Interoception in normative development and the drive toward agency: Relevance for understanding aspects of schizophrenia.

Trust-based healthcare communication with marginalized youth: A meta-ethnographic synthesis.

Psychological phenotypes of sense of coherence: How illness perception mediates distress differently across patient subgroups with hematologic malignancies.

The Influence of Psychological Factors on Biofilm-Related Oral Outcomes in Adults: A Systematic Review of Prospective Studies.

Public health centers (PHCs) played a critical role in managing health crises during the coronavirus disease (COVID-19) pandemic in Japan. Sense of coherence (SOC), comprising comprehensibility, manageability, and meaningfulness-a key framework for stress resilience-is important for mental health, with meaningfulness especially being important. This study examined the associations between SOC components and mental health among PHC directors during the pandemic. A nationwide cross-sectional questionnaire survey was conducted among all 468 PHC directors in Japan between September and November 2022. Mental health was assessed using the six-item Kessler Psychological Distress Scale (K6), and SOC using the University of Tokyo Health Sociology version of the SOC3 scale (SOC3-UTHS). Information on the maximum number of consecutive working days and average sleep duration during the most demanding pandemic period were obtained. Logistic regression analyses were performed with K6 as the outcome and total SOC3-UTHS or each component as explanatory variables, adjusting for consecutive working days or sleep duration, and the interaction with SOC component. Overall, 189 valid responses were analyzed. After adjusting for the number of consecutive working days, higher K6 scores were significantly associated with lower total SOC3-UTHS scores (Odds Ratio (OR) = 0.349), comprehensibility (OR = 0.413) and manageability (OR = 0.278), but not meaningfulness. Similar associations were observed after adjusting for average sleep duration. However, the interaction between comprehensibility and consecutive working days suggests the protective association of higher comprehensibility with mental health may be attenuated under prolonged working conditions. Shorter sleep duration also tended to be associated with worse mental health. SOC components may play different roles for leaders operating under crisis conditions, and comprehensibility, manageability, and adequate sleep may warrant attention in this context.

Aim This study aimed to explore the effect of physical activity on alexithymia and to establish a chain mediation model with sense of coherence and social anxiety as mediators. A cross-sectional design was adopted. Methods A total of 650 chemistry major students from six universities in the eastern coastal region of China were surveyed using the Physical Activity Rating Scale, the Toronto Alexithymia Scale, the Sense of Coherence Scale, and the Social Anxiety Scale. Results (1) Physical activity was negatively correlated with alexithymia, although the magnitude of this correlation was small ( r = −0.088, P < 0.01). Sense of coherence was negatively correlated with alexithymia ( r = −0.473, P < 0.01). Social anxiety was positively correlated with alexithymia ( r = 0.664, P < 0.01). Physical activity was positively correlated with sense of coherence ( r = 0.101, P < 0.05) and negatively correlated with social anxiety ( r = −0.119, P < 0.01), both with small effect sizes. Sense of coherence was negatively correlated with social anxiety ( r = −0.430, P < 0.01). (2) Physical activity had a negative predictive effect on alexithymia among university students, with a direct effect value of −0.200. (3) Sense of coherence and social anxiety not only played separate mediating roles but also a chain mediating role between physical activity and alexithymia, with effect sizes accounting for 7.06, 24.12, and 15.88% of the total effect, respectively. Conclusion Physical activity shows a statistically significant but weak negative association with alexithymia among chemistry major students ( r = −0.088, small effect size). The direct protective effect is limited. However, physical activity influences alexithymia indirectly through the separate mediating effects of sense of coherence and social anxiety, as well as through their chain mediating effect, which together account for a substantial portion (47.06%) of the total effect. Due to the cross-sectional design, causal relationships cannot be inferred from these findings; the results primarily indicate associations and mediating pathways that require longitudinal or experimental validation.

Schizophrenia is characterized by widespread neural dysconnectivity and impaired temporal coordination. Despite these pervasive disruptions, patients often maintain coherent perception and sense of agency, particularly during remission. This paradox remains underexplored, as research has mainly focused on symptom emergence rather than the mechanisms supporting preserved conscious experience. We propose a dual-role hypothesis of sensorimotor temporal recalibration, a process of adaptation to temporal asynchronies in sensorimotor integration. Temporal recalibration may serve both as a compensatory mechanism mitigating neural incoherence and, under certain conditions, as a trigger for positive symptoms. We compared clinically stable schizophrenia patients with healthy controls using a visuomotor temporal-order-judgement task following adaptation to sensorimotor asynchronies (0, 150, 300 ms). Patients exhibited significantly greater temporal recalibration than controls. When they experienced asynchrony between their actions and visual outcomes, they adjusted their point of subjective simultaneity more strongly, indicating enhanced adaptation to new temporal relationships. Consequently, after adaptation, patients were more likely to perceive outcomes as occurring before their actions when the adapted asynchrony was transiently reduced, whereas without adaptation they perceived them as following the action. No group differences emerged in just noticeable differences, indicating comparable temporal precision and task difficulty. These findings suggest that patients not only possess an intact recalibration mechanism but may engage it more to counteract neural delays and preserve temporal coherence. Overreliance on this adaptive process, however, may distort the perceived order of actions and outcomes, especially under transient temporal instability in information processing, and contribute to disrupted causality and agency in schizophrenia.

Examination of personal, job-related, and organizational resources of professional and managerial staff in disability services when working with people with intellectual disabilities and challenging behavior. Online survey (n=279) on working conditions, experiences of aggression, stress, resources, and work-related sense of coherence; hierarchical multiple regression analysis to identify predictors of professionals' work-related sense of coherence. Work-related sense of coherence was more strongly associated with perceived resources, structural conditions, and job satisfaction than with adverse events (experienced verbal and physical aggression; psychological stress symptoms). Team cohesion and exchange, appreciation, and clear roles and structures were highlighted as key resources. Measures to promote team cohesion, reliable staffing, and an appreciative, clearly structured organizational culture are essential.

While workplace health promotion has traditionally emphasized risk reduction, knowledge about the extent to which interventions incorporate health-promoting resources such as Sense of Coherence, Participation, Goal-Setting, Variability, and Empowerment is fragmented. This scoping review examined how these salutogenic principles are operationalized in behavioral workplace health promotion programs focused on primary prevention. A systematic search across five databases identified 128 intervention studies published between 2014 and 2024. Each program was assessed using a Salutogenesis-Score (0-5) reflecting the number of salutogenic principles integrated into its design and delivery. Overall, the incorporation of salutogenic principles was moderate. Empowerment, Variability, and Sense of Coherence were most frequently represented, whereas Participation and Goal-Setting appeared considerably less often. For instance, tailored interventions that included individualized counseling or self-management tools achieved high scores, with multi-component programs showing the strongest overall alignment. Although many programs contain elements that support health-promoting behavior, their potential to fully activate salutogenic mechanisms remains underused. Strengthening participatory approaches and personalized goal-setting may enhance employee agency, adaptability, and long-term engagement, thereby fostering more sustainable and empowering workplace health promotion.

Efficacy of the voice-activated intelligent personal assistant (VIPA) intervention on psychosocial well-being among people with Parkinson's disease: A pilot randomized controlled trial.

ABSTRACTBackground and AimsAging is accompanied by various physical, psychological, and social changes that can adversely affect the quality of life (QoL). Psychological constructs such as wisdom and sense of coherence (SOC) are believed to serve as important protective and promotive factors in maintaining QoL in older adults. This study aimed to examine the relationship between wisdom, SOC, and QoL among elderly individuals referred to hospitals in eastern Guilan, northern Iran.MethodsThis cross‐sectional and correlational study was conducted in 2024 with a sample of 200 elderly patients selected through multistage cluster sampling from general hospitals. Data collection tools included a demographic questionnaire, the Abbreviated Mental Test (AMT), the CASP‐19 Quality of Life Scale, the Antonovsky SOC‐13, and the Wisdom Questionnaire. Data were analyzed using SPSS version 21, employing descriptive statistics, partial correlation analyses, and multivariate linear regression (p < 0.05).ResultsThe majority of participants were male (66.5%) and aged 60–74 years (66.5%). The mean scores for wisdom, SOC, and QoL were 75.35 ± 8.81, 52.88 ± 10.84, and 38.10 ± 6.58, respectively. Mean scores for wisdom, SOC, and QoL were 75.35 ± 8.81, 52.88 ± 10.84, and 38.10 ± 6.58, respectively. Wisdom (r = 0.267, p < 0.001) and SOC (r = 0.253, p < 0.001) positively correlated with QoL. The regression model was statistically significant (F = 7.59, p < 0.001) and explained 41.5% of the variance in QoL (R2 = 0.415). Higher levels of wisdom (β = 0.270, p < 0.001) and SOC (β = 0.301, p < 0.001) were significantly associated with higher QoL.ConclusionWisdom and sense of coherence are significant psychological predictors of quality of life among hospitalized elderly individuals. Designing interventions to enhance these internal resources may help promote psychological well‐being and life satisfaction in this population.

RESUMOObjetivos:Analisar a mediação de fatores psicossociais na associação entre controle glicêmico e qualidade de vida relacionada à saúde (QVRS) em diabéticos da zona leste de Manaus, Amazonas, Brasil.Métodos:Foi realizado um estudo transversal com 288 diabéticos de 18 ou mais anos de idade, de ambos os sexos, usuários de Unidades de Saúde da Família da Atenção Primária à Saúde (APS). A coleta de dados envolveu entrevistas individuais utilizando instrumentos validados como WHOQoL-bref para a QVRS, o SOC-13 para o senso de coerência (SOC) e o Medical Outcomes Study – Social Support Survey para o apoio social. Dados de hemoglobina glicada foram coletados no Sistema de Informação em Saúde e-SUS APS. Realizou-se análise descritiva, seguida de modelagem de equações estruturais.Resultados:A média de idade foi 59,0 ± 11,3 anos, sendo 110 indivíduos (38,2%) do sexo masculino e 178 (61,8%) do sexo feminino. Quanto ao controle glicêmico, 89 (31,0%) apresentaram hemoglobina glicada adequada (menor que 7,0%), enquanto 199 (69,0%) apresentaram valores inadequados (maior ou igual a 7,0%). As médias e desvio padrão de SOC, apoio social e QVRS foram 59,2 ± 16,8; 71,9 ± 26,5 e 52,6 ± 16,4, respectivamente. O controle glicêmico associou-se à QVRS por via direta (β=0,185; p < 0,05) e indireta mediada pelo SOC (β=-0,200; p < 0,01) e apoio social (β=-0,096; p < 0,05).Conclusão:O SOC e o apoio social se mostraram elementos-chave na associação entre controle glicêmico e QVRS e são fatores que poderiam ser considerados nas práticas clínicas.

BackgroundWomen express lack of knowledge about the menopause transition, finding it hard to understand and navigate symptoms. This period may negatively influence quality of life and level of functioning.ObjectivesTo explore menopausal women’s experiences, perspectives and coping strategies to comprehend, manage and find meaning in the menopausal transition.DesignIndividual interviews of women with different backgrounds and menopausal experiences, recruited by hairdressers in Norway.MethodsSemi-structured in-depth interviews were conducted with 11 women in 2024. Data were analysed using reflexive thematic analysis. The theory of Salutogenesis and Sense of Coherence developed by Antonovsky, was used as guiding theoretical lens.ResultsThree main themes were developed, incorporating the intercorrelated aspects of Sense of Coherence: Comprehensibility, Manageability and Meaningfulness. 1. A transition from the unknown to normalisation – without knowledge, understanding menopausal changes was challenged, but normalisation of menopause gave comprehension. 2. From distress and silence to empowerment – manageability increased with comprehension, discussions with other women and knowledge dissemination, but was challenged by inadequate health care. 3. Finding meaning in the change menopause brings – meaningfulness motivated to seek understanding and coping strategies, and gave acceptance and value to this transition, although often accompanied by an undesirable sense of aging.ConclusionsThis study shows the importance of enhancing knowledge among women, the public and general practitioners to understand and manage menopause, and to improve menopausal care and women’s quality of life.

ABSTRACT This study examines how Chinese language teachers in Latin America construct and negotiate their professional and personal identity in cross-cultural and resource-constrained contexts through everyday material practices. It employs the kit bag method as an embodied, object-based elicitation approach to examine how identity is materially carried, enacted, and negotiated across borders through everyday objects. Data were generated through participant-recorded videos and follow-up interviews conducted via social media (WeChat). The findings show that material objects actively mediate teachers’ identity work. Professionally, handmade posters, puzzles, and logbooks enable teachers to enact authority and negotiate their role as ‘cultural mediators’ under resource scarcity. Personally, cosmetics for role transition, a thermos and tea for affective shelter, and a notebook or stuffed toy for self-continuity anchor their ontological identity across time and space. These findings show that objects mediate identity construction, enabling a coherent sense of self across contexts. By foregrounding how teacher identity is enacted, negotiated, and sustained through material engagement, this study contributes to sociomaterial approaches to teacher identity research and demonstrates the value of the kit bag method for capturing the lived, embodied dimensions of cross-cultural language teaching.

Previous studies have established that higher Sense of Coherence (SoC) predicts lower pregnancy-specific distress, fewer delivery complications, and increased birth satisfaction. However, less is known about how SoC typically changes over pregnancy, birth, and postnatally and the risk factors and protective factors contributing to SoC trajectory during the perinatal period. In this study, we aim to describe and predict common trajectories of SoC in the perinatal period. 680 women in the Mercy Pregnancy and Emotional Wellbeing Study completed measures of SoC on four occasions across pregnancy and the postpartum. Predictors included history of childhood trauma, expectations and outcomes from birth and the postpartum, and postpartum social support. Depression was assessed by structured clinical interview in early pregnancy. Growth mixture modeling was used to classify participants into trajectories of SoC, and multinomial logistic regression models predicted class membership. Four trajectories were identified: (1) High (67%), (2) Low (21%), (3) Rising (8%), (4) Falling (3%). The strongest predictors of class were depression diagnosis, associated with Low and Rising trajectories, and a history of childhood trauma, associated with Low and Falling trajectories. Childhood trauma was thus predictive of a poor SoC at 12 months postpartum, suggesting that pregnancy and birth have a negative impact on women's resilience resources, whereas depression in early pregnancy is more predictive of poorer starting point of SoC. Targeted mental health support in the perinatal period may ensure individuals have adequate coping resources.

to evaluate two interventions to improve sense of coherence (SOC) and social support on oral health-related quality of life (ORHQoL), health-related quality of life (HRQoL), dental biofilm and bleeding on probing (BOP) among adolescents. A cluster-randomised school-based clinical trial was conducted with 254 adolescents aged 15-16 years from four secondary schools in Brazil. The SOC intervention group (SOC-G) included seven 60-minute sessions aimed at developing and empowering positive attitudes, personal skills and coping strategies. The SOC plus social support intervention group (SOC/SS-G) comprised face-to-face and online meetings between participants and high school students to enhance social support, along with the SOC intervention. Mixed-effects models revealed significant effects of SOC-G and SOC/SS-G on SOC, social support, self-esteem, dental biofilm, BOP, OHRQoL and HRQoL at three-month follow-up. Structural equation modelling showed direct effects of interventions on dental biofilm and HRQoL. Interventions indirectly predicted ORHQoL via SOC change. Social support change mediated the effect of the interventions on BOP. The present findings suggest that interventions aiming to enhance SOC and social support can positively impact quality of life and periodontal clinical outcomes among adolescents. Identifier: RBR-3rxj6y6.

Paramedics are frequently exposed to trauma and may be at elevated risk of posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD). This review aimed to map PTSD prevalence among paramedics, identify risk and protective factors, and scope existing literature on CPTSD in paramedics. Studies wereidentifiedthrough a systematic database search, appraised using the Appraisal Tool for Cross-Sectional Studies (AXIS) and the Newcastle-Ottawa Quality Assessment Scale (NOS; for cohort studies). Data were analyzed through narrative synthesis. A total of 43 studies involving 12,783 paramedics were included. PTSD prevalence ranged from 1.0% to 82.4% in the 29 studies that reported prevalence, with 15 studies reporting rates of 14.6%-40%. Consistent risk factors included low social support, poor sleep, workplace stress, anxiety, and depression. Protective factors included resilience, social support, and a sense of coherence. Most cross-sectional studies were rated as high quality. The limited longitudinal evidence suggests lower PTSD prevalence or symptom levels than cross-sectional findings. No studies examined CPTSD. Taken together, the findings indicate that PTSD is common among paramedics, although evidence on CPTSD is absent. Future research should prioritize longitudinal designs and examine CPTSD prevalence in paramedics.

Elevated risk of alcohol use disorder in Japanese men living with HIV: Psychosocial determinants and protective role of sense of coherence.

To assess the impact of parental psychosocial profile on the effectiveness of educational interventions aiming to improve oral hygiene among preschool children living in a rural area. A controlled randomised trial (RBR-44nrnjz, March 5, 2023) was conducted with 78 preschool children and their caregivers residing in a rural area in southern Brazil. The participants were randomly assigned to two intervention groups: standard guidance (SG) and the teach-back technique (TB). The study comprised three phases: baseline (oral examination and data collection), Phase I (educational intervention), and Phase II (oral examination seven days post-intervention). Oral hygiene was assessed using the visible plaque index (VPI) and the Simplified Oral Hygiene Index (OHI-S). For OHI-S assessment, a mature dental biofilm (> 24h) was identified with a disclosing agent. Psychosocial factors were assessed using the sense of coherence (SOC) and parental locus of control (PLOC) instruments. For statistical analysis, participants were categorised into two clusters: Cluster 1 (lower SOC and higher internal PLOC) and Cluster 2 (higher SOC and lower internal PLOC). Data were analysed using non-parametric tests. A reduction in the number of teeth with visible plaque was observed only among participants in Cluster 1 subjected to the TB intervention. OHI-S scores decreased, regardless of the caregivers' psychosocial profile or the type of intervention. The psychosocial profile of caregivers did not affect the effectiveness of oral health educational interventions when a mature dental biofilm was considered.

BackgroundGroup therapies address the growing treatment demand-supply gap for depression. This study evaluated whether the novel WISE-Therapy (WISE-T; What’s Important: Schedule and Engage) and Bouldering Psychotherapy (BPT) are more effective in reducing depressive symptoms in an outpatient group therapy setting than treatment as usual (TAU).MethodsThis randomized, controlled, assessor-blinded, longitudinal, clinical trial was conducted in a naturalistic monocentric setting in Erlangen (Germany) between April 2022 and March 2023, with follow-up until July 2024. 128 adults were randomly assigned to WISE-T (44), BPT (40), or TAU (44). In 10 weekly 2-hour group sessions, WISE-T focused on identifying what is important, scheduling meaningful activities, and engaging in them for long-term mental health, and BPT combined psychotherapy with bouldering, while the control group received TAU. Depression severity was measured with the Montgomery-Asberg Depression Rating Scale at baseline, post-intervention, and one-year follow-up, and analyzed with a hybrid marginal model.ResultsBoth intervention groups showed significantly greater reduction in depressive symptoms than controls at post-intervention (WISE-T: -5.5 points, 95%-CI [-9.5 to -1.5], P = .007, d = 0.62; BPT: -4.2 points, 95%-CI [-8.2 to -0.3], P = .037, d = 0.48). Response rates were 35.3% for WISE-T, 29.7% for BPT, and 21.1% for controls. Remission rates were significantly higher in WISE-T (17.6%) than in controls (2.6%, P = .047). Treatment adherence was good with minimal adverse events reported. The secondary outcomes showed significant results for anxiety, sense of coherence, self-efficacy, and mindfulness during physical activity.ConclusionsBoth interventions demonstrated efficacy in reducing depressive symptoms compared with controls in this single-center setting. The study supports the integration of both therapies into outpatient care settings.Trial registrationStudy procedures received approval from the Friedrich-Alexander-Universität Erlangen-Nürnberg Ethics Committee (Ref. 21-332-B) on December 13, 2021. The Trial was preregistered in March 2022 via ISRCTN12347878.