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Worry is a transdiagnostic symptom common to many neurocognitive disorders of aging, including early stages of Alzheimer's disease and related dementias (ADRD). Severe worry is associated with amyloid burden in cognitively intact older adults, yet the mechanisms underlying this association are not well understood. We hypothesize that this relationship involves altered brain and cardiovascular reactivity to acute stressors, a brain-body phenotype that also increases risk for cardiovascular disease. Twenty cognitively normal older adults (age 60 to 80) with varying levels of worry severity underwent positron emission tomography using Pittsburgh Compound-B and functional magnetic resonance imaging. We examined associations of worry severity and amyloid burden with cardiovascular reactivity, brain activation, and brain connectivity using a cognitive stressor task. Worry severity was not associated with global amyloid burden, but was associated with greater resting levels of cardiovascular physiology and lower systolic blood pressure reactivity. Worry severity also was associated with altered stressor-evoked activation and effective connectivity in brain circuits implicated in stress processing, emotion perception, and physiological regulation. These associations showed small to medium effect sizes. These preliminary findings introduce key components of a model that may link severe worry to ADRD risk via stressor-evoked brain-body interactions. • Examined worry, amyloid burden, and stress reactivity in a cohort of older adults. • Worry associated with greater resting blood pressure and less blood pressure reactivity. • Worry associated with altered stressor-evoked brain activation and connectivity. • Associations showed small to medium effect sizes in this pilot cohort. • Worry may relate to ADRD risk via stressor-evoked brain-body pathways. [ABSTRACT FROM AUTHOR]

Objective: This mixed methods study examined student and parent experiences with anxiety and preferences for campus-based programming to address anxiety. Participants: College students (n = 156) completed a survey, and 20 students participated in focus groups. Parents of college students (n = 85) completed a survey, and 12 parents completed a phone interview. Methods: Students and parents completed surveys about trait worry, mental health literacy, and preferences for proposed programming. Descriptive statistics were calculated. Students participated in focus groups, and parents completed interviews regarding their experiences and preferences. Thematic analysis was conducted with the coded focus group and interview transcripts. Results: Quantitative and qualitative findings revealed specific program preferences (eg scheduling). Qualitative findings highlighted mismatches between student and parent perspectives and opportunities for parental skill building. Conclusions: Students and their parents are open to and eager for campus programming that provides education, skills, and support for college students with anxiety. [ABSTRACT FROM AUTHOR]

Purpose: Cancer survivors experience barriers to primary healthcare (PHC) services. The aim was to explore reactions to and opinions about perceived challenges associated with PHC access and quality among cancer survivors in Sweden, including how they have acted to adapt to challenges. Methods: Five semi-structured focus group interviews were conducted with cancer survivors (n = 20) from Skåne, Sweden, diagnosed with breast, prostate, lung, or colorectal cancer or malignant melanoma. Focus groups were mixed in regard to diagnosis. Data were analysed using a descriptive template analysis approach. Results: In light of perceived challenges associated with access to adequate PHC, participants experienced that they had been forced to work hard to achieve functioning PHC contacts. The demands for self-sufficiency were associated with negative feelings such as loneliness and worry. Participants believed that cancer survivors who lack the ability to express themselves, or sufficient drive, risk missing out on necessary care due to the necessity of being an active patient. Conclusions: The findings highlight negative patient experiences. They have implications for the organization of care for cancer survivors as they indicate a need for more efficient post-treatment coordination between cancer specialist care and PHC providers, as well as increased support for patients leaving primary cancer treatment. [ABSTRACT FROM AUTHOR]

Purpose: Being of working age while at the same time needing to help a partner with young onset dementia has specific consequences for spouses. Research to date has been sparse concerning this particular group of spouses. The aim of the study was to explore spouses' everyday experiences when living with a person with young onset dementia. Method: The study had a descriptive qualitative design with semi-structured interviews with nine spouses. The interviews were analysed using content analysis. Result: The interviewed spouses experienced emotions that varied from feelings of loneliness, frustration, and worry to peace of mind. They said that they used coping strategies, which included adopting a positive mindset, adapting to inabilities, adopting an avoidant approach, and finding ways to recharge. Spouses also felt that they could use more support, both formal and informal. Conclusion: The spouse of a person with young onset dementia has a range of emotional experiences and has resourceful ways of handling everyday life. Various types of support are offered to spouses, however, they seemed to desire more from health care services. [ABSTRACT FROM AUTHOR]

Background: Breast cancer patients experience various adverse symptoms during adjuvant chemotherapy. These adverse symptoms often form symptom clusters and have a negative impact on patients. Aims: To summarise common symptom clusters in different dimensions and their longitudinal changes among breast cancer patients receiving adjuvant chemotherapy. Design: A systematic review. Data Sources: Ten electronic databases were searched from 2001 to January 2024, and the search was last updated on 16 August 2024. Methods: Two reviewers independently assessed the eligibility of each study and extracted data. The Standard Quality Assessment Criteria for Evaluating Primary Research Papers was used to evaluate the quality of included studies. The findings were synthesised narratively. This systematic review has been registered (CRD42022370210). Results: Nine studies with a total of 1454 participants were included. The common symptom clusters in breast cancer patients receiving adjuvant chemotherapy were the gastrointestinal symptom cluster (nausea‐lack of appetite), the fatigue‐pain‐sleep disturbance symptom cluster and the psychological symptom cluster (worry‐sadness‐nervousness‐distress‐feeling irritable‐difficult concentrating). The severity dimension was the most frequently utilised in identifying symptom clusters, with the number and concurrence of symptom clusters showing variation over time. Conclusions: This study summarised common symptom clusters in breast cancer patients receiving adjuvant chemotherapy and revealed their changes from symptom dimensions and the chemotherapy process. These findings support further exploration of symptom cluster changes and underlying mechanisms, facilitating the design of targeted management strategies, including appropriate interventions and measurement dimensions in clinical nursing, to ultimately reduce patients' symptom burden. Impact: Common symptom clusters have been identified in breast cancer patients receiving adjuvant chemotherapy. Clinical nursing in oncology can prioritise these symptom clusters and provide patients with targeted management strategies. Reporting Methods: PRISMA guidelines and SWiM guidelines. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Nurses are the frontline professionals caring for patients who have attempted suicide. When clinical nurses learn from medical records or nursing handover, or are proactively informed by patients or family members, that the patients they are caring for have suicidal tendencies, they often experience pressure and face challenges. However, little attention has been given to the experiences of the nurses caring for patients with suicidal intent on medical and surgical wards. We aimed to address this knowledge gap. The purpose of this study was to explore medical and surgical nurses' experiences, especially the internal conflicts they might experience while caring for patients who have a history of attempted suicide. A qualitative descriptive design and semi‐structured interviews were used in this study. Twenty‐three nurses were recruited and interviewed individually. Data were analysed by qualitative content analysis. The focus of this paper is to examine the emergent theme of intrapersonal conflict experienced by the participants. Nurses' experiences can be clustered into two themes: (1) Pity and annoyance and (2) Hard work does not necessarily pay off. Intrapersonal conflict was identified by participants as considerable fear and anxiety about the possibility of a patient's suicide, as well as a mixture of pity for and annoyance with the patients. Nurses feel sorry for such patients, but they are also annoyed by the extra work required to prevent suicide attempts in the ward. Additionally, having limited time and ability, they see that their hard work does not necessarily pay off and may sometimes lead to punishment. Our findings raise serious concerns about the adequacy of the knowledge of the nurses, their competence and their difficulties in caring for such patients. In addition, there is a need to provide them with appropriate on‐the‐job education and immediate emotional support relevant to caring for survivors of suicide attempts. [ABSTRACT FROM AUTHOR]

This study aimed to understand nurses' perceptions of COVID‐19‐related policies and risks during the outbreak of COVID‐19 in Hong Kong and to determine how their perceptions influenced their mental health status. A web‐based online survey among Hong Kong nurses was conducted. The questionnaire included a self‐designed 5‐point Likert scale with 17 items to assess the nurses' perceptions of COVID‐19‐related policies and risks, as well as the Davidson Trauma Scale (DTS), the Perceived Stress Scale (PSS), the Patient Health Questionnaire‐2 (PHQ‐2) and the Generalised Anxiety Disorder scale (GAD) for measurement of posttraumatic stress disorder (PTSD), stress, depression and anxiety, respectively. Of 592 nurses enrolled, 30.6% had PTSD (DTS total score ≥40), and 80.4%, 19.9% and 16.4% had moderate‐to‐high levels of stress (PSS‐10 score ≥14), depression (PHQ‐2 score ≥3) and anxiety (GAD score ≥3), respectively. The top three concerned aspects were 'worried about themselves and friends to suffer this disease' (84.5%), 'insufficient number of isolation wards' (81.8%) and 'insufficient number of personal protective equipment' (74.3%). Logistic regression analyses showed that more negative perception on 'personal protective equipment in the healthcare institutions', 'the confidence in HK's control of COVID‐19', 'worried about themselves and friends to suffer this disease' and 'self‐perceived risk of infection' indicated higher severity of the four mental health problems (all p < 0.01). The perception on 'public gathering ban', 'the number of isolation wards' and 'expected time to control COVID‐19' were significantly associated with PTSD and stress (all p < 0.05). Nurses' perception on government policies and COVID‐19 risks played an important role in predicting their mental health status. Policy makers should be aware of nurses' psychological responses and provide timely and targeted emotional support to nurses amid and after the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

Objective: In a preregistered study, we examined whether worries about COVID‐19 are simultaneously linked with enhanced well‐being through social interaction and with reduced well‐being through depression symptoms. Method: In August 2020, census‐matched participants from high‐ and low‐prevalence regions in the United States and Italy (N = 857) completed assessments of COVID‐19 worry, social interaction, depression symptoms, and well‐being. Results: Worries about COVID‐19 predicted both more social interaction and more depression (ps < 0.001). In multiple mediational analyses, an adaptive pathway of COVID‐19 worry through social interaction was associated with higher well‐being, whereas a maladaptive pathway through depression symptoms was associated with lower well‐being. Further, a comparison of high and low COVID‐19 prevalence regions replicated the mediational findings for social interaction, providing evidence against reverse causation and common method variance. Conclusion: Findings suggest that normative worries about acute stressors may both benefit and undermine well‐being, depending on their impact on social behavior or depression symptoms. [ABSTRACT FROM AUTHOR]

Background: Illness Anxiety Disorder (IAD), is a type of worry about the existence or occurrence of serious medical diseases. worry, alexithymia, intolerance of uncertainty and cognitive emotion regulation strategies can be effective factors in the development and persistence of mental disorders such as illness anxiety. Since individuals with IAD suffer from many problems, identifying the influencing and predicting factors of IAD simultaneously in research are considered important. Aims: The purpose of the present study was to predict illness anxiety symptoms based on worry, alexithymia, intolerance of uncertainty and cognitive emotion regulation strategies. Methods: The present study was descriptive correlation and the statistical population included all people living in Tehran between the ages of 20 and 60 in 2021. A total of 414 individuals (344 females, 70 males) participated in the study. Participants were asked to complete the Illness Anxiety Scale (Besharat, 2011), Penn State Worry Questionnaire (Meyer et al., 1990), Toronto Alexithymia Scale-20 (Bagby et al., 1994), Intolerance of Uncertainty Scale (Carleton et al., 2007) and Cognitive Emotion Regulation Questionnaire (Garnefski & Kraaij, 2007). The data were analyzed by Pearson correlation coefficient and stepwise regression methods by SPSS27. Results: worry, alexithymia, intolerance of uncertainty and maladaptive emotion regulation strategies had a significant positive association with illness anxiety symptoms (P< 0.05). This result was reversed for adaptive emotion regulation strategies; revealing that this type of strategies had a significant negative association with illness anxiety symptoms (P< 0.05). Furthermore, the cognitive emotion regulation strategies were removed from the model due to the lack of predictive power, but worry, alexithymia and intolerance of uncertainty have the ability to predict the illness anxiety symptoms. Conclusion: Based on the research findings, worry, alexithymia and intolerance of uncertainty can predict illness anxiety symptoms. These results can be useful in the prevention, diagnosis and treatment of IAD. [ABSTRACT FROM AUTHOR]

Anxiety is very pertinent to systemic family therapy (SFT), however, there is little research that seeks to understand people's experiences with anxiety symptoms and how they impact people's lives and relationships. The aim of this study was to examine the trending hashtag #ThisIsWhatAnxietyFeelsLike—a commonly used hashtag related to anxiety—to look more closely at how users talk about their anxiety symptoms on Twitter and how these symptoms influence people's interactions and relationships with others. We used a qualitative thematic analysis to analyze 1318 relational tweets posted with this hashtag that occurred between February 2017 and February 2018 and uncover themes related to experiences with anxiety. The analysis revealed six core themes: (a) deflated self in relation to others and their perceptions; (b) fear, worry and avoidance behaviors that influence relationships; (c) negative emotional responses leading to feeling misunderstood, lonely, and like a failure; (d) social triggers; (e) anxiety management strategies; and (f) things for others to avoid. [ABSTRACT FROM AUTHOR]

Personality dysfunction operationalized as impairment in self- and interpersonal functioning is a characteristic of personality disorders. The metacognitive model suggests that dysfunctional metacognitive beliefs are a common cause of psychological disorders, but the relevance and importance of metacognitions for personality dysfunction is less explored and was the objective for the current study. In a sample of 1278 individuals, we conducted a multiple hierarchical regression analysis to test the predictive role of metacognitive beliefs for personality dysfunction. We found a unique and independent contribution from negative beliefs about the uncontrollability and danger of worry and lower cognitive confidence to personality dysfunction whilst controlling age, gender, maladaptive personality traits, big-5 personality traits, emotional distress symptoms, and general psychosocial functioning. The results bring further support for the metacognitive model of psychological disorders which may be relevant for formulation and treatment of personality dysfunction and disorder. [ABSTRACT FROM AUTHOR]

Objectives: To examine how change in benzodiazepine (BZD) use is linked to changes in depressive symptoms intensity, worry intensity, and sleep quality over 16 months. Method: Data come from a larger randomised controlled trial (RCT) named the 'Programme d'Aide du Succès au SEvrage (PASSE-60+)' study (NCT02281175). Seventy-three participants age 60 years and older took part in a 4-month discontinuation programme and were assessed four times over 16 months. Change in BZD use was defined as the difference in reported mg/day between two assessments. Control variables were RCT discontinuation group; BZD use at T1; and either depressive symptoms, worry intensity, or sleep quality at T1. Hierarchical multiple regressions were used to analyse data. Results: In the short term, right after the discontinuation programme, sleep quality worsened with lower BZD use. This link was no longer significant at the 3- and 12-month follow-up. In the long term, depressive symptoms lowered with lower BZD use. No change was found in worry intensity in relation to BZD use at all measurement times. Conclusion: Discontinuation may improve depressive symptoms. Our study also questions the long-term effectiveness of BZD use, since long-term discontinuation was not linked with change in worry intensity and sleep quality. [ABSTRACT FROM AUTHOR]

Background/Objectives: The Hogg Eco-Anxiety Scale (HEAS-13) is a thirteen-item measure of eco-anxiety, with four dimensions: (1) affective symptoms, (2) rumination, (3) behavioural symptoms, and (4) anxiety about personal impact. Being a recently developed questionnaire, data on its psychometrics are limited. The aim of this study was to introduce a Polish version of the HEAS-13 and examine its psychometric properties. Methods: Our sample consisted of 634 Polish-speaking adults, with ages ranging from 18 to 67 years. We assessed the HEAS-13's factor structure, internal consistency, test–retest reliabilities, and its concurrent validity via relationships with climate-related variables, psychopathology symptoms, and well-being. We put emphasis on examining the discriminant validity of the HEAS-13 against general psychological distress. Results: As expected, the Polish HEAS-13 demonstrated strong factorial validity with an intended four-factor structure. The internal consistency and test–retest reliabilities of the scale were good and moderate, respectively. Higher levels of eco-anxiety were associated with higher environmental concerns, the experience of climate change (i.e., one's perception of being affected by climate change), pro-environmental behavioural engagement, climate change worry, anxiety, and depressive symptoms, as well as lower levels of well-being. We empirically supported the strong discriminant validity of the HEAS-13, demonstrating that eco-anxiety was separable from general psychological distress. We also noted that females, younger people, and those with lower educational levels experienced higher eco-anxiety. To facilitate the use of this measure, we propose a potential screening cut-off value for the HEAS-13, which can indicate meaningfully elevated levels of eco-anxiety. Conclusions: Overall, the Polish version of the HEAS-13 has strong psychometric properties, usefully enabling the examination of climate-related anxiety. Our findings highlight its potential in cross-cultural research and healthcare practice. [ABSTRACT FROM AUTHOR]

Background/Objectives: Autistic adults exhibit core and comorbid features that can have an impact on their daily functioning and lead to considerable psychological distress. Significant and consistent associations have been identified between autism characteristics—restricted repetitive behaviors and sensory features—and high levels of stress and anxiety. For a better understanding of the issue, it is necessary to consider the cognitive aspects that can help explain variations in stress and anxiety levels among adults with autism. We therefore aimed to model the contributions of worry and intolerance of uncertainty on the relationship between autism characteristics (sensory sensitivities and repetitive behaviors) and psychological distress (stress and anxiety). Methods: The sample comprised 144 autistic individuals with a mean age of 35.15 (SD = 11.44). They participated in the study by completing an online questionnaire to assess the study variables. Most of the participants reported being diagnosed with Asperger syndrome (63.6%) or Level 1 autism spectrum disorder (27.1%). Results: The model fit index values tested through path analysis indicated a good fit (χ2 = 5.65; p = 0.13 ns; CFI = 0.993; NFI = 0.985; RMSEA = 0.079; SRMR = 0.025) and identified worry and intolerance of uncertainty as significant mediating variables within a comprehensive explanatory model. Conclusions: These findings highlight the importance of worry and intolerance of uncertainty as specific targets in interventions aimed at improving stress and anxiety problems in autistic adults. [ABSTRACT FROM AUTHOR]

Introduction: Women experience numerous episodes of adverse events, often linked to violence, which create emotional difficulties that contribute to the development of post-traumatic stress disorder. However, more research is required to understand the nature of post-traumatic reactions and the underlying psycho-emotional processes. Objective: To determine whether emotional dysregulation and worry mediate the relationship between the experience of stressful events and post-traumatic stress symptoms in a sample of adult Mexican women seeking online psychological treatment. Method: A cross-sectional study was conducted with a non-probabilistic sample of 687 women ages 18 to 76. Results: The data show that emotional dysregulation mediated the relationship between the type of trauma and post-traumatic stress symptoms for illness- and death-related events, but not for other types of stressors, whereas worry mediated the association between sexual and physical assault and post-traumatic stress symptoms. Discussion and conclusion: This study contributes to current psychopathology models focused on the transdiagnostic perspective. The findings may guide interventions targeting emotion regulation and worry as modifiable risk factors for the development of post-traumatic stress. [ABSTRACT FROM AUTHOR]

Objective: Although parental threatening behaviors are associated with poor mental health outcomes among college students, the underlying mechanisms of this relationship are understudied. This investigation examined the underlying role of perceived anxiety control in the association between childhood exposure to maternal threatening behaviors and depression, worry, and attention/deficit hyperactivity disorder (attention-deficit/hyperactivity disorder) symptoms. Participants: Participants (N = 862; Mage = 18.75 years, SD = 1.04, age range = 18–24) were recruited from a large state university in the northeast. Methods: Participants completed a battery of self-report questionnaires. Results: Tests of indirect effects indicated that greater childhood exposure to maternal threats was associated with lower perceived anxiety control, which in turn was associated with more severe depression, worry, and ADHD symptoms, respectively. Conclusions: Childhood exposure to maternal threatening behaviors may contribute to college students' low perceived anxiety control, which in turn increases the risk for these symptom clusters. [ABSTRACT FROM AUTHOR]

Objectives: Beginning in February 2022, the United States faced an infant formula shortage that severely impacted access and affordability. Little is known about how this shortage impacted infant feeding intentions among expectant mothers. Our study sought to determine the impact of the formula shortage on prenatal feeding intentions and to understand expectant mothers' feelings and perceived stress related to the shortage. Methods: This cross-sectional, exploratory, observational study of pregnant women (n = 57) residing in New York City utilized a self-administered online survey in May–July 2022. Results: The results indicate that ten (17.5%) respondents changed their feeding intentions during the infant formula shortage for months 0–3 or 3–6 of infancy to include more breastfeeding than originally intended. These mothers also reported significantly higher stress levels related to the shortage than their non-changing peers. Conclusions for practice: Our results suggest that the formula shortage influenced feeding intentions among a subset of surveyed expectant mothers. The stress associated with the shortage influenced prenatal feeding intentions to include more breastfeeding than intended prior to the shortage. Prenatal healthcare providers should consider the availability of infant formula as one of myriad factors that influence infant feeding intentions, and that the stress associated with whether infant formula is readily available may influence these intentions as well. Significance: Numerous factors, including social, cultural, and economic influences, can shape prenatal infant feeding intentions. Our results suggest that availability of infant formula may be an additional element in this decision-making process. Our study found that the 2022 infant formula shortage influenced expectant mothers to include more breastfeeding in their feeding plans than they had originally intended as a result of the shortage. To our knowledge, there has been no research published that examines the effect of an infant formula shortage on the feeding intentions of expectant mothers. [ABSTRACT FROM AUTHOR]

Objective: This study aims to examine the relationship between human papillomavirus (HPV) testing attitudes and beliefs, knowledge, and vaccination attitudes. Design: This study was a cross‐sectional design. Sample: This study was conducted between March 15, 2024, and June 2, 2024, through social media platforms such as Facebook, Instagram, Twitter, and Telegram, by sharing on forum pages, and involved 674 women who volunteered to participate. Measurements: The research data were collected using the "health belief model scale regarding HPV infection and vaccination (HBMS‐HPVV)" and the "HPV Testing Attitudes and Beliefs Scale (HTABS)," which were developed by the researchers through a literature review. Results: The average age of the women participating in the study was 46.59 ± 11.15 years; 81.5% were married, 57.6% had no knowledge about cervical cancer, and 62.2% had no knowledge about the HPV vaccine, a protective vaccine against cervical cancer. The average scores for the subdimensions of severity, barriers, benefits, and susceptibility of the HBMS‐HPVV were 3.19 ± 0.60, 2.96 ± 1.22, 2.29 ± 1.40, and 3.92 ± 0.49, respectively. The average scores for the subdimensions of personal barriers, social norms, confidence, and worries of the HTABS were 31.14 ± 19.27, 7.57 ± 4.47, 30.03 ± 7.18, and 11.91 ± 2.52, respectively. A statistically significant positive relationship was found between all HBMS‐HPVV subdimensions and the HTABS subdimensions (p < 0.001). Conclusion: The study found that as the perceived severity increases, the perceived benefits, susceptibility, and confidence increase, while the perceived barriers, personal barriers, social norms, and worries decrease. Based on these results, it is recommended that women's health nurses provide education and seminars to raise awareness about cervical cancer, early screening and diagnosis programs, and the HPV vaccine. [ABSTRACT FROM AUTHOR]

Objectives The intergenerational stake hypothesis and theories of the life course posit that older generations are invested in the well-being of younger generations. Consistent with this, previous research has shown that adult children's problems are associated with worse parental well-being. Because multigenerational ties have become increasingly important in the 21st century, we propose that adult grandchildren's problems may also impact grandparents' well-being. In this paper, we test this hypothesis and investigate the moderating effects of grandparents' race and maternal/paternal status. Methods The analytic sample includes 206 grandparents aged 65–95 who participated in the second wave of the Family Exchanges Study. Adult grandchildren's problems were operationalized as the proportions of adult grandchildren who experienced (1) physical–emotional problems and (2) lifestyle–behavioral problems. Results Main effects multilevel analyses suggested that adult grandchildren's problems did not predict grandparents' well-being. However, moderation analyses revealed that the association between grandparents' depressive symptoms and adult grandchildren's physical–emotional problems was larger among Black than White grandparents, and maternal than paternal grandparents. Adult grandchildren's lifestyle–behavioral problems did not predict grandparents' depression, and these effects were not conditioned by race or maternal/paternal status. Discussion These findings expand research on the importance of grandparent–adult grandchild relationships and contribute to research on multigenerational relationships and health by considering how problems experienced by members of younger generations affect the psychological well-being of older adults. [ABSTRACT FROM AUTHOR]

Purpose: To present the first 14 years' data from 1 academic institution using the American Foundation for Suicide Prevention's online Interactive Screening Program (ISP). The ISP probes suicide risk factors in healthcare workers, utilization of mental health services, levels of engagement, and seeks to reduce barriers to help-seeking. Design: Data from all healthcare system students, medical trainees, physicians, nurses, and staff who completed the ISP's online Stress and Depression Questionnaire between May 1, 2009, and April 30, 2023, were tabulated and analyzed for features related to burnout, depression, suicide risk, treatment, and engagement with program counselors. Results: 5368 individuals engaged in ISP screening. Findings included 39.9% experiencing depression symptoms, 53.9% symptoms of burnout, and 10% suicidal ideation. In this self-selecting group, medical students reported depression symptoms less than physicians in practice, nurses almost 3 times more than physicians, and females more than males. Suicide risk was indicated by multiple domains of distress, with 49.4% in the highest risk tier. At the time of completing the questionnaire, 13.1% were receiving counseling/therapy. After receiving feedback, more than one-quarter of all participants (27.6%) engaged with the program counselors, with an additional 941 individuals who were not already receiving counseling or therapy accepting referrals to mental health providers. Conclusion: The unattended high distress levels throughout the healthcare training and workforce demonstrated the need for safe screening and referral, while the level of engagement and referrals generated by the ISP attested to its effectiveness. [ABSTRACT FROM AUTHOR]

Background: The literature indicates an increasing interest in the mental health of refugees (R) and asylum seekers (AS) – particularly how it could be affected by previous exposure to trauma and violence – but less has been written about the issues they are forced to face during the post-migration period and how these also can affect mental health. Research shows that the mental health of R/AS is highly influenced by their post-migration conditions and may deteriorate due to post-migration social health-related determinants; in addition, a lack of language skills, discrimination, separation from family, poverty, and other stressors can contribute to social isolation. The difficulty in asking for help in case of psychological distress and, consequently, in accessing care, contributes to the worsening of their clinical condition. Aims: The primary purpose of this study is to identify and provide a review of the clinical tools used to screen migrants (R/AS) at risk of developing psychological distress, identifying post-migration difficulties. Methods: We searched studies in PubMed, Embase, Scopus, Cochrane (Central), and Cinahl (ultimate) with the last search on 14 April 2023, using a combination of keywords and Medical Subject Headings (MeSH). Results: Our systematic search identified 1,878 records. After removing duplicates, we screened 1,238 records by title and abstract, retaining 97 for full text review. Of these, 68 met full eligibility criteria (1995–2023). A total of 30 social scales have been identified, as well as structured or semi-structured questionnaires and interviews. Translated into multiple languages, the tools can be self-administered or administered by trained professionals. PMLD is known for its effectiveness in evaluating the post-migration period and predicting mental health issues. Conclusions: Considering the limited number of studies and, consequently, the limited number of tools found, it can be inferred that not enough attention is given to post-migration in the broader sense. [ABSTRACT FROM AUTHOR]

People high in depressive or anxious symptom severity show repetitive negative thinking, including worry and rumination. They also show various cognitive phenomena, including probability, cost, and interpretation biases. Since there is conceptual overlap between these cognitive biases and repetitive negative thinking – all involve thinking about potential threats and misfortunes – we wondered whether repetitive negative thinking could account for (mediate) these cognitive biases' associations with depressive and anxious symptom severity. In three studies, conducted in two languages and cultures, cost bias and (in two studies) interpretation bias only predicted symptom severity via worry and repetitive negative thinking; this suggests these biases are actually associated with repetitive negative thinking, rather than with symptoms. In contrast, probability bias showed direct relationships with depressive (all studies) and anxious (two studies) symptom severity, suggesting its relationships with symptoms are partly independent of repetitive negative thinking. These results show the value of studying relationships among the various cognitive features of psychopathology. Furthermore, new interventions which target cognitive biases in depression or anxiety must show that they can improve upon cognitive behavioural therapy, which is already widely available, targets both repetitive negative thinking and probability bias, and is highly effective. [ABSTRACT FROM AUTHOR]

Objective: Obsessive-compulsive disorder (OCD) is a clinically heterogeneous condition with a variety of symptom dimensions. The aim of this study was to assess the ability of university students and the lay public to identify a lesser-known theme of obsessive-compulsive symptoms known as relationship obsessive-compulsive disorder (ROCD) and to examine factors that impact identification and stigma of this symptom subtype. Method: A total of 258 participants (M = 24.1 years, SD = 7.61) completed an online survey. A series of clinical vignettes depicted hypothetical characters with ROCD, varied by symptom presentation (partner-focused, relationship-centred) and gender (female, male), as well as a contamination OCD vignette for comparison purposes. Results: As expected, participants showed significantly higher misidentification rates for ROCD (88.3%) compared to the contamination vignettes (28.7%). ROCD was most often misidentified as relationship issues and worry. Although partner-focused ROCD was not misidentified more frequently than relationship-centred ROCD, partner-focused vignettes were significantly more stigmatised than relationship-centred vignettes as predicted (with the male, partner-focused vignette most stigmatised). Conclusions: High levels of misidentification of ROCD may contribute to the existing lag between OCD symptom onset and proper treatment, emphasising the need for greater education and media focus on the heterogeneity of OCD. KEY POINTS: What is already known about this topic: Relationship obsessive-compulsive disorder (ROCD) is a relatively newly identified OCD subtype, which involves intrusive and ego-dystonic doubts related to a range of interpersonal relationships. ROCD has two main presentations: relationship-centred (doubts about the relationship itself) and partner-focused (doubts about the partner's perceived flaws). Stigmatizing attitudes from the public and self-stigma have been identified as treatment barriers, exacerbating the pre-existing gap between the onset of OCD symptoms and receiving appropriate treatment. What this topic adds: The results of this study demonstrated that ROCD vignettes are more likely to be misidentified and stigmatized by participants than contamination vignettes, consistent with past literature on taboo thoughts in OCD. Partner-focused ROCD symptom presentations were significantly more stigmatized than relationship-centred ROCD presentations. ROCD was most-often misattributed to worry, relationship problems, a phobia, or no disorder, resulting in the potential for ROCD to be overlooked as a substantive psychiatric condition. [ABSTRACT FROM AUTHOR]

Although increasingly popular, theoretical frameworks describing complex and multidimensional cancer information behaviors remain limited. In response, this study developed a context-specific model by integrating cancer worry into the situational theory of problem solving (STOPS) to explain individuals' active and passive information behaviors. An online survey conducted in Hong Kong (N = 593) and the United States (N = 625) revealed that STOPS factors play different roles in explaining active and passive information behaviors, with the referent criterion and situation motivation being the dominant factors of active and passive information behaviors, respectively. Cancer worry partly mediated the relationship between such behaviors and situational motivation. While the effect of STOPS factors can be generally replicated across Hong Kong and U.S. contexts, the effects of cancer worry cannot. Altogether, our study has answered the call for research on the boundary conditions of STOPS and a more systematic understanding of cancer information behaviors. [ABSTRACT FROM AUTHOR]

Background: Worry is frequently associated with reduced cognitive performance, through consumption of attention control resources. Assessing attention control during acute worry may better reflect cognitive performance in real-world scenarios. This study examined whether attention control (assessed at rest and under acute worry) moderates the relationship between worry and academic performance. Methods: Worry (Penn State Worry Questionnaire) and academic performance (examination grades) were assessed in 87 undergraduates, with attention control (antisaccade performance) measured at baseline and following worry induction. Results: When assessed at rest, attention control did not moderate the relationship between trait worry and academic performance. However, under acute worry, attention control significantly moderated the relationship between worry and academic performance (p =.05, f2 = 0.14), such that at low levels of attention control under worry, higher trait worry was significantly associated with lower academic performance. At high levels of attention control under worry, however, the relationship between trait worry and academic performance was not significant. Conclusions: Findings suggest that worry may shape performance according to attention control levels, with attention control's moderating role being more pronounced under conditions of acute worry. These results provide preliminary evidence that attention control assessed under worry may better predict real-world performance, compared to assessment at rest. [ABSTRACT FROM AUTHOR]

Objectives: Past research has been inconclusive regarding the specificity of associations between discrete pleasurable emotions and internalizing symptoms. Contentment may be especially relevant to depression, whereas tranquillity may be especially relevant to worry. The goal of the current research was to clarify the mixed findings regarding the relation between pleasure deficits and internalizing psychopathology. Methods: Participants from three samples (Total N = 757) completed alternative measures of depression and pleasurable emotions. Participants in Study 1 also completed a measure of anticipatory and consummatory pleasure, and close peers to a subset of participants (N = 64) reported their perceptions of participants' depression severity. Participants in Studies 2 and 3 also completed a measure of worry. Results: Across the three samples, contentment was significantly negatively associated with self‐reported depression. This association could not be accounted for by tranquillity, cheerfulness, anticipatory pleasure, or consummatory pleasure. Contentment was also strongly negatively associated with peer‐reported depression. Contentment was more strongly associated with depression than was cheerfulness. However, the strength of the association between contentment and depression relative to the strength of the association between tranquillity and depression depended on how contentment and depression were measured. Conversely, tranquillity was more strongly associated with worry than were contentment or cheerfulness. Conclusions: This study provides further evidence of the potential importance of the role of contentment in depression and tranquillity in worry. It may be useful to attend to contentment when assessing and treating depression and to attend to tranquillity when assessing and treating elevated worry. [ABSTRACT FROM AUTHOR]

Although previous research has investigated the impact of parents and peers on test anxiety in secondary or tertiary education, little is known about younger students, especially during the transition to secondary school. Additionally, it is unclear whether these social factors affect girls' and boys' test anxiety differently. Therefore, the current study examined the role of perceived peer integration into the new class context, perceived parental control, and autonomy support on girls' and boys' test anxiety (worry and emotionality) during the transition to secondary school. Data from 1770 students (Mage = 10.47, SD = 0.56; 51% females) were analyzed before (4th grade) and after the transition (5th grade) using a multigroup (girls vs. boys) structural equation model. Both facets of test anxiety decreased from 4th to 5th grade. Perceived peer integration into the new class was only relevant for girls' test anxiety, while parental control predicted post-transition test anxiety for boys. The results suggest that the perceived social environment is an important factor in helping students cope with the demands of the transition to secondary school. [ABSTRACT FROM AUTHOR]

Research on the nature and prevalence of phenomena like climate anxiety (or eco-anxiety) is increasing rapidly but there is little understanding of the conditions under which climate change worry becomes more or less likely to significantly impact mental wellbeing. Here, we considered two plausible moderators of the relationship between climate change worry and mental wellbeing: neuroticism and efficacy beliefs. Analysis was conducted with survey data gathered in six European countries in autumn 2019. Participants were recruited from universities in the participating countries using opportunity sampling. We found that climate change worry is negatively related to mental wellbeing at any level of perceived efficacy. In contrast, climate change worry is only significantly related to mental wellbeing at low and average levels of neuroticism. High neuroticism appears to have a masking, rather than amplifying, role in the relationship between climate change worry and mental wellbeing. The cross-sectional design of the study precludes verification of causal relationships among variables. The brief measure of neuroticism employed also did not allow for nuanced analysis of how different facets of neuroticism contribute to the observed interaction with climate change worry. Findings cannot be indiscriminately generalised to less privileged groups facing the worst impacts of the climate crisis. Our findings lend to a view that harmful impacts of climate change worry on mental wellbeing cannot simply be ascribed to dispositional traits like neuroticism. We advocate for interventions that tackle negative climate-related emotions as unique psychological stressors. • We examined whether neuroticism and efficacy beliefs interact with climate worry. • Efficacy beliefs did not moderate climate worry – mental wellbeing relationship. • Climate worry and mental wellbeing only significantly linked at low neuroticism. • High neuroticism has a masking role in climate worry – mental wellbeing link. [ABSTRACT FROM AUTHOR]

Objectives: Perceived expectations for active aging (PEAA) reflect subjective exposure to social expectations about staying active and fit in old age, for example, by maintaining health and social engagement. We investigated whether motivational and personality factors were related to PEAA in the domains of physical health, mental health, and social engagement. Method: We used a nationally representative sample of German adults (SOEP-IS) covering the entire adult life span (N = 2,007, age range 16–94 years) to test our pre-registered hypotheses. Results: Multiple regression analyses indicated that motivation (i.e. life goals and health-related worries) was consistently associated with PEAA in the matching domains and mediated the effects of openness to experience on PEAA. No other personality trait was associated with PEAA. Conclusion: Our findings suggest that individuals preferentially notice the expectations for active aging whose content relates to their personal concerns and goals. [ABSTRACT FROM AUTHOR]

Background: Resilience is a protective feature against anxiety and depression disorders. However, the precise relationship and structure of resilience and anxiety and depression remain poorly understood. This study sought to investigate the link among resilience' components and anxiety as well as depression. Methods: 1,279 clinical nurses were recruited. 10-item Connor-Davidson Resilience Scale, Generalized Anxiety Disorder 7, and Patient Health Questionnaire 9 were employed to evaluate resilience, anxiety, and depression, respectively. The regularized partial-correlation network was generated utilizing data from cross-sectional survey and the bridge expected influence index was utilized to quantify bridge components. Results: The rates of anxiety and depression within clinical nurses were 67.3% and 67.2%, accordingly. Four strongest bridge edges appeared in the resilience-anxiety network, like "Adapt to change"- "Fear that something might happen", and "Stay focused under pressure"- "Uncontrollable worry". Two strongest bridge edges appeared in the resilience-depression network, like "Adapt to change"- "Concentration difficulties" and "Stay focused under pressure"- "Fatigue". "Adapt to change" was recognized as bridging nodes in both the resilience-anxiety network and the resilience-depression network. Conclusions: Interventions targeting the bridge component "Adapt to change" within resilience, may mitigate the intensity of anxiety and depression symptoms among clinical nurses. [ABSTRACT FROM AUTHOR]

Purpose: To examine quality of life (QoL) and mental health among Asian Indians in Southwest and Central-west Florida by COVID-related lifestyle changes, and demographic characteristics. Methods: QoL was assessed using SF-12 questionnaire while mental health/healthcare was assessed using the household pulse survey. Face-to-face interviews and self-administered online surveys were conducted among 151 participants in 2021–22. F and Chi-square statistics were used to examine the differences in QoL scores and mental health/mental healthcare by sociodemographic factors and COVID-related lifestyle changes. Results: Mental Component Summary (MCS) scores were lower for those who experienced changes in work expectations (p 0.041), sleep (p 0.002), exercise (p < 0.001), meditation (p.004) and connecting with family (p 0.007) and among those with family testing COVID positive (p.012). Mean Physical Component Summary (PCS) scores were lower for caregivers (p.008). PCS scores were lower for certain income groups (p 0.006), retired (p 0.004), older age groups (p 0.002). Lower MCS scores with college education (p.005), those who were students (p <0.001), younger age groups (p < 0.001). Those who helped with homeschooling felt anxious (p 0.049), couldn't stop worrying (p 0.046) and took medications (p < 0.001). Participants' families who tested COVID positive were anxious (p = 0.019) and worried (p = 0.015). Those with greater work expectations sought counseling (p = 0.009) and those who connected more with their family were anxious (p = 0.008). Conclusion: The pandemic affected QoL, especially the mental component and increased anxiety and worrying. Mental health services for younger individuals, those with caregiving responsibilities and facing increased job demands must be prioritized. [ABSTRACT FROM AUTHOR]

Using the metacognitive model of emotion dysregulation as a basis, this study explored whether, among participants with substance use disorders (SUDs), metacognitive beliefs and repetitive negative thinking were associated with emotion dysregulation. 127 participants with SUDs and 127 controls without SUDs were recruited. Emotion dysregulation, metacognitive beliefs, rumination, worry, anxiety, and depression were assessed. t -tests, Mann–Whitney tests, logistic regression, correlation, and hierarchal regression analyses were run. Participants with SUDs reported significantly higher levels of emotion dysregulation, positive beliefs about worry, beliefs about the need to control thoughts, rumination, and worry, compared to controls without SUDs. Among participants with SUDs negative beliefs about thoughts concerning uncontrollability and danger, cognitive confidence, beliefs about the need to control thoughts, rumination, and worry were significantly associated with an increase of emotion dysregulation. The cross-sectional design. Emotion dysregulation, metacognitive beliefs, and repetitive negative thinking may contribute to increase the risk of substance use. Among participants with SUDs emotion dysregulation is associated with the tendency to endorse dysfunctional metacognitive beliefs and report repetitive negative thinking. Metacognitive beliefs and repetitive negative thinking could be a suitable therapeutic target to reduce emotion dysregulation among participants with SUDs. • Emotion dysregulation may increase the risk of substance use. • Dysfunctional metacognitions are associated with emotion dysregulation in SUDs subjects. • Engagement in worry is associated with emotion dysregulation in SUDs subjects. • Engagement in rumination is associated with emotion dysregulation in SUDs subjects. • Metacognitions may be a therapeutic target to reduce emotion dysregulation in SUDs subjects. • Repetitive negative thinking may be a therapeutic target to reduce emotion dysregulation in SUDs subjects. [ABSTRACT FROM AUTHOR]

According to contextualism, a gender term such as ‘woman’ does not invariantly refer to a specific social or biological kind. Instead, gender terms have different extensions depending on the context of utterance. Contextualism accommodates that speakers are perfectly able to use gender terms in very different ways and still be coherent and successful in their communicative exchanges. However, while the flexibility of contextualism is its primary asset, it has also turned out to be its potential demise. The worry is that the view not only makes trans-including claims true but also allows that trans-excluding claims can be true and therefore, does justice to the claims of trans people only in a trivial sense. This paper defends the view that contextualists can respond to this worry by showing why trans-excluding claims are often morally problematic even in contexts where they are true. Contextualists are well-equipped to say that when speakers insist on using gender terms in trans-excluding ways, they engage in a meta-linguistic negotiation about how gender terms ought to be used – where using them trans-excluding is treated as normatively superior. This constitutes a kind of epistemic injustice. [ABSTRACT FROM AUTHOR]

Background Theory and research indicated that executive functioning (EF) correlated with, preceded, and stemmed from worry in generalized anxiety disorder (GAD). The present secondary analysis (Zainal & Newman, 2023b) thus determined whether EF domains mediated the effect of a 14-day (5 prompts/day) mindfulness ecological momentary intervention (MEMI) against a self-monitoring control (SM) for GAD. Method Participants (N = 110) diagnosed with GAD completed self-reported (Attentional Control Scale, GAD Questionnaire, Perseverative Cognitions Questionnaire) and performance-based tests (Letter-Number Sequencing, Stroop, Trail Making Test-B, Verbal Fluency) at baseline, post-treatment, and one-month follow-up (1MFU). Causal mediation analyses determined if pre-post changes in EF domains preceded and mediated the effect of MEMI against SM on pre-1MFU changes in GAD severity and trait repetitive negative thinking (RNT). Results MEMI was more efficacious than SM in improving pre–post inhibition (β = −2.075, 95% [−3.388, −0.762], p =.002), working memory (β = 0.512, 95% [0.012, 1.011], p =.045), and set-shifting (β = −2.916, 95% [−5.142, −0.691], p =.010) but not verbal fluency and attentional control. Within groups, MEMI but not SM produced improvements in all examined pre–post EF outcomes except attentional control. Only pre–post improvements in inhibition mediated the effect of MEMI against SM on pre-1MFU reductions in GAD severity (β = −0.605, 95% [−1.357, −0.044], p =.030; proportion mediated = 7.1%) and trait RNT (β = −0.024, 95% [−0.054, −0.001], p =.040; proportion mediated = 7.4%). These patterns remained after conducting sensitivity analyses with non-linear mediator-outcome relations. Conclusions Optimizing MEMI for GAD might entail specifically boosting inhibition plausibly by augmenting it with dialectical behavioral therapy, encouraging high-intensity physical exercises, and targeting negative emotional contrast avoidance. [ABSTRACT FROM AUTHOR]

Aim: To examine and compare the level of cancer‐related concerns and affecting factors between cancer survivors who completed their treatment and those still receiving treatment. Design: The study has a cross‐sectional comparative design. Methods: Convenience sampling was used and the study included 350 Turkish cancer survivors. Data were collected between March and June 2022 online with a descriptive characteristics form and the Assessment of Survivor Concerns. Obtained data were analysed with numbers, percentages, mean values, t‐test and multiple linear regression analysis. Results: The cancer survivors who completed their treatment had a significantly higher level of concerns than those who were still on treatment. Female cancer survivors, cancer survivors with less than 5‐year time elapsing after diagnosis and gynaecological cancer survivors with completed cancer treatment can also have a higher level of cancer‐related concerns. Conclusion: Cancer survivors who have completed their treatment have a higher level of concerns than those who still receive treatment. Gender, time elapsing after diagnosis and type of cancer affect the level of concerns. Implications for the Profession and/or Patient Care: Nurses should evaluate psychosocial care and needs of cancer survivors in addition to their physical care. Raising awareness about the concerns of the cancer survivors with completed treatment in addition to those still receiving treatment and providing holistic care to them can reduce their concerns. Impact: It is of great importance to be aware of the factors likely to increase cancer‐related concerns during and after cancer treatment. This study identifies cancer‐related concerns in cancer survivors who completed or were still receiving treatment and provides a comparison with other studies in the literature. Reporting Method: We have adhered to STROBE statement using STROBE checklist for cross‐sectional studies. Patient or Public Contribution: There was no patient or public involvement. [ABSTRACT FROM AUTHOR]

The clinical literature encourages further exploration of the relationship between anxiety and paranoid ideation with the overall objective of identifying processes that mitigate such relationship, thus establishing targets for cognitive intervention. Empirical studies demonstrate that increased levels of anxiety precede the emergence of paranoid cognitions. Yet, possible mediators are still to be investigated. In all, 273 adults completed a battery of standardized questionnaires, and collated data were analyzed statistically. Generalized anxiety was positively associated with paranoid ideation, for both ideas of reference and persecutory beliefs. Although the relationship was not mediated by cognitive flexibility in its entirety, perceived control over internal experiences and external events, an essential constituent of cognitive flexibility, acted as a significant mediator. The results highlight the importance of increasing adaptive perceptions of control among individuals experiencing generalized anxiety, which would likely reduce the co-occurrence of paranoid ideation and lower the risk of transitioning into clinical levels of paranoia. [ABSTRACT FROM AUTHOR]

Background: There are limited studies on barriers to seeking treatment for Alcohol Use Disorders (AUD) among males in tertiary care centers in India and abroad. Identification of these factors can aid in addressing the barriers to seeking treatment for AUD in low-and-middle-income countries. Objective: To investigate the barriers to seeking treatment for AUD among males in a tertiary care center in South India. Methods: The study design was cross-sectional. We employed a semi-structured interview proforma, Barriers Questionnaire (Alcohol), and assessed the age of onset of initiation of alcohol, problem drinking, and AUD. Results: The majority (73.3%) belonged to Low-Barrier group. Individual items such as "Denial of Alcoholism", "avoid others counseling", "don't like to talk in groups", "Worried about what others will think for taking help or made fun of by others", "Self or Family embarrassed of taking treatment", "cannot afford treatment due to various reasons", "Fear of losing job", "Fear of losing friends" and "Fear of seeing people" were significantly higher in High-Barrier group. Conclusions: Our study has helped to identify some of the important impediments. Psychoeducation and reducing the stereotypes related to the treatment of AUD can increase trust in the treatment process, resulting in greater help-seeking, early intervention, and improved quality of life. [ABSTRACT FROM AUTHOR]

Under processes of responsibilisation and individualisation in the 'risk society', as well as discourses of intensive motherhood, mothers are expected to make 'good' decisions regarding their children's health. Consequently, decision-making concerning childhood vaccination becomes an emotionally challenging process, as mothers strive to minimise risk while simultaneously promoting and protecting health. Existing research shows that a substantial number of parents of young children have concerns regarding childhood vaccination. This article aims to examine how mothers who identify as vaccine hesitant dynamically construct risk, emotion, and responsibility when accounting for their decisions about childhood vaccination. Based on 15 in-depth interviews conducted in Belgium, this article reports the findings of a discourse analysis. For the latter, we draw on positioning theory and Lupton's emotion-risk assemblage. The findings report three storylines that mothers discursively construct when discussing risk and responsibility in relation to childhood vaccination, namely a health promotion, a maternal protection and a critical healthcare consumer storyline. These storylines help to clarify the fluid and multidimensional nature of the mothers' accounts of vaccine hesitancy. Furthermore, the findings provide empirical evidence for the use of the emotion-risk assemblage, as we find that vaccine hesitant mothers construct risk in relation to feelings of safety, control, empowerment, anxiety, fear, worry, intuition, vulnerability, being overwhelmed, pity and contempt. Overall, the findings demonstrate that when accounting for their decisions concerning childhood vaccination, hesitant mothers assume responsibilities within a context of social and gendered vulnerability, which affects their constructions of risk. [ABSTRACT FROM AUTHOR]

Objective: Epidemiological studies revealed an unestablished association between neuroticism and posttraumatic stress disorder (PTSD) and we conducted mendelian randomization (MR) analyses to examine whether neuroticism clusters of worry, depressed affect, and sensitivity to environmental stress and adversity (SESA) were involved in the development of PTSD. Method: We obtained data on three neuroticism clusters, PTSD, and nine other psychiatric disorders from genome‐wide association studies summary statistics and employed univariable, multivariable, and mediation MR analyses to explore causal associations among them. Results: Neuroticism clusters were linked with PTSD (depressed affect (odds ratio [OR]: 2.94 [95% confidence interval: 2.21–3.92]); SESA (2.69 [1.95–3.71]; worry (1.81 [1.37–2.99])). Neuroticism clusters were also associated with psychiatric disorders, with the depressed effect on panic disorder (PD) (2.60 [1.14–5.91]), SESA on anorexia nervosa (AN) (2.77 [1.95–3.94]) and schizophrenia (2.55 [1.99–3.25]), worry on major depressive disorder (MDD) (2.58 [2.19–3.05]). In multivariable MR, only the SESA‐PTSD association remained (2.60 [2.096, 3.107]) while worry‐PTSD and depressed affect‐PTSD associations attenuated to nonsignificance. Mediation MR analyses suggested that PD mediated 3.76% of the effect of depressed effect on PTSD and AN mediated 10.33% of the effect of SESA on PTSD. Conclusion: Delving deeper into neuroticism clusters, we comprehensively understand the role of neuroticism in PTSD. [ABSTRACT FROM AUTHOR]

Introduction: This study examined the effects of the coronavirus disease 2019 (COVID‐19) pandemic on depression and suicidal ideation in community‐dwelling elderly in Korea. Methods: Data were employed from a survey on elderly mental health in Jeollanam‐do (southwest province in Korea), conducted by the Jeollanam‐do Provincial Mental Health and Welfare Center. A total of 2423 people were recruited from all 22 cities in Jeollanam‐do from April to October, 2021. We used self‐reported questionnaires including sociodemographic factors, COVID‐19‐related stress, the Geriatric Depression Scale‐Short Form Korean Version, the Multidimensional Scale of Perceived Social Support, the Satisfaction With Life Scale and the Brief Resilience Scale. Logistic regression was performed to examine the factors of depression and suicidal ideation. Results: Of the 2423 subjects, 622 (25.7%) reported depressive symptoms and 518 (21.4%) reported suicidal ideation. The multivariate logistic regression analysis revealed that living alone, poor perceived health status, worry of COVID‐19 infection, and restriction of daily activities due to COVID‐19 pandemic are significantly associated with depression. Female gender, poor perceived health status, inability to perform household chores, and depressive symptom are risk factors of suicidal ideation. Conclusion: These findings show that old age, negative perception of health, and restriction of daily activities due to COVID‐19 are risk factors of depression in community‐dwelling elderly in the context of the COVID‐19 pandemic. Female gender, poor self‐perceived health status, and depression increase the risk of suicidal ideation among the elderly. Social support and life satisfaction are protecting factors of both depression and suicidal ideation. Resilience decreased risk of depression but not in suicidal ideation. [ABSTRACT FROM AUTHOR]

Perceived threat of Alzheimer's disease and related dementias (ADRD) has been found a widespread phenomenon in developed countries, but has not yet been fully explored in developing countries. Analyzing data from 300 family caregivers of older adults with cognitive impairment in China, this study found caregiver burden was positively associated with the perceived threat of ADRD, and this association was buffered by higher family income and longer caregiving time. To alleviate undue ADRD concerns, it suggests expanding respite care and community elder care beds, and initiating education programs on reducing unnecessary worries about developing ADRD. [ABSTRACT FROM AUTHOR]

Objectives: Anal incontinence (AI) is a distressing condition with grave impact on many aspects of life, including quality of life (QoL), social life and sexual activities. This study explored how AI and bowel symptoms impact QoL in a Norwegian population by (1) describing the psychosocial and sexual consequences of AI, and (2) investigating factors most often associated with AI-specific QoL. Materials and methods: A cross-sectional study among patients with AI referred to hospital outpatient clinics was conducted. A Norwegian version of ICIQ-B was used to measure bowel control, bowel symptoms, sexual impact, and impact on QoL. Results: A total of 208 persons with AI completed the questionnaire. The results demonstrated that these patients are overall embarrassed, make plans according to the bowels, ensure the presence of a nearby toilet, and many abstain from sexual activities. After adjusting for other variables included in a multivariable model, we found that having bowel accidents on one's mind had the greatest relative impact on QoL, followed by lower bowel control, using more medications to stop bowels, having more pain/soreness around the back passage, lower age, and more straining to open the bowels. Conclusions: AI has substantial consequences for the psychosocial function and sexual activities of persons with AI. This study indicates that worrying about potential faecal accidents and the social stigma associated with this have greater impact on QoL than actual bowel leakages. Future studies should therefore focus on the emotional burden, patient coping, and health education related to bowel function and AI. [ABSTRACT FROM AUTHOR]

Background: Tackling poor mental health in university students has been identified as a priority in higher education. However, there are few evidence-based prevention initiatives designed for students. Repetitive Negative Thought (RNT, e.g. worry, rumination) is elevated in university students and is a well-established vulnerability factor for anxiety and depression. Furthermore, there are now evidence-based cognitive-behavioural interventions to tackle RNT. A mobile self-help cognitive-behavioural app targeting RNT, adapted for students may therefore be an effective, scalable, and acceptable way to improve prevention in students. Methods: An online single blind, two-arm parallel-group Randomised Controlled Trial (RCT) to examine the incidence of major depression and symptoms of anxiety and depression across 12 months in university students aged over 16 who screen into the study with self-reported high levels of worry and/or rumination and no current diagnosis of major depression. Eligible participants will be randomised to the active intervention arm (usual practice plus using a self-guided mobile app targeting RNT) or to the control arm (usual practice). In total, 648 participants aged over 16, with no current major depression, bipolar disorder or psychosis will be recruited from UK universities. Assessments will take place at baseline (pre-randomisation), 3 months and 12 months post- randomisation. Primary endpoint and outcome is incidence of major depression as determined by self-reported diagnostic criteria at 12-month follow-up. Depressive symptoms, anxiety, well-being, health-related quality of life, functioning and academic outcomes are secondary outcomes. Compliance, adverse events, and potentially mediating variables will be carefully monitored. Discussion: The trial aims to provide a better understanding of the causal role of tackling RNT (worry, rumination) using a self-help mobile app with respect to preventing depression in university students. This knowledge will be used to develop and disseminate innovative evidence-based, feasible, and effective mobile-health public health strategies for preventing common mental health problems. Trial registration: https://www.isrctn.com/ISRCTN86795807 Date of registration: 27 October 2022 [ABSTRACT FROM AUTHOR]

Objective: Job strain has been implicated in a variety of adverse health outcomes, particularly cardiometabolic and inflammatory diseases. However, the mechanisms underlying these effects remain largely unknown. One possibility is that the maladaptive coping response to stress, (perseverative cognition (PC); the cognitive representation of past stressful events (rumination) or feared future events (worry)), either in work or more generally, mediates the relationship between job strain and physical disease. The aim of this study was thus to test the potential role of both general, and work- related PC as a mediating, or potentially moderating, mechanism between job strain and ill- health outcomes. Design & Measures: Using an online cross- sectional design, 650 full- time employees completed measures of job strain, general and work- related PC (rumination & worry) and health outcomes (burnout, somatization, health behaviours & sleep quality). Results: General and work- related worry and rumination significantly mediated, often independently, the relationship between job strain and burnout, somatization, and sleep quality. No significant mediation effects were observed for health behaviours and no type of PC (general or work- related) moderated job strain- health outcome relations. Conclusion: Both general and work- related worry and rumination are likely to play important, and partly independent, roles in understanding the adverse relationships between job strain and various health outcomes. [ABSTRACT FROM AUTHOR]

This study examined mental adjustment to breast cancer, that is, coping strategies. Participants were 130 women undergoing breast cancer treatment in two medical settings in Accra, Ghana. They completed questionnaires assessing mental adjustment to cancer, psychological distress (anxiety and depression), negative religious coping, body change stress, and illness perceptions. Data were analyzed using hierarchical linear regression. Results showed that patients who reported higher depression were more likely to engage in anxious preoccupation (worry and thinking about breast cancer). Higher depression was associated with a greater sense of helplessness/hopelessness. Moreover, patients higher in negative religious coping were more likely to experience a greater sense of helplessness/hopelessness. Illness perception facets of personal control and emotional response were positively associated with fatalism and anxious preoccupation, respectively. The results suggest that screening breast cancer patients for psychological morbidity could help identify patients with increased risks for maladaptive adjustment to the disease. [ABSTRACT FROM AUTHOR]

• What is the primary question addressed by this study? Are there specific anxiety symptoms associated with Alzheimer's disease pathologies, amyloid-β and tau, in cognitively unimpaired older adults? • What is the main finding of this study? Greater amyloid-β deposition was associated with higher levels of self-reported worry but not global anxiety, independent of subjective and objective cognition and depression. No associations were found between regional tau deposition and either worry or global anxiety. • What is the meaning of the finding? These findings implicate worry as an early, specific behavioral marker and possible therapeutic target in preclinical AD. Anxiety disorders and subsyndromal anxiety symptoms are highly prevalent in late life. Recent studies support that anxiety may be a neuropsychiatric symptom during preclinical Alzheimer's disease (AD) and that higher anxiety is associated with more rapid cognitive decline and progression to cognitive impairment. However, the associations of specific anxiety symptoms with AD pathologies and with co-occurring subjective and objective cognitive changes have not yet been established. Baseline data from the A4 and Longitudinal Evaluation of Amyloid Risk and Neurodegeneration studies were analyzed. Older adult participants (n = 4,486) underwent assessments of anxiety (State-Trait Anxiety Inventory–6 item version [STAI]), and cerebral amyloid-beta (Aβ; 18F-florbetapir) PET and a subset underwent tau (18F-flortaucipir) PET. Linear regressions estimated associations of Aβ in a cortical composite and tau in the amygdala, entorhinal, and inferior temporal regions with STAI-Total and individual STAI item scores. Models adjusted for age, sex, education, marital status, depression, Apolipoprotein ε4 genotype, and subjective and objective cognition (Cognitive Function Index-participant; Preclinical Alzheimer Cognitive Composite). Greater Aβ deposition was significantly associated with higher STAI-Worry, adjusting for all covariates, but not with other STAI items or STAI-Total scores. In mediation analyses, the association of Aβ with STAI-Worry was partially mediated by subjective cognition with a stronger direct effect. No associations were found for regional tau deposition with STAI-Total or STAI-Worry score. Greater worry was associated with Aβ but not tau deposition, independent of subjective and objective cognition in cognitively unimpaired (CU) older adults. These findings implicate worry as an early, specific behavioral marker and a possible therapeutic target in preclinical AD. [ABSTRACT FROM AUTHOR]

Understanding tourist profiles and behaviors during health pandemics is key to better preparedness for unforeseen future outbreaks, particularly for tourism and hospitality businesses. This study develops and applies a novel data analytics methodology to gain insights into the health risk reduction behavior of restaurant diners/patrons during their dining out experiences in a pandemic. The methodology builds on data relating to four constructs (question categories) and measurements (questions and attributes), with the constructs being worry, health risk prevention behavior, health risk reduction behavior, and demographic characteristics. As a unique contribution, the methodology generates a behavioral typology by identifying risk profiles, which are expressed as one- and two-level decision rules. For example, the results highlighted the significance of restaurants' adherence to cautionary measures and diners' perception of seclusion. These and other factors enable a multifaceted analysis, typology, and understanding of diners' risk profiles, offering valuable guidance for developing managerial strategies and skill development programs to promote safer dining experiences during pandemics. Besides yielding novel types of insights through rules, another practical contribution of the research is the development of a public web-based analytics dashboard for interactive insight discovery and decision support. [ABSTRACT FROM AUTHOR]

This paper discusses the use of specification grading in sport management courses. The process organizes assignments around grading bundles and evaluates students as either Satisfactory or Unsatisfactory in meeting each assignment. A token system is created to provide flexibility to the students. There are advantages to using specification grading. For example, it empowers students to choose their grade, reduces stress and worry over "points," allows students the opportunity to resubmit Unsatisfactory assignments, and provides a sense of freedom to the instructor through the feedback to students. This paper explores the process of creating the specification grading method in a class and reflecting on implementation and utilization of the method in undergraduate sport management classes. [ABSTRACT FROM AUTHOR]

Abstract Background Tackling poor mental health in university students has been identified as a priority in higher education. However, there are few evidence-based prevention initiatives designed for students. Repetitive Negative Thought (RNT, e.g. worry, rumination) is elevated in university students and is a well-established vulnerability factor for anxiety and depression. Furthermore, there are now evidence-based cognitive-behavioural interventions to tackle RNT. A mobile self-help cognitive-behavioural app targeting RNT, adapted for students may therefore be an effective, scalable, and acceptable way to improve prevention in students. Methods An online single blind, two-arm parallel-group Randomised Controlled Trial (RCT) to examine the incidence of major depression and symptoms of anxiety and depression across 12 months in university students aged over 16 who screen into the study with self-reported high levels of worry and/or rumination and no current diagnosis of major depression. Eligible participants will be randomised to the active intervention arm (usual practice plus using a self-guided mobile app targeting RNT) or to the control arm (usual practice). In total, 648 participants aged over 16, with no current major depression, bipolar disorder or psychosis will be recruited from UK universities. Assessments will take place at baseline (pre-randomisation), 3 months and 12 months post- randomisation. Primary endpoint and outcome is incidence of major depression as determined by self-reported diagnostic criteria at 12-month follow-up. Depressive symptoms, anxiety, well-being, health-related quality of life, functioning and academic outcomes are secondary outcomes. Compliance, adverse events, and potentially mediating variables will be carefully monitored. Discussion The trial aims to provide a better understanding of the causal role of tackling RNT (worry, rumination) using a self-help mobile app with respect to preventing depression in university students. This knowledge will be used to develop and disseminate innovative evidence-based, feasible, and effective mobile-health public health strategies for preventing common mental health problems. Trial registration https://www.isrctn.com/ISRCTN86795807 Date of registration: 27 October 2022