Psychological Distress Scores Research Articles

Low-Intensity Online Intervention for Mental Distress Among Help-Seeking Young People in Hong Kong

Mental health issues among young people are increasingly concerning. Conventional psychological interventions face challenges, including limited staffing, time commitment, and low completion rates. To evaluate the effect of a low-intensity online intervention on young people in Hong Kong experiencing moderate or greater mental distress. This randomized clinical trial was conducted from May 12, 2022, to September 22, 2023, in Hong Kong. Participants (aged 12-30 years) were recruited from a community project, self-reported moderate to severe distress (Kessler Psychological Distress Scale score ≥5), and were randomized 1:1 to receive the low-intensity online intervention or self-help tips (waitlist group). The low-intensity online intervention group received 4 weekly 1-on-1 online sessions on stress management, sleep, or problem-solving delivered by trained psychological well-being practitioners. The waitlist group received weekly mental health tips via text messaging. Primary outcomes were changes in Kessler Psychological Distress Scale scores and depression and anxiety subscale scores of the Depression, Anxiety, and Stress Scale. Secondary outcomes included general stress, overall negative emotions, quality of life, sleep quality, resilience, and self-efficacy. The primary outcome analysis was based on intention to treat with the last observation carried forward approach. Sensitivity analyses were conducted using per-protocol and multiple imputation methods. Of 332 screened participants, 120 (mean [SD] age, 22.4 [3.4] years; 87 [72.5%] female) were randomized. From baseline to 4 weeks, the low-intensity online intervention group and the control group both saw reductions in scores for depression (mean [SD] difference, 6.0 [7.7] and 4.8 [7.9]; P = .17; ηp2 = 0.02), anxiety (mean [SD] difference, 6.0 [7.7] and 3.5 [7.7]; P = .07; ηp2 = 0.03), and psychological distress (mean [SD] difference, 3.8 [3.8] and 2.9 [3.8]; P = .24; ηp2 = 0.01), but none of these differences were statistically significant. However, the intervention group showed greater reductions in general stress (mean [SD] difference, 7.5 [7.2] vs 4.4 [7.2]; P = .02; ηp2 = 0.05), negative emotion (mean [SD] difference, 20.3 [19.2] vs 12.7 [19.2]; P = .03; ηp2 = 0.04), and increased resilience (mean [SD] difference, 0.5 [0.6] vs 0.2 [0.6]; P = .01; ηp2 = 0.05) compared with the waitlist group. Younger participants and those with lower initial distress experienced greater improvements. The findings were supported by the per-protocol analysis but not by multiple imputation analysis. A low-intensity online intervention did not significantly improve distress, depressive, or anxiety symptoms but showed some potential in reducing general stress and negative emotions and improving resilience. These findings are encouraging but not definitive, and caution is needed due to missing data. These data suggest that a low-intensity online intervention may offer a scalable option for youth mental health. ClinicalTrials.gov Identifier: NCT05510453.

IMPLEMENTING ISUPPORT IN UGANDA: A PILOT RCT FOR REDUCING CAREGIVER STRESS

Abstract Background: Dementia is a significant public health issue in low- and middle-income countries, and Uganda has seen a notable increase in cases. The iSUPPORT program, adapted into AiSUPPORT, provides tailored interventions that address the sociocultural and economic context of Uganda, aiming to alleviate psychological distress among caregivers of patients with AD and dementia. Methods: This pilot randomized controlled trial (RCT) was conducted in the Wakiso District, enrolling 65 caregivers of Alzheimer’s disease and related dementia (ADRD) patients. Participants were randomly assigned to either an intervention group that received AiSUPPORT sessions, or a control group that received standard care. This study aimed to assess the feasibility, fidelity, acceptability, and impact of the intervention on caregivers’ psychological distress, quality of life, and depression severity, as measured using the Kessler Psychological Distress Scale and other tools. Results: In the intervention group, psychological distress scores reduced significantly, averaging 29.2 to 23.7 (p< 0.001), and depression severity scores dropped from 33.4 to 25.6 (p< 0.001). Quality of life scores improved substantially, from an average of 81.1 to 89.4 (p< 0.001), compared with the control group. The AiSUPPORT program demonstrated effectiveness and cultural appropriateness, with a 95% retention rate and high engagement. Conclusion: The AiSUPPORT program for dementia caregivers in Uganda’s successful implementation in low-resource settings demonstrates its potential. The program’s effectiveness, feasibility, and cultural sensitivity underscore the importance of cultural considerations in intervention design, supporting the integration of culturally adapted evidence-based interventions in national health systems to address the complex needs of dementia caregivers.

Assessing the Feasibility and Acceptability of the Daybreak Drink Tracker: Prospective Observational Study.

Excessive alcohol use is associated with significant harms, with wide-ranging social and economic impacts. Efforts to prevent and reduce the harmful use of alcohol are a public health priority. Smartphone apps have the potential to provide accessible and cost-effective support to those seeking to reduce alcohol consumption; however, the evidence base regarding which components are effective is lacking. Self-monitoring is considered as one of the most effective components for behavior change across multiple health domains, yet there is mixed evidence for its role in the alcohol use space. An improved understanding of the use, acceptability, and outcomes of smartphone apps and their inherent components is required to determine their potential role in alcohol behavior change. We investigated the feasibility and acceptability of the Drink Tracker, a novel feature of the commercially available Daybreak (Hello Sunday Morning) app. The Daybreak app is accessible worldwide via major app stores and is offered free of charge to Australian residents. Individuals (aged over 18 years) registering for Daybreak were invited to access the Drink Tracker to monitor their alcohol consumption as part of an uncontrolled observational prospective study. Feasibility was assessed via uptake and frequency of use of the Drink Tracker. Acceptability was measured via participant feedback to determine overall satisfaction, perceived helpfulness, and likelihood of recommending the Drink Tracker to others. Self-reported changes in alcohol consumption (Alcohol Use Disorders Identification Test score) and psychological distress (Kessler Psychological Distress Scale score) at 3-month follow-up were also measured. Preliminary data collected for the first 4 months (October 2023 to February 2024) of the study were reported, including 3-month follow-up outcomes. Feasibility was demonstrated, with almost 70% (2847/4119) of those registering for Daybreak going on to access the Drink Tracker. Of those accessing the Drink Tracker, 71.1% (n=2024) consented to research, comprising the final participant sample. Frequency of use was high, with over half of participants (1112/2024, 54.9%) using the Drink Tracker more than once, and more than one-third (757/2024, 37.4%) using the Drink Tracker more than 5 times. Of the 30 participants completing a 3-month follow-up, acceptability was high, with 73% (n=22) reporting high satisfaction levels with the Drink Tracker overall, 87% (n=26) indicating it was easy to use and rating a mean score of 7.7 (SD 2.8) out of 10 in terms of likelihood of recommending to others. Significant reductions in alcohol consumption (P<.001) and psychological distress scores (P<.001) were observed at the 3-month follow-up. Our results suggest that the Daybreak Drink Tracker is highly feasible and acceptable in supporting individuals accessing commercially available smartphone apps to change their relationship with alcohol. While positive clinical outcomes were observed, the absence of a control group disallows any conclusions with regard to the efficacy of the Drink Tracker. Further testing via a randomized controlled trial is required.

The Association Between Workplace Violence and Psychological Distress Among Nurses Working in Psychiatric Hospitals in Jordan.

To assess the prevalence of workplace violence (WPV) and investigate factors that contribute to psychological distress among psychiatric nurses in Jordan. In this cross-sectional, correlational study, a convenience sampling technique was used to recruit 190 psychiatric nurses. Mean scores for WPV and psychological distress were 13.22 (SD = 2.51) and 56.11 (SD = 23.29), respectively. All psychiatric nurses reported incidences of verbal aggression from patients and their families, and a significant majority (92.6%) admitted to experiencing physical violence in the past year. For every unit increase in WPV scores, there was an average increase of 0.631 points in psychological distress (p < 0.001). Findings suggest that psychiatric nurses working in psychiatric hospitals experience a high level of WPV, resulting in moderate psychological distress. It is suggested to enhance nurses' knowledge regarding the risk factors of WPV to decrease the occurrence of this phenomenon. Furthermore, implementing educational initiatives designed to support psychiatric nurses in alleviating psychological distress resulting from WPV would yield positive outcomes. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

“Stop, pause and take a break”: a mixed methods study of the longer-term outcomes of digital emotional wellbeing training for perinatal women

BackgroundMaternal psychological distress is related to poorer physical and mental health as well as child developmental problems. Interventions that optimise maternal mental health and wellbeing during the “first 1,000 days” of life should have wide-reaching benefits for the mother and her child. Digital mental health interventions (DMHIs) during this critical period have the potential to equip women with enhanced coping strategies that can be applied and maintained in daily life. This study aimed to understand uptake of DMHIs in pregnancy, and the extent participants apply intervention strategies 10–12 months post-participation in a pilot randomised controlled trial (RCT) comparing different digital programs.MethodsA mixed methods triangulation approach was undertaken. We explored demographic data and psychological distress measures in the intervention groups and a comparison group that were offered the intervention but did not participate or did not meet the inclusion criteria based on gestational age (n = 525). Intervention participants (n = 54) were invited to undertake an interview up to 12 months post-intervention to understand ongoing skills application. Fifteen interviews were undertaken using a phenomenological approach to analyse the data.ResultsBaseline psychological distress results showed a significant difference between those who enrolled in the intervention, compared to those who did not, with higher psychological distress (combined), and stress and depression (sub-scale) scores for the intervention groups. Qualitative content analysis identified four main themes relating to long-term engagement: (1) Motivations to use skills; (2) Taking time for oneself; (3) Emotional support; and (4) Improving wellbeing (such as aids sleep and emotional impacts). Within each theme there were several sub-themes, including enablers or barriers to engagement.ConclusionsThis study indicated that women who chose to enrol in DMHIs in pregnancy have greater psychological distress than those who chose not to participate. Many participants in this study continued to apply learnt skills in everyday life, such as breathing exercises. This implies that digital strategies may be effective and applicable longer-term to enable women to apply positive coping skills during critical child developmental periods. Ultimately, this will contribute to designing apps that sustain wellbeing and could be protective in preventing postnatal psychological distress.Trial registrationAustralian New Zealand Clinical Trials Registry Number (ACTRN12620000672954p); (12/06/2020).

Psychological distress in biliary tract malignancy patients: influencing factors and development of a predictive nomogram model.

This study aims to investigate the psychological distress and its influencing factors in patients with biliary tract malignant tumors, alongside the development of a predictive model. A total of 219 patients diagnosed with biliary tract malignant tumors who were admitted to the Department of Liver Surgery at Fudan University Shanghai Cancer Center from July 2021 to May 2023, were selected using a convenience sampling method. Research tools involve psychological distress management screening tools, a demographic questionnaire, self-rating anxiety and depression scales, and the Chinese version of the Memorial Symptom Assessment Scale. Bootstrap method was utilized for repeated sampling to identify relevant factors influencing psychological distress in biliary tract cancer patients. The R software was employed to create a nomogram model, and the model's accuracy and predictive performance were assessed using the receiver operating characteristic curve (ROC) and the Hosmer-Lemeshow test. The average score of psychological distress among the 219 patients was (3.91 ± 2.44), with a psychological distress detection rate of 54.8%. Regression model results indicated that factors such as the presence of distant metastasis, comorbidity with other major diseases, poor sleep quality, anxiety, and severity of anxiety and depression were the primary influencers of psychological distress. The detection rate of psychological distress in patients with biliary tract malignant tumors is notably high. The predictive model constructed in this study exhibits good predictive efficacy and clinical value, providing valuable reference for healthcare professionals in developing targeted intervention strategies.

‘Mental heAlth and well-being in rUgby pLayers’ (MAUL) study: an online survey of diverse cohorts of rugby union players internationally

IntroductionMental health and well-being is a relatively under-researched area in rugby, especially outside the elite men’s game. Evidence suggests that physical activity and sports benefit mental health and well-being, and...

Longitudinal Trajectories of Psychological Distress and Its Influence Factors in Young and Middle-Aged Patients With Colorectal Cancer.

To identify the longitudinal trajectories of psychological distress and to explore the predictive factors of different trajectories among young and middle-aged colorectal cancer patients from diagnosis to 6 months postoperation. A longitudinal study was conducted, guided by the STROBE checklist. A total of 214 patients were recruited from July 2021 to May 2022 at a cancer hospital in Guangzhou, China. Data were collected from diagnosis to 6 months post-surgery, using the Brief Symptom Inventory-18, Distress Disclosure Index, Connor-Davidson Resilience Scale and Social Support Rating Scale. We also collected socio-demographic and clinical characteristics at baseline. General estimation equation (GEE) was used to analyse the overall trend of psychological distress. To identify distinct distress trajectories, growth mixture modelling (GMM) and latent class growth modelling (LCGM) were both used. Longitudinal trajectories of psychological distress: the average score of psychological distress at different time points were 12.02 ± 9.87, 17.40 ± 9.73, 15.91 ± 10.05, 16.28 ± 11.24 and 16.31 ± 11.66. GEE showed four unique trajectories of psychological distress: chronic distress, no distress, steady increase and significantly increased. With reference to resilient group, multinomial logistic regression showed that education level, monthly income, minor offspring, stoma, residence, self-disclosure and psychological resilience were predictive factors of chronic distress class or increase-distress class. From diagnosis to 6 months post-surgery, psychological distress increased at discharge, gradually stabilising thereafter. Meanwhile, results revealed heterogeneity in this population. To effectively alleviate distress, it is crucial to identify high-risk individuals through predictive factors and implement tailored interventions. This study offers the trajectory and predictors of psychological distress in the process of diagnosis and treatment, and can be used in the clinical identification and monitoring of high-risk patients. The findings suggest that healthcare providers should regularly monitored and identified the psychological distress of patients, and took individualised intervention measures. This study is reported using the STROBE guidelines. No patient or public engagement.

Multidimensional employment trajectories and dynamic links with mental health: Evidence from the UK Household Longitudinal Study.

Low-quality and precarious employment have been associated with adverse mental health and wellbeing. More evidence is needed on how the quality of employment trajectories - including transitions in and out of unemployment, inactivity, and employment of varying quality - are associated with individuals' mental health over time. This paper aimed to derive a typology of multidimensional employment trajectories and assess associations with mental health in the UK. Data from waves 1-9 of the UK Household Longitudinal Study were used (2009-2019). Individuals aged 30-40 at baseline were included (N=1603). Using multichannel sequence and clustering analyses, we derived a typology of employment trajectories across employment statuses and four employment quality indicators. We assessed associations with subsequent psychological distress, accounting for baseline mental health. Changes in average General Health Questionnaire scores are described. A typology of five trajectory clusters highlighted stable and secure and precarious/low-quality trajectories for both men and women. Women who reported being economically inactive at most waves had higher odds of experiencing psychological distress than did women in 'standard' trajectories, regardless of baseline mental health. Women's scores of psychological distress in the 'precarious' group on average increased along their trajectories characterized by instability and transitions in/out of unemployment, before a move into employment. Men who likely moved in and out of unemployment and economic inactivity, with low probability of paid employment, reported increased psychological distress at the end of follow-up. This may partly be due to pre-existing mental ill-health. This paper shows the importance of high-quality employment for individuals' mental health over time. Researchers need to consider dynamic associations between employment quality and mental health across the life-course.

71 Development and validation of the COCINL scale assessing family resilience in the NICU among parents of preterm infants

Abstract Background Given the negative impact of parental distress on preterm infants and their families, examining the role of family resilience in the neonatal intensive care unit (NICU) is a promising avenue for promoting parental mental health while remaining consistent with family-centered care. A tool to assess NICU family resilience is essential to guide care and research, yet none specifically adapted for the neonatal context exists to date according to a recent systematic review. Objectives Therefore, the aim of this study was to develop and validate a new scale, the COCINL scale, designed to measure family resilience in the context of neonatal care among French-speaking parents of preterm infants. Design/Methods This methodological design study was carried out in four successive phases: (I) compilation of an item pool (II) mixed-method evaluation of content validity (clarity, relevance, representativeness) involving 12 experts, (III) pre-testing and electronic administration of the COCINL scale, along with a measure of psychological distress (Kessler-6) and an open-ended self-report question on family resilience to parents of preterm infants (n=88) and (IV) psychometric testing of the COCINL scale (internal consistency, construct validity, exploratory sensitivity and specificity). Parents of preterm infants and experts were recruited by convenience sampling from two urban, level III NICUs. Results From a pool of 112 items, 55 items were favorably evaluated after content validation (S-CVI&amp;gt;0.95). Based on preliminary interitem correlations and internal consistency results, the COCINL scale was shortened to 42 items and divided in four subscales. High internal consistency is also shown in subscales (0.796 to 0.908) and total scale (0.937) Cronbach’s alphas. The COCINL scale displays adequate construct validity, as determined by the Pearson correlation obtained between scores of family resilience and psychological distress (r=-0.236, p=0.027). Strong in between correlations of the four subscales and with the COCINL total score (0.732 to 0.851), further indicated good construct validity. Exploratory sensitivity and specificity analysis revealed the COCINL scale compares to participants' self-reported perception of family resilience (AUC 0.754). Conclusion The COCINL scale has shown strong evidence of validity and internal consistency. Thus, the scale can be recommended for research use as a measure of family resilience in the neonatal context. Still, additional evidence of its validity and reliability should be compiled before clinical use is considered. The COCINL scale could potentially support the development, evaluation and implementation of nursing interventions consistent with the family-centered care approach being promoted in NICUs across Canada and worldwide.

Prevalence of psychological distress: a scientific approach towards the mental health and wellbeing of population during the SARS-COV-2 outbreak

Background The global challenge of the novel coronavirus has led to an unprecedented downturn, adversely affecting the health and mental wellbeing of communities worldwide. The objective of this study is to assess mental health and psychological distress levels within the general population of Peshawar, Pakistan amidst the ongoing COVID-19 pandemic. Method A cross-sectional online survey was conducted among 715 residents of Peshawar, Pakistan. The questionnaire collected data on demographics, socioeconomic status, and residential area. The Modified K10 Kessler Psychological Distress Scale was used to measure mental well-being. Descriptive statistics, including means and standard deviations, were calculated, and statistical analyses were performed using SPSS (IBM, USA, version 22). Results A total of 715 responses were collected. The comprehensive psychological distress score was identified as 25.55, signifying moderate stress levels. Among the respondents, 53.3% were females, 46.7% had completed a bachelor’s degree, 41% were employed, 78.7% were single, 93.1% were non-smokers, and 69.4% resided in urban areas. The study revealed that both gender (p=0.001) employment status (p=0.018) were linked to a more pronounced psychological impact of the outbreak. Conclusions This study highlights age, gender, employment status, and urbanization as influential factors contributing to psychological distress during the COVID-19 outbreak. As we face the challenges of the new normal, it is essential for policymakers to address these mental health concerns through targeted support and interventions, ensuring that mental health resources are accessible and responsive to the needs of affected populations.

The relationship between demographic factors, psychological distress, COVID worries, resilience, and athletic identity: A study of collegiate student-athletes

The COVID-19 pandemic provided athletes with an entirely new unforeseen circumstance, as many collegiate sport events and seasons were halted or canceled, forcing athletes into premature and non-normative retirement from sport. In the current study we analyzed the relationship between demographic factors, psychological distress, COVID worries, resilience, and athletic identity while controlling for student-athletes’ year of eligibility and NCAA division. Three-hundred and twenty-five student-athletes (232 females; 88 males; 5 non-binary) participated in the study by completing a demographic survey, the Athletic Identity Measurement Scale, the Brief Resilience Scale, the Depression Anxiety Stress Scale-21, and the COVID-specific worries questionnaire, which were administered electronically through a Qualtrics survey link. A stepwise hierarchical regression analysis revealed that (a) being either a senior (β = -0.15, p = .03) or a junior (β = -0.12, p = .01) was associated with lower levels of athletic identity; and (b) higher psychological distress scores were positively related to athletic identity (β = 0.14, p = .01). A path analysis revealed that resilience predicted psychological distress (β = -0.159, p = .01), which in turn predicted both COVID worries (β = 0.43, p < .01) and athletic identity (β = 0.12, p = .03).

Depression, anxiety, psychological distress, and perceived social support among Ugandan palliative care providers during the COVID-19 pandemic.

To identify the prevalence of depression, anxiety, and psychosocial distress among Ugandan palliative care providers during the COVID-19 pandemic, measure providers' perceived levels of social support, and identify factors affecting a provider's likelihood of being depressed, anxious, distressed, or perceiving various levels of social support. Data was collected from 123 palliative care providers using an online survey. Depression, anxiety, and psychological distress were measured using the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7, and the Self-Reporting Questionnaire, respectively. Information on perceived level of social support was gathered through the Multidimensional Scale of Perceived Social Support. The survey also asked about mental health resources available to providers at their place of work and what resources are still needed. Participants ranged in age, gender, religion, marital status, clinical position, and years of experience in palliative care. Results indicate that 20% of respondents show signs of moderate to severe depression, 14% show signs of moderate to severe anxiety, and 33% show signs of psychological distress. Additionally, 50% of respondents reported a low total level of social support. Depression, anxiety, and psychological distress scores were all negatively correlated with perceived social support scores. Over 50% expressed a desire for additional mental health resources at their place of work. In 2021-2022, the severity of depression, anxiety, and psychological distress varied among palliative care providers in Uganda, with some experiencing moderate to severe mental health effects. Higher degrees of depression, anxiety, and psychological distress were correlated with lower levels of perceived social support, highlighting the importance of social support during times of crisis. The results highlight a desire for improved access to mental health resources and will help providers and organizations provide better support and better prepare for future crises.

Association of Family-Centered Care With Psychological Distress Among Caregivers of Children With Cancer at a Tertiary-Level Hospital in Ethiopia: Cross-Sectional Study.

Psychological distress (PD) is a common mental health problem faced by caregivers of children with cancer. The involvement of families in childcare was found to be associated with lower levels of distress. The study aims to determine the associations between family-centered care (FCC) and PD among caregivers of children with cancer receiving treatment at Tikur Anbessa Specialized Hospital (TASH), Ethiopia. An institution-based, cross-sectional study was conducted from June to December 2022. Caregivers of children with cancer aged 0-14 years receiving cancer treatment at the pediatric oncology unit completed a face-to-face, interviewer-administered, structured questionnaire during a routine inpatient or outpatient visit. The questionnaire included questions on the characteristics of the child and caregiver, PD (measured by the Kessler Psychological Distress Scale [K10]), FCC (measured by the Measure of Processes of Care [MPOC-20]), and social support (measured by the Oslo-3 Social Support Scale [OSS-3]). Data were collected using the Kobo toolbox and exported to SPSS (version 26; IBM Corp) for cleaning and analysis. A multivariable logistic regression model was used. An odds ratio with a 95% CI was calculated, and a P value less than .05 was considered statistically significant. A total of 384 caregivers of children with cancer participated in the study. The total PD score ranged from 10 to 50, with a mean score of 17.30 (SD 8.96; 95% CI 16.84-18.60). The proportion of caregivers found to have mild, moderate, and severe levels of PD was 43 (11.2%), 35 (9.1%), and 51 (13.3%), respectively. The overall prevalence of mild to severe PD symptoms was 33.6% (95% CI 28.9%-38.3%). A statistically significant negative association was found between FCC and PD (adjusted odds ratio [AOR] 0.68, 95% CI 0.53-0.86). In addition, having no formal education (AOR 2.87, 95% CI 1.28-6.45), having a history of relapse (AOR 3.24, 95% CI 1.17-9.02), beginning cancer treatment at TASH (AOR 2.82, 95% CI 1.4-4.85), beginning treatment within the last 3 months (AOR 3.99, 95% CI 1.73-9.23), and beginning treatment within the last 4 to 18 months (AOR 2.68, 95% CI 1.25-5.76) were significantly associated with higher level of PD. A total of 1 in 3 caregivers have reported PD. FCC was found to be protective of PD. The finding of this study suggests the need for FCC intervention to improve the mental health condition of caregivers. In addition, the intervention needs to consider the educational status of the caregivers, the time since the cancer diagnosis, and the history of relapse.

The relationship between smartphone overuse, anxiety, and depression among middle school adolescents in the city of Kenitra, Morocco: a cross-sectional study

BackgroundAdolescents face various addiction issues, including excessive smartphone use, which significantly impacts their mental health, leading to anxiety and depression. This study aimed to analyze the impact of smartphone use on the mental health of middle school adolescents in the city of Kenitra, Morocco, focusing particularly on the prevalence of depression and anxiety and to identify the factors influencing these behaviors. The present cross-sectional study included a sample of 341 middle school adolescents from Kenitra city, Morocco. Participants completed a comprehensive questionnaire covering various aspects, including sociodemographic information, smartphone addiction assessment using the Smartphone Addiction Scale (SAS), and mental health assessment using the Hospital Anxiety and Depression Scale (HADS). Descriptive statistics were performed, and Mann–Whitney U-test and chi-square test were both used for comparisons between the excessive and non-excessive group, respectively. A Spearman’s correlation analysis was performed to evaluate associations of smartphone overuse with depression and anxiety.ResultsAmong 341 participants, 37.4% demonstrated smartphone overuse. Males exhibited nonsignificantly higher scores on the SAS than females (p = 0.082). In addition, the mean psychological distress scores for the study participants were 7.62 ± 3.31 for anxiety and 7.75 ± 3.7 for depression. Males exhibited significantly lower scores on the HADS subscales in comparison with females (p < 0.001). Interestingly, the results of the study showed a statistically significant positive correlation between anxiety (r = 0.2441, p = 0.013) and depression (r = 0.4035, p < 0.0001) subscales of HADS and SAS.ConclusionsOur findings suggest that adolescent students exposed to smartphone overuse are vulnerable to mental disorders. The results will be useful in helping schools put in place efficient measures to prevent excessive use of smartphones.

The protective power of dissent? A longitudinal study on cognitive and socio-emotional determinants of COVID-19 vaccine hesitancy among young people in Canada.

COVID-19 has elicited polarized reactions to public health measures, fueling anti-vaccination movements worldwide which indicate that vaccine hesitancy represents a common expression of dissent. We investigate changes in cognitive (i.e., trust in government, conspiracy beliefs, vaccine attitudes, and other COVID-19-related factors) and socio-emotional factors (i.e., psychological distress and social support) over time, and examine if these factors are associated with COVID-19 vaccine hesitancy. A sample of Canadian young adults (N = 2,695; 18 to 40 years old) responded to an online survey in May/June 2021 (after the first vaccination campaign) and then in November 2021 (after vaccine mandates were introduced). Based on survey answers, participants were categorized as "not hesitant", "hesitant", and "do not intend to get vaccinated" at each time point. Results from generalized estimating equation models indicate that vaccination hesitancy decreased over time. The importance attributed to specific COVID-19-related factors (e.g., research and science about COVID-19 vaccines, opinions of friends and family) decreased whereas psychological distress increased over time. Cognitive and socio-emotional factors were associated with vaccine hesitancy, with participants who did not intend to get vaccinated reporting the lowest psychological distress scores. We argue that dissent may be an empowering way for young people to restore a sense of personal agency via the opposition to a system perceived as illegitimate and/or unfair. These results raise important questions about potential collateral effects of top-down government and public health interventions in times of crisis.

Health enhancing behaviors in early adolescence: an investigation of nutrition, sleep, physical activity, mindfulness and social connectedness and their association with psychological distress and wellbeing.

Nutrition, sleep and physical activity are termed the "big three" health enhancing behaviors (HEB) associated with psychological distress and wellbeing. This study sought to understand differential associations between an expanded group of HEB (nutrition, sleep, physical activity, mindfulness, social connectedness) and psychological distress/wellbeing in early adolescents. Correlational and regression analyses were conducted in N=103 (51% females) adolescents (12.6 ± 0.3 years of age) recruited from the Longitudinal Adolescent Brain Study. Higher scores on sleep, social connectedness and mindfulness scales were significantly associated with lower psychological distress scores. While higher scores on social connectedness and mindfulness scales were significantly associated with higher wellbeing scores. When adjusting for sex, nutrition, sleep, social connectedness and mindfulness accounted for a significant proportion of variance in the psychological distress model whereas physical activity and social connectedness accounted for a significant proportion of the variance in the wellbeing model. Overall findings make a strong case for expansion of the "big three" HEB to include mindfulness and social connectedness, especially given social connectedness emerged as the strongest predictor of both psychological distress and wellbeing. In addition, this research suggests that early adolescent nutrition, sleep quality, and mindfulness should be prioritized in efforts to reduce risk of difficulties, and physical activity prioritized as a protective factor for wellbeing in this population. Findings have implications for interventions, emphasizing the importance of addressing HEB factors comprehensively and tailoring strategies to the unique needs of early adolescents to foster positive mental health outcomes.

Barbie Deformity after Edge Labiaplasty: Classification and Repair Algorithm.

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

Parental Stress and Psychological Distress and Their Association With Spousal Support Among Parents of School-Age Children During the COVID-19 Pandemic in South India: A Cross-Sectional Observational Study.

The COVID-19 pandemic presented unprecedented challenges to families in the form of social isolation, economic difficulties and inaccessibility of educational and supportive services. To assess the levels of parental stress and psychological distress among parents of school-age children during the COVID-19 pandemic and to analyse its correlation with spousal support. A cross-sectional, web-based study was conducted among the parents of school-age children in south India. One hundred thirty-two completed responses were obtained. Study tools included Parental Stress Scale, Spouse Support Scale and Kessler's psychological distress scale-6 item version. The mean parental stress score was 42.39 ± 9.679. Sixty percent of the participants reported moderate to high levels of psychological distress. Parental stress and psychological distress scores were noted to have a significant negative correlation with spousal support scores (r=-.486, p=.000 and r=-.401, p=.000 respectively). Our study findings show that the COVID-19 pandemic has taken a toll on the psychological well-being of parents of school-age children. Supportive interventions to address parenting difficulties need to be undertaken to prevent long-term adverse mental health outcomes. Lessons learnt from the pandemic are important for clinicians and policymakers to take measures to alleviate parental stress as well as to promote the psychological well-being of parents and children.

Psychological Distress and Quality of Life in Hepatitis Patients: The Mediating Role of Hope

This study examined the association between psychological distress, hope, and quality of life in patients with hepatitis. A correlational research design was employed, and 200 hepatitis patients (100 males &amp; 100 females) were chosen using purposive sampling from various hospitals in Faisalabad city. The variables were evaluated using the Kessler psychological distress scale, hope index, and quality of life scale. The data was analyzed using the Statistical Package for Social Sciences (SPSS). The results indicate a substantial negative association between psychological distress and both hope and quality of life, and a strong positive association between hope and life quality. The finding of the mediation analysis also showed that hope was a significant partial mediator in the association between psychological distress and quality of life. The t-test analysis revealed no statistically significant variations in the mean scores for psychological distress, hope, and quality of life between man and women hepatitis patients. The findings of the present research have implications for a range of health-related areas, including the use of the study findings by healthcare professionals in treating patients suffering from life-threatening chronic conditions such as hepatitis.