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Background: Anxiety is one of the most commonly experienced psychological states and diagnosed disorders in adolescent populations (ages 13-19). Research indicates that the prevalence of anxiety and phobic disorders is often higher than stated in epidemiologic studies of adolescent mental health. However, mental health experiences, such as anxiety, are easy to dismiss or overlook due to broader issues in mental health service needs, preference for informal sources of help, and mental health stigma. This study will seek to understand how young people convey their experiences online. Reddit, a social networking platform, is a suitable platform for this, as large-scale subreddits focus on anxiety and mental health distress specifically. Method: Our study will adopt an Internet-mediated research methodology entailing a retroductive analysis of adolescent user posts on Reddit. The retrieved posts will be systematically organised to extract meaningful patterns across the dataset by using qualitative thematic analysis. Discussion: By analysing anonymous posts about the experience of anxiety, we anticipate that our study results will shed light on help-seeking behaviours, development of coping strategies, and stigma attitudes. [ABSTRACT FROM AUTHOR]

Aim. Vaginismus is the presence spasm of the muscles in the vagina not allowing sexual intercourse or any interactions in the absence of any disease. Neurological diseases can cause degenerative changes in brain structures such as the corpus callosum (CC), the main white matter structure that connects the hemispheres. Studies have shown that abnormalities in the CC, which acts as a conduit for sensory information transmission. The aim of this study is to evaluate the corpus callosum of patients with vaginismus with statistical shape analysis (SSA) using magnetic resonance imaging (MRI) images and compare it with healthy controls. Material and Methods. Ten female patients diagnosed with vaginismus in the psychiatry outpatient clinic and healthy individuals who met the study criteria, had no psychiatric diagnosis, were equal in number and age were selected as the control group. Mid-sagittal T1-weighted MRI images of each individual were obtained, and the corpus callosum was marked with software on each selected image using standard anatomical landmarks, and data were collected. The mean of 'Procrustes' landmark points was calculated and shape deformations were evaluated using thin plate spline (TPS) analysis. Results. A significant slightly difference was found in terms of corpus callosum areas in the mid-sagittal images of patients with vaginismus and controls. Maximum CC deformation was observed in almost all regions markings in those with vaginismus. In the evaluation of allometry, multivariate regression test was used for the relationship between size and shape and a statistically significant model was obtained for CC. Conclusion. CC analysis with SSA using MRI images revealed significant differences between patients and healthy subjects. The study findings highlighted the abnormal distribution of white matter in the corpus callosum and the variable subregional nature of CC in vaginismus patients. This study may help future studies in terms of vaginismus etiology, diagnosis and treatment options. [ABSTRACT FROM AUTHOR]

Background and Objectives: It is predicted that the negative effects of the novel coronavirus disease 2019 (COVID-19) pandemic will continue. These negative effects are not limited to psychological problems. Serious physiological and economic problems have also been observed. It is important to develop and standardize appropriate tools to assess its different effects. This study aims to investigate the psychometric properties of the Persian version of the COVID-19 Phobia Scale (C19P-S) in Iranian samples. Methods: In this study, participants were people aged 18-60 years in Iran from March to May 2022, who were selected by a convenience sampling method. In order to evaluate the convergent and discriminant validity, the second version of the acceptance and action questionnaire, the brief version of the difficulty in emotion regulation scale, and the fear of COVID‐19 scale were used. The factor structure of the questionnaire was examined by confirmatory factor analysis. Reliability was examined using Cronbach’s alpha coefficient and the test-retest method. The data were analyzed in SPSS version 25 and LISREL version 8.8. Results: The results of confirmatory factor analysis confirmed the four-factor structure the Persian C19P-S. Cronbach’s alpha coefficient for the whole scale was 0.90; for the subscales of psychological, psychological, economic and social factors, it was 0.87, 0.88, 0.89, and 0.91, respectively. In addition, the test-retest reliability with a four-week interval for the whole scale was 0.86; for the subscales of psychological, psychological, economic and social factors, it was 0.83, 0.79, 0.82, and 0.88, respectively. The correlation coefficients indicated the favorable convergent and discriminant validity of the Persian C19P-S (P

Abstract Background In the UK, around 93,000 (0.8%) children and young people (CYP) are experiencing specific phobias that have a substantial impact on daily life. The current gold-standard treatment—multi-session cognitive behavioural therapy (CBT) – is effective at reducing specific phobia severity; however, CBT is time consuming, requires specialist CBT therapists, and is often at great cost and limited availability. A briefer variant of CBT called one session treatment (OST) has been found to offer similar clinical effectiveness for specific phobia as multi-session CBT. The aim of this study was to assess the cost-effectiveness of OST compared to multi-session CBT for CYP with specific phobias through the Alleviating Specific Phobias Experienced by Children Trial (ASPECT), a two-arm, pragmatic, multi-centre, non-inferiority randomised controlled trial. Methods CYP aged seven to 16 years with specific phobias were recruited nationally via Health and Social Care pathways, remotely randomised to the intervention group (OST) or the control group (CBT-based therapies) and analysed (n = 267). Resource use based on NHS and personal social services perspective and quality adjusted life years (QALYs) measured by EQ-5D-Y were collected at baseline and at six-month follow-up. Incremental cost-effectiveness ratio (ICER) was calculated, and non-parametric bootstrapping was conducted to capture the uncertainty around the ICER estimates. The results were presented on a cost-effectiveness acceptability curve (CEAC). A set of sensitivity analyses (including taking a societal perspective) were conducted to assess the robustness of the primary findings. Results After adjustment and bootstrapping, on average CYP in the OST group incurred less costs (incremental cost was -£302.96 (95% CI -£598.86 to -£28.61)) and maintained similar improvement in QALYs (QALYs gained 0.002 (95% CI − 0.004 to 0.008)). The CEAC shows that the probability of OST being cost-effective was over 95% across all the WTP thresholds. Results of a set of sensitivity analyses were consistent with the primary outcomes. Conclusion Compared to CBT, OST produced a reduction in costs and maintained similar improvement in QALYs. Results from both primary and sensitivity analyses suggested that OST was highly likely to be cost saving. Trial registration ISRCTN19883421 (30/11/2016).

Abstract Background Osteoarthritis (OA) is a common degenerative joint disease leading to significant pain, mobility limitation, economic burden, reduced quality of life, and disability among adults globally. Psychological factors related to pain intensity (PI), kinesiophobia, fall self-efficacy (FSE), and balance may lead to a poor OA prognosis. This study was designed to explore the association between PI, kinesiophobia, FSE, balance, and age, gender, marital status, site of OA, duration, symmetry, comorbidity, and adaptive behaviours among patients with knee or hip OA. Methods This cross-sectional study involved 70 purposively selected participants aged 59.91 ± 11.12 years. Numeric pain rating scale, Tampa scale for kinesiophobia, fall-efficacy scale, and timed up and go test were used to measure PI, kinesiophobia, FSE, and balance, respectively. Statistical analyses were completed with the Pearson correlation test, independent samples t-test, and multiple linear regression. Results The participants were mainly women (n = 59, 84.3%). However, there was no gender difference in the reported PI, kinesiophobia, FSE, and balance. There was a significant correlation between FSE and balance (r = 0.422, p

Augmented reality has been increasingly used as a therapeutic tool in psychiatry. In particular, augmented reality exposure therapy (ARET) has been developed from and proposed as an alternative to standard cognitive behavioral therapy (CBT) for the treatment of phobic disorders. Using real-time 3D model and visual displays, the child is immersed in different computer-generated virtual environments designed for different types of phobia. As imaginative or in vivo exposure therapy, ARET consists in a gradual presentation of phobic stimuli. The desensitization through ARET has been found to be efficient in different types of anxiety disorder, and in particular in phobic disorders. The endeavor of this work is to examine researches done in the field of AR applied to children With Disorders. Thus, we will try to verify whether the use of these techniques makes useful or not an intervention in the case of children with disorder. The work presented aims at a reflection on the introduction of the use of AR in the treatment of these children by means of current researches. We will also observe, throughout this work, the involvement of NICTs such as augmented reality in changing the activities made with these tools on the didactic and methodological level.

Introduction: Phobia is an anxiety disorder characterized by fear or intense and irrational fear toward something. It presents an annual rate of incidence of 8 % and hypnosis is one of the most used treatments in those who suffer from this disorder. Objective: To evaluate the effectiveness of the hypnotherapeutic pattern applied to patients in school age with phobic anxiety disorders. Methods: A quasi-experiment hypnotherapeutic intervention was carried out in the 30 patients with school phobia that attended the hypnosis multidisciplinary service at the Therapeutic Hypnosis Clinic in Santiago de Cuba, from October, 2016 to the same month in 2018. To such an effect, the intervention consisted of 3 stages and the Mc-Nemar test was applied for 2 related samples, as well as the chi-square test. Results: In the series there was a prevalence of the male sex patients (53.3 %), mainly between 8 and 9 years (37.5 %), as well as the specific phobias. After having applied the hypnosis, a favorable psychological response was obtained in all the patients. Conclusions: The hypnotherapeutic pattern applied was effective, because a favorable clinical course and a good treatment response were achieved. [ABSTRACT FROM AUTHOR]

Background: Kinesiophobia is a significant factor affecting the prognosis of patients with total hip arthroplasty (THA). At present, the primary intervention for kinesiophobia is a 1-way intervention process of healthcare professionals on patients. The video teach-back method uses bidirectional information feedback to ensure high-quality health education. However, little is known about the effect of the video teach-back method on kinesiophobia in patients after unilateral THA., Purpose: To explore the effect of the video teach-back method on the degree of kinesiophobia, hip function, the first ambulation time, hospitalization days, and hospitalization costs in patients after THA., Methods: This quasi-experimental study was conducted in the Department of Joint Surgery of a grade III hospital in Changchun City, Jilin Province, targeting patients with kinesiophobia following unilateral THA. A nonconcurrent control design was employed, with participants divided into an intervention group (n = 46) and a control group (n = 45). The control group received conventional care, while the intervention group received video teach-back intervention in addition to traditional care. Within 24 hours post-surgery, patients with a kinesiophobia score of more than 37 completed a general information questionnaire. Primary outcomes, including kinesiophobia and hip function, were assessed on discharge day, 1 and 3 months after surgery, and counted on the day of discharge. Repeated-measures analysis of variance was used to analyze the differences in observation indexes at different time points. Secondary outcomes included the first postoperative ambulation time, hospitalization days, and hospitalization costs., Results: In comparison between the intervention group and the control group, the kinesiophobia scores and hip function scores of the patients on the discharge date, the first and third months after surgery, had a time effect (P < .001), a group effect (P < .001). The intervention group's reduction in kinesiophobia had a significant effect size (Cohen's d = 0.82) and hip function improvement also demonstrated a significant effect size (Cohen's d = 0.77). The first postoperative ambulation time in the intervention group was significantly earlier than that in the control group (P < .05, Cohen's d = 0.55), with both hospitalization days and costs lower than in the control group; the differences were statistically significant (P < .05)., Conclusion: The intervention group showed improvements in kinesiophobia, hip function, first postoperative ambulation time, hospitalization days, and hospitalization costs. These findings suggest that the video teach-back method, as an effective intervention, can be widely applied in clinical practice., Trial Registration Number: The trial was registered with the Chinese Clinical Trial Registry (registration number: ChiCTR2400079966)., (© Society of Behavioral Medicine 2025. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Nomophobia (NO MObile PHone Phobia) is a psychological condition in which people are anxious of being cut off from their mobile phones and been associated with adverse consequences to physical and psychosocial health. The objective of this study was to measure the impact of nomophobia on musculoskeletal problems in the upper extremity among adults. The Nomophobia scale (NMP-Q) was used to measure addiction to smartphone use among 5,087 Middle Eastern adults. A snowball sampling approach was used to recruit the participants between March and June 2021. Results showed that nomophobia was evident in 1,119 participants (22%) with a mean NMP-Q score of 114.1 (SD 11.1). A total of 3,396 upper extremity symptoms were reported among our participants. The binomial logistic regression showed that NMP-Q score is a significant predictor of symptoms to the thumb only ( β  = 0.01, p = .026). This study has provided evidence of the negative physical consequences of addiction to smartphone use. Participants with thumb-related symptoms were more prone to sustain other concurrent upper extremity symptoms, probably due to their maladaptive habits of using the phone. Thus, it is important to increase awareness about the risks associated with the use of smartphones. Implications for occupational therapy are presented.

Objectives: This study aimed to identify the main barriers that prevent patients with diabetes mellitus from accepting insulin therapy. Methods: This cross-sectional study was conducted from May to December 2019. Convenience sampling was used to recruit participants from three diabetes clinics in Muscat, Oman. Eligible participants were interviewed in person based on a pre-prepared questionnaire. The questionnaire, which was administered in Arabic, includes demographic data and 19 specific items on barriers to insulin therapy. Results: A total of 201 participants (response rate: 93%) were enrolled in the study. The most common barriers were as follows: concern of frequent blood glucose checking (36.3%), long-term injections (33.8%), side-effects of insulin (29.9%) and weight gain (29.4%). Needle phobia was considered a barrier by only 9% of the participants. Overall, 125 (62.2%) participants were willing to initiate insulin therapy despite the presence of these barriers and only 20 (10%) of them were influenced by these barriers to such a degree that they rejected the insulin therapy. Conclusion: The majority of participants had no identifiable reasons to stop them from accepting insulin therapy. Effective strategies should be developed to address each of the main barriers to improve acceptance and adherence to insulin therapy. [ABSTRACT FROM AUTHOR]

Background and objectivesAlthough exposure therapy is an effective treatment for anxiety disorders, fear sometimes returns following successful therapy. Recent literature in animal models indicates that incorporating some aversive events into extinction training may offset these return of fear effects.MethodsThe effect of occasional reinforced extinction trials was investigated in a sample of thirty-nine participants using a fear conditioning and extinction paradigm. Participants either underwent traditional extinction procedures during which the conditional stimulus which had been paired with the unconditional stimulus (US) during acquisition training (CS+) was presented alone with no presentations of the US or partially reinforced extinction during which there were several unpredicted CS+/US pairings.ResultsAs measured by skin conductance responses, physiological fear responding remained elevated during extinction for participants who experienced partially reinforced extinction; however, these participants demonstrated protection from rapid reacquisition effects. Results from the subjective US-expectancy ratings did not provide evidence of protection against rapid reacquisition in the partially reinforced extinction group; however, there was evidence of protection from spontaneous recovery effects. Lastly, as measured by valence ratings, it was unclear whether partially reinforced extinction provided protection from fear recovery effects.LimitationsAlthough participants who experienced partially reinforced extinction demonstrated protection from rapid reacquisition as measured by skin conductance responses, they also demonstrated significantly higher levels of physiological fear responding during extinction which made the results of the spontaneous recovery test more difficult to interpret.ConclusionsOccasional CS-US pairings during extinction may protect against return of fear effects. Clinical implications are discussed.

BackgroundTo address the fear of cancer recurrence (FCR) research gap, we used prospective data to explore FCR predictors and FCR associations with health-related quality of life among Asian-American breast cancer survivors (BCS).MethodsA total of 208 diverse Asian-American BCS completed T1 survey, and 137 completed T2 survey after 1 year.ResultsFear of cancer recurrence scores (range = 0-4) were 2.01 at T1 and 1.99 at T2 reflecting low-to-moderate FCR. Scores of FCR were stable over the 1-year period (t(126) = .144, P = .886). Multiple regression analyses showed that Chinese women reported lower FCR both at T1 (t(193) = -2.92, P = .004) and T2 (t(128) = -2.56, P = .012) compared to other Asian women. Also, more positive health care experience at T1 predicted lower FCR at T2 (β = -.18, P = .041). Controlling for other covariates, greater FCR at T1 predicted poorer outcomes 1 year later including lower physical (β = -.31, P

Background: Up to 10% of children and young people have a specific phobia that can significantly affect their mental health, development and daily functioning. Cognitive–behavioural therapy-based interventions remain the dominant treatment, but limitations to their provision warrant investigation into low-intensity alternatives. One-session treatment is one such alternative that shares cognitive–behavioural therapy principles but has a shorter treatment period. Objective: This research investigated the non-inferiority of one-session treatment to cognitive–behavioural therapy for treating specific phobias in children and young people. The acceptability and cost-effectiveness of one-session treatment were examined. Design: A pragmatic, multicentre, non-inferiority randomised controlled trial, with embedded economic and qualitative evaluations. Settings: There were 26 sites, including 12 NHS trusts. Participants: Participants were aged 7–16 years and had a specific phobia defined in accordance with established international clinical criteria. Interventions: Participants were randomised 1 : 1 to receive one-session treatment or usual-care cognitive–behavioural therapy, and were stratified according to age and phobia severity. Outcome assessors remained blind to treatment allocation. Main outcome measures: The primary outcome measure was the Behavioural Avoidance Task at 6 months’ follow-up. Secondary outcomes included the Anxiety Disorder Interview Schedule, Child Anxiety Impact Scale, Revised Children’s Anxiety and Depression Scale, a goal-based outcome measure, Child Health Utility 9D, EuroQol-5 Dimensions Youth version and resource usage. Treatment fidelity was assessed using the Cognitive Behaviour Therapy Scale for Children and Young People and the One-Session Treatment Rating Scale. Results: A total of 274 participants were recruited, with 268 participants randomised to one-session treatment (n = 134) or cognitive–behavioural therapy (n = 134). A total of 197 participants contributed some data, with 149 participants in the intention-to-treat analysis and 113 in the per-protocol analysis. Mean Behavioural Avoidance Task scores at 6 months were similar across treatment groups when both intention-to-treat and per-protocol analyses were applied [cognitive–behavioural therapy: 7.1 (intention to treat), 7.4 (per protocol); one-session treatment: 7.4 (intention to treat), 7.6 (per protocol); on the standardised scale adjusted mean difference for cognitive–behavioural therapy compared with one-session treatment –0.123, 95% confidence interval –0.449 to 0.202 (intention to treat), mean difference –0.204, 95% confidence interval –0.579 to 0.171 (per protocol)]. These findings were wholly below the standardised non-inferiority limit of 0.4, which suggests that one-session treatment is non-inferior to cognitive–behavioural therapy. No between-group differences in secondary outcome measures were found. The health economics evaluation suggested that, compared with cognitive–behavioural therapy, one-session treatment marginally decreased the mean service use costs and maintained similar mean quality-adjusted life-year improvement. Nested qualitative evaluation found one-session treatment to be considered acceptable by those who received it, their parents/guardians and clinicians. No adverse events occurred as a result of phobia treatment. Limitations: The COVID-19 pandemic meant that 48 children and young people could not complete the primary outcome measure. Service waiting times resulted in some participants not starting therapy before follow-up. Conclusions: One-session treatment for specific phobia in UK-based child mental health treatment centres is as clinically effective as multisession cognitive–behavioural therapy and highly likely to be cost-saving. Future work could involve improving the implementation of one-session treatment through training and commissioning of improved care pathways. Trial registration: This trial is registered as ISRCTN19883421. Funding: This project was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 26, No. 42. See the NIHR Journals Library website for further project information.

Background: In the UK, around 93,000 (0.8%) children and young people (CYP) are experiencing specific phobias that have a substantial impact on daily life. The current gold-standard treatment—multi-session cognitive behavioural therapy (CBT) – is effective at reducing specific phobia severity; however, CBT is time consuming, requires specialist CBT therapists, and is often at great cost and limited availability. A briefer variant of CBT called one session treatment (OST) has been found to offer similar clinical effectiveness for specific phobia as multi-session CBT. The aim of this study was to assess the cost-effectiveness of OST compared to multi-session CBT for CYP with specific phobias through the Alleviating Specific Phobias Experienced by Children Trial (ASPECT), a two-arm, pragmatic, multi-centre, non-inferiority randomised controlled trial. Methods: CYP aged seven to 16 years with specific phobias were recruited nationally via Health and Social Care pathways, remotely randomised to the intervention group (OST) or the control group (CBT-based therapies) and analysed (n = 267). Resource use based on NHS and personal social services perspective and quality adjusted life years (QALYs) measured by EQ-5D-Y were collected at baseline and at six-month follow-up. Incremental cost-effectiveness ratio (ICER) was calculated, and non-parametric bootstrapping was conducted to capture the uncertainty around the ICER estimates. The results were presented on a cost-effectiveness acceptability curve (CEAC). A set of sensitivity analyses (including taking a societal perspective) were conducted to assess the robustness of the primary findings. Results: After adjustment and bootstrapping, on average CYP in the OST group incurred less costs (incremental cost was -£302.96 (95% CI -£598.86 to -£28.61)) and maintained similar improvement in QALYs (QALYs gained 0.002 (95% CI − 0.004 to 0.008)). The CEAC shows that the probability of OST being cost-effective was over 95% across all the WTP thresholds. Results of a set of sensitivity analyses were consistent with the primary outcomes. Conclusion: Compared to CBT, OST produced a reduction in costs and maintained similar improvement in QALYs. Results from both primary and sensitivity analyses suggested that OST was highly likely to be cost saving. Trial registration: ISRCTN19883421 (30/11/2016). [ABSTRACT FROM AUTHOR]

The Youth Anxiety Measure for DSM-5 (YAM-5) is a new self- and parent-report questionnaire to assess anxiety disorder symptoms in children and adolescents in terms of the contemporary classification system. International panels of childhood anxiety researchers and clinicians were used to construct a scale consisting of two parts: part one consists of 28 items and measures the major anxiety disorders including separation anxiety disorder, selective mutism, social anxiety disorder, panic disorder, and generalized anxiety disorder, whereas part two contains 22 items that focus on specific phobias and (given its overlap with situational phobias) agoraphobia. In general, the face validity of the new scale was good; most of its items were successfully linked to the intended anxiety disorders. Notable exceptions were the selective mutism items, which were frequently considered as symptoms of social anxiety disorder, and some specific phobia items especially of the natural environment, situational and other type, that were regularly assigned to an incorrect category. A preliminary investigation of the YAM-5 in non-clinical (N = 132) and clinically referred (N = 64) children and adolescents indicated that the measure was easy to complete by youngsters. In addition, support was found for the psychometric qualities of the measure: that is, the internal consistency was good for both parts, as well as for most of the subscales, the parent-child agreement appeared satisfactory, and there was also evidence for the validity of the scale. The YAM-5 holds promise as a tool for assessing anxiety disorder symptoms in children and adolescents.