搜索结果：Anxiety, stress, and coping

BACKGROUND: Infertility distress is a major concern for couples. The primary aim of this study was to predict ability to share feelings about infertility using the Fertility Problems Inventory (FPI) depression, anxiety and additional variables. METHODS: Randomly selected couples responded to paper-pencil instruments that measured ability to share feelings about infertility, fertility stress, coping, stress, anxiety and depression as key variables. Selected participants were adults diagnosed with infertility undergoing assisted reproductive treatment for at least 6 months in Hungary. Multiple linear regression analysis was applied to predict fertility related stress scores separately for female and male participants. RESULTS: A total of 94 couples participated. Employing Wilcoxon tests, a significant difference was identified in the use of emotional coping (females using more emotional coping compared to males) (z = -4.18, p&#x2009;<&#x2009;0.001). No significant difference was found in the utilization of problem-solving coping. With regard to the ability to share feelings about infertility, no significant difference was identified in favor of either gender. With regard to the impact of treatment on everyday life, female respondents indicated a significantly greater effect (z = -2.67, p&#x2009;=&#x2009;0.008). One-point increase in anxiety scores increased fertility distress by 0.83 and 1.25 points for women and men, respectively. One-year increase since infertility diagnosis was linked to a 1.61-point increase in fertility distress for males. For women, for every one-point increase in the perception of their inability to discuss personal issues with someone else, there was a five-fold increase in infertility-related distress. CONCLUSIONS: Stress, anxiety, and depression were linked to problem-solving in women, but were associated with emotional coping in men. Regression analysis showed a difference between women and men in predicting stress related to infertility. In women, the inability to talk about their feelings related to infertility was significantly negatively associated with fertility stress. However, in men, feelings related to infertility were not predictors of infertility stress. This result requires further research to clarify the reason for the difference. Infertility distress is a significant issue for couples. The main goal of this study was to predict fertility distress using the Fertility Problems Inventory (FPI).Here&#x2019;s how we did it: We asked 94 couples to answer questions on a questionnaire about their coping strategies, stress levels, anxiety levels, and depression levels.Here are the results: It turned out that women used more emotional coping strategies than men. Female respondents said that the treatment had a much bigger impact on their everyday life. For both women and men, higher anxiety was linked to more distress related to fertility. Each one-point increase in anxiety scores led to an 0.83-point increase in distress for women and a 1.25-point increase for men. Additionally, each year since being diagnosed with infertility was associated with a 1.61-point increase in distress for men. For women, every one-point increase in the feeling that they could not talk about personal issues with someone else was linked to a fivefold increase in infertility-related distress.In light of these findings, we can draw the following conclusions: Women who were stressed, anxious, or depressed tended to use problem-solving strategies, while men were more likely to rely on emotional coping. However, the study did not find a significant link between coping strategies, depression, stress, and infertility distress.Finally, among women, an inability to discuss feelings related to infertility was associated with higher levels of fertility stress. However, in men, feelings related to infertility did not predict infertility distress.

In the United States, Black women face racial stressors that significantly undermine their well-being and contribute to poor mental health outcomes. The current study examines how racial stressors (i.e., racial violence exposure through social media, vicarious racism, and interpersonal racism) are associated with racial trauma and dysphoria (i.e., depression, anxiety, and hostility) and the moderating role of emotion-focused coping self-efficacy (e.g., suppression of unpleasant thoughts and emotions) among Black women (Mage&#x2009;=&#x2009;35, N&#x2009;=&#x2009;283). The study employed a quantitative, cross-sectional, analytical design. A cross-sectional online survey was administered to Black women aged 18 and over in the Northeast US between March and July 2024. Participants from diverse socioeconomic backgrounds were recruited. Data were collected via Qualtrics and analyzed using IBM SPSS version 29.0. A hierarchical regression analysis assessed the association between racial stressors (social media violence, interpersonal racism, and vicarious racism), racial trauma, and dysphoria, with emotion-focused coping self-efficacy as a moderator. Greater exposure to racial stressors and the suppression of unpleasant thoughts and emotions were associated with higher dysphoria. Interpersonal racism was positively linked to racial trauma, while social media exposure to racial violence was associated with lower trauma. Interaction effects showed that Black women who reported high social media violence exposure and suppressed unpleasant thoughts experienced less trauma. Similarly, those who reported higher vicarious racism and felt confident in suppressing unpleasant thoughts also experienced less trauma. Conversely, those who felt less efficacious in suppressing unpleasant thoughts were more likely to endorse racial trauma symptoms. Black women's racial stressors, dysphoria, and racial trauma are linked. However, the psychological effects of racial violence exposure through social media depend on available coping resources. Suppressing unpleasant thoughts and emotions is a conditional coping strategy that may mitigate racial trauma when accompanied by high coping self-efficacy, especially in situations involving vicarious racism and social media-based racial violence exposure. Conversely, low confidence in suppressing distress is associated with heightened racial trauma, highlighting the importance of emotion-focused coping self-efficacy in shaping psychological vulnerability. How racism affects Black women&#x2019;s healthWhy was the study done?Black women in the United States are regularly exposed to different forms of racism, including direct experiences, witnessing racism toward others, and exposure to racial violence on social media. These experiences can harm mental health, leading to emotional distress and symptoms of racial trauma.What did the researchers do? The research team studied how these types of racial stress are related to mental health among 283 Black women in the Northeast United States using survey data. We also looked at whether feeling confident in managing difficult thoughts and emotions shapes these relationships.What did the researchers find? We found that greater exposure to racism was linked to more emotional distress. Interpersonal racism was also associated with higher racial trauma. However, the impact of social media exposure to racial violence varied. Women who felt more confident in managing distress reported lower racial trauma in some contexts, while those with less confidence experienced higher racial trauma.What do the findings means? These findings highlight that racism remains a key driver of mental health inequities. While some Black women who feel confident in managing difficult emotions may experience less racial trauma in certain situations, suppressing distress is not a universally protective strategy. In some cases, it may reduce immediate emotional impact but does not address the underlying harm of repeated racial stressors. Overall, the results suggest that strengthening coping resources may help reduce harm, but meaningful improvements in mental health will require structural changes to reduce exposure to racism and its effects.

Domestic violence (DV) profoundly affects not only those who experience or have experienced it but also the professionals who support them, exposing workers to trauma narratives and operational pressures that may harm mental health. This study examined depressive (PHQ-9) and generalised anxiety (GAD-7) symptoms among Portuguese DV-service professionals (n&#x2009;=&#x2009;251) and assessed whether coping domains and self-care are associated with-and may condition-the links between burnout, secondary traumatic stress (STS) and symptoms. Participants completed ProQOL-5 (compassion satisfaction [CS], burnout, STS), PHQ-9, GAD-7, the Brief COPE (higher-order: avoidant, self-sufficient, socially supported) and a self-care capacity scale (EACAC). Analyses comprised correlations and three-step hierarchical regressions, with interaction terms between burnout, STS and theoretically selected coping and self-care variables entered at Step 3 to test moderation. DV professionals reported moderate levels of burnout, STS and CS, along with mild depressive and generalised anxiety symptoms. Across correlations and regressions, burnout and STS were positively associated with both symptom domains; avoidant coping aligned with higher symptoms, and self-care aligned with lower symptoms. The hierarchical regressions explained 61.7% (PHQ-9) and 54.9% (GAD-7) of variance in Step 2. Evidence for moderation was limited and exploratory: although the interaction block did not reach conventional significance for either outcome, one individual interaction term-Burnout &#xd7; Avoidant coping-was significant for generalised anxiety symptoms, suggesting that the positive association between burnout and generalised anxiety symptoms may be stronger at higher levels of avoidant coping. Findings consolidate robust correlational signals-higher burnout/STS and greater avoidance co-occur with higher symptoms, while self-care co-occurs with lower symptoms-and motivate longitudinal and intervention research to test causal leverage and evaluate whether targeting avoidance and routine self-care can improve mental-health outcomes in DV services.

Work-family role conflict is a prevalent source of stress among working adults and has been consistently associated with anxiety and depressive symptoms. Health literacy, which refers to an individual's capacity to obtain, comprehend, and utilize health-related information to make informed decisions, may serve as a crucial mediator in the relationship between work-family conflict and anxiety and depressive symptoms. Furthermore, workers in different occupational categories may differ substantially in their exposure to and coping mechanisms for such conflicts. To examine whether the three components of health literacy-health promotion, disease prevention, and health care-mediate the associations of work-to-family conflict (WFC) and family-to-work conflict (FWC) with anxiety and depressive symptoms among white- and blue-collar workers, and to explore differences across occupational groups. Data were drawn from the 2021 Psychology and Behavior Investigation of Chinese Residents. A cross-sectional survey was conducted among 4,591 working adults, including 2,487 white-collar and 2,104 blue-collar employees. Data were collected on sociodemographic characteristics, WFC, FWC, health literacy, and anxiety and depressive symptoms assessed using validated instruments. Group comparisons, partial correlation analysis, and bootstrap-based parallel mediation modeling were employed. Blue-collar workers reported significantly higher FWC scores (p = 0.003) and lower health literacy across all components (p < 0.001) compared to white-collar workers. No significant occupational differences were observed in overall anxiety or depressive symptom scores. WFC and FWC were positively associated with anxiety and depressive symptoms in both groups; however, the indirect associations through health literacy dimensions differed. Among white-collar workers, disease prevention literacy mediated the associations of WFC and FWC with depressive symptoms. Among blue-collar workers, health care literacy mediated the associations of WFC and FWC with anxiety and depressive symptoms, while health promotion literacy additionally mediated the association between WFC and depressive symptoms. Additionally, the negative correlation between WFC and health literacy was stronger in blue-collar workers, whereas the positive correlation between FWC and anxiety and depressive symptoms was more pronounced in white-collar workers. Occupational differences may partly characterize the mediating pathways between health literacy and anxiety and depressive symptoms in the context of work-family conflict. Workplace health promotion programs for white-collar workers should emphasize strengthening disease prevention literacy, while strategies for blue-collar workers should aim to concurrently enhance skills in health care and health promotion. Tailoring workplace health programs to occupational characteristics may provide more effective means of addressing anxiety and depressive symptoms associated with work-family role conflicts. Given the cross-sectional design, these findings should be interpreted as associations rather than evidence of causal pathways.

During wartime, civilians rely on digital media for information, connection, and coping. However, engagement patterns may differ in their associations with stress, resilience, and well-being. This study aimed to characterize patterns of digital media engagement during wartime and examine their associations with stress, resilience, and well-being in a cross-sectional survey of Israeli adults. We conducted a cross-sectional web-based survey in Israel in early January 2024. Participants (N=512; age: range18-65, mean 37.54, SD 12.89 years; 241/512, 47.1% male) were recruited using nonprobability quota sampling. Well-being was measured using the 5-item World Health Organization Well-Being Index, stress using the 21-item Depression Anxiety Stress Scales stress subscale, and resilience using the 10-item Connor-Davidson Resilience Scale. Participants reported the extent to which their use of 10 digital media activities increased since the beginning of the war (5-point Likert scale). Analyses included 2-step cluster analysis, exploratory factor analysis (principal axis factoring with Promax rotation), and structural equation modeling path analysis. Cluster analysis identified 2 engagement profiles: low engagement (126/512, 24.6%) and high engagement (386/512, 75.4%; silhouette coefficient=0.30). The high-engagement profile reported higher stress (median 2.39, 95% CI 2.31-2.47) than the low-engagement profile (median 2.01, 95% CI 1.87-2.15; P<.001). Exploratory factor analysis supported a 3-factor structure (active, passive, and institutional engagement), explaining 61.86% of the variance (Kaiser-Meyer-Olkin=0.77; Bartlett &#x3c7;236=1007.6; P<.001). Structural equation modeling showed acceptable fit (&#x3c7;21=1.5; P=.21; Comparative Fit Index=0.999; Tucker-Lewis Index=0.981; standardized root-mean-square residual=0.013; root-mean-square error of approximation=0.033). Resilience was negatively associated with stress (&#x3b2;=-0.24, 95% CI -0.34 to -0.14; P<.001) and positively associated with well-being (&#x3b2;=0.30, 95% CI 0.18-0.42; P<.001). Stress was positively associated with active (&#x3b2;=0.27, 95% CI 0.17-0.37; P<.001), passive (&#x3b2;=0.31, 95% CI 0.21-0.41; P<.001), and institutional engagement (&#x3b2;=0.16, 95% CI 0.06-0.26; P<.001). Active engagement was positively associated with well-being (&#x3b2;=0.12, 95% CI 0.04-0.20; P=.006), passive engagement showed a negative trend (&#x3b2;=-0.08, 95% CI -0.18 to 0.02; P=.08), and institutional engagement was not significantly associated with well-being (&#x3b2;=0.07, 95% CI -0.01 to 0.15; P=.11). The total indirect association between resilience and well-being through stress and engagement was significant (indirect effect=0.09, 95% bootstrap CI 0.05-0.13). Wartime digital media engagement clustered into distinct profiles and dimensions, each showing different associations with stress, resilience, and well-being. This study advances the field by empirically distinguishing active, passive, and institutional engagement, with the latter often overlooked in crisis-media research. The findings offer a more detailed framework for understanding how civilians navigate digital environments during an ongoing armed conflict and provide practical implications for psychosocial guidance and crisis communication, encouraging more intentional engagement and reducing excessive passive consumption. Causal inferences are limited by the cross-sectional design.

To determine the prevalence and associated factors of depression, anxiety, and stress among pharmacy students at the University of Phayao, Thailand. Undergraduate students aged &#x2265;18 years majoring in pharmaceutical care at the University of Phayao in northern Thailand during the 2024 academic year were invited to participate in an online survey. Demographic and academic data were collected using a self-administered questionnaire. Mental health was assessed using the Thai version of the Depression, Anxiety and Stress Scale. Outcomes were dichotomised as present (at least moderate severity) or absent (normal/mild) for regression analyses. Of 470 undergraduate pharmacy students, 296 completed the questionnaire, yielding a response rate of 58.0%. Overall, 41.9%, 53.7%, and 34.1% of participants reported having depressive symptoms, anxiety, and stress, respectively; 64.2% experienced at least one mental health problem, and 23.3% reported comorbid depression, anxiety, and stress. The three mental problems were positively correlated (r = 0.48-0.52, all p < 0.001). Independent factors for depression were parental separation (adjusted odds ratio [aOR] = 10.80), high self-imposed pressure (aOR = 7.71), untreated mental health problems (aOR = 53.81), sleep deprivation (aOR = 2.92), lecture-based class (aOR = 4.08), and academic workload (&#x2265;4 assignments) [aOR = 3.22]. Independent factors for anxiety were commuting by private car (aOR = 2.07), compulsory participation in student clubs (aOR = 9.26), many problems with peers or partner (aOR = 3.48), sleep deprivation (aOR = 2.28), and lecture-based class (aOR = 2.52). Independent factors for stress were living with a partner (aOR = 13.20), living with family (aOR = 3.26), low support from peers or partner (aOR = 10.63), moderate problems with lecturers (aOR = 88.75), high self-imposed pressure (aOR = 18.61), self-study (aOR = 7.12), project-based learning (aOR = 3.13), and examinations (aOR = 3.60). Notably, sleep deprivation was inversely associated with stress (aOR = 0.19), suggesting potential confounding effects or adaptive coping mechanisms. Depression, anxiety, and stress are prevalent among pharmacy students, particularly during preclinical years. These psychological disorders are associated with a combination of individual vulnerability, interpersonal dynamics, health behaviours, and excessive academic workload. Proactive mental health screening, integrated care, and reforms to foster supportive learning environments that promote sustained well-being and resilience among students are recommended.

The COVID-19 pandemic has significantly affected mental health globally, with important implications for pandemic preparedness, yet psychological responses across pandemic phases in the Gulf region remain underexplored. This study assessed mental health outcomes among adults in Kuwait across pre- and post-vaccine phases of the COVID-19 pandemic to identify factors that can guide preparedness strategies. Two independent web-based surveys were conducted in June 2020 (pre-vaccine phase) and August 2021 (post-vaccine phase). In total, 1,923 adults completed validated questionnaires, including the Depression, Anxiety, and Stress Scale (DASS-21). Outcomes were compared across periods using descriptive analyses, and multivariate logistic regression identified predictors of moderate-to-severe mental health symptoms. Overall, 40.9% of participants reported depression, 36.0% anxiety, and 25.0% stress. Participants surveyed during the post-vaccine phase had higher adjusted odds of moderate-to-severe anxiety (OR&#x202f;=&#x202f;2.14, 95% CI: 1.61-2.85) and stress (OR&#x202f;=&#x202f;2.31, 95% CI: 1.73-3.07) compared with those surveyed during the pre-vaccine phase. Females, young adults (18-29&#x202f;years), and non-Kuwaitis had greater odds of adverse mental health outcomes, with non-Kuwaitis showing 50% higher odds of depression. Lower confidence in the healthcare system was also associated with greater psychological distress. In contrast, faith-based coping was associated with lower odds of stress (OR&#x202f;=&#x202f;0.30, 95% CI: 0.20-0.45), and time management practices were linked to reduced anxiety (OR&#x202f;=&#x202f;0.73, 95% CI: 0.55-0.96). Adherence to mask use and hand hygiene was lower during the post-vaccine phase. Substantial mental health challenges were observed in both pre- and post-vaccine phases of the pandemic, particularly among women, younger adults, and non-citizens. Protective coping strategies, especially faith-based and social support mechanisms, should thus be integrated into pandemic preparedness alongside biomedical responses.

The irregular migration of unaccompanied girls, boys, and adolescents from Central America, Mexico, and the United States has increased over the past decade. These individuals face a continuum of violence at the origin, path, and destination of their trajectories that affects their mental health and well-being. This study investigates the violence suffered by these unaccompanied girls, boys, and adolescents in their communities of origin, migratory journey, and final destination, exploring the associated mental health problems and implemented coping strategies. This binational qualitative study was carried out (June 2022-June 2023) with semi-structured interviews with 20 unaccompanied girls, boys, and adolescents from Central America and 14 key informants in Mexico and the United States of America. Unaccompanied girls, boys, and adolescents described multiple forms of violence in their place of origin, during the path, and final destination. These experiences generated emotional, cognitive, and behavioral consequences consistent with migratory stress, including anxiety, depressive symptoms, suicidal ideation, and difficulties in adapting. However, adolescents used coping strategies such as migrating to escape violence, denouncing perpetrators, consolidating support networks with peers and civil society organizations, continuing their studies, and starting family life again at their destination. The findings show the exposure of unaccompanied girls, boys, and adolescents to a continuum of structural and daily violence that affects their mental health and challenges government support. However, they also show their capacity for resilience and action. A comprehensive public policy approach is needed that acknowledges these experiences, guarantees mental health care, and ensures the best interest of these young migrants. La migraci&#xf3;n irregular de ni&#xf1;as, ni&#xf1;os y adolescentes no acompa&#xf1;ados de Centroam&#xe9;rica hacia M&#xe9;xico y Estados Unidos ha aumentado en la &#xfa;ltima d&#xe9;cada. Estos adolescentes enfrentan un continuum de violencia en el origen, tr&#xe1;nsito y destino, que impacta su salud mental y bienestar. Este estudio analiza las violencias experimentadas por ni&#xf1;as, ni&#xf1;os y adolescentes no acompa&#xf1;ados en sus comunidades de origen, durante el tr&#xe1;nsito migratorio y en el destino, explorando los problemas de salud mental asociados y las estrategias de afrontamiento implementadas. Se realiz&#xf3; un estudio cualitativo binacional (junio 2022-junio 2023) con entrevistas semiestructuradas a 20 ni&#xf1;as, ni&#xf1;os y adolescentes no acompa&#xf1;ados de origen centroamericano y 14 informantes clave en M&#xe9;xico y Estados Unidos. Ni&#xf1;as, ni&#xf1;os y adolescentes no acompa&#xf1;ados reportaron m&#xfa;ltiples violencias en el origen, durante el tr&#xe1;nsito y en el destino. Estas experiencias generaron consecuencias emocionales, cognitivas y conductuales consistentes con estr&#xe9;s migratorio, incluyendo ansiedad, s&#xed;ntomas depresivos, ideaci&#xf3;n suicida y dificultades de adaptaci&#xf3;n. A pesar de ello, los adolescentes desplegaron estrategias de afrontamiento como migrar para escapar de la violencia, denunciar a perpetradores, conformar redes de apoyo con pares y organizaciones de la sociedad civil, continuar estudios y reiniciar la vida familiar en destino. Los hallazgos evidencian la exposici&#xf3;n de ni&#xf1;as, ni&#xf1;os y adolescentes no acompa&#xf1;ados a un continuum de violencias estructurales y cotidianas que afectan su salud mental y desaf&#xed;an la protecci&#xf3;n estatal. Sin embargo, tambi&#xe9;n muestran su capacidad de resiliencia y agencia. Se requiere un abordaje integral en pol&#xed;ticas p&#xfa;blicas que reconozca estas experiencias, garantice atenci&#xf3;n en salud mental y asegure el inter&#xe9;s superior de la ni&#xf1;ez migrante. A migra&#xe7;&#xe3;o irregular de garotas, garotos e adolescentes desacompanhados da Am&#xe9;rica Central, M&#xe9;xico e Estados Unidos tem aumentado na &#xfa;ltima d&#xe9;cada. Estes indiv&#xed;duos enfrentam um continuum de viol&#xea;ncia na origem, caminho e destino de suas trajet&#xf3;rias, afetando a sa&#xfa;de mental e bem-estar. Este estudo investiga a viol&#xea;ncia sofrida por estes garotos, garotas e adolescentes desacompanhados em suas comunidades de origem, durante o percurso migrat&#xf3;rio e o destino final, explorando os problemas de sa&#xfa;de mental associados e as estrat&#xe9;gias de enfrentamento implementadas. Foi realizado um estudo qualitativo binacional (junho de 2022-junho de 2023) com entrevistas semiestruturadas com 20 garotas, garotos e adolescentes desacompanhados oriundos da Am&#xe9;rica Central e 14 informantes-chave no M&#xe9;xico e Estados Unidos. Garotas, garotos e adolescentes desacompanhados descreveram m&#xfa;ltiplas formas de viol&#xea;ncia no seu local de origem, durante o caminho e no destino final. Estas vivencias geraram consequ&#xea;ncias emocionais, cognitivas e comportamentais consistentes com estresse migrat&#xf3;rio, incluindo ansiedade, sintomas depressivos, idea&#xe7;&#xe3;o suicida e dificuldades em se adaptar. Contudo, os adolescentes utilizaram estrat&#xe9;gias de enfrentamento como migra&#xe7;&#xe3;o para escapar da viol&#xea;ncia, denuncia de perpetradores, consolidar redes de apoio com pares e organiza&#xe7;&#xf5;es da sociedade civil, continuar os estudos e recome&#xe7;ar a vida em fam&#xed;lia no destino. Os achados evidenciam a exposi&#xe7;&#xe3;o dos garotas, garotos e adolescentes desacompanhados a um continuum de viol&#xea;ncias estruturais e cotidianas que afetam sua sa&#xfa;de mental e desafiam o suporte governamental. Contudo, tamb&#xe9;m mostram sua capacidade de resili&#xea;ncia e a&#xe7;&#xe3;o. &#xc9; necess&#xe1;rio uma abordagem integral de pol&#xed;ticas p&#xfa;blicas que reconhe&#xe7;a estas viv&#xea;ncias, garanta aten&#xe7;&#xe3;o em sa&#xfa;de mental e assegure o interesse destes jovens migrantes.

The aim of the is to determine the occurrence, severity, and correlates of distress in patients undergoing oncological treatment during the SARS-CoV-2 pandemic, focusing on the relationships with demographic factors, such as gender, age, residence, and treatment types. The relationships between distress and strategies for coping with cancer are also examined. A diagnostic survey method was utilised which incorporated such tools as the Distress Thermometer and the Mini-MAC Scale. The survey assessed stress severity and coping strategies among 104 oncological patients treated for colorectal cancer at the Oncology Centre of the Lublin Region, eastern Poland, during the last year of the pandemic. The average stress score was 6.96 [95% Confidence interval (CI) (6.60, 7.32)] with a standard deviation of 1,86. Women and younger patients exhibited higher anxiety and destructive coping styles. Analysis also revealed that cancer patients residing in rural areas reported higher levels of distress and more frequent use of destructive coping mechanisms, compared to their urban counterparts. Positive re-evaluation as a coping strategy increased with age. The study found that a history of cancer was associated with higher levels of distress and a greater use of destructive coping styles, regardless of the cancer stage or type of treatment. Coping strategies in cancer patients are significantly associated with demographic factors, including gender, age, and place of residence. Distress levels in cancer patients are positively correlated with non-constructive coping strategies, such as anxious preoccupation and helplessness-hopelessness. High levels of distress underscore the need for routine distress screening and comprehensive psychosocial support.

Changes within neurotransmitter systems are associated with variation in anxiety-related behavior. The adenosine signaling pathway has been linked to anxiety, and caffeine has been utilized as a modulator. However, studies have not considered the impact of an individual's stress coping style (e.g., proactive, reactive) and the corresponding differences in neuromolecular signaling that can influence behavioral responses. To assess the role of adenosine signaling, we acutely treated reactive and proactive zebrafish with 50&#xa0;mg/L caffeine and evaluated anxiety-like behavior using a novel tank diving test. We then quantified whole-brain gene expression of genes representing distinct parts of the adenosine signaling pathway: adenosine receptors A1B, A2Aa, A2Ab, and A2B (adora1b, adora2aa, adora2ab, and adora2b, respectively) and enzymes adenosine deaminase (ada) and ecto-5'-nucleotidase (nt5e). Individuals with the reactive coping style had higher anxiety-related behavior (lower composite stress behavior score, more time spent frozen, less transitions to the top half, swam less distance, and swam slower) than the proactive coping style, and all females had higher anxiety-related behavior (lower composite stress behavior score, more time spent frozen, swam less distance, and swam slower) than males. Surprisingly, caffeine treatment decreased anxiety-related behavior (swam a higher distance and swam faster) compared to controls. Caffeine reduced anxiety behavior (higher composite stress behavior score, swam a higher distance, and swam faster) in reactive males only. We also observed significant differential gene expression within the adenosine signaling pathway between the reactive and proactive strains, where reactive zebrafish expressed higher levels of adenosine receptors A1B, A2Ab, A2B, and ada, and lower levels of adenosine receptor A2Aa than proactive zebrafish. These findings indicate that variation in adenosine signaling between the stress coping styles and sexes may be contributing to differences in anxiety-related behavior.

Individuals with more purpose in life tend to report less subjective stress. This association may be due, in part, to the use of more adaptive coping strategies. This research examines how purpose is associated with common coping strategies and whether the relations differ by either sociodemographic factors or current psychological distress. Participants (N&#x2009;=&#x2009;1,998) completed a survey that included purpose in life, coping strategies, current symptoms of depression and anxiety, and current feelings of stress. Purpose in life was related to more use of active (&#x3b2;&#x2009;=&#x2009;.36, p&#x2009;<&#x2009;.001) and support (&#x3b2;&#x2009;=&#x2009;.32, p&#x2009;<&#x2009;.001) strategies, and less use of disengaged strategies (&#x3b2;&#x2009;=&#x2009;-.08, p&#x2009;<&#x2009;.001). The associations between purpose and coping were similar across sociodemographic factors (age, sex, race, education). The association with disengaged coping differed by current distress (&#x3b2;interaction&#x2009;=&#x2009;.23,&#x2009;.15,&#x2009;.16, respectively, for depression, anxiety, and stress, all ps&#x2009;<&#x2009;.001): The expected negative association was apparent for participants not in distress, whereas there was a positive association among participants experiencing depression, anxiety, or stress. Purpose in life is associated with coping strategies that can help regulate stress, which may contribute to the lower stress and better psychosocial and health outcomes among people with high purpose.

To compare the prevalences of mental health problems, substance use, and suicidal ideation between first-year and final-year medical students. First- and final-year medical students at ESIC Medical College and Hospital, Faridabad, Haryana, India, were invited to participate in a survey using consecutive sampling. The 21-item Depression, Anxiety and Stress Scale (DASS-21) was used to assess depression, anxiety, and stress. The 10-item Drug Abuse Screening Test was used to assess drug use during the previous 12 months. The 10-item Alcohol Use Disorders Identification Test was used to evaluate alcohol consumption patterns, drinking behaviours, and alcohol-related problems. The six-item Fagerstr&#xf6;m Test for Nicotine Dependence was used to assess frequency of use, compulsion, and level of nicotine dependence. The four-item Suicidal Behaviour Questionnaire-Revised was used to assess suicidal thoughts and behaviours. Of 160 medical students approached, 20 declined to participate; 140 (70 each from the first and final years) were included in the analysis. Most students were single (90.0% among first-year students and 58.6% among final-year students). Students who were in a relationship had lower DASS-21 scores than those who were single (32.8 vs 40.6, p = 0.03). The mean DASS-21 score was higher among first-year students than among final-year students (41.6 vs 35.7, p = 0.07). However, final-year students had higher proportions of hazardous-to-dependent alcohol use (14.3% vs 1.4%, p = 0.004), moderate-to-severe drug use (17.1% vs 1.4%, p = 0.006), and smoking during the previous year (37.1% vs 7.1%, p < 0.001). Overall, 20.0% of first-year students and 15.7% of final-year students had a high risk of suicidal behaviour. DASS-21 scores were moderately correlated with Drug Abuse Screening Test scores in both first-year students (r = 0.43, p < 0.001) and final-year students (r = 0.37, p < 0.001), as well as in both first-year students (r = 0.43, p < 0.001) and final-year students (r = 0.37, p < 0.001), as well as Suicidal Behaviour Questionnaire-Revised scores in both first-year students (r = 0.41, p < 0.001) and final-year students (r = 0.44, p < 0.001). In binary logistic regression, higher DASS-21 scores predicted both high-risk suicidal behaviour (adjusted odds ratio [OR] = 1.06 per unit, p < 0.001) and moderate-to-severe drug use (adjusted OR = 1.08 per unit, p = 0.001). Final-year students had higher odds of moderate-to-severe drug use (adjusted OR = 23.70, p = 0.032), independent of psychological distress. Older age predicted high-risk suicidal behaviour (adjusted OR = 1.65 per year, p = 0.017). Medical students in an Indian hospital experience a high burden of psychological distress. Although first-year students exhibit greater emotional distress, final-year students demonstrate a higher prevalence of substance use, which may reflect maladaptive coping behaviours. Early, continuous, institution-based mental health interventions are needed.

In research on the mental health of migrants and refugees, the framework of pre-migration and post-migration stressors is frequently applied. The present study sought to determine which of these stressors contribute to mental health disorders among forced migrants from Ukraine and Russia. In addition, the analyses aimed to compare the prevalence of mental health disorders between these two groups and to evaluate the effectiveness of coping strategies employed. The study also aimed to broaden the understanding of the predictors of mental health outcomes among different groups of forced migrants. A cross-sectional survey was conducted using the Computer-Assisted Web Interview (CAWI) technique. Participants were recruited through purposive sampling, with invitations disseminated via social media platforms (Telegram, Facebook) targeting Ukrainians residing in Russia. The sample comprised N&#x2009;=&#x2009;200 Ukrainian and N&#x2009;=&#x2009;164 Russian respondents. Data collection took place in the first quarter of 2025, which corresponds to the third year of Russia&#x2019;s war against Ukraine. Depression, anxiety, and stress were assessed using the PHQ-9, GAD-7, and PSS-10 scales, respectively. Multivariate linear regression analyses were performed to identify predictors of mental health outcomes. Ukrainian migrants exhibited significantly higher rates of anxiety, depression, and stress (45%, 56%, 20.76&#x2009;&#xb1;&#x2009;5.9) compared with Russian migrants (37%, 39%, 18.79&#x2009;&#xb1;&#x2009;2.92). Notable differences in coping strategies were also observed: Ukrainian female migrants more frequently employed emotion-focused and resignation strategies, whereas Russian migrants tended to use problem-focused strategies. Among Ukrainians, significant predictors of poorer mental health included negative attitudes from the host population, relocation during the stay, higher educational attainment, and the use of emotion-focused or avoidance coping strategies. For Russian migrants, poorer mental health was associated with lower self-rated quality of life, underemployment, negative attitudes from the host population, and emotion-focused or avoidance coping strategies. In the context of prolonged residence in a host country, post-migration stressors and dysfunctional coping strategies appear to be the primary risk factors for mental health disorders among forced migrants. Given the cross-sectional design, the findings should be interpreted as associative rather than causal.

Determining the relations between risk factors of psychopathology in college students, such as avoidant coping and dependent stressors, could benefit well-being and educational outcomes. However, current research is limited in describing the bidirectional relations between these variables over time and within individuals. The current study aimed to longitudinally test the bidirectional relations between avoidant coping and dependent stressors in college students during the COVID-19 pandemic. Participants were from two university sites, with 299 participants from Site 1 and 154 from Site 2. Participants completed an online survey followed by biweekly online surveys during an eight-week period. Surveys contained questions measuring avoidant coping and number of dependent stressors experienced. Random intercept cross-lagged panel models were analyzed at both sites. At both sites, students with higher avoidant coping also reported more dependent stressors overall, but dependent stressors did not predict future avoidant coping. When an individual reported increased use of avoidant coping, they reported increases in the number of dependent stressors they experienced two weeks later, with partial replication across sites. Avoidant coping is associated with stressor generation across individuals and within individuals over time. Resources that help reduce avoidant coping may also reduce experiences of dependent stressors.

We applied the existential-social psychological perspective of anxiety buffer disruption theory to explain the emergence of psychopathological reactions - post-traumatic stress (PTS) symptoms, depression, anxiety, and substance and behavioral addictions - following exposure to combat-related threats. Israeli reserve soldiers in the Swords of Iron war (N&#x2009;=&#x2009;357) completed measures of exposure to combat-related threats during the war, attachment anxiety, political voting, mental health (PTS, anxiety, depression) and problematic substance use and behavioral addictions. In support of our hypotheses, exposure to combat-related threats was associated with increased severity of PTS symptoms, depression, and problematic alcohol consumption, especially among soldiers with high levels of attachment anxiety and those who voted for left/center-wing political opposition parties (for whom the war might be experienced as a threat to their political views). Among left/center-wing political opposition voters, there were also indirect effects of exposure to combat-related threats, attachment anxiety, and political voting on depression, anxiety, and substance and behavioral addictions via PTS severity. Findings highlight the transdiagnosis quality of anxiety buffer disruption theory, specifically of attachment anxiety and political-worldview threat, as predictors of both mental health problems and substance and behavioral addictions.

Digital interventions can increase the reach and continuity of physical activity promotion, but evidence remains fragmented across mental health and addictive behaviors. We conducted a comprehensive integrative review supported by structured searches (2015-2026) in biomedical, psychological, multidisciplinary and technology-oriented databases, complemented by backward/forward snowballing. Eligible studies included digital interventions in which physical activity (or sedentary reduction) was a core component and those that reported mental health outcomes (e.g., depression, anxiety, stress, and well-being) and/or addiction-related outcomes (e.g., craving, consumption, lapses/relapse, and treatment retention). We synthesized findings thematically by intervention typology (apps, wearables, hybrid models with human support, and adaptive approaches) and by key active ingredients (goal setting, self-monitoring, feedback, reinforcement, planning, and engagement strategies). Overall, most studies targeted mental health outcomes and used app-based multicomponent programs, sometimes complemented by wearables, with generally short follow-up and heterogeneous engagement metrics. Evidence in addictions was more context-specific and concentrated in alcohol treatment and opioid agonist therapy settings, supporting feasibility and a plausible role for physical activity as a coping strategy. Advanced personalization frameworks (EMA/EMI/JITAI) provide a clear implementation pathway but are less consistently operationalized when physical activity is the central therapeutic component. This review highlights practical design recommendations and research priorities for scalable, safe, and equity-oriented digital physical activity interventions in mental health promotion and relapse prevention.

To investigate the prevalence of depression, anxiety and stress among primary caregivers of children with childhood-onset systemic lupus erythematosus (cSLE) in China and to explore their psychosocial correlates based on the stress process model. A cross-sectional study. 3 tertiary public hospitals in Hunan Province, China. 242 primary caregivers were invited, and 211 completed the study (87.2% response rate). Convenience sampling was used. Eligible participants were unpaid adult caregivers (aged &#x2265;18 years) of children (aged <18 years) with cSLE, providing care for >1&#x2009;month. Exclusion criteria included inability to complete questionnaires independently, cognitive impairment due to major physical or mental disorders and current participation in other psychological interventions. Primary outcomes (depression, anxiety and stress) were measured using the Depression Anxiety and Stress Scale-21. Correlates included threat/challenge appraisal, coping style and perceived social support. Among 211 caregivers (mean age 40.55&#xb1;8.22 years; 77.3% female), 31.8% reported depression, 27.0% anxiety and 24.2% stress. Higher threat appraisal was consistently associated with depression (regression coefficients (B) =1.012, p<0.001), anxiety (B=0.514, p<0.001) and stress (B=1.091, p<0.001). A higher number of hospitalisations was associated with higher depression (B=0.118, p=0.005) and anxiety (B=0.099, p=0.012). Anxiety and stress were also associated with younger child age (anxiety: B=-0.339, p=0.028; stress: B=-0.393, p=0.024), lower challenge appraisal (anxiety: B=-0.252, p=0.044; stress: B=-0.421, p=0.002) and negative coping (anxiety: B=0.492, p<0.001; stress: B=0.311, p=0.019). Caregivers of children with cSLE face substantial psychological distress, with threat perception and negative coping as key modifiable correlates. Interventions to reshape cognitive appraisal and promote adaptive coping, alongside expanded health insurance coverage and optimised caregiving role distribution, are needed to alleviate caregiver burden.

BACKGROUND: Germany is a popular destination for international students. However, little is known about their mental health issues. Further, there is limited research in European countries investigating risk and protective factors for acculturative stress and mental health issues among international student samples. This study aimed to investigate the prevalence of depression, anxiety and acculturative stress among international students in Germany. Further, we examined the association of possible protective and risk factors with these outcome variables. METHODS: A total of 327 international students in Germany completed an online survey. Standardised measures for depression (PHQ-9), anxiety (GAD-7), and acculturative stress were used. Hierarchical regression analyses were employed to assess the impact of demographic factors, psychological variables, and coping strategies on mental health outcomes. RESULTS: The prevalence of depression and anxiety was high among international students (46.5% and 46.8%, respectively). A substantial proportion of the sample (31.2%) reported suicidal ideation or thoughts of self-harm. Further, international students in our study reported moderate acculturative stress. Mindfulness, different sources of social support, self-efficacy, optimism and acceptance were protective factors against depression, anxiety or acculturative stress. However, less than half of our sample was well supported by university facilities. A few demographic variables (gender, graduation, education, home country) were related to higher acculturative stress and anxiety. Acculturative stress was a significant predictor of depression and anxiety. CONCLUSION: Our findings highlight the importance of addressing mental health issues among international students. The results suggest that universities may consider providing adequate psychological services and strengthening institutional support for international students.

BACKGROUND: Understanding social media use among rural adolescents is important because they are a geographically and socially isolated population which may impact how they use social media and affect the impacts of use. The goal of this study was to systematically review and evaluate the literature on rural US adolescent social media use. Specifically, what is known about their social media use, amount and type of use, and the associations between social media use and health outcomes. METHODS: A systematic search was conducted on seven databases: PubMed, CINAHL, SCOPUS, PsycINFO (ProQuest), Web of Science, Embase, and Google Scholar. Studies were eligible for inclusion if they sampled rural US populations, sampled adolescents (ages 10&#x2013;19), and had at least one of the following as an outcome: how much adolescents use social media, how adolescents are using social media including content, and/or whether social media use was associated with a health outcome. RESULTS: A total of 34 articles matched the inclusion criteria and were included in analysis (N&#x2009;=&#x2009;22,315). Results suggest that rural US adolescents use social media to the same extent as non-rural adolescents. Rural adolescents with marginalized identities rely on social media to form connections with those with shared identities outside of their geographic area. Social media also fostered an environment for harmful connections, as numerous studies reported cyberbullying. In respect to mental health, using social media was found to be an avenue for coping with anxiety during the COVID-19 pandemic; however, increased time spent on social media did not reduce existing feelings of nervousness, anxiety, depression, or stress in the pandemic. Interventional studies indicated that social media was successfully used as a tool to disseminate health information and provide support to marginalized groups amongst the already hard-to-reach population of rural adolescents. CONCLUSIONS: This systematic review highlights the lack of research dedicated to social media use amongst rural US adolescents, despite high prevalence of use. More research on the specific popularity of platforms and content consumed is needed to understand the nuanced effects of social media and to further investigate social media usage as a potential intervention target for this geographically and socially isolated population.