This study aims to contribute to an improved dynamic person-centred comprehension of the distinct trajectories of alcohol-related problems observed among first-year nursing students. Data was collected from 2963 first-year nursing students on four occasions over the course of their first semester of professional training (3 months). Four main profiles best described trajectories of alcohol-related problems: High and Decreasing, Moderate and Stable, Moderate and Increasing, and Low and Stable. Our results suggested that initial (but not change in) levels of boredom, harassment, and alcohol use were primary drivers of these trajectories, reinforcing importance of early intervention. Initial levels of boredom and alcohol use were associated with a lower likelihood of membership into the Low and Stable profile relative to the other profiles. Boredom was also associated with higher initial levels of alcohol-related problems in the High and Decreasing and Low and Stable profiles, while alcohol use was associated with membership into the Moderate and Stable profile relative to High and Decreasing and Moderate and Increasing profiles, as well as with higher initial levels and fluctuations over time in alcohol-related problems in most profiles. Harassment was associated with higher initial levels of alcohol-related problems in the Moderate and Stable profile, and with fluctuations in problems in the High and Decreasing and Moderate and Stable profiles. Profiles with lower levels of alcohol-related problems tended to display lower levels of fatigue, and higher levels of perceived health and sleep quantity. Conversely, profiles with higher levels of alcohol-related problems displayed poorer health outcomes. The person-centred approach adopted in this study allows us to improve our understanding of how alcohol-related problems first unfold among first-year nursing students, as well as of the outcomes and predictors of these trajectories.
The COVID-19 pandemic and the Russia-Ukraine war are seen as global crises, possibly affecting mental health worldwide. Longitudinal research seeking to understand these effects is still scarce. The current study aimed to examine mental health trajectories and links between stress, anxiety, depression, and positive mental health (PMH) over time from pre-pandemics to the ongoing war in Ukraine. The four-measurement points study was conducted on a sample of young adults from Lithuania and Germany (N = 432; 76.4% female; Mage (SDage) = 22.98 (6.35) at T1). The latent change analysis was used to reveal the change trajectories, the latent class change analyses to indicate the patterns of change, and the cross-lagged panel analysis was used to examine how mental health indicators predict one another over time. On average, no changes were observed in mental health indicators over the study period. Nevertheless, latent class analysis revealed two distinct trajectories: 76.4% of participants belonged to the low-symptom group, where depression (d = -0.61), anxiety (d = -0.19), and stress (d = -0.26) decreased over time, while 23.6% belonged to the high-symptom group, where depression (d = 2.32), anxiety (d = 0.79), and stress increased (d = 1.09) substantially, and positive mental health (PMH) decreased (d = 0.82). Moreover, better PMH before the pandemic and during the 2nd COVID-19 outbreak predicted lower stress a year after; higher anxiety before the pandemic and during the release of COVID-19 restrictions predicted higher stress a year after. Crisis interventions should target anxiety and positive mental health to help young adults cope with stress in times of change, threat, and unpredictability.
Emergency medicine clinicians (EMCs) experience high levels of burnout and mental health strain as a function of the work demands they encounter. The present study examined meaningful work as a buffer of the relationship between work demands and measures of burnout and mental health strain, with the prediction that higher levels of meaningful work would protect EMCs from high levels of work demands. This study offers a longitudinal examination of these relationships in a sample of 113 emergency medicine registered nurses, physicians, residents, and advanced practice providers during the COVID-19 pandemic. Participants completed an online survey containing measures of work-related demands, meaningful work, burnout, and mental health strain at Time 1 and then completed the same survey 2 months later at Time 2. Work demands at Time 1 were correlated with burnout and mental health strain at Time 2. Meaningful work at Time 1 correlated negatively with burnout and mental health strain at Time 2. Moderated multiple regression tests revealed that meaningful work at Time 1 moderated the relationship between work demands at Time 1 and burnout at Time 2, such that the relationship between work demands and burnout was not significant for EMCs reporting average or high meaningful work. Moderate to high levels of meaningful work at Time 1 substantially reduced the impact of work demands on EMCs 2 months later. Results suggest that interventions should be explored to enhance meaningful work, thereby reducing the negative effects of work demands on burnout and mental health strain.
This is a longitudinal stydy to explore the relationship between fear of disease progression and dyadic self-care in stroke patients and their spouses. Between August 2024 and May 2025, 369 stroke patient-spouse dyads completed two rounds of surveys, including the General Demographic Questionnaire, the Fear of Progression Questionnaire Short Form, the Fear of Progression Questionnaire Short Form/Partner, the Self-Care of Chronic Illness Inventory, and the Caregiver Contribution to Self-Care Chronic Illness Inventory. Contemporaneous and cross-lagged network analyses were used to examine the interaction between these variables in stroke patients and spouses. Contemporaneous networks confirmed: (1) At dimensional level, there is a positive association between patients' self-care behavior and spousal contribution to self-care, as well as a positive association between their mutual fear of disease progression; (2) Spouses' fear of disease progression negatively correlated with their spousal contribution to self-care at dimensional level. Cross-lagged network confirmed bidirectional predictions between: (1) patients' fear of disease progression and their self-care; (2) spouses' fear of disease progression and their contribution to self-care. Patients' fear of disease progression and self-care dimensions predicted corresponding dimensions in spouses. The fear of disease progression and dyadic self-care among stroke patients and their spouses are dyadic phenomena and can predict each other. Stroke rehabilitation is a dynamic dyadic synergy; both partners' behaviours and emotions change together. Future rehabilitation programs should be phased and multi-targeted. In the early phase, focus on disease knowledge and symptom management to alleviate physiological fear. In the later phase, reconstruct social roles and family communication, correct the cognitive biases of spouses regarding patients' self-care behaviours, break negative loops, and promote mutual growth.
Takotsubo syndrome (TTS), or 'broken heart' syndrome, is an acute, reversible cardiomyopathy classically linked to emotional stress. Although physiological mechanisms have been extensively described, the psychological stress profile of patients with TTS remains incompletely synthesised. This study aimed to systematically review and meta-analyse observational studies examining psychological stress-related factors in patients with TTS compared with cardiac and non-cardiac control groups. We searched PubMed/MEDLINE, Embase, PsycINFO, Scopus, and Web of Science from 1 January 2011 to 31 March 2024 for observational studies of adults with TTS that used validated psychological assessments and included a cardiac or non-cardiac comparison group. Two reviewers independently screened studies, extracted data, and assessed risk of bias with the Newcastle-Ottawa Scale. Random-effects meta-analysis pooled odds ratios (ORs) for study-defined binary psychological endpoints, and comparator-group subgroup analyses were treated as main analyses. Sixteen studies met the inclusion criteria, comprising 1133 patients with TTS and 1396 controls, including 1061 cardiac controls and 335 non-cardiac controls. Across studies, patients with TTS showed higher rates of acute emotional triggers, lifetime mood and anxiety disorders, trauma history, maladaptive personality traits (e.g., neuroticism and Type D personality), and broader psychological distress, including posttraumatic stress symptoms, sexual distress, and reduced quality of life. The pooled OR for overall psychological morbidity/stress exposure was 6.50 (95% CI: 3.14-13.49), with substantial heterogeneity (I2 = 84.1%). Comparator-category subgroup analyses showed larger effects against acute coronary syndrome/acute myocardial infarction controls than against healthy volunteers alone. TTS is strongly associated with both acute emotional stressors and chronic psychological vulnerability, supporting models that conceptualise the syndrome as an extreme stress response of the cardiovascular system. These findings reinforce the value of routine psychosocial assessment and stress-focused interventions in the care of patients with TTS.
The fear of cancer recurrence (FCR) is one of the most frequently expressed concerns among breast cancer (BC) survivors. This study explored profiles of FCR and adaptation indicators, centring on body image and 'bouncing back', 18 months post-diagnosis. It also examined psycho-social predictors for profiles. The study sample comprised 494 women from Finland, Italy, Portugal, and Israel, diagnosed with Stage I-III BC. Participants' ages ranged from 40 to 70 years (M = 54.92, SD = 8.22) and were assessed at diagnosis and after 3 and 18 months. Participants completed self-report questionnaires, including Fear of Cancer Recurrence Inventory-Short Form, Body Image Subscale- from the quality-of-life questionnaire- BC module, Bounce Back single self-report item, Hospital Anxiety and Depression Scale, modified Medical Outcomes Study Social Support Survey along with medical-social-demographic data. Three profiles of FCR and adaptation indicators were identified: (1) the Adaptive Profile (67% of the sample), indicated relatively low levels of FCR and higher levels of body image and bounce back; (2) the Distressed Profile (19%), marked by higher FCR compared to the other profiles, moderate body image and bouncing back; and (3) the Body Image Impairment Profile (14%), with participants reporting the lowest body image levels relative to the other two profiles. Depression levels 3 months post-diagnosis predicted more challenged coping FCR profiles. This study identifies distinct patterns of FCR and adaptation during the initial phase of BC survivorship. While most women adjust well, a considerable portion continue to face challenges. Among women experiencing elevated depressive symptoms early in the disease, these difficulties may be further compounded, highlighting the importance of early screening and timely preventive intervention.
Compared with non-left-behind children (NLBC), left-behind children (LBC) face a higher risk of academic stress, depression, and anxiety symptoms due to separation from their parents; however, the heterogeneity of academic stress profiles and their relationships with the symptom network remain insufficiently explored. To address this gap, a cross-sectional survey of 10,524 Chinese children compared LBC (n = 2487) and NLBC. Latent profile analysis (LPA) was first conducted to identify academic stress subgroups among LBC. Subsequently, depression-anxiety symptom networks were estimated using Ising and Gaussian graphical models (GGM), with edge weights derived from regularised logistic regression (Ising) and partial correlation (GGM). Simulated interventions were further evaluated via the NodeIdentifyR algorithm (NIRA). Overall, compared to NLBC, LBC exhibited higher levels of academic stress, depression, and anxiety (ps < 0.001, Cliff's δ = 0.076; Cohen's d = 0.067). LPA revealed three academic stress subgroups: moderate (31.44%), high (9.17%), and low (59.39%). The severity of depression and anxiety symptoms increased with the level of academic stress. The high stress subgroup displayed a sparse network with stronger edges (e.g., A1 'Sudden Fear'-A4 'Physical Symptoms', edge weight = 2.10) compared to moderate- and low-academic stress subgroups. Core nodes with the strongest expected influence were A8 ('Decision Hesitation', moderate subgroup), A2 ('Worry', high subgroup), and D1/D6 ('Sadness' and 'Failure', low subgroup). Simulated interventions indicated that alleviating A8 'Decision Hesitation' or A2 'Worry' most effectively reduced symptom risk (16.66%-30.76%), whereas D8 'Motor' and A7 'Early Departure' were associated with maximal symptom aggravation. Taken together, by integrating LPA-derived academic stress profiles with symptom network analysis, this study reveals distinct symptom associations across subgroups. In the high stress subgroup, symptom A2 ('Worry') is a core intervention target; in the low stress subgroup, A7 ('Early Departure') holds preventive potential. These findings underscore subgroup-specific interventions tailored to individual stress profiles.
Child's challenging behaviours can pose complex, highly stressful demands on parents. Such chronic stress may affect autonomic regulation, particularly vagal balance, and increase oxidative stress and the risk of developing chronic diseases. This study investigated the association between the child's challenging behaviour and heart rate variability, psychological and oxidative stress in parents of children with chronic conditions. We included parents of children with autism spectrum disorder, cerebral palsy, Down syndrome, diabetes type 1, and parents of healthy children. Multivariate linear regression was used to determine the association between parenting, the child's challenging behaviour, parental stress, resilience, heart rate variability, and advanced glycation end products. Parents of children with autism spectrum disorder reported the highest level of child's challenging behaviour, while parents of children with diabetes type 1 showed lower stress resistance. Child's challenging behaviour was significantly associated with higher parental stress, reduced stress resilience, higher advanced glycation end products and longer mean interval between heartbeats. Advanced glycation end products were associated with parental age, nonsmoking, and time-domain parameter pNN50. Parents of children with chronic conditions had increased sympathetic activity and impaired sympathovagal balance. The study confirms the increased risk for the development of adverse health outcomes in parents of children with chronic conditions. A healthy lifestyle and non-pharmacological strategies, including heart rate variability biofeedback and emotional self-regulation, alongside respite care programs, may help prevent disrupted autonomic function, oxidative stress, and parental overload. Public health programs are essential to promote health and slow the ageing process in these vulnerable populations.
Smoking represents a significant public health problem and exploring the factors that may influence its development in youth is of major importance. The research on adolescent populations that addresses the impact of posttraumatic stress on smoking over time, especially using ethnicity and gender perspectives, remains limited. The study was conducted on a representative sample of predominantly ethnic minority youth (N = 2596; 53.5% female; age 11-16 years old (M(SD) = 12.75(1.27)); 58.8% African-American, 25.5% Hispanic American, 13.6% White). Self-reported information was obtained on smoking, symptoms of posttraumatic stress and depression in year 1 and on smoking in year 2. Generalised Linear Models were used to explore the association between posttraumatic stress in year 1 and smoking in year two in youth from the different ethnic groups, while controlling for their baseline levels of smoking, depressive symptoms, age and socio-economic status. Posttraumatic stress was related to smoking one year later, and the association remained significant while also adjusting for the baseline variables. Sensitivity analyses indicated that the association was primarily driven by smoking frequency rather than smoking quantity. The association between posttraumatic stress and smoking did not differ by gender or ethnicity, although more females than males reported smoking both at baseline and one year later, and fewer African American adolescents reported smoking, as compared to White and Hispanic American adolescents. The findings emphasize the importance of the timely recognition of traumatic exposure and may inform targeted prevention and early interventions.
Adverse childhood experiences (ACEs) and stress are associated with both mental health and chronic medical conditions later in life. Social and psychosocial determinants of mental health, including social connectedness measures (i.e., emotional support and social isolation), and life satisfaction, can serve as protective or risk factors shaping overall mental well-being. The purpose of this study was to examine the links between adverse childhood experiences, stress, and three psychosocial outcomes: emotional support, social isolation, and life satisfaction in US adults along with determining whether these relationships varied by race and sex. Cross-sectional data were obtained from the 2022 Behavioural Risk Factor Surveillance System dataset. The main predictor variables were ACEs reported stress levels, race/ethnicity, and sex. The outcome variables measured were social isolation, life satisfaction, and emotional support. Survey procedures were used to build the multiple logistic regression models to measure the association between predictor and outcome variables. Adjusted odds ratios (OR), 95% confidence intervals (CI), and p-values were computed. When controlling for covariates, both the ACE count category and stress demonstrated a statistically significant association with all three outcome variables (i.e., life satisfaction, social isolation, and emotional support). When controlling for ACE count category and stress levels, race and sex both demonstrated a statistically significant association with social isolation and emotional support. Our study demonstrated that ACEs and chronic stress are significantly associated with lower life satisfaction, increased social isolation, and reduced emotional support. Racial and sex differences persisted even after adjusting for covariates. Our findings underscore the lasting psychosocial effects of early adversity and the need for culturally sensitive interventions, community-based support systems, and early prevention programs to promote long-term well-being.
Military personnel and veterans are exposed to high levels of stress throughout their military careers and following separation and are susceptible to stress-related psychopathology. The objective of this systematic review is to evaluate research on the repeated monitoring of stress and stress-related mental health outcomes in these populations (PROSPERO ID#CRD42024587783; Funding: US Department of Veterans Affairs). Systematic searches of three databases (APA PsycInfo, PubMed, PTSDPubs) were conducted from inception until September 30, 2025. Inclusion criteria were military or veteran samples, self-report or clinician-rated stress, depression, anxiety, trauma-related distress, or mood measures, repeated monitoring within a 4-week timeframe, and original peer reviewed research. Each study was assessed for risk of bias with an empirically supported critical appraisal checklist. Data were synthesised by three authors (A.M., E.H., and N.M.M.). Of the 61 included studies, most were in majority male (94.9%), White (82.6%), and veteran-only (67.2%) samples. Traditional self-report measures were the most used assessment type (32.7%), followed by ecological momentary assessment (26.2%). Most studies monitored posttraumatic stress disorder (PTSD) (52.5%) and depressive (44.3%) symptoms, with fewer studies measuring stress (31.1%) and anxiety (11.5%). Approximately a quarter (26.2%) measured stress and stress-related mental health outcomes concurrently. Most studies measuring mood were completed in samples with a primary focus on PTSD (63.2%). Although repeated assessment in military and veteran populations provides important insight into changes in stress and stress-related outcomes, studies together were limited by inconsistencies in methodology. We highlight potential contributions in methodology to capture risk and resilience and improve outcomes for these populations. TRIAL REGISTRATION: This systematic review was pre-registered: https://www.crd.york.ac.uk/PROSPERO/view/CRD42024587783.
Paramedicine students experience disproportionately high rates of anxiety, depression, stress, and insomnia compared to the general population, placing them at risk of post-traumatic stress disorder and long-term psychological distress. Breathwork has emerged as a promising self-regulation intervention that may enhance resilience and wellbeing while reducing symptoms of mental illness. This randomised controlled trial (RCT) evaluated the effectiveness of the A52 Breath Method, a structured breathwork protocol, in improving mental health and resilience among student paramedics. A single-blind parallel-group mixed-methods RCT was conducted with 98 student paramedics from two Australian universities, randomised to either a 12-week breathwork intervention or control, with results interpreted in light of differential attrition. The intervention involved twice-daily practice of slow, diaphragmatic breathing (5-s inhale, 5-s exhale, 2-s hold) with video and guided audio instruction. Outcomes included changes in anxiety, depression, stress (DASS-21), insomnia (ISI), resilience (RS-14), and psychological wellbeing (RPWB-18), between baseline and post-intervention. Analyses included 2 × 2 mixed factorial ANOVA, ANCOVA for baseline differences, and correlation analyses. At post-intervention, participants in the breathwork group reported significantly lower stress, anxiety, and depression scores, and higher resilience compared to controls (all p < 0.05), with medium to large effect sizes. Insomnia and psychological wellbeing showed non-significant changes. Qualitative feedback highlighted perceived benefits for self-regulation, including emotional regulation and perceived psychological safety and control-although challenges to practice engagement was noted. The A52 Breath Method significantly reduced reported symptoms of psychological distress and enhanced resilience in student paramedics, even during exam stress. Breathwork shows promise as a scalable, upstream intervention to support mental health in paramedic student training. TRIAL REGISTRATION: Registered with the Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12625000101482 on 30/01/2025. Available at: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=388884&showOriginal=true&isReview=true.
Physiological markers are increasingly used to monitor individuals undergoing Virtual Reality (VR) stress interventions. However, several challenges arise when employing these markers to assess the impact of VR stress interventions. This systematic review synthesises and critically discusses the literature on VR stress interventions across contexts, study designs using physiological markers, marker usage, measurement setups, trends in interpreting data for stress recovery, and meanings assigned to marker changes. This review follows the PRISMA guidelines. EMBASE, IEEE Xplore, PsycINFO, PubMed, and Web of Science were searched until 12th March 2024. Studies were included if they used a head-mounted display (HMD) VR stress intervention and evaluated at least one physiological marker. The quality of studies was evaluated using the Evaluation Public Health Practice Project tool. Data were systematically extracted and summarised thematically and narratively. This review was registered with PROSPERO ID: CRD42024510162. Out of 11,479 articles identified, 69 studies were included: 59 conducted in the general population, four in mental healthcare, and six in the professional context. Study characteristics, experiment characteristics, and physiological outcomes were extracted. Most studies featured nature-based experiences, referenced Attention Restoration Theory (ART) and Stress Reduction Theory (SRT), and induced stress with mental arithmetic tasks or the Trier Social Stress Test (TSST). Many studies lacked theoretical grounding, had small sample sizes, conducted only a single VR session in a laboratory setting, and had low quality. Physiological markers and timepoints varied widely, with heart rate (HR), HRV (RMSSD, SDNN, LF, HF), and blood pressure being the most common. Fifty-six studies found that VR interventions reduced stress as measured by physiological markers. However, methodological inconsistencies limited their findings. Future research should prioritise ambulant measurements to improve real-world applicability and assess long-term effects. Additionally, standardising marker selection and measurement protocols is necessary to enhance validity and comparability, thereby strengthening evidence of VR stress interventions. TRIAL REGISTRATION: PROSPERO ID: CRD42024510162.
The effects of adverse childhood experiences (ACEs) and positive childhood experiences (PCEs) and its interactions on the development of sleep quality in adolescents were unclear. To investigate the effect of ACEs and PCEs on the developmental trajectories of sleep quality in adolescents and to examine the potential moderating role of PCEs on the effects of ACEs. This study was conducted based on Anhui Child & Adolescent Healthy Growth Cohort. Latent class growth analysis (LCGA) was applied to capture the developmental trajectory of sleep quality. Logistic regression analyses were conducted to determine the effects of ACEs and PCEs exposure on sleep quality trajectories. Interaction analyses were performed to explore the moderating role of PCEs on the impact of ACEs. A total of 877 adolescents were included in this study (mean age: 11.31 ± 1.63, 51.1% were boys). Adolescents with ACEs exposure showed higher risk of poor development of sleep quality and there was a positive dose-response relationship. Adolescents with a pattern of 'high ACE levels' exposure (OR: 3.74, 95% CI: 2.02-6.91) were more likely to experience poor sleep quality development. In contrast, adolescents with a pattern of 'high PCE levels' (OR: 0.50, 95% CI: 0.31-0.80) were less likely to experience poor sleep quality development. Moderate to high levels of PCEs exposure (3-7 PCEs) can significantly moderate the adverse effects of ACEs on sleep quality development. This study suggests that ACEs exposure adversely affects the development of sleep quality among adolescents, while PCEs can moderate this effect. These findings highlight the urgency of early screening and intervention for ACEs and emphasise the importance of implementing various strategies in early life to promote PCEs.
The October 7, 2023, attack on Israel marked a traumatic escalation in the Israel-Gaza conflict, placing immense psychological pressure on first responders (FRs). This study examined whether the relationship between burnout and psychological distress was moderated by profession (FR vs. non-FR) during the 'Iron Swords' war. Data were collected between December 2024 and February 2025, from a convenience sample and snowball sampling of 885 Israeli participants (257 FRs and 628 non- FRs). Participants completed validated measures of burnout and distress, along with socio-demographic information. Hierarchical regression analyses revealed that burnout significantly predicted distress across the full sample. No main effect of FR on distress was found. However, a significant interaction emerged: burnout's effect on distress was significantly stronger among FRs than non-FRs. The findings suggest that FRs are more vulnerable to the psychological toll of burnout, particularly in trauma-exposed environments. These results align with the Conservation of Resources (COR) theory, highlighting the depletion of emotional resources as a key mechanism driving distress under chronic occupational strain. The study underscores the importance of assessing burnout alongside trauma exposure when evaluating FR mental health. Clinically, results emphasise the need for early identification and tailored interventions targeting burnout among FRs, with an emphasis on resilience-building, psychological flexibility, and organizational support (e.g., peer debriefings, workload management). Future longitudinal research is needed to clarify causality and examine profession-specific effects. Overall, burnout appears to be a key amplifier of wartime distress in FRs, with implications for intervention policy and mental health strategy during crisis contexts.
Despite increasing recognition of the workplace as a key social determinant of health, the role of the workplace in shaping the mental health and well-being of Black mothers has been understudied. The current study examined whether certain occupational stressors and coping resources (i.e., pressure, flexible work arrangements, benefits, supervisor support, and coworker support), predicted levels and changes in African American mothers' depressive symptoms from 6 to 24 months postpartum. Analyses were conducted using data from the Family Life Project, which included 152 full-time employed African American mothers living in rural, low-income communities in North Carolina and Pennsylvania. Results revealed that more flexible work arrangements and greater support from supervisors and coworkers predicted fewer depressive symptoms at 6 months postpartum. Additionally, greater work pressure predicted more depressive symptoms at 6 months postpartum as well as increases in depressive symptoms over time. Furthermore, coworker support and workplace flexibility interacted to predict depression levels at 6 months postpartum, with less flexibility associated with higher levels of depression under conditions of low support. This study demonstrates the critical role of the workplace in shaping maternal mental health outcomes for African American mothers during the postpartum period. Findings underscore the importance of understanding work stressors that may heighten risk for maternal depression as well as leveraging the resources that serve as protective factors to promote better mental health outcomes for Black mothers. Implications and future directions are further discussed.
Chronic stress, common in university students and particularly pronounced in women, negatively impacts health. Heart Rate Variability (HRV), an autonomic balance measure, is influenced by stress, physical activity (PA), and the menstrual cycle. This study examined HRV and perceived stress differences in healthy-weight female university students by PA level. Fifty-two female university students (18-30 years, BMI 18.5-24.9 kg/m2) were recruited. To minimise hormonal variability, assessments for naturally menstruating participants were conducted during the early follicular phase, confirmed through a cycle-tracking application and luteinizing hormone (LH) tests. For participants using hormonal contraceptives, measurements were scheduled during the first week of a new contraceptive cycle. PA was assessed (IPAQ-SF) and categorised as low-moderate or vigorous. HRV was recorded using a Polar H10 over three days for reliability (SDNN, LF, HF, LF/HF ratio) were analysed. Perceived stress used the Perceived Stress Questionnaire (PSQ). Group differences and associations were then analysed, controlling for total PA (METs). Forty-two participants completed the study. Vigorous PA was associated with higher SDNN (p = 0.099, d = -0.620) and lower LF (p = 0.045, d = -0.761) versus the low-moderate PA group, indicating more efficient cardiac autonomic modulation. METs significantly influenced SDNN, HF, LF, and pNN50. However, no significant differences were found in LF/HF ratio (p = 0.990) or perceived stress (p = 0.249) between groups, nor were significant correlations observed between PSQ scores and any HRV indices. Higher PA levels correlate with a more favourable autonomic profile (increased parasympathetic activity, reduced sympathetic drive at rest, unaltered LF/HF balance). The lack of association between PA/perceived stress and perceived stress/HRV suggests a potential dissociation between subjective stress perception and objective autonomic activity in this population.
Mental health therapists (MHTs) providing care during shared traumatic reality face distinct emotional and professional challenges, particularly when they are also personally affected. While a central concern is compassion fatigue, emotional exhaustion that arises from prolonged exposure to others' trauma, this concept does not capture the dual nature of the MHT's traumatic experience, both as a citizen of the region and as a helping professional exposed to the traumatic narratives of their clients. This study explores the shared traumatic reality experiences of MHTs working in a war zone, offering support to trauma survivors while navigating their own exposure to the same crisis. Through qualitative, semi-structured interviews with 20 therapists conducted between April and July 2024, three key themes emerged: (1) We're All in the Same Boat-When Boundaries Blur, reflecting how shared traumatic reality erodes traditional therapeutic roles; (2) The Collapse of Everyday Concerns-When Nothing Feels Important Unless It's Related to the War, illustrating how therapists deprioritised non-trauma issues and experienced emotional detachment; and (3) Therapy as Shared Emotional Support, highlighting a shift towards mutual validation rather than structured interventions. From these findings, we propose a model conceptualising the dual impact of shared traumatic reality on therapists: boundary dissolution can both increase distress and foster resilience, especially when cultural values of solidarity and mutual responsibility are present. Although rooted in one cultural context, this model underscores the importance of identifying community-level resilience factors that help MHTs maintain professional functioning during collective crises and when operating in war zones and other high-stress environments.
The COVID-19 pandemic has become a major psychosocial stressor, exacerbating depressive symptoms among youth. Amid escalating environmental stressors, early intervention is essential. Digital music therapy (dMT) shows promise; however, stress-context randomized controlled trials examining its effectiveness and mechanisms are lacking. A total of 1581 youths were identified with depressive symptoms via survey. In a randomized trial, 105 participants were 1:1 assigned to the dMT or control (CON) group. The dMT group received 3 weeks of intervention, while the CON group received none. The primary outcome will assess depression changes ( Δ ${\Delta }$ ) of pre- and post-intervention, compared to CON group. Secondary outcomes will evaluate Δ ${\Delta }$ Stress and Δ ${\Delta }$ Insomnia, compared to CON group. Mediation analysis examined depressive symptoms' role in mediating stress and insomnia, further assessed dMT efficacy's mediating role in these outcomes. There were significant differences in Δ ${\Delta }$ Depression, Δ ${\Delta }$ Stress, and Δ ${\Delta }$ Insomnia between dMT group (n = 30) and CON group (n = 30). Depressive symptoms directly and indirectly mediated the relationship between stress and insomnia among depressive youth identified via survey. The therapeutic effect of the dMT intervention on Δ ${\Delta }$ Depression indirectly mediated the relationship between Δ ${\Delta }$ Stress and Δ ${\Delta }$ Insomnia. Digital MT-driven depression improvement mediates stress and insomnia alleviation, filling a crucial gap in early-stage mental health interventions with potential social and clinical impact. TRIAL REGISTRATION: The clinical trial registration was ClinicalTrials.gov NCT05949736.
Scarcity significantly impacts individual decision-making processes. Meanwhile, perceived stress has been identified as closely linked to both scarcity and risk-taking. While psychological resilience serves as a crucial protective factor in coping with stress, prior research has predominantly focused on the relationship between tangible resource scarcity (e.g., financial scarcity) and risky decision-making. There's a notable lack of studies exploring how time scarcity, a common form of intangible resource scarcity, influences individual risk-taking. This study employed behavioural experiments to investigate the effects of time scarcity on risky decision-making, as well as the roles played by perceived stress and psychological resilience. Our findings indicate that individuals operating under conditions of time scarcity exhibit a greater tendency towards risk-seeking, making more adventurous decisions. Perceived stress was found to mediate the relationship between time scarcity and risky decision-making. Furthermore, psychological resilience negatively moderated both the impact of time scarcity on perceived stress and the mediating effect of perceived stress. Specifically, high-resilience individuals experienced less perceived stress and demonstrated lower levels of risk-taking in their decisions under time scarcity. This research sheds light on the underlying mechanisms through which time scarcity influences risk-taking behaviour, offering valuable insights for improving individual decision-making quality.