Anger at emergency department discharge increases chronic pain risk at four months.

Dyslexia is one of the most common learning disabilities that affects a lot of kids in school. Even though more people know about it, many cases still go undiagnosed or don’t get enough help, which leads to academic problems and emotional pain. This paper talks about NeuroLearn, an AI-powered educational platform that aims to fill this gap by allowing early dyslexia screening, personalized learning support, and mental health features that are built into the platform. NeuroLearn wants to give dyslexic students power by creating a digital environment that is holistic, welcoming and easy to use. It does this by using assistive technology, gamified assessments and smart analytics.

ABSTRACT Background: Prolonged Grief Disorder (PGD) is characterised by persistent longing or preoccupation with a deceased loved one, accompanied by intense emotional pain that lasts six-months or more and significantly impairs functioning. While Cognitive Behavioural Therapy (CBT) with a grief focus is effective, access is limited due to high costs and therapist shortages. Guided digital therapy, which delivers psychological support via an app or website with professional guidance, may offer a scalable solution. Building on the success of a guided digital intervention for post-traumatic stress disorder (PTSD), this study evaluates a similar intervention for PGD in a UK-based randomised controlled trial (RCT). Objective: This study aims to assess the acceptability and feasibility of Spring PGD, a co-produced guided digital therapy for PGD, in preparation for a future definitive RCT. Methods: This exploratory, randomised, parallel-group controlled trial will allocate 42 participants in a 1:1 ratio to either immediate access to Spring PGD or a waiting list control group. After 11 weeks, control participants will cross over to receive Spring PGD. The primary outcome measure is the Prolonged Grief 13 Revised (PG-13-R). A nested process evaluation will explore fidelity, adherence, and programme theory through interviews with purposively sampled participants and therapists. Results: Findings will provide preliminary data on the acceptability, engagement, and feasibility of Spring PGD, informing the design of a future definitive RCT. Conclusions: If Spring PGD shows promise, it could offer an accessible, scalable treatment for PGD, particularly in areas with limited access to specialised mental health services. The results will contribute to understanding the potential of guided digital therapy in addressing gaps in PGD treatment.

In recent years, a pattern has emerged in healthcare systems where clinicians and organisations are publicly blamed and punished following tragic events such as suicides or homicides. These responses often reflect more than institutional accountability, they reveal unconscious cultural mechanisms of scapegoating rooted in collective anxiety, grief, and the intolerability of uncertainty. This paper explores scapegoating in healthcare not merely as an ethical or organisational failure, but as a deep-seated psychological and sociocultural process. It aims to illuminate how blame is mobilised as a primitive defence against psychic pain and systemic dysfunction, and to consider the implications for clinical practice, regulation, and public trust. This article employs an interpretive narrative approach, synthesising psychoanalytic and sociological theory to illuminate scapegoating in healthcare. It draws on the work of Freud, Bion, Menzies-Lyth, Douglas, and Girard, and integrates contemporary case material from international healthcare refined through peer discussion to illustrate and develop the theoretical analysis.Key Arguments:Scapegoating functions as a symbolic ritual of emotional discharge that obstructs learning and distorts justice. Organisational investigations and media narratives often collapse systemic complexity into linear blame, serving retributive rather than restorative purposes. Those targeted are frequently among the most vulnerable, socially, professionally, or structurally. The paper argues that only by recognising and resisting these unconscious group dynamics can healthcare systems foster genuine accountability, psychological safety, and real learning.

BackgroundDementia has been a condition I have been aware of from a very young age as I witnessed my grandmother decline, and my mother step into the role as a caregiver, health care director and power of attorney. I was taught the foundation for this process by direct observation of my mother's actions. One aspect of caregiving that isn’t teachable is the emotional pain, anguish, sadness and guilt that often accompanies that role.MethodMy mother started exhibiting symptoms of FTD in 2010, right as I was graduating college. Despite having a family history, it took 8 harrowing years to receive a correct diagnosis and genetic testing. It was then confirmed that my family possesses the MAPT mutation causing bvFTD. My mother passed away in 2021 at the age of 62. Shortly after her passing, I learned that I was a positive carrier for the MAPT gene as well.ResultThis started a new mission by using my past experience, to change the present, in hopes for a future. Currently, my future is not a guarantee, but I will not wait for the next 10 years hoping for a cure by staying quiet. Instead, I am using this time of waiting to use my voice and failed experiences with my mother, to motivate change, understanding and awareness for FTD. Further, I am using the knowledge of my genetic status to engage with the scientists and researchers to help in ways I am capable of driving progress forward. Being honest about the psychosocial implications genetic testing has on a person is that this test doesn’t have to render them useless, but use it to propel them forward.ConclusionI look toward the future with hope knowing that the community fighting this disease is doing everything they can to find a solution. If there isn’t light at the end of my tunnel, I hope the light of the journey I led will burn so bright with persistence, strength and perseverance that my daughters will have the resilience to survive another generation of caregiving. All while they await their unpromised future because of genetic MAPT FTD.

BackgroundChronic pain (CP) and depression frequently co‐occur in the elderly, severely impacting individuals with Alzheimer's disease (AD). Their overlapping neurobiological pathways exacerbate each other, accelerating functional decline and worsening cognitive deficits. Untreated CP and depression may even contribute to dementia progression, while adverse social determinants of health (SDH) further compound their effects. However, the triadic relationship between CP, depression, and AD remains poorly understood, particularly in Latin American (LA) populations, where health disparities and environmental factors may shape outcomes. This study explores their interplay in this underrepresented context.MethodA cohort of 320 older adults, including 146 individuals with AD and 174 healthy controls (HC), was recruited from Chile, Argentina, Mexico, and Peru. The sample was sex‐balanced, and all participants provided informed consent in accordance with the Declaration of Helsinki. Recruitment was facilitated through the Multicenter Consortium to Expand Dementia Research in Latin America (ReDLat), utilizing standardized protocols across all sites. Data collection encompassed neuropsychological assessments, CP and depression evaluations, SDH measures, and demographic factors. CP was assessed through indicators such as pain frequency, intensity, and symptom severity, while depression was evaluated using validated scales.ResultStructural equation modeling (SEM) revealed that depression significantly mediated the relationship between CP and AD. A marginally significant positive association was identified between depression and CP (p = 0.050), and a strong association was observed between depression and AD (p = 0.001). CP, as represented by pain frequency, intensity, and symptom severity, demonstrated high explanatory power (R2 = 97.6%). Depression also showed a strong association with dementia risk (R2 = 96.4%). Furthermore, unfavorable SDH were positively correlated with higher CP and depression scores.ConclusionThese findings underscore the critical role of depression as a mediator in the CP‐AD relationship, which is further exacerbated by adverse SDH in older adults from LA. Addressing social disparities and improving access to mental health and pain management services are essential for mitigating dementia risk and improving overall health outcomes in this vulnerable population.

Disability readings of Susanna Kaysen’s Girl, Interrupted (1993) have so far focused on the challenges the memoir offers to psychiatric authority, as well as the author’s subversion or rejection of her own BPD diagnosis. However, the article argues that a neuroqueer feminist reading of the text, which redirects attention towards the physical body, reveals variations in embodied knowing that foster a nuanced, non-medicalized understanding of neurodiverse sexuality and self-injury. In addressing these areas of critical neglect, the article aligns the memoir with Pamela Moss’s concept of “perching” (2016), arguing that Kaysen criticizes BPD’s authorization of an unjustly gendered form of discrimination while simultaneously demonstrating its value in structuring a particular kind of emotional pain. Her strategic identification with certain BPD symptoms, and her disidentification with their sexist implications, functions to destigmatize BPD through a provocative narrative stance that prioritizes metaphorical framing and images of disgust. Ultimately, the analysis explores Kaysen’s efforts to assert the right of the neurodiverse woman to exist as both a sexual and a rhetorical agent.

Background: An anterior cruciate ligament (ACL) rupture is one of the most psychologically demanding injuries in professional sport. This study aimed to describe a structured psychological intervention conducted during the rehabilitation process following an ACL rupture in a professional female futsal player. Methods: A single-case longitudinal design was implemented with three phases (pre-test, intervention, post-test) across a 12-month rehabilitation period. Psychological assessment was conducted at four key points: initial evaluation, rehabilitation follow-up, medical discharge, and three- and six-month follow-ups. The battery included perfectionism (FMPS), anxiety (STAI), depression (BDI-II), mental health indicators (DASS-21, GHQ-12), sleep quality (PSQI), pain perception and catastrophizing (VAS, PCS), mood states (POMS), psychological readiness for return to play (PRIA-RS), and perceived intervention effectiveness. The program consisted of 15 individual sessions plus a follow-up, combining cognitive–behavioral therapy principles, mindfulness-based techniques (relaxation, body scan, visualization), cognitive restructuring, sleep hygiene, goal setting, problem-solving, and emotional expression strategies. Results: Progressive and sustained improvements were observed in mood states and pain catastrophizing, along with enhanced sleep quality, psychological readiness, and reintegration into competition. Improved overall mental health indicators were also observed, supporting adherence to rehabilitation and return-to-play confidence. Conclusions: This case highlights the relevance of structured psychological intervention as an integral component of injury rehabilitation in professional athletes with ACL rupture, supporting its inclusion in multidisciplinary care and future research to optimize recovery and prevent maladaptive outcomes.

Vipassana meditation (VM), a mindfulness-based practice, has been known to promote good health all the way. Global chronic diseases such as cardiovascular diseases, diabetes, and hypertension often bring physical and mental pain together. Through developing emotional regulation and helping to reduce stress, VM can be used as an alternative medicine in combination with the conventional therapies now used for treating this condition. The aim of the study was to evaluate how VM alters key health measures, including body weight, blood pressure and sugar levels, pulse rate, body mass index (BMI), and emotional state. It also sought to identify changes in emotional spectrum of reactions, such as fear, expectations, and concern before/after the 10-day VM camp. A pre-experimental study was done at Khadavli Vipassana Center, from which time it admitted 156 first-time participants. After excluding four participants, the final sample size was 152. Health indices were assessed before and after the meditation using standard tools, while the emotional spectrum was ascertained with a unstructured questionnaire. Paired samples t-tests and analysis of the content of emotional responses were conducted on the data. There were significant improvements in physical health: the participants' mean weight decreased by 0.8 kg, BMI dropped 0.3 kg/m², and their systolic and diastolic readings were slightly reduced. This was accompanied with reduced random blood sugar (by 8.8 mg/dl). Oxygen saturation (SpO2) increased by 0.92%. Emotional responses demonstrated a marked reduction in fear and a corresponding increase in positive affect, including enhanced feelings of peace and well-being, observed upon completion of the 10-day intervention period. People said that they had found peace of mind and taken away stress. VM has a significant impact on the physical health system and psychological health, which suggests that it may be not only useful in relieving chronic illness but also could become an adjunct to standard medical treatment. Randomized controlled trials are needed to confirm these findings.

ObjectiveThis study seeks to identify brain regions with atypical neural connectivity in individuals suffering from arthritis-related chronic pain, compared to healthy controls, using resting-state functional magnetic resonance imaging (rs-fMRI).MethodsA seed-based connectivity analysis was conducted between the known pain-related regions of interest (ROIs), derived from the MNI (n = 76) and the Automated Anatomical Labeling (AAL) whole brain atlas (n = 116). We examined the connectivity differences in a cohort of 56 osteoarthritis patients and 20 healthy controls. Connectivity matrices were compared using permutation tests corrected for multiple comparisons, identifying statistically significant differences (p < 0.05). Subsequent network analysis resulted in hub scores, identifying the most central and influential brain regions within the altered connectivity network in patients experiencing pain.ResultsThe most significant atypical neural connections in osteoarthritis patients were identified in the cingulate gyrus, insula, inferior parietal lobe, and thalamus, with notable involvement of the occipital lobe, postcentral gyrus, inferior frontal gyrus, orbitofrontal cortex, temporal lobe, hippocampus, and basal ganglia. The thalamus, cingulate gyrus, and insula emerged as key hubs in the chronic pain network, reflecting disrupted sensory, emotional, and cognitive pain processing. No significant connectivity differences were found in the brainstem, cerebellum, superior parietal lobe, precentral gyrus, superior and middle frontal gyri, or amygdala.ConclusionOur data-driven approach reveals specific neural connectivity disruptions in OA, highlighting connections between the cingulate gyrus, temporal lobe, and thalamus. These findings identify specific network disruptions in OA-related pain, offering insight into altered brain connectivity and potential avenues for targeted interventions.Supplementary informationThe online version contains supplementary material available at 10.1186/s12880-025-02009-0.

In Igbo culture, most people believe that death is only a transition. It is only a means of passing from the world of men to the world of spirits. Though many have written on the concept of ancestors and ancestral cults in Africa, few have tried to explore the issue of their possible connection to suffering and pain. This study explored Igbo spirituality, philosophy, and cultural beliefs to unravel the complexities surrounding the potential suffering of ancestors in the “land of the dead” and its implications for the nature of evil and human suffering. The study adopted a qualitative research design. Hence, interviews and surveys were done so as to gather qualitative data on respondents’ views, experiences, or beliefs regarding the potential suffering of ancestors. The findings show that in Igbo culture, people believe that an ancestor could suffer if, for example, he breaks the rules of the “cult of ancestors” or neglects his older ancestors while alive. Some of the ways they can experience suffering include hunger, shame, and exclusion from the cult or gathering of their ancestors, mockery, and emotional pain.

Social exclusion, whether due to physical isolation or the subjective perception of being ignored and unwanted, threatens the fundamental human need for social belonging and is experienced as social pain. While its detrimental effects on mood disorders are well documented, its impact on individuals living with chronic pain remains largely unexplored. This study investigates emotional responses to social exclusion in individuals with chronic pain (CPs) compared to healthy controls (HCs), considering the role of comorbid mood disturbances. It also examines whether behavioral and social functioning, across cognitive and psychological domains, modulate the experience and impact of social exclusion. We recruited 38 CPs and 38 HCs, grouped according to validated cut-offs on the Hospital Anxiety and Depression Scale as follow: 22 Normal-CPs (G1), 16 Altered-CPs (G2), 22 Normal-HCs (G3) and 16 Altered-HCs (G4). All participants completed the Cyberball task, a virtual ball-tossing game designed to simulate social inclusion (control condition) and exclusion (ostracism condition) by manipulating the distribution of ball tosses. After each condition, participants reported their mood, emotional state, and perceived threat to psychological needs. Additional assessments included pain intensity, coping strategies, social functioning, and social cognition. All groups were matched for age, sex, education, and cognitive efficiency. Participants with mood alterations (G2 and G4) reported higher levels of loneliness than the other groups. All CPs showed higher levels of catastrophizing compared to HCs. In the Cyberball task, all participants felt more excluded in the exclusion condition than in the inclusion condition, indicating decreased well-being following ostracism. Notably, only Altered-CPs exhibited blunted emotional reactivity after exclusion. Compared to HCs, Altered-CPs reported lower self-esteem, reduced happiness, and greater negative affect even during the inclusion condition. Correlation analyses revealed that psychological responses to social exclusion in CPs were associated with mood symptoms, catastrophizing, loneliness, and perceived social isolation. These findings suggest that chronic pain, particularly when accompanied by mood disorders, alters emotional processing and increases sensitivity to social context, even in neutral or positive social situations. Addressing social functioning may be crucial for developing personalized and effective treatment strategies for chronic pain.

Background/Aims Obstetric anal sphincter injuries have serious and occasionally lifelong impacts on women's physical and mental health. In the UK, the incidence of these injuries appears to be rising. While there is a significant body of literature on interventions aimed at reducing such injuries, little is known about how women perceive these interventions. The aim of this review was to investigate women's experiences of intrapartum perineal care and how midwifery care can optimise women's birth experience in this respect. Methods This extended literature review searched CINAHL, Medline and Pubmed for studies conducted between 2013 and 2023, with no restrictions on type or region. The data were described narratively, organised into different interventions used. Results A total of 12 articles were included. Episiotomy and obstetric care bundles dominated the literature. Most studies used quantitative methods to investigate women's perceptions, limiting the depth of understanding. Elements of the obstetric anal sphincter injury bundle were not acceptable to many women and may have caused some women long-term emotional and physical pain. Conclusions Further research is needed to determine how midwifery care can optimise women's birth experience with regard to perineal care. Implications for practice Maternity staff must consider the impact of intrapartum perineal care interventions on women's birth experiences.

The clinical and research fields have long relied on a dichotomous classification of adolescent self-harm, rigidly separating non-suicidal self-injury (NSSI) from suicide attempts (SA) based on intent. While operationally convenient for acute risk assessment, this framework oversimplifies the complex clinical reality of mixed and fluctuating intent and obscures the profound developmental and functional links between these behaviors. This perspective article argues for a conceptual shift away from this dichotomy toward a functional continuum model (FCM). The FCM posits that all self-harm behaviors exist on a multidimensional spectrum and are selected from a shared pool of psychological functions—primarily to regulate overwhelming emotional pain (psychache). We reinterpret epidemiological, psychological, and neurobiological evidence to demonstrate that NSSI and SA are not disparate phenomena but rather evolving expressions of the same underlying pathological process. Specifically, NSSI can act as a behavioral training ground that builds the acquired capability for suicide. This model reframes clinical intervention, shifting the focus from mere behavioral cessation to functional rehabilitation—equipping adolescents with adaptive skills to replace the maladaptive functions of self-harm. Finally, we outline future directions for research, including the use of ecological momentary assessment (EMA) and the development of function-specific assessment tools to translate this model into a more precise, dynamic, and compassionate standard of care.

A conceptual framework for the intersection of hyperalgesia and hyperkatifeia in alcohol addiction.

Risk factors of transition from suicidal ideation to suicide attempt: A one-year longitudinal study among hospital-based in- and outpatients.

Economic gains with social pains: Migration patterns and their consequences among internal migrants in China

Neural patterns for empathic versus subjective fear in classifying between generalized anxiety disorder and major depressive disorder.

Introduction: Social connections are vital to human wellbeing, yet interactions often entail misunderstandings and disappointments. When ostracized, people react with strong emotional pain. In this experiment, we investigated whether principles derived from psychotherapy and/or the presence of a friend could mitigate negative reflexive and reflective reactions to ostracism induced using the Cyberball experiment. We tested how participants responded emotionally and their downstream behavioral choices, focusing on selfish and prosocial offers in the Dictator Game. Methods: Participants came to the testing session accompanied by a friend (n = 100) or alone (n = 96) and were randomized to receive a brief psychological flexibility micro-intervention or a control task before playing Cyberball with either one confederate (i.e., friend-condition) or two confederates (i.e., stranger-condition). Results: The Cyberball game resulted in an increase in negative and a decrease in positive affect. Participants who received the intervention showed stronger negative affect reactions than participants in the control condition. The presence of a friend did not alter the reflexive emotional reaction. However, the presence of a friend, but not the intervention, led to significantly more prosocial behavior and less selfish behavior. The interaction of friends-condition and intervention reduced reflective “revenge” behavior following ostracism in the Dictator Game. Discussion: The results demonstrate different reflexive and reflective responses. These findings suggest that the strength of having a friend present was stronger than that of the intervention. Implications are discussed in light of evolutionary, social, and clinical theories.

In recent years, researchers have increasingly focused on the impact of pain on impulsive choice. Some studies suggested that pain leads to shortsightedness, while others found no effect of pain conditions on impulsive choice. Based on the dual system theory of decision-making, this study proposed that moderate levels of social pain might prompt individuals to adopt forward-looking and predictive responses, think more rationally and process relevant information about future rewards through an analytical system to make long-term decisions. Additionally, this study included a framework variable to investigate whether the perception of monetary gain in a gain scenario and loss aversion in a loss scenario could regulate the influence of social pain on impulsive choice. This study found that moderate levels of social pain led to a long-term view, which provided implications for human survival and evolution. Drawing upon the influence of social pain intensity and different frameworks, this study investigated the impact of social pain on impulsive choice, thereby contributing to advancements in pain research.