Intolerance of uncertainty (IU) is associated with poorer emotional wellbeing and worse prognosis of chronic physical health and pain conditions (CPHPCs). Our current understanding of IU in CPHPCs is siloed within the literature on specific CPHPCs. However, IU is consistently identified as a risk factor for anxiety and depressive disorders. In this exploratory study, we used a mixed methods design to better understand the role of IU and anxiety in people's (n = 139) lived experiences of their CPHPCs and how they respond to uncertainty across health and everyday contexts. Higher acceptance of illness and perceived social support were related to lower IU and anxiety among people with CPHPCs. Higher IU and anxiety were also related to lower scores on many domains of quality of life. Our reflexive thematic analysis resulted in four primary themes: 1) distressing contexts characterized by uncertainty are not limited to health scenarios and require management in diverse ways; 2) interference of CPHPC affects multiple domains of life beyond physical health; 3) navigating uncertainty for a chronic period changes coping abilities and identity development; and 4) responsivity to uncertainty is a multifaceted cognitive-behavioural and emotional-physiological response that hinders or promotes coping. IU plays an important contextual role in the lives of those with CPHPCs and holds potential as a transdiagnostic target for early prevention and intervention. Therapeutic approaches that acknowledge the role of health-related cues and cultivate comfort with uncertainty may provide a more supportive trajectory for those with CPHPCs.
Mindfulness-based stress reduction (MBSR) has shown benefits for cognition and stress relief. Enhancing these functions may have a protective role in vulnerable populations, particularly older immigrants who face a higher risk of neurodegenerative disease. However, whether MBSR can have positive effects on cognitive and affective functions in these populations remains understudied. This trial compared the effects of MBSR with a health promotion program (HPP) in older immigrants. In this single-center, randomized, double-blind controlled trial, 151 Portuguese-speaking older immigrants (≥55 years old) residing in Luxembourg were screened and 89 participants (age range: 55-80, M age: 62.58 years ± 6.08, 72 % women) were randomized to 2-month weekly group interventions of either MBSR (n = 44) or HPP (n = 45). Data were collected at three time points: baseline, immediately after the intervention (post-intervention), and at follow-up, conducted one to three months after the intervention. Executive functioning measures, including Letter-Number Sequencing, Trail Making Test, and Stroop color-word, were the main outcomes. Secondary outcomes included general cognitive functioning, cortisol level, heart rate variability, and self-reported affective and mindfulness states. 75 % of participants in the MBSR group and 53 % in the HPP group completed at least one post-assessment. Linear mixed model analyses showed significant time effects in Letter-Number Sequencing (p = .04), as well as reductions in anxiety (p < .01) and perceived stress (p < .01), with no significant group differences or group × time interactions. These improvements were observed from baseline to post-intervention and still persisted at follow-up. Both interventions positively influenced attention, with the most notable improvements observed in anxiety and perceived stress. These findings suggest that group interventions may have the potential to improve cognitive and affective indicators, regardless of their specific content. Despite their diverse goals, the interventions shared procedural features, such as the organization and delivery of the sessions, which may have contributed to the outcomes observed. This underscores the potential value of well-designed group-based programs in cognitive and affective indicators among vulnerable older adults. While further research is needed, our findings point to the relevance of including these interventions within the realm of promoting healthy aging and dementia prevention.
Anecdotal observations suggest that self-diagnoses and desired psychiatric diagnoses may be increasing among emerging adults, yet systematic evidence from clinical practice is scarce. This mixed-methods study surveyed 93 Austrian clinical psychologists (CPs) regarding their experiences with these phenomena in the context of conducting psychological assessments. CPs rated the frequency of both self-diagnoses and desired diagnoses as significantly higher than the neutral scale midpoint ("no change"), with large effect sizes (both p < .001). ADHD and ASD were most frequently identified as self-diagnosed or desired. Patients presenting with such expectations were commonly described as female, highly educated, and strongly engaged in online activities. CPs, many of whom indicated that they actively inquire about patients' motives when suspecting a desired diagnosis, explained such pursuits mainly in terms of relief from guilt, identity affirmation, and social recognition, while treatment access was cited less often. Qualitative analyses highlighted three recurring themes: (1) the impact of self- and desired diagnoses on the course of the assessment itself, including diagnosis-driven responding and limited openness to collaborative exploration; (2) strong reactions to diagnostic discrepancies, such as emotional distress, rejection of outcomes, criticism of clinicians, or "diagnosis shopping"; and (3) increased demands on clinical practice, particularly extended assessment time and the challenges of feedback sessions where unexpected outcomes must be communicated with clarity and empathy. These dynamics are discussed in relation to online mental health cultures and the symbolic appeal of neurodivergence, underscoring how digital environments shape both the spread of self-diagnosis and the pursuit of professional confirmation.
Adolescents' sleep is intertwined with their well-being and daily life experiences. Sleep health is conceptualized as a multidimensional construct encompassing complementary components, including subjective dimensions (e.g., perceived sleep quality and sleep problems, assessed via self-reports) and quantifiable aspects (e.g., sleep duration and sleep efficiency, assessed via actigraphy). During adolescence, poor sleep health is increasingly recognized as a public health concern. However, there is a lack of evidence on how adolescents' interactions in contemporary societies, characterized by increasing cultural diversity, are intertwined with sleep health. Thus, this study investigated the reciprocal longitudinal associations between sleep health, considering subjective dimensions (i.e., sleep problems) and quantifiable aspects (i.e., sleep efficiency and duration), and the intercultural interactions of adolescents (quantity and quality) in two different life contexts (i.e., school and leisure time). A total sample of 1470 adolescents living in North-Eastern Italy (M age = 15.71, SD = 1.22, 47.58% females, 20.58% with a migrant background) wore an actigraph for one week and completed questionnaires about intercultural interactions and sleep health four times across one year. Results of Random-Intercept Cross-Lagged Panel models showed that negative interactions were consistently associated with lower subjective sleep health, lower sleep efficiency, and shorter sleep duration. Conversely, positive intercultural interactions were positively associated with better sleep efficiency, although these effects were mainly observed at the between-person level. These findings underscore the nuanced interplay between the quality of intercultural interactions and both the subjective and objective indicators of sleep health. These findings allow for a conceptualization of adolescents' sleep as a socially embedded phenomenon shaped by the cultural contexts in which young people live.
Sleep health is a significant risk factor for incident depression. Much less is known about the impact of sleep health on the course of depressive symptoms in those who have already developed the disorder. The present study used longitudinal data of individuals with a depression diagnosis from the UK Biobank to analyse sleep health as a potential predictor for the course of depressive symptoms. The hypothesis was that better sleep health would predict a milder course of depressed mood and loss of interest. Self-reported insomnia symptoms, sleep duration, chronotype and daytime sleepiness were assessed as predictors at baseline. Depressive symptoms were self-reported and assessed at baseline and at follow-up, 8.76 ± 3.00 years after the baseline assessment. Linear regression models were calculated for each outcome variable. The study comprised 4817 participants. Frequent insomnia symptoms and daytime sleepiness predicted a worse course of depressed mood (insomnia: β = 0.31 ± 0.10, p = 0.002; daytime sleepiness: β = 0.45 ± 0.11, p < 0.001) and loss of interest (insomnia: β = 0.30 ± 0.11, p = 0.005; daytime sleepiness: β = 0.32 ± 0.11, p = 0.003). On the contrary, early chronotype (β = -0.27 ± 0.10, p = 0.008) predicted a milder course of loss of interest. Our findings suggest that sleep health variables have a significant impact on the course of depressive symptoms in a sample with clinically diagnosed depression. Future research may investigate the add-on effects of sleep health improvements in patients with depression receiving guideline-concordant treatment.
Previous studies show positive results when acceptance and commitment therapy is used in the treatment of cancer patients. To establish the efficacy of acceptance and commitment therapy in the treatment of common symptoms in cancer patients using trials with an adequate level of control. Sixty-nine patients affected by different types of cancer (breast, gynecologic, lung, colorectal and ovarian) were recruited and randomly assigned to three experimental conditions defined as follows: the ACT group, the ACT+ACT-ON group, and the waitlist group. Data relating to psychological inflexibility, fatigue, insomnia, anxiety and depression, post-traumatic growth as well as quality of life were collected before (T0) and at the end of the intervention (T1). Results showed better outcomes for the two intervention groups, but significant differences were only observed with regard to fatigue (ω2 = .074), where the ACT group obtained lower scores. This group also showed higher scores for post-traumatic growth (ω2 = .066). Similarly, in the quality-of-life subscales, results indicate significantly higher scores for physical role (ω2 = .062) and cognitive function (ω2 = .087), and lower scores for fatigue (ω2 = .118) than in the waitlist group. Preliminary results suggest that acceptance and commitment therapy is effective in improving relevant aspects such as fatigue, post-traumatic growth and key aspects of quality of life in cancer patients. However, the benefits of using the mobile application need to be confirmed.
While virtual reality (VR) is increasingly used across health-related domains to improve cognitive abilities, mental health, and motor function, the mechanisms underlying the transfer of skills learned in VR to real-world performance (the ultimate objective of health interventions) remain largely unknown. This study investigated the effectiveness of VR training in transferring spatial and visual memory skills to real-world performance using an everyday task consisting on navigating and locating items in a grocery-store aisle, a complex instrumental activity of daily living. Forty-seven healthy adults were randomly assigned to train either in a virtual replica of the aisle or directly in the physical setting. Participants trained in VR subsequently demonstrated significantly improved real-world task performance, exhibiting shorter task completion times and reduced travel distances compared to those performing the task for the first time. However, while skill transfer from VR to real-world tasks was confirmed, performance improvements in task completion time were superior following direct real-world training, consistent with the principle of encoding specificity. Consequently, although the results provide robust evidence supporting VR as a valuable training tool for improving skills relevant to daily activities and indicate the utility of VR as a preparatory training stage, precise context-dependent tasks might necessitate direct physical practice for maximum efficacy.
The experiences of shame and stress are associated with social anxiety disorder (SAD). In the present study, we examined a sample of 111 participants (54 with SAD and 57 without SAD) who completed a daily diary measuring stress and shame over the course of 21 days. We modelled the temporal changes in shame and stress using linear and quadratic models as well as sinusoidal models. We found sinusoidal models to be superior to linear and quadratic ones in capturing the temporal dynamics of stress and shame. Specifically, linear models explained 9.91 % and 11.69 % of the changes in shame and stress over time (respectively), whereas sinusoidal models explained 35.76 % and 39.10 % of the changes in shame and stress over time (respectively). The differences in explained variances were statistically significant for both shame and stress. In addition, we examined whether the parameters of the best-fitting sinusoidal models were associated with levels of social anxiety. As expected, we found that the vertical offset parameters (i.e., average levels) of both shame and stress were significantly and positively associated with social anxiety. In addition, we found that fluctuations (sine wave amplitudes) in shame were positively associated with social anxiety whereas fluctuations in stress were negatively associated with social anxiety. Our findings demonstrate that sinusoidal waves can model temporal changes in emotions successfully. Moreover, sine wave parameters of shame and stress can be markers of social anxiety and can have implications for diagnosis and treatment.
Early signs of autism often emerge through distinct developmental pathways, particularly in communication, social interaction, and play. While naturalistic parent-child interactions during free play are ideal for observing spontaneous social behaviors, few autism studies have adopted this ecological and developmental approach. To address this gap, we used a fine-grained microanalytic method to examine motor, gestural, and vocal behaviors in young children, integrating machine learning to explore how combinations of these traits distinguish early autistic neurodivergence. We analyzed video recordings of 58 autistic and non-autistic children (aged 13-40 months) engaged in naturalistic parent-child play. A frame-by-frame micro-coding scheme was applied to capture actions, gestures, speech, and their multimodal integration. Clear differences emerged between neurotypical (NT) and autistic (ASC) children. NT children displayed more gestures, particularly deictic and conventional-interactive, greater gesture-gaze coordination, more functional object play, and more frequent multi-word utterances. In contrast, ASC children showed fewer deictic and conventional-interactive gestures and greater use of instrumental gestures, reduced gesture-gaze coordination, a higher reliance on vocalizations rather than words, and increased object manipulation compared to functional play. Feature selection using ANOVA F-tests identified a core set of key predictors most frequently and independently selected across folds of cross-validation: Alternate Gaze, Reaching, and Instrumental Gesture. Higher values of Alternate Gaze were associated with NT classification, while elevated frequencies of Reaching and Instrumental Gestures were linked to ASC classification. A logistic regression classifier trained on these features achieved over 85% accuracy in distinguishing the two groups. These findings underscore the value of an ecologically valid, and developmentally informed approach to identifying early behavioral markers of autism, supporting earlier recognition and the design of more personalized, strengths-based interventions.
To investigate the effects of repetitive bilateral transcranial direct current stimulation (tDCS) on sleep of latency (SOL) and resting-state electroencephalography (EEG) in individuals. Twenty-eight young adults, aged 21-25 years, with a mean of 22.96 ± 0.87 years, were recruited and randomly grouped into an experimental group(13 people) and a control group (15 people). Subjects in the experimental group received five awake-phase resting-state tDCS over a one-week period, with anodes placed bilaterally in the dorsolateral prefrontal cortex (F3, F4) and cathode in the left upper arm. The current intensity was 1.5 mA, and the stimulation time was 15 min. The control subjects received pseudo-stimulation, with only the beginning and end of the stimulation for 30 s to receive a gradual rise and fall of the current. The intermediate current intensity was 0 mA, and the rest of the treatment parameters and processes were the same as those in the experimental group. All subjects filled out a sleep diary every day during the experiment. Compared with the pre-intervention period, in the subjective scale results, the sleep of latency factor score in the subjective sleep quality assessment scores of the subjects in the experimental group was significantly lower (p = 0.001); in the EEG results, the theta band power in the midline regions of the brains of the subjects in the experimental group (especially in the central Cz location and the prefrontal cortex) was significantly elevated, whereas the control group did not show such a difference. Transcranial direct current stimulation can significantly reduce the sleep of latency of individuals and enhance theta band power to promote changes in the brain from wakefulness to drowsiness, thus enhancing sleep quality. This enhancement may be due to enhancement of inhibitory executive function. In the future, neuromodulation technology is expected to be applied to insomnia patients, especially those whose main symptom is difficulty falling asleep.
Elevated error-related brain potentials such as the error-related negativity (ERN) and error positivity (Pe) have been discussed as neural markers of error sensitivity and are thought to reflect increased risk for anxiety and obsessive-compulsive disorders. Consequently, targeting error sensitivity with precise interventions has been found a promising avenue of recent mechanism-based research aiming to reduce this risk. In this preregistered, randomized-controlled trial, we tested the efficacy of a one-week, online intervention designed to reduce error sensitivity. A sample of 237 individuals was randomly assigned to either the intervention or a waitlist control group. Participants completed self-report measures of error sensitivity as well as worry, obsessive-compulsive, and depressive symptoms at pre- and post-intervention, and at an eight-week follow-up. Additionally, neural measures (ERN and Pe) were assessed in a subsample of 69 participants before and after the intervention. Intent-to-treat analyses revealed a medium-sized reduction of self-reported error sensitivity and worry symptoms in the intervention group, with effects persisting at follow-up. Moreover, greater baseline severity and higher intervention adherence were associated with larger reductions of self-reported error sensitivity. In the subsample, no evidence was found for an ERN reduction. However, a reduction in the Pe was observed, indicating diminished error significance and decreased allocation of cognitive resources to erroneous actions. These results suggest that the online intervention reduces both self-reported and neural error sensitivity (Pe but not ERN), offering a low‑threshold, easily disseminable approach with promise as an early prevention tool and as an adjunct to established cognitive‑behavioral treatments.
Combining virtual reality-focused mindfulness (VR-FM) and transcranial direct current stimulation (tDCS) can enhance cognitive performance, offering new insights for scientific research and clinical applications. We aimed to examine the effects of a single session of VR-FM, a single session of tDCS, and their combination on sustained attention, attention control, and inhibitory control. We conducted a double-blind, controlled, randomized study (N = 107) with five groups: VR-FM or VR-mind wandering, paired with active (2 mA for 20 min) or sham tDCS with the anode over F3 and cathode over F4, and a no-intervention control group. Non-specific skin conductance response (nsSCR) was collected during virtual reality, and cognitive performance was measured with Sustained Attention to Response Task (SART) and the Emotional Stroop (EST) after intervention. Differences between groups were not statistically significant in cognitive tasks (all p>.05) but we found a main effect of group in nsSCR (F (3, 66) = 4.07, p = .010, η² = 0.156), with significant differences between VR-FM + tDCS active and VR-MW + tDCS sham (p = .014). Single sessions of VR-FM and tDCS did not significantly impact cognitive performance. However, reduced autonomic activation might be associated with mindfulness. Future studies should include several sessions and consider other individual conditions to understand the factors involved.
Stress increased markedly in recent years, highlighting the need for effective and accessible relaxation strategies. Virtual Reality (VR) has emerged as a promising intervention. While most prior VR studies were conducted under controlled conditions, the present study explored the acceptability and feasibility of VR as a relaxation tool in naturalistic settings. Additionally, it explored the effects on the perceived level of relaxation and mood, and whether heart rate (HR) data obtained from consumer-grade wearables correlated with changes in psychological state. The study involved 160 participants, including healthcare and research professionals, patients, and attendants in healthcare organizations. VR relaxation was tested using both smartphone-based and standalone VR applications in clinical and non-clinical studies. Changes in mood and relaxation were explored using validated instruments, while acceptability and feasibility were assessed through open-ended questions. Qualitative feedback was predominantly positive, with participants willing to reuse and recommend the VR application. VR relaxation was perceived as an effective means of environmental escape, offering immersive natural settings complemented by guided exercises, ambient sounds, and voice instructions. Wearable devices generally recorded HR reductions during VR sessions; however, these exploratory physiological changes did not significantly correlate with subjective relaxation levels. Participants reported increased relaxation (VAS scores), reduced muscle tension, fewer cardiovascular symptoms of stress (slower breathing and HR), and greater overall physical calmness. Regarding mood, most participants experienced fewer negative emotions (e.g., anxiety, guilt, sadness) following VR exposure, although positive affect (e.g., enthusiasm, confidence) remained unchanged according to PANAS. POMS scores indicated reductions in tension after VR sessions.
Continuous positive airway pressure is the standard treatment for obstructive sleep apnoea (OSA), a condition marked by recurrent interruptions in breathing during sleep that impairs quality of life. Despite its efficacy, adherence to continuous positive air pressure (CPAP) remains suboptimal and is influenced by various psychological and contextual factors. This scoping review adopts the 3P model-predisposing, precipitating, and perpetuating factors-to identify key motivators and barriers impacting CPAP adherence in OSA patients. A systematic search of PubMed, PsycINFO, and Scopus identified 43 relevant studies. Inclusion criteria focused on peer-reviewed, full-text articles investigating psychological aspects influencing CPAP adherence in adults with OSA. Paediatric populations, non-English publications, and studies without an explicit focus on psychological variables were excluded. Predisposing factors include psychological comorbidities, low health literacy, and misconceptions about OSA and CPAP. Perpetuating factors include ongoing psychological barriers, inadequate patient education, and suboptimal communication with healthcare providers. Precipitating factors include device-related anxiety, and perceived stigma. In addition, motivators that support adherence have been identified, such as perceived improvements in quality of life, bed partners' support, and tailored educational programmes highlighting the benefits of CPAP. Interventions such as cognitive behavioural therapy and psychological patient support show promise in improving adherence. Introducing a novel application of the 3P model, this scoping review underscores the complexity of psychological and behavioral determinants of CPAP adherence, highlighting the need of a multifaceted, patient-centered approach. Future research should evaluate the effectiveness of personalized interventions through longitudinal studies to assess their impact on treatment adherence and clinical outcomes.
Previous theoretical and empirical research has highlighted the predictive utility of different physiological reactivity and recovery patterns during acute stress for long-term mental health outcomes. Timely identification of mental health risk can be achieved by integrating these multiple temporal responses to characterize adaptive, dynamic resilience factors and then generating a resilience index. This study aimed to generate a resilience index to characterize the adaptive and dynamic resilient physiological responses and identify the predictors of these responses from a wide array of candidate predictors of psychological resilience in previous studies. Trier Social Stress Test (TSST) was used to induce acute stress responses in a sample of 248 participants (56.0 % female). Principal component analyses (PCA) were employed to integrate cortisol and cardiovascular responses to the TSST. The resilience index, comprising of the PCA reactivity and recovery scores, was related to better mental health. Using the least absolute shrinkage and selection operator regression, 25 of the 48 predictors were identified as critical ones, including baseline physiological activity, coping and emotion regulation strategies (e.g., positive reappraisal and instrumental support seeking), positive affective style and emotional reactivity, cognitive functions (e.g., interference inhibition), and demographic factors (e.g., minor medical conditions) (absolute magnitude of coefficients=0.402-3.865). These findings highlighted the importance of considering stress reactivity and recovery and physiological stress responses to understand the resilience factors, offering significant insight into developing wearable cognitive behavioral adjustment protocols to promote recovery from stress and hence mental well-being.
This study explored the feasibility and the preliminary efficacy of adaptive tablet-based cognitive training (CT) and paper-and-pencil CT approaches for mitigating multidomain post-stroke cognitive and noncognitive deficits. In this two-arm pilot randomized controlled trial, participants were randomly assigned to the NeuroAIreh@b (NAIr; adaptive tablet-based CT inspired by activities of daily living) and the Task Generator (TG; adaptive paper-and-pencil CT). A non-randomized passive control group was recruited for comparative purposes. Interventions comprised 12 bi-weekly 30-minute sessions. Primary outcomes explored training effects on several cognitive (e.g., global cognition, episodic memory), and noncognitive domains (e.g., quality of life, functional abilities). A total of 20 participants were randomized (NAIr: n = 10; TG = 10). Within-group analysis revealed that the NAIr group presented significant improvements in more cognitive domains than the TG, and reported less functional disability, increased quality of life and greater motivation for rehabilitation at post-intervention. At follow-up, the NAIr group further improved in several cognitive domains and reported greater quality of life, while TG only improved in global cognition. Between-group analysis exhibited a pattern of superior performance in the adaptive CT groups over passive controls. Findings suggest that adaptive CT interventions are feasible to implement and lead to cognitive and noncognitive improvements in community-dwelling stroke survivors. However, while both training approaches yield different short and medium/long-term benefits, the NAIr - a more ecologically valid method - was the only to promote generalization of training effects to functionality and quality of life at post-intervention and three-month follow-up, respectively. The trial is registered at ClinicalTrials.gov, number NCT05929287. Registered July 3rd, 2023 (cf. https://classic.clinicaltrials.gov/ct2/show/NCT05929287).
Hope and despair are often conceptualized as opposing emotional responses following adversity. While traditionally considered as mutually exclusive, contemporary theoretical frameworks and qualitative research suggest that these emotions may coexist or fluctuate over time. This study examines the relationship between hope and despair in the context of protracted war, exploring their connection with three types of resilience, negative coping factors such as distress, sense of danger, and perceived threats, as well as demographic variables, using quantitative methods. The study is a correlational research based on an internet panel sample of 745 Hebrew-speaking adults in Israel, surveyed at two time points during the ongoing war between Israel and Gaza, with data collected in December 2024 and June 2025. A range of established scales was used to assess the various variables. The findings showed that hope and despair predicted each other only in the first measurement, and, contrary to the assumption that they are opposites, both emotions increased simultaneously from the first to the second measurement. Furthermore, they were predicted by different factors: resilience, particularly societal, individual, and community resilience, predicted hope, while negative coping factors, such as distress symptoms, sense of danger, and perceived threats, predicted despair. These findings suggest that hope and despair are not merely opposites, but rather distinct emotions influenced by different underlying factors. The results underscore the need for further research on the interplay between these emotions and highlight the importance of understanding the mechanisms influencing them in extreme contexts to inform therapeutic and resilience-building interventions.
Depression is common among cancer patients, adversely affecting treatment adherence, toxicity, and quality of life (QoL). However, its course during adjuvant therapy and its impact on outcomes in resected cancer remain poorly understood. This study evaluated changes in depression from treatment initiation (T1) to six months later (T2) and examined associations with demographic, clinical, and psychological factors, treatment-related toxicities, and QoL. In this multicenter, prospective observational study, 927 patients with resected, non-metastatic cancer receiving adjuvant treatment were enrolled. Depressive symptoms were measured using the Brief Symptom Inventory-18 (BSI-18) at T1 and T2. Patients were classified as "never" (no symptoms at T1 or T2), "new-onset" (absent at T1, present at T2), "remission" (present at T1, absent at T2), or "persistent" (present at both time points). Treatment-related toxicities were evaluated according to CTCAE v4.0, and QoL was assessed with the EORTC QLQ-C30. At T2, 50.8% of patients remained asymptomatic, 12.3% experienced remission, 23.4% exhibited persistent depression, and 13.5% developed new-onset depression. Persistent depression was more common among women, younger patients, those without a partner, and breast cancer patients. Patients with persistent symptoms showed significantly higher toxicities-including hematologic, digestive, and neuropathic events, as well as increased asthenia (p < .001)-and poorer functioning with greater symptom burden, resulting in markedly reduced overall QoL. In multivariate analyses, baseline depression and ECOG performance status were the main predictors of depressive symptoms at six months, while age predicted changes over time; other sociodemographic or clinical factors were not significant. Logistic regression confirmed that younger age, female sex, breast cancer, and poorer ECOG were associated with higher odds of persistent depression compared with never-depressed patients. Both baseline depression and functional impairment (ECOG) are independent predictors of depressive symptoms during adjuvant therapy. Persistent depression is significantly associated with increased treatment toxicity and poorer QoL in patients with early-stage resected cancer, highlighting the need for routine screening and early psychological intervention during adjuvant treatment.
Suicidality is a complex, multifaceted issue with significant biopsychosocial causes, ranking as a major cause of death in developed nations. This study aims to leverage machine learning (ML) to predict monthly suicide counts in Poland using Google Trends data, contributing to ongoing efforts to improve public health strategies. Using data from the Polish National Police (2013-2023), monthly suicide attempt counts were analysed alongside relative search volumes (RSVs) of 40 suicide-related and mental health terms. Pearson Correlation Coefficient (PCC) identified the strongest predictors. Four ML models: Linear Regression, Random Forest, Support Vector Regression (SVR), and XGBoost Regression were tested, with PCC and error metrics guiding model selection. Results showed that 16 terms were the best predictors for the general population and 13 for the adult cohort. Random Forest Regression outperformed the other models, achieving a PCC of 0.909 and a mean absolute percentage error (MAPE) of 6.78% for the general population, compared to SVR's PCC of 0.644 and 14.8% MAPE. For the adult cohort, Random Forest yielded a PCC of 0.853 and MAPE of 7.21%, again outperforming SVR. Key predictors included anxiety disorders and psychiatrist terms for the general population, with also social isolation being significant for adults. This study presents one of the first ML approaches to predicting suicide attempts at national level, highlighting the utility of Google Trends data. Further research with higher-resolution data is recommended to refine predictive models and enhance suicide prevention strategies.
Considering masturbation parameters other than frequency provides a more holistic view of this sexual behavior. This study aims to provide validity evidence for masturbation parameters (i.e., negative attitudes toward masturbation, solitary sexual desire, current masturbation frequency, and subjective orgasm experience) through their relationship with different measures of sexual arousal (i.e., genital response, rating of sexual arousal, and rating of genital sensations). Eighty young cisgender adults (40 men and 40 women) aged 18 to 30 years, who engaged in heterosexual sexual relationships, participated in a laboratory task in which their sexual arousal was recorded in response to neutral and sexual videos. Regression models were conducted to examine the association between masturbation parameters and sexual arousal measures. In men, solitary sexual desire (β = .72) and current masturbation frequency (β = -0.49) were related to the rating of genital sensations. In women, current masturbation frequency was related to genital response (β = .33), the rating of sexual arousal (β = .43), and the rating of genital sensations (β = .44); this last measure of sexual arousal was also related to the rewards dimension of subjective orgasm experience (β = .37). These results provide validity evidence of masturbation parameters in individuals who engaged in heterosexual sexual relationships. The importance of considering these parameters in the induction of sexual arousal, taking gender into account, is discussed.