Psychological Risk Factors Research Articles

Development, Validation, and Visualization of a Web-Based Nomogram to Predict the Risk of Psychological Distress in Patients Undergoing Chemotherapy After Breast Cancer Surgery

Background Psychological distress of postoperative chemotherapy patients with breast cancer is significant and has a serious impact on their quality of survival. Risk prediction models can efficiently assess patients’ psychological distress and risk factors. Objectives To investigate the factors influencing psychological distress in postoperative chemotherapy patients with breast cancer and construct a nomogram model to predict the occurrence of psychological distress in patients. Methods Two hundred forty-seven women in treatment for breast cancer who were postoperative and receiving chemotherapy were recruited. Participants completed a distress management screening measure, a numerical rating scale, the Pittsburgh Sleep Quality Index, and demographic and clinical items. Results Experiencing significant psychological distress was reported by 65.6% of participants. The psychological distress risk prediction model included 5 variables: financial problems, appearance/shape, distant metastases, the Numerical Rating Scale Pain score, and fatigue. A web calculator was designed based on the model (https://77nomogram.shinyapps.io/dynnomapp/). Conclusions This study found that financial and appearance/shape problems, distant metastases, pain scores, and fatigue were predictors of greater psychological distress in women undergoing chemotherapy after breast cancer surgery. The model constructed in this study has good predictive efficacy. Implications for practice This web-based nomogram model can help healthcare professionals quickly assess the likelihood of psychological distress in patients and screen for risk factors for psychological distress.

Temporal summation of pain in sickle cell disease: comparison of adolescents and young adults with chronic vs. infrequent pain.

This study examined the role of central sensitization in the experience of pain among adolescents and young adults with the most severe genotypes of sickle cell disease (SCD). We hypothesized that adolescents and young adults with chronic SCD pain would demonstrate a higher perceptual response to repeated stimulation of identical intensity (i.e., temporal summation of pain, TSP) compared to counterparts with infrequent pain. We also examined psychological risk factors that can impact pain sensitivity. Patients ages 12-21 years, diagnosed with SCD type Hb SS or Hb S Beta0Thalasemia, who reported infrequent pain (≤2 pain days/month; n = 25) or met AAPT criteria for chronic SCD pain (n = 25) were enrolled. Patients were age- and sex-matched, with similar proportions receiving chronic blood transfusion and hydroxyurea. Patients completed static quantitative sensory testing (QST) and dynamic TSP testing to assess pain sensitivity. Patients and a caregiver completed demographic and psychological measures (depression, anxiety, pain interference, pain catastrophizing). Simple slope analysis revealed differentially elevated heat TSP among adolescents and young adults with chronic SCD pain (b = 3.14, p = .002) but not those with infrequent pain (b = 0.45, p = .61). Faster habituation was further observed for those with chronic compared to infrequent pain. Adolescents and young adults with chronic pain reported more frequent depression, anxiety, and pain interference symptoms; however, psychological symptoms and pain catastrophizing were not associated with QST or TSP (ps >.17). Current results demonstrate that a well-established, prognostic, QST risk marker (i.e., TSP) may distinguish chronic from infrequent pain subgroups of adolescents and young adults with SCD.

Limitations of the investor information confirmation form in capturing investor risk propensity

The financial consumer protection laws in South Korea emphasize the principle of suitability to ensure the well-being of the financial consumer. To adhere to these regulations, financial institutions utilize the behavioral risk assessment (BRA) form to assess investors’ characteristics. This study evaluates the effectiveness of these forms in capturing investor risk propensities, using Economic Risk Attitude (ERA), Instrumental Risk-Taking (IRT), and Stimulating Risk-Taking (SRT) as comparative benchmarks. Unlike previous research focused mainly on financial risk attitudes, this study introduces a multidimensional approach that includes psychological factors like SRT, offering a more comprehensive understanding of investor behavior. Findings reveal that while BRA assessments correlate with ERA and IRT, they fail to capture the excitement-driven aspects of risk propensity represented by SRT, indicating that BRA forms may inadequately reflect investors' risk profiles. This underscores the need for refining BRA forms by integrating psychological risk factors, advocating for a multidimensional framework that enhances consumer protection and enables more tailored investment strategies. The study contributes actionable insights for financial consumer protection and sets the stage for integrating advanced technologies, such as AI, to further refine risk assessments.

Predictive value of Type D personality combined with unhealthy cardiovascular behaviors for the long-term adverse cardiovascular events in ACS patients

Abstract Background Acute coronary syndrome (ACS) has become a major public health problem worldwide due to its high morbidity and mortality. In addition to traditional risk factors, psychosocial factors play an important role in the development of ACS.Type D personality, as a combination of social inhibition and negative affect, has been defined as a psychological risk factor for coronary heart disease by the European Society of Cardiology.Meanwhile, ACS patients with Type D personality may have behaviors such as unhealthy dietary behaviors, less regular physical activity, and poorer self-management behaviors. Then, whether the combination of Type D personality and poor cardiovascular health behaviors can increase the risk of poor prognosis in patients with ACS requires further research. Purpose The aim of this study was to investigate the effect of Type D personality combined with poor cardiovascular health behaviors on long-term major adverse cardiovascular events(MACE) in patients with ACS. Methods A total of 18631 patients diagnosed with ACS between January 2017 and July 2023 were included in this study. Type D personality, cardiovascular health behaviors (smoking cessation, physical activity, average sleep duration at night, dietary assessment index, BMI, lipids, blood glucose, blood pressure) were assessed during the admission period, and were divided into poor, general, and ideal cardiovascular health with a cut-off score of 50 and 80.The binary logistic regression analysis was used to assese the effect of Type D personality combined with cardiovascular health score on the occurrence of MACE (stroke, reinfarction, revascularization, all-cause death). Results The median follow-up in this study was 37 months, and we found that a total of 3750 people had MACE during the follow-up period. The logistic regression result showed that compared with Type D personality (-) and cardiovascular health behaviors (poor) group, Type D personality (+) and cardiovascular health behaviors (poor) group (OR=1.451, 95%CI=1.055-1.995,P=0.022), Type D personality (+) and cardiovascular health behaviors (general) group (OR=1.425, 95%CI=1.092-1.858,P=0.009), Type D personality (-) cardiovascular health behavior (poor) group (OR=1.301, 95%CI=1.013-1.670, P=0.039) were independent risk factors for the occurrence of further adverse cardiovascular events. Conclusion Type D personality combined with unhealthy cardiovascular behavior individuals may be at high risk for MACE. Therefore, early assessment of Type D personality and cardiovascular health behaviors are needed, thereby reducing the incidence of MACE in ACS patients.

Process evaluation of a randomised controlled trial - prevention of sickness absence through early identification and rehabilitation of at-risk patients with musculoskeletal disorders (PREVSAM)

BackgroundMusculoskeletal disorders are commonly treated in primary healthcare and may, if not treated adequately, entail a risk for long-term disability and sickness absence. A team-based rehabilitation intervention (PREVention of Sickness Absence for Musculoskeletal disorders, PREVSAM) was evaluated in a randomised controlled trial. The purpose of this study was to evaluate the process of implementing the PREVSAM model in primary care rehabilitation.MethodsThis process evaluation was conducted alongside the trial, collecting quantitative and qualitative data to evaluate how the PREVSAM model was implemented, mechanisms of impact, and contextual factors. Acceptability, feasibility, appropriateness, adaptations, training and support, resources, recruitment, reach, retention, dose, fidelity, and readiness for change were investigated. Qualitative data were collected from healthcare professionals and patients.ResultsEight of 22 invited rehabilitation clinics (36%) and 28 of 54 healthcare professionals (52%) were included in the PREVSAM trial and this process evaluation. Of 507 eligible patients, 261 (51%) were included. Of those, 134 were randomised to the intervention and 129 (96%) were retained. Twelve healthcare professionals and 15 patients participated in the qualitative evaluations. The model’s essential components; individual assessments and structured, team-based rehabilitation with clear division of responsibilities agreed in a joint health plan; were generally delivered according to protocol. The optional components early access to psychological treatment and workplace contact were delivered to a lesser extent. Perceived acceptability, feasibility, and appropriateness of the PREVSAM model were moderate to high. Several contextual barriers, in the form of missing prerequisites, affected the implementation. Qualitative data showed that the model, with its holistic view, was appreciated by both healthcare professionals and patients.ConclusionsThis process evaluation suggests that PREVSAM is acceptable, feasible and appropriate for patients with MSDs reporting psychological risk factors associated with increased risk for sickness absence. While essential components were implemented with fidelity for most patients, optional components were not. This variability reflects the complexity of the model, its mandatory and optional components, contextual barriers, and the person-centred approach meeting individual patient needs. As all model components were not delivered to all patients, the intervention may have been too similar to treatment as usual to detect differences on a group level. A limitation of the study is that half of the participating rehabilitation clinics withdrew prematurely.

Factors influencing sleep duration among middle-aged women in Korea: insights from the community health survey.

This study aimed to investigate the influence of demographic and health-related characteristics on sleep duration among middle-aged women aged 44-64. Utilizing raw data from the 2022 Community Health Survey, a cross-sectional analysis was conducted. The study included middle-aged women who participated in the survey, with data collected through structured interviews. χ2 tests and logistic regression analysis were employed to assess associations between sleep duration and demographic as well as health-related factors. The findings revealed that sleep duration in middle-aged women was significantly associated with multiple factors. Age (p < .001), spouse status (p = .001), occupation (p < .001), self-rated health (p = .004), perceived stress (p < .001), depression (p < .001), cognitive impairment (p = .009), unmet medical needs (p = .034), current cigarette smoking (p = .001), and binge drinking (p = .006) were all identified as important determinants of sleep duration. The results highlight the need for targeted interventions that address both health and psychological risk factors contributing to sleep disturbances among middle-aged women. An integrated approach, considering these factors, is essential to improve sleep health in this vulnerable population.

Effects of Virtual Reality Therapy for Patients With Breast Cancer During Chemotherapy: Randomized Controlled Trial.

Patients with breast cancer endure high levels of psychological and physical pain. Virtual reality (VR) may be an acceptable, safe intervention to alleviate the negative emotions and pain of patients with cancer. We aimed to test the long-term effects of VR on psychological distress and quality of life (QOL) with traditional care in Chinese patients with breast cancer. We also explored the intervention mechanism and the acceptability of VR. A total of 327 eligible participants were randomly assigned to a VR intervention group or a control group. The Distress Thermometer, QLQ-C30 (Quality of Life Questionnaire version 3.0), and Virtual Reality Symptom Questionnaire were assessed at baseline, postintervention (3 mo), and follow-up (6 mo). Analysis followed the intention-to-treat (ITT) principle. The generalized estimating equations model was used to analyze the longitudinal data, and the PROCESS macro was used to analyze the mediating effect. Compared with the control group, patients with breast cancer in the VR group had lower distress scores (P=.007), and higher health-related QOL scores (physical, role, emotional, cognitive, and social functioning) after 6 months (P<.05). Psychological distress had mediating effects on the longitudinal association between VR and the health-related QOL (indirect effect=4.572-6.672, all P<.05). VR intervention technology may help reduce distress and improve QOL for patients with breast cancer over time. By incorporating a mediating analysis, we showed that the QOL benefits of VR intervention was manifested through positive effects on psychological distress risk factors.

Psychological Predictors of Recidivism for Intimate Partner Violence Perpetrators: A Systematic Scoping Review.

Theoretical accounts of recidivistic intimate partner violence (IPV) continue to differ considerably in relation to the relative weight given to psychological risk factors. A systematic overview of studies that have established psychological predictors of reoffending is currently lacking. This study aimed to identify and provide an overview of studies examining various psychological factors associated with IPV perpetration patterns. A systematic search of research conducted from 1945 to 2024 was carried out on PsycINFO, PubMed, and PILOTS. The inclusion criteria were that studies must not use self-reported reoffending data only, must use a criminal justice sample, must be longitudinal, participants must be over 17 years of age, and that studies must be published in the English language and peer reviewed. A total of 25 longitudinal studies examining individual psychological factors, proposed as potential predictors of IPV reoffending, were eligible. The identified factors were grouped into five categories: personality, anger and hostility, beliefs, attitudes and motivation, neurocognitive deficits and trauma (i.e., family of origin abuse/post-traumatic stress disorder). The current systematic scoping review found that the most-researched psychological predictor of IPV recidivism was personality. While studies vary in relation to the personality traits or disorders that contribute most to the likelihood of reoffending, in general, personality assessment appears to be a promising tool in predicting reoffending. Anger, childhood maltreatment, post-traumatic stress disorder (PTSD), implicit attitudes, and neurocognitive deficits were also identified as predictors of IPV recidivism. Methodological issues were found to be present across studies.

The Cosmetic Readiness Questionnaire (CRQ): Validation of a Pre-Operative Psychological Screening Tool for Aesthetic Procedures.

Several psychological risk factors are associated with patient dissatisfaction with aesthetic procedures, such as body dysmorphic disorder (BDD), unmanaged mental health concerns or unrealistic expectations. Identifying these risks via preoperative screening may protect patients from adverse psychological outcomes and provide reputational or legal protection for practitioners. This study aimed to further develop and validate the Cosmetic Readiness Questionnaire (CRQ), a comprehensive psychological screening tool to assess patient suitability for surgical and non-surgical aesthetic procedures. The CRQ was validated across two studies in clinical contexts, examining structural and construct validity in a sample of 8031 individuals who completed the CRQ as part of routine clinical care. In a further sample (n = 574), criterion validity was explored through the relationship between the CRQ and dissatisfaction with past aesthetic treatments. Risk category cut-off scores were developed. Results supported the reliability and validity of a five-factor CRQ which measures Body Dysmorphia, Psychological Distress, Self-Criticism, Unrealistic Expectations and Lack of Openness. High scorers on the CRQ were 78% more likely to report dissatisfaction with a past cosmetic procedure than low scorers. The CRQ is a comprehensive and valid screening measure to identify patients who may require further psychological assessment or additional support prior to aesthetic treatment. Instructions are provided on how to implement the CRQ in clinical practice.

Prevalence and risk factors of low back pain in military personnel: a systematic review.

Low back pain (LBP) has a significant impact on the general population, especially on military personnel. This study aimed to systematically review the relevant literature to determine the prevalence and risk factors of low back pain among military personnel from different military occupational categories. For this systematic review, we searched Embase, PubMed, and Cochrane. We performed study selection, data extraction, and assessed the quality of the evidence using the adapted risk of bias assessment tool by Hoy et al. This review process was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. This study is registered on the Center for Open Science, registration DOI: 10.17605/OSF.IO/HRGE8. Out of 860 papers, 19 studies met the inclusion criteria. More than 360 000 military people with lumbar pain situation were considered for inclusion in this systematic review. The 1-year prevalence of LBP could be up to 81.7% in the Army, 5.2% in the Marines, and 48.1% in the Air Force. Age (OR = 0.494-2.89), history of LBP (OR = 2.2-8.91), and sedentary position (OR = 0.55-3.63) were the most common physical, sociodemographic, and occupational risk factors, respectively. Low back pain was prevalent among military personnel. There was heterogeneity in studies and a significant difference in prevalence and incidence across various occupational categories. Physical, sociodemographic, and occupational risk factors were researched more than psychological risk factors in the military.

Paternal perinatal depression: underestimation of the disorder, its clinical and classificatory entanglements, and therapeutic alternatives

In the perinatal period, fathers may also suffer from depression, referred to as paternal perinatal depression. Studies have shown that the prevalence of paternal perinatal depression is considerably higher than in the general adult population. For example, a meta-analysis showed that the prevalence of depression among fathers was 9.76% during the prenatal period and 8.75% during the postpartum year.1 Paternal perinatal depression can deteriorate the marital relationship and generate psychosocial and behavioral problems in the offspring (Ramchandani et al., 2021).2 However, paternal perinatal depression has received comparatively little clinical attention. A review of the literature on this subject will list the biological, psychological and social risk factors for this condition, which include a history of depression or anxiety disorders, lack of social support, conflicts in the couple's relationship, economic and labor problems. The clinical characteristics of depression share similarities with depressions in other periods of life, and there are differential clinical features, such as anger, aggressiveness, somatic symptoms and greater comorbidity with substance abuse disorder. Early detection with scales such as the Edinburgh, Gotland and PAPA and the appropriate approach are fundamental to mitigate the effects of paternal perinatal depression. Psychotherapeutic support, psychoeducation of the disorder, and self-care tools can be part of a comprehensive approach to help parents experiencing this condition. In conclusion, the proposal to include this disorder within the parental perinatal affective disorders, as proposed by the author Baldoni,3 given the level of overlap that it usually has with other comorbid conditions (anxiety, alcohol abuse, impulse control disorders) and high frequency of masked symptoms, goes in the direction to give the attention it deserves for early detection and provide adequate support and treatment.

Physical and Psychological risk and protective factors for injury, illness, and tactical performance in law enforcement recruits: a systematic review

Physical and Psychological risk and protective factors for injury, illness, and tactical performance in law enforcement recruits: a systematic review

Psychological risk factors and cardiovascular disease.

Cardiovascular diseases (CVDs) are a leading cause of death worldwide, emerging from a combination of several factors. The aim of this review is to define the psychological factors that are significant in the development and progression of these disorders. Studies published through 2023 concerning adults with psychological vulnerability factors and/or cardiovascular disease were selected through searches of PubMed, PsychINFO, Science Direct, and Google Scholar. Psychological stress may influence CVD, in combination with other risk factors, or it can act independently, as in cases of workplace stress, post-traumatic stress disorder, Takotsubo syndrome and bereavement. Coping strategies, anxiety and depression have also been identified as relevant psychological factors in cardiac patients. Adverse childhood experiences are linked to a reduced quality of life and have been identified as significant risk factors for the development of acquired CVDs. This review demonstrates that several psychological factors affect cardiovascular function. An in-depth study of the psychological correlates of CVDs would allow healthcare professionals to design more effective prevention and intervention programs.

Characteristics and Management Outcome of Vaginismus

Vaginismus, a common pelvic floor dysfunction characterized by involuntary vaginal muscle spasms, often impedes sexual intercourse and is exacerbated by cultural barriers in Indonesia, where sexual issues are taboo. Healthcare providers' lack of knowledge contributes to patient dissatisfaction with treatments. This study aimed to evaluate risk factors and management outcomes in 36 Indonesian women with vaginismus. Primary data, including demographic details, vaginismus history, severity, and FSFI-6 scores, were collected through interviews and medical records. Results showed that 94.4% of participants were under 40 years old, 66.7% had been married for over two years, and 94.5% were university graduates. Most had normal BMI and no significant illness history. Among them, 77.8% had no history of penetration, with the majority having no medical, social, or psychological risk factor yet reporting good sexual satisfaction. Self-dilation was the primary treatment, with a 29.41% success rate in achieving penetration. Younger age and higher education were notable characteristics among cases, suggesting a need for increased disease awareness. The study highlights that while traditional risk factors were not predominant, self-dilation therapy yielded moderate success, and patient satisfaction with sexual and interpersonal relationships remained high.

Self-regulation deficiencies and perceived problematic online pornography use among young Chinese women: The role of self-acceptance

Although perceived problematic online pornography use has attracted attention, how this phenomenon manifests among females is not well understood. Based on self-regulation theory and the Interaction of Person-Affect-Cognition-Execution model, this study explored the prospective effects of behavioral (i.e., pornography use frequency) and psychological (i.e., difficulties in engaging in goal-directed behaviors) risk factors on perceived problematic online pornography use. Furthermore, it examined the direct and moderating roles of self-acceptance in these associations. Analysis of anonymous survey data of 559 young Chinese women (mean age = 19.86 years) collected at two time points over a one-year interval revealed that both Time 1 (T1) pornography use frequency and T1 difficulties in engaging in goal-directed behaviors were positively correlated, whereas T1 self-acceptance was negatively correlated with perceived problematic online pornography use assessed at both T1 and Time 2 (T2). Moreover, T1 self-acceptance moderated the prospective effect of T1 pornography use frequency on T2 perceived problematic online pornography use after the hierarchical regression model controlled for T1 perceived problematic online pornography use. This prospective effect was weaker for individuals with high rather than low self-acceptance. Our findings advance knowledge of the complex underlying psychological mechanisms of perceived problematic online pornography use by providing evidence of both the direct and/or moderated roles of pornography use frequency, difficulties in engaging in goal-directed behavior, and self-acceptance in these mechanisms. Our study also offers a novel perspective and potential for implementing preventive and therapeutic interventions based on acceptance and commitment therapy among young women with problematic pornography use.

Effects of Physical Therapy Integrated with Dance/Movement Therapy on Heart Rate Variability and Fall-Related Variables: A Preliminary Controlled Trial

AbstractFalls among older adults are influenced by both physical and psychological risk factors. This pilot study specifically examined the impact of integrating Dance/Movement Therapy (DMT) into a regimen of physical therapy exercises (PTE) for fall prevention. The primary objectives included examining the effect of post-PTE+DMT intervention on heart rate variability (HRV), a psychophysiological marker, and fall risk factors. Additionally, this study aimed to examine correlations between HRV and levels of fall risk. Eight community-dwelling older adults (median = 83 [interquartile ranges: 80.5–85.75]) from a day center for senior citizens were randomly assigned to either a PTE+DMT group or a PTE group. A post intervention battery of HRV, physical and psychological fall risk assessments, was conducted. The results of nonparametric analysis demonstrated the potential impact of the PTE+DMT intervention in improving balance and self-efficacy measures related to falls when compared to participation in PTE alone. No statistically significant differences were observed between the groups in term of HRV and other physical and psychological fall risk factors. The emerging trends in the associations between HRV, fall risk, and balance levels suggest the potential utility of HRV as an objective psychophysiological marker for assessing fall risk levels. Moreover, the results underscore the potential advantages of interventions that integrate both physical and psychological components to mitigate fall risk in older adults, emphasizing the intricate mind–body connection.The ClinicalTrials.gov ID: NCT05948735, July 7, 2023.

Creating an intergenerational cohort of mothers and their children using administrative data from health, education and social care in England (ECHILD)

ObjectiveMaternal physical, psychological, and social risk factors extend beyond impacting maternal wellbeing to significantly influence their children. Sibling dynamics also play a crucial role in individual development, health and wellbeing. We established a national intergenerational cohort of mothers and their children using administrative health, education and social care data in England (ECHILD). ApproachWe extracted 14.5 million baby records from hospital records for births between 1997-2022 and linked 13.6 million (94.1%) of these to delivery records of 8.0 million mothers using a validated probabilistic algorithm. We then identified clusters of mothers with only-children and mothers with sibling-children by identifying livebirths linked to the same mother. ResultsThe cohort captures 87.7% of all livebirths in England and includes mothers aged up to 37 and their children. We identified 4,086,648 mother-only-child clusters and 3,957,856 mother-sibling-children clusters. Compared with only-children, children with siblings were more likely to live in more deprived areas and have younger mothers, but were less likely to be overdue births (&gt;=42 weeks gestation), or to have very low birth weight (&lt;1500g). Among the mother-sibling-children clusters, sibship sizes varied between 2-15, with a mean of 2.4 children per mother. The median birth interval was 3.0 years. Conclusions and ImplicationsThis national cohort of 8 million mothers and their children (including 4.1 million mother-only-child and 4.0 million mother-sibling-children clusters) linked to hospital, education and social care data is an important resource for investigating the effects of maternal exposures, sibling dynamics and their interplay on individual development, health and wellbeing.

Virtual Reality for Subacute Pain After Orthopedic Traumatic Musculoskeletal Injuries: A Mixed Methods Pilot Study.

Acute orthopedic traumatic musculoskeletal injuries are prevalent, costly, and often lead to persistent pain and functional limitations. Psychological risk factors (eg, pain catastrophizing and anxiety) exacerbate these outcomes but are often overlooked in acute orthopedic care. Addressing gaps in current treatment approaches, this mixed-methods pilot study explored the use of a therapeutic virtual reality (VR; RelieVRx ), integrating principles of mindfulness and cognitive-behavioral therapy, for pain self-management at home following orthopedic injury. We enrolled 10 adults with acute orthopedic injuries and elevated pain catastrophizing or pain anxiety from Level 1 Trauma Clinics within the Mass General Brigham health care system. Participants completed daily RelieVRx sessions at home for 8 weeks, which included pain education, relaxation, mindfulness, games, and dynamic breathing biofeedback. Primary outcomes were a priori feasibility, appropriateness, acceptability, satisfaction, and safety. Secondary outcomes were pre-post measures of pain, physical function, sleep, depression, and hypothesized mechanisms (pain self-efficacy, mindfulness, and coping). The VR and study procedures met or exceeded all benchmarks. We observed preliminary improvements in pain, physical functioning, sleep, depression, and mechanisms. Qualitative exit interviews confirmed high satisfaction with RelieVRx and yielded recommendations for promoting VR-based trials with orthopedic patients. The results support a larger randomized clinical trial of RelieVRx versus a sham placebo control to replicate the findings and explore mechanisms. There is potential for self-guided VR to promote evidence-based pain management strategies and address the critical mental health care gap for patients following acute orthopedic injuries.

A systematic review and Bayesian meta-analysis of 30 years of stress generation research: Clinical, psychological, and sociodemographic risk and protective factors for prospective negative life events.

Stress generation posits that (a) individuals at-risk for psychopathology may inadvertently experience higher rates of prospective dependent stress (i.e., stressors that are in part influenced by their thoughts and behaviors) but not independent stress (i.e., stressors occurring outside their influence), and (b) this elevated dependent stress, in some measure, is what places these individuals at-risk for future psychopathology. In recognition of 30 years of stress generation research, we conducted a systematic review and meta-analysis using frequentist and Bayesian approaches (102 articles with 104 eligible studies, N = 31,541). Generally strong support was found for psychopathology predicting dependent stress (e.g., dsOverall psychopathology = 0.36-0.52, BF₁₀ = 946.00 to 4.65 × 10¹⁸). Moderator analyses for dependent stress revealed larger effects for briefer assessments periods, shorter follow-ups, and self-report measures than for interviews. Among risk factors, depressogenic cognitive styles (ds = .26-.50, BF₁₀ = 47.50 to 1.00 × 10⁵) and general interpersonal vulnerability (ds = .26-.44, BF₁₀ = 2.72 to 2708.00) received the strongest support as stress generation mechanisms, and current evidence is modest for protective factors predicting dependent stress. Overall, larger effects were generally found for prospective prediction of dependent stress than independent stress. Evaluations of mediation in the research literature were relatively few, limiting the current review to qualitative analysis of the mediation component of stress generation. General support was found, however, for dependent stress as a mediator for psychopathology and associated risk factors in relation to subsequent psychopathology. The current review ends with recommendations for future research and integration of stress generation within minority stress frameworks. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Development of a Pre-Operative Psychological Screening Tool: Piloting the Cosmetic Readiness Questionnaire (Pilot-CRQ).

Patients with psychological risk factors, such as body dysmorphic disorder (BDD), and unmanaged mental health concerns are considered higher risk of dissatisfaction with aesthetic procedures. Identifying these risks before a procedure may decrease the chance of adverse outcomes for patients and practitioners. This study aimed to develop a comprehensive psychological screening tool to assess patient's psychological suitability for surgical and non-surgical aesthetic procedures. Items for the Pilot-Cosmetic Readiness Questionnaire (CRQ) were developed by psychologists (n = 3) and then reviewed by plastic surgeons (n = 2) and non-surgical cosmetic doctors (n = 3). Patient interviews (n = 15) and piloting of the questionnaire (n = 69) provide data to examine the scale's initial psychometric properties. Results supported the reliability and validity of the Pilot-CRQ's subscales of Body Dysmorphia, Psychological Distress, Self-Criticism, Perfectionism, and Lack of Openness. 'Lack of Openness' is a validity scale which examines the degree that respondents may be underreporting symptoms. The CRQ predicted individuals with a BDD diagnosis as rated by a blinded expert clinical psychologist, with high sensitivity and specificity. These results provide support for the Pilot-CRQ in identifying people with BDD and psychological factors related to aesthetic treatment outcomes and provide a strong basis for using the CRQ in clinical contexts and in future research.