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Black men are disproportionately affected by firearm assaults in the United States, and these disparities are rooted in structural and social inequities. The objective of this scoping review of research was to identify risk and protective factors for firearm assault injuries among Black men at all levels of the social-ecological framework. The search was conducted in 2021. The initial search generated 1,122 articles. Studies were eligible if they (a) included an analysis of modifiable risk or protective factors for firearm assaults among Black men; (b) reported an estimate of correlation, association, or effect between risk or protective factors and firearm assault injuries, firearm violence, and/or firearm homicides; and (c) were published peer-reviewed articles. In all, 19 articles were identified for review. Risk factors identified at each ecological level include the following: (1) Individual: firearm possession/weapon use and criminal legal system interaction; (2) Relationships: gang membership and exposure to other people who have experienced a firearm assault; (3) Community: indicators for socioeconomic status and racial residential segregation; and (4) Societal: historical racist policy. Individual-level substance use had mixed results. Few (26%) studies examined protective factors at any ecological level, but community-level factors like neighborhood tree cover were identified. Future research needs to examine risk and protective factors at the societal level and multiple ecological levels simultaneously leading to more effective multi-level interventions that will guide policy formation. A greater diversity of study designs, research methods, and theoretical frameworks is needed to better understand factors associated with firearm assault among Black men.

Introduction Musculoskeletal injuries (MSKIs) among active duty soldiers result in more than 10 million limited duty days each year and account for more than 70% of the medically nondeployable population. Overuse injuries in lower limbs from running, foot marching long distances with heavy loads, and lifting heavy objects are the most common types of injuries in the military. Physical training and rehabilitation exercises for greater resiliency through aerobic, muscle strength, endurance, and agility conditioning programs can prevent or reduce the effects of MSKIs if Soldiers adhere to proper biomechanics and training techniques. We are introducing a three-dimensional (3D) camera-based platform for Optical Screening and Conditioning for Injury Resilience (OSCIR) that is designed to identify and correct high-risk movement patterns based on quantifiable biomechanical measurements in clinical or field settings. Our goal is to improve resilience to MSKI by offering greater access to quality of movement skills in warfighters through an autonomous device that can be used in Sports Medicine and Reconditioning Team (SMART) clinics and High-Intensity Tactical Training (HITT) sites. Materials and Methods OSCIR fuses four pairs of Kinect Azure cameras into a concise footprint to achieve suitable sampling rates and an unobstructed field of view for accurate dynamic movement tracking using a custom point cloud solution. We designed a unique multistage 3D joint tracking algorithm architecture to methodically isolate the human body point cloud from the background, identify individual limb segments, and perform iterative joint optimization at the global and local joint levels. We evaluated the feasibility of our prototype system among N  = 12 control participants (6 M/6 F; 21-37 years) in compliance with the Western Institutional Review Board (Tracking #20225920, approved on November 4, 2022). Five task-specific MSKI outcome metrics identified by end-user physical therapists and athletic trainers as indicators for movement quality were assessed across 7 lower-extremity exercises derived from standardized MSK assessment/conditioning batteries used in the military. Data were recorded concurrently by OSCIR and a reference standard Vicon motion capture system for validating system accuracy. Results Task-specific MSKI indicators for knee flexion and hip flexion range of motion achieved an average error of 4.05 ± 2.34°, while 3D position-based postural outcomes of left-right foot distance, left-right hand distance, and step length obtained mean absolute errors of 2.58 ± 2.30 cm. Results support the feasibility of our system in achieving outcomes that are comparable to currently accepted laboratory standards. Conclusions Our study describes the integration process for a 3D camera-based clinical system for MSKI conditioning and rehabilitation. The impact of our system will enable key stakeholders in the military to manage MSKIs in warfighters by automating key assessment and rehabilitation test batteries; making tests more readily accessible, and interpretations more accurate by providing objective biomechanical measures. OSCIR is undergoing turn-key design features to serve as a screening tool for warfighters to readily assess susceptibility to MSKI or as a training platform to help guide exercise techniques to achieve resiliency against future injuries. [ABSTRACT FROM AUTHOR]

Introduction Disease and non-battle injury (DNBI) has historically been the leading casualty type among service members in warfare and a leading health problem confronting military personnel, resulting in significant loss of manpower. Studies show a significant increase in disease burden for DNBI when compared to combat-related injuries. Understanding the causes of and trends in DNBI may help guide efforts to develop preventive measures and help increase medical readiness and resiliency. However, despite its significant disease burden within the military population, DNBI remains less studied than battle injury. In this review, we aimed to evaluate the recently published literature on DNBI and to describe the characteristics of these recently published studies. Materials and Methods This systematic review is reported in the Prospective Register of Systematic Reviews database. The systematic search for published articles was conducted through July 21, 2022, in Cumulative Index of Nursing and Allied Health, Cochrane Library, Defense Technical Information Center, Embase, and PubMed. Guided by the Preferred Reporting Items for Systematic Reviews and Meta-analyses, the investigators independently screened the reference lists on the Covidence website (covidence.org). An article was excluded if it met any of the following criteria: (1) Published not in English; (2) published before 2010; (3) data used before 2001; (4) case reports, commentaries, and editorial letters; (5) systematic reviews or narrative reviews; (6) used animal models; (7) mechanical or biomechanical studies; (8) outcome was combat injury or non-specified; (9) sample was veterans, DoD civilians, contractors, local nationals, foreign military, and others; (10) sample was U.S. Military academy; (11) sample was non-deployed; (12) bioterrorism study; (13) qualitative study. The full-text review of 2 independent investigators reached 96% overall agreement (166 of 173 articles; κ = 0.89). Disagreements were resolved by a third reviewer. Study characteristics and outcomes were extracted from each article. Risk of bias was assessed using the Newcastle-Ottawa Scale. Meta-analysis of pooled estimates of incidence rates for disease (D), non-battle injury (NBI), and combined DNBI was created using random-effects models. Results Of the 3,401 articles, 173 were included for the full review and 29 (16.8%) met all inclusion criteria. Of the 29 studies included, 21 (72.4%) were retrospective designs, 5 (17.2%) were prospective designs, and 3 (10.3%) were surveys. Across all studies, the median number of total cases reported was 1,626 (interquartile range: 619.5-10,203). The results of meta-analyses for 8 studies with reported incidence rates (per 1,000 person-years) for D (n  = 3), NBI (n  = 7), and DNBI (n  = 5) showed pooled incidence rates of 22.18 per 1,000 person-years for D, 19.86 per 1,000 person-years for NBI, and 50.97 per 1,000 person-years for combined DNBI. Among 3 studies with incidence rates for D, NBI, and battle injury, the incidence rates were 20.32 per 1,000 person-years for D, 6.88 per 1,000 person-years for NBI, and 6.83 per 1,000 person-years for battle injury. Conclusions DNBI remains the leading cause of morbidity in conflicts involving the U.S. Military over the last 20 years. More research with stronger designs and consistent measurement is needed to improve medical readiness and maintain force lethality. Level of Evidence Systematic Review and Meta-Analysis, Level III. [ABSTRACT FROM AUTHOR]

Identifying protective factors that promote academic resilience is vital. Nevertheless, due to the variations in the operationalizations of academic resilience, timeframes, data sources, and employed research methods, it remains unclear whether the impact of protective factors identified across studies can be attributed to the factors themselves or to these variations. By addressing these uncertainties, this study aims to provide an overview of the protective factors that have been extensively investigated in academic resilience and their degree of influence. A literature search found 119 empirical studies on protective factors in education settings for children and adolescents. The review analyzed five protective factors groups (individual, family, school, peer, community), three operationalizations of academic resilience (simultaneous, progressive, instrumental), two timeframes (longitudinal, non-longitudinal), three data sources (self-collected, national/local assessments, international large-scale assessments), and commonly employed research methods. The studies analyzed in this review yielded mixed results regarding the impact of the examined protective factors, with measurement instruments and statistical power playing a significant role in explaining the variations. Individual and school-level characteristics emerged as the most well-studied protective factors; individual characteristics were often investigated through "instrumental" operationalization and structural equational models, whereas school-level characteristics were typically explored through "simultaneous" or "progressive" operationalizations and multilevel modeling. Approximately 31 and 16% of the studies utilized national assessments and international large-scale assessment data, respectively. Both data sources promoted the exploration of school-level factors, with the former facilitating the exploration of protective factors across time and the latter contributing to the investigation of teaching-related factors. [ABSTRACT FROM AUTHOR]

The postdisaster experiences of 167 social work students in the aftermath of the Great Flood of 2016 were examined. Using a cross-sectional survey design and validated self-report measures, the current study examined the association between students' protective factors (hope, altruism, spiritual support; at 8, 20, and 12 items, respectively) and six adaptive coping mechanisms, and further sought to determine whether such associations varied according to students' race (white vs. African American). Six hierarchical multiple linear regression analyses were conducted using each of the adaptive coping strategies (acceptance, active coping, positive reframing, self-distraction, planning, and venting). Results showed that students' race moderated the associations between altruism and active coping, spiritual support and active coping, spiritual support and self-distraction, altruism and planning, spiritual support and planning, and altruism and venting. The decomposition of the significant interactions indicated that the effect of altruism on active coping, planning, and venting was greater among white than among African American participants; the effect of spiritual support on active coping, self-distraction, and planning was greater among African American than among white participants. Recommendations include educating all students about risks incurred when working with traumatized populations. Research examining postdisaster coping responses of social workers can inform culturally responsive supervision approaches. [ABSTRACT FROM AUTHOR]

Mother‐infant bonding is influenced by several risk and protective factors, and the literature has investigated the relationships between these factors independently. This study aimed to verify the interrelationships of some of these factors and how they influence mother‐infant bonding in Brazil. In this study, 361 mothers participated, and the outcome variable of mother‐infant bonding was assessed using the Postpartum Bonding Questionnaire (PBQ). Multivariate regression analysis was performed using a hierarchical model with three blocks structured according to the influence exerted on mother‐infant bonding. The PBQ's factor scores were estimated and used in the subsequent analyses to decrease measurement error. The variable "violence experienced by mothers" was statistically significant for explaining the second block model but not significant for the third block. Network analysis was performed after multiple regression, showing that the violence experienced by mothers does not directly influence mother‐infant bonding but rather is mediated by postpartum depression. This explains why violence is not significant in the hierarchical multiple regression when maternal depression is added to the model. This study's strengths lie in its utilization of PBQ factor scores and network analysis, enabling the estimation of conditional relationships among variables. This approach provides deeper insights into factors affecting mother‐infant bonding. [ABSTRACT FROM AUTHOR]

The objective of this research was to compare social, emotional, and cognitive determinants of depression and anxiety symptoms and mental wellbeing using the two-continua model of mental health and illness in two age groups. The two-continua model proposes that mental health and mental illness are not two ends of the same spectrum but are, in fact, two separate but related spectrums. This cross-sectional study used a multi-age group comparison approach to identify the relative predictive strengths of risk and protective factors for the two-continua model of mental health and mental illness. Participants (n = 458: 251 16–25 year olds, and 207 35–64 year olds) completed an online survey that measured the outcome variables of depression and anxiety symptoms and mental wellbeing. Independent variables from three conceptual areas in psychology—(1) positive psychology: optimism, pessimism, and accomplishment; (2) emotion regulation: cognitive reappraisal and expressive suppression; and (3) interpersonal theories: belonging and relationship with parent/child—were measured to ascertain the determinants of these outcome variables. The all-variables models explained 58–68% of the variance in depression symptoms, 77–80% in mental wellbeing, and 26–43% in anxiety symptoms. For both groups, the strongest predictor of mental wellbeing in these models was accomplishment. The strongest predictors in these models of mental illness symptoms differed between groups: belonging in the younger group and accomplishment in the older group. Programs targeting belonging and accomplishment could be highly effective in promoting mental wellbeing and reducing mental ill-health for these groups. Interventions require contextual investigation to locate drivers of mental wellbeing and illness for different age groups prior to implementation. [ABSTRACT FROM AUTHOR]

To explore the impacts of double minority status (ethnic and sexual/gender minority) and protective factors associated with the emotional wellbeing and mental health of Asian Rainbow (sexual/gender minority) youth in New Zealand. The data were extracted from the Youth19 Rangatahi survey, which surveyed 7,374 students from 45 mainstream secondary schools. The comparison groups were Asian non-Rainbow youth and Pākehā (New Zealand European) Rainbow youth. A secondary analysis was performed examining the associations between postulated protective factors and the emotional wellbeing and mental health outcomes of Asian Rainbow youth. Asian Rainbow youth had higher odds of depressive symptoms, anxiety, and suicidal thoughts and attempts and lower odds of good emotional wellbeing compared to Asian non-Rainbow youth. However, Asian Rainbow youth had lower odds of anxiety compared to Pākehā Rainbow youth. Among Asian Rainbow youth, family acceptance and feeling safe at school were associated with higher odds of good emotional wellbeing, and lower odds of depressive symptoms, anxiety, and suicidal thoughts. Several other protective factors were also associated with 1 or more (but not all) of the emotional wellbeing and mental health indicators. This study suggests that family acceptance and feeling safe at school may serve as important buffers mitigating risks of adverse emotional wellbeing experienced by Asian Rainbow youth. [ABSTRACT FROM AUTHOR]

Objective: The resilience portfolio model is a conceptual framework that provides a more holistic understanding of the protective factors, collectively considered polystrengths, that promote resilience among survivors of trauma. Polystrengths are the range of strengths individuals possess that allow them to cope with adversity. Guided by the resilience portfolio model and the construct of polystrengths, this study examined the association between economic resilience–related protective factors, polystrengths, and resources on economic self-sufficiency among survivors of intimate partner violence (IPV). Method: Data from this study came from a cross-sectional online survey administered via Qualtrics research service in July 2022. This study sample includes 330 survivors, who screened positive for IPV using the Extended—Hurts, Insult, Threaten, Scream screening tool. Survivors were asked about their sociodemographic characteristics, access to resources, experiences with adversities (i.e., IPV and material hardship), along with six economic resilience–related protective factors representing three resilience portfolio model domains—regulatory strengths, interpersonal strengths, and meaning making. Results: Polystrengths was uniquely associated with economic self-sufficiency after controlling for other factors. Specifically, three regulatory strengths—economic self-efficacy, coping, and financial knowledge—were significantly and positively related to economic self-sufficiency. Two resources—social capital and childhood financial socialization—were positively related to economic self-sufficiency as well. Conclusions: Findings provide empirical support for the benefit of polystrengths in the context of economic resilience for survivors of IPV. As such, strengths-based approaches, particularly those that promote regulatory strengths, may increase the effectiveness of economic empowerment interventions, such as financial literacy, for survivors. [ABSTRACT FROM AUTHOR]

Background: Nearly three in four U.S. medical students graduate with debt in six-figure dollar amounts which impairs students emotionally and academically and impacts their career choices and lives long after graduation. Schools have yet to develop systems-level solutions to address the impact of debt on students' well-being. The objectives of this study were to identify students at highest risk for debt-related stress, define the impact on medical students' well-being, and to identify opportunities for intervention. Methods: This was a mixed methods, cross-sectional study that used quantitative survey analysis and human-centered design (HCD). We performed a secondary analysis on a national multi-institutional survey on medical student wellbeing, including univariate and multivariate logistic regression, a comparison of logistic regression models with interaction terms, and analysis of free text responses. We also conducted semi-structured interviews with a sample of medical student respondents and non-student stakeholders to develop insights and design opportunities. Results: Independent risk factors for high debt-related stress included pre-clinical year (OR 1.75), underrepresented minority (OR 1.40), debt $20–100 K (OR 4.85), debt >$100K (OR 13.22), private school (OR 1.45), West Coast region (OR 1.57), and consideration of a leave of absence for wellbeing (OR 1.48). Mental health resource utilization (p = 0.968) and counselors (p = 0.640) were not protective factors against debt-related stress. HCD analysis produced 6 key insights providing additional context to the quantitative findings, and associated opportunities for intervention. Conclusions: We used an innovative combination of quantitative survey analysis and in-depth HCD exploration to develop a multi-dimensional understanding of debt-related stress among medical students. This approach allowed us to identify significant risk factors impacting medical students experiencing debt-related stress, while providing context through stakeholder voices to identify opportunities for system-level solutions. [ABSTRACT FROM AUTHOR]

Background: Suicide is a worldwide public health problem. In response to this problem, Australia was one of the first countries to develop national suicide prevention policy. Guided by the National Suicide Prevention Office (NSPO), which was established in 2021, suicide prevention in Australia is in a period of reform. The NSPO is driving a nationally consistent and integrated approach to suicide prevention including leading the development of a new National Suicide Prevention Strategy. This article summarises findings from an environmental scan of government-led suicide prevention in Australia, conducted as an input for the development of the new Strategy. Methods: The scan was conducted from August 2022 to January 2023. We searched relevant government websites and Google to identify policy documents and programs and services. We undertook a desktop review of documents and programs/services using coding templates developed to address the objectives of the scan. Qualitative information was extracted in a systematic manner using these templates. Results: Australia's suicide prevention efforts are significant as demonstrated by activities ranging from policy documents intended to guide and plan activity, the National Mental Health and Suicide Prevention Agreement committing the Federal Government and jurisdictions to work together, and the availability of national, state, local area based, and digital services and programs. Suicide prevention approaches in Australia are mostly selective or indicated. There is less emphasis on universal approaches, wellbeing promotion, strengthening protective factors and mitigating the impact of known drivers of distress. In addition, there is limited evidence to demonstrate a whole-of-government or whole-of-system approach is operating in Australia. Findings should be interpreted in the context that suicide prevention in Australia is currently in a period of transition. Conclusions: Current government emphasis on and investment in suicide prevention activity, together with strong commitment to lived experience and cross sectorial collaboration, are substantial and appropriate. There are also many opportunities to further progress cross-portfolio and cross-jurisdiction suicide prevention and response efforts. This requires urgently adopting a shared understanding of suicide, which includes the diverse drivers of suicidal distress, and improving protective factors and social wellbeing. [ABSTRACT FROM AUTHOR]

Introduction Design Method Findings Conclusion Clinical Relevance Nurses in southern Israel's public hospitals were exposed to unusual traumatic events following the October 7, 2023, Hamas attack on Israel, and the ensuing Swords of Iron War. This study aimed to clarify the complexity of wartime nursing by identifying profiles based on risk factors (i.e., psychological distress and adjustment disorders) and protective factors (i.e., positive affect (PA), resilience, and perceived social support [PSS]).This study utilizes a cross‐sectional design.Two hundred nurses at a major public hospital in southern Israel completed self‐report questionnaires. A latent profile analysis (LPA) was conducted to identify distinct profiles based on nurses' risk and protective factors. Differences in profiles were examined alongside sociodemographic and occupational variables and traumatic event exposure. The LPA was conducted using MPlus 8.8 Structural Equation Modeling (SEM) software.Two distinct profiles were identified: “reactive” and “resilient.” The “reactive” group included nurses who had higher risk factor scores (psychological distress and adjustment disorder), whereas the “resilient” group included nurses who had higher protective factor scores (PA, resilience, and PSS). Furthermore, nurses in the “reactive” group were younger, with greater seniority, worse self‐rated health, and a higher frequency of kidnapped family members compared to nurses from the “resilient” group.Nurses in wartime are at risk if identified as “reactive.” Identifying these profiles can assist in developing effective support practices to help nurses cope with wartime challenges and maintain their mental well‐being.Healthcare organizations should tailor interventions to prepare and support nurses of various ages and experience levels, during and after conflicts. This approach aims to reduce risk factors and promote protective factors among nurses during wartime. [ABSTRACT FROM AUTHOR]

Aim Design Methods Results Conclusion Implications for Practice Patient or Public Contribution To explore the experiences of significant others of adult patients with severe burn injury in the Intensive Care Unit. Specifically, this study explored the strategies implemented by significant others and obstacles faced that served to protect or placed them at risk of psychological sequelae during their experience of trauma.A qualitative study using a Narrative Inquiry approach was undertaken.Individual semi‐structured interviews were conducted with 17 participants during 2021–2022, who were a significant other of an adult patient in ICU with severe burn injury. These participants were recruited from the two major severe burns receiving hospitals in New South Wales, Australia. Participants' stories were analysed using a narrative analysis approach informed by Polkinghorne. The COREQ guideline was used in reporting.As each participant navigated the traumatic experience of supporting a loved one with a severe burn injury, they faced unique obstacles to maintaining their own mental health and well‐being. They employed strategies that were likely to protect them on this journey. Psychologically protective factors included taking back control, coexisting in the trauma with the patient and forging a trauma bond. These strategies effectively contained the trauma and protected others (such as children, extended family and friends). While this allowed significant others an element of control, it also effectively isolated them from the support of family and friends.This study shows that significant others may also experience personal trauma and may not recognize this as they focus all their attention on supporting the patient with the burn injury.With increased awareness of both protective and risk factors, support can be directed towards enhancing protective factors and addressing risk factors, thereby decreasing their impact and improving support for significant others.No patient or public contribution. [ABSTRACT FROM AUTHOR]

Background: Chronic pain often clusters in families, where parents and their offspring both experience chronic pain conditions. Young children of parents with irritable bowel syndrome (IBS) represent an at-risk group for the development of abdominal pain, disability, and excess health care visits in later childhood. Parental solicitous responses to children's expressions of discomfort and maternal modeling of their own illness behavior contribute to a greater focus on somatic sensations, leading to illness behaviors in children. This randomized controlled trial will test the effectiveness of an early preventive web-based psychosocial intervention (REACH)[TM] vs. an educational web-based safety comparison condition delivered to parents with IBS to alter parental responses and lead to improved child health and decreased health care costs. Methods: Parents with IBS who have children ages 4–7 years are recruited via community-based approaches (e.g., social media advertisements, school electronic distribution, research networks) and health care providers. The target sample is 460 parents randomized to REACH, a web-based social learning and cognitive behavior therapy (SLCBT) intervention or an educational web-based safety comparison condition (EC). Participants will be assessed at baseline, 6-week (immediate post-intervention), 6-month, 12-month, and 18-month follow-up periods (months post-completion of intervention). The primary outcome is change in parental solicitous/protective behaviors. Secondary outcomes include parent risk and protective factors, child health and symptom outcomes, and health care utilization and cost savings. Discussion: This study adapts a validated, parent-delivered intervention to treat chronic pain in children to a web-based application designed to prevent the development of chronic pain in very young, high-risk children. If successful, this strategy can both prevent adverse sequelae of this condition from developing as well as be widely accessible. Furthermore, the availability of a prevention model for parent training could result in significant short- and long-term health benefits across a broad spectrum of conditions. Trial registration: ClinicalTrials.gov NCT05730491. Registered on February 15, 2023. [ABSTRACT FROM AUTHOR]

AbstractObjectivesMethodResultsConclusionPopulation ageing raises major public health and psychosocial challenges. Particularly, lesbian, gay, and bisexual (LGB) older people may face increased vulnerabilities and marginalization when compared to their non-LGB (heterosexual) counterparts, which may entail more risks for their mental health. The aim of this study was to comparatively evaluate the levels of protective – social support, spirituality, and resilience and stress factors – loneliness and ageism – among LGB and non-LGB older adults, and their impact on psychological distress (PD).A sample of 647 people aged 60 years or older (M = 66.01; SD = 4.93) was collected, 368 non-LGB and 279 LGB. Participation was carried out through an online survey in Portugal.LGB older adults had lower scores on all protective factors, except on social support from friends, and higher levels on all stress factors, except on hostile ageism, compared to non-LGB older adults. Further, resilience and loneliness were the main predictors of PD regardless of the sexual orientation. Stress factors explained the levels of PD over and above the effects of protective factors, both among LGB and non-LGB older adults.Psychological distress in aging presents different protective and stressful factors according to the sexual orientation of older adults. More comparative studies are suggested in the intersection between ageing and sexual orientation. [ABSTRACT FROM AUTHOR]

Objective: The aim of our study was to explore the relationship between changes in neural oscillatory power in the EEG, the severity of depressiveanxiety symptoms, and the risk of suicide in MDD. Methods: 350 MDD patients' demographic and clinical data were collected, and their depressive and anxious symptoms were evaluated using HDRS-17 and HAMA-14, along with a suicide risk assessment using the Nurses' Global Assessment of Suicide Risk (NGASR). EEG data were captured, processed, and analyzed to study brain activity patterns related to MDD. The participants were divided based on suicide risk levels, and statistical analyses, including chi-square, t-tests, Pearson's correlations were used to explore the associations between brain activity, symptom severity, and suicide risk. Closely related variables were identified and ultimately the optimal model was screened using stepwise regression analysis with a forward strategy, and mediation effects were further used to determine the possible interactions between the variables in the regression model. Results: The regression model showed a significant effect of HDRS-17 and alpha power of Medial Occipital Cortex (MOC) on suicide risk, with elevated HDRS-17 increasing suicide risk and elevated alpha power decreasing suicide risk. Mediation effect analyses showed that MOC alpha power partially mediated the effect of depression level on suicide risk, and that an increase in depression severity may lead to a decrease in MOC alpha power, while a decrease in MOC alpha power may lead to an increase in suicide risk. Conclusion: The severity of depression directly increases suicide risk, whereas higher alpha power in the MOC serves as a protective factor, reducing this risk. Notably, MOC alpha power not only directly impacts suicide risk but also mediates the effects of both depression severity and anxiety levels on this risk. Limitations: The relatively small sample size of this study may limit the representativeness of the overall MDD patient population and the detailed analysis of different subgroups. This study did not delve into the relationship between the severity of cognitive symptoms in MDD patients and suicide risk. [ABSTRACT FROM AUTHOR]

Objective: Using a salutogenic approach, this study aimed to identify similarities in the protective factors of nurses' psychological Quality of Life (QoL) and professional wellbeing (PWB) in four countries and to assess their variability over time during the COVID-19 pandemic. Methods: This multicentric study used a longitudinal design with three measurements points: Autumn 2021, spring 2022, and autumn 2022. The study consisted in a self-administered online questionnaire addressed to nurses working in hospitals. Across all measurement times, 3,310 observations were collected in France, 603 in Switzerland, 458 in Portugal, and 278 in Canada. The outcomes were psychological QoL and PWB, and several potential protective factors were used as determinants. Results: Analyses revealed few changes over time in the outcomes. Across all countries, psychological QoL was associated positively with resilience and perceived social support, whereas PWB was associated positively with the ability to provide quality work and support from colleagues and superiors. Conclusion: The findings of this study highlighted the potential of several factors protective of nurses' psychological QoL and PWB. These should be fostered through policies and measures to support nurses. [ABSTRACT FROM AUTHOR]

Summary The aim of this study is to describe the patterns of prescription of benzodiazepine‐receptor agonists in hospitalised patients in four psychogeriatric units in Switzerland. This is a retrospective cross‐sectional study that included patients aged 65 years or more hospitalised in one of the four psychogeriatric units of a university hospital in Switzerland during 2019. The presence, type and dose of benzodiazepine‐receptor agonists was assessed at admission and at discharge. Three‐hundred and eighty‐six patients (214 women, 78.2 ± 8.1 years) were included in the study; 33.4% of patients had at least one benzodiazepine‐receptor agonist at admission and 22.5% at discharge. The relative reduction of benzodiazepine‐receptor agonists prescription in standardised dose was 78%. Age was found to be a protective factor against benzodiazepine‐receptor agonists prescription at admission (adjusted odds ratio 0.94, confidence interval 0.91–0.98), and diagnosis of substance abuse was found to be a risk factor (adjusted odds ratio 4.43, confidence interval 1.42–17.02). Longer hospital stays (> 14 days) were associated with higher reduction of benzodiazepine‐receptor agonists. The prevalence of a prescription of benzodiazepine‐receptor agonists at admission was high, but during the psychogeriatric hospitalisation benzodiazepine‐receptor agonists prescription decreased both in absolute and relative terms. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusion Suicidal ambivalence is increasingly understood as the result of the interplay of two conflicting motivational orientations, the wish to die (WTD) and wish to live (WTL). However, research is scarce regarding the nature of their relationship, their temporal structure, and their relevance in predicting suicidal desire.Fifty psychosomatic/psychiatric inpatients (17 reporting suicide attempts) took part in an intensive longitudinal design with 10 signal‐contingent prompts per day over 10 days; assessing WTD, WTL, and suicidal desire. We calculated mean values and variability of WTD, WTL, suicidal ambivalence, and suicidal desire and tested mixed‐effects models of suicidal desire.The mean number of answered prompts was 40.98 (SD = 21.68). Repeated‐measures correlation of WTD and WTL was r = −0.60. Patients with a history of suicide attempts reported higher WTD, lower WTL, more suicidal ambivalence, stronger suicidal desire, and showed higher variability in all constructs. At the same assessment, WTD was the strongest statistical predictor of suicidal desire. Only WTL and the interaction of WTD and WTL predicted suicidal desire prospectively.Wish to die and WTL are likely two distinct (although correlated) constructs that should not be reduced to a single ambivalence score. A stronger focus on WTL holds potential for suicide research and practice. [ABSTRACT FROM AUTHOR]

Objective: This study investigated how protective factors, stress, and anxiety levels affected the resilience of healthcare workers (HCWs) during the COVID-19 pandemic. Specific aims included examining whether HCW resilience levels varied significantly according to demographic variables. Methods: A total of 303 HCWs from two training and research hospitals completed the survey. The Protective Factors for Resilience Scale (PFRS), The Stress and Anxiety to Viral Epidemics–9 Items Scale, and Brief Resilience Scale were used as data collection tools. Confirmatory factor analysis, reliability analyses, construct validity analysis, discriminant validity analysis, structural equation modeling, t-test and ANOVA were conducted respectively. Results: Only the impact of the individual sub-factor of PFRS on the resilience level of HCWs was positive and significant (b=.847, t= 8.670, p<.001); stress and anxiety levels of HCWs to viral epidemics on their resilience level were both insignificant (b= .039, t=-.468, p=.640; b= .095, t=1.073, p=.283). The resilience level of HCWs who were male (M=4.53, SD=.55), married (M=4.50, SD=.55), had high school graduates (M=4.87, SD=.27), had 31 years and above experience (M=5.00, SD=.00), had children (M=4.54, SD=. 53), and exercised 2-3 days a week (M=4.54, SD=.46) had significantly higher levels of resilience. Conclusion: This study pointed out that individual protective factors (such as healthy skills and abilities) positively affect the resilience of HCWs and play a crucial for the mental health of HCWs. HCWs who were male, married, low educated, more experienced, had children and doing sports 2-3 days a week had significantly higher resilience. [ABSTRACT FROM AUTHOR]

The present study examined ecstasy past-year use among 7th–12th grade students (N = 38,753) in Greater Cincinnati schools. The PRIDE National Drug Use survey for grades 7–12 was administered to youth in their school classrooms. Results indicated that male students, 9th–12th grade students, non-Caucasian students, and employed students were at highest risk for ecstasy use. In addition, students with low involvement in protective factors (participation in community activities, school activities and clubs, sports, faith-based institutions, and getting good grades), parent factors, teacher factors and school factors, and high involvement in risk factors (taking part in gang activity, friend's use of drugs, access to substances, and getting into trouble at school or with the law) were more likely to use this substance. These findings should be considered when developing programs to prevent ecstasy use among youth. [ABSTRACT FROM AUTHOR]

The research examined impacts and recovery from institutional child abuse. There were three linked studies; a survey of 10 institutional abuse victims, a Rapid Evidence Assessment of 26 UK-based institutional child abuse case reviews, and a quantitative study of 384 adults reporting either institutional child abuse (n = 93), at home abuse (n = 191) or no abuse (n = 100). Collectively there was evidence for a focus on negative impacts and disclosure. There was an indirect effect of institutional abuse on PTSD symptoms mediated by personality dysfunction but not strength factors or resilience. The research highlighted the importance of disclosure and integrates findings into a preliminary conceptual model, the Integrated Model of Institutional Child Abuse impacts (IMICA). [ABSTRACT FROM AUTHOR]

The current study explored perceptions of homicide risk and protective factors among Latina survivors of gender-based violence and culturally specific practitioners, including indigenous and transgender survivors. Themes resulting from a grounded theory analysis include histories of violence and homicide threats, power and social connections, difficulty disclosing threats to safety, fear and conviction, and separating/leaving partners. Listening sessions with transgender and indigenous Latina survivors uniquely emphasized experiences of structural discrimination. Narratives also shed light on community strengths that can inform intimate partner homicide prevention, including the role of kinship in culturally specific programing. [ABSTRACT FROM AUTHOR]

Mental health and traumatic stress symptoms are prevalent in juvenile offenders, yet research on diversion programs rarely examine these important outcomes. Program duration and the role of protective factors are also understudied in this literature. This study examined the impact of program duration and youth protective factors on mental health and traumatic stress symptoms of 713 youth participating in an Illinois diversion program. Overall, the more time youth spent in the diversion program, the more improvement they demonstrated in mental health and trauma symptoms. Both program duration and number of youth strengths at program entry were significantly associated with improvement in mental health and traumatic stress symptoms. Findings highlight the importance of program duration and suggest that youth protective factors should be identified early on and targeted to maximize the impact of juvenile justice diversion programs on mental health and trauma symptoms. [ABSTRACT FROM AUTHOR]

When confronted with a traumatic event, people may suffer from adverse posttraumatic outcomes, such as posttraumatic stress disorder (PTSD) or complex PTSD (CPTSD). Positive psychology research has shown that meaning in life and vitality are potentially correlated protective factors against negative developments following trauma exposure that can lead to PTSD or CPTSD. This systematic review aimed to synthesize global empirical research findings, emphasizing the impact of meaning in life and vitality on both PTSD and CPTSD. A search of empirical studies was performed within the Embase, Scopus, and Web of Science core collection databases, as well as PsycInfo, using the PRISMA checklist. A total of 29 studies were included after a systematic exclusion process. The collective findings from 22 studies examining meaning in life and five studies focusing on vitality revealed a consistent negative association with symptoms of PTSD. No study that explored the associations among meaning in life, vitality, and CPTSD was found. In contrast to vitality, meaning in life has been extensively studied in relation to traumatic stress worldwide, and few discrepancies in results were found. This systematic review identified the need to intensify scientific efforts in capitalizing on meaning in life as a possible target for psychological interventions, especially for trauma survivors globally, and to consider vitality as a protective factor that needs more empirical attention in relation to posttraumatic stress. Furthermore, there is a need for studies that encompass diverse target samples and employ longitudinal study design to examine the associations between protective factors and CPTSD. [ABSTRACT FROM AUTHOR]

Objective: Residents of Puerto Rico are disproportionately exposed to social and environmental stressors (e.g., Hurricane María and the 2020 sequence of tremors) known to be associated with psychological distress. Shift-and-persist (SP), or the ability to adapt the self to stressors while preserving focus on the future, has been linked with lower psychological distress, but no study has evaluated this in Puerto Rico. This study examined the association between SP and psychological distress (including that from natural disasters) in a sample of young adults in Puerto Rico. Methods: Data from the Puerto Rico-OUTLOOK study (18–29 y) were used. Participants (n = 1497) completed assessments between September 2020 and September 2022. SP was measured with the Chen scale and categorized into quartiles (SPQ1–SPQ4). Psychological distress included symptoms of depression (CESD-10), anxiety (STAI-10), post-traumatic stress disorder (Civilian Abbreviated Scale PTSD checklist), and ataque de nervios (an idiom of distress used by Latinx groups). Outcomes were dichotomized according to clinical cutoffs when available, otherwise used sample-based cutoffs. Two additional items assessed the perceived mental health impact of Hurricane María and the 2020 sequence of tremors (categorized as no/little impact vs. some/a lot). Adjusted prevalence ratios (PR) and their 95% confidence intervals (CI) were estimated. Results: The most commonly reported psychological distress outcome was PTSD (77%). In adjusted models, compared to SP Q1, persons in SP Q2–Q4 were less likely to have elevated symptoms of depression (PR Q2 = 0.79, 95% CI = 0.72–0.85; PR Q3 = 0.65, 95% CI = 0.58–0.73; and PR Q4 = 0.41, 95% CI = 0.35–0.48), PTSD (PR Q2 = 0.92, 95% CI = 0.87–0.98; PR Q3 = 0.86, 95% CI = 0.80–0.93; and PR Q4 = 0.76, 95% CI = 0.70–0.83), anxiety (PR Q2 = 0.39, 95% CI = 0.31–0.48; PR Q3 = 0.27, 95% CI = 0.20–0.37; and PR Q4 = 0.11, 95% CI = 0.07–0.17) and experiences of ataque de nervios (PR Q2 = 0.85, 95% CI = 0.76–0.94; PR Q3 = 0.79, 95% CI = 0.70–0.90; and PR Q4 = 0.68, 95% CI = 0.60–0.78). Compared to persons in SP Q1, persons in SP Q3–Q4 were less likely to report adverse mental health impacts from Hurricane María (PR Q3 = 0.66, 95% CI = 0.55–0.79; and PR Q4 = 0.53, 95% CI = 0.44–0.65) and the 2020 sequence of tremors (PR Q3 = 0.77, 95% CI = 0.61–0.98; and PR Q4 = 0.74, 95% CI = 0.59–0.94). Conclusion: SP was associated with lower psychological distress. Studies are needed to confirm our findings and evaluate potential mechanisms of action. [ABSTRACT FROM AUTHOR]

This study examines instances of negative mentoring among undergraduate researchers within STEM education, and specifically, the common yet subtle issue of inadequate mentoring characterized by a faculty mentor's failure to provide their mentee with adequate research, educational, career‐related, or emotional support. Using data from the Mentor‐Relate survey of 514 participants in the National Science Foundation Research Experiences for Undergraduates program, we identify prevalent patterns of inadequate mentoring and examine protective factors against it. Results indicate that inadequate research support is the least prevalent form, while inadequate educational and career guidance is more common, and inadequate emotional support is the most prevalent. Enhanced faculty mentoring skills emerge as a protective factor, with culturally responsive mentoring and gender concordance also playing significant protective roles. Less hierarchical mentoring structures, such as multiple faculty mentors, offer better emotional support. These findings underscore the importance of comprehensive mentor training and culturally sensitive practices to mitigate inadequate mentoring in undergraduate research experiences. By promoting inclusive and supportive mentoring environments, institutions can maximize the transformative potential of undergraduate research experiences for all participants. [ABSTRACT FROM AUTHOR]

Clergy wives often face high congregational expectations that impact their psychological well-being. This study investigates the impact of perceived congregational perfectionism on the psychological well-being of 215 Asian clergy wives and explores the moderating effects of self-compassion, social support, and communion with God. The results indicated that the two perceived congregational perfectionism dimensions—perceived congregational standards and judgment—were positively associated with depression, emotional exhaustion, and loneliness. Contrary to the previous literature, high congregational standards alone (without critical judgment) were associated with negative psychological outcomes. Additionally, self-compassion and communion with God emerged as significant buffers against depression associated with congregational perfectionism. However, these protective factors did not significantly prevent ministry burnout or loneliness. This study highlights the maladaptive nature of congregational perfectionism in clergy wives and emphasizes the importance of protective factors like communion with God and self-compassion. It also suggests the need for further research on diverse samples and additional protective factors while providing insights for clinicians and ministry organizations in developing coping strategies that emphasize self-compassion and spiritual practices. [ABSTRACT FROM AUTHOR]

INTRODUCTION: We examined whether the aging suppressor KLOTHO gene's functionally advantageous KL‐VS variant (KL‐VS heterozygosity [KL‐VSHET]) confers resilience against deleterious effects of aging indexed by cerebrospinal fluid (CSF) biomarkers of neuroinflammation (interleukin‐6 [IL‐6], S100 calcium‐binding protein B [S100B], triggering receptor expressed on myeloid cells [sTREM2], chitinase‐3‐like protein 1 [YKL‐40], glial fibrillary acidic protein [GFAP]), neurodegeneration (total α‐synuclein [α‐Syn], neurofilament light chain protein), and synaptic dysfunction (neurogranin [Ng]). METHODS: This Alzheimer disease risk‐enriched cohort consisted of 454 cognitively unimpaired adults (Mage = 61.5 ± 7.75). Covariate‐adjusted multivariate regression examined relationships between age (mean‐split[age ≥ 62]) and CSF biomarkers (Roche/NeuroToolKit), and whether they differed between KL‐VSHET (N = 122) and non‐carriers (KL‐VSNC; N = 332). RESULTS: Older age was associated with a poorer biomarker profile across all analytes (Ps ≤ 0.03). In age‐stratified analyses, KL‐VSNC exhibited this same pattern (Ps ≤ 0.05) which was not significant for IL‐6, S100B, Ng, and α‐Syn (Ps ≥ 0.13) in KL‐VSHET. Although age‐related differences in GFAP, sTREM2, and YKL‐40 were evident for both groups (Ps ≤ 0.01), the effect magnitude was markedly stronger for KL‐VSNC. DISCUSSION: Higher levels of neuroinflammation, neurodegeneration, and synaptic dysfunction in older adults were attenuated in KL‐VSHET. Highlights: Older age was associated with poorer profiles across all cerebrospinal fluid biomarkers of neuroinflammation, neurodegeneration, and synaptic dysfunction.KLOTHO KL‐VS non‐carriers exhibit this same pattern, which is does not significantly differ between younger and older KL‐VS heterozygotes for interleukin‐6, S100 calcium‐binding protein B, neurogranin, and total α‐synuclein.Although age‐related differences in glial fibrillary acidic protein, triggering receptor expressed on myeloid cells, and chitinase‐3‐like protein 1 are evident for both KL‐VS groups, the magnitude of the effect is markedly stronger for KL‐VS non‐carriers.Higher levels of neuroinflammation, neurodegeneration, and synaptic dysfunction in older adults are attenuated in KL‐VS heterozygotes. [ABSTRACT FROM AUTHOR]

Background There is controversy regarding the maximum number of elements that can be included in a surgical site infection prevention bundle. In addition, it is unclear whether a bundle of this type can be implemented at a multicentre level. Methods A pragmatic, multicentre cohort study was designed to analyse surgical site infection rates in elective colorectal surgery after the sequential implementation of two preventive bundle protocols. Secondary outcomes were to determine compliance with individual measures and to establish their effectiveness, duration of stay, microbiology and 30-day mortality rate. Results A total of 32 205 patients were included. A 50% reduction in surgical site infection was achieved after the implementation of two sequential sets of bundles: from 18.16% in the Baseline group to 10.03% with Bundle-1 and 8.19% with Bundle-2. Bundle-2 reduced superficial-surgical site infection (OR 0.74 (95% c.i. 0.58 to 0.95); P = 0.018) and deep-surgical site infection (OR 0.66 (95% c.i. 0.46 to 0.93); P = 0.018) but not organ/space-surgical site infection (OR 0.88 (95% c.i. 0.74 to 1.06); P = 0.172). Compliance increased after the addition of four measures to Bundle-2. In the multivariable analysis, for organ/space-surgical site infection, laparoscopy, oral antibiotic prophylaxis and mechanical bowel preparation were protective factors in colonic procedures, while no protective factors were found in rectal surgery. Duration of stay fell significantly over time, from 7 in the Baseline group to 6 and 5 days for Bundle-1 and Bundle-2 respectively (P < 0.001). The mortality rate fell from 1.4% in the Baseline group to 0.59% and 0.6% for Bundle-1 and Bundle-2 respectively (P < 0.001). There was an increase in Gram-positive bacteria and yeast isolation, and reduction in Gram-negative bacteria and anaerobes in organ/space-surgical site infection. Conclusions The addition of measures to create a final 10-measure protocol had a cumulative protective effect on reducing surgical site infection. However, organ/space-surgical site infection did not benefit from the addition. No protective measures were found for organ/space-surgical site infection in rectal surgery. Compliance with preventive measures increased from Bundle-1 to Bundle-2. [ABSTRACT FROM AUTHOR]

When children experience extreme or persistent stressors (e.g., maltreatment, housing insecurity, intimate partner violence), prolonged elevation of the stress‐response system can lead to disrupted development of multiple physiological systems. This response, known as toxic stress, is associated with poor physical and mental health across the life course. Emerging evidence suggests that the effects of toxic stress may be transmitted through generations, but the biological and behavioral mechanisms that link caregivers' childhood history with the health of the children they care for remain poorly understood. The purpose of this report is to describe the research protocol for The CARING (Childhood Adversity and Resilience In the Next Generation) Study, a cross‐sectional study of caregivers with children aged 3–5 years designed to (1) examine the intergenerational transmission of toxic stress and protective factors; (2) explore three hypothesized pathways of transmission: parenting, daily routines, stressors, and supports; and (3) explore the extent to which genotypic variation in candidate genes related to caregiving and stress contribute to caregivers' and children's susceptibility to the effects of early childhood experiences (i.e., gene × environment interactions). We expect that findings from this study will provide critical data needed to identify targets for precision health interventions, reduce health disparities related to toxic stress, and prevent cycles of adversity among families at risk. [ABSTRACT FROM AUTHOR]

There is growing support for the dual-continua model of mental health, which emphasizes psychopathology and well-being as related but distinct dimensions. Yet, little is known about how these dimensions co-develop from childhood to early adolescence and what factors predict their different trajectories. The current study aimed to identify distinct patterns of mental health in Chinese early adolescents, focusing on both psychopathological symptoms (i.e., depressive symptoms and self-harm behaviors) and subjective well-being (i.e., life satisfaction and affect balance). This study also examined the contributions of school climate and future orientation to these trajectories. A total of 1,057 students (Mage = 11.88, SDage = 1.67; 62.1% boys) completed four assessments over two years, with six-month intervals. Using parallel-process latent class growth modeling, we identified four groups: Flourishing (32.5%), Languishing (43.8%), Troubled with Stable Depressive Symptoms (16.1%), and Troubled with Increasing Self-Harm Risk (7.6%). Furthermore, school climate and future orientation contributed to adolescents' membership in these trajectories, either independently or jointly. Specifically, higher levels of future orientation combined with higher school climate were associated with a lower likelihood of belonging to the Troubled with Increasing Self-Harm Risk trajectory, compared to the Flourishing group. Our findings identified four distinct mental health trajectories consistent with the dual-continua model, and demonstrated that the development of psychopathology and well-being were not always inversely related (e.g., the Languishing group). Adolescents with unique developmental profiles may benefit from tailored intervention strategies that build on the personal and environmental assets of the adolescent. [ABSTRACT FROM AUTHOR]

Background/Objectives: Evidence indicates that persistent transgressive behaviors often begin early in development and increase around age twelve, and warns that children who exhibit transgressive behaviors in childhood or early adolescence tend to develop criminal behaviors in adulthood which makes childhood a critical unit of analysis for timely intervention. The study examines risk and protective factors in childhood related to illegal behavior, through the perspective of developmental criminology. The observation of risk and protective factors in early stages allows us to design interventions that prevent social adjustment problems in children from becoming more complex by maintaining the transgression of social norms over time. Factors identified by developmental criminology can be organized according to ecological systems theory and discussed in relation to previous criminological studies. Methods: Using a systematic review based on the PRISMA method, the study identifies 24 updated developmental criminology articles that study early protective factors between birth and age twelve. Result: Risk factors at the individual level include biological, socioemotional, behavioral, symptomatic aspects and adverse life experiences. Individual protective factors include cognitive, socioemotional, and personality development aspects. Risk factors at an interpersonal and contextual level are related to family, school, peers, socioeconomic situation and governance. Conclusions: This review highlights the importance of recognizing risk and protective factors in child development, contemplating interventions at multiple levels where an articulation between the various institutions involved in child care is possible. [ABSTRACT FROM AUTHOR]

Objective: We aimed to investigate the potential environmental risk factors, protective factors, and biomarkers of hearing loss (HL), and establish a hierarchy of evidence. Data Sources: Embase, PubMed, Cochrane Library, and Web of Science electronic database from inception to June 1, 2023. Review Methods: We included meta‐analyses of observational studies of associations between HL and environmental risk factors, protective factors, or biomarkers. We calculated summary effect estimates, 95% confidence interval, heterogeneity I2 statistic, 95% prediction interval, small study effects, and excess significance biases. Results: Of the 9211 articles retrieved, 60 eligible articles were included. The 60 eligible articles identified 47 potential environmental risk and protective factors (N = 4,123,803) and 46 potential biomarkers (N = 173,701). Evidence of association was convincing (class I) for rheumatoid arthritis (RA) and every 1 cm increase in height. Evidence of association was highly suggestive (class II) for human immunodeficiency virus (HIV), diabetes, cumulative noise exposure (CNE), smoking, congenital cytomegalovirus (CMV) infection, combined exposure to organic solvents and noise, non‐Gaussian noise exposure, each 1 kg increase in birth weight, noise exposure, and alopecia areata (AA). Conclusion: In this umbrella review, RA, every 1 cm increase in height, HIV, diabetes, CNE, smoking, congenital CMV infection, combined exposure to organic solvents and noise, non‐Gaussian noise exposure, each 1 kg increase in birth weight, noise exposure, and AA were strongly associated with HL. [ABSTRACT FROM AUTHOR]

Background: The offspring of parents with bipolar disorder (OBD) are at higher risk of developing psychopathology than the offspring of parents with no affective disorder (control). In addition to genetic predisposition, childhood adversity and a stressful family environment are important risk factors for the OBD. Protective factors in parents, such as social support and coping strategies, may buffer the effects of stress on at-risk children. This study tested whether parents' social support and coping style attenuated the link between risk status (OBD vs. control) and psychopathology in offspring. Methods: During offspring's middle childhood, parents underwent a diagnostic interview and completed social support and coping style questionnaires. Sixty-nine OBD (39 female) and 69 control (29 female) offspring between ages 13 and 29 completed a diagnostic interview approximately 10 years later. Results: Parents' social support satisfaction moderated the link between offspring risk status and their development of substance use disorder (SUD) symptoms (F(1,131) = 5.90, p =.017). Parents' social network size moderated the link between offspring risk status and their development of anxiety and depression symptoms in an unexpected direction (F(1,131) = 5.07, p =.026). No effects of parents' coping style were found. Conclusions: Among the OBD, having parents with greater social support satisfaction and, unexpectedly, a smaller social network buffered their development of SUD and depression and anxiety symptoms by early adulthood. Parents' social support may thus have a protective function for children in these high-risk families. [ABSTRACT FROM AUTHOR]

AbstractObjectivesResearch approachFindingsConclusionCancer survivors are at risk for suicidality. We aimed to expand the knowledge about protective factors and their interplay with risk factors by testing social support as a modifier of the association of Quality of Life (QoL) deficits with suicidal ideation.We surveyed N = 633 childhood cancer survivors (CCS) using validated questionnaires (EORTC Core Quality of Life questionnaire QLQ-C30, Patient Health Questionnaire PHQ-9). The interaction of QoL and social support was investigated using multiple linear regression analysis.CCS reporting suicide attempts and current suicidal ideation (SI) had lower QoL. CCS with SI reported less social support. QoL and social support were independently associated with SI and interacted: among CCS with less social support, low QoL was more strongly associated with SI.The results highlight the need for interdisciplinary survivorship care, and to focus on risk and protective factors to strengthen suicide prevention. [ABSTRACT FROM AUTHOR]

There are multiple risk and protective factors for depression. The association between these factors with vulnerability to depression is unclear. Such knowledge is an important insight into assessing risk for developing depression for precision interventions. Based on the behavioral data of 496 participants (all unmarried and not cohabiting, with a college education level or above), we applied machine-learning approaches to model risk and protective factors in estimating depression and its symptoms. Then, we employed Random Forest to identify important factors which were then used to differentiate participants who had high risk of depression from those who had low risk. Results revealed that risk and protective factors could significantly estimate depression and depressive symptoms. Feature selection revealed four key factors including three risk factors (brooding, perceived loneliness, and perceived stress) and one protective factor (resilience). The classification model built by the four factors achieved an ROC-AUC score of 75.50% to classify the high- and low-risk groups, which was comparable to the classification performance based on all risk and protective factors (ROC-AUC = 77.83%). Based on the selected four factors, we generated a mood vulnerability index useful for identifying people's risk for depression. Our findings provide potential clinical insights for developing quick screening tools for mood disorders and potential targets for intervention programs designed to improve depressive symptoms. • The risk and protective psychosocial factors can estimate depression and its symptoms. • Brooding, loneliness, perceived stress, and resilience were identified as significant features in estimating depression. • The classification model built using the four selected factors performed comparably to model built with all risk and protective factors. [ABSTRACT FROM AUTHOR]

Introduction: Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) young people experience higher prevalence rates of suicidality than their heterosexual and/or cisgender peers. However, there is limited research that can inform suicide prevention efforts. Our aim was to synthesize quantitative, qualitative, and mixed methods research on risk and protective factors among LGBTQ+ young people, from countries with a high Global Acceptance Index. Methods: A scoping review guided by Arksey and O'Malley's five‐stage framework, using the Preferred Reporting Items for Systematic Reviews and Meta‐analysis Extension for Scoping Reviews protocol. Five databases and grey literature were searched for relevant studies. Identified factors were clustered by thematic type, according to the socio‐ecological model to identify empirical trends and knowledge gaps. The mixed methods appraisal tool was used for quality assessment of studies. Results: Sixty‐six studies met our inclusion criteria. Overall, 59 unique risk factors and 37 unique protective factors were identified. Key risk factors include past suicidality, adverse childhood experiences, internalized queerphobia, minority stress, interpersonal violence, bullying, familial conflict, and anti‐LGBTQ+ policies/legislation. Key protective factors include self‐affirming strategies, adult/peer support, at‐school safety, access to inclusive healthcare, family connectedness, positive coming out experiences, gender‐affirming services and LGBTQ+ inclusive policies and legislation. Conclusions: Overall, our findings affirm that multiple risk and protective factors, at all levels of the socio‐ecological model, interact in complex, unique and diverse ways upon suicidality among LGBTQ+ young people. Implications for suicide prevention are discussed. Further empirical studies are required, particularly at the communities, policies, and societal levels of the socio‐ecological model, and these studies should include a focus on protective factors and significant within‐group differences. [ABSTRACT FROM AUTHOR]

Psychological flexibility constitutes one of the most crucial protective factors of mental health in the context of the lengthy COVID-19 pandemic. The Acceptance and Action Questionnaire II (AAQII) is the most widely used instrument in assessing psychological flexibility and change processes involved in interventions aimed to promote them, mainly within the Acceptance and Commitment Therapy (ACT) model. Various translations and adaptations of the AAQ-II address specific clinical and non-clinical contexts. However, an instrument that assesses psychological flexibility in the context of the COVID-19 pandemic needs to be developed. The present study conducted a pilot phase of developing an Acceptance and Commitment Questionnaire in the COVID-19 pandemic (AAQ-COVID-19) context. The instrument is a 10-item Likert-type scale with five response options, it assesses the unidimensional construct of psychological flexibility. Data collected from a convenience sample of 36 adults, ages 42-76 (M=59.3), shows that all ten scale items have discriminating power. Methodological considerations regarding the construction and adaptations of items to address specific contexts are the main points of the discussion. [ABSTRACT FROM AUTHOR]

Objective: Suicide rates in older adults are often the highest of any age group, particularly among high income countries. However, there is a limited understanding of the factors that could protect against suicidality in older age. This systematic review aimed to identify and evaluate the psychological factors that protect against suicidality in older age. Method: An a priori protocol was established and registered on PROSPERO (CRD42022343694). EMBASE, MEDLINE, PsycINFO, Web of Science and Scopus were searched. Papers were quality assessed using the Quality Assessment with Diverse Studies (QuADSs) tool. The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines were followed. Seventeen papers were included and narratively synthesised. Results: The initial searches identified 10,673 records, resulting in the screening of 5441 records after the removal of duplicates. The protective factors identified were (1) meaning/purpose in life, (2) reasons for living, (3) coping styles, (4) psychological wellbeing, (5) life satisfaction, (6) personality factors, (7) cognitive functioning, and (8) sense of belonging. The factors with the most empirical support were meaning in life, followed by psychological wellbeing and coping responses, such as primary control strategies, and personality traits, such as positive affect and agency. There was also evidence to suggest that the influence of some protective factors, for example meaning in life, may depend upon stage in older life and gender. Conclusion: This review identified several psychological factors that have been found to protect against suicidal ideation in older adults, representing potential treatment targets for reducing suicide in older adults. Recommendations for future research includes greater use of longitudinal and case–control designs, measuring outcomes across the continuum of suicidality and using samples that allow comparison between younger and older adults and within the spectrum of old age. [ABSTRACT FROM AUTHOR]

Introduction: Compelling evidence shows that the COVID-19 pandemic has detrimental effects on the mental health of university students. However, little is known about the psychological distress experienced by students from high schools during the pandemic. This study, therefore, sought to examine the prevalence of depression, anxiety and stress and their associated factors among students from high schools in Rwanda. Methods and materials: A retrospective, cross-sectional study was conducted on 384 students randomly selected from high schools. Data were collected using standardized measures of mental disorders and their associated factors. Bivariate and multivariate analyses based on the odds ratio were used to indicate the associated factors of anxiety, depression, and stress. Results: The results indicated that slightly above half of the participants (51%, n = 195) had clinically significant symptoms of depression, 30.3% (n = 116) had stress and 67.3% (n = 259) had anxiety. Our analyses identified several key risk factors associated with increased odds of these mental disorders. These include exposure to domestic violence, COVID-19 symptoms like cough and myalgia, eating twice per day, having one of the three mental disorders, gender, with females showing higher susceptibility, and direct contact with the people who positively tested covid-19. Conversely, protective factors such as heightened awareness about Covid-19, positive mental health, social support, eating three times, belonging to the third Ubudehe category, and a high resilience emerged as significant elements mitigating the risks of these mental health challenges within our sample. Intriguingly, religious affiliation emerged as a notable factor, with students affiliated with the Witness of Jehovah and Adventist denominations exhibited lower risks for depression and anxiety. Conclusion: Our findings highlighted a high prevalence of depression, anxiety, and stress among students from secondary schools. Interestingly, this study also revealed the associated risk and protective factors of depression, anxiety, and stress in Rwandan students in high schools. Therefore, mental health interventions targeting the impact of COVID-19 on students, as young people are needed. [ABSTRACT FROM AUTHOR]

Studies have consistently shown that LGBTQ individuals are at increased risk for several mental and physical health challenges including suicidality. The relationship between religion and LGBTQ well-being in general and LGBTQ suicidality specifically has increasingly been the subject of scholarly investigation. This systematic review examines all peer-reviewed articles included in the EBSCO PsycInfo database since 2000 that examined the relationship between religiosity and LGBTQ suicide (50 studies in all). These studies reveal a complex relationship that is nuanced and, at times, contradictory. Overall, 65% identified at least one religiosity-related predictor as a risk factor for LGBTQ suicidality, 41% identified at least one religiosity-related predictor as a protective factor against suicidality, while 53% found no associations between religiosity-related predictors and suicide risk. However, when specifically examining religious affiliation/denomination, salience, or beliefs and behaviors, typically, religiosity was either protective or unassociated with LGBTQ suicidality. This held particularly true for studies that had population-based samples, employed control variables and included comparison groups, thus enhancing their generalizability. The one religiosity-related predictor that was almost universally identified as a risk factor was when an individual felt conflicted between their religious and sexual-gender identities. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusion Research has indicated a rise in the prevalence of depression and anxiety among adolescents over the past three decades. However, the factors underpinning increases in mental health difficulties remain poorly understood. This study examines psychological, social and environmental risk and protective factors that may explain changes in depression and anxiety among adolescents.Data were taken from two nationally representative My World Surveys of adolescents aged 12–19 years in 2012 (N = 5,490) and 2019 (N = 9,844). Survey data on depression and anxiety and a range of potential risk (e.g., alcohol use, psychotic symptoms) and protective factors (e.g., resilience, self‐esteem) were assessed at both time points. Multiple group analyses assessed whether the predictive ability of risk/protective factors changed from wave 1 to wave 2.Results showed that the prevalence of depression and anxiety increased significantly between 2012 and 2019, particularly among females. Predictors accounted for between 37% and 61% of the variance in outcomes across waves. While some risk/protective factors were consistent predictors of depression and anxiety at both waves (e.g., bullying, discrimination, optimism), reporting female gender and having higher formal help‐seeking tendencies more strongly predicted anxiety at wave 2, while lower self‐esteem and lower resilience (personal competence) strongly predicted both depression and anxiety at wave 2.Findings highlight the need to prioritize adolescent mental health service provision, especially in females. Self‐esteem and resilience are potentially important targets for supporting adolescent mental health. Further research is required to understand the causal factors associated with increases in anxiety and depression. [ABSTRACT FROM AUTHOR]

In forensic practice, clinicians often need to apply risk assessment results to complex correctional decisions, but a strong empirical base to support some practices (such as assessing strengths or measuring change) is limited and still emerging. Using data from 195 adult men (M age = 32.02, SD = 8.53) who completed a custody-based violence prevention rehabilitation program, we supplemented existing static and dynamic risk factor ratings recorded prospectively by correctional staff by conducting retrospective file reviews and coding additional dynamic risk factors and strengths (including motivation and program engagement). We observed small average reductions in dynamic risk ratings and increases in strength ratings. After controlling for static risk scores, increases in client motivation and program engagement predicted reduced violent recidivism. Results from multivariate models suggested clients' interest in engaging with post-custodial support for staying crime-free was critical for post-release success. Although our methodology was innovative in this context, inconsistent interrater reliability (ICC1 =.05–.74) and results suggest clinicians should cautiously interpret change scores and strength factor ratings. Rehabilitation research would benefit from partnerships with corrections agencies to design rigorous prospective research on client motivation and program engagement. [ABSTRACT FROM AUTHOR]

Humanitarian practitioners, specifically emergency aid and relief workers, disaster responders, social workers, and crisis clinicians, are at elevated risk of experiencing trauma as a result of their professions. Approaches for responding to the silent pandemic of reactive traumatic stress, including secondary traumatic stress and vicarious traumatization among humanitarian practitioners continue to be inadequate. The current model of self‐care, emphasizing internal regulation and processes to promote positive health, wellbeing, and the ability to continue to support others, is insufficient to best equip humanitarian practitioners with protective factors to stave off reactive traumatic responses to their work. We therefore propose our theory to extend the current self‐care model to include the external focus of compassion resilience and conclude with recommendations. [ABSTRACT FROM AUTHOR]

Objective: China's early encounter with COVID‐19 and protracted prevention policies, presents an ideal case to study psychological changes during a prolonged and evolving crisis. This study aims to examine the shifts in mental health symptoms, risk‐related perceptions, and associated coping behaviors within two large‐scale samples of Chinese respondents, spanning from the pandemic's onset to the relaxation of the zero‐COVID policy. Moreover, the study strives to identify protective factors that could potentially mitigate the pandemic's impact. Methods: Two online surveys were conducted during China's initial pandemic phase (February 25–28, 2020) and the relaxation of the zero‐COVID policy (March 30–April 18, 2023). Participants' mental health indicators, risk‐related perceptions, and coping behaviors were assessed using the Depression, Anxiety, and Stress Scale‐21 Items, the 9‐item Bergen Burnout Inventory, and other adopted scales. Multivariable linear models were employed to examine the enduring psychological impact of the pandemic and identify potential protective factors. Results: Analysis of two datasets comprising 1946 and 1878 participants from the onset and the remission of China's COVID‐19 pandemic revealed an upward trend in various mental health indicators of Chinese respondents between 2020 and 2023. Similarly, risk‐related perceptions, encompassing perceived severity, susceptibility, and self‐efficacy, and risk‐related information sharing witnessed an increase. Being female, single, residing in rural areas, having higher education, and lacking acquaintances with COVID‐19 are protective factors against mental health risks. Additionally, being female, married, over 30, living in big cities, having higher education, and lacking personal or acquaintances' infection history are associated with engaging in protective behaviors and reduced information avoidance. Conclusion: The study investigated the changes in mental health symptoms, risk‐related perceptions, and coping behaviors of Chinese respondents between 2020 and 2023 and identified protective factors against the pandemic's impact, including demographic (gender, age), social (education, marital status, residence), and exposure (infection history) elements. Understanding these fluctuations and protective elements is crucial for policymakers, as it can inform the development of targeted strategies to alleviate negative psychological impacts while effectively managing future pandemics. [ABSTRACT FROM AUTHOR]

Healthcare professionals are exposed to stressful situations that may favor substance use vulnerability. This systematic review aims to synthesize the risk and protective factors associated with use, abuse, and dependence of alcohol, tobacco, psychoactive drugs, and cannabis in healthcare professionals. Following PRISMA recommendations, a systematic search was performed in PsycINFO, Web of Science, PubMed/MEDLINE, Embase, Scopus, and Cochrane Library. The search yielded 1523 studies, of which 19 were selected. The identified risk factors were demographic factors (i.e. male gender, and single/divorced marital status), psychopathological factors, social factors, positive attitudes toward drugs, unhealthy lifestyle habits, the COVID-19 pandemic, and the coexistence of the use of several substances. The protective factors were demographic factors (i.e. ethnicity and having dependent children), healthy lifestyle habits, and workplace anti-drug policies (i.e. restriction of tobacco use). These findings highlight the need for preventive actions against drug use in healthcare professionals to improve their health and reduce the possible negative impact on their healthcare practice. Knowledge of modifiable risk and protective factors allows their incorporation as components in preventive actions, and non-modifiable factors (e.g. demographic variables) may contribute to the detection of groups of greater vulnerability to propose selective prevention actions in this population. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) is a complex, multidimensional phenomenon and may involve different risk and protective factors, as well as people of different sexual orientations, including gay men. Despite scientific evidence of the high prevalence of victimization and perpetration of this phenomenon, IPV in gay men is still largely invisible. The aim of this study was to map the risk and protective factors related to IPV among gay cis men based on a literature review. The Scopus, PsycNET, Pubmed, BVS-Psi, and SciELO databases were searched to retrieve articles published between 2018 and 2022. Thematic analysis was used to map the risk and protective factors of the 29 articles that met the inclusion criteria. Among the results, most studies investigated the risk factors for victimization of IPV, despite showing the high prevalence of bidirectionality in IPV among gay men. In addition, multiple risk and protective factors (individual, relational, and socio-community) have been shown to be associated with IPV among gay men. Mapping risk and protective factors for IPV at different ecological levels makes it possible to identify a more accurate profile of gay men's vulnerabilities, in addition to enabling the construction of more systemic interventions, which are multisectoral with specific prevention strategies, for IPV among gay men. [ABSTRACT FROM AUTHOR]

Caregiving is recognised as a source of stress with potential for negative health impacts as well as positive outcomes and development of resilience. For young carers, children, and adolescents providing care for close family members, adaptation through resilience is crucial, yet work using a resilience approach is limited. This study explored protective factors and pathways to resilience in a sample of young carers, through application of the socioecological model in caring relationships. An in-depth qualitative approach was used, with in-person interviews facilitated by auto-driven photo elicitation. Deductive thematic analysis was applied, framed by three levels (individual, community, and society) of the socioecological model of resilience. Twelve participants (nine girls and three boys) aged 5–18 years, each providing care to a family member, were recruited using opportunity and volunteer sampling via carers' centres in the southwest of England. Ten key themes were identified, four at the individual level: pre-empting challenges and planning, cognitive strategies, emotional strategies, and seeking solitude; three at the community level: family support, friendships, and pets and inanimate objects; and three at the society level: professional support, access to caregiver activities and community, and being outdoors. The location of themes at each level indicated relevance of the socioecological model to identification of protective factors in a young carer population. These findings have important applications for guidance to charities and organisations supporting young carers. Identification of factors that promote resilience offers support for the development of well-informed interventions, which harness these protective factors to develop resilience and improve health for young carers. [ABSTRACT FROM AUTHOR]

Purpose: Recovery in people with first-episode psychosis (FEP) remains a major issue. When risk factors are studied in relation to the disorder, potential protective factors should also be considered since they can modulate this relationship. This study is aimed at exploring which premorbid and baseline characteristics are associated with a good and poor global recovery in patients with FEP at 3-year follow-up. Methods: We categorized patients' outcome by using a Latent Class Analysis (LCA) considering a multimodal set of symptomatic and functional outcomes. A Mixed effects Models Repeated Measures analysis of variance (MMRM) was used to highlight group differences over time on symptomatic and functional outcomes assessed during the 3-year follow-up. Results: A total of 325 patients with FEP aged between 18 and 35 years were included. Two groups were identified. A total of 187 patients (57.5%) did not achieve recovery, and 138 patients (42.5%) achieved recovery. Recovered patients had generally a better premorbid and baseline profile in comparison with non-recovered patients (as among which shorter duration of untreated psychosis (DUP), higher degree of insight, better functional level and lower illness severity at baseline). The trajectories for the psychopathological and functional outcomes over 36 months differed between the non-recovered and the recovered group of patients. Conclusions: Our results pointed to some variables associated with recovery, acting as potential protective factors. These should be considered for early intervention programs to promote psychological resilience specifically in those with a worse prognosis in order to mitigate the effects of the variables that make them more vulnerable to poorer outcome. [ABSTRACT FROM AUTHOR]