European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16080109

Authors: Maja Ribar Josip Razum Goran Milas

Adolescence is a developmental period characterized by increased exposure to stress and elevated vulnerability to mental health problems. The present study examined the structure of perceived stress, its longitudinal stability, and its associations with mental health in adolescents. Data were collected from a probabilistic sample of 1679 Croatian adolescents who were in the first or second year of high school at baseline and were followed across three measurement waves approximately six months apart. Perceived stress was assessed across six domains (school, future, parents, friends, romantic partners, and self), and structural equation modeling was used to test factor structure, measurement invariance across time and sex, and temporal stability. Competing models supported a hierarchical structure comprising six domain-specific factors and a higher-order general perceived stress factor. The measure demonstrated strong longitudinal and sex invariance. General perceived stress showed high stability across the three waves, despite being assessed as a current subjective experience. Perceived stress was moderately to strongly associated with depression, generalized anxiety, internalizing and externalizing symptoms, life satisfaction, and happiness, with no evidence of sex differences in these associations. These findings suggest that adolescent perceived stress is best conceptualized as a hierarchical and highly stable construct that is closely linked to multiple indicators of mental health and well-being.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16080108

Authors: Giuseppe Marano Senad Hasaj Oksana Di Giacomi Marco Lanzetta Gabriele Sani Marianna Mazza

Background: The widespread use of appearance-focused social media platforms has transformed how body-related attitudes are constructed, internalized, and evaluated, particularly among adolescent girls and young women, yet the existing literature remains heterogeneous in conceptual frameworks, populations, and outcome measures. Objective: This scoping review maps the extent, nature, and characteristics of the available evidence on the relationship between appearance-focused social media use, body image, self-esteem, and psychological wellbeing in adolescent girls and young women. Methods: Following PRISMA-ScR, PubMed, Scopus, and Web of Science were searched for quantitative, qualitative, and mixed-methods studies on female samples aged 10–30; data were charted and synthesized descriptively. Results: Fifty-eight studies (2014–2026) met the inclusion criteria. Evidence was concentrated in Australia and the United States and skewed toward emerging adults, with adolescent girls aged 10–17 examined in only nine studies. Appearance-focused engagement was consistently linked to body dissatisfaction, body surveillance, drive for thinness, and negative affect, with appearance comparison, internalization of appearance ideals, and self-objectification emerging as recurrent explanatory mechanisms. Body positive and body neutrality content emerged as the most promising protective categories. Conclusions: The review clarifies current evidence and identifies critical gaps for future research, informing clinical, educational, and preventive interventions.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070107

Authors: Keren Dopelt Shiran Bord Nourit Houminer-Klepar

The journal retracts the article titled “What Drives the Non-Medical Use of Stimulants Among College Students [...]

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070106

Authors: Julie C. Mitchiner Tahleen A. Lattimer Gigi Zheng Emma Kane Gabrielle Majeri Christina Whetsel Jessica Contreras Michael M. McKee Peter C. Hauser

Deaf parents experience higher rates of healthcare barriers and adverse parenting outcomes compared with their hearing peers. This qualitative study explored the parenting experiences of Deaf parents to better understand barriers and facilitators to optimal parenting situations. Semi-structured, individual remote interviews were conducted with twenty Deaf parents in the United States who primarily communicate using American Sign Language (ASL) and have children aged 13 years old and under. Interviews examined experiences related to access to information and resources, relationships with healthcare providers, communication accessibility, and involvement with the educational system. Data were analyzed using thematic analysis. Four major themes emerged: communication accessibility across parenting contexts, lack of accessible parenting-related information and services, family dynamics, and the role of assistive technologies in parenting. Participants reported that systemic barriers across healthcare, educational, and service systems create persistent communication challenges and delays, disempowering experiences, and contribute to a critical lack of resources designed for Deaf parents. These findings underscore the need for increased awareness and improved communication access for Deaf parents across healthcare, educational, and legal settings to support positive parenting experiences.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070105

Authors: Heyner Yuliano Marquez-Yauri Sandra Lizzette León Luyo Moises David Reyes-Perez César Pol Arévalo-Aranda Luisa Angélica Orejuela Guerrero Carlos José Sandoval Reyes Angelica María Minchola Vásquez Marco Agustín Arbulú Ballesteros Roger Ernesto Alarcón García

The rapid integration of artificial intelligence (AI) into higher education has renewed concern that technology-related strain may erode students’ higher-order thinking. Drawing on a social–cognitive framework, this study tested whether AI self-efficacy and technostress predict critical thinking in 340 Peruvian undergraduates, who completed three validated scales (Yoon’s Critical Thinking Disposition Inventory; the brief General Self-Efficacy Scale for AI, GSE-6AI; and the RED-Technostress scale). Data were modeled with PLS-SEM, with significance from 5000 bootstrap resamples and an out-of-sample predictive assessment (PLSpredict, CVPAT). AI self-efficacy was a robust positive predictor of critical thinking (β = 0.42, p < 0.001), whereas technostress had no direct effect (β = −0.06, p = 0.50); AI self-efficacy was associated with higher technostress (β = 0.24, p < 0.001), but that path did not carry over to critical thinking (no mediation). A hypothesized moderation (AI self-efficacy mattering more at higher technostress) was not confirmed: it reached significance under the two-stage method but not under a stricter bootstrap, and the hypothesis was therefore not supported. The model explained a modest share of variance in critical thinking (R2 = 0.17) and was invariant across public and private universities. These findings reposition technostress as, at most, a distal correlate and identify confident, literate engagement with AI, rather than the absence of strain, as the more promising lever for cultivating critical thinking.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070104

Authors: Quentin Hallez Sandrine Gil

Time is a peculiar object for psychological science [...]

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070103

Authors: Jeffrey Levi Palmer Carrie Lou Bloom Mary Sanderson Linling Shen

Education is a well-established determinant of health and well-being, yet its benefits may not be equally distributed across populations. This study examines whether educational attainment predicts psychological well-being, financial difficulty, and social support among deaf adults and whether these associations differ from those observed among hearing adults. Using nationally representative data from the U.S. Household Pulse Survey, we analyzed a weighted sample of adults aged 25–54 (N = 36,810), employing multivariate linear regression models that included education, hearing status, their interaction, and demographic covariates. Higher education was generally associated with more favorable outcomes among deaf adults, particularly in psychological well-being and social and emotional support, though effects were modest and less consistent for financial difficulty. Hearing adults reported significantly better outcomes across all domains, and interaction effects indicated that the benefits of education were significantly larger for hearing adults than for deaf adults. These findings suggest that while education remains beneficial for deaf people, its protective effects are limited, likely due to persistent structural and communication barriers. Given the importance of education, improving access alone will not eliminate disparities in well-being without concurrent efforts to address structural and social inequities.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070102

Authors: Eva-María Barroso-Márquez María-de-los-Ángeles Merino-Godoy Izaro Eraña-Méndez David Gómez-Asencio Yeray Cabrera-Arana Cristina Arana-Álvarez Francisco-Javier Gago-Valiente Eva-María Carrasco-Barroso

Background: The global prevalence of anxiety and internalizing disorders in adolescence has increased epidemiologically over the past decade, compounded by the impact of the COVID-19 pandemic and the expansion of digital social networks. Despite the availability of empirically based interventions, their systematic implementation in Spanish educational settings—especially in socioeconomically vulnerable environments—remains insufficient. This study aimed to assess the emotional symptomatology profile in a sample of adolescents enrolled in the 2nd year of Compulsory Secondary Education (CSE) and to describe the changes in symptomatology observed after implementation of a multicomponent intervention program in an ordinary school setting. Methods: a quasi-experimental single-group repeated-measures design was used, with pretest–posttest measurements (T1–T2). The sample included 79 participants (age in completed years: M = 13.28 years, SD = 0.64; range: 12–15; 49.4% female, 44.3% male, 6.3% undisclosed), selected by convenience at IES Estuaria (Huelva). The assessment instrument was the Revised Child Anxiety and Depression Scale (RCADS-47), which measures total anxiety, total internalization, and six clinical subdimensions aligned with DSM-5: generalized anxiety disorder (GAD), major depressive disorder (MDD), panic disorder (PD), separation anxiety (SA), social phobia (SP), and obsessive–compulsive disorder (OCD). The intervention consisted of five multicomponent group workshops (45 min/session; three class groups) integrating emotional psychoeducation, receptive music therapy, cognitive–behavioral emotional regulation, assertive communication, and body expression/mindfulness. Results: At pretest, Social Phobia (SP) showed the highest clinical impairment, significantly affecting more females (66.67%) than males (20.00%). Generalized Anxiety Disorder (GAD) also presented high impairment in females. Significant correlations between pairs of subdimensions revealed a high comorbidity pattern. Following the intervention, reductions in clinically significant levels were observed across all dimensions. Matched-pairs Wilcoxon signed-rank tests confirmed statistically significant score reductions from T1 to T2 in Total Anxiety, Total Internalization, Social Phobia, and Generalized Anxiety Disorder (all p < 0.05), with the largest effect for Social Phobia (r = 0.46); no significant change was detected for Panic Disorder, Separation Anxiety, Major Depressive Disorder, or Obsessive–Compulsive Disorder, although the direction of change favored improvement in all cases. Conclusions: The multicomponent intervention program produced improvements in emotional symptomatology over the short-term follow-up period, although without achieving complete clinical remission in any subdimension. The persistent sex differences—with greater residual impairment in the female group after intervention—underscore the need to incorporate a gender perspective in the design of school emotional health programs. High comorbidity rates between subdimensions support the utility of transdiagnostic approaches. Implications for school nursing practice and future research are discussed.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070101

Authors: Alexis Emmanuel Salinas-Santoyo Gabriela Luna-Hernández Victor Horacio Orozco-Covarrubias Janvier Andre Martinez-Godinez Jaime Briseno-Ramírez Cecilia Alejandra Zamora-Figueroa

Undergraduate nursing students are trained to promote health in clinical and community settings, but their own health-promoting behaviors occur in the context of academic demands, clinical training, work responsibilities, and limited time for self-care. The primary objective of this cross-sectional analytic study was to estimate the adjusted association between health-professional advice seeking and global Health-Promoting Lifestyle Profile II (HPLP-II) scores among 506 undergraduate nursing students at the Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara. Secondary analyses described HPLP-II scores, stress ratings, information sources, subscale-specific associations, and propensity-score sensitivity analyses; exploratory analyses evaluated HPLP-II psychometrics, level-based lifestyle profiles, and stress-by-advice-seeking interaction. The overall median HPLP-II score was 2.40 (IQR: 2.06, 2.79). Internal consistency was high for the global scale (Cronbach’s alpha = 0.961) and ranged from acceptable to high across subscales (alpha = 0.812–0.900). Ordinal exploratory factor analysis using polychoric correlations supported exploratory use of the theoretical six-domain structure but did not provide confirmatory validation; parallel analysis suggested eight factors. Two level-based lifestyle profiles were identified: Low HPLP (58.1%) and High HPLP (41.9%), reflecting broad score-level separation rather than distinct validated phenotypes. In the primary HC3 robust model, health-professional advice seeking was associated with higher global HPLP-II scores (b = 0.242, 95% CI: 0.140, 0.344; p < 0.001), whereas academic stress and vacation-period stress showed small inverse adjusted associations with HPLP-II scores. Sensitivity analyses, including IPTW, a modified HPLP-II score excluding Health Responsibility, and a model excluding willingness to improve lifestyle, showed advice-seeking coefficients in the same positive direction. The exploratory stress-by-advice-seeking interaction was not statistically significant. Findings should be interpreted as associations rather than causal effects.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070100

Authors: Bonginkosi A. Thango Lerato Matshaka Alaa M. S. Azazz Ibrahim A. Elshaer

This study investigates how positive affect during ChatGPT-4 use is associated with perceived academic skill development in higher education, emphasising the mediating role of attitudes toward ChatGPT and the moderating role of learning orientation, grounded in Broaden-and-Build Theory and the Technology Acceptance Model. The enrichment of academic skills through ChatGPT is proposed to be maximised when students who experience positive affect develop positive attitudes toward the tool and channel their interactions through deep learning orientations. This study uses quantitative analysis with n = 12,035 active ChatGPT-using students from 135 countries. PLS-SEM using bootstrapping with 200 resamples is employed for data analysis. The results confirm that positive affect is positively associated with perceived academic skill development (H1: β = 0.199, p < 0.001) and attitude (H2: β = 0.267, p < 0.001), and that attitude is significantly associated with skill development (H3: β = 0.354, p < 0.001). Attitude partially mediates the positive affect to skill development relationship (H4: β = 0.095, t = 24.923, p < 0.001). Learning orientation negatively moderates both the attitude skill development (H5: β = −0.021) and positive affect skill development (H6: β = −0.045) pathways, indicating a desirable difficulty effect: when learning orientation is high, less evaluative scaffolding is needed for skill acquisition, consistent with cognitive challenge theory. What this implies for practice is that access alone is not enough. Institutions need to cultivate AI interactions that feel emotionally positive and, alongside them, a learning-oriented form of engagement; only when the two are developed together does ChatGPT’s potential for academic skill development carry across the diverse global contexts of higher education.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070099

Authors: Zhengqi Wei Hualing Miao Cheng Guo

Subjective well-being is a crucial indicator of higher vocational college students’ mental health, while materialistic values may be associated with poorer well-being. This study examined the mechanisms through which materialism is related to subjective well-being among Chinese higher vocational college students, with subjective well-being operationalized using life satisfaction and depressive symptoms, focusing on the mediating role of basic psychological need satisfaction (BPNS) and the moderating role of self-compassion. The final analytic sample included 4012 higher vocational college students from southwestern China (Mage = 18.79 years, SD = 0.96, 37.1% male), and the data were analyzed using structural equation modeling with robust maximum likelihood estimation and latent moderated structural equations. Results indicated that materialism was associated with lower life satisfaction and higher depressive symptoms. BPNS partially mediated the associations between materialism and both outcomes. Self-compassion moderated the associations between BPNS and both life satisfaction and depressive symptoms, but the moderated mediation effect was significant only for depressive symptoms. Specifically, self-compassion weakened the indirect association between materialism and depressive symptoms through BPNS. These findings contribute to SDT-based research by integrating vulnerability and resilience perspectives and suggest that self-compassion may be particularly relevant to lower depressive symptoms associated with lower BPNS among higher vocational college students.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070098

Authors: Giuseppe Forte Elena Cilloco Micaela Ambalagi Ilaria Corbo Renata Tambelli Maria Casagrande Francesca Favieri

Personality research has traditionally focused on stable trait differences, but increasing attention has been devoted to the internal organization of personality traits within individuals. The present study examined whether intraindividual variability in the Big Five traits, operationalized as the within-person standard deviation across trait scores (iSD_BFI), is associated with problematic digital engagement in young adults. A sample of 316 participants completed the Big Five Inventory and selected subscales of the Behavioral Addiction Questionnaire assessing smartphone use, internet use and video gaming. Pearson correlations, hierarchical regression and independent samples t-tests were conducted to evaluate associations between personality trait-profile dispersion and digital behaviors. Results showed that higher iSD_BFI was weakly but significantly associated with greater problematic smartphone use (r = 0.115, p = 0.044) and internet use (r = 0.141, p = 0.012), whereas no significant association emerged with video gaming (r = 0.029, p = 0.764). Hierarchical regression analyses further indicated that iSD_BFI explained a small but statistically significant additional proportion of variance in smartphone use (ΔR2 = 0.014, p = 0.023) and internet use (ΔR2 = 0.019, p = 0.008) beyond age, sex, and the five Big Five traits, but not in video gaming. Participants in the problematic smartphone use group exhibited significantly higher iSD_BFI than those in the moderate risk group. Rather than representing a direct measure of self-coherence or identity fragmentation, iSD_BFI was considered an exploratory structural indicator of personality profile dispersion. Accordingly, a more heterogeneous personality profile may be associated with a greater approach to digitally mediated environments, possibly because these environments provide predictability, feedback, and reinforcement. Overall, the study highlights the importance of exploring intraindividual personality configuration as a complementary dimension to traditional trait-based approaches.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070097

Authors: Hiruni Hewapathiranage-Mayadunne Erika Bergeron Poorna Kushalnagar

Deaf, deafblind, and hard-of-hearing (DDBHH) American Sign Language (ASL) users assigned female at birth experience disparities in cervical cancer screening. There is a need to further clarify the roles of education status and English proficiency in adherence to the U.S. Preventive Services Task Force (USPSTF) screening guidelines. Using the NCI Health Information National Trends Survey in ASL, we surveyed participants; those who reported being female and within the USPSTF age-eligible range (21–65) were included in analyses. Associations were determined using Pearson Chi-squared tests. A two-sided p ≤ 0.05 was considered significant. Six hundred and forty-three participants, recruited between July 2023 and October 2025, answered questions in ASL and English, with 65% self-reporting screening adherence. Chi-square results indicated that more years of education were significantly associated with screening adherence [X2 (2) = 9.72, p = 0.008]. Consistent with the results, English proficiency was not a significant predictor of screening adherence [Fisher’s exact p = 0.267]. Those who self-report as HS graduates and/or have left college demonstrate lower adherence as well. These findings suggest that educational attainment may be an important factor associated with screening adherence among DDBHH ASL users and warrants further investigation in efforts to improve adherence toward Healthy People 2030 targets.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070096

Authors: Achraf Ammar Atef Salem Khaled Trabelsi Martha Montalvan Bassem Bouaziz Mohamed Ali Boujelbane Mohamed Kerkeni Liwa Masmoudi Hadeel Ali Ghazzawi Adam Tawfiq Amawi Bekir Erhan Orhan Raynier Zambrano-Villacres Juliane Heydenreich Christiana Schallhorn Tarak Driss Evelyn Frias-Toral Giuseppe Grosso Piotr Zmijewski Haitham Jahrami Waqar Husain Hamdi Chtourou Wolfgang I. Schöllhorn

Sleep is a multidimensional health domain influenced by behavioural, psychological, and lifestyle factors. However, multinational evidence integrating insomnia severity and multiple sleep outcomes within the Mediterranean lifestyle framework remains limited. This study examined correlates of insomnia severity and key sleep outcomes in adults from Mediterranean and neighbouring countries participating in the MEDIET4ALL survey. Data were collected from 4010 adults (59.5% female) across 10 countries using a standardized multilingual e-survey. Insomnia severity was assessed as primary outcome using the Insomnia Severity Index (ISI), while sleep characteristics were assessed using sleep duration, sleep latency, sleep efficiency, and subjective sleep quality. Regression analyses examined sociodemographic, health-related, Mediterranean dietary, movement-related, psychological, and social correlates. Exploratory statistical indirect association analyses involving life satisfaction were also conducted. Insomnia severity showed the highest explained variance among sleep outcomes (adjusted R2 ≈ 0.29). Higher insomnia severity was associated with female sex, higher body mass index, and greater depression, anxiety, and stress (β ≈ 0.15–0.17), whereas lower insomnia severity was associated with older age, better self-reported health status, higher life satisfaction, and greater adherence to Mediterranean dietary consumption patterns (β ≈ −0.04 to −0.11). Models for secondary sleep outcomes explained more modest variance and should be interpreted as exploratory. Across these outcomes, psychological well-being and distress showed the most consistent associations, while Mediterranean dietary dimensions and social participation showed smaller and outcome-specific associations. Exploratory indirect association analyses showed small but statistically significant indirect associations involving life satisfaction between Mediterranean dietary dimensions, social participation, and selected sleep outcomes, particularly sleep quality and insomnia severity. The findings confirm and contextualize established associations between sleep, psychological well-being, distress, Mediterranean lifestyle-related behaviours, and regional context within a large multinational sample. Psychological well-being and distress emerged as the most consistent correlates. Insomnia severity was the most robustly explained sleep outcome, whereas secondary sleep dimensions reflected more modest exploratory correlational profiles.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070095

Authors: Vasiliki Katsarou Vassiliki Pliogou Maria Gasouka Evaggelia Kalerante

This study examines parents’ and teachers’ perceptions of Comprehensive Sexuality Education (CSE) in preschool and primary school settings in Greece. Using a quantitative survey design, data were collected from 326 parents and 212 teachers. The study explored perceptions of the importance of CSE, appropriate age and content, implementation barriers, and the influence of socio-demographic and ideological factors. Both groups expressed strong support for CSE, particularly when framed as a means of protecting children and providing reliable information. However, support appeared conditional and selective, with greater hesitation toward topics directly related to sexuality and sexual behaviour. Significant differences emerged, with parents expressing greater concerns regarding age appropriateness and potential negative consequences, while teachers showed stronger support for earlier and more comprehensive implementation. Both groups endorsed a developmental approach, with increasing acceptance of more complex topics at older ages. Although statistically significant differences emerged in several areas, effect sizes were generally small, indicating substantial overlap between parents’ and teachers’ views. Teachers were more likely to identify key implementation barriers, including lack of training, limited resources, and parental resistance. Ideological orientation appeared to be consistently associated with the perceived importance of CSE across both samples.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070094

Authors: Roman V. Reshetnikov Yuriy A. Vasilev Yuliya F. Shumskaya Dina A. Akhmedzyanova Yulya A. Alymova Anton V. Vladzymyrskyy Ilya A. Tyrov Olga V. Omelyanskaya Ivan A. Blokhin

Background: Large language models (LLMs) are increasingly integrated into real-world medical practice as chatbots for answering clinical queries. However, the perceptions of this technology among its end-users remain understudied. Existing research on physicians’ attitudes toward LLMs relies on non-validated questionnaires, raising concerns about the accuracy and reliability of the findings. The aim of this study is to develop and validate a questionnaire to assess physicians’ attitudes toward LLM-based chatbots used as a reference tool for answering queries. Methods: The instrument was based on the previously developed and validated ATRAI-14 questionnaire assessing radiologists’ attitudes toward artificial intelligence. Items for the new questionnaire were formulated and refined through focus group testing. Validation involved 562 physicians of various specialties working in medical institutions within the Moscow healthcare system. Some respondents had prior experience working with medical LLMs. We assessed face, content, construct, and criterion validity. Criterion validity was evaluated through correlation between respondents’ self-assessed attitudes toward LLMs measured by visual analogue scale (VAS), and construct validity through confirmatory factor analysis. Results: The resulting ATRAI-LLM questionnaire comprised 19 items (8 in the background part and 11 in the main part). The questionnaire demonstrated acceptable internal consistency (Cronbach’s α = 0.770, McDonald’s ωt = 0.830). It encompasses three domains: “Willingness to Use”, “Implementation Perspective”, and “Hopes and Fears.” Confirmatory factor analysis supported the three-factor structure, with satisfactory fit indices achieved (RMSEA = 0.05, CFI = 0.97, TLI = 0.96, SRMR = 0.03). Criterion validity was confirmed as acceptable with moderate correlation between the final score and VAS scores (Spearman’s rho 0.68, p < 0.001). Conclusions: ATRAI-LLM is a validated instrument for assessing physicians’ attitudes toward LLMs as a knowledge base.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070093

Authors: Katia Rolán Francisca Fariña Miguel Cuevas-Alonso

Peer conflict in early adolescence ranges from everyday disagreements to repeated aggression and bullying-related experiences. Bullying should not be reduced to physical violence: it may involve relational exclusion, psychological harassment, or verbal aggression without direct physical harm, whereas isolated aggressive acts do not necessarily constitute bullying. This study evaluated Reformulando, a school-based program that trains communication-based socio-emotional skills through pragmatic reformulation and respectful language. Using a quasi-experimental pretest–posttest design with a non-equivalent control group, we assessed changes in conflict management strategies, peer aggression, and bullying-related experiences among students aged 10–13 years. Initial analyses suggested reductions in verbal peer aggression in the experimental group relative to the control group, although these effects were attenuated in age-adjusted and classroom-clustered sensitivity analyses. Collaborative conflict management increased over time, although this change did not differ significantly between groups. Bullying-related experiences decreased during the study period, but these reductions were not specific to the experimental group. This pattern emerged in the primary analyses but was attenuated in age-adjusted and cluster-adjusted sensitivity analyses. Findings suggest the potential value of brief communication-based training for addressing verbal peer conflict, while highlighting the need for cautious interpretation due to baseline group differences, grade-level imbalance, classroom clustering, and the quasi-experimental design.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070092

Authors: Luis Edgardo Cruz Salinas Marco Agustín Arbulú Ballesteros Carlos José Sandoval Reyes Gerardo Antero Barba Ureña Carla Mercy Flores Sánchez

The general objective of this study is to test an integrative PLS-SEM model that simultaneously explains thesis quality and process efficiency among undergraduate students through the affective-motivational mediators of research self-efficacy and project management. Students who stall in the final stage of their degree rarely do so because they lack technical skill. More often, confidence erodes under sustained uncertainty, motivation shifts from intrinsic engagement to anxious compliance, and the demands of organizing months of research exceed what willpower alone can sustain. This study examines those emotional and motivational dynamics directly, treating research self-efficacy and intrinsic motivation not as background variables but as the affective-motivational core of thesis performance. Using partial least squares structural equation modeling (PLS-SEM) grounded in self-determination theory and social cognitive theory, we tested an integrative model with data from 396 undergraduate students actively completing theses at public and private universities in the northern region of Peru. Four enabling factors—methodological competencies, intrinsic motivation, tutorial support, resources and conditions—were linked to thesis quality and process efficiency through two mediating mechanisms: research self-efficacy (the confidence to face methodological difficulty without retreating) and project management (the behavioral self-regulation that converts motivation into organized work). Resources and conditions showed the strongest associations in the model, with the largest effects on both project management (β = 0.533) and research self-efficacy (β = 0.418). Self-efficacy, in turn, showed the strongest association with thesis quality (β = 0.518), while project management and quality were jointly associated with process efficiency. The model explained 70.5% of variance in thesis quality and 81.4% in process efficiency. These patterns point to a concrete institutional lever: securing the material and temporal conditions that allow students to do the work, rather than attributing delays solely to failures of individual motivation. Because the design is cross-sectional and based on self-report, these relationships are interpreted as theory-consistent associations rather than causal effects.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070091

Authors: Amy L. Stamates Sabrina M. Todaro Anna L. Sherman Melissa C. Rothstein Dahianna López Lisa L. Weyandt

Background: Alcohol use and attention-deficit/hyperactivity disorder (ADHD) are prevalent among college students. Individuals with ADHD are at increased risk for developing alcohol use disorder, but mechanisms contributing to this risk are unclear. Subjective alcohol response, or how one experiences the effects of alcohol use, is an important factor that contributes to alcohol consumption. Research suggests that individuals with ADHD, as compared to those without ADHD, may differentially experience the effects of alcohol. Consequently, the purpose of the present study was to examine the association between ADHD symptoms and subjective alcohol response (i.e., subjective effects of alcohol, perceived intoxication, and craving). Methods: Participants (N = 26; 38.5% male, 61.5% female) were college students who completed an in-person alcohol administration session where they received a 0.65 g/kg dose of alcohol. Breath alcohol concentrations and subjective effects of alcohol (feel, like, sedation, and stimulation), perceived intoxication (intoxication and willingness to drive), and craving were assessed at multiple time points throughout the session. ADHD symptoms were assessed at baseline. Results: Area under the curves (AUC) were generated for each participant and each subjective effect, perceived intoxication, and craving. Controlling for typical alcohol use, multiple regressions revealed that higher ADHD symptoms were associated with greater liking the drink, willingness to drive, and craving AUC scores. Conclusions: Individuals with higher ADHD symptoms may experience greater liking and craving during a drinking session. The present findings may also be useful to consider when tailoring intervention and prevention efforts to help reduce risk for college students who report elevated ADHD symptomology.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070090

Authors: Othman A. Alfuqaha Rasha M. Abdelrahman Kyle Msall

(1) Background: Artificial intelligence tools have become integrated into undergraduate students from academic assignments to seek help with psychological concerns, particularly during the crises period. Scales measuring Artificial Intelligence-help-seeking behavior (AI-HSB) are still limited. This study aims to develop a new bilingual scale (Arabic and English) to assess AI-HSB by providing a reliable and useful tool for researchers worldwide. (2) Methods: We conducted a methodological cross-sectional design among 416 undergraduate students in United Arab Emirates (AUE) between the period of 1 October 2025 and 10 December 2025, using an online Google Form. The development, translation, validation, and reliability processes were conducted for the AI-HSB scale. (3) Results: It has been found that 13 items (two factors) are strong indications of factorial validity, reliability, and construct validity of AI-HSB scale. The two factors explained about 58% of the total variance. The confirmatory factor analysis confirmed the two-factor structure with all items loading above recommended thresholds and the goodness-of-fit indices of AI-HSB all exceeded 0.90. (4) Conclusions: The AI-HSB is a valid and reliable tool for assessing AI-based psychological help-seeking behavior among university students in the UAE. This scale will allow universities, counselors, and policymakers to use a well-validated scale to measure the extent to which students are using AI for psychological coping.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070089

Authors: Tina Vilovic Josko Bozic Marko Kumric Roko Santic Josip Vrdoljak Marion Tomicic Marko Rada Edvard Kamsigovski Mariana Radovic Marino Vilovic

Background: Mental health disorders (MHDs) are an important concern among biomedical students, but estimates vary depending on whether studies assess confirmed diagnoses, perceived problems or current symptoms. This study assessed the presence of self-reported MHD history, operationalised as a heterogeneous combined outcome that included either a confirmed MHD diagnosis or a subjective perception of having or having had an MHD without official confirmation, and examined its associations with self-reported coping behaviours, resilience, study-related exhaustion and disengagement symptoms and healthy lifestyle adherence. Methods: A cross-sectional online survey was conducted among students from Medicine, Dental Medicine and Pharmacy programmes. Of 936 eligible students, 520 completed the survey (55.6%). The survey assessed self-reported MHD history and coping behaviours, while standardised questionnaires measured resilience, exhaustion and disengagement symptoms and healthy lifestyle adherence. Analyses included descriptive statistics, group comparisons, Spearman correlations, false-discovery-rate correction for exploratory coping-behaviour analyses and age- and gender-adjusted logistic regression. Results: Overall, 159 students (30.6%) had self-reported MHD history present, including 32 (6.2%) with a confirmed diagnosis and 127 (24.4%) with a subjectively perceived MHD without official confirmation. Exhaustion/disengagement scores negatively correlated with resilience and lifestyle scores, while resilience positively correlated with lifestyle scores (all p < 0.001). In adjusted logistic regression, higher resilience (OR = 0.539, 95% CI = 0.389–0.747, p < 0.001) and lifestyle scores (OR = 0.951, 95% CI = 0.929–0.974, p < 0.001) were associated with lower odds of self-reported MHD history being present. Conclusions: Self-reported MHD history was common among respondents and was associated with lower resilience, poorer lifestyle adherence and higher study-related exhaustion and disengagement symptoms. Because the outcome was heterogeneous and the design was cross-sectional, findings should be interpreted as associations rather than clinically verified prevalence estimates or causal effects.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070088

Authors: Sandra Pérez-Rodríguez Blanca Gallego-Hernández de Tejada María José Beneyto-Arrojo Xavier Sanz-Sendra

Background: Non-suicidal self-injury (NSSI) is highly prevalent during adolescence and is associated with a range of emotional, cognitive, and interpersonal vulnerabilities. Although prior research has identified key correlates such as emotion dysregulation, hopelessness, interpersonal distress, and attachment insecurity, these factors have largely been examined in isolation, limiting understanding of how they jointly contribute to NSSI. Methods: The present study examined the network structure of NSSI and associated vulnerability processes in a community sample of 2067 Spanish adolescents (M age = 14.62, SD = 1.80). A regularized partial correlation network (EBICglasso) was estimated, including NSSI frequency and functions, emotion dysregulation, hopelessness, perceived burdensomeness, thwarted belongingness, and attachment representations. Centrality and network stability were evaluated using standard indices and bootstrapping procedures. Results: The network revealed a differentiated structure of associations. Perceived burdensomeness and intrapersonal NSSI functions emerged as the most influential nodes, whereas emotion dysregulation occupied a key bridging position connecting attachment-related experiences, interpersonal vulnerability, and NSSI processes. In contrast, NSSI frequency and interpersonal functions showed a more peripheral role. Attachment security was negatively associated with core risk variables, consistent with a protective role within the network. Conclusions: Findings suggest that NSSI in adolescence is embedded within a system of interacting emotional and interpersonal processes, structured around the functional meaning of the behavior and key interpersonal appraisals. Emotion dysregulation emerged as a highly connected node linking multiple domains, while attachment was associated with several key variables within the network. These findings suggest potential targets for early identification and intervention, particularly focusing on emotion regulation, perceived burdensomeness, and intrapersonal functions of NSSI.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070087

Authors: Christian J. Wiedermann Verena Barbieri Giuliano Piccoliori Doris Hager von Prainsack Strobele

Adolescents growing up in multilingual regions experience diverse educational contexts that may shape their daily routines and psychosocial environments, but their independent relevance for mental health remains unclear. South Tyrol, with its parallel German-, Italian-, and Ladin-language school systems, provides a unique setting to examine these associations. This study assessed whether school language and home–school language mismatch are associated with mental health, psychosomatic symptoms, and health-related behaviors among adolescents. We analyzed data from a population-based survey of 2005 adolescents aged 11–19 years who provided self-reported information on mental health, psychosomatic complaints, school stress, social support, digital behaviors, lifestyle, and sleep. Multivariable regression analyses examined the independent association of home–school language mismatch with mental health outcomes, adjusting for sociodemographic and educational factors and further incorporating sleep-related behaviors. Mental health outcomes, psychosomatic symptoms, and most health-related behaviors showed little variation by school language, with generally small effect sizes. Home–school language mismatch was associated with slightly higher depressive symptom scores in unadjusted analyses but was not independently associated with mental health outcomes after adjustment. In contrast, weekly sleep problems emerged as the strongest correlate of depressive symptoms, accounting for a substantial proportion of explained variance. These findings indicate that adolescent mental health in this multilingual context is associated less with the language of schooling itself than with broader behavioral and developmental factors, highlighting sleep-related behaviors as a central and modifiable target for prevention.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16070086

Authors: Filipa Gomes Carol Coelho Daniela Fumega Bárbara C. Machado Sónia Gonçalves

Non-suicidal self-injury (NSSI) is a significant public health concern, with disproportionately higher prevalence among sexual and gender minority (SGM) populations compared to cisgender heterosexual individuals. While prior research has examined NSSI and related outcomes in SGM groups, evidence on specific risk and protective factors remains limited. This scoping review aimed to systematically map and synthesize risk and protective factors associated with NSSI in SGM populations. A systematic search was conducted in PubMed, Scopus, and Web of Science up to 2 February 2026. A total of 43 studies were included, the majority of which were conducted in the United States and employed cross-sectional designs. Data were charted and synthesized using a minority stress-informed socioecological framework. Findings indicate that NSSI is consistently associated with the co-occurrence of minority stress processes and intrapersonal vulnerabilities. Additional risk factors were identified across family, peer, and community domains. Protective factors were less frequently examined but included social support, family connectedness, school safety, and adaptive coping strategies. Overall, the findings suggest that NSSI among SGM populations is best understood as the result of interacting risk processes across multiple ecological levels. These results support a minority stress-informed, multi-level conceptualization of NSSI in SGM individuals and highlight the need for longitudinal research and greater focus on protective factors.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16060085

Authors: Velia Graciela Vera-Calmet Haydee Mercedes Aguilar-Armas Mabel Ysabel Otiniano León Marco Agustín Arbulú Ballesteros Lucy Angelica Yglesias-Alva Cristian Edgardo Alegría-Silva

Psychological empowerment is associated with women’s well-being, yet how it translates into life satisfaction in high-informality Latin American settings remains untested—as does whether empowerment must cross a threshold before any benefit appears. We tested mediation and moderation hypotheses as separate questions with 251 women aged 18–44 from three northern Peruvian regions using PLS-SEM with 5000 bootstrap resamples. Coping engagement fully mediated the empowerment–life satisfaction relationship (indirect β = 0.134, 95% CI [0.065, 0.213]; VAF = 87.6%; R2 [engagement] = 0.070, R2 [life satisfaction] = 0.285); the direct path was non-significant (β = 0.019, p = 0.754). Mediation and moderation were examined as separate analytical questions; the formal index of moderated mediation was non-significant, indicating that the indirect effect did not differ significantly across subgroups. In exploratory threshold analyses, empowerment predicted life satisfaction only above a normative cut-point anchored to the IMWE scoring manual (≥136; β = 0.382, p < 0.001); below it, the association was flat (β = 0.047, p = 0.547). This pattern is instrument-anchored rather than empirically derived and should be treated as hypothesis-generating pending replication with an independently optimized cut-point. Age moderated the engagement–satisfaction link (β = −0.239, p = 0.031), with stronger effects among younger women; motherhood amplified the negative impact of disengagement on satisfaction (β = −0.272, p = 0.021). Tentatively, programs that move participants only modestly along the empowerment continuum may under-deliver on well-being outcomes, though firm prescriptions require independent confirmation; tailored design for mothers and younger women is warranted.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16060084

Authors: Shimin Zhu Yuxi Hu Di Qi An Xi Shiyun Chen Ruobing Wang Paul Lee Paul Wai Ching Wong

Adolescent depression and anxiety are prevalent, yet brief and scalable parent–child digital interventions remain understudied. This study evaluated the effects of a digital parent–child single-session growth mindset intervention targeting beliefs about intelligence, failure, and emotion on adolescent internalizing of symptoms. In a three-arm waitlist cluster randomized controlled trial, 390 parent–child dyads from seven secondary schools in Hong Kong were assigned to a parent–child intervention group, a child-only intervention group, or a waitlist control group. Students were assessed at baseline, 2 weeks, and 3 months, and parents at baseline and 3 months. Cluster-adjusted generalized estimating equations were used for intention-to-treat analyses. A significant time-by-group interaction was observed for child-reported depression, whereas the interaction effects for other outcomes were non-significant. However, cluster-adjusted baseline differences across groups limited attribution of changes in depression to intervention effects. Relative to controls, the parent–child intervention descriptively showed short-term improvement in hopelessness and sustained gains in child-reported parent–child relationships over 3 months. Moderation analyses suggested clearer short-term benefits among adolescents with higher baseline symptoms and among girls. Overall, the PC-SMILE intervention in this study did not show statistically significant effect on reducing internalizing symptoms. Improvement on intervention design and implementation would benefit further refinement of brief, scalable parent–child digital interventions. Trial registration: ClinicalTrials.gov NCT05493865.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16060083

Authors: Ateret Gewirtz-Meydan Kimberly J. Mitchell Jennifer E. O’Brien Deirdre Colburn

Childhood family support is widely recognized as a protective factor for mental health, yet it remains unclear whether its buffering role is maintained under conditions of cumulative adversity. This study examined whether perceived childhood family support is associated with adult mental health distress and whether this association varies across levels of childhood adversity and victimization. Data were drawn from a convenience sample of 1571 adults in the United States who completed an online survey assessing childhood family support, adult mental health distress (PHQ-4), childhood victimization, non-victimization adversity, family substance use, and childhood social determinants of health (SDoH) hardship. Ordinary least squares regression models with interaction terms were used to test main and moderating effects. Greater perceived family support was associated with lower adult mental health distress (β = −0.23, p < 0.001). Childhood adversity (β = 0.11, p = 0.002) and childhood victimization (β = 0.13, p = 0.001) were independently associated with higher distress. Importantly, both adversity and victimization significantly moderated the association between family support and distress, such that the protective effect of family support weakened at higher levels of cumulative risk. Robustness analyses indicated that these patterns did not differ by family structure. These results suggest that while family support is beneficial, its protective effects are context-dependent and reduced under conditions of elevated risk. Overall, the findings highlight the importance of conceptualizing resilience as a multi-system process and underscore the need for interventions that address both relational and structural sources of adversity.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16060082

Authors: Emily Jo Noschese Alina Engelman Leah R. Oakes Lorne Farovitch

Deaf people experience significant barriers to education, healthcare, employment, and information access, resulting in inequities across a myriad of contexts. To better understand these disparities, our all-deaf research team conducted semi-structured interviews with deaf and hearing (parents, caregivers, and educators) adults across Ecuador, exploring how structural, institutional, and social factors influence daily life and well-being. Participants (n = 36) described systemic exclusion from education and employment, limited access to interpreters and assistive technologies, and constrained autonomy due to insufficient family support and institutional resources. These barriers compound health risks by restricting access to care, information, and social participation. Participants’ narratives highlighted how political and economic instability, institutional neglect, and discrimination create structural vulnerabilities that extend beyond individual-level factors. Findings underscore the importance of public health interventions that address structural and communicative inequities, including inclusive education, accessible health services, and community-based support, to improve health equity and quality of life for deaf populations in Ecuador.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16060081

Authors: Colin T. Henning Emily Storey-Hurtubise Yelnura N. Autalipova Samantha M. Van Rens Laura J. Summerfeldt James D. A. Parker

The present study examined the psychometric properties of a short form of the Emotional Quotient Inventory Youth Version (EQ-i:YV-S), a 30-item scale developed to be an efficient tool to assess trait emotional intelligence (TEI) in children and adolescents. The 4-factor model of TEI used to develop the measure (also used in the development of the original adult form) consists of intrapersonal, interpersonal, adaptability, and stress management dimensions. Confirmatory factor analysis showed acceptable fit in a large sample of youth and was invariant across gender and education level. The results also showed the EQ-i:YV-S scale to have good internal and 6-month test–retest reliabilities. Relationships between the TEI measure and alexithymia in older adolescents provide additional evidence of convergent validity. Overall, the results suggested that the EQ-i:YV-S is a valid and reliable short, multidimensional measure of core TEI dimensions in youth.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16060080

Authors: Vincenzo Caretti Eleonora Topino Andrea Fontana Gianluigi Di Cesare Clara Mucci Adriano Schimmenti Alessio Gori

The internal saboteur may be understood as a multidimensional configuration of maladaptive inner processes involving recurrent negative self-evaluation, distressing relational expectations, repetitive negative thinking, and self-undermining inner experiences. Within this framework, the present study aimed to develop and examine the psychometric properties of the Internal Saboteur Scale (ISS), a self-report measure designed to assess this construct. A sample of 328 Italian adults (women 71.6%; Mage = 37.37, SD = 14.88) completed the survey. Confirmatory factor analyses supported both an eight-factor correlational model and a theoretically meaningful higher-order model, in which the lower-order dimensions were grouped into four broader domains: Negative Relational Expectations (Expected Rejection; Expected Judgment), Self-Devaluation (Negative Self-Appraisal; Interpersonal Unworthiness), Rumination (Retrospective Rumination; Anticipatory Rumination), and Internal Destructiveness (Helplessness; Defensive Relational Withdrawal). Measurement invariance across gender was also supported. All dimensions showed satisfactory-to-good internal consistency. Furthermore, ISS scores were negatively associated with secure attachment, self-reassurance, and mentalizing and positively associated with insecure attachment, self-criticism, shame, and anger. Overall, the ISS appears to be a theoretically grounded and psychometrically promising instrument for the assessment of maladaptive inner dialogue and self-sabotaging internal processes. It may represent a useful tool for both research and clinical practice, particularly in supporting transdiagnostic assessment and case formulation.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16060079

Authors: Soraya Jaime-Jorge Cristina García-Ael Garazi Azanza Ana María Fernández-Fernández Gabriela Topa

This paper analyses associations between psychological health at work and life satisfaction among employees. Specifically, it investigates the association between work stress and emotional exhaustion and explores whether connectedness to nature and work engagement are involved in the indirect association between emotional exhaustion and life satisfaction. Structural Equation Modelling (SEM) was used to analyse data from a final sample of 1851 Spanish workers from diverse professional categories. These included technical and support professionals, administrative employees, middle managers, civil servants and healthcare professionals, unskilled workers, and other occupational groups. SEM analyses were conducted with 1850 valid cases due to one missing or invalid case in the SEM model. The results indicated that work stress was positively associated with emotional exhaustion, whereas emotional exhaustion was negatively associated with life satisfaction. Connectedness to nature and work engagement were involved in this indirect association: higher emotional exhaustion was associated with lower levels of connectedness to nature and work engagement, while higher levels of connectedness to nature and work engagement were associated with higher life satisfaction. The findings suggest that connectedness to nature and work engagement may be relevant psychological and work-related resources in this relationship.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16060078

Authors: Paweł Grygiel Sylwia Opozda-Suder Roman Dolata

Background: Loneliness and depression are interrelated constructs that significantly impact adolescents’ mental health. Understanding their interplay, particularly at the symptom level, is critical for developing effective interventions. Objective: To examine longitudinal relationships between loneliness and depressive symptoms during late childhood, aiming to identify symptom-level interactions and directional effects. Participants and Setting: A total of 4333 children (Mage = 11.06, SD = 0.73; 50.8% girls) from the NLSY79 Children and Young Adults survey participated, with data collected over two years. Methods: A cross-lagged panel network (CLPN) model was employed to analyze symptom-level associations between loneliness and depressive symptoms. This approach combines network analysis and cross-lagged panel modeling, allowing for the estimation of both autoregressive effects (stability of symptoms over time) and cross-lagged effects (directional relationships between symptoms across time points). Results: The longitudinal network suggests the following: (1) a reciprocal link between loneliness and both sadness and parental pressure; (2) a forward effect of loneliness on anxiety and being busy; (3) the loneliness-reducing effect of prior happiness and loneliness-increasing effect of boredom. Conclusions: The findings highlight the complex interplay between loneliness and depressive symptoms, emphasizing reciprocal and unidirectional effects at the symptom level. These insights underscore the need for targeted, symptom-focused interventions to address loneliness and its impact on adolescent mental health.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16060077

Authors: Verónica Estruch-García María Dolores Gil-Llario Encarnación Satorres

Background: Sexuality remains an important dimension of well-being in later life, yet it is often surrounded by misconceptions and ageist stereotypes. Understanding sociodemographic, cognitive, attitudinal, motivational, and behavioral aspects of sexuality among older adults may contribute to a more comprehensive view of sexual well-being in aging. Objectives: This study aimed (1) to describe older adults’ knowledge, attitudes, sexual motivation, behaviors, and satisfaction; (2) to examine differences between individuals who reported engaging in partnered eroto-genital activity during the previous six months and those who did not; and (3) to identify sociodemographic (age, gender, religiosity and health condition), cognitive, attitudinal, and motivational factors associated with engagement in partnered eroto-genital activity. Methods: A cross-sectional study was conducted with 186 adults aged 65–88 years (M = 73.29). Participants completed the Aging Sexual Knowledge and Attitudes Scale (ASKAS) and a Sexual Behavior Questionnaire assessing sexual motivation, sexual behaviors, and sexual satisfaction. Descriptive analyses, group comparisons, and hierarchical logistic regression analyses were performed. Results: Participants showed relatively adequate knowledge and generally favorable attitudes, although several misconceptions persisted. Affective behaviors were more frequent than eroto-genital practices. Individuals reporting partnered eroto-genital activity showed higher knowledge, more positive attitudes, greater perceived importance of sexuality, and higher sexual satisfaction. Regression analyses indicated that age, gender, attitudes toward sexuality, and perceived importance of sex were significant predictors of partnered eroto-genital activity, with perceived importance of sex showing the strongest association. Conclusions: Sexuality in later life reflects diverse patterns shaped by cognitive, attitudinal, and especially motivational dimensions. These findings highlight the central role of subjective importance and attitudes in sexual engagement, suggesting that interventions may benefit from moving beyond information provision to also address motivational and relational aspects of sexuality in aging populations.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16060076

Authors: Lucía Quinde Victor López-Guerra Sandra Guevara-Mora

This study examined the mediating role of negative stress in the relationship between Psychological Capital (PsyCap) and psychological distress indicators among Ecuadorian university students. PsyCap was conceptualized as a higher-order construct composed of hope, self-efficacy, resilience, and optimism. A cross-sectional study was conducted with 1732 university students (55% women; M = 20.44, SD = 2.29) from three Ecuadorian universities using validated self-report measures. Structural equation modeling supported the proposed mediational model and demonstrated an adequate fit to the data, χ2(367) = 1732, p < 0.001, CFI = 0.972, TLI = 0.969, RMSEA = 0.061 (90% CI [0.058, 0.063]), and SRMR = 0.041. PsyCap showed a significant negative association with negative stress (β = −0.311, p < 0.001). In turn, negative stress was positively associated with anxiety–depression symptoms (β = 0.785, p < 0.001) and psychological inflexibility (β = 0.774, p < 0.001). Mediation analyses revealed significant indirect effects of PsyCap on anxiety–depression (β = −0.244, p < 0.001) and psychological inflexibility (β = −0.241, p < 0.001) through negative stress. Direct effects remained significant but smaller in magnitude (β = −0.131 and β = −0.107, respectively), supporting a partial mediation model. The model explained 69.7% of the variance in anxiety–depression and 66.3% of the variance in psychological inflexibility. These findings suggest that PsyCap functions primarily as a protective psychological resource through its capacity to reduce maladaptive stress responses, which subsequently influence broader transdiagnostic indicators of psychological distress. The study highlights the relevance of integrating strengths-based approaches and stress-reduction strategies in university mental health interventions. Furthermore, it provides empirical evidence from a Latin American context, contributing to the understanding of mechanisms linking positive psychological resources and mental health among university students.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16060075

Authors: Waleed El-Sayed Mohammed Hemaida Ekram Mohammed Gomaa Geenedy Mohamed Sayed Abdellatif Mohamed Ali Nemt-allah

Despite growing recognition that nurses must be equipped with sustainability competencies to address climate-related health challenges, the psychological mechanisms through which nursing education fosters sustainability attitudes are not yet fully understood. This study examined the mediating role of clinical performance self-efficacy in the relationship between simulation-based learning quality and sustainability attitudes among undergraduate nursing students. A cross-sectional correlational design was employed with a main sample of 679 nursing students from four Egyptian universities. Data were collected using the CHEST, SECP Scale, and SANS_2. Mediation analysis used Hayes’ PROCESS macro with 5000 bootstrap resamples. Simulation-based learning quality significantly predicted both self-efficacy (β* = 0.772) and sustainability attitudes (β* = 0.613). Self-efficacy partially mediated this relationship, accounting for 68.34% of the total effect (indirect β* = 0.419, Boot 95% CI [0.343, 0.494]). Nursing educators should design simulation curricula that deliberately cultivate self-efficacy while embedding sustainability content, producing clinically competent and environmentally responsible graduates.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16060074

Authors: Naomi Odira Owuor Bettina F. Piko

Mental well-being has been considered a fundamental contributor to overall academic success and psychological stability. Based on the Transactional Theory of Stress and Coping, this study examined the mediating role of academic resilience in the relationship between perceived academic support and mental well-being of Kenyan TVET trainees. A quantitative cross-sectional design was employed, with a sample of 1933 trainees (Mage = 22.87 years; 57.7% male) from 239 public TVET institutions in Kenya. The following measures were administered: Perceived Academic Support Questionnaire, Academic Resilience Scale, and the Short Warwick–Edinburgh Mental Well-Being Scale. Correlation analysis demonstrated that perceived academic support showed a strong positive association with mental well-being, whereas academic resilience indicated a moderate association. Consistent with the hypothesized model, parallel mediation analysis indicated that academic resilience partially mediated the relationship between academic support and mental well-being. The indirect effects observed across resilience dimensions indicated that emotional response was the dominant mediating pathway, while perseverance showed a small positive indirect effect, and adaptive help-seeking demonstrated a small but significant negative indirect effect. These findings contribute to the growing but limited literature on well-being in vocational training and suggest that while academic resilience serves as a key mediating mechanism, perceived academic support may also function as a direct protective factor, underscoring the importance of embedding structured emotional coping support within TVET academic environments.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16060073

Authors: Shan Chen Penkarn Kanjanarat Tinakon Wongpakaran Danny Wedding

Parental divorce, as an adverse childhood experience, may disrupt family systems and exert enduring effects on psychological development, with impacts becoming particularly salient during emerging adulthood, a stage characterized by identity exploration and increasing autonomy. Within the Thai cultural context, inner strengths grounded in Buddhist values may serve as important resources for resilience. This study examined associations between inner strength dimensions derived from the Ten Perfections (Pāramīs) and resilience among emerging adults who experienced parental divorce in childhood. A cross-sectional design was employed with 160 Thai participants aged 20 to 29 years, who completed the Inner Strength-Based Inventory (I-SBI) and the Resilience Inventory (RI-9). Correlation analysis indicated that equanimity, determination, perseverance, wisdom, meditation, and loving-kindness were positively correlated with resilience. Multiple regression analysis showed that equanimity (β = 0.312, p < 0.001), determination (β = 0.227, p < 0.01) and loving-kindness (β = 0.213, p < 0.01) were significantly associated with resilience. These findings suggest that culturally embedded inner strengths are associated with resilience in a non-Western context. More specifically, among the ten dimensions examined, equanimity, determination, and loving-kindness emerged as being significantly associated with resilience in Thai emerging adults with childhood parental divorce experiences.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16060072

Authors: Giordano Mayer De Freitas Guilherme Teixeira Lopes Graziele Borges Bueno Mariana Lentino Coelho Julia Gomes Caroline Leffa Venturini Maria Eduarda Louzada Sara Machado Peres Barbara Regina França Iraci L. S. Torres Pham Felipe Fregni Andrea Cristiane Janz Moreira Wolnei Caumo

Background: Work disability in fibromyalgia is only partially explained by symptom severity, suggesting a relevant contribution of cognitive–behavioral mechanisms. Objective: This study aimed to determine whether kinesiophobia is associated with fibromyalgia impact and work-related disability and to assess whether pain catastrophizing mediates these relationships within a hierarchical biopsychosocial framework. Methods: This cross-sectional study included 2096 women with fibromyalgia recruited through a nationwide online survey. Participants completed validated instruments assessing fibromyalgia impact (FIQ), pain catastrophizing (PCS), depressive symptoms (PHQ-9), central sensitization (CSI), and kinesiophobia (Tampa Scale). Pain-related work disability was defined using the Graded Chronic Pain Scale–Revised (GCPS-R). Hierarchical logistic regression models identified factors independently associated with work disability. Mediation was tested using bootstrapped analyses (5000 resamples). Results: Kinesiophobia demonstrated a robust independent association with work disability (OR 1.03; 95% CI 1.02–1.05) after adjustment for sociodemographic factors, clinical pain phenotype, systemic burden, pain severity, psychocognitive load, and medication burden. Other relevant contributors included pain severity (OR 1.96; 95% CI 1.70–2.27), psychocognitive burden (OR 1.35; 95% CI 1.15–1.58), use of benzodiazepines (OR 1.74; 95% CI 1.33–2.28), and opioid use (OR 1.29; 95% CI 1.06–1.56). Mediation analysis indicated a significant indirect effect of kinesiophobia on work disability through pain catastrophizing (β = 0.131; 95% CI 0.078–0.188). Conclusions: Kinesiophobia is a proximal determinant of work disability in fibromyalgia, exerting direct and cognitively mediated effects through pain catastrophizing, reinforcing the fear-avoidance framework and the need for psychologically informed rehabilitation.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16050071

Authors: Olivia Bruce Wan H. Sim Aspasia Stacey Rabba Anthony F. Jorm Elizabeth Nicolaou Ling Wu Marie B. H. Yap

Depression and clinical anxiety (also known as ‘internalising disorders’) are commonly experienced by autistic children. Parents play an important role in reducing their child’s risk of developing internalising disorders, and existing technology-assisted parenting programs have shown promise in empowering parents in this role. Yet, existing interventions do not currently meet the unique needs of parents of autistic children. This study aimed to co-design adaptations to an existing technology-assisted parenting program (Partners in Parenting Kids) to enhance its relevance and acceptability for parents of school-aged autistic children. An iterative two-phase co-design study was conducted with parents of autistic children (n = 5) and service providers (n = 5). In Phase 1, semi-structured interviews explored participant experiences and needs in the context of parenting support, as well as perspectives on parenting programs. In Phase 2, eight co-design workshops were conducted with parents and service providers to build on the findings from Phase 1 and to collaboratively adapt the program content, delivery, and design features. Workshops involved participatory design activities to foster collaborative sharing of ideas and decision-making. Transcripts from both phases were analysed using reflexive thematic analysis. Themes identified in Phase 1 included: (1) Day-to-day challenges of parenting an autistic child; (2) Unique parent knowledge base and skill set; and (3) Desired qualities of parenting programs. Themes from Phase 2 of the study included: (1) Meaningful connections with others in the community; (2) Acceptance of autism; and (3) Diversity within the community. These themes are described in terms of their design implications for the resultant parenting program (Partners in Parenting Kids-Autism). The findings provide critical insights into desired qualities of parenting programs for parents of autistic children. Importantly, they also shed light on key design recommendations for future work focused on empowering parents to support their child’s mental health through interventions.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16050070

Authors: María J. Navas-Martínez Lourdes Contreras Nazaret Bautista-Aranda M. Carmen Cano-Lozano

Background: The aim of this study was to examine the pattern of child-to-parent violence (CPV) across a broad age range, from early adolescence to late emerging adulthood. Specifically, the objectives were to analyze the linear and quadratic relationships between CPV types (psychological, physical, financial, and control/domain behaviors) and age, as well as to examine the interaction of sex within this relationship. Methods: A total of 1959 adolescents (13–17 years) and 1046 young adults (18–25 years) completed, respectively, the adolescent and young adult versions of the Child-to-Parent Violence Questionnaire (CPV-Q). Results: Age was curvilinearly associated with psychological CPV (increasing until approximately age 19 and then decreasing), positively linearly associated with financial CPV (increasing with age), and negatively linearly associated with control/domain behaviors (decreasing with age). No significant association was found between age and physical CPV. Furthermore, boys and girls showed different age-related patterns in some CPV types. Conclusions: These findings suggest that CPV does not disappear after adolescence, and that the pattern is not uniform throughout development nor the same for boys and girls. The results (1) underscore the importance of studying CPV considering developmental stage, sex, and the specific CPV types, and (2) may contribute to facilitate the early detection of CPV, anticipating changes in violence patterns, and guiding prevention strategies tailored to each developmental stage.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16050069

Authors: Christian Scholtes Petru Lucian Curșeu Sabina Ramona Trif

This systematic literature review synthesizes and integrates research on dysfunctional cognition (DC) in organizational settings, addressing the lack of a coherent model explaining how cognitive vulnerabilities shape work-related outcomes. Following the PRISMA guidelines, we analyzed 41 manuscripts (selected from more than 4523 initial and secondary search hits), leading to an integrative model of DC at work. Results show that DC is activated by job demands, alongside other demanding situational and contextual features. The model specifies maladaptive appraisal processes as the cognitive–affective mechanism through which DC shapes (dis)engagement in the task and relational domains at work and ultimately impacts outcomes such as well-being, stress, burnout, performance, and decision quality. It further incorporates job, personal, and social resources as buffering contingencies that promote adaptive appraisal and attenuate the detrimental role of DC. By integrating insights from clinical, cognitive–behavioral and organizational research, this review advances theory in three ways: (1) by emphasizing the role of appraisal as the cognitive–affective mechanism linking DC to work (dis)engagement, (2) by embedding DC in the job demands–resources model and identifying job demands as activating conditions and resources as regulatory factors for dysfunctional cognitive dynamics at work and (3) by differentiating between task and interpersonal (dis)engagement as domain-specific paths through which self-focused and relational schema impact work-related outcomes. The integrative DC model provides a foundation for future research using longitudinal and mixed-method designs, and for more fine-grained examinations of how specific forms of DC relate to distinct cognitive–affective pathways and work-related outcomes, while offering practical implications for developing schema-informed and resource-based interventions in organizations.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16050068

Authors: Peipei Wang Yanan Li Xu Cheng Hong Xie Huanxian Huang Jun Yang Yangwei Chen Alex Pak Ki Kwok Jiacheng Chen

Relapse in substance use disorders remains a persistent clinical challenge. Identity reconstruction, the psychological transition from an internalized “addict” identity to a recovery-oriented self, may be a core coping mechanism for abstinence maintenance. This exploratory pilot stratified randomized controlled trial examined the feasibility and preliminary effects of a Narrative Therapy (NT) group intervention, delivered within an evidence-based practice framework. Forty-five male residents of a closed rehabilitation facility were randomly assigned (n = 15 each) to an 8-week NT intervention, standard psychoeducation (TAU), or waitlist control (WLC). The Self-Identity Scale and an abbreviated four-item Stimulant Relapse Risk Scale served as outcomes. The Self-Concept Clarity Scale assessed a candidate process variable. A 3 (group) × 3 (time) repeated-measure ANOVA showed significant group × time interactions for self-identity (F = 64.215, p < 0.001, and η2p = 0.754) and relapse-risk indicators (F = 62.131, p < 0.001, and η2p = 0.747). For self-identity, only the NT group showed significant within-group gains. For relapse-risk indicators, NT scores were significantly lower than both control groups at post-test and follow-up (all pairwise p ≤ 0.008), with these reductions maintained at two-month follow-up. Within-group self-concept clarity gains emerged for NT, though between-group differences were nonsignificant. Because the study was conducted in a custodial setting, the relapse-risk findings reflect psychological vulnerability rather than observed behavior. Larger adequately powered trials are needed.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16050067

Authors: Mostafa Aboulnour Salem

Excessive gaming (EG) is increasingly recognised as a modifiable behavioural risk among youth, with potential implications for mental health and well-being in digitally mediated environments. This study examines excessive gaming as a behavioural exposure and AI cyber-shielding (AI-CS) as a perceived digital protective factor among Generation Z university gamers. AI-CS is conceptualised as users’ perceived exposure to AI-enabled safety mechanisms embedded in gaming-related digital environments. The study investigates the associations of EG and AI-CS with four psychological outcomes: depressive symptoms (DEP), anxiety symptoms (ANX), hostile behaviours (HB), and personal well-being (PWB). Data were collected through a cross-sectional online survey of 983 university students aged 18 to 22 years from multicultural Middle Eastern backgrounds enrolled in Saudi universities. The sample included 54.2% males and 45.8% females. The proposed relationships were analysed using Partial Least Squares Structural Equation Modelling (PLS-SEM). The results show that excessive gaming is positively associated with depressive and anxiety symptoms and negatively associated with personal well-being. No significant association was found between excessive gaming and hostile behaviours. AI cyber-shielding is negatively associated with depressive and anxiety symptoms and positively associated with personal well-being, but it does not significantly predict hostile behaviours. These findings indicate that excessive gaming is primarily associated with internal psychological outcomes rather than external behavioural responses. They also suggest that perceived AI-enabled safety affordances in gaming-related digital environments are associated with lower psychological distress and higher well-being. The study contributes to research on digital well-being by introducing and empirically examining AI cyber-shielding as a perception-based environmental factor associated with psychological functioning among university students.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16050066

Authors: Pablo J. Marcos-Pardo Adrián Mateo-Orcajada Rodrigo Gomes de Souza Vale Raquel Vaquero-Cristóbal

Growing urbanization has significantly contributed to the global burden of cardiovascular and musculoskeletal diseases. Green exercise, defined as structured physical activity in natural environments, has emerged as a potential intervention to address these health outcomes. This scoping review aims to synthesize the current scientific evidence on the cardiovascular and musculoskeletal benefits of green exercise among middle-aged (35–64 years) and older adults (≥65 years), examining potential mechanisms, intervention characteristics, and practical implications. A systematic search was conducted across PubMed, Web of Science, Scopus, and Google Scholar databases. Methodological quality was assessed to contextualize the strength of the findings. The available evidence suggests potential cardiovascular benefits, particularly in blood pressure regulation and heart rate variability, supported by both high and moderate-quality studies. Regarding musculoskeletal health, high-quality evidence appears to show improvements in muscle strength, lean mass and functional capacity, as well as reductions in fat mass. While green exercise appears to offer additional psychophysiological advantages over indoor exercise, results remain mixed regarding the clinical superiority of natural versus urban outdoor settings. Notably, significant benefits were observed across diverse frequencies and durations, suggesting that a strictly optimal dose–response remains elusive due to study heterogeneity. Consequently, green exercise appears to be a promising, evidence-informed strategy for healthy aging. While it is associated with improvements in cardiovascular and musculoskeletal health, its added value over traditional settings should be viewed as a complementary factor for adherence. Future research should prioritize high-quality mechanistic trials and standardized protocols to refine clinical prescriptions.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16050065

Authors: Ainhoa Coloma-Carmona Cristina J. Valdivia Blanco José Luis Carballo Antonia Pelegrín-Muñoz

Gambling self-efficacy is a key construct in understanding gambling behavior and behavior change. This study examined (i) differences between individuals with low and high gambling self-efficacy and (ii) tested whether gambling self-efficacy moderated the associations between impulsivity, gambling-related cognitive distortions, and problem gambling severity. Data were drawn from a cross-sectional web-based survey of 1429 Spanish adults aged 18–64. Analyses focused on the 921 who had engaged in gambling activities during the previous 12 months (mean age = 40 years, SD = 12.1, 52.2% men). Measures included sociodemographic characteristics, gambling self-efficacy (BSCQ-G), problem gambling severity (PGSI), impulsivity (UPPS-P), gambling-related cognitive distortions (Labrador’s cognitive distortion scale), and gambling involvement indicators. Participants were classified into low (BSCQ-G < 80%; 51.5%; n = 474) and high (BSCQ-G ≥ 80%; 48.5%; n = 447) gambling self-efficacy groups. Individuals with low self-efficacy showed broader and more intensive gambling involvement, including greater participation in gambling-like activities, and higher scores on PGSI, impulsivity, and gambling-related cognitive distortions. In moderation models adjusted for gambling involvement indicators, the association between impulsivity and PGSI was weaker at higher levels of gambling self-efficacy, although the incremental variance explained was very small (ΔR2 = 0.0024). The interaction between gambling self-efficacy and cognitive distortions was not statistically supported. These findings suggest that gambling self-efficacy is associated with gambling risk profiles among adults who gamble and may play a modest buffering role in the association between impulsivity and gambling severity.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16050064

Authors: Georgiana Bogos Octav-Sorin Candel Ana Tiperciuc Magdalena Iorga

Background: Dissociation is associated with multiple psychiatric disorders and mental health issues. However, there are some limitations in the existing studies, such as the predominant use of clinical samples and the lack of focus on potential mediators that can explain this relationship. Among the latter, an unclear self-concept may serve as a risk factor for many psychological disturbances, while a well-established self-concept may be a resilience factor. This study aimed to examine the gender differences among the variables, to test whether dissociative experiences are associated with psychopathological symptoms in a non-clinical sample, and to explore the mediating role of self-concept clarity. Materials and methods: 257 participants (Mage = 23.92 ± 7.33, 69.6% females) were included in the research. The Symptoms Checklist-90, The Dissociative Experiences Scale, and The Self-Concept Clarity Scale were used. Results: Women scored higher on somatization (Mwomen = 1.28, SD = 0.86) than men (Mmen = 0.93, SD = 0.70), t(255) = 3.47, p = 0.001, d = 0.42. Moreover, women had a higher level of depression (Mwomen = 1.37, SD = 0.96) compared to men (Mmen = 0.98, SD = 0.77), t(255) = 3.49, p = 0.001, d = 0.43. Dissociative experiences were positively associated with psychopathological symptoms (r = 0.69, p < 0.01). Self-concept clarity mediated this relationship (β = 0.21, SE = 0.04, 95% CI [0.13, 0.30]). Conclusions: The findings showed gender differences regarding psychopathological symptoms and highlighted the importance of self-concept clarity in reducing the risk of developing them.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16050063

Authors: Getachew Tassew Woreta Girum Tareke Zewude

Background: In an era characterized by rapid technological disruption and vocational uncertainty, Career Adaptability (CA) has emerged as a critical meta-competency for university students transitioning into the workforce. While the importance of CA is well-documented, the internal mechanisms that foster it remain under-explored. This research adopts a resource-based perspective to investigate how Mindfulness—a state of non-judgmental present-moment awareness—acts as a catalyst for career readiness. Specifically, this study examines a dual-mediation model, proposing that Mindfulness enhances Emotional Intelligence (EI) and Psychological Capital (PsyCap) (comprising hope, efficacy, resilience, and optimism), which in turn bolsters an individual’s capacity to adapt to changing career landscapes. By integrating these four constructs, the study provides a comprehensive framework for understanding how “being present” (Mindfulness) translates into “being prepared” (Career Adaptability) through the cultivation of emotional and psychological resources. Methods: The study collected data from 705 final-year students at Wollo University (male = 399 and female = 306). The study employed several well-established instruments: the Compound Psychological Capital Scale (CPC), the Five Facet Mindfulness Questionnaire (FFMQ), the Wong and Law Emotional Intelligence Scale (WLIES), and the Career Adapt-Abilities Scale (CAAS). These instruments were rigorously evaluated for their psychometric applicability within the Ethiopian context. Results: PLS-SEM analysis revealed: (a) direct and positive influences of mindfulness, PsyCap, and EI on career adaptability; (b) partial and positive mediation effects of PsyCap and EI in the mindfulness-career adaptability link; (c) a serial mediation effect of mindfulness through PsyCap and EI; and (d) the proposed model explained a substantial amount of variance in university students’ career adaptability. Conclusions: Despite its strengths, the study acknowledged certain limitations and discussed potential implications for enhancing career adaptability, highlighting the benefits of cultivating mindfulness.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16050062

Authors: María-Dolores Cárcel-López Mercedes Ferrando-Prieto

Sensory alterations affect 90% of individuals with autism and have been recognized in the DSM-5 as a diagnostic criterion. These alterations often exacerbate emotional stress and may increase levels of anxiety, impacting everyday life activities. The general objective of this work is to assess the changes before and after a multisensory stimulation program aimed at improving sensory processing, repetitive behaviors, and adaptation to the environment in a sample of students with ASD. Twenty-seven schoolchildren participated (M = 10.04, SD = 4.24), with different levels of impairment, diagnosed by specialized teams. The design included a pretest and post-test condition. The results highlight significant improvements in the assessed areas. The Sensory Profile-2, the Bodfish Repetitive Behavior Scale, and the Vineland Scale were administered. The results suggest that changes may be conditioned by the student profile. The profiles that benefited the most in terms of sensory profile and repetitive behaviors were students with levels 1 and 3; meanwhile, students with level 2 did not show improvements in these areas but did show gains in overall adaptation, as measured by the Vineland Scale.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16050061

Authors: Laura Petitta Lixin Jiang

While the literature acknowledges the importance of emotion management for effective leadership, no leadership theory embeds the management of contextual emotions that involuntarily spread among multiple workplace stakeholders (i.e., holistic emotional contagion) and are jointly intertwined with leaders’ actions. The present research aimed to: (1) include emotional contagion into leadership theorizing and assess the cross-country validity of the accompanying measure (Leader Awareness of Holistic Contagion Scale; LAHCS), and (2) examine the LAHCS’ convergent, discriminant and nomological/criterion validity. Data (Study 1) from 1454 Italian employees supported the LAHCS construct and convergent validity with multiple leadership scales and discriminant validity against group-member-prototypicality. Data (Study 2) from the U.S. (N = 400) and Italy (N = 186) supported measurement invariance. SEM model results suggest that leaders’ awareness of holistic contagion and their orientation to manage contagion are associated with higher followers’ commitment and leadership satisfaction. Interestingly, the leader’s engagement in active exploration of contagion exchanges and their awareness of the leader–follower emotional distance is associated with followers’ higher burnout, lower commitment and leadership dissatisfaction. In conclusion, our cross-country findings support the LAHCS validity and reveal that leaders who are aware of workplace emotional traffic are appreciated. Notably, if they attempt to actively explore this traffic or are aware of followers’ emotional distance, then the situation becomes likely intrusive and uncomfortable, resulting in followers’ dissatisfaction, poor commitment and distress. For scholars and practitioners alike, our findings provide a leadership conceptual framework, including emotional contagion as a springboard to the understanding of some apparently inconvenient truths about emotions and leadership.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16050060

Authors: Liyan Ji Pengjin Yang Song Zhou Ruiyi Huang Huimin Ma Xiaoman Rong Sai Zhang

Using a sample of Chinese junior high school students (N = 1133), this study examined the latent heterogeneity and structural characteristics of mobile phone addiction risk. Latent profile analysis was conducted to identify subgroups with varying levels of risk. Network analysis was then used to model the relationships among smartphone addiction, materialism, and childhood neglect and compare structural differences across subgroups. Finally, five machine learning models were applied to model smartphone addiction scores and compare model performance across different combinations of variables. Results revealed three distinct risk groups of smartphone addiction. Network analysis indicated that loneliness-related nodes exhibited the highest expected influence in the overall network. Across latent profiles, childhood neglect-related nodes consistently occupied central positions, whereas materialism-related nodes showed relatively stable centrality. Network comparison tests further demonstrated significant structural differences across risk groups. In addition, incorporating latent profile information and centrality indices improved model performance, suggesting that these features capture individual differences in smartphone addiction. These findings provide structural evidence for the heterogeneity of mobile phone addiction risk and offer implications for subgroup-specific intervention strategies.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16050059

Authors: Sijun Chen Aqeel Khan Mohd Rustam Mohd Rameli

Background: Suicide among emerging adults has become a significant global public health concern. Suicidal ideation is the prerequisite for suicide, and social support is recognized as a key protective factor against suicidal ideation. However, the relationship between the strength and consistency of social support and suicidal ideation among undergraduate students remains unclear. This study synthesized empirical studies to quantify the relationship between social support and suicidal ideation among undergraduate students and determine the different correlations between various sources of social support and suicidal ideation. Methods: A systematic review and meta-analysis was conducted following PRISMA 2020 guidelines. Five electronic databases (Web of Science, Scopus, PubMed, ProQuest, and ScienceDirect) were searched for studies published from 2016 to 2025. Eligible studies reported quantitative associations between social support and suicidal ideation among undergraduate students. Correlation coefficients were transformed using Fisher’s z and pooled using a random-effects model. Heterogeneity was evaluated using Cochran’s Q and I2 statistics. Risk of bias assessments, moderator analysis, sensitivity analysis, subgroup analysis, and publication bias assessments were conducted. Results: Fifteen studies with sixteen independent effect sizes and more than 26,000 participants were included. The meta-analysis showed a moderate negative association between social support and suicidal ideation (pooled r = −0.33, 95% CI [−0.40, −0.25]) under a random-effects model. A high heterogeneity was observed among studies (I2 = 97%, p < 0.001). There are no studies classified as having a high risk of bias. The standardized sample size demonstrated a significant moderating effect (β = 0.2568, p = 0.0022). Sensitivity analysis confirmed the stability of the pooled effect. Subgroup analysis indicated that the strength of the association between social support and suicidal ideation did not differ significantly between Asian and non-Asian studies. No significant publication bias was detected (Egger’s p = 0.19). Narrative synthesis further suggested that family support showed the most consistent protective association compared with friends’ support and support from others. Conclusions: Social support is moderately and consistently associated with reduced suicidal ideation among undergraduate students. These findings highlight social connectedness, particularly family support, as a central interpersonal protective factor and strengthen social support’s role in university suicide prevention initiatives.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16050058

Authors: Claudia Venuleo Serena Miccoli Alessia Petrachi Tiziana Marinaci

Research on how patients and family carers experience their relationships with physicians and healthcare staff is limited, particularly regarding the gap between ideal expectations and actual care. This study explored patients’ and carers’ perceptions of the ideal care relationship, their lived experiences, and factors shaping discrepancies between expectations and reality. A total of 143 individual, face-to-face semi-structured interviews (mean age = 56.7 ± 13.2; 61.4% women) were conducted with 57 cancer patients and 86 family carers in outpatient oncology clinics in Southern Italy. Participants were recruited through purposive sampling and interviewed separately, with carers recruited as an independent group. Transcripts were analysed using Thematic Analysis of Elementary Contexts (TAEC), a mixed-methods approach combining qualitative and quantitative techniques. Methodological rigor and trustworthiness were ensured in line with COREQ reporting guidelines. Four thematic clusters emerged: “Variability in the experience,” “The ideal care relationship,” “Waiting times and delays in care,” and “The luck of being cared for by a good physician.” Oncology care experiences emerge as inherently ambivalent: supportive in interactions with clinicians, yet tension-laden due to systemic and organizational constraints. These findings suggest that strengthening patient- and family-centered care requires both relational improvements and organizational interventions aimed at reducing waiting times, enhancing care integration across fragmented pathways, and improving continuity of care.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16050057

Authors: Julia S. Malmborg Petra Svedberg Jens Nygren Håkan Jarbin Ingrid Larsson

Background: Parents of children with attention-deficit/hyperactivity disorder (ADHD) and sleep problems can experience challenges and negative health effects. The aim of this study was to explore parents’ own health-related experiences as their child with ADHD and sleep problems underwent a sleep intervention with a weighted blanket. Methods: A convergent mixed methods design was undertaken. Sociodemographic and questionnaire data were collected from 68 parents at baseline and at the 16-week follow-up. Paired-samples t-tests were used to analyze the data. An inductive qualitative content analysis was used to analyze interviews with 21 parents after the follow-up. An integrative analysis was performed and assessed for confirmation, expansion, or disconfirmation. Results: At the follow-up, parents reported improvements in their own health status (EQ-5D-3L—index 0.83 ± 0.15 vs. 0.87 ± 0.13; p = 0.034), in well-being (Outcome Rating Scale—individual 7.08 ± 2.22 vs. 7.55 ± 1.82; p = 0.045), and in family life (the Brief Child and Family Phone Interview—family comfort score 5.62 ± 1.62 vs. 5.14 ± 1.66; p = 0.003). Parents’ health-related experiences were described as: (1) having a sense of well-being, including being well rested, sustaining energy, reaching a state of calm, and finding hope, (2) balancing family life, including reclaiming personal sphere and nurturing relationships, and (3) managing everyday life, including keeping to the daily schedule and dealing with household chores. The integrative analysis resulted in the overarching themes of health through: (1) inner strength (confirmed), (2) recovery (expanded), (3) close relationships (confirmed), and (4) social engagements (expanded). Conclusions: The findings suggest that sleep interventions for children with ADHD and sleep problems may also be associated with positive changes in aspects of parents’ health, well-being, and family life.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16040056

Authors: Sagrario Gómez-Cantarino Henrique Ciabotti Elias Miriam Hermida-Mota Pablo Pando Cerra Deisa Salyse dos Reis Cabral Semedo Ana Suzete Baessa Moniz Sonsoles Hernández-Iglesias Ana Maria Aguiar Frias Tuğba Erdem Maria da Conceição Fernandes Santiago Inmaculada García-Valdivieso Amelia Marina Morillas Bulnes Jahit Sacarlal Renata Karina Reis

Pediatric pain remains a highly prevalent and under-addressed health problem worldwide, largely due to educational gaps, limited humanization of care, and insufficient integration of digital and pedagogical innovations in higher education, and the purpose of this study is to describe and implement an international, higher education–driven model to improve training in humanized pediatric pain management. This multicenter mixed-methods study involves 15 universities from Europe, Africa, and Latin America and includes the development and cross-cultural validation of the HUPEDCARE-Q questionnaire to identify knowledge gaps, the design of an open-access, multilingual digital learning platform (PEDCARE) that integrates learning management and social networking functions, and the implementation of capacity-building workshops based on a training-the-trainers model for students, educators, health professionals, and families. The expected outcomes of the project include the establishment of a standardized instrument for assessing educational needs, the creation of a scalable digital educational environment, and the feasibility of international academic collaboration to strengthen competencies in pediatric pain care. The study suggests that higher education, combined with digital transformation and culturally sensitive approaches, may support the humanization of pediatric pain management and address educational and health inequities, although further research is needed to confirm these potential impacts.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16040055

Authors: Lucía Poladura Elena Blanco Ellián Tuero Celestino Rodríguez José Carlos Núñez

This structured narrative review aimed to synthesize the findings of various studies to determine the efficacy of Self-Regulated Learning (SRL) training programs for in-service and pre-service teachers on their knowledge and skills, and to evaluate the transfer to teaching practice and student outcomes. Following PRISMA guidelines, a search was conducted across Web of Science, Scopus, and PsycInfo, ultimately including 30 intervention studies. The results confirmed that professional development is effective in enhancing teachers’ knowledge, skills, and beliefs related to SRL. However, due to wide methodological diversity, the review identified varied intervention factors showing promise, but a unified association between sample type (in-service vs. pre-service) and overall impact was unattainable. While SRL training successfully improves teacher competency, the limited evaluation of student performance or long-term effects prevents the definitive claim that the training reliably changes teaching practice toward a more self-regulated approach. Future research should prioritize robust longitudinal designs and include student-level measures.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16040054

Authors: Philippos Zdoupas

Gender differences in the prevalence of psychosocial problems during adolescence are well established, with girls reporting higher internalizing symptoms and boys higher externalizing symptoms. However, it remains unclear whether these differences extend beyond symptom levels to the structural organization linking psychosocial problems and school well-being (SWB). The present study examined gender-specific network structures comprising internalizing symptoms, externalizing symptoms, and six dimensions of SWB in a sample of 949 secondary school students in Germany (Grades 8–10; 50.6% boys, 49.4% girls). Partial correlation networks were estimated separately for boys and girls using EBIC-regularized graphical models, followed by network comparison tests and centrality analyses. Results indicated no significant differences in global strength, network structure, or individual edges between genders, suggesting a largely shared network structure. Across both networks, internalizing symptoms, particularly symptoms of anxiety and depression, emerged as central and bridging nodes connecting psychosocial problems with multiple dimensions of SWB. Externalizing symptoms showed minor descriptive differences in prominence but did not alter the overall structural pattern. These findings indicate that gender differences in adolescent mental health may reflect differences in symptom intensity rather than fundamentally distinct psychosocial systems, suggesting common structural patterns underlying SWB across gender.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16040053

Authors: Emadeldin M. Elsokkary Abd elmureed Abd elgaber Kaseem Abdulrahman Suliman Alnamlah

Objective: This study examined psychological resilience (PR) as a potential moderator and mediator of the association between borderline personality symptoms (BPS) and suicidal ideation (SI) among university students. Method: A cross-sectional design was used with (N = 257) university students. Moderation and mediation were tested in separate, theory-guided models using the PROCESS macro for SPSS, version 28. The moderation model (Model 1) and the mediation model (Model 4) were estimated with heteroskedasticity-consistent standard errors (HC3). In the adjusted analyses, sex, age, previous psychological consultation, previous psychotropic medication use, and family history of mental illness were entered as covariates. The indirect effect was evaluated using percentile bootstrap confidence intervals based on (5000) resamples. Results: BPS was positively correlated with SI, whereas PR was negatively correlated with both BPS and SI. In the adjusted moderation model, BPS was positively associated with SI (b = 0.118, p < 0.001) and PR was negatively associated with SI (b = −0.204, p = 0.048), but the interaction term was not significant (b = −0.001, p = 0.820) with negligible explained variance (ΔR2 = 0.0003). In the adjusted mediation model, BPS was significantly associated with lower PR (a: b = −0.135, p < 0.001), and PR was associated with lower SI while controlling for BPS and the covariates (b: b = −0.216, p = 0.028). The total effect of BPS on SI was significant (c: b = 0.146, p < 0.001), and the direct effect remained significant after including PR (c′: b = 0.117, p < 0.001). The indirect effect was significant (ab = 0.029; 95% bootstrap CI [0.005, 0.061]). Conclusions: Psychological resilience did not moderate the association between BPS and suicidal ideation, but it showed a statistically significant indirect association consistent with the proposed mediation model. Higher BPS were associated with lower resilience, which in turn was associated with higher suicidal ideation. These findings suggest that resilience-related targets may complement interventions addressing core BPS-related risk processes, while the cross-sectional design precludes causal conclusions.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16040052

Authors: Alqa Ashraf Qingfei Min Aleena Ashraf

This study intended to examine how human–AI collaboration-based identity threat appraisals in the form of the loss of autonomy and loss of skill trigger a professional identity that fosters cyberloafing. Based on social identity theory, this study applied a three-wave survey design with 507 employees. The proposed research model was tested using partial least squares structural equation modeling (PLS-SEM) with SmartPLS 4, which enabled the assessment of both measurement and structural models. The perceived loss of skill and loss of autonomy are positively associated with professional identity threat, which mediates their relationships with cyberloafing. AI-inclusive identity weakens these associations for the loss of autonomy, suggesting that employees with strong AI-inclusive identity exhibit weaker professional identity threat. When integrating AI, organizations should mitigate appraisals of the loss of autonomy and loss of skill through participatory design, role redesign, and communication that emphasizes unique human contributions. Supporting healthy AI–human identity integration may reduce counterproductive behaviors such as cyberloafing. By positioning identity threat appraisals as human–AI collaboration-driven antecedents of professional identity threat and cyberloafing, this study extends social identity theory to human–AI contexts. It further demonstrates that over-identification with AI may heighten professional identity threats by diminishing the value of uniquely human contributions.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16040051

Authors: Yifei Liu Dhananjay Nayakankuppam

Understanding health behaviors is fundamental to designing effective health interventions [...]

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16040050

Authors: Alaa M. S. Azazz Ibrahim A. Elshaer Hemdan El-Shamy Sameh Fayyad Osman Elsawy Abuelkassem A. A. Mohammad

The hotel industry is widely induced by emotional transactions between frontline employees and their guests leading to unintentional transfer of emotions, a phenomenon known as emotional contagion (EC). EC can result in positive or negative outcomes in the workplace influencing employees’ well-being and performance. This research paper explored direct effects of emotional contagion (EC) on (H1) employees’ well-being (PW), (H2) job performance (JP), and (H3) turnover intention (IL). Based on the affective events theory (AET) and the social exchange theory (SET), employee’s psychological well-being was employed as a mediating factor (H6-H7) and leader–member exchange (LMX) as a moderator variable that might alleviate the adverse consequences of EC (H8). Cross-sectional survey data were collected online from 792 frontline employees. The proposed model was evaluated with partial least squares structural equation modeling (PLS-SEM). The findings revealed that EC can significantly weaken PW, which accordingly decreases JP and increases IL. Nonetheless, strong levels of LMX can alleviate these harmful influences, emphasizing the main significant role of LMX in regulating emotional dynamics in the service workplace. This study expands our understanding of how emotional mechanisms and LMX practices can adjust employee resilience, retention, and performance in the context of high-emotion service.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16040049

Authors: Sergio Guntín Santiago López-Roel Manuel Isorna Francisca Fariña

The mental health of veterinary professionals has become an increasing concern due to the high levels of psychological distress and suicide risk reported in this profession. The present study examined the association between emotional exhaustion and suicidal ideation, considering the mediating role of depressive, anxiety, and stress symptoms. A total of 216 Spanish veterinary professionals completed standardized questionnaires assessing emotional exhaustion, affective symptoms, and suicidal ideation. The results revealed a high prevalence of emotional exhaustion, with more than half of the participants reporting high or very high levels. In addition, a considerable proportion of the sample reported experiencing at least one indicator of suicidal ideation during the previous year. Emotional exhaustion was associated with higher levels of depression, anxiety, and stress. However, the mediation analysis indicated that only depressive symptoms explained the relationship between emotional exhaustion and suicidal ideation, whereas anxiety and stress did not show a significant mediating effect. Overall, the model accounted for a substantial proportion of the variance in suicidal ideation. These findings highlight the central role of depression in the link between emotional exhaustion and suicidal ideation, underscoring the need for early detection and prevention of depressive symptoms in veterinary professionals.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16040048

Authors: Maria Rita Sergi Aristide Saggino Michela Balsamo Leonardo Carlucci Michela Terrei Marco Tommasi

Background: Recent data show that approximately 3.8% of the global population has a diagnosis of depression. Understanding psychological risk and protective factors is crucial for improving prevention strategies and mental health interventions. Among these, worry and emotional intelligence (EI) have emerged as relevant, yet they are rarely studied together. To date, no studies that analyzed the relationship between emotional intelligence, worry, and depression have been found. Therefore, this study aims to investigate the association among EI, worry, and depression. Methods: This study included 924 participants (N = 806 non-clinical and N = 118 subclinical sample with elevated depressive symptoms), with a mean age of M = 25.55 years (SD = 11.38). A total of 118 participants (12.8%) met the criteria for clinical depression based on the BDI-II cut-off. All participants completed the Penn State Worry Questionnaire, the Beck Depression Inventory-II, and the Emotional Intelligence Scale. To examine the relationships among all variables examined, zero-order correlation coefficients were calculated. To investigate the predictive power of EI and worry on depression, Bayesian linear regression was conducted. Results: The results showed significant and positive correlations between worry and depression in both samples. EI showed significant and negative correlations with both depression and worry in both the subclinical sample with elevated depressive symptoms and the non-clinical sample. Finally, worry emerged as the strongest contributor to the somatic dimension of depression in both groups. In the subclinical sample with elevated depressive symptoms, age and Evaluation and Expression of Emotion to Self, along with worry, were the best predictors of somatic symptoms. Conclusions: Our data suggest that higher worry levels are associated with higher levels of depressive symptoms, whereas higher EI was negatively associated with depressive symptoms and may play a potential buffering role. Training programs designed to enhance EI could help mitigate the impact of negative events, improve problem-solving skills, and enhance the expression of one’s own emotions.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16040047

Authors: Cristina Galino Buen David Martínez-Rubio Lorena González-García Alexandra-Elena Marin Mª Dolores Vara Carlos López-Pinar

Introduction: University students are vulnerable to psychological distress due to the academic and social demands of this life stage. Mindfulness and self-compassion are effective and adaptable strategies in an academic environment that promote emotional regulation and psychological well-being. This study aims to conduct a systematic review and meta-analysis to evaluate the combined impact of mindfulness- and self-compassion-based interventions (MBSCIs) on psychological distress. It will also analyze their role as predictors of therapeutic change, as well as the moderating influence of sociodemographic and contextual factors. Method: We systematically searched PubMed, Scopus and Web of Science for randomized controlled trials (RCTs) and single-group pre-post trials investigating the effect of MBSCI on anxiety, depression and stress in college students. Studies were combined using the inverse variance method in a random effects model. Additional subgroup and meta-regression analyses were performed, and risk of bias was assessed. The review was pre-registered (PROSPERO registration number: CRD420251003822). Results: Our review included 49 studies with a total of 5043 participants (3721 in the intervention group, and 1322 in the control group). The results provide relevant evidence on the efficacy of MBSCI in the university population, especially in reducing symptoms of stress, anxiety, and depression. The effect sizes observed were moderate-to-large for stress and small-to-moderate for anxiety and depression, supporting their clinical usefulness in university educational settings. However, these findings should be interpreted with caution, as no included study achieved low risk of bias, and heterogeneity was moderate-to-high across most outcomes. Conclusions: The results suggest that MBSCI could alleviate psychological distress in university students. However, these results are limited by some methodological issues (risk of bias, heterogeneity, lack of follow-ups, poor standardization). It would be advisable to integrate these practices into the university curriculum as workshops or complementary activities. Further studies are needed to confirm their effectiveness and explore sustained effects and differences according to individual characteristics.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16030046

Authors: Ahmed Mohamed Hasanein Hazem Ahmed Khairy

This study examines how abusive leadership influences non-green behavior among employees in five-star hotels in Egypt, drawing on Conservation of Resources (COR) theory and the Job Demands–Resources (JD–R) model. Using survey data collected from 400 full-time hotel employees, the study investigates the mediating roles of emotional exhaustion and presenteeism, as well as the moderating role of perceived co-worker support. Partial Least Squares Structural Equation Modeling (PLS-SEM) was employed to test the proposed relationships. The results indicate that abusive leadership increases emotional exhaustion and presenteeism, both of which contribute to higher levels of non-green behavior. Emotional exhaustion mediates the relationship between abusive leadership and non-green behavior, while presenteeism partially mediates the link between abusive leadership and emotional exhaustion. Additionally, perceived co-worker support buffers the negative effect of presenteeism on emotional exhaustion. By integrating COR and JD–R perspectives, this study advances understanding of the psychological mechanisms through which abusive leadership undermines environmentally responsible behavior. The findings offer practical insights for hospitality managers seeking to promote employee well-being and sustainability in high-pressure service environments.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16030045

Authors: Wolnei Caumo Graziele Borges Bueno Giordano Mayer De Freitas Guilherme Teixeira Lopes Mariana Lentino Coelho Julia Gomes Caroline Leffa Venturini Maria Eduarda Louzada Sara Machado Peres Iraci L. S. Torres Andrea Cristiane Janz Moreira Felipe Fregni

Background: The biopsychosocial model positions fibromyalgia (FM) as the result of altered pain modulation shaped by trauma, psychological vulnerability, and structural stressors. The Sense of Coherence (SOC) may be a key resilience factor explaining differences in symptom severity after similar hardships. Objectives: To evaluate whether SOC mediates and/or moderates associations between trauma-related adversity and symptom burden in FM and whether comorbidities, medication use, healthcare factors, or treatment engagement modify these relationships. Methods: In this cross-sectional study, 2099 women with FM completed an online survey assessing adversity, psychosocial factors, core symptoms, healthcare support, treatment engagement, and medication use. A theory-driven SOC composite followed Antonovsky’s model (comprehensibility, manageability, meaningfulness) using the proxy SOC composite derived from a theory-driven framework that underwent internal construct validation, including discriminant validity analyses and latent structure evaluation, but it was not benchmarked against a gold-standard SOC questionnaire. Linear regression evaluated adversity–symptom associations, SOC mediation, and moderation by SOC and medication classes. Results: Higher adversity predicted lower SOC (e.g., cumulative abuse: B = −0.25), and lower SOC predicted higher symptom burden (e.g., Fibromyalgia Impact Questionnaire (FIQ): B = −6.77), producing significant indirect effects (cognitive symptoms: 0.22; FIQ: 1.69). SOC also moderated the effects of adversity on fatigue and global impact, weakening associations at higher SOC. Comorbidities showed modest influence: hypertension had minor indirect effects (ab = 0.27), scheduled consultation produced small interactions (cognition β = −0.38 to −0.46; fatigue β = ~0.05–0.06), and stroke showed the only clinically meaningful moderation (β ≈ 4.9–5.2), all far smaller than SOC effects. Conclusions: SOC functions as a central psychosocial pathway and resilience-related factor in the association between trauma and FM symptoms. Targeting SOC-related processes may help reduce symptom burden and improve outcomes.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16030044

Authors: Eduardo Sandoval-Obando Stephanie Armstrong-Gallegos Mauricio Véliz-Campos Guido Salazar-Sepúlveda Alejandro Vega-Muñoz Miguel Salazar-Muñoz

The rapid digital transformation of education systems has profoundly changed teachers’ working conditions, intensified administrative demands, and highlighted territorial and organizational inequalities. In this context, understanding how these dynamics influence teacher engagement is essential for promoting healthy educational organizations. This study examined the factor structure of the UWES-17 and analyzed the relationship between engagement levels and sociodemographic variables in a sample of 314 elementary school teachers from four regions of Chile. Descriptive analyses, exploratory factor analysis with polychoric correlations and unweighted least squares, and confirmatory factor analysis using robust ULS and the Hull method were performed. The results showed a robust two-factor structure—Inspired Vitality and Challenging Commitment—with excellent fit indices. Freeman–Halton exact tests showed that Inspired Vitality was significantly associated with age, gender, region, location, administrative dependency, and professional experience, while Challenging Commitment was associated with gender, region, context, and professional experience. These findings indicate that teacher engagement is influenced by both structural inequalities and individual trajectories. The results underscore the need to strengthen organizational resources, regulate digital intensification, and reduce territorial gaps to promote teacher well-being.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16030043

Authors: Keren Dopelt

In the digital era, the line between evidence-based health information and viral misinformation has become increasingly blurred (Scheufele et al [...]

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16030042

Authors: Tjari Klimpki Tim Heemsoth

Physically Active Learning (PAL) integrates physical activity into classroom teaching and has been shown to benefit students’ cognitive, social, and academic outcomes. Despite these advantages, PAL is not yet sustainably implemented in everyday school practice, highlighting the need for effective professional development (PD) formats for teachers. This randomized controlled experimental study examined how different PD formats, varying in their mode of engagement with ready-to-use PAL materials, affect teachers’ motivation, professional competence, and implementation of PAL. A total of 153 in-service primary teachers participated in a 2.5 h PD training and were randomly assigned to one of three formats: example-based learning, experience-based learning, or problem-solving. Data were collected at pre-test, post-test, and a six-week follow-up using standardized questionnaires. Results showed that teachers in the experience-based format reported significantly higher motivation during the PD training than those in the other formats. Across all formats, attitude and self-efficacy regarding PAL increased over time, whereas no significant gains in knowledge were observed. No significant differences between PD formats regarding overall implementation of PAL were observed. Exploratory analyses indicated a potential advantage of the experience-based format. Overall, the findings suggest that immersive, experience-based PD formats may be particularly effective in fostering teachers’ motivation.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16030041

Authors: Sofía Castro-Trigo Alexa von Hagen Paloma Alonso-Stuyck Pau Miquel Donovan Barba-Reynoso Agustina Quintero Julieta Zorrilla de San Martín Augusto Ferreira-Umpiérrez

Psychosocial and cognitive interventions are increasingly implemented in pediatric hospital settings. However, evidence regarding their structure, delivery, and outcomes remains dispersed. This scoping review aimed to synthesize current evidence on these interventions, focusing on their design, professional delivery, reported outcomes, and existing research gaps. It was conducted using established scoping review methodology and is reported in accordance with PRISMA-ScR guidelines. Systematic searches were conducted in PubMed, Scopus, Web of Science, PsycINFO, and ProQuest Dissertations to identify peer-reviewed and grey literature published between 2009 and 2024. Following study selection based on predefined inclusion criteria, data were charted using a standardized data extraction form and analyzed to synthesize and map key characteristics of interventions and outcomes in relation to the review questions. Sixty-one studies met the inclusion criteria. Interventions primarily targeted school-aged children and adolescents and were delivered by psychologists, educators, and nurses, frequently within interdisciplinary teams. A wide range of materials and resources were used, including digital technologies, playful and artistic materials, audiovisual and informational supports, and sensory or therapeutic objects. Techniques primarily involved guided conversation, cognitive and body-based exercises, and play-based approaches. Outcomes mainly focused on emotional well-being and recovery, while fewer interventions explicitly addressed cognitive processes such as attention and executive functioning. Overall, reported effects were generally positive. These findings suggest that psychosocial and cognitive interventions in pediatric hospital settings reflect a wide range of approaches, while also revealing methodological heterogeneity, variability in reporting, and the underrepresentation of low- and middle-income countries, pointing to the need for more robust and inclusive future research.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16030040

Authors: Khaled Trabelsi Waqar Husain Hadeel Ghazzawi Zahra Saif Achraf Ammar Haitham Jahrami

This study aimed to translate, culturally adapt, and validate the Arabic version of the 6-Item Lubben Social Network Scale (LSNS-6). The LSNS-6 was translated, culturally adapted, and administered, alongside the Medical Outcomes Study Social Support Survey (MOS-SSS), to 327 Arabic-speaking adults aged 60 years and older. Internal consistency was examined using Cronbach’s alpha and McDonald’s omega. Confirmatory factor analysis (CFA) tested the hypothesized two-factor structure (Family and Friends), and measurement invariance was evaluated across key sociodemographic and lifestyle variables. Convergent validity was assessed through correlations with MOS-SSS domains. Item response theory (IRT) analyses examined item discrimination and threshold parameters. Latent class analysis (LCA) explored whether the LSNS-6 could identify subgroups with distinct patterns of social connectedness and perceived support. The Arabic LSNS-6 demonstrated good internal consistency (α = 0.83; ω = 0.84) and supported the expected two-factor structure with satisfactory model fit (CFI = 0.963; TLI = 0.931; SRMR = 0.03). Convergent validity was evidenced by moderate correlations with overall perceived social support (r = 0.51). IRT analyses indicated strong discrimination for most items, and LCA identified four distinct latent classes. Overall, the Arabic LSNS-6 is a reliable and valid tool for assessing social isolation among older Arabic-speaking adults.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16030039

Authors: Claudio Maggio Vittorio Edoardo Scuderi Marcello Boccadamo Silvia Platania

Burnout represents a critical occupational health issue within the maritime sector, where demanding work schedules, prolonged periods at sea, and safety-critical responsibilities expose seafarers to significant psychological strain. This study investigates how burnout influences safety behaviors among maritime workers, adopting a multilevel framework that incorporates work engagement, quality of life, and work–family conflict as key factors shaping this relationship. Data was collected through a structured questionnaire administered to 216 seafarers distributed across 36 commercial vessels, representing a diverse range of onboard roles and operational contexts. The multilevel design allows for simultaneous examination of individual-level experiences and ship-level dynamics, offering a more nuanced understanding of how psychosocial risks translate into safety-relevant outcomes in maritime environments. Data were analyzed using multilevel structural equation modeling (MSEM), including multilevel confirmatory factor analysis (ML-CFA) and multilevel path analysis, implemented in Mplus version 8.10. The findings reveal that burnout undermines seafarers’ safe behaviors through diminished work engagement and a worsened quality of life. Furthermore, high levels of interference between work and family life amplify the negative effect of burnout on safe behaviors. This study contributes to the limited empirical literature on maritime behavioral health and provides implications for strengthening safety culture and crew well-being in the global shipping industry.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16030038

Authors: Jiaxuan Wang Ziqi Wang Fan Du Jiaojiao Lv Jiulong Kou Jieting Chen Mingxia Jing

(1) Background: Proactive health behaviors are key to reducing their burden and supporting healthy aging. (2) Methods: We analyzed five waves (2011–2020) of CHARLS data from 1343 middle-aged and older adults (≥45 years) with multimorbidity. An entropy weight method was used to create a composite score for proactive health behaviors, and group-based trajectory modeling identified behavioral trajectories. Multivariate logistic regression and Shapley value decomposition assessed determinants and their relative contributions. Generalized structural equation modeling and latent class analysis were applied to estimate direct and indirect effects across the full sample and key multimorbidity subgroups. (3) Results: Two trajectories emerged: a “declining group” (91.44%) and an “improving group” (8.56%). The improving group was more likely to include younger, urban individuals with higher education, retired status, smaller family size, and lower depression levels. Education (40.67%) and depressive symptoms (31.22%) were the strongest determinants of trajectory. Path analysis showed that higher education and retirement indirectly supported sustained proactive health behaviors by reducing depression. The direct and indirect effects varied across subgroups. (4) Conclusion: The proactive health behaviors of middle-aged and elderly patients with multimorbidity exhibit a declining trend. Future health policies and interventions should prioritize mental health.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16030037

Authors: Nicola Magnavita Carlo Chiorri

Eating disorders (EDs) are complex conditions that can significantly affect health and productivity, yet their assessment in occupational settings remains underexplored. This study aimed to evaluate the psychometric properties of the Italian version of the Eating Disorder Examination Questionnaire—Short Form (EDE-QS) among 1912 workers undergoing health surveillance. Using an Item Response Theory framework, we tested dimensionality, reliability, and measurement invariance across gender, applying a graded response model to assess item discrimination and threshold parameters. Results supported an approximate unidimensional structure with excellent internal consistency (ω ≈ 0.95) and strong indices of factor score determinacy and construct replicability. Measurement invariance analyses indicated configural and metric invariance but not full scalar invariance, due to differential item functioning in a subset of items. Latent mean differences were small, with women scoring slightly higher than men, and associations with psychological, occupational, and health-related variables did not differ by gender. These findings indicate that the Italian EDE-QS shows promising structural validity as a brief measure of ED symptomatology in occupational samples in workplace contexts. However, gender-related item bias warrants cautious interpretation of specific behaviors, suggesting the need for tailored assessments to enhance diagnostic accuracy and inform preventive interventions.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16030036

Authors: Dylan G. Serpas Jordan K. Aquino Laura Zettel-Watson Barbara J. Cherry

Background: Fibromyalgia (FM) is a chronic widespread pain condition implicated in accelerated aging, functional decline, and physical frailty. Objective: This study examined differences in performance-based and self-reported physical frailty phenotypes among middle-aged and older adults with and without FM. Materials and Methods: A cross-sectional sample of 234 community-dwelling middle-aged and older adults with (59.0%) or without FM was analyzed. Physical frailty was defined as weakness, low physical activity, exhaustion, and slowness, assessed using validated performance-based (Fullerton Advanced Balance Scale [FAB], 8-foot up and go test [8FUPGT], 30-second chair stand [30SCS], 6-minute walk [6MWT], 30-foot walk [30FW]) and self-report measures (Rapid Assessment of Physical Activity [RAPA], fatigue numeric rating scale). Principal component analysis (PCA) evaluated the underlying structure of physical frailty indicators, yielding performance-based and self-reported components. Standardized factor scores were used as outcomes in regression analyses examining associations with pain intensity. Results: PCA supported a two-component frailty structure explaining 61% of the variance. After adjusting for age, gender, depressive symptoms, and body mass index, greater pain intensity was associated with worse performance-based (B = −0.10, p < 0.001; adjusted R2 = 0.36) and self-reported (B = −0.10, p < 0.001; adjusted R2 = 0.39) frailty. Discussion: Findings suggest that pain intensity is associated with frailty risk among aging adults, supporting the clinical utility of both performance-based and self-reported physical frailty assessments in FM.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16030035

Authors: Marin Mamić Goranka Radmilović Jakov Ivković Bruno Dokozić Danijel Mikulić Ivana Mamić Valentina Matijević Ivan Vukoja

This study investigated an integrative mediation model examining whether anxiety and depression mediate the relationship between the Big Five personality traits and the severity of alcohol and nicotine dependence among psychiatric patients with neurotic disorders (ICD-10 codes F40–F48). A cross-sectional design was conducted on a clinical sample of 232 patients (57.3 female; mean age = 48.58, SD = 10.77) using standardized instruments: Big Five Inventory (BFI-44), Fagerström Test for Nicotine Dependence (FTND), Michigan Alcoholism Screening Test (MAST), and Depression, Anxiety, and Stress Scale (DASS-21). Data were analyzed using MLR mediation modeling. The model explained 32.6 of the variance in nicotine dependence and 27.1 in alcohol dependence. Results revealed a pattern of complete mediation: neuroticism had no direct effect on addiction but influenced alcohol dependence exclusively through anxiety (p = 0.001) and nicotine dependence through depressive symptoms (p = 0.012). Extraversion and agreeableness showed a dual role, exerting significant direct positive paths toward addiction severity (p = 0.005) while simultaneously reducing it through negative indirect effects on affective distress. Overall, neuroticism was confirmed as a universal risk factor for mental health issues. These findings suggest that personality-driven addiction in neurotic patients is operationalized through specific clinical symptoms, highlighting the necessity for therapeutic interventions focused on targeted affect regulation and social assertiveness to mitigate substance use in this population.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16030034

Authors: Paola Romera-Gasparico María del Carmen Carcelén-Fraile Javier Cano-Sánchez Marcelina Sánchez-Alcalá Juan Miguel Muñoz-Perete Agustín Aibar-Almazán Fidel Hita-Contreras Yolanda Castellote-Caballero

Psychological problems such as depression, anxiety, stress, loneliness, and reduced quality of life are prevalent in older adults, yet the effectiveness of psychological interventions remains heterogeneous. This systematic review with meta-analysis evaluated the impact of psychological and psychoeducational interventions on emotional symptoms and quality-of-life outcomes in adults aged 60 years and older. Following PRISMA 2020 guidelines, a comprehensive search was conducted in PubMed, Scopus, CINAHL, and Web of Science. Randomized controlled trials published in the last five years were included if they assessed interventions such as mindfulness, cognitive behavioral therapy, reminiscence therapy, or behavioral activation. Twenty-eight trials were included in the qualitative synthesis and twenty-two in the meta-analysis. Standardized mean differences (Hedges’ g) were pooled under fixed- and random-effects models. Heterogeneity, subgroup analyses, and publication bias were examined using Q, I2, Begg–Mazumdar, Egger, and Trim-and-Fill methods. The global meta-analysis showed a moderate and significant favorable effect of psychological interventions on emotional symptoms under the random-effects model (SMD = −0.623, 95% CI −0.888 to −0.359; p < 0.001), where negative values indicate reductions in symptom severity. Subgroup analyses revealed a moderate effect on depressive symptoms, which remained significant after adjustment for publication bias, and a large effect on perceived stress (SMD = 0.581; p < 0.001); for stress outcomes, positive SMDs indicate reductions in stress (i.e., improvement) after aligning scale directionality. Anxiety showed a significant effect only under the fixed-effects model, while loneliness showed a small but significant effect (SMD = −0.110; p = 0.018). Mindfulness-specific outcomes and quality of life did not show significant pooled effects. No substantial publication bias was detected. Psychological interventions significantly improve emotional well-being in older adults, particularly by reducing depression and stress. Effects on anxiety, loneliness, mindfulness, and quality of life are more variable, emphasizing the need for methodological consistency and longer follow-up in future studies.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16030033

Authors: Ameni Essid Mohamed Mansour Bouzourraa Hajer Sahli Wissem Dhahbi Achraf Ammar Khaled Trabelsi Mohamed Jarraya Makram Zghibi

Background: Adolescent football players are exposed to substantial psychological demands, and psychosocial support within family and sport environments has been shown to influence motivational climate, stress responses, and emotional well-being. However, the comparative effects of coordinated multi-source psychosocial support from parents and coaches versus single-source support on psychological outcomes remain insufficiently examined. Aims: to examine the effects of a multi-component psychosocial program involving parents and coaches on depression, anxiety, stress, and self-regulation in adolescent football players. Methods: A total of 60 male adolescent soccer players were recruited and randomly assigned to four groups: combined supportive communication from both parents and coaches (SCCP; n = 15), supportive communication from coaches only (SCC; n = 15), supportive communication from parents only (SCP; n = 15), and a control group (CG; n = 15). Over a 12-week intervention period, participants attended 12 sessions incorporating structured supportive communication and related psychosocial strategies. Mental health outcomes were assessed using the Depression Anxiety Stress Scale (DASS-21), while self-regulation was measured with the Self-Regulation Questionnaire (SRQ). Results: The SCCP group demonstrated the largest improvements across outcomes, with reductions observed in anxiety, depression, and stress, and significant time effects for all mental health parameters. For depression, the time effect showed a (p < 0.001; η2p = 0.93 [Very large]; −45.77%). Anxiety scores also indicated a significant time effect (p < 0.001; η2p = 0.81 [Very large]; −46.55%). Stress demonstrated an exceptionally significant time effect (p < 0.001; η2p = 0.98 [Very large]; −48.29%). Additionally, the self-regulation outcomes showed significant improvements, with a time effect for the Planning subscale of the SRQ indicating (p < 0.001; η2p = 0.86 [Very large]; +66.38%). Conclusion: The findings provide preliminary evidence that a multi-component program involving parents and coaches is associated with improvements in depression, anxiety, stress, and self-regulation among adolescent football players. These results suggest that coordinated psychosocial support across family and sport environments may contribute to adolescent athletes’ psychological well-being, although replication in other cultural and sporting contexts is required.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16030032

Authors: Mohamed Ali Nemt-allah Mamdouh Mahmoud Mostafa Mamdouh Mosaad Helali Hussam Khalifah Aldawsari Bandar Saud Alromaih Ashraf Ragab Ibrahim

Despite the pervasive role of digital platforms in contemporary higher education, existing measurement tools fail to capture students’ psychological dependence on online approval within academic contexts, focusing instead on technical competencies or clinical addiction symptoms. This study developed and psychometrically validated the Digital Validation Seeking Scale (DVSS), a multidimensional instrument measuring university students’ reliance on digital feedback for academic and identity confirmation. Two independent samples of Egyptian undergraduate students were recruited: an exploratory sample of 511 students and a confirmatory sample of 740 students from six universities. The DVSS underwent rigorous content validation by eleven experts, exploratory factor analysis (EFA) using Principal Axis Factoring with Promax rotation, and confirmatory factor analysis (CFA) comparing competing structural models. Results revealed a robust four-factor structure comprising Academic Self-Quantification (ASQ), Feedback Hyper-vigilance (FHV), Social Comparison (SC), and Performative Studiousness (PS), with the first-order four-factor model demonstrating superior fit indices. The final 19-item scale exhibited excellent internal consistency, with Cronbach’s alpha coefficients ranging from 0.807 to 0.938 for subscales and total score, respectively, and strong test–retest reliability. The DVSS provides researchers and practitioners with a theoretically grounded, psychometrically sound instrument for identifying maladaptive digital validation patterns before they compromise academic engagement or psychological well-being, enabling targeted interventions within hybrid educational environments.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16020031

Authors: Roger Angulo-Salas Jonatan Baños-Chaparro Geraldinne Ayala Garcilazo Jeremy Yovani Juarez Medina Delly Santos-Chuquispuma

Background: Adolescence is a developmental window of heightened vulnerability to psychological distress, yet the interplay between pathology and protective factors remains understudied in a low-to-middle-income urban district in North Lima, Peru. This study examined the network structure of resilience, happiness, and mental health indicators in Peruvian adolescents to identify precise intervention targets. Methods: A sample of 559 adolescents (49.9% boys; Mage = 14.72, SD = 1.43) recruited from public secondary schools in Carabayllo, a low-to-middle-income urban district in North Lima, Peru, completed validated measures of resilience (CD-RISC-25), subjective happiness, and mental health (anxiety, depression, and stress). A Gaussian Graphical Model was estimated using non-regularized partial correlations. Node centrality, predictability, and network stability were assessed, and a Network Comparison Test evaluated structural differences by sex. Results: Anxiety, depression, and stress formed a tightly interconnected core, with the strongest edge between stress and anxiety. Among the psychological resources, self-regulation and external resources showed the highest centrality and predictability, followed by personal competence and tenacity. Happiness occupied a peripheral position but maintained a negative association with depression. The network demonstrated strong stability (CS = 0.75). No significant structural or global strength differences emerged between boys and girls. Conclusions: Findings challenge generic well-being approaches, revealing that happiness is a distal factor rather than a central buffer in this population. Instead, the network architecture suggests that interrupting the stress–anxiety loop and fostering self-regulation skills constitute the most effective pathways for school-based mental health protection, regardless of student gender.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16020030

Authors: George Fedorov Glen Bates

Post-Traumatic Stress Disorder (PTSD) is a global mental health concern, with recent research focussing on the psychological mechanisms that contribute to its development and maintenance. Alexithymia, characterised by difficulty identifying and expressing emotions, has been identified as a potential risk factor for PTSD. This study was a preliminary investigation of a model of the relationship between alexithymia and PTSD symptoms, focussing on the potential mediating roles of self-compassion and difficulties in emotional regulation. Participants (N = 332), who were university students and members of the community, completed self-report measures of the key variables. As expected, alexithymia was strongly associated with higher levels of PTSD symptoms. Three mediation pathways were also significant. In one, alexithymia was associated with greater regulation difficulties for negative emotions, which was associated with higher levels of PTSD symptoms. In the second, higher alexithymia was associated with greater difficulties regulating positive emotions, which was associated with higher levels of PTSD symptoms. The final pathway involved a serial mediation in which higher alexithymia was associated with lower self-compassion, and lower self-compassion was associated with greater difficulties in regulating negative emotions, which were associated with higher PTSD symptoms. Contrary to expectation, self-compassion had no direct relationship with PTSD symptoms and did not relate to difficulties in regulating positive emotions. The general pattern of results was evident for the PTSD subtypes of negative alterations in cognitions and mood and alterations in arousal and reactivity. However, mediation by difficulties in regulating positive emotions was nonsignificant for the symptoms of re-experiencing and avoidance. The theoretical and clinical implications of the findings are discussed.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16020029

Authors: José Manuel García-Álvarez Alfonso García-Sánchez José Luis Díaz-Agea

(1) Background: The complexity of today’s healthcare system requires the formation of highly cohesive work teams that guarantee safe and high-quality care. Clinical simulation has become established as a pedagogical strategy capable of promoting the collaborative skills of teams of students and healthcare professionals. The objective of this study was to analyze the influence of learning through clinical simulation on group cohesion in nursing student teams. (2) Methods: A pre–post quasi-experimental study without a control group was conducted with final-year nursing students using the short Spanish version of the Group Environment Questionnaire, validated for nursing students. This questionnaire was administered twice, before and after participation in clinical simulation sessions. (3) Results: Clinical simulation significantly increased group cohesion in most items and in all dimensions with moderate to large effect sizes (r > 0.5). The Group Integration-Task (GI-T) dimension showed the greatest improvement after clinical simulation. Although causal relationships cannot be established, the results suggest an association between exposure to clinical simulation and increased group cohesion. (4) Conclusions: Clinical simulation was associated with significant improvements in both task-oriented and social dimensions of group cohesion among nursing students. These findings suggest that clinical simulation may enhance collaboration, communication, and commitment to shared goals within student teams. Future studies including control groups are needed to confirm these associations and further explore the impact of clinical simulation on team performance in both student and healthcare professional contexts.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16020028

Authors: José Antonio Romero-Macarrilla Robert Bauer Javier Fernández-Sánchez Eva Fernández-Sánchez Iván González-Gutiérrez José Carmelo Adsuar Daniel Collado-Mateo

Problematic internet use has been consistently associated with different adverse effects on bio-psycho-social health outcomes. However, there is a lack of consensus in the definition and measures. This study aimed to translate and culturally adapt the Internet Addiction Test–Short Form (IAT-7) into Spanish and to evaluate its validity and reliability among adolescents. A total of 783 participants aged 12–18 years completed the questionnaires while 106 answered again two months later to assess test–retest reliability. Construct validity was examined using confirmatory factor analysis to test the two-factor structure. Convergent and discriminant validity, reliability, and invariance were analyzed. All items showed significant standardized loadings (0.55–0.85; p < 0.001), and fit indices supported the two-factor model. Both factors showed adequate convergent validity, while moderate correlation between factors (ρ = 0.667) supported discriminant validity. Test–retest reliability was strong (ICC = 0.814), and internal consistency was satisfactory (Cronbach’s α = 0.850; McDonald’s ω = 0.853). Furthermore, measurement invariance analyses supported the equivalence of the scale across gender and age. In conclusion, the Spanish IAT-7 is a valid and reliable instrument for assessing problematic internet use in adolescents aged 12–18 years.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16020027

Authors: Leanne Jackson

The first 1001 critical days, spanning from conception to two years postpartum, are a critical window for infant development (Leach, 2017) [...]

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16020026

Authors: Jiri Remr

Background/Objectives: Commitment to self-tracking refers to the extent to which individuals are dedicated to the practice of wearable- and app-based self-monitoring. This commitment is behaviorally grounded and captures users’ sustained investment in wearable and app-based self-monitoring. The objective of this study was to validate the Commitment to Self-Tracking (C2ST) scale in Czechia by examining its dimensionality, confirmatory model fit, reliability, and known-groups evidence among self-tracking device users. Methods: The results were obtained from a face-to-face survey of a sample of 502 self-tracking device users who were recruited from the Czech general population using address-based sampling. The sample was randomly split into two subsamples for exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Item- and scale-level descriptive statistics and internal consistency (Cronbach’s α, McDonald’s ω) were calculated. The EFA was utilized to evaluate the factorability and latent structure of the model, and the CFA was employed to assess the model’s fit. The known-groups validity was examined using nonparametric group comparisons (Kruskal–Wallis H and Mann–Whitney U tests) with theoretically relevant external indicators, such as social comparison orientation, willingness to share data, perceived usefulness of tracking, and self-rated health. Results: The C2ST score demonstrated a full range of theoretical variation, exhibiting minimal floor (7.2%) and ceiling (2.0%) effects and a nearly symmetrical distribution. The internal consistency of the scale was found to be high (α = 0.968; ω = 0.968), and the corrected item-total correlations were uniformly high. The EFA supported a single-factor solution that explained 74.4% of the variance. The CFA model demonstrated a unidimensional structure, indicating that the observed variables were best explained by a single factor. An improved model attained an adequate-to-excellent fit (RMSEA = 0.051; SRMR = 0.018; CFI = 0.991; TLI = 0.986) and accounted for substantial item variance (R2 = 0.60–0.82). The known-groups validity was supported by pronounced differences in C2ST scores across social comparison and data-sharing orientations, as well as perceived usefulness of tracking for health and training goals (all p < 0.001). Conclusions: The Czech C2ST has been demonstrated to exhibit high reliability and a clear, unidimensional structure. Additionally, it exhibited robust CFA support and theory-consistent known-groups validity among self-tracking device users. The scale is appropriate for research on self-tracking commitment and persistence.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16020025

Authors: Muhammad Adeeb Mariny Abdul Ghani Azlin Hilma Hillaluddin Luca Flesia

Mental health concerns are increasingly prevalent among postgraduate students, who face academic, social, and career pressures. Although research on student mental health is expanding, less is known about the psychological resources that support well-being in postgraduate learners. Meaning in life has been identified as a key psychological resource that helps individuals interpret challenges and maintain coherence and well-being, and recent research highlights the contribution of self-transcendent traits such as gratitude, forgiveness, and spirituality in fostering meaning in life. However, empirical evidence on these interrelationships remains limited. This study involves 1527 Pakistani postgraduate students (M = 795; mean age = 24.89 years) recruited through multistage random sampling from ten public universities in Punjab. Participants completed the Gratitude Questionnaire, Heartland Forgiveness Scale, Spirituality Scale, Meaning in Life Questionnaire, and Mental Health Inventory (assessing psychological well-being and psychological distress). Correlation analyses showed that gratitude, forgiveness, and spirituality were positively associated with psychological well-being and negatively associated with psychological distress. Structural equation modeling (SEM) further indicated that these traits predicted mental health both directly and indirectly, with meaning in life serving as significant partial mediator. Overall, the findings highlight the central role of meaning in life in linking self-transcendent traits to mental health among postgraduate students and suggest important implications for culturally sensitive, university-based mental health initiatives.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16020024

Authors: Fatimah Ali Alhuraybi Bassam M. A. Makram Mohamed Sayed Abdellatif Ashraf Ragab Ibrahim Mohamed Ali Nemt-allah

This study examined the mediating role of problem-solving attitudes in the relationship between catastrophic thinking and environmental awareness among university students using structural equation modeling. Two samples of undergraduate students from Al-Azhar University, Egypt, participated: a psychometric validation sample (N = 670) and a main study sample (N = 989). Participants completed three validated instruments assessing catastrophic thinking, problem-solving attitudes, and environmental awareness. Results revealed that catastrophic thinking was significantly negatively associated with environmental awareness both directly (β = −0.266) and indirectly through problem-solving attitudes (β = −0.172), with the indirect pathway accounting for approximately 39% of the total effect. The structural model demonstrated excellent fit to the data, and all hypothesized relationships were statistically significant. These findings suggest that catastrophic cognitions are associated with reduced environmental awareness both directly and through their negative relationship with problem-solving orientations that facilitate engagement with complex issues including environmental challenges. The study highlights the importance of addressing trait-level cognitive distortions alongside environmental content in education programs, as general catastrophic thinking patterns may impair environmental awareness even among students without climate-specific anxiety.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16020023

Authors: Henrik Stelling Armin Kraus Gerrit Grieb Ibrahim Güler

Background and Objectives: Large language models (LLMs) have demonstrated high performance on knowledge-based medical examinations but their capabilities on cognitive aptitude tests emphasizing reasoning and abstraction remain underexplored. The Test for Medical Studies (TMS), a German medical school admission test, provides a standardized framework to examine these capabilities. This study aimed to evaluate the performance and consistency of multiple LLMs on text-based and visual-analytic TMS items. Materials and Methods: Eight contemporary LLMs, comprising proprietary and open-source systems, were evaluated using a multi-run design on standardized TMS items spanning text-based and visual-analytic cognitive domains. Results: Mean accuracy remained substantially below levels typically reported for knowledge-based medical examinations, with marked performance differences between text-based and visual-analytic subtests. Open-source models performed competitively compared with proprietary systems. Inter-run reliability was heterogeneous, indicating notable variability across repeated evaluations. Conclusions: Current LLMs show limited and domain-dependent performance on cognitive aptitude tasks relevant to medical school admission. High accuracy on knowledge-based examinations does not translate into stable performance on aptitude tests emphasizing fluid intelligence. The observed modality-dependent performance patterns and inter-run variability highlight the importance of differentiated, multi-run evaluation strategies when assessing LLMs for applications in medical education.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16020022

Authors: Gabriela Sequeda Sandra Durán-Rondón Johan E. Acosta-López Eduardo-Andrés Torres-Santos Diego Rivera-Porras

Background: Experiential avoidance (EA) refers to the tendency to evade or suppress unpleasant internal experiences, such as distressing thoughts, emotions, or bodily sensations. Increasing evidence indicates that EA plays a central role in the onset and maintenance of addictive behaviours. Objective: To synthesise quantitative evidence on the association between experiential avoidance (EA), operationalised as psychological inflexibility, and psychoactive substance use (PSU) outcomes, including substance use frequency/quantity, craving, dependence severity, relapse/abstinence, and treatment response, and to characterise putative pathways (EA as predictor/mediator) and correlates (e.g., affect regulation and trauma-related factors). Methods: A systematic search was conducted in SCOPUS, Web of Science, PubMed, and APA PsycNet, following PRISMA 2020 guidelines. Eligible studies included experimental and observational designs, clinical and non-clinical populations, and publications from January 2000 to January 2026 in English or Spanish. Primary outcomes were PSU behaviour and severity (frequency/quantity, craving, dependence symptoms, relapse/abstinence) and treatment outcomes; secondary outcomes included emotional and behavioural correlates linked to EA. Results: Across studies, higher levels of EA were consistently associated with greater substance use—particularly alcohol, tobacco, cannabis, and other illicit drugs. EA frequently mediated the relationships between emotional dysregulation, trauma exposure, and addictive behaviour. Elevated EA was also linked to impulsivity, psychiatric comorbidity, and poorer treatment adherence and outcomes. Interventions explicitly targeting EA—most notably Acceptance and Commitment Therapy (ACT)—showed promising effects in reducing avoidance and substance use. Conclusions: Experiential avoidance emerges as a transdiagnostic process underlying vulnerability to, and persistence of, substance use disorders. Integrating third-wave behavioural interventions that promote psychological flexibility may enhance the efficacy of addiction treatment. Future research should explore these mechanisms in culturally diverse and under-represented contexts.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16020021

Authors: Xingyu Zhu Xiaojing Shi Jiahao Liang Bukuan Sun Wuji Lin Jingyuan Lin

In recent years, the number of people viewing pet videos and images online has risen. Although numerous studies have shown that owning pets positively impacts human mental health, the potential mental health benefits of prolonged exposure to pet media content remain debated. This study conducted three experiments to investigate how viewing pet videos affects human emotional face processing and to clarify the associated emotional regulatory mechanisms. Experiment 1 examined how viewing pet videos influences attentional bias toward emotional faces. Experiment 2 assessed the impact of watching pet videos on the valence perception of emotional faces. Experiment 3 analyzed how exposure to pet videos affects the valence perception of emotional text. The results showed that watching pet videos increased attentional bias toward subsequent positive emotional faces and decreased bias toward negative ones. This effect resulted from higher perceived valence ratings for both positive and neutral emotional faces. Importantly, this effect was only observed in facial stimuli with social attributes. These findings indicate that watching pet videos modulates emotional processing, and prolonged exposure to pet media content may affect mental health through this mechanism.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16020020

Authors: Muhammad Imran Umaira Iftikhar Arooj Arshad Komal Hassan Norah Almusharraf

Children with autism spectrum disorder (ASD) frequently struggle with emotion regulation, which can be influenced by parental practices and the supportive role of siblings in encouraging emotional and social development. The study aimed to examine the relationship between parenting practices and emotional regulation of children with ASD and to explore the mediating role of the prosocial behavior of siblings between parenting practices and emotional regulation in children with ASD. Additionally, this study investigated the moderating role of sibling gender in the relationship between prosocial behavior and emotional regulation. A total of 600 parents/caregivers aged 25–40 years (M = 32.91, SD = 4.23) of children with ASD were selected from special education institutes in Lahore, Pakistan, using a non-probability, purposive sampling method. Although the majority of respondents were mothers (94.5%), the term parenting practices is used to reflect a family-level caregiving construct rather than exclusively maternal behavior. Data were interpreted through IBM SPSS Statistics 23 and PROCESS macros, revealing that authoritative parenting had a significant positive relation with emotional regulation in children with ASD. Results also indicated that the prosocial behavior of siblings partially mediated the relationship between authoritative parenting and emotional regulation in children with ASD. Furthermore, sibling gender significantly moderated the indirect effect, with female siblings showing stronger facilitation of emotional regulation through prosocial behaviors compared to male siblings.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16020019

Authors: Yuting Song Justin DeMaranville Kanyarat Khattiya Kelvin C. Y. Leung Nahathai Wongpakaran Tinakon Wongpakaran

Inner strength is increasingly recognized as a protective factor in mental health, but its structure and dynamics remain underexplored, particularly in individuals with borderline personality disorder (BPD) symptoms. This study applied network analysis to investigate the complex relationships among inner strengths in individuals exhibiting BPD symptoms, aiming to identify core and bridging strengths that could inform targeted interventions. The sample comprised 346 Thai university students (25.4% males, 74.6% females; mean age = 21.60 ± 2.24 years) who screened positive for BPD symptoms using the Screening Instrument for Borderline Personality Disorder. Network analysis revealed that inner strengths formed an interconnected system with both core and peripheral features. The strongest association was observed between generosity and loving-kindness. A cognitive behavioral cluster comprising perseverance, wisdom, and determination also emerged. Centrality analysis identified loving-kindness as the most influential node in terms of direct connections, while equanimity exhibited the highest bridge centrality. Generosity and determination demonstrated the greatest expected influence. A negative link between truthfulness and equanimity highlighted a potential conflict between absolute honesty and inner balance in this population. Notably, exploratory analyses by gender revealed distinct network structures. In males, determination, wisdom, and precept emerged as central strengths; however, results for males should be interpreted with caution due to sample size. In females, perseverance, loving-kindness, and meditation were the most influential. These gender-specific patterns suggest that targeting different core strengths according to gender may enhance the effectiveness of interventions for individuals with BPD symptoms. Overall, the findings suggest that fostering specific inner strengths, particularly equanimity, loving-kindness, and those identified as central for each gender, may enhance psychological resilience and inform more tailored intervention strategies for BPD.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16020018

Authors: Hannah Quick Marc Lochbaum

The purpose of this systematic review and meta-analysis (PROSPERO ID: CRD42024575181) was to quantify the relationships between dispositional and situational achievement goal involvement and sport confidence. A secondary purpose was to examine potential moderators of these relationships. Published studies reporting sufficient data, including one achievement goal measure from the dichotomous framework and one measure of sport confidence in an athlete sample, were included. Information sources included EBSCOhost databases, Web of Science databases, and relevant meta-analyses. The random-effects correlational coefficient (r) served as the summary statistic. Thirty-six studies yielding 37 independent samples, published between 1988 and 2026, which met all inclusion criteria, representing a total of 10,461 participants from youth to elite sports across four continents. Meta-analyzed random-effects correlations between task climate (k = 15, r = 0.33 [95% CI 0.23, 0.43]), ego climate (k = 13, r = −0.08 [95% CI −0.16, −0.00]), task orientation (k = 26, r = 0.27 [95% CI 0.21, 0.32]), ego orientation (k = 26, r = 0.11 [95% CI 0.06, 0.17]), and sport confidence ranged from small and negative to medium and positive in magnitude. Mixed-effects moderator analyses revealed significant differences (p < 0.05) for task climate when comparing state (r = 0.24) versus trait (r = 0.41) sport confidence measures, for task orientation scale (TEOSQ r = 0.31 vs. POSQ r = 0.18) in relation to sport confidence, and for study quality (lowest r = 0.35, medium r = 0.18, highest r = 0.24) in the task orientation–sport confidence relationship. However, nearly all prediction intervals for the examined relationships crossed zero, with the exception of a few TEOSQ- and POSQ-based moderator analyses. Thus, researchers and practitioners are cautioned that relationships between dispositional achievement goals, motivational climate perceptions, and sport confidence might be minimal or vary based on the dispositional achievement goal measure.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16020017

Authors: Yurika Tamekuni Kenta Okuyama Atsushi Motohiro Daijo Shiratsuchi Minoru Isomura Linda Abrahamsson Martin Lindström Kristina Sundquist Takafumi Abe

Low back pain is common and negatively impacts quality of life and workplace productivity. However, few studies have focused on small- and medium-sized enterprises (SMEs) where risk factors are prevalent. This cross-sectional study examined the association and structural relationships between physical and social factors in low back pain among Japanese SME workers. We analyzed survey data collected between April 2021 and August 2022 from 762 SME workers aged 18–65 years in Shimane, Japan, to assess acute (less than 3 months) and chronic low back pain using a self-reported questionnaire. Workplace physical (physical load) and social (stress of interpersonal relations) factors were measured using a brief job stress-related questionnaire. Associations between workplace factors and acute and chronic low back pain were evaluated using multivariable, multinomial logistic regression. Among the 762 workers, 50.9% and 7.3% reported acute and chronic low back pain, respectively. The odds ratio (OR) for acute pain was 2.08 for ‘Very much so’ in those with a high physical load. Compared with those with low interpersonal stress, the OR for chronic pain was 2.20 for medium stress and 2.82 for high stress. Reducing physical workloads may mitigate acute low back pain, while lowering interpersonal stress at work may reduce chronic low back pain. Future studies should investigate whether improving workplace physical and social factors is longitudinally effective.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16020016

Authors: Noemí SanMiguel Clarys Custodio Giada Aulicino Miguel-Ángel Serrano

Non-invasive vagus nerve stimulation (nVNS) is gaining attention as a promising approach to modulate emotional, cognitive, and autonomic processes. This exploratory study analyzed the short-term effects of manual vagal maneuver (MVM), applied to the left or the right side of the neck (carotid region), on emotional regulation, cognitive performance, and cardiac autonomic activity in healthy young females. Sixty participants, divided equally into three groups (left MVM, right MVM, and control), completed attentional tasks under their respective conditions. Heart rate variability (HRV), cardiac coherence, self-reported emotional states, and task performance were measured. The preliminary findings of this pilot study offer mixed evidence: while both stimulation groups seem to show significant improvements in attentional performance, only left-sided MVM was associated with increased cardiac coherence and elevated perceived emotional dominance. No significant changes were observed in HRV indices across groups, highlighting potential limitations of current physiological markers in capturing subtle autonomic modulation. These preliminary findings from a pilot study suggest that, in young healthy women, stimulation—particularly on the left side—may have a potential to enhance cognitive and affective functioning, even though no detectable changes were observed in conventional HRV metrics. Given the small sample size and other important methodological limitations, such as the single-session design, these results should be interpreted with caution, and replication in larger, more rigorous studies is necessary.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16010015

Authors: Haitham Jahrami Waqar Husain Zahra Saif Achraf Ammar Khaled Trabelsi

Background: Ghosting, the sudden cessation of communication without explanation, is a growing phenomenon in digital interactions. Objective: This study translated and validated the Ghosting Questionnaire (GHOST) into French to address the lack of a culturally appropriate tool for French-speaking populations. Methods: Using a cross-sectional design, we followed rigorous translation protocols, including forward and back translation, expert review, and pilot testing. A diverse group of 274 French-speaking adults participated in a multisite study in Bahrain and Tunisia by completing the French language GHOST and the Romantic Ghosting Scale (RG-C). Results: Psychometric analyses revealed strong reliability (Cronbach’s α = 0.880, test–retest ICC = 0.920) and a unidimensional structure (CFI = 0.963, RMSEA = 0.058). Convergent validity was confirmed through significant correlations with RG-C subscales: Role of Aggressor (r = 0.899), Role of Victim (r = 0.829), and Emotional Impact (r = 0.632, all p < 0.001). Item response theory analysis demonstrated proper category functioning and meaningful item hierarchy across ghosting severity levels. Conclusions: The French GHOST offers a robust instrument for researchers and clinicians to explore ghosting’s psychological impacts in French-speaking communities.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16010014

Authors: Cristina Curcio Anna Rosa Donizzetti

Background: In a context of profound transformation within Public Administration, the growing generational diversity of the workforce poses critical challenges to organisational well-being. While ageism is a known risk, the intersectionality of age and gender—manifesting as gendered ageism—remains an under-explored area that can significantly undermine job satisfaction and employee health. Objective: This study aimed to explore the subjective work experience of public sector employees, specifically focusing on intergenerational relations and the impact of gendered ageism. Methods: A qualitative study was conducted involving 30 employees of the Italian Public Administration, recruited via purposive sampling. Data were collected through semi-structured interviews lasting approximately 38 min and analysed using a thematic analysis of elementary contexts via T-Lab software. Results: The analysis revealed four distinct thematic clusters positioned along two main factor axes (Individual/Organisation and Difficulties/Potential). The results show a dichotomy: while positive relationships with colleagues (Cluster 1) and the drive for change (Cluster 4) act as potential resources, the experience is marred by significant difficulties. These include organisational imbalances (Cluster 3) and, crucially, specific experiences of gendered ageism (Cluster 2), manifesting as stereotypes, pressure on women’s physical appearance, and exclusionary dynamics. Conclusions: The findings highlight that gendered ageism is a distinct stressor impacting workforce sustainability. Combating intersectional discrimination represents a strategic priority to safeguard well-being, retain skills, and build a healthy, resilient, and productive working environment.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16010013

Authors: David Leistner Fabio Richlan

The rapid digitalization of healthcare has led to the widespread availability of mobile health (mHealth) applications, including those aimed at mental health and well-being. The present study followed the PRISMA guidelines and systematically reviewed English and/or German mental health apps available in the Google Play Store to evaluate their functional quality and behavior-change potential. It utilized the Mobile App Rating Scale (MARS) to assess app quality, including engagement, functionality, esthetics, and information quality, and the App Behavior Change Scale (ABACUS) to evaluate the potential for behavior change by inclusion of behavior change techniques (BCTs). A total of 77 apps were reviewed, with findings indicating an average functional quality and moderate behavior-change potential, as the reviewed apps only utilized a limited amount of BCTs. Notably, only a small fraction of apps had been evaluated in randomized controlled trials (RCTs). Further analysis showed that MARS and ABACUS scores had limited predictive power regarding app popularity as measured by stars awarded by users and number of user ratings in the Google Play Store. The study highlights the need for more rigorous testing of mHealth apps and suggests that factors beyond those measured by MARS and ABACUS may influence app popularity. In addition to the scientific value, this review provides insights for both users interested in mental health support via apps and developers aiming to enhance the quality and impact of mental health applications.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16010012

Authors: Gustavo Mortari Ferreira Calliandra Maria de Souza Silva Alexandre Sampaio Rodrigues Pereira Larissa Sousa Silva Bonasser Maria Gabriela do Nascimento Araújo Marcelly de Oliveira Barros Roniel Sousa Damasceno Fauston Negreiros Izabel Cristina Rodrigues da Silva

Autism spectrum disorder (ASD) and intellectual disability (ID) frequently coexist and share heterogeneous cognitive manifestations, yet their specific performance patterns on Wechsler scales remain poorly systematized. This meta-analysis synthesized data from 31 studies using the WISC-IV, WISC-V, WAIS-III, and WAIS-IV to compare cognitive index profiles in individuals with ASD, ID and ASD+ID. Standardized mean differences (Hedges’ g) were calculated using random-effects models, adopting a normative reference of mean 100 and SD 15. Results showed a distinct profile for ASD, with greater impairments in the Processing Speed Index (PSI) and Working Memory Index (WMI), while the Vocabulary Comprehension Index (VCI), Perceptual/Fluid Reasoning Index (PRI/FRI), and Visual Processing Index (VPI) remained close to normative scores. In contrast, ID and ASD+ID exhibited generalized deficits across all indices, with the lowest scores in Full-Scale IQ (FSIQ) and broad effects above g = −2.5. No significant differences emerged between Wechsler versions or age-based test types. Heterogeneity was high in ASD and ID across outcomes, but negligible in ASD+ID due to reduced k. These findings reinforce that ASD presents a specific cognitive pattern, whereas ID and ASD+ID display diffuse impairment, and that Wechsler scales are consistent across versions for identifying these profiles.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16010011

Authors: Corinna A. Södel Marga Motzkau Marcel Wilfert Raphael M. Herr Katharina Diehl

University students worldwide experience considerable health challenges. We examined health inequalities in a nationwide, gender-balanced sample of 1105 German students, considering negative (stress, depression, burnout) and positive health outcomes (self-rated health [SRH], well-being) alongside vertical (subjective social status [SSS], parental academic background) and horizontal (gender) determinants. Analyses used bivariate statistics, multivariate regressions, and interaction terms. Higher SSS was associated with better SRH (β = 0.322) and well-being (β = 0.355), and lower stress (β = −0.154), depression (β = −0.127), and burnout (β = −0.219). First-generation students reported highly significant poorer SRH and well-being than students with one (β = 0.114; β = 0.112) or two academic parents (β = 0.162; β = 0.192). Students with two academic parents showed lower stress (β = −0.087, p = 0.007) and burnout (β = −0.099, p = 0.002). Interactions suggest a protective effect of higher SSS on depression (β = −0.219, p = 0.026) and burnout (β = −0.264, p = 0.006), more pronounced among male students, who additionally benefited more from an academic household regarding SRH (β = 0.100, p = 0.044). These findings underscore intersectional and multifaceted inequalities among German students and the need for interventions.

European Journal of Investigation in Health, Psychology and Education doi: 10.3390/ejihpe16010010

Authors: Mariana Ribeiro Paula Saraiva Carvalho Ana Torres Dário Ferreira

(1) Background: Perinatal loss is a deeply painful and often invisible experience, with a significant impact on mental health. This study aimed to assess levels of psychopathological symptoms, shame, and perceived social support according to the type of perinatal loss; explore the relationships between these variables; and analyze the mediating effect of perceived social support on the relationship between shame and symptoms, as well as the moderating effect of the type of loss. (2) Methods: A total of 501 Portuguese women who had experienced perinatal loss participated in the study, recruited through an online questionnaire. Psychopathological symptoms, shame, perceived social support, and type of loss were assessed. Analyses included descriptive statistics, Spearman correlations, normality and homogeneity of variances tests, and mediation and moderation models with PROCESS. (3) Results: The results revealed high levels of anxiety and depression, and moderate levels of shame. Perceived social support, especially from partners and family members, was high. Shame correlated positively with symptoms and negatively with social support. Only social support from friends significantly mediated the relationship between shame and psychological distress. (4) Conclusions: These results reinforce the protective role of support networks and the importance of clinical interventions focused on reducing shame.