 weeks (T2), and follow-up at 12 weeks (T3). ACT was delivered in four weekly sessions between T1 and T2. Data were analyzed using repeated-measures analysis of variance (ANOVA). Sixty-six participants completed all assessments (ACT, n = 32; TAU, n = 34). Compared with TAU, ACT significantly reduced helplessness and improved overall QoL and all QoL domains across time points (all p < 0.05). Effects were maintained at 12-week follow-up. ACT is an effective psychosocial intervention for breast cancer patients, producing sustained improvements in QoL partly by reducing helplessness. Integrating ACT into supportive and palliative care may address critical psychological mechanisms affecting patient well-being. ClinicalTrials.gov, NCT05327153. Registered on April 6, 2022.

Latent transition analysis of perceived social support and associations with caregiver burden, illness cognition, and family resilience in pediatric cancer caregivers: A longitudinal study.

This study examines early ECT response and correlations between repeat ECT courses, focusing on patients whose treatment indications changed between courses. Our retrospective observational study included patients from the Institute of Mental Health (Singapore) who underwent at least 2 ECT courses for different indications between March 2017 and May 2023. For each course, the MADRS and BPRS scores were assessed 1 to 2 days before the first ECT session and after the sixth. Pearson correlation and paired t tests were employed to analyze the relationship between responses to the first and second ECT courses, along with 6 additional clinical outcome assessments (GAF, VAS, CGI-S, US, Q-LES-Q-SF, and MoCA) spanning illness severity, quality-of-life, and cognition. Twenty-five patients were included. Psychosis was the most common indication for the first course and mania for the second. Overall, early response rates were 38.9% for the first course and 42.1% for the second, with no significant correlation between responses across courses (P = 0.229). Notably, no patients with catatonia responded to acute treatment in the first course, even when indications changed in the second. Strong correlations were found for global illness severity (CGI-S, r = 0.519, P = 0.023) and quality-of-life (US, r = 0.935, P < 0.001) across the 2 courses. Changes in ECT indications between courses suggested a poorer prognosis, but those who showed improvement in global illness severity and quality-of-life tended to experience similar benefits in subsequent ECT courses. Given the lack of correlation between symptom-specific early response across courses, a poor early response in a previous ECT course should not preclude patients from future ECT when clinically indicated.

High healthcare costs and the poor outcomes associated with dementia have led to the application of new technologies to support management of people with dementia (PwD) in the community. To date, technology-based support for post diagnostic care for PwD has primarily focused on safety monitoring and memory aids, and has largely ignored the need to support PwD to better self-manage their condition. We recently developed and co-designed an innovative digital voice assistant program (Dementia Australia Research Foundation - Project Grant) that delivers personalised two way conversational post-diagnostic care at home. It utilises natural language processing to interpret speech across all languages circumventing barriers using web-based, touch screens or other digital input applications for PwD. We conducted a 12-week co-designed feasibility and pilot randomised controlled trial of a digital voice assistant-delivered personalised rehabilitative program in men and women with early dementia. We recruited 30 community-based adults aged 60-85 years and their carers residing anywhere in Australia with a recent (≤6 months) clinical diagnosis of early dementia (any type). Using a person-centred approach to care, participants and carers consulted with a clinical psychologist to develop personally meaningful goals, in relation to improving cognition, function and/or activities of daily living delivered by our digital voice assistant program. (N=30/30) have shown mean±SD adherence to personalised, digital voice assistant program was 85±23% with no intervention-related adverse events. System usability was rated above average (80.4±16.9 out of 100). Compared with controls, the intervention group significantly improved the Illness Cognition Questionnaire and the Bayar Activities of Daily Living Scale. A home-based rehabilitative intervention delivered and monitored by health professionals using digital voice assistants was feasible for improving memory, cognition and activities of daily living in older adults with dementia. Future large-scale, longer-term studies are warranted to explore the clinical- and cost effectiveness of this digital health approach to supporting self-management of dementia in older adults.

BackgroundGiven the projected increase in the percentage of older adults globally, particularly in highly populated low- and middle-income countries such as Nigeria, there is a pressing need to investigate the role of sociodemographic and clinical factors in the progression of illness and the quality of life of older adults. This study examined the influence of sociodemographic characteristics (age, sex, marital status, educational qualifications, and income status) and clinical factors (duration of symptoms before treatment and illness cognition) on illness progression and quality of life among older adults residing in Ibadan, Nigeria.MethodA Sequential explanatory mixed-methods research design, which combines quantitative and qualitative approaches, was adopted. The quantitative approach involved a self-reported survey of fifty (50) older adults (65 years and above) using psychometrically sound scales. The qualitative aspect adopted a phenomenological theory utilising key informant interviews and thematic analysis among healthcare professionals for further insights. Both phases of the study were conducted at Jericho Specialist Hospital and the Chief Tony Anenih Geriatric Centre in Ibadan. The study’s hypotheses were tested using two-step hierarchical regression analysis at a 0.05 level of statistical significance.ResultsThe findings of the quantitative phase indicate a significant joint influence of clinical factors, such as the duration of symptoms before treatment and illness cognition, on quality of life when perceived social support is controlled for (R = .16, F(3, 46) = 2.82, p < .05). The results of the explanatory phase of the study identified four themes, which further justify the roles of sociodemographic and clinical factors in influencing the progression of illness and the quality of life of older adults. These themes are the issue of ageing, health motivations, treatment outcomes, and the need for stakeholders’ involvement.ConclusionDuration of symptoms before the commencement of treatment and illness cognition play a significant role in the quality of life of older adults. It is recommended that caregivers of older adults and clinicians consider these factors to improve illness progression and quality of life among the elderly. Qualitative inquiry suggests the need for increased public awareness and stakeholder involvement in interventions for the elderly.

BackgroundTo investigate the relationship between stroke patients’ illness perception and rehabilitation exercise adherence, while also exploring the potential mediating influences of frailty and family care, as well as the moderating impact of nutrition.MethodsA total of 307 ischemic stroke patients underwent surveys utilizing the Illness Perception Questionnaire, the Frailty Assessment Scale, the Family APGAR Index, the Rehabilitation Adherence Assessment Scale, and the Mini Nutritional Assessment-Short Form. Pearson correlation analysis was used to examine the associations among the scores of various scales. Following data standardization, mediation and moderation effects were tested using PROCESS v4.1 Models 6 and 83, with the Bootstrap method employed to assess the robustness of these effects.ResultsIllness perception was negatively correlated with rehabilitation exercise adherence (r=−0.532, P<0.01). Both frailty (β=−0.17, 95% CI [−0.26, −0.079]) and family care (β=−0.101, 95% CI [−0.156, −0.052]) had significant independent mediating effects between illness perception and rehabilitation exercise adherence, and the chain mediation effect was also significant (β=−0.087, 95% CI [−0.14, −0.045]), accounting for 68.45% of the total effect. Nutrition moderated the relationship between illness perception and frailty (β=−0.176, P<0.001), with the positive influence of illness perception on frailty weakening as the level of nutrition increased.ConclusionIllness perception is negatively associated with rehabilitation exercise adherence, exacerbating frailty and reducing family care. The impact of illness perception on escalating frailty is primarily manifested through inadequate nutritional status. Therefore, healthcare providers are required to help stroke patients establish correct illness cognitions, prevent the occurrence of frailty, encourage family members to provide sufficient family care, and pay attention to patients’ nutritional status to promote better recovery.

This paper examined the Six Modes of Depression proposed by Zhu Danxi and the theory of Rufus in his On Melancholy, compared and analysed the theories and treatments related to qi depression, phlegm depression, blood depression, food depression, heat depression and dampness depression (Six Modes) and the theory of Rufus on depression. It was found that similarities existed between the Six Modes of Depression and On Melancholy in terms of theories. Both of them paid attention to qi and food in depression while they were in different cultural and medical backgrounds. Additionally, they both had their unique insights into the etiology, pathogenesis and treatment of depression, for instance, they had different views on 'dryness' (Gan in Chinese medicine) and 'wetness' (Shi in Chinese medicine) in depression pathogenesis. Such comparison interprets the commonalities and differences in the understanding of mental illness between the two systems of medicine and provides an important reference for broadening the cognition of mental illness and understanding Chinese medicine and Middle Eastern medicine.

The Old English medical text, Bald's Leechbook, represents the most comprehensive medical treatise written in the vernacular. Book 1 is arranged broadly in the order of head to foot, presenting herbal recipes alongside occasional comments on their efficacy, details of the symptoms and etiology of illnesses. Though in a minority, several recipes involving magic, religion, and symbolism appear. This text provides evidence of cultural views on health and illness, such as the humoral theory of disease etiology, as well as ideas reflecting common human cognitive tendencies, such as the belief in the power of words. The recipes also reveal herbal knowledge, as well as schemas for recipe preparation. This article brings a novel perspective to the text by examining the construction of medical recipes in terms of cognition and culture. It considers how language reflects and directs attentional focus and what this shows about the structure of medical knowledge, including what is considered to be valuable knowledge as well as assumed information. As the text reflects the medical practice of Early Medieval English physicians, this Cultural Linguistic analysis demonstrates how an understanding of language and cognition in historical texts can shine some light on knowledge structures in distinct historical periods.

Relationship between caregiver burden and family resilience among Chinese parents of children with autism spectrum disorder: The mediating role of social support and positive cognition.

This study explored the relationship between illness cognitions (helplessness, acceptance, and perceived benefits) and psychological distress in colorectal cancer couples. A cross-sectional study involving 403 colorectal cancer patients aged 26-59, diagnosed within 5 years, and their spouses in China was conducted from May to September 2023. Self-report questionnaires assessed illness cognitions, dyadic coping, and psychological distress. The results revealed that positive illness cognitions (acceptance and perceived benefits) and helplessness of patients and spouses both had direct and indirect effects on their own psychological distress through dyadic coping. The spouses' coping mediated the relationship between patients' positive illness cognitions and spouses' psychological distress. Patients' coping mediated the association between spouses' positive illness cognitions and patients' psychological distress. The same results were found in the relationships between helplessness and psychological distress. Interventions targeting illness cognitions in colorectal cancer couples may promote better coping and alleviate psychological distress.

BackgroundsPatients with End-Stage Kidney Disease (ESKD) receiving Hemodialysis (HD) face significant psychosocial and physical challenges. Improving their resilience by integrating protective factors is important for effectively managing the difficulties associated with the disease and its treatment. This study intended to identify factors associated with resilience among patients with ESKD receiving HD.MethodsA cross-sectional analytical study was done among 143 patients with ESKD receiving HD in a Tertiary Hospital “A” in Nepal. A non-probability convenience sampling technique was used to select samples. Data were collected following ethical approval through face-to-face interviews. A Nepali version of socio-demographic and clinical characteristics-related questions and five standardized and structured instruments were used to measure resilience, family support, illness cognition, self-efficacy, and self-esteem. Data were analyzed with descriptive and inferential statistics (i.e., correlation and multiple linear regression) using the Statistical Package for Social Science Software version 16.ResultsThe respondents had intermediate (49.0%), low (27.3%), and high (23.7%) levels of resilience. Illness cognition, self-efficacy, and self-esteem had statistically significant positive associations with resilience. However, age was negatively associated with resilience. These associated variables account for 64.0% of the variance in resilience (Adjusted R2 = 0.64).ConclusionsThe highest proportion of patients with ESKD receiving HD had an intermediate level of resilience. Factors such as illness cognition, self-efficacy, and self-esteem play an important role in enhancing resilience while advancing age appears to diminish it. Therefore, focusing on enhancing illness cognition, self-efficacy, and self-esteem with special care on older patients may be an effective strategy for improving resilience in patients with ESKD receiving HD.Trial registrationNot applicable.

PurposeTo explore the self-perceived illness cognition and perception status, as well as the relevant factors among lymphangioleiomyomatosis (LAM) patients.MethodsA web-based questionnaire survey was conducted in September 2023. A total of 121 LAM patients participated (including 16 patients with TSC-LAM), and the survey collected general demographic information, responses to a disease cognition questionnaire, and a simplified disease perception questionnaire.ResultsLAM patients have a higher level of negative illness cognition and a lower level of positive illness cognition, specifically characterized by helplessness (15.74 ± 4.68 points), acceptance (16.00 ± 3.28 points), and perceived benefits (16.92 ± 3.86 points). Single-factor analysis of variance found significant correlations between cultural level, age, family average monthly income, use of rapamycin, use of home oxygen therapy, hospitalization frequency, disease duration, severity of respiratory distress, activity limitation, and the helplessness score of LAM patients (p ≤ 0.05); the number of children was significantly associated with acceptance scores of LAM patients (p ≤ 0.05); and whether surgery had been performed was significantly associated with acceptance and perceived benefits scores of LAM patients (p ≤ 0.05). Disease duration and activity limitation entered the regression equation for helplessness dimension, while whether surgery had been performed entered the regression equation for perceived benefits dimension, but no factor entered the regression equation for acceptance dimension. Applying the same analysis to disease perception, we found that the average score of the Illness Perception Questionnaire was 45.43 ± 8.97, with lower scores in the reverse-scored items of individual control, treatment, and understanding.ConclusionsLAM patients exhibit higher levels of helplessness, particularly among those with longer disease duration and greater activity limitations, leading to a more negative perception of the disease. Additionally, patients who have undergone surgical procedures tend to perceive fewer benefits. Furthermore, there is a significant correlation between illness perception and factors such as rapamycin usage, home oxygen therapy, disease duration and activity limitations caused by LAM. This indicates that clinical healthcare providers should pay more attention to LAM patients and their associated groups, providing both informational and psychological support.

Irritable bowel syndrome [IBS] is classified as a disorder of gut-brain interaction related to stress with no curative option. Heart rate variability biofeedback [HRV-BFB] is a non-drug therapy recently suggested to be relevant in reducing both autonomic nervous system [ANS] dysregulations and psychiatric comorbidities. Nevertheless, empirical evidence is still scarce and only a few studies have tested HRV-BFB in adults with IBS. Our aims were therefore to examine the effectiveness of HRV-BFB training on the psychophysiological states of 29 adults with IBS. The study took place in three sessions, spaced 24days apart. In all sessions, participants completed self-report questionnaires to assess their psychological state (affectivity, anxiety, depression, perceived stress, coping strategy, life satisfaction, illness cognitions), ANS measurements were then recorded of them at rest, during completion of a mental task (reactivity), and while in recovery following this task. The first 24-day period was a control period without any practice, and the second was an intervention period with HRV-BFB. Participants practiced HRV-BFB daily for 5min, three times a day, for 24days. We found that HRV-BFB reduced psychological distress and the feeling of helplessness, and led to a decrease in sympathetic reactivity during the mental task. Our findings support the potential relevance of HRV-BFB to manage mental health in adults with IBS.

Purpose To explore associations of environmental and personal factors, participation, and health-related quality of life (HR-QoL) with physical behavior (PB) after subarachnoid hemorrhage (SAH). Materials and Methods PB, expressed in duration and distribution of physical activity (PA; walking, running, cycling) and sedentary behavior (SB; lying/sitting) and PA intensity was assessed with the Activ8 accelerometer during 7 days. Environmental and personal factors (social influence, health-condition, illness-perception, self-efficacy, fatigue, mood, kinesiophobia, cognition, coping, sleep), participation and HR-QoL, were assessed with validated questionnaires. Correlation analyses were conducted. Results In total 39 SAH survivors participated on average 9.6 months post-SAH onset, mean age was 53.2 years (SD = 13.2) and 59% were women. Moderate correlations were found (r = 0.300-0.500, p < 0.05): worse illness-perception, cognition, fatigue, social support, participation, and HR-QoL were associated with worse PA outcomes. Additionally, higher age, unemployment, smoking, longer hospital stay, aneurysmal-SAH, and discharge to outpatient rehabilitation were associated with worse PA outcomes. Worse cognition, participation, smoking, more severe SAH and longer hospital stay were associated with worse SB outcomes. Conclusions Targeting illness perception, cognition, fatigue, and social support, might improve PB post-SAH, which may improve participation and HR-QoL. In smokers (former/current), unemployed, older or more severely affected individuals, improving PB might be more challenging.

Measuring treatment expectations using the Treatment Expectations in Chronic Pain (TEC) scale has the potential to help clinicians and researchers better understand the role that treatment expectations play within the framework of multimodal pain management settings. The purpose of this study is to determine the cross-cultural adaptation, construct validity and reliability of the TEC Scale in the Turkish language. The study included 191 volunteers aged 22-65 with chronic musculoskeletal diseases. This study composed of a six-stage cross-cultural adaptation process, which included translation, translation synthesis, back-translation, expert committee review, pre-testing and documentation submission. The Positivity Scale and Illness Cognition Questionnaire were used to measure convergent validity while the Hospital Anxiety and Depression Scale was used to test divergent validity. The psychometric properties of the Turkish version of the TEC scale was examined by confirmatory factor analysis (CFA). Scale's internal consistency was examined using Cronbach's alpha. Pearson correlation coefficients were utilized to evaluate both convergent and divergent validity. The significance level was set at p < .05. The results of the CFA showed that factor structure of predicted subscale fitted well the data (x2/df = 3,07;CFI = 0,91,IFI = 0,91 TLI = 0,87,RMSEA = 0,10). The results of the CFA indicated that factor structure of ideal subscale fitted well with the data (x2/df = 2,38;CFI = 0,92,IFI = 0,93,TLI = 0,90,RMSEA = 0,08). Both subscales of the TEC were strongly correlated. The predicted subscale had moderate relationships to depression, anxiety, and positivity (r=-0.37 to r = 0.55) but poor correlations with measures of acceptance, perceived benefits and helplessness (r=-0.24 to 0.35). The ideal subscale had moderate correlations with measures of positivity (r = 0.36) and depression (r=-0.38) but poor correlations with measures of acceptance, perceived benefits helplessness and anxiety (r = 0.14). The Turkish version of the TEC scale is acceptable, valid, and reliable for use in Turkish patients with chronic musculoskeletal pain in physiotherapy outpatient practice.

Background: Current treatments for adolescents with eating disorders (ED) show limited effectiveness, emphasizing the need for enhanced therapeutic approaches. Cognitive behavioral therapy (CBT) has emerged as a potential alternative. A derivative of this approach, group cognitive behavioral therapy (G-CBT), has been shown to reduce treatment costs and increase treatment accessibility when compared to CBT. This program evaluation aimed to assess the effectiveness of G-CBT in adolescents and young adults diagnosed with anorexia nervosa (AN) or bulimia nervosa (BN) and experiencing comorbid anxiety and depression within a Canadian mental health facility. The specific objectives were to determine if participants increased their knowledge about eating normalization and coping strategies after participating in the eating disorder (ED) treatment program and examine if participants experienced changes in eating-disordered behavior, anxiety, and mental health.Methods: We conducted a program evaluation using secondary data collected at admission and discharge from 44 adolescents and young adults (16-39 years) with AN or BN participating in the ED program at a Canadian health center. Outcome measures were eating psychopathology, depression, anxiety, and illness cognitions assessed using validated tools: Eating Disorder Examination Questionnaire (EDE-Q), Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder-7 (GAD-7), and Illness Cognition Scale (ICS).Results: The mean age of participants was 24.1 years (standard deviation (SD) = 5.8). All outcome measures showed statistically significant improvement from admission to discharge (p < 0.001). Specifically, subscales of the EDE-Q (eating concern, weight concern, shape concern, and restraint) and the global score indicated a significant reduction in ED behaviors (p < 0.001).Conclusion: Findings suggest that G-CBT is effective in reducing eating-disordered behavior, depression, anxiety, and maladaptive illness cognitions in adolescents and young adults with EDs. These results underscore the potential of G-CBT to address both behavioral and psychological aspects of ED recovery, although further studies with control groups are warranted to confirm these findings.