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Background: Psychological interventions are a promising area for fatigue management in patients with inflammatory bowel disease (IBD). However, most interventions trialled to date have been pilots with limited direct input from patients about the type of intervention they want. Thus, this study aimed to explore patient preferences for a psychological IBD fatigue intervention. Methods: An international online cross-sectional survey was conducted with adults with self-reported IBD. A conjoint analysis was employed to elicit, through a series of forced-choice scenarios, patient preferences for a fatigue intervention. For this study, the attributes manipulated across these forced-choice scenarios were type of intervention, modality of delivery, and duration of intervention. Results: Overall, 834 people with IBD were included in analysis. Respondents ranked the type of psychological intervention as most important for overall preference (with cognitive-behavioral therapy (CBT) preferred over the other approaches), followed by modality of delivery, but placed very little importance on how long the intervention runs for. Patients with IBD appear to most strongly preference a short online CBT intervention for managing their IBD-related fatigue. Conclusion: This study helps provide therapists and program developers clear direction on patient preferences when it comes to developing new psychological programs that address fatigue in IBD. [ABSTRACT FROM AUTHOR]

The current study explored perspectives of those with inflammatory bowel disease (IBD) and comorbid anxiety and/or depression on a hybrid acceptance and committment therapy (ACT) intervention, compared to an active control. This qualitative study was nested within a randomized controlled trial (RCT) where an experimental group received an 8-week blended delivery ACTforIBD intervention (four sessions telehealth, four sessions pre-recorded self-directed), while an active control group received a psychoeducation program of similar intensity. Semi-structured interviews were conducted post-intervention and at a 3-month follow-up. Themes were interpreted using reflexive thematic analysis. Twenty individuals participated; ten in each condition. Seven themes were constructed, including three shared themes between groups: I Am Worth Advocating For, Present Moment Is My Biggest Ally, and Ambivalence About Self-Directed Modules. Two themes were identified for the ACTforIBD group: Symptoms Are Going to Happen and Moving Toward Values while two themes identified from the ActiveControl group were: Reset and Refresh and It's Ok to Say No. Acceptance and values modules from ACTforIBD were perceived as useful in reducing psychological distress for those with IBD, while the ActiveControl group felt their program affirmed existing effective coping strategies. Access to external resources for self-directed modules and networking may increase engagement with content long term. [ABSTRACT FROM AUTHOR]

Purpose: Evidence shows that dialectical behavioural therapy (DBT) is efficacious for eating disorders (ED), yet few people have access to specialized treatments like DBT. Translating key DBT skills for delivery via a smartphone application may broaden the dissemination of evidence-based interventions. However, prior to developing a DBT-based app, it is crucial to gather information on target-user needs and preferences. Assessing overall acceptance and identifying predictors of acceptance, informed by the UTAUT framework, is also important. This process ensures not only a demand for such an app, but also that users receive content and features tailored to their needs. Method: This study aimed to understand target-user preferences of DBT-based apps for EDs by assessing willingness to engage, overall acceptance levels, and preferred functionality/content delivery modes (n = 326 symptomatic participants). Results: Eighty-eight percent indicated they would be willing to use a DBT-based ED app if it were available. Acceptance levels of a DBT app were high (64%), which was uniquely predicted by performance expectancy (perceptions of how beneficial an intervention is) and facilitating conditions (expectations of technological infrastructure and support in interventions) in path analysis. Content perceived as important to contain were emotion regulation techniques, tailored intervention strategies, and psychoeducation. Conclusion: Findings generate important information about target-user preferences of a DBT-based app for EDs, highlighting necessary design principles for apps of this kind. Level of evidence Level V, cross-sectional descriptive study. [ABSTRACT FROM AUTHOR]

This study examined the sustained and moderating effects of a behavioural sleep intervention for autistic children in a randomised controlled trial. Autistic children (5–13 years) with sleep problems were randomised to the Sleeping Sound intervention or Treatment as Usual (TAU). At 12-month follow-up (n = 150), caregivers of children in the Sleeping Sound group reported greater reduction in child sleep problems compared to TAU (p <.001, effect size: − 0.4). The long-term benefits of the intervention were greater for children taking sleep medication, children of parents who were not experiencing psychological distress, and children with greater autism severity. The Sleeping Sound intervention demonstrated sustained improvements in child sleep. Identified moderators may inform treatment by indicating which subgroups may benefit from further support. [ABSTRACT FROM AUTHOR]

Although consensual sending of sexts between adolescents is considered developmentally appropriate, it may also entail a range of negative consequences. Current sexting research lacks a comprehensive theoretical framework identifying a range of risk and protective factors underpinning adolescent consensual sending of sexts across individual, interpersonal, and distal levels. Further, there is a lack of systematic evaluation of how the importance of these factors may vary across adolescent age. This study investigated the utility of the Social Development Model to predict a range of risk and protective factors across individual, family, peer, school, and community-level factors. The sample included 1302 teenagers from Victoria, Australia (Mage = 14.54, SD = 1.14, 50.8% girls). Results indicated that 146 (11.7%) participants sent a sext (76 boys and 70 girls). Logistic regression analyses revealed that the Social Development Model accounted for 45.8% of variance in sexting, with greater likelihood of sending sexts being associated with older age, prior sexual activity, school sector, physical activity, lifetime substance use, greater depressive symptoms, sensation seeking, and perceived substance availability in the community. Multigroup analyses revealed that lifetime substance use was associated with a greater likelihood of sending sexts among younger teens. Among older adolescents, adaptive coping was associated with reduced engagement in sexting, while higher parental overcontrol and family conflict increased the odds of sending sexts. Overall, sexting is associated with a range of modifiable factors potentially amenable to intervention. [ABSTRACT FROM AUTHOR]

Background: Fatigue in inflammatory bowel disease (IBD) is poorly controlled, with few existing interventions. Psychotherapy interventions for IBD fatigue show promise; however, due to mixed findings in efficacy and attrition, current interventions need improvement. Some research shows beliefs about psychotherapy and stigma toward psychotherapy may impact engagement in psychotherapy interventions. Aims: This study aimed to examine the effects of IBD activity, fatigue, mental health status, previous experience with psychotherapy, and stigma toward psychotherapy on willingness to use psychotherapy as a fatigue intervention. Methods: An online cross-sectional survey was conducted, and linear regression models were used to examine willingness to engage in psychotherapy for fatigue. Results: Overall, 834 participants completed the survey. Regression analysis examining demographics, mental health status, IBD activity, fatigue, pain, antidepressant use, psychotherapy experience, and self-worth intervention efficacy belief significantly explained 25% of variance in willingness to use psychotherapy for fatigue. Significant factors included antidepressant use (b =.21, p <.01), pain (b = −.05, p <.001), and self-worth intervention belief (b = −.27, p <.001), which uniquely explained 18% of variance in the outcome. Conclusions: Willingness to engage in psychotherapy for fatigue in IBD appears to be driven by expectations related to specific self-worth beliefs, rather than stigma, IBD activity, or any prior experience with psychotherapy. Clinicians should directly address these expectations with their patients. [ABSTRACT FROM AUTHOR]

Background: Inflammatory bowel disease (IBD) is a common and debilitating disease of the gastrointestinal tract. Psychological distress is highly comorbid to IBD, especially during periods of active disease. However, a controversy exists on how to best manage its symptoms in the IBD population. Aims: This study aimed to explore protective and risk factors of psychological distress in IBD. Methods: A cross-sectional online survey was conducted via social media and online patient forums. Respondents (N = 235) filled out questionnaires on demographics, health characteristics and a range of psychological variables. Measures of pain, disease activity, comorbid functional symptom severity, social support, subjective wellbeing, sleep quality, fatigue, stress, age, BMI and gender were entered into the Classification and Regression Tree Analysis model. Results: Overall, 87 participants (37%) reported distress. Self-reported stress significantly discriminated between cases of probable psychological distress. In those with high stress, patients with and without probable psychological distress were separated by subjective wellbeing. Among patients with low stress, fatigue was the primary discriminator. Conclusions: Monitoring patients for low subjective wellbeing and high stress in clinical settings could offer an opportunity to engage in early intervention to limit psychological distress development. Monitoring for fatigue in patients who seem otherwise psychologically well could offer preventative benefits. [ABSTRACT FROM AUTHOR]

We explored the utility of chatbots for improving data quality arising from collection via sonline surveys. Three-hundred Australian adults sampled via Prolific Academic were randomized across chatbot-supported or unassisted online questionnaire conditions. The questionnaire comprised validated measures, along with challenge items formulated to be confusing yet aligned with the validated targets. The chatbot condition provided optional assistance with item clarity via a virtual support agent. Chatbot use and user satisfaction were measured through session logs and user feedback. Data quality was operationalized as between-group differences in relationships among validated and challenge measures. Findings broadly supported chatbot utility for online surveys, showing that most participants with chatbot access utilized it, found it helpful, and demonstrated modestly improved data quality (vs. controls). Absence of confusion for one challenge item is believed to have contributed to an underestimated effect. Findings show that assistive chatbots can enhance data quality, will be utilized by many participants if available, and are perceived as beneficial by most users. Scope constraints for this pilot study are believed to have led to underestimated effects. Future testing with longer-form questionnaires incorporating expanded item difficulty may further understanding of chatbot utility for survey completion and data quality. [ABSTRACT FROM AUTHOR]

Self-regulated learning (SRL) is associated with increased academic achievement and improved learning outcomes for students. Thus, it is import to find ways to improve SRL, such as through training. Face-to-face training, discipline-dependent training, and paper-and-pencil diaries are limited in the number of students they can reach. The current randomised control study implemented discipline-independent online training and novel mobile-app based diaries and tested SRL motivation and perceived strategy use in 73 University students from mixed disciplines and study mode. Results showed that participants in the combined condition (training with diaries) improved more than other conditions. Specifically, they improved on SRL knowledge, metacognitive strategies, cognitive strategies (elaboration, organisation and critical thinking), and resources management strategies (time-management and effort regulation). The present study extends previous findings, showing that positive effects can be found for SRL when a discipline-independent approach is used coupled with online training and a mobile-app based daily diary. [ABSTRACT FROM AUTHOR]

Objectives: Recent evidence suggests that parents' negative experiences of combining work and family roles can have harmful effects on children, but little is known about the mechanisms that explain the crossover from the work–family interface to children's mental health over time. This study tested whether inter-parental conflict mediated the relation between maternal work–family factors (conflict or enrichment) and subsequent child mental health problems across childhood (4–5 to 8–9 years) and adolescence (10–11 to 14–15 years). Methods: Data were six waves from the kindergarten cohort of the Longitudinal Study of Australian Children, including mother-report of work–family conflict/enrichment and inter-parental conflict, mother- and adolescent-report of internalizing and externalizing problems, and adolescent-report of disordered eating. The final sample consisted of 2158 children and 2181 adolescents. Results: Results from structural equation modeling indicated that during childhood, inter-parental conflict partially mediated the relation between maternal work–family conflict and child internalizing problems, but not externalizing problems. During adolescence, there was no evidence for mediation, although work–family conflict was associated with higher adolescent-reported externalizing problems; and inter-parental conflict was also associated with elevated mother-reported internalizing and externalizing problems. Both work–family conflict and enrichment were associated with elevated inter-parental conflict during childhood, but not adolescence. There was no evidence for associations between work–family factors and adolescents' disordered eating, and work–family enrichment was not associated with child or adolescent mental health. Conclusions: Intervention programs aimed at reducing both work–family conflict and inter-parental conflict over early childhood are likely to benefit children and families most. [ABSTRACT FROM AUTHOR]

The present study evaluated whether the strength of relationship between child nonverbal behaviors (expressivity, attention, and coordination) across time points varied as a function of interviewer nonverbal behaviors (expressivity, attention, and coordination) under supportive versus neutral interviewing conditions. Children (n = 123) participated in an event where they were involved in breaking some rules. Three to four days later they were interviewed by either a supportive or neutral adult interviewer. Interviews were video recorded and nonverbal behaviors of both children and interviewers were coded. Multi-level modeling revealed that optimal interviewer nonverbal behaviors were predictive of optimal child nonverbal behaviors at the end of the interview. In contrast, explicitly manipulated interviewer supportiveness was related to suboptimal displays of child nonverbal behavior. Interestingly, as the interview progressed, optimally attentive interviewing was associated with suboptimal child expressivity scores. Likewise, displays of optimal interviewer coordination were associated with suboptimal child coordination scores over time. The implications of the findings for nonverbal behavior literature and professionals talking with children about sensitive information are discussed. [ABSTRACT FROM AUTHOR]

Background: Smartphone-based interventions are a potentially effective way to minimize alcohol-related harm in young adult, non-dependent drinkers. This pilot study is the first to evaluate the benefits and feasibility of a personalized alcohol harm-minimization intervention delivered via smartphones. Methods: Within a single-blind, randomized controlled design, 45 young adults were randomly assigned to either the intervention app (n = 25; 18 females; Mage = 21.36 years, SDage = 4.15 years) or the control app (n = 20; 18 females; Mage = 22.75; SDage = 4.41). The two primary outcomes were frequency of risky drinking and drinking-related harms, and the secondary outcome was frequency of protective behavioral strategies (PBS) use. All outcomes were measured at baseline and immediately post-intervention. Using the Enlight framework [1], usability was evaluated via structured one-on-one phone interviews with a subgroup of six participants from the intervention group (3 females; Mage = 19.5 years, SDage = 1.64). Results: There was no significant reduction in the primary outcomes from baseline to post-intervention across the groups. For the secondary outcome, the application of PBS within drinking contexts increased at follow-up for those in the intervention group but not for control participants. End-users rated the app as highly usable but had some concerns with repetition of the app-recommended strategies. Conclusions: This intervention, designed to reduce risky drinking behaviors among young adults, was rated as highly usable and was shown to increase the application of harm minimization strategies within drinking contexts. While the intervention and its delivery show promise, it did not appear to mitigate risky drinking behaviors. Implications of this research and future directions are discussed. Trial Registration: This trial is registered at the Australian New Zealand Clinical Trials Registry: BLINDED. [ABSTRACT FROM AUTHOR]

Background: A range of psychological constructs, including perceived pain, self-efficacy, and pain avoidance, have been proposed to account for the comorbidity of chronic pain and affective disorder symptoms. Despite the likely inter-relation among these constructs, few studies have explored these predictors simultaneously. As such, the relative contributions of these psychological influences remain an open question. Purpose: The present study uses a novel, network model approach to help to identify the key psychological contributors to the pain-affective disorder link. Method: A cross-sectional design was implemented. The sample comprised 169 individuals with chronic pain (Mage 49.82; range 22–80 years; 58% female) admitted to a metropolitan chronic pain clinic in Victoria, Australia. Participants completed self-report measures of anxiety, depressive, and pain symptoms, pain self-efficacy, fear avoidance beliefs, perceived control, and pain-related disability. Results: Network analysis identified self-efficacy, fear avoidance, and perceived disability as key constructs in the relationship between pain and affective disorder symptoms, albeit in different ways. While self-efficacy appeared to have direct links to other constructs in the network model, fear avoidance and perceived disability seemed to function more as mediators, linking other constructs in the model. Perceived control and anxiety were found to be less influential in the model. Conclusions: Present findings identify self-efficacy, fear avoidance, and perceived disability as plausible candidate variables to target to disrupt the link between pain experience and affective disorder symptoms. However, further testing with longitudinal designs is needed to confirm this. [ABSTRACT FROM AUTHOR]

This study examines a person-centered approach to self-regulated learning among 606 University students (140 online, and 466 in blended learning mode). Latent profile analysis revealed five distinct profiles of self-regulated learning: minimal regulators, restrained regulators, calm self-reliant capable regulators, anxious capable collaborators, and super regulators. These profiles showed that: (1) differences in academic success are associated with a learner’s capacity for motivational regulation and self-regulated learning strategy implementation, (2) online learners are more likely to belong to profiles that are more adaptive, and less reliant on collaborations with others, (3) for learners at the lower end of the self-regulation spectrum, an increase in both motivational regulation and adoption of self-regulated learning strategies may be academically beneficial, and (4) high motivational regulation and strategy adoption can be all for naught, if the student is also highly anxious with worry and concern regarding performance. [ABSTRACT FROM AUTHOR]

Research is scarce concerning the validity of subjective wellbeing measures for children aged 12 years and less. There are even fewer subjective wellbeing data for children with complex backgrounds and personal circumstances and those experiencing socio-demographic disadvantage. This study compares the psychometric properties of the child and adult versions of the Personal Wellbeing Index. Participants were 1761 'at-risk' children aged 10-12 years, and 2000 geographically representative Australian adults. While there was sufficient fit with a one-factor structure, the reliability estimates were lower in the child sample and the incidence of response bias was significantly higher. Collectively, these findings suggest caution in the use of subjective wellbeing measures with children. [ABSTRACT FROM AUTHOR]

This study tests relative contributions and time-course of proposed risk/protective factors (e.g., stress, coping, and lack of social interactions) for influencing depressed mood states in daily life. Seventy-three participants completed baseline measurement of major depressive disorder symptomatology, followed by smartphone app-based monitoring of momentary experiences of depressed mood and risk/protective factors for 7 days. All predictors had deteriorating impacts on mood as lag increased, and the optimal lag appears to be less than 120 min. Linear decay in effect sizes was found for physical activity, social interaction, and tiredness, whereas exponential decline in effect sizes was found for stress and coping ability. Stress, coping, and depressed mood at the prior time-point were the best predictors of subsequent mood. These effects did not differ as a function of trait depressive symptom severity. Findings highlight the influence of spacing of assessments in identification and magnitude of predictors of mood states, and provide insights into key drivers of change in mood and their time-course. [ABSTRACT FROM AUTHOR]

The present study proposes and demonstrates a comprehensive framework for evaluation of a universal school-based depression prevention program. Efficacy was evaluated by considering the impact of continuous versus categorical approaches to operationalizing outcome, the effect of the intervention on key change agent variables, and moderation of intervention effects by student symptom severity at baseline. Participants 252 adolescent boys and girls (60 % male), aged 13 to 17 years (M = 13.62 years, SD = 0.60 years) from four schools in the state of Victoria, Australia, who were allocated by school into a waitlist = control (n = 88) or a CBT-based intervention (n = 164) group. The intervention involved six 45-min weekly sessions run during wellbeing classes. While the intervention and control groups did not differ in average improvement in symptoms by post-intervention, further analyses showed that responsiveness was highly variable within the intervention, and those with elevated depressive symptoms benefitted most. The proposed change agents of self-esteem, resilience, body image satisfaction, and perceived social support did not uniquely predict change in depressive symptoms but collectively accounted for substantial variance in this change process. Collectively, this framework provided insights into aspects of the intervention that worked and highlighted areas for improvement, thus providing clear direction for future research. [ABSTRACT FROM AUTHOR]

The article presents a study that evaluated the efficacy of a health coaching (HC) intervention designed to prevent excessive gestational weight gain (GWG) and whether there were improved psychological, motivational and behavioral outcomes for women in the HC intervention compared to a usual care control group. The study recommends that despite lack of success of the HC intervention, health professionals should continue to recommend appropriate GWG.

Understanding subjective wellbeing (SWB) at the population level has major implications for governments and policy makers concerned with enhancing the life quality of citizens. The Personal Wellbeing Index (PWI) is a measure of SWB with theoretical and empirical credentials. Homeostasis theory offers an explanation for the nature of SWB data, including the distribution of scores, maintenance and change over time. According to this theory, under normal conditions, the dominant constituent of SWB is Homeostatically Protected Mood (HPMood), which is held within a genetically determined range of values around a set-point. However, in extreme circumstances (e.g., financial hardship, chronic illness), HPMood may dissociate from SWB, as cognitive/emotional reactions to the cause of homeostatic challenge assume control over SWB. This study investigates two groups as people scoring in the positive range for SWB and people who are likely to be experiencing homeostatic defeat/challenge. We test whether the reduced influence of HPMood on SWB due to homeostatic defeat has implications for the validity of SWB measurement. Participants were 45,192 adults (52 % female), with a mean age of 48.88 years (SD = 17.35 years), who participated in the first 23 surveys of the Australian Unity Wellbeing Index over the years 2001-2010. Multiple regression analysis, multiple group confirmatory factor analysis, and Rasch modelling techniques were used to evaluate the psychometric performance of the PWI across the two groups. Results show that while the PWI functioned as intended for the normal group, SWB in the challenged group was lower across all PWI domains, more variable, and the domain scores lacked the strength of inter-correlation observed in the normal, comparison group. These changes are consistent with predictions based on homeostasis theory and one major implication of the findings is that SWB measures may not function equivalently across the entire spectrum of possible domain satisfaction scores. [ABSTRACT FROM AUTHOR]

Purpose: While intervention effects in target outcomes have typically been tested based on change from baseline to post-intervention, such approaches typically ignore individual differences in change, including time taken to see improvement. The present study demonstrates how weekly patient-reported data may be used to augment traditional pre-post intervention evaluations in order to gain greater insights into treatment efficacy.Methods: Two hundred and fifty-two adolescent boys and girls (M age = 13.6 years, SD = 0.6 years) from four secondary schools in Victoria, Australia, were assigned by school into control (n = 88) or intervention (n = 164) groups. The intervention group participated in a 6-week course designed to improve subjective wellbeing (SWB) by fostering resilience, coping skills, and self-esteem. In addition to baseline, post-intervention, and 3-month follow-up assessments of SWB, intervention group participants also completed weekly summarise of affective experiences for the duration of the intervention phase.Results: While standard pre-post data showed significant improvement in SWB for the intervention group relative to controls, weekly data showed individual differences in the trajectory of change during this intervention phase; low SWB individuals experienced initial worsening of symptoms followed by improvement in the second half of the intervention phase, whereas high SWB individuals experienced initial gains, followed by a plateau from Week 4 onwards.Conclusions: Addition of weekly data provided greater insights into intervention effects by: (1) contradicting the notion that early responsiveness to treatment is predictive of level of improvement by post-intervention, and (2) providing data-based insights into ways to enhance the intervention. [ABSTRACT FROM AUTHOR]

Despite increasing research interest in the subjective wellbeing (SWB) of Indigenous Australians, SWB measures used in these studies have not been validated for use in this population. Until the measurement equivalence of scales used in this population are demonstrated, inferences regarding potential differences in SWB across Indigenous and non-Indigenous groups cannot be validly inferred. To rectify this, the present study examines the psychometric equivalence of the Personal Wellbeing Index-School Children (PWI-SC) for use among samples of Indigenous and non-Indigenous Australian adolescents using multiple-group confirmatory factor analysis. The Indigenous sample comprised 1,378 adolescents enrolled in the Australian Federal Government's Youth Connections Program. A sample of 6,401 non-Indigenous adolescents also enrolled in the Youth Connections Program represented a second comparative group. Finally, the third comparative group comprised a convenience sample of 983 Victorian high-school students. The results demonstrated strict factorial invariance between all three adolescent groups, suggesting that the PWI-SC measures the same underlying construct in each sample. These findings support quantitative comparisons between Indigenous and non-Indigenous SWB data as valid. The implications of this research are discussed. [ABSTRACT FROM AUTHOR]

Despite the wealth of accumulated research evaluating subjective wellbeing (SWB) in children and adults, the validity of scores from parallel forms of SWB measures for each age group has yet to be empirically tested. This study examines the psychometric equivalence of the child and adult forms of the personal wellbeing index (PWI) using multiple-group confirmatory factor analysis. The child sample comprised 1,029 Victorian high-school students (aged 11-20) sampled across three independent studies. The adult sample comprised 1,965 Australian adults drawn from the Australian Unity Wellbeing Index. The results demonstrated strict factorial invariance between both versions, suggesting that the PWI measures the same underlying construct in adolescent and adult populations. These findings provide support for quantitative comparisons between adult and adolescent SWB data as valid. [ABSTRACT FROM AUTHOR]

This study examined the relationship between body image and self-esteem across time and age for men and women. Participants were 150 men and 239 women aged between 20 and 86 years ( M = 59.73), recruited from the general population in Australia. They completed a questionnaire assessing self-esteem, body dissatisfaction, body importance, and a range of other domains of life satisfaction at baseline and 2 years later. Cross-sectionally, we found that higher self-esteem was associated with lower body dissatisfaction, but there was no consistent relationship between these variables across time for age and gender. Women were more dissatisfied with their bodies than men; yet, men placed greater importance on their appearance than women, and also reported high levels of body dissatisfaction. [ABSTRACT FROM AUTHOR]

The interactions between sleep problems, autism symptoms and emotional and behavioural difficulties were explored using network analysis in 240 autistic children (mean age: 8.8 years, range 5–13 years) with moderate to severe sleep problems. Findings revealed a highly connected and interpretable network, with three separate clusters identified of the modelled variables. Depression, anxiety and behavioural difficulties were the most central variables of the network. Depression, anxiety and restricted repetitive and stereotyped patterns behaviours (RRBs) were the strongest bridging variables in the network model, transmitting activation both within and between other symptom clusters. The results highlight that depression and anxiety were highly connected symptoms within the network, suggesting support in these areas could be helpful, as well as future research. [ABSTRACT FROM AUTHOR]