搜索结果：Psychological assessment

Psychological research increasingly compares mental health outcomes across generations, with studies reporting elevated anxiety and depression in Generation Z and Alpha. Current instruments, interpretive frameworks, and normative standards were developed using language and contextual assumptions from earlier cohorts developing in distinct technological, economic, and social ecosystems. This Hypothesis and Theory article proposes to (i) evaluate measurement validity and interpretive framework issues in cross-generational research, (ii) analyze how contexts shape construct meaning across cohorts, (iii) examine artificial intelligence's impact on Generation Alpha assessment, and (iv) develop methodological frameworks for generation-specific assessment. This manuscript presents a Hypothesis and Theory contribution. We conducted a broad theoretical analysis drawing on literature identified through PubMed, PsycINFO, and Web of Science using the terms "generational differences," "measurement invariance," "cohort effects," "differential item functioning," "psychological assessment," and related terms. Articles were selected based on theoretical relevance to construct validity, psychometric principles, and generational context. Selection followed expert judgment rather than a formal systematic protocol, consistent with the Hypothesis and Theory format. Current instruments appear to suggest systematic linguistic drift, with identical items potentially measuring different constructs across generations. Interpretive frameworks fail to account for context-dependent meanings, leading to identical scores representing different psychological realities. Economic transformations reshaped how achievement is defined and assessed across cohorts, with each generation calibrating success relative to the material and social conditions of its formative years. Technology integration from analog to AI-integrated cognition may require adapted assessment frameworks. Generation-specific pathological presentations may be emerging, with corresponding diagnostic categories absent. Differential Item Functioning analyses reveal items operate differently across cohorts, yet uniform interpretations persist. Clinical cut-offs may misclassify generations when responses reflect adaptive functioning. Cross-generational comparisons using standardized instruments with uniform frameworks may lack fundamental validity. These findings support calls for generation-appropriate assessment, context-sensitive interpretation, cohort-specific norms, and mandatory testing of measurement invariance before cross-generational comparisons.

Background and Objectives: Low participation rates in exercise programs among older adults highlight the need for theory-driven, biopsychosocial interventions that enhance adherence, self-efficacy, and functional outcomes. Grounded in principles of motor learning and behavioral reinforcement within physiotherapy practice, this study aimed to examine the effect of periodic assessments combined with verbal feedback on functional and psychological outcomes in community-dwelling older adults. Methods: A pilot RCT was conducted involving 54 individuals aged &#x2265;65 years (53 women and 1 man), recruited from senior community centers. Participants were randomly allocated to an intervention group (periodic assessment and verbal feedback; n = 27) or a control group (n = 27). Both groups participated in an identical 12-week structured exercise program, delivered twice weekly, focusing on balance, gait, and lower-limb functional training. An intention-to-treat approach was applied. Data were analyzed using Linear Mixed Models, with statistical significance set at p < 0.05. Results: Significant group &#xd7; time interactions were observed in favor of the intervention group for key kinesiology-related functional outcomes, including the Short Physical Performance Battery (SPPB; p < 0.001), Timed Up and Go test (TUG; p = 0.011), and Activities-specific Balance Confidence Scale (ABC; p < 0.001). No statistically significant differences were identified between groups for the Behavioral Regulation in Exercise Questionnaire-2 (BREQ-2; p = 0.164) and the Self-Efficacy for Exercise Scale (ESE; p = 0.108), indicating that the primary psychological outcome (ESE) was not confirmed. However, both ESE and BREQ-2 demonstrated significant baseline differences favoring the intervention group, and, therefore, these findings should be interpreted with caution despite statistical adjustment. Conclusions: Periodic assessments followed by verbal feedback appear to selectively improve the functional effectiveness of structured exercise programs in older women, particularly physical performance, functional mobility, and balance confidence, with no significant differential effect on the primary psychological outcome (ESE; group &#xd7; time interaction: p = 0.108). These findings support assessment-informed and feedback-driven physiotherapy strategies as a promising adjunct to exercise programs in older adults, with potential implications for optimizing functional outcomes within applied kinesiology and rehabilitation contexts.

Screening children for Attention-Deficit Hyperactivity Disorder (AD/HD) often relies upon subjective behaviour ratings which are susceptible to biases. A brief (35-40&#x202f;min) post-screening assessment that does not directly address symptoms, increases objectivity, and accurately discriminates children with AD/HD from typically developing peers, could serve as an adjunct to symptom-focussed screening to support decisions about referral for comprehensive specialist assessment. This study examined the classification performance of the subjective parent-reported SNAP-IV screening questionnaire and the multi-domain Neurocognitive Assessment Tool (NCAT), both alone and in combination, in children with and without AD/HD of the Combined presentation (AD/HD-C). The SNAP-IV and NCAT were administered to 46 children with AD/HD-C and 138 typically developing children. The NCAT assessed executive function performance, brain electrical activity, quality of life, psychological needs satisfaction, sleep habits, self-regulation and social behaviour. Discriminant function and receiver operating characteristic analyses evaluated classification performance for SNAP-IV, NCAT, and combined (NCAT+) models. The SNAP-IV (97.8% accuracy; 91.3% sensitivity; 100% specificity; AUC =.990) and NCAT+ (95.1%; 87.0%; 97.8%; AUC =.993) demonstrated high classification performance; the NCAT showed lower but robust performance (88.0%; 78.3%; 91.3%; AUC =.966). The SNAP-IV showed the highest classification performance based on subjective ratings of symptoms, which are susceptible to a range of biases. The NCAT exhibited strong classification, particularly in specificity, highlighting its capacity to discriminate children with AD/HD-C from typically developing children using objective measures and non-symptom-specific subjective assessments. Combining the SNAP-IV and NCAT yielded superior performance to NCAT alone, supporting integrated use as screening and decision-support tools to identify children warranting comprehensive specialist assessment. External validation in diverse clinical populations, including those with co-occurring diagnoses, is needed.

Trauma can lead to mental illness, but it can also result in positive outcomes known as post-traumatic growth (PTG). Many cancer survivors who experience trauma report experiencing PTG, which is connected to psychological resilience-the ability to adapt and cope with stress. Metacognitive skills, cognitions about cognitions, are critical for managing life challenges. Previous studies assessing metacognition in cancer patients have primarily utilized self-report scales to evaluate metacognitive cognitions. In contrast, the present study is the first to assess metacognitive skills in cancer patients using a semi-structured, interview-based approach with interviewer-administered scoring Metacognition Assessment Scale-Abbreviated (MAS-A). This study investigated the relationship between metacognitive skills with psychological resilience and PTG in cancer survivors. The study included 45 cancer patients in remission. Participants completed assessments: the MAS-A for metacognitive skills, the Post-traumatic Growth Inventory (PTGI) for PTG, the Resilience Scale for Adults (RSA) for resilience, World Health Organization Quality of Life Scale-Brief for life quality. MAS-A is interviewer-rated, while the remaining scales are self-reports. There was no significant relationship between the MAS-A and PTGI scores (p&#x2009;>&#x2009;.05). However, positive correlations were found between the MAS-A and RSA scores (rs&#x2009;=&#x2009;.297 to .454; p&#x2009;=&#x2009;.048-.002). Additionally, higher PTGI- Changes in Philosophy of Life scores were found in those receiving chemotherapy and radiotherapy (p&#x2009;=&#x2009;.008 and .001, respectively). While metacognitive skills do not directly impact PTG, they are related to psychological resilience, a key predictor of PTG. This highlights the importance of further research on metacognitive interventions and their effectiveness in cancer patients.

Music streaming platforms have become essential parts of daily life that people now use to regulate their emotions and cope with their psychological needs in online environments. Research has investigated how digital jazz activities connect to neuroemotional functions, emotional control and psychological escape among adult participants from Guangdong Province, China, who are aged 18 to 45&#xa0;years. The researchers used a mixed-methods design that combined streaming behavior analysis with neurophysiological tests that employed electroencephalography (EEG) and heart rate variability (HRV), skin conductance response (SCR) and psychometric assessment and semistructured interview analysis. The researchers applied structural equation modeling together with regression analysis and thematic analysis to perform the data analysis. The results revealed that people who engaged more in digital jazz music showed greater increases in alpha and theta brainwaves, higher levels of parasympathetic system activity and lower levels of physical arousal, and they used emotional regulation skills and engaged in psychological restoration through their music listening activities. The qualitative results revealed that people experienced deep emotional experiences while their minds separated from reality and that they felt safe because of the algorithms that controlled their emotional experiences. The study revealed that people use streaming-based jazz listening to help their emotional needs, which they use for digital well-being treatment and music-based mental health methods in their daily lives.

The authors critically evaluated whether evidence supports an association between selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors and reported bruxism, and they analyzed possible causal inferences. The authors appraised published case reports, case series, and cross-sectional studies in which antidepressant use and bruxism outcomes were investigated. Study selection included reports in which bruxism onset or prevalence among users of selective serotonin reuptake inhibitor and serotonin-norepinephrine reuptake inhibitor were described. Assessment methods, timing relative to drug initiation, differentiation between awake and sleep bruxism, and presence of comparison groups were critically analyzed. Evidence was predominantly observational and based largely on self-reported or clinically reported bruxism. Data were available for 41 patients in case reports, 17 patients in case series, and 2,655 patients in cross-sectional studies. Polysomnography was used in only 1 study. No researchers prospectively assessed bruxism before and after antidepressant initiation while adequately controlling for psychological confounding variables. Inconsistent differentiation between awake and sleep bruxism and heterogeneous diagnostic approaches contributed substantially to interstudy variability. Dentists should interpret reports of antidepressant-related bruxism cautiously. Overreliance on subjective assessment may lead to misattribution of symptoms to medication rather than underlying psychological or sleep-related factors. The protocol was registered in the Open Science Framework on November 22, 2025 (doi:10.17605/OSF.IO/6X27Y).

The Sport Mental Health Assessment Tool (SMHAT-1) is a screening tool aiming to identify mental health issues in elite athletes. The tool is composed of two steps, starting with a short triage questionnaire (Athlete Psychological Strain Questionnaire (APSQ); step 1), followed by subsequent disorder-specific screening instruments (step 2) only if APSQ yields positive results. SMHAT-1 has been successfully employed in various sports settings; however, no studies assessing this screening tool have been examined in endurance (ER, distance runners 21.1-42.2&#xa0;km) and ultra-endurance runners (UER; >42.2&#xa0;km), where the prevalence of mental health issues is high. We examined the coherence of the SMHAT-1 overall assessment and the validity of the APSQ screening tool in ER/UER. This is a cross-sectional study, in which 601 ER and UER completed the SMHAT-1 (triage tool APSQ, and all subsequent disorder-specific screening questionnaires) via an online survey. APSQ and screening outcomes were dichotomized using established cut-offs. APSQ performance as a triage tool was evaluated by comparison with disorder-specific screening outcomes. Agreement was assessed using confusion matrices, classifying cases into true positives (TP), true negatives (TN), false positives (FP), and false negatives (FN). We sampled 601 runners (37% female), with a mean age of 42.8&#xa0;&#xb1;&#xa0;10.1&#xa0;years. The proportion of FP was 20.14%, and the proportion of FN was 37.43%. Overall, the coherence between APSQ triage and the aggregated screening outcome was 66.89%. A higher concentration of alcohol use, sleep disturbances, eating disorders, and drug use symptoms was observed among FN cases. The APSQ is not suitable to identify ER/UER with a higher risk of mental health symptoms, especially for disorders related to alcohol use, sleep disturbances, eating disorders, and drug use symptoms. The use of the SMHAT-1 screening component (step 2) is more appropriate, although it does not assess for other specific conditions prevalent in this group of athletes.

This article presents a survey dataset on psychological drivers and impulsive buying behavior on social commerce platforms in Vietnam. The data were collected between January and April 2026 through a cross-sectional online questionnaire administered to Vietnamese consumers who had purchased at least one product through a social commerce platform within the previous six months. The refined analytical dataset contains 589 valid observations retained after removal of 42 submitted cases that showed straight-lining, duplicate response patterns, or other survey-quality problems from an initial pool of 631 responses. The instrument contains 31 Likert-type indicators measuring eight reflective constructs: perceived enjoyment, hedonic motivation, stress state, social influence, immediate gratification, perceived social value, fear of missing out, and impulsive buying behavior. The repository package contains the cleaned dataset, codebook, questionnaire, informed consent materials, and repository documentation. The repository package also reports reflective measurement-model diagnostics computed in SmartPLS 4, including indicator loadings, reliability coefficients, average variance extracted, heterotrait-monotrait ratios, and collinearity statistics, so that users can inspect measurement properties before reuse. These data can be reused for scale assessment, replication, multigroup comparison, mediation and moderation analysis, and comparative research on social commerce and digital consumer behavior in emerging-market contexts.

It is well established that psychological factors impact sport injuries, recovery, and return to sport among youth athletes. Medical associations and sport governing bodies have advocated for the assessment and intervention of mental health concerns among athletes. However, there is less research on methods of incorporating pediatric psychology services within sports medicine (SM) settings. By drawing on the framework of the Substance Abuse and Mental Health Services Administration-Health Resources and Services Administration for understanding and implementing medical and behavioral health integration, this paper outlines various approaches to utilizing pediatric psychologists' expertise in the treatment of youth athletes. Specifically, the paper focuses on how pediatric psychologists can support patient needs, contribute to research goals, and expand reach in SM clinics through coordinated, colocated, and integrated levels of care. (1)Despite calls to assess and address athletes' mental health, there is little guidance on how to integrate psychology into pediatric sports medicine (SM) clinics.(2)Applying and adapting a preexisting framework for behavioral health and medical specialty integration provides guidance on how to integrate psychology into pediatric SM clinics.(3)Thoughtful relationships and integration between psychology and pediatric SM clinics have the potential to expand access, reduce stigma, and further the reach of SM clinics.

Many clinically relevant aspects of health are expressed through behavior, affect, and interaction, and therefore rely on observation rather than instrumental measurement; yet such information is often documented infrequently in routine care. Dementia, and particularly behavioral and psychological symptoms of dementia (BPSD), is a relevant case because symptoms fluctuate across time and context. Little is known about how structured daily symptom assessment can be integrated into routine dementia care practice. This pilot study aimed to investigate whether structured daily observation of BPSD, supported by digital documentation, can be incorporated into everyday residential dementia care. A convergent mixed methods design was applied across 4 nursing home units in southern Sweden. Feasibility was operationalized through 4 focus areas (implementation, practicality, acceptability, and integration), with adherence to the registration routine as the primary feasibility outcome. Quantitative data comprised structured registrations collected daily by care staff over 90 days for 8 residents with BPSD, analyzed descriptively, and interpreted using selected NASSS (nonadoption, abandonment, scale-up, spread, and sustainability) framework domains to contextualize variation in symptom patterns, adherence, and registration practices. Semistructured dyadic interviews were analyzed using deductive content analysis guided by the same domains, with integration occurring at the analytical and interpretive stages. A total of 21,993 item-level registrations were completed: 19,123 NPI-NH (Neuropsychiatric Inventory - Nursing Home version) symptom ratings, recorded across 1623 shift registrations (1 per resident per shift), and 2870 individually selected variables. Overall adherence to the registration routine averaged 75% across shifts but varied considerably between residents (range 33%-90%) and between staff members. Mean time per shift registration decreased from 77.1 seconds in the initial 30-day period to 46.2 seconds in the final 30-day period (P=.008). Symptom prevalence varied widely across NPI domains (7.5% to 38.1% of observation days), and daily symptom counts varied both between and within residents. The routine was experienced as technically straightforward and easy to incorporate into daily work. At the same time, challenges emerged, including time constraints, inconsistent participation, varying levels of interpretive confidence, and difficulties distinguishing among overlapping symptoms. Organizational routines and team stability were central to sustaining staff engagement. The high number of completed registrations indicates that daily observations can be integrated into daily dementia care. The participants perceived it as meaningful and useful. Feasibility was primarily influenced by organizational and interpretive factors rather than technical constraints. Further research should explore strategies to support shared routines and sustain engagement over time.

Diabetes-related stigma adversely affects psychological wellbeing, self-care behaviors, and glycemic control in individuals with Type 1 diabetes (T1D). Despite the high prevalence of T1D in the Middle East and North Africa region, validated Arabic instruments to assess stigma remain limited. This study aimed to translate, culturally adapt, and evaluate the psychometric properties of the Arabic version of the Type 1 Diabetes Stigma Assessment Scale (DSAS-1-Ar) from the original English instrument. A cross-sectional study was conducted among 299 adults with T1D attending the Endocrinology and Diabetes Centre in Jazan, Saudi Arabia, recruited using consecutive sampling (response rate 99.3%). Translation followed established cross-cultural adaptation guidelines. Construct validity was examined using confirmatory factor analysis, with three competing structural models tested. In addition, Known-groups comparisons were executed between DSAS-1-Ar scores and self-reported clinical variables. All 19 items loaded significantly onto their hypothesized latent factors (Treated Differently (TD), Blame and Judgment (BJ), and Identity Concerns (IC); standardised loadings 0.642-0.947). Internal consistency was good (total &#x3b1;&#x2009;=&#x2009;0.985, &#x3c9;&#x2009;=&#x2009;0.986). None of the three compared structural models met conventional fit thresholds (CFI range 0.812-0.888; RMSEA range 0.167-0.202). SRMR for the three-factor model was acceptable (0.065), while CFI (0.816) and RMSEA (0.202) indicated suboptimal global fit. Known-groups validation analyses yielded plausibly different scores across distinct populations; e.g. higher stigma scores among females, older participants and those with diabetes-related complications. The DSAS-1-Ar represents an important initial step toward assessing T1D-related stigma in Arabic-speaking populations. Items loaded strongly onto theoretically assigned subscales and internal consistency was good. However, global CFA fit indices were suboptimal, indicating that the factor structure requires further evaluation in this cultural context. Future studies can include assessing convergent validity, test-retest stability, and model fit in more diverse Arabic-speaking samples. Clinical trial number: not applicable. The online version contains supplementary material available at 10.1007/s40200-026-02022-2.

Cognition is not a static process but is subject to substantial and meaningful variation within individuals over time. This has led to an increase in studies that aim to describe cognition in daily life by sampling participants repeatedly and remotely. Such studies, which we call high-frequency cognitive assessment or "HFCA", tend to use a limited number of brief cognitive tests. This focus on a small number of tests leaves open questions concerning the psychometric characteristics of a wide array of cognitive tasks useful for HFCA that can guide researchers on appropriate task selection. We developed the Cognitive Variability Battery (CVB), a series of nine cognitive tests clustered into three distinct cognitive domains: attentional control, processing speed, and episodic memory. CVB was administered to participants three times per day for 3&#xa0;weeks. Cognitive tests were rotated to reduce the length of any single testing session. Each test was administered up to 60 times. We provide detailed descriptions of the performance of each task, including variability, skew, and reliability statistics, using intraclass correlations. We examine the sensitivity of each test to several contextual factors including stress, affect, and social interactions. Finally, we provide power analyses on each cognitive test to determine how many assessments and participants are needed to detect effects of interest. These analyses will be essential to anyone seeking to implement HFCA testing in their own research programs, by providing guidance on which cognitive tests to select and how many participants and observations may be needed.

Wernicke's aphasia is a challenging communication disability to live with, characterised by fluent speech, impaired auditory comprehension and reduced self-monitoring. There is little literature addressing functional therapy approaches. For example, there is limited evidence for communication partner training (CPT) for this client group, despite research on its effectiveness more generally. It is not known how speech and language therapists (SLTs) understand and apply this limited and disparate evidence to their practice. To explore how SLTs assess and treat people with Wernicke's aphasia (PwWA), specifically how SLTs engage with PwWA; work with the multi-disciplinary team to support PwWA; support significant others of PwWA, including through the provision of CPT. In this qualitative interview study, SLTs were recruited through social media and professional newsletters. Interviews via videoconferencing followed a topic guide and were transcribed and analysed using Framework Analysis. Fifteen SLTs participated, with 1.5-34 years of experience, working in England and Wales across a range of inpatient and community settings. SLTs described a range of issues when working with PwWA. Building a therapeutic alliance was considered important, but could take longer than in other types of aphasia. Informal assessment was required for many PwWA, with published language assessments deemed unsuitable by many. It was perceived that available outcome measures did not capture change. SLTs took differing views on which theoretical models they should use to guide impairment-based therapy. Treatment choices were sometimes driven by trial and error. SLTs offered CPT throughout the stroke pathway, reporting it to be clinically useful; however, there was uncertainty around which communication strategies to recommend. Many SLTs viewed working with PwWA negatively. They wanted to help but felt unsure about how to do so, and commented that the evidence base for treatment was limited. SLTs worked most closely with occupational therapists to manage Wernicke's aphasia. SLTs expressed concerns around the quality of decision-making capacity assessments completed by other members of the multidisciplinary team and access to psychological support for PwWA. SLTs want evidence to guide their practice when working with Wernicke's aphasia. Further research is needed to inform CPT and outcome measures for PwWA. CPT should be supported by empirical research into interactions involving PwWA. There needs to be improved access to mental health support and high-quality decision-making capacity assessment for PwWA. What is already known on this subject Impairment-based treatments for Wernicke's aphasia from varied theoretical perspectives are reported in the literature. There is little literature reporting on functional approaches and communication partner training for Wernicke's aphasia. It is not known how practising speech and language therapists (SLTs) assess and treat people with Wernicke's aphasia (PwWA). What this paper adds to existing knowledge SLTs found PwWA difficult to work with; they wanted to help but felt unsure about what to offer. SLTs are offering communication partner training for Wernicke's aphasia throughout the stroke pathway; however, they expressed differing opinions on which communication strategies to recommend. What are the potential or actual clinical implications of this work? SLTs would like more research evidence to guide them when managing Wernicke's aphasia. There is a need for assessments, treatments, outcome measures and psychological support that meet the unique needs of PwWA.

Description More than 45% of Americans have at least 1 chronic disease, with chronic disease also being a leading cause of death in the United States. In primary care settings, about 75% of visits are for management of multiple chronic diseases. Due to the increasing medical complexity of patients who present to primary care, these numbers make it more challenging for Primary Care Clinicians (PCCs) to manage these conditions alone and point to the need for innovative solutions to chronic disease care. One evidence-based innovation is team-based care to improve the treatment of these conditions. Clinicians such as clinical pharmacists, registered dietitians, behavioral health clinicians, oral health clinicians, and health educators have an important role in primary care to co-manage the patient population, but often, the primary care setting underutilizes these other health care team members. Therefore, if the PCC understands how the psychological and behavioral aspects of health behavior change and chronic disease management fit within a team-based care model, care may improve. Team-based care has been implemented and studied in many ways, but with the Accreditation Council for Graduate Medical Education recently necessitating significant behavioral health training and practice opportunities for medical residents in primary care residency training programs, new and innovative approaches to training medical residents in behavioral health are needed to meet the health behavior change needs of their future populations upon graduation. This article provides an overview of health behavior change theories and translates theory into primary care practice within medical education through case examples. Our goal is to provide PCCs in primary care specialties such as Family Medicine, Pediatrics, and Internal Medicine with evidence-based and inventive behavioral treatment approaches to increase their ability to holistically treat chronic conditions in primary care through collaboration with other health care team members as well as train upcoming PCCs in these important practices.

Psychological distress may be associated with systemic immune regulation through neuroendocrine-immune pathways. Emergency medical services (EMS) personnel represent a high-demand occupational group, but their circulating cytokine and chemokine profiles and their relationship with psychological distress remain poorly characterized. This exploratory cross-sectional study examined inflammatory and physiological markers in EMS personnel compared with matched controls, with particular attention to the association between cortisol and CX3CL1 and exploratory sex-related patterns. Seventy-eight participants, including 39 EMS personnel and 39 matched controls, underwent assessment of blood pressure, plasma cortisol, cytokines, chemokines, soluble adhesion molecules, and an exploratory panel of cardiovascular-related proteins. Psychological distress, including depression, anxiety, and stress symptoms, was assessed using the Depression, Anxiety and Stress Scale-21 in EMS personnel. Plasma concentrations of inflammatory mediators were analyzed after log10 transformation using two-way analysis of variance with group and sex as fixed factors. Spearman correlation analyses were used to explore associations between cortisol and inflammatory mediators. The EMS group showed higher systolic blood pressure and cortisol levels than the control group. The EMS group also exhibited a broad cytokine-chemokine alteration characterized by increased concentrations of several cytokines, including GM-CSF, IFN-&#x3b1;, IL-1&#x3b1;, IL-1&#x3b2;, IL-6, IL-10, and IL-13, and chemokines, including CCL2 and CX3CL1/fractalkine. In contrast, circulating E-selectin, P-selectin, and sICAM-1 were reduced in the EMS group. Most cytokines and chemokines formed a highly intercorrelated inflammatory cluster. However, CX3CL1 showed a more independent correlation pattern and was selectively associated with cortisol, whereas cortisol was not associated with the broader cytokine-chemokine network. This cortisol-CX3CL1 association was more evident among women. Within the EMS group, women reported higher anxiety and stress scores than men, whereas men showed higher systolic and diastolic blood pressure. EMS personnel exhibited an altered systemic cytokine-chemokine profile together with physiological changes and exploratory sex-related patterns. The selective association between cortisol and CX3CL1 suggests that circulating CX3CL1/fractalkine may reflect a stress-sensitive chemokine and a candidate marker of neuroendocrine-immune interaction. These findings support the relevance of integrating psychological, endocrine, and immune markers to characterize biological responses to psychological distress in high-demand healthcare populations.

Capacity to experience positive emotions supports psychological resilience. Reward neural circuitry, implicated in positive emotionality, tends to be dampened in individuals with posttraumatic stress disorder (PTSD). Less understood is the relationship between neural response to reward and being highly resilient in the face of trauma exposure. We recruited World Trade Center rescue and recovery workers (N=94) from three groups: "Highly Resilient" (higher WTC-related trauma exposure plus no current/lifetime psychopathology; n=34), "Lower WTC-exposed" (lower WTC-related trauma exposure plus no current/lifetime psychopathology; n=31), and "PTSD" (chronic WTC-related PTSD; n=32). We examined reward anticipation during the Incentive Flanker Task, focusing on a priori regions of interest associated with reward salience (nucleus accumbens) and reward valuation (ventromedial prefrontal cortex; vmPFC). Highly Resilient and Lower WTC-exposed groups scored comparably on self-report measures of positive emotionality, and higher than those in the PTSD group. However, left nucleus accumbens modulation by cue valence (reward, neutral, loss) was significantly greater in the Highly Resilient group compared to the Lower WTC-exposed group (Cohen's d=0.70) and, after statistically adjusting for psychotropic medication, the chronic WTC-related PTSD group (d=0.62), Similar results were observed for the vmPFC. Findings support the premise that neural responsivity to potential rewards may enable resilience, potentially by buffering negative effects of substantial trauma exposure. Integrating neurobiological assessments with psychological measures may help better understand how positive emotionality is linked to psychological resilience. Improved understanding of this link could be leveraged for clinical assessment and intervention in trauma-exposed populations.

Mild cognitive impairment (MCI) is a critical transition stage toward dementia, making the identification of modifiable risk factors essential for early intervention. While individual conditions such as sensory loss, tooth loss, and psychological distress are independently linked to cognitive decline, their cumulative and combined longitudinal effects remain under-researched. Therefore, we aimed to evaluate the association between the number and specific combinations of multiple functional impairments, including vision, hearing, tooth loss, and psychological distress, and the risk of incident MCI among community-dwelling older adults in Taiwan. This cohort study analyzed data from 57,494 adults aged &#x2265;65&#x202f;years who participated in the Taipei City Government's annual physical examination program from 2005 to 2011. The study population comprised community-dwelling older adults with at least two examination records. Functional impairments were categorized as vision impairment, hearing impairment, tooth loss, and psychological distress, assessed via objective measurements and self-administered questionnaires. Impairments ranged from none to multiple. The primary outcome was incident MCI, assessed using the Short Portable Mental Status Questionnaire. Associations between the number and type of impairments and MCI were analyzed using multivariable-adjusted generalized estimating equation models. Participants with multiple functional impairments had a significantly higher risk of developing MCI than those without impairments. The adjusted odds ratio (aOR) was 1.57 (95% confidence interval (CI), 1.40-1.76) for a single impairment, 2.41 (95% CI, 2.11-2.76) for dual impairments, and 2.94 (95% CI, 2.38-3.64) for multiple impairments. Combinations involving visual impairment, tooth loss, and psychological distress showed an aOR of 3.40 (95% CI, 2.61-4.44). The highest risk was observed in participants with all four functional impairments (aOR, 5.06; 95% CI, 2.76-9.27). These findings suggest that older adults with multiple functional impairments are at a higher risk of developing MCI. Comprehensive assessment and multifaceted intervention strategies targeting multiple impairments may be crucial for reducing the risk of cognitive decline in this population.

Cancer-related cognitive impairment (CRCI) is increasingly recognized in patients with non-central nervous system malignancies, including non-small cell lung cancer (NSCLC), although evidence on pre-treatment cognitive functioning and associated psychosocial factors remains limited. This exploratory study investigated baseline cognitive functioning in NSCLC patients before oncological treatment and examined the role of cognitive reserve, emotional distress, sleep quality, and subjective cognitive complaints. Fifty NSCLC patients underwent comprehensive neuropsychological and psychological assessment before treatment initiation. Cognitive functioning was evaluated through standardized tests assessing global cognition, executive functions, memory, attention/processing speed, and language. Cognitive impairment was classified according to International Cognition and Cancer Task Force criteria. Psychological measures included subjective cognitive complaints, depressive symptoms, anxiety, sleep quality, cognitive reserve, and quality of life. Associations with a Composite Cognitive Score (CCS) and domain-specific scores were examined using univariable linear regression analyses. Eighteen patients (36%) met criteria for objective cognitive impairment at baseline. Higher cognitive reserve was associated with better global cognitive performance and stronger attention/processing speed and executive functioning. Conversely, depressive symptoms, anxiety, and poorer sleep quality were associated with lower CCS and worse performance across several domains, particularly global cognition, memory, and attention/processing speed. Subjective cognitive complaints showed partial concordance with objective cognitive performance. Cognitive impairment may already be present in a substantial proportion of NSCLC patients before treatment initiation. Early cognitive and psychosocial assessment may help identify patients at higher risk for CRCI and guide supportive interventions. These findings support early multidisciplinary screening strategies targeting vulnerable patients before treatment.

Background: While prior studies have examined linguistic markers of PTSD using everyday discourse or autobiographical narratives, comparative studies identifying specific markers across different projective personality tests remain limited.Objective: To investigate whether language features in projective personality tests differentiate individuals with PTSD from non-PTSD controls and assess their predictive value for symptom severity.Method: Verbatim transcripts from 283 participants (183 PTSD, 100 controls) across the Rorschach, TAT, and SCT were analysed using NLP across six categories: negative emotion, positive emotion, insight, causation, body-related, and self-focus. ANCOVAs with Bonferroni correction compared linguistic indicators between groups controlling for age and sex. Hierarchical regression analyses assessed predictive validity for symptom severity.Results: Following Bonferroni correction (&#x3b1;&#x2009;=&#x2009;.0028), four indicators showed significant group differences (&#x3b7;p&#xb2;&#x2009;=&#x2009;.036-.092): Rorschach Negative Emotion, SCT Positive Emotion, SCT Insight, and TAT Negative Emotion. In the PTSD group, TAT Negative Emotion was the strongest cross-symptom predictor of PTSD, depressive, and anxiety severity. Reduced Rorschach Body-related language and elevated SCT Insight were associated with greater symptom burden. TAT Positive Emotion negatively predicted symptom severity. In the non-PTSD group, SCT Self-Focus was the strongest predictor of PTSD-related severity, and SCT Positive Emotion negatively predicted anxiety. A sensitivity analysis revealed that SCT Positive Emotion and TAT Negative Emotion did not replicate under a more conservative Core Lexicon and should be treated as exploratory; only Rorschach Negative Emotion and SCT Insight were robust across lexicon configurations.Conclusions: Individuals meeting PTSD criteria showed reduced somatic language and elevated negative emotional expression, while self-referential processing and positive emotional expression emerged as salient markers in non-clinical individuals, though these differences should be interpreted cautiously given substantial demographic imbalances. These preliminary findings suggest that projective linguistic analysis may have potential as a supplementary approach in trauma-related research, pending external validation and replication in independent datasets. Language reveals trauma in distinct ways: People with post-traumatic stress show different language patterns than those without trauma-related disorders, and these patterns vary depending on the type of psychological test used.Projective tests offer supplementary linguistic insights: Responses to structurally distinct projective tests elicit different patterns of emotional, cognitive, and somatic language, providing supplementary perspectives on trauma-related psychological functioning that may not be fully captured by a single assessment paradigm.Language analysis supports clinical insight: Systematic analysis of word use helps identify subtle markers of symptom severity, suggesting potential utility as a supplementary research approach for understanding and assessing trauma-related psychological functioning.