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Abstract Background Weight stigma is pervasive, and it has a significant impact on the social, physical, and psychological health of an individual. Weight stigma is observed from several different sources. Therefore, the present study developed and validated a new instrument, the Weight Stigma Exposure Inventory (WeSEI), to assess different sources of observed weight stigma across interpersonal and non-interpersonal sources. Methods The participants (n = 15,991) comprised Taiwanese young adults, Chinese adolescents, and Chinese young adults who completed paper-and-pencil and online surveys between September 2023 and December 2023. All participants provided demographic information, and completed the WeSEI, Weight Self-Stigma Questionnaire (WSSQ), and Perceived Weight Stigmatization Scale (PWSS). Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to examine the factor structure of the WeSEI. Results EFA and CFA results confirmed a seven-factor structure (television sources, traditional media sources, social media sources, parent sources, stranger sources, significant other sources, and friends sources) across 35 items of the WeSEI. Moreover, the WeSEI was supported by measurement invariance across subgroups (i.e., subsamples, gender, and weight status). Moreover, there were positive correlations between all seven factors of the WeSEI and the WSSQ and PWSS. Conclusion The WeSEI appears to assess observed weight stigma from different sources, and had good reliability, validity, and invariance across various subsamples. The WeSEI may be useful in clinical practice and research for assessing exposure to weight stigma from different sources.

Objectives: An outbreak of monkeypox (Mpox) appeared suddenly and rapidly spread worldwide during 2022. Men who have sex with men (MSM) are at a high risk of contracting Mpox compared to other cohorts. In the present study, we intended to examine the psychometric properties of a newly developed scale among MSM: the Fear of Mpox Scale (FMS) assessing the fear of Mpox. Methods: This is an online study. The factor structures of the FMS were first examined using exploratory factor analysis. After determining the factor structure, the FMS was further examined for (a) internal consistency using Cronbach’s α and (b) concurrent validity using correlations with anxiety, depression, and risk perception of contracting Mpox, and the known-group validity by comparing the scores of the FMS across MSM with sexual orientation and education level. Results: In total, 389 MSM participated in this study. The results indicated that the FMS had a one-factor structure. The FMS had acceptable internal consistency (α = 0.911) and concurrent validity (associated with anxiety [p < 0.01], depression [p < 0.001], and risk perception [p < 0.001]). No significant difference in the FMS scores was found between the groups with regard to sexual orientation or educational level. Conclusion: The results of the present study indicated that the psychometric properties of the FMS were good and that they can be used for assessing the fear of Mpox among MSM.

Abstract Aims Understanding the healthcare access challenges facing diabetic patients in low- and middle-income countries is very important. The present study investigated the association between availability (physical access) and affordability (economic access) to diabetes healthcare services and the frequency of diabetes-related complications. Methods A cross-sectional survey study was conducted between February and May 2023 in Qazvin, Iran. Using convenience sampling, 373 type 2 diabetic patients (mean age = 57.99 years; SD = 11.71) referred to diabetic specialists’ clinics were surveyed. Demographic characteristics, physical access to diabetes healthcare services, economic access to diabetes healthcare services, and frequency of diabetes-related complications (FDRCs) were assessed. Data were assessed using linear regression analysis. Results The mean total access score to healthcare services was 17.71 (out of 30; SD ± 4.21; range 6–30). Patients who had more access to healthcare services had less diabetes-related complications (p

Abstract The present study examined the psychometric properties of the Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS). A total of 742 Italian participants (84.6% female), with a mean age of 33.08 years (SD = 12.44) took part in a cross-sectional survey study. Confirmatory factor analysis and Rasch analysis were used to examine the psychometric properties. The CFA showed that the SWEMWBS had a unidimensional structure with robust psychometric properties and showed good internal consistencies (Cronbach’s alpha 0.88; McDonald’s omega 0.91). Overall, most items showed no substantial differential item functioning in the Rasch analysis, except for Item 7, indicating that female participants reported more difficulty with this item than the male participants. The SWEMWBS was positively associated with life satisfaction and negativity associated with general psychological distress (i.e., anxiety, stress, and depression). In sum, the SWEMWBS showed robust psychometric properties capable of assessing positive aspects of mental health and well-being among Italian-speaking adults.

Abstract Background Previous studies have shown that the Gaming Disorder Test (GDT) and Gaming Disorder Scale for Adolescents (GADIS-A) have promising validity and reliability when assessing symptoms of gaming disorder among young adults. However, validity and reliability properties of the two scales have not been established among a Vietnamese population. Objective The present study translated the GDT and GADIS-A into Vietnamese and examined their factor structures, measurement invariance, convergent validity, concurrent validity, and divergent validity among university students. Methods A total of 610 young adults (mean age = 21.09 years; 63.4% females) were recruited using convenience sampling and who completed a paper-and-pencil survey between April and June 2023. All participants completed a demographic questionnaire, GDT, GADIS-A, and six standardized scales related to gaming disorder, social media addiction, smartphone addiction, and psychological distress. Confirmatory factor analysis (CFA), internal consistency testing, and Pearson’s correlations were performed. Results CFA showed that the GDT had a one-factor structure and the GADIS-A had a two-factor structure. The internal consistency was excellent for both scales among this population. Moreover, both GDT and GADIS-A showed convergent, concurrent, and divergent validity with other standardized scales. Conclusion The Vietnamese versions of the GDT and GADIS-A have good psychometrics, which may be utilized in future research regarding gaming disorder among Vietnamese populations.

Abstract Objectives The study of comprehensive satisfaction with healthcare is still limited due to nonstandard measurement tools of patient satisfaction for the Chinese population. Therefore, the present study aimed to verify the validity, reliability, and measurement invariance of the revised Patient Satisfaction Questionnaire (PSQ-R) and conducted network analysis among a sample of the Chinese population. Methods A cross-sectional study using telephone surveys was conducted from April 2022 to August 2022. A total of 1377 participants who had been hospitalized completed the survey (481 males [34.9%], mean age = 49.4 years [SD ± 19.0]). Results Four factors (‘satisfaction with medical staff’, ‘satisfaction with hospital’, ‘satisfaction with medical costs’, and ‘satisfaction with medical insurance premiums’), were verified through confirmatory factor analysis (CFA) and had good equivalence across genders. The ‘satisfaction with medical staff’ and ‘satisfaction with hospital’ factors had the strongest edge intensity in the factor-level network. Conclusions The 18-item (four-factor) PSQ-R has good validity, reliability, and measurement invariance. The four dimensions appear to describe patient satisfaction well among the Chinese population who had been hospitalized. To effectively enhance patient satisfaction, the quality of healthcare service and medical staff skills should both be improved, medical insurance premiums should be increased, and medical costs should be decreased.

Abstract Background Given that social media use (SMU) is an increasingly widespread activity among university students, more information is needed to evaluate its relationship with students’ mental health, particularly medical students. Objective The present study assessed the relationships between SMU and coping style with psychological distress and academic performance of medical students. Methods An offline cross-sectional survey conducted with 398 undergraduate medical students. The survey collected data on demographics, psychological distress (DASS-21), coping strategies (Brief COPE Scale), academic performance (grade point average) and estimated average time spent on social media per day. Structural equation modeling was used to clarify relationships between the main study variables. The study also examined the mediating effect of maladaptive coping between SMU and psychological distress. Results Students with higher levels of psychological distress were more likely to be engaged in frequent social media use. Spending more than two hours a day on social media use had a positive association with maladaptive coping (p

Abstract Background One of the most significant events in recent Afghan history is the rise of the Taliban and the war that followed, which had profound impacts on the lives of Afghans. The present study examined the mental health of Afghans living under the Taliban government. Methods Between June 5, 2023 and February 12, 2024, a cross-sectional study was conducted among the Afghan population in three key regions of Afghanistan. Data were collected using a pre-tested structured questionnaire. The 21-item Depression, Anxiety and Stress scale (DASS-21) was utilized to assess depression, anxiety and stress of the Afghan population. Ethical permission for this study was granted by the Afghanistan Center for Epidemiological Studies (ACES). Logistic regression models were employed to explore the relationship between socio-demographic characteristics and depression, anxiety, and stress among 2,698 participants. Results The prevalence of depression was 72.05%, anxiety was 71.94%, and stress was 66.49%. Multiple regression analysis indicated that gender (being female), economic status (being poor), residency (living in rural areas), education level (being illiterate), being a cigarette smoker, and having experienced a bad event during the past month were significantly associated with depression, anxiety and stress. Conclusion The findings of the present study show very high levels of anxiety, depression, and stress, most likely reflecting the profound impact of recent political, social, and economic changes. Notably, a significant majority of participants, particularly females and individuals above 35 years of age, reported severe to extremely severe mental health symptoms. The mental health crisis in Afghanistan is a complex and urgent issue that requires a comprehensive and compassionate response.

Abstract Background Perceived weight stigma (PWS) and internalized weight stigma (IWS) are both associated with psychological distress and food addiction (FA). Using the previously proposed ‘cyclic obesity/weight-based stigma’ (COBWEBS) model, the present study extended the framework to investigate the mediating effects of IWS and psychological distress in the association between PWS and FA among young adults. Given that individuals who are overweight/have obesity have different vulnerabilities, this population was separately analyzed alongside the total study population. Methods An online survey comprising the Perceived Weight Stigma Scale, Weight Bias Internalization Scale (WBIS), Depression, Anxiety and Stress Scale-21 (DASS-21), and modified Yale Food Addiction Scale Version 2 was completed by 601 participants (59.6% females; mean age 29.3 years [SD = 6.07]). A total of 219 participants were categorized as being overweight/having obesity. Results A direct correlation was found between PWS and FA (standardized coefficient [β] = 0.28, p

ABSTRACT Background In today's post‐truth times, where personal feelings and beliefs have become increasingly important, determining what is accurate knowledge has become an important skill. This is especially important during uncertainty crises (e.g., epidemics and pandemics) because alternative explanations other than scientific knowledge may be disseminated vigorously. Epistemic justification concerns how and in what way the truth of knowledge claims is justified and the criteria for knowledge to be true and/or a fact. Given this backdrop, the present study examined how individuals reacted to conspiracies in an uncertainty crisis (using the COVID‐19 pandemic as an example). Aim The mediating role of epistemic justification was investigated regarding its relationship between COVID‐19 conspiracy beliefs and COVID‐19 vaccine conspiracy beliefs. Methods A cross‐sectional study was conducted incorporating a multifactorial correlational design. Using convenience sampling, 690 participants (55.7% females, Mage = 32.24 years, SD = 9.75) from different regions of Türkiye completed an online survey via Google Forms. Results The results demonstrated a strong and statistically significant correlation between beliefs in COVID‐19 conspiracy theories and beliefs in COVID‐19 vaccination conspiracy theories. The mediating effects of justification by authority and personal justification were statistically significant between COVID‐19 conspiracy beliefs and COVID‐19 vaccine conspiracy theories. Conclusion Using the COVID‐19 pandemic as an example, the present results indicated the complex relationships between conspiracy beliefs and epistemic justification. The present results indicate the importance of authorities in taking early action to provide scientific evidence and information to the public to avoid individuals believing false information.

Introduction: Although the coronavirus disease 2019 (COVID-19) pandemic has ceased globally, individuals may still suffer from various psychological burdens in the post-COVID-19 era. The present observational cross-sectional study investigated how fear of COVID-19 can affect mental health through mediators including stress, perceived stigma, and preventive behaviors among young adults in Ghana. Methods: A total of 635 participants aged between 18 and 29 years (mean age = 20.2 years [SD = 2.04]) were recruited to complete measures of COVID-19 fear, stress, perceived stigma, preventive behaviors, and mental health status from June to August 2022. Results: Results from structural equation modeling found that (i) fear of COVID-19 was associated with stress and perceived stigma (standardized coefficients [βs] = 0.518 and 0.148, p-values

During the COVID-19 pandemic, the fear of COVID-19 increased, especially among nurses. The present study investigated the effect of in-person and virtual methods of Eye Movement Desensitization and Reprocessing (EMDR) on the fear of COVID-19 among nurses. In a three-armed randomized control trial, the sample comprised 141 nurses working in hospitals affiliated to Qazvin University of Medical Sciences, Qazvin, Iran. Eligible individuals were randomly assigned in study groups (virtual EMDR, in-person EMDR, and control) using balanced block method with a block size of six. The main outcome of the study was the fear of COVID-19 assessed before, immediately after, and three months after intervention. The secondary outcomes assessed included anxiety, depression and work-related quality of life assessed before and three months after the intervention. The results of variance-covariance analysis for repeated measures showed a significant reduction in the mean score fear of COVID-19 immediately after and three months after the intervention in the in-person EMDR intervention group compared to the virtual group (mean difference equal to -3.48 and -3.57) and the control group (mean difference equal to -5.45 and -5.57). Considering the minimum clinically significant difference was equal to 2.54 on the Fear of COVID-19 Scale, this reduction was also clinically significant. The average number of intervention sessions was two. No significant difference was observed regarding anxiety, depression and work-related quality of life after intervention between all three groups. In-person EMDR is more effective than the virtual EMDR as a non-pharmacological method in the treatment of fear of COVID-19 among nurses. In-person EMDR should be conducted in preference to virtual EMDR. However, in situations where in-person EMDR cannot be conducted, virtual EMDR could be considered as a potential alternative.

An outbreak of monkeypox (Mpox) appeared suddenly and rapidly spread worldwide during 2022. Men who have sex with men (MSM) are at a high risk of contracting Mpox compared to other cohorts. The present study examined the psychometric properties of a newly developed scale among MSM: the Motors of Mpox Vaccination Acceptance Scale (MoMVA) assessing cognitive components of the motivation to receive an Mpox vaccination. In total, 389 MSM participated in an online survey study. The factor structures of the MoMVA were first examined using exploratory factor analysis. After determining the factor structures, the MoMVA was further examined for: (i) internal consistency using Cronbach’s α; (ii) concurrent validity using correlations with risk perception of contracting Mpox and intention to receive an Mpox vaccination; and (iii) known-group validity by comparing the scores of the MoMVA between MSM who vaccinated and those who did not. The results indicated that the MoMVA had a two-factor structure (positive and negative motors). The MoMVA had acceptable internal consistency (α = 0.793 to 0.914), concurrent validity (associated with intention to receive an Mpox vaccination), and known-group validity (participants who vaccinated had higher MoMVA scores than those who did not). The results of the present study indicated that the psychometric properties of the MoMVA were good and that they can be used for assessing cognitive components of the motivation to receive an Mpox vaccination among MSM.

Background: Anxiety is a common psychological disorder in school-aged children and adolescents. The present study aimed to assess the prevalence of anxiety symptoms and sleep disturbances and their relationship with academic achievement among female students in Herat, Afghanistan. Methods: A cross-sectional survey of 737 female students (mean age 11.8 years old) was conducted across 10 randomly selected schools in Herat, Afghanistan, covering Grades 1 to 6. Students were randomly chosen within these schools. The Depression Anxiety Stress Scale for Youth (DASS-Y) and Pittsburgh Sleep Quality Index (PSQI) assessed anxiety and sleep disturbance, while academic achievement ratings were provided by schoolteachers. Results: Using the DASS-Y and the PSQI, 65.5% reported anxiety symptoms and 46.4% reported sleep disturbance. Low academic achievement correlated significantly with anxiety (r = 0.228) and sleep issues (r = 0.161). Multiple logistic regression analysis identified predictors for anxiety and sleep disturbance. Predictors for anxiety included being aged 13–16 years, having lower class grade, being of low economic status, and having unemployed parents. Predictors for sleep disturbance included being aged 13–16 years, having lower class grade, having an uneducated father, being of low economic status, and having unemployed parents. Conclusion: There is a high prevalence of anxiety symptoms and sleep disturbances among female school students in Herat, Afghanistan. Significant correlations exist between students' academic achievement, anxiety, and sleep disturbances. Addressing anxiety and sleep disturbances among Afghan female school students could be facilitated by revising current government policies concerning students' health. Educational campaigns focused on sleep hygiene and anxiety management for both students and their parents may also prove beneficial.

Mukbang watching (i.e., watching eating broadcasts) is an emerging online behaviour that has recently gained popularity. Although, there are a number of positive impacts of recreational mukbang watching (e.g., helping overcome loneliness), for a minority of individuals, excessive mukbang watching may turn into problematic (i.e., addictive) mukbang watching and lead to negative consequences. The present study investigated the addictive symptoms of mukbang watching using a qualitative design. The study attempted to determine the addictive symptoms of mukbang watching through semi-structured interviews with a sample of eight mukbang viewers who frequently watched mukbang. Directed content analysis was used to analyse the data. Nine key themes were explored comprising preoccupation, withdrawal, tolerance, inability to stop, loss of interest, continuing despite problems, deceiving family/friends, relieving negative mood, and risking relationships. Findings of the present study concur with those of previous survey research suggesting that mukbang watching may be another online addictive behaviour that can result in adverse consequences for individuals’ mental, social, and physical health.

Objective Emotional labour is expected, especially from service sector employees, to ensure customer satisfaction and meet corporate expectations. Previous studies have mainly focused on the effects of emotional labour on employees. Few studies have examined its predictors in terms of personality traits. In the present study, the predictive levels of the Big Five and dark triad traits on emotional labour were examined possibly for the first time.Method Four hundred and seventy-three service sector employees participated in the research. Data were collected using an online survey comprising questions relating to the Big Five personality traits, dark triad personality traits, emotional labour and personal (demographic) information. Descriptive statistics, internal consistency test, Pearson’s correlation and hierarchical regression were used to analyse the data.Results According to the findings, Machiavellianism was the strongest predictor of surface acting, and agreeableness was the strongest predictor of deep acting and naturally felt emotions. Narcissism was found to be a predictor of surface acting.Conclusions As a result of examining the Big Five and dark triad traits in predicting emotional labour styles, the fact that agreeableness predicted deep acting and naturally felt emotions suggests that agreeableness should be given closer attention in recruitment and promotion decisions, especially in the service sector.

Numerous studies suggest a negative impact of problematic internet use (PIU) not only on mental health but also on somatic components of adolescent health. The present study aimed to identify the associations between different types of PIU – generalized PIU (GPIU), problematic video game use (PVGU), and problematic social media use (PSMU) – and recurrent pain symptoms (headache, abdominal pain, and back pain), as well as to determine the role of psychosocial factors in these associations. In a cross-sectional school-based study, 4411 urban Siberian adolescents were asked about the presence, frequency, and intensity of pain symptoms in the past three months. Standardized psychometric scales were used to assess GPIU, PSMU and PVGU. Given the presence of psychosocial problems as a major confounder, direct associations of PSMU and GPIU with recurrent pain symptoms (headache, abdominal pain, and back pain) were found. PVGU was weakly associated only with abdominal pain. Further analysis indicated that the positive associations were largely mediated by comorbid psychosocial problems. These findings highlight the importance of addressing both problematic internet use and comorbid psychosocial problems to effectively reduce PIU-associated recurrent headaches, abdominal pain, and back pain among adolescents.

Abstract Objectives Older adults are more likely to have poor sleep quality and be socially isolated. The present study examined the potential benefits and disadvantages of social media use (SMU) with respect to sleep quality and perceived social isolation among Iranian late-middle-aged and older adults with focus a on both the mediating and moderating role of psychological distress. Methods A population-based cross-sectional study was conducted among 900 older community-dwellers living in Shiraz using a structured questionnaire. Social media use was assessed by estimating the frequency of social networking site visits per week. Data concerning self-rated physical health, chronic medical and mental health conditions, perceived social isolation, sleep quality, and psychological distress were also collected. Multiple linear regression was used to identify independent variables associated with outcomes. Then, mediation and moderation models were used to examine the potential mediating and moderating effects of psychological distress and SMU on their relationships with the study variables. Results Higher social media use was associated with better sleep quality and less perceived social isolation. Nevertheless, the relationships between SMU and participants’ sleep quality and perceived social isolation were largely mediated by their level of psychological distress. Furthermore, SMU had a significant moderating effect in the relationship between the psychological distress and the levels of perceived social isolation, so that participants with higher frequency of SMU per week felt less loneliness. Conclusions The study findings suggest that SMU has a positive buffering effect regarding late middle-aged and older adults’ mental health mainly through moderation of their perceived social isolation. The mediating role of psychological distress in research examining the relationship between SMU and older adults’ mental health outcomes should be considered in future research.

Abstract Background COVID-19-related stigmatization refers to COVID-19-related judgements by others that devalue the individual. Such stigmatization towards healthcare workers may cause psychological burden and negative consequences. Such stigmatization may have particularly overwhelmed allied health trainees (AHTs) and post-graduate year doctors (PGYDs) because they just started their medical career. Social support and resource support have been reported to benefit psychological health and reduce stigmatization. Therefore, the present study used a cross-sectional study design to investigate the association between perceived stigma, self-stigma, psychological distress, and negative outcomes (including emotional exhaustion, insomnia and suicidal ideation) among AHTs and PGYDs in Taiwan. Methods An online survey distributed between July and December, 2022 received 522 responses. Variables were assessed using the 21-item Depression, Anxiety and Stress Scale, Insomnia Severity Index and a series of self-designed questions to assess social support, resource support, perceived stigma, self-stigma, emotional exhaustion, and suicidal ideation. Results Structural equation modeling showed that perceived stigma was associated with self-stigma (standardized coefficient [β] = 0.428, p

Abstract Background Emotional intelligence and life satisfaction are essential components for good psychological well-being. Studies examining the elements contributing to emotional intelligence and its relationships with different psychological constructs are likely to positively contribute to mental health. Therefore, the present study examined the mediating roles of perceived stress and psychological resilience in the relationship between emotional intelligence and life satisfaction. Methods The study sample comprised 780 university students (62.3% females) studying at universities in different regions of Türkiye. An online survey included the Emotional Intelligence Scale, Satisfaction with Life Scale, Psychological Resilience Scale, and Perceived Stress Scale. A multifactorial complex predictive correlational design was used. Results The results showed that emotional intelligence was (i) positively correlated with life satisfaction and psychological resilience, and (ii) negatively correlated with perceived stress. In the final model, perceived stress and psychological resilience played a mediating role in the relationship between emotional intelligence and life satisfaction. The findings suggest that higher emotional intelligence may lower perceived stress and appears to have a positive effect in relation to life satisfaction and psychological resilience. Conclusion Individuals working in the field of mental health need to help individuals increase their level of EI, which may help reduce the level of perceived stress and increase psychological resilience and life satisfaction.

Abstract Background The main cause of growth and development delays remains unknown, but it can occur as an interaction between genetic, environmental, and socio-economic factors. Objective The aim of the study was to investigate the prevalence and social determinants of growth and developmental delays among children aged under five years in Qazvin, Iran. Methods A cross-sectional study was conducted between January 2019 to December 2020 with participation of 1800 mothers with children aged 4–60 months who were referred to comprehensive health centers in Qazvin city, Iran. Structural and intermediate social determinants of health were assessed including: parents and children socio-demographic characteristics, families’ living and economic status, parents’ behavioral factors, household food security, mother’s general health, and perceived social support. Children’s growth was assessed based on their anthropometric assessment and their development was assessed using their age-specific Ages and Stages Questionnaire. Data were analyzed using univariable and multivariable logistic regression models using SPSS software version 24 and Stata version 14. Results The prevalence of developmental problems in each domain were 4.28% for personal and social delay, 5.72% for gross motor delay, 6.5% for communication delay, 6.72% for fine motor delay, and 8% for problem-solving delay. The prevalence of weight growth delays was 13.56% and height growth delays was 4.66%. Communication, gross motor, and problem-solving delays were higher among children whose fathers’ smoked cigarettes. Fine motor delays were lower among mothers with education status of high school diploma and university degree vs. the under diploma group. Personal and social delay was significantly higher among families with fair economic status and lower among children when their fathers were employed (vs. unemployed). Weight and height growth delays were higher among mothers who had experienced pregnancy complications and household food insecure families, respectively. Conclusion There are different predictors of growth and developmental delay problems among Iranian children aged under five years including fathers’ smoking, families’ economic status, and household food insecurity as well as history of mothers’ pregnancy complications. The present study’s findings can be used to screen for at-risk of growth and developmental delays among children and could help in designing and implementation of timely interventions.

Attention-deficit/hyperactivity disorder (ADHD) is a common neurobehavioral disorder beginning in childhood and often extending into adulthood. ADHD may negatively impact emotional regulation and cause addictive behaviors such as social media addiction. The present study investigated the association of ADHD symptoms (i.e., attention deficit [AD] and hyperactivity/impulsivity [HI]) with social media addiction among young adults. The mediating effect of internalizing and externalizing emotional regulation (i.e., self-blame [SB] and blaming others [BO]) were examined. Participants (n = 96; mean age = 19.9 years [SD = 2.07]) comprising 35 individuals with probable ADHD and 61 individuals who did not have ADHD completed measures assessing social media addiction, ADHD symptoms, and emotional regulation strategies. Results of Hayes' Process Micro showed that both ADHD symptoms were significantly positively associated with social media addiction (standardized coefficient [β] = 0.30 and 0.38 for AD and HI) and emotional regulation strategies (β = 0.38 and 0.27 for AD to SB and BO, β = 0.23 and 0.28 for HI to SB and BO). In addition, BO was a significant mediator in the association between AD and social media addiction (β = 0.07, 95 % confidence interval = 0.003, 0.11). The results suggest that externalizing emotional regulation may mediate the association between symptoms of AD and social media addiction. It is recommended that individuals with probable ADHD should focus on improving self-awareness (such as mindfulness), developing resilience skills, and/or incorporating positive coping strategies (such as physical activity) to reduce the negative impacts derived from symptoms of ADHD.

Background: Teachers in demanding work environments are prone to anxiety, depression, and stress. Validated measures across different cultural contexts are required. The present study evaluated the psychometric properties of the 21-item Depression, Anxiety and Stress Scale (DASS-21) and DASS-12 and DASS-8 among Spanish and Chinese primary school teachers. Methods: A total of 3930 primary school teachers were recruited, comprising samples from Spain (n = 1350) and China (n = 2580). Scale structure was analyzed using confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM). Model comparisons were conducted to identify the best-fitting factor structure. Convergent and discriminant validity were examined, and concurrent validity was assessed using emotional exhaustion as a criterion variable. Optimal diagnostic thresholds were established through latent profile analysis (LPA) and receiver operating characteristic (ROC) analysis. Results: Among the tested factor structures (unidimensional, oblique three-factor, ESEM, bifactor, and bifactor ESEM models), the ESEM model demonstrated superior fit indices, supporting acceptable factorial validity among both Spanish and Chinese samples. The DASS versions in the ESEM structure exhibited strong convergent, discriminant, and concurrent validity in the Spanish sample, while showing relatively weaker validity indices among the Chinese sample. Notably, the empirically derived cutoff scores for DASS-21 sub-dimensions among teachers were substantially higher than the originally recommended thresholds. Conclusion: The three DASS versions effectively assessed three types of psychological distress among Spanish teachers, while among the Chinese teachers, the DASS instruments appeared useful for assessing distress, though caution is recommended when using individual subscale scores.

Background Adolescence is a period marked by significant physical, psychological, and emotional changes as youngsters transition into adulthood. During this time, many adolescents consume alcohol, and in some cases, this leads to binge drinking, a behavior associated with various health risks and other problematic behaviors. However, knowledge about binge drinking in this population remains limited. Additionally, many adolescents engage in intensive technology use, which has been linked to mental health issues and substance abuse. Stress is often considered a precursor to both alcohol consumption and problematic internet use. In this context, emotional regulation could serve as a protective factor. Therefore, the present study aimed to examine the relationship between stress, problematic internet use, emotional regulation, and binge drinking among adolescents using structural equation modeling. Methods A cross-sectional survey was completed by a sample of 876 high school adolescents (63.57% female, mean age 16.86 years). Data were collected using an online survey, which included sociodemographic information and measures of perceived stress, emotional regulation, excessive alcohol consumption, and problematic internet use. Problematic alcohol use was assessed using several questions adapted from the ‘Survey on Drug Use in Secondary Education in Spain’. Results Problematic internet use emerged as a mediator between stress and binge drinking, suggesting that stress contributes to the development of problematic internet use, which in turn increases the likelihood of binge drinking. Furthermore, stress was negatively correlated with emotional regulation, indicating that inadequate emotional management may predispose adolescents to problematic internet use and binge drinking. The complex interplay between stress, emotional regulation, problematic internet use, and binge drinking underscores the need for comprehensive interventions targeting these factors among adolescents. Conclusions The results provide insights into potential pathways linking stress and binge drinking via problematic internet use and highlight the importance of emotional regulation as a protective mechanism against maladaptive behaviors.

BackgroundDespite the increasing proportion of older-aged individuals suffering from problematic gambling, research on gambling among this specific age cohort is still in its infancy. Chasing is a pathognomonic feature of disordered gambling and is considered one of the key risk factors in the transition from recreational to disordered gambling. Despite the increased research on chasing over the past decade, no previous study has ever examined the psychological determinants of chasing behavior among old-aged gamblers. Given the importance of chasing in facilitating and maintaining problem gambling, and the paucity of research examining gambling among older individuals, the present study is the first to empirically investigate the joint role of chasing behavior, negative affectivity, and mentalizing among older-aged gamblers.MethodsThe sample comprised 116 older-aged gamblers who were administered the South Oaks Gambling Screen (SOGS), the Depression Anxiety Stress Scale (DASS-21) and the Reflective Functioning Questionnaire (RFQ-8) to assess gambling severity, psychological distress, and mentalizing, respectively. Participants also performed the ChasIT, a computerized task that assesses chasing behavior, in which participants were randomly assigned to three different experimental conditions: loss, control, and win.ResultsNo effect of the experimental conditions of ChasIT on chasing behavior was observed. Regression analyses indicated that heightened levels of gambling severity and lower levels of certainty about mental states (i.e., hypermentalizing) predicted both the decision to chase and chasing frequency. Along with problem gambling and hypermentalizing, chasing frequency was also predicted by high levels of depression.ConclusionsThe present study demonstrated the association between disordered gambling, depression, and hypermentalizing in chasing behavior among older-aged gamblers. The findings make an important contribution to providing insight regarding variables that are associated with chasing among older-aged gamblers, one of the least represented populations of gamblers in the literature. The results suggest that specific training on mentalizing abilities could help gamblers to reflect on their own behaviors in terms of mental states, rather than following the impulse to gamble in order to ameliorate poor mood.

Background: Problematic use of the internet (PUI) is prevalent, particularly among adolescents and young adults. Given the limited measures to assess specific types of PUI, which encompasses a broad spectrum of activities such as online gaming, social media use, pornography use, shopping, gambling, and web-streaming, Muller et al. (2022) developed the Assessment of Criteria for Specific Internet-use Disorders (ACSID-11) to comprehensively assess different types of PUI (i.e., gaming, shopping, social media use, gambling, and pornography use). The present study aimed to validate the Chinese ACSID-11 among adolescents incorporating cross-cultural adaptations. Methods: Using forward-backward translation method, a culturally adapted version of the ACSID-11 was prepared. Then, a cross-sectional online survey was administered between September 8 and September 26, 2023. Adolescents, using a convenience sample (N = 11,492; mean age = 16.42 years [SD ± 0.91]; 59.1% male), were recruited from six schools to complete the translated ACSID-11, Internet Gaming Disorder Scale-Short Form (IGDS9-SF), Bergen Social Media Addiction Scale (BSMAS), and Smartphone Application Based Addiction Scale (SABAS) via an online platform. Pearson correlation coefficients assessed convergent/discriminant validity. Factor structure and measurement invariance were examined through confirmatory factor analysis (CFA) and multi-group CFA. Cronbach's alpha and McDonald's omega tested internal consistency. Results: Associations between the ACSID-11 components and other scales supported convergent validity (i.e., ACSID-11 gaming scale with IGDS9-SF [0.37 ≤ r ≤ 0.41]; social networks use scale with BSMAS [0.24 ≤ r ≤ 0.31]) and discriminant validity (i.e., online gambling scale with BSMAS [0.16 ≤ r ≤ 0.19] and with SABAS [0.11 ≤ r ≤ 0.13]). A four-factor solution indicated good fit with comparative fit index (CFI) ranging from 0.982 to 0.958. The ACSID-11 was measurement invariant across sexes (∆CFI = -0.001 to 0.000) and different levels of related addictive behaviors (∆CFI = -0.001 to 0.000). Both Cronbach's alpha and McDonald's omega (0.63 to 0.97) were acceptable for both frequency and intensity of responses. Conclusions: The ACSID-11 is an appropriate scale to assess different kinds of PUI among Chinese adolescents and students. Psychometric assessment of the measure in other cultures and among clinical samples is recommended.

ABSTRACT Background Long COVID symptoms (i.e., experiencing symptoms of COVID‐19 for 3 months post‐COVID‐19) affect individuals’ health and their quality of life (QoL). However, the pathways through which it does so are not fully known. Aim The present study examined the mediating roles of sleep quality, psychological distress, and self‐stigma in the associations between long COVID symptoms and QoL among individuals with mental illness. Method Individuals with mental illness (n = 333) were recruited from a psychiatric center in southern Taiwan to participate in the study. Data were collected regarding sleep quality, psychological distress, self‐stigma, and QoL. Independent t‐tests, Pearson correlations, and regression with Hayes’ Process Macro were used to compare groups, examine relationships, and parallel mediation models, respectively. Results Participants with long COVID symptoms had significantly worse sleep quality, psychological distress, physical QoL, and psychological QoL compared to those without symptoms. There were significant relationships between sleep quality, psychological distress, self‐stigma, and QoL. Sleep quality significantly mediated the associations between long COVID symptoms and physical and social QoL. Psychological distress significantly mediated the associations between long COVID symptoms and all domains of QoL, but not self‐stigma. Conclusion There are alternative pathways (e.g., sleep quality and psychological distress) through which long COVID symptoms may affect the QoL of individuals with mental illness. The findings suggest that individuals with long COVID symptoms have a higher chance of having poor QoL. Therefore, there may be the need for counseling and possible therapy for those who contract COVID‐19, especially among individuals who already have mental illness.

In the highly dynamic and fast growing online mobile gaming industry, revenue streams are the most important for the game developers. One of the significant ways to generate revenues is to boost the in-app purchases by gamers. Using Stimulus-Organism-Response (SOR) framework, the present study modelled addiction, loyalty and in-app purchases with chronotypes (a biological disposition) as a moderator. The study posited that loyalty is one of the significant mediators to convert addiction into in-app purchases. For the present study, 345 university students completed a survey, and the data were analyzed via SmartPLS using multigroup analysis. The moderation of chronotypes (a biological disposition) and mediation of loyalty for in-app purchase intention were tested and supported by the results. The study suggested that evening type individuals had a higher tendency to be loyal towards online mobile gaming compared to morning type individuals. Moreover, evening type individuals had higher inclination toward in-app purchase intention compared to morning type individuals. Loyalty functioned as a mediator between addiction and in-app purchase intention. The present study is one of the first to investigate the role of chronotypes as moderator and loyalty as a mediator for online mobile gaming in-app purchase intention utilizing the SOR framework. From a practitioners’ perspective, the present study highlighted a loyal segment of gamers who is more inclined to make in-app purchases. In addition, it highlights a dilemma for gaming operators to balance revenue generation with the well-being of its clientele.

Abstract Background and Aims Sleep is a complex physiological process during which the body and mind enter a period of rest. For a healthy lifestyle, different cohort groups can be affected in different ways. One such cohort is healthcare workers (HCWs)—an unexplored group in Afghanistan. Therefore, the present study examined the association between a range of sociodemographic factors including having night shift work and sleep quality among Afghan HCWs. Methods A cross‐sectional survey was administered in January 2023 among HCWs (N = 342) in the Herat province of Afghanistan. The survey examined sleep quality and its association with a range of sociodemographic factors among HCWs. Logistic regression models were used to examine the association of sleep quality with sociodemographic characteristics among HCWs. The Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality among HCWs. Results A total of 342 HCWs participated in the present study with an age range of 18 to 60 years. The mean age of the participants was 28.90 years (SD ± 8.10). Just over half of the participants were male (50.3%). Of the 342 participants, 58.5% reported poor sleep quality. Being married status, having higher number of children, not being a doctor, having low economic status, working night shifts, and having a traumatic event occur during past month were among the main variables associated with sleep quality among Afghan HCWs. Multiple regression analysis indicated that having high income [negatively] (AOR = 4.132, p = 0.002), working night shifts [positively] (AOR = 0.288, p

Abstract Background Approximately one in five pregnant women experience antenatal depression globally. The purpose of the present study was to estimate the prevalence of antenatal depression and explore its relationship between various demographic variables, recent sexual engagement, and recent adverse life events among pregnant Afghan women. Methods A cross-sectional survey study was carried out between January, 2023 and April 2023 among 460 women aged 15–45 years who were recruited using convenience sampling from Herat province (Afghanistan). Logistic regression models were utilized to explore the relationship between antenatal depression and socio-demographic characteristics among the participants. Results The prevalence of antenatal depression symptoms was 78.5%. Multiple regression analysis indicated that antenatal depression was significantly associated with (i) being aged 30–45 years (AOR: 4.216, 95% CI: 1.868–9.515, p = .001), (ii) being of low economic status (AOR:2.102, 95% CI: 1.051–4.202, p = .036), (iii) not being employed (AOR: 2.445, 95% CI:1.189–5.025, p = .015), (iv) not having had sex during the past seven days (AOR: 2.335, 95% CI: 1.427–3.822, p = .001), and (v) not experiencing a traumatic event during the past month (AOR:0.263, 95% CI: 0.139–0.495, p

Abstract Objectives Research regarding the contribution of specific psychoactive substances to suicidality has yielded equivocal results. The present study examined the prevalence and factors associated with suicidal thoughts and behaviors among a population-based sample of untreated illicit substance users. Methods A total of 616 illicit substance users who were recruited from high-risk areas of Shiraz using snowball sampling participated in the study. Eligible participants were individuals aged 18 years and older who regularly used one illicit psychoactive substance (e.g., opioids, heroin, cannabinoids, stimulants, hallucinogens) for at least one year and who had received no treatment for their drug use during the past year. Data were collected regarding socio-demographic characteristics, mental history, and substance use habits. Data regarding suicidal thoughts and behaviors were assessed using the Beck Suicidal Ideation Scale (BSIS) and self-reports of previous suicide attempts. Multiple logistic regression analysis was used to identify independent variables associated with suicidality. Results Among the participants, 23.6% reported having had suicidal thoughts during the past week and 6.7% reported having attempted suicide during the past year. Methamphetamine was reported as the primary substance of use among approximately half of the participants who attempted suicide during past year (49.2%). Multiple logistic regression analysis showed that current suicidal thoughts were independently associated with having no job, a history of mental health condition, previous suicidal attempts, concurrent use of more than one substance, and using methamphetamine and heroin as the primary substances. Suicidal thoughts were not associated with increased odds of regular opium and cannabis use. Conclusion Both methamphetamine and heroin use are significantly associated with current suicidal thoughts. Evaluation of the risk of suicidality by physicians and mental health care professionals in both community and outpatient settings would be especially appropriate among those individuals using these psychoactive substances.

Abstract Background The World Health Organization (WHO) proposed the concept of intrinsic capacity (comprising composite physical and mental capacity) which aligns with their concepts of healthy aging and functional ability. Consequently, the WHO promotes the Integrated Care for Older People (ICOPE) framework as guidance for geriatric care. Consequently, each government should have a screening tool corresponding to ICOPE framework to promote geriatric care. The present study examined the initial psychometric properties of the Taiwan version of ICOPE (i.e., ICOPES-TW). Methods Older people (n = 1235; mean age = 72.63 years; 634 females [51.3%]) were approached by well-trained interviewers for participation. A number of measures were administered including the ICOPES-TW, WHOQOL-AGE (assessing quality of life [QoL]), Clinical Frailty Scale (assessing frailty), Barthel Index (assessing basic activity of daily living [BADL]), and Lawton Instrumental Activities of Daily Living Scale (assessing instrumental activity of daily living [IADL]). Results The ICOPES-TW had a two-factor structure (body functionality [eigenvalue = 1.932] and life adaptation [eigenvalue = 1.170]) as indicated by the results of exploratory factor analysis. Internal consistency of the ICOPES-TW was low (Cronbach’s α = 0.55 [entire ICOPES-TW], 0.45 (body functionality factor), and 0.52 (life adaptation factor). ICOPES-TW scores were significantly (i) positively correlated with age (r = 0.321), IADL (r = 0.313), and frailty (r = 0.601), and (ii) negatively correlated with QoL (r=–0.447), and BADL (r=–0.447), with all p-values

Abstract Background The use of social media has become an important part individuals’ daily lives and is used in many daily life activities, such as social interaction, education, and shopping. However, with the increase in the use of social media, a minority of individuals can experience problematic use (and in extreme cases, ‘social media addiction’). The purpose of the present study was to examine the effect of personality traits on social media addiction and the mediating role of social network identity management in this relationship among preservice teachers. Methods The data were collected from 275 pre-service teachers at a university in Türkiye. The survey included the Big Five Inventory-10 (BFI-10), the Social Network Identity Management Scale, the Bergen Social Media Addiction Scale, and a personal information form. Results The findings of the study indicated that there was a relationship between personality traits, social network identity management, and social media addiction. Specifically, neuroticism was positively associated with social media addiction, whereas extraversion, agreeableness and conscientiousness were negatively associated. The results also indicated that social network identity management mediated the effect of personality traits on social media addiction. Conclusion Given that the present investigation was only a preliminary study, further research is needed to examine whether social network identity management is an important determinant in understanding the relationship between personality traits and social media addiction.

Abstract Introduction Empirical studies have demonstrated the role that attentional bias, the mutual excitatory relationship between attentional bias and craving, and mentalizing play in problem gambling. Although problem gambling rates among older-aged adults have steadily increased in recent years, research studies among this cohort are scarce. The present study is the first to empirically investigate attentional bias, as well as the joint role of attentional bias, craving, and mentalizing among older-aged gamblers. Method Thirty-six male older-aged gamblers were administered the South Oaks Gambling Screen (SOGS), the Gambling Craving Scale (GACS), and the Reflective Functioning Questionnaire (RFQ-8) to assess gambling severity, craving levels, and mentalizing, respectively. Participants also performed a modified Posner Task to investigate attentional biases. Results Hierarchical linear regression analysis showed that among older-aged male gamblers, GACS Anticipation and RFQ-8 Uncertainty about mental states, as well as disengagement bias at 100 ms, significantly predicted gambling severity. Conclusion The present study provides the first empirical support for the role of attentional bias, craving, and mentalizing among older-aged gambling. More specifically, a difficult in disengaging attention away from gambling, the anticipation of pleasure deriving from gambling, and hypomentalizing predicted gambling severity among older-aged gamblers. The findings make an important contribution, by identifying the factors responsible for problem gambling among this specific age cohort and suggesting that timely interventions for mentalizing and attentional bias may be necessary to prevent problem gambling in old age.

The internet has facilitated significant transformations in interpersonal interactions, and offers new possibilities for finding romantic partners through the use of online dating apps. However, as with other technology-based tools, some individuals can develop problematic patterns of dating apps use, exhibiting symptoms resembling addiction. Consequently, the aim of the present study was the development of a new psychometric instrument to assess problematic dating apps use, the Problematic Online Dating Apps Use Scale (PODAUS), and the examination of its psychometric properties. The sample comprised 384 participants (254 females and 130 males; Mage=25.90 years; SD=5.21) who used dating apps daily. They completed an online survey including the PODAUS, Bergen Social Media Addiction Scale, Cyber Pornography Addiction Test, Love Addiction Inventory-Short-Form, and Ten‐Item Personality Inventory. The PODAUS showed a one-factor structure with good indications of validity, reliability, and gender measurement invariance. Problematic online dating apps use was significantly associated with problematic social media use, problematic cyberpornography use, love addiction, and three personality traits (i.e., agreeableness, conscientiousness, and openness). The PODAUS is a new and succinct self‐report measure that assesses problematic dating apps use, and can be easily used in both research and clinical practice.

Background and aim: Fear of Missing Out (FoMO) is consistently associated with problematic social media use (PSMU). Moreover, previous studies have shown a significant association between FoMO, self-esteem, and social comparison. However, there is a lack of studies that have investigated the relationship between, FoMO, social comparison, self-esteem, and PSMU in an integrated model. The present study hypothesized that FoMO may influence PSMU through the serial mediating role of social comparison and self-esteem. Method: A cross-sectional survey study was conducted comprising 256 Italian university students (74.4% female), aged 18 to 38 years (M = 23.05 years; SD = 3.58). The participants completed an online survey assessing the variables of the study. Results: Controlling for age and gender, the results showed positive associations between FoMO, social comparison, and PSMU, and a negative association between FoMO and self-esteem. Self-esteem was also negatively associated with PSMU. It was also found that social comparison and self-esteem sequentially mediated the association between FoMO and PSMU. Conclusions: The present study contributes to understanding the mechanisms that underline the complex effects of FoMO on PSMU.

Physical exercise is a widely recommended practice for promoting health, but for some individuals, this activity can result in pathological and morbid behaviour. Therefore, the study of the factors contributing to the onset, development, and progression of exercise addiction is particularly relevant. Within this framework, the present study assessed the effect of family functioning, body image concerns, age, and gender on exercise addiction. A sample of 300 regular exercisers (Mage = 30.3 years, SD = 11.6; 69.7% females, 30.3% males) participated in the study and completed the Family Adaptability and Cohesion Evaluation Scales–IV, Body Image Concern Inventory, and Exercise Addiction Inventory. Data were analysed by implementing a series of moderated moderated-mediations. Results showed that three significant models were relevant. First, positive associations of disengaged (p < 0.05), enmeshed (p < 0.05), and rigid (p < 0.01) family functioning with exercise addiction were found. Furthermore, body image concerns mediated all these relationships, and the interaction between gender and age significantly moderated the effects of body image concerns on exercise addiction (p < 0.05). Such data may be useful for a deeper understanding of the variables associated with the development of exercise addiction, suggesting key elements on which it might be useful to focus in clinical and/or preventive activity.

Abstract Background Previous studies have associated videogame playing and social media use with suicidal behaviors together with lower stress coping or poor emotion regulation strategies. Due to the inconclusive evidence regarding the factors associated with suicidal behavior, the present study aimed to overcome the limitations of previous research and explored the relationship between adolescent stress, problematic internet use (PIU), gaming disorder (GD), and emotional regulation (ER) in a cross-section design. It was hypothesized that stress would have a direct effect on suicide risk (SR) as well as being mediated by PIU, GD, and ER. Methods The participants comprised 430 adolescents (58.4% male) aged between 16 and 19 years. They completed an online survey including the Mobile-Related Experiences Questionnaire, Internet Gaming Disorder Scale-Short Form, Meta-Mood Trait Repair Scale, and Spanish version of the Suicidal Behaviors Questionnaire. Results A total of 34.2% of the adolescents (N = 147) were at risk for SR. Results also indicated that 30,7% had experienced suicidal ideation at some point in their life, 12.1% had at least one plan to die by suicide, and 5.1% had attempted suicide. Results of path analysis confirmed that stress appeared to be a risk factor for suicide, but that its effects were not mediated by PIU. However, ER and GD mediated the effect of stress on SR. The results suggest that stress is a main risk factor for suicide, especially among adolescents with poor emotional regulation or problematic gaming. Conclusions Considering the prevalence of suicide among adolescents, the results of the present study suggest that suicide prevention programs should include emotional regulation strategies, stress coping, and videogaming management skills in the early stages of high school. Providing these protective resources to adolescents will help them face the stressful and changing situations typical of adolescence and will help them to attain greater well-being and satisfaction with life.

Abstract Objective To examine the effectiveness of nutritional education based on the health action process approach (HAPA) on pregnancy outcomes among malnourished pregnant mothers utilizing nutritional support. Methods In a randomized controlled trial, 234 malnourished pregnant women under nutritional support from the fourth month of pregnancy participated. Participants were randomly allocated in study groups by the balance block randomization method. Data were collected using a socio-demographic and pregnancy outcomes checklist as well as self-devised questionnaire assessing the constructs of the HAPA model before and three months after the educational intervention. The framework of the educational intervention was based on the constructs of the HAPA and included three one-hour training sessions through lectures, group discussions, ‘question and answer’ sessions, and the use of educational tools. Data were analyzed using analysis of covariance (ANCOVA) and SPSS software. Results Pregnancy outcomes including optimal weight gain during pregnancy (p = 0.47), neonate’s birth weight (p = 0.58), gestational age at delivery (p = 0.83), type of delivery (p = 0.48) gestational anemia (p = 0.22), diabetes (p = 0.59) and hypertension (p = 0.29) were not significantly different in the intervention and control groups. The results showed that the educational intervention produced a significant increase in the total score (24 points) in the intervention group. Improvement of scores in the intervention group compared to the control was observed in all of the model constructs except outcome expectation (0.68 decrease). The educational intervention in the present study had a large measure of effect in total (SMD: 2.69, partial eta2: 0.664). Conclusion A nutritional education intervention based on the HAPA model for malnourished pregnant women increased behavioral intention and planning for action to have better nutritional behavior. However, the intervention did not change the pregnancy outcomes significantly. Practice implications Nutritional education based on the HAPA model can be used to improve nutritional behaviors of malnourished pregnant women.

INTRODUCTION: Gaming disorder is defined as a pattern of gaming behaviour characterised by impaired control over gaming, prioritisation of gaming over other activities to the point where gaming takes precedence over other interests and daily activities, and persistence or escalation of gaming despite negative consequences. Given the increasing global interest in videogames, particularly among adolescents and young adults, this study investigated the prevalence of gaming disorder and its associated factors among Sri Lankan adolescents and young adults, with a focus on factors associated with gaming addiction. MATERIALS AND METHODS: A cross-sectional survey was conducted involving 401 Sri Lankan adolescents and young adults who played video games, through an anonymous online survey using snowball sampling. The survey comprised four sections: demographic data, influencing factors for game playing, the seven-item Game Addiction Scale and a validated depression scale (nine-item Patient Health Questionnaire). SPSS IBM (version 27) was used for data analysis, which includes means, standard deviations, frequencies, percentages, Pearson’s correlation and chi-square tests. RESULTS: A total of 401 gamers participated, comprising adolescents (10-18 years; 9.5%) and young adults (19-35 years; 90.5%). The majority were non-gaming addicts (71.57%), and among the gaming addicts, 8.48% were classified as monothetic gaming addicts, while 19.5% were classified polythetic gaming addicts. Slightly more males were game addicts (52.63%) than females. There was a low positive correlation between videogame addiction and depression (r=0.321). More than half of the sample believed that visual triggers (58.6%) and frequent reward systems (56.1%) influenced their gameplay. There was a significant association (p

Previous evidence has demonstrated a relationship between insecure attachment and the development of emotional dependence towards an individual’s partner. However, the possibility that this relationship may be indirect and mediated by individual factors such as difficulties in emotional regulation has not previously been explored. Consequently, the objectives of the present study were to analyze the (i) differences in emotional dependence on an individual’s partner and difficulties in emotional regulation capacity according to secure, preoccupied or dismissing attachment style and (ii) mediating role of difficulties in emotional regulation in the relationship between both insecure attachment styles and emotional dependence on an individual’s partner. The sample comprised 741 participants ranging in age from 18 to 30 years (M = 21.32, SD = 2.93). The mediations were tested with linear regressions with the macro PROCESS v4.0. The results showed that emotional dependence on a partner and difficulties in emotional regulation were greater among individuals who had developed a dismissing attachment compared those with secure or preoccupied attachment. Likewise, the mediation model confirmed the mediating role of difficulties in the capacity for emotional regulation in the relationship between dismissing attachment and emotional dependence, with rejection of negative or discomfort-generating emotions predominating. The findings provide preliminary evidence that rejection of negative emotional experiences may play an important role in the relationship between insecure dismissing attachment style and emotional dependence on an individual’s partner. Consequently, it is recommended that emotional dependence intervention programs include of the management of intolerance to negative emotions.

Abstract Background The benefits of physical activity are well-known to prevent multiple long-term health conditions. Physical appearance and weight-related stigma may influence individuals’ decision to engage in physical activity and sport. Therefore, the present study examined the psychometric properties of a newly developed instrument, the Tendency to Avoid Physical Activity and Sport Scale (TAPAS), using modern test theory. Methods A total of 2319 university students were recruited from mainland China and they completed the TAPAS. Rasch analysis was used to examine the TAPAS’ rating scaling functioning, test unidimensionality, item hierarchy, ceiling and floor effects, and differential item functioning (DIF). Moreover, the concurrent validity of the TAPAS was examined using the Weight Self-Stigma Questionnaire (WSSQ), Weight Bias Internalization Scale (WBIS), and body mass index (BMI). Results Unidimensionality was confirmed except for one item. Items corresponding to attitude toward physical activity were more easily adopted compared to items corresponding to actual behavioral aspects. No ceiling and floor effects were found. No DIF existed in the TAPAS items. The TAPAS was strongly correlated with both the WSSQ and WBIS, but not BMI. Conclusion The study showed that overall, the TAPAS has robust psychometric properties. However, future research needs to address the misfit item and explore the feasibility of applying the TAPAS to other populations including wider ethnic groups, age ranges, and life stages.

Abstract Background The study investigated ethnicity as a risk factor for gambling disorder (GD), controlling for demographics, citizenship, and years of residency in Norway. Methods The sample comprised 65,771 individuals from a national patient registry (n = 35,607, age range 18–88 years) and a national social insurance database in Norway (n = 30,164, age rage 18–98 years). The data covered the period from 2008 to 2018. Results The results showed that when controlling for age and sex, ethnic minorities were overall less likely than those born in Norway to be diagnosed with GD (odds ratio [OR] ranging from 0.293 to 0.698). After controlling for citizenship and years of residency in Norway, the results were reversed and indicated that ethnic minorities were overall more likely to be diagnosed with GD (OR ranging from 1.179 to 3.208). Conclusion The results suggest that citizenship and years of residency are important variables to account for when assessing the relationship between ethnicity and being diagnosed with GD. Our results may be explained by people from ethnic minority groups being more likely to experience gambling problems but less likely to seek contact with healthcare services for gambling problems.

Abstract Background In recognizing the need for a reliable and valid instrument to assess psychological distress among children and adolescents, the present study translated the newly developed Depression Anxiety Stress Scale for Youth (DASS-Y) into Chinese, while also comparing its psychometric properties with those of the well-established DASS-21 within a primary and middle school demographic. Methods Utilizing a combination of convenience sampling and purposive sampling, a cohort comprising 1,507 primary and 1,131 middle school students was recruited. Rasch analysis, confirmatory factor analysis (CFA), and structural equation modeling (SEM) were used in the data analysis. Results Significant differences were observed between the DASS-Y and the DASS-21, notably within the anxiety subscale. The proportions of individuals with clinical mood disorders identified by the two scales demonstrated a significant disparity. Both scales, following an adjustment of responses, exhibited satisfactory internal consistency and convergent validity, with the acceptance of a three-factor structure. Furthermore, the DASS-Y showed superior discriminant validity relative to the DASS-21, providing more compelling evidence regarding concurrent validity. Conclusion Overall, the Chinese version of the DASS-Y demonstrated superior robustness to the DASS-21 in terms of psychometric properties. The findings provide initial evidence for the psychometric properties of the DASS-Y from another culture.

Abstract Background During the period of adolescence, several major developmental changes occur that can have significant impact on an individual’s brain structure and functioning through their entire life. Aims The present study aimed to examine the association between depression and self-esteem alongside specific sociodemographic factors among school-going adolescents living under the rule of Taliban. Methods A cross-sectional survey study was conducted with adolescents (n = 452) from 20 randomly selected public primary, secondary and high schools of Herat province (Afghanistan) out of the 86 schools registered in Herat Education Department. The survey included the Center for Epidemiological Studies-Depression Scale (CES-D) and Rosenberg's Self-Esteem Scale (RSES). Results Two-thirds of adolescents reported depression symptoms (65.3%) and 86.3% reported poor self-esteem. Multiple regression analysis indicated that (i) mother's education level was significantly associated with depression symptoms and (ii) low-income economic status was significantly associated with self-esteem. Conclusion As well as being one of the few studies in Afghanistan, the present study is one of the very few to assess the association between class group, self-esteem, and depression symptoms. These findings may be used by healthcare authorities and school administrators to raise awareness and implement strategies to facilitate self-esteem among school school-going adolescents.

Background: Addressing mental health of diabetic pregnant women is important as it might increase the chance of obstetric complications, preterm birth, and neonatal complications. Aim: The present study investigated the prevalence of anxiety and depression among pregnant women with diabetes and their predictors. Methods: A cross-sectional study was conducted in 2023. The sample comprised 350 pregnant women with diabetes (pre-pregnancy or gestational) referred to comprehensive health centers in Qazvin Province, Iran. Fertility and demographic characteristics, anxiety, depression, partner social support, self-efficacy, medication adherence, and fear of hypoglycemia were assessed. Results: Among the sample, 28.9 % had pre-pregnancy diabetes and 71.1 % had gestational diabetes. Anxiety and depression were reported by 74.9 % and 79.4 % of all participants (significantly higher among those with pre-existing diabetes compared to gestational diabetes). Self-efficacy (OR: 0.91 [95 % CI: 0.86; 0.96]) and spouse's social support (OR: 0.68 [95 % CI: 0.56; 0.82]) were significant predictors of abnormal anxiety. Fear of hypoglycemia (OR: 1.06 [95 % CI: 1.02; 1.09]), medication adherence (OR: 1.05 [95 % CI: 1.01; 1.09]), self-efficacy (OR: 0.86 [95 % CI: 0.82; 0.91]), partner social support (OR: 0.62 [95 % CI: 0.49; 0.78]), diabetes type (pregnancy vs. pre-pregnancy diabetes; OR: 0.26 [95 % CI: 0.09; 0.77]), perceived family economic status (fair vs. good; OR: 3.08 [95 % CI: 1.12; 8.49]), and diabetes treatment (insulin vs. diet; OR: 0.21 [95 % CI: 0.08; 0.55]) were significant predictors of abnormal depression. Conclusion: Diabetic pregnant women should be evaluated for anxiety and depression during their prenatal visit. Improving self-efficacy, increasing medication adherence, reducing the fear of hypoglycemia, and improving the spouse's social support might all be helpful in reducing anxiety and depression among pregnant women with diabetes.

There is accumulating evidence that mukbang (i.e., eating broadcasts) watching may be another emerging online behaviour that has the potential to become uncontrolled and harmful among a small number of individuals. However, there is still a large gap in the literature regarding the psychological and mental health predictors of problematic mukbang watching. Due to the paucity of research, the present study investigated the emotional and psychological correlates of problematic mukbang watching (PMW) including emotion regulation difficulties (ERDs), impulsivity facets (i.e., negative urgency, positive urgency, sensation seeking, lack of premeditation, lack of perseverance), and psychological distress (i.e., depression, anxiety, stress). A total of 513 adults (54% female; Mage = 32.05 years, SD = 11.14) who watched mukbang in the past seven days completed a survey including psychometric assessment tools for the aforementioned variables. ERDs were directly and indirectly related to PMW via anxiety and positive urgency. Daily time spent watching mukbang was also moderately positively associated with PMW. Consequently, the present study suggests that individuals with emotional and psychological impairments may use PMW as a maladaptive coping strategy.