Search Results (1,433)

Objectives: Prolonged opioid use leads to tolerance and hyperalgesia in patients with chronic pain. Apart from an increase in pain, opioid use also leads to several other adverse effects. Nevertheless, the prevalence of opioid use as a treatment for chronic pain remains high, and opioid withdrawal interventions deserve more attention. This study evaluates the effects of a guideline for an opioid withdrawal intervention method that is nested in cognitive behavioral treatment (CBT) and is specifically for patients with a history of long-term opioid use and chronic pain. Methods: We conducted a clinical, exploratory, and mixed-methods study involving pre- and post-measurements on opioid use and health-related quality of life (SF-36), as well as a qualitative analysis of patient experiences (interviews) to evaluate the program. Results: A total of 29 patients were included in the study; 23 of these patients no longer used opioids, and some continued withdrawal under the guidance of their general practitioner. Quality of life improved in all domains, including the amount of pain experienced. No patients reported increased pain levels, and most experienced significantly fewer adverse side effects. Patient satisfaction was high, with no negative long-term side effects of the intervention reported. Conclusions: In light of the results of this study, it is important to address opioid use in patients with chronic pain. There are strong arguments in favor of motivating patients to withdraw from using opioids to treat chronic pain, which can be achieved in combination with CBT. Full article

Background: Posterior Cortical Atrophy (PCA) is a clinical syndrome marked by progressive visuospatial impairment, usually due to underlying Alzheimer’s disease. While reading and spelling deficits are recognized clinical features of this syndrome, the contributions of visuoperceptual versus linguistic deficits to these impairments are still unclear. Methods: To that end, we examined reading and spelling performance in 23 individuals from the Massachusetts General Hospital PCA cohort. Participants completed tests of reading from the Western Aphasia Battery and spelling to dictation from the Boston Diagnostic Aphasia Examination. A mixed-methods analysis included quantitative scoring and qualitative observations of visual behaviors, error patterns, and compensatory strategies. Results: Participants commonly demonstrated visual scanning errors, difficulty following multi-line text, and spelling errors reflecting both visual–perceptual and orthographic–linguistic breakdowns. Conclusions: Because reading and spelling in PCA are variably impaired cognitive skills driven by visual deficits and lexical vulnerability, assessments and interventions must account for deficits in both cognitive processes. Our findings highlight the vulnerability of reading and spelling in PCA and underscore the need for multimodal assessment strategies that account for the interplay of visual, phonological, and lexical processes. These insights can inform diagnosis and guide the development of accessible interventions tailored to optimize compensatory strategies to support functional language abilities. Full article

Background/Objective: The sequelae of COVID-19 on geriatric health is profound, yet its consequences on mental well-being remain insufficiently elucidated, particularly in older adults with musculoskeletal conditions. This study aimed to explore the interrelationships and magnitude of the effects of fear of COVID-19, fear of falls, physical activity, and social frailty on depressive symptoms in this population. Methods: Purposive sampling was applied to recruit 292 older adults with musculoskeletal conditions. Data were collected through structured interviews (face-to-face and telephone) using standard questionnaires. Path analysis with Satorra–Bentler correction examined the relationships in the proposed model of depressive symptoms. The model fit indices were evaluated using the chi-square (χ²); the goodness-of-fit test was assessed with standard criteria of the comparative fit index (CFI ≥ 0.95), the Tucker–Lewis index (TLI ≥ 0.95), the root mean squared error of approximation (RMSEA < 0.08), and the standardized root mean square residual (SRMR < 0.05). Results: Mean participant age was 70.30 ± 6.56 years, with 74.3% female. The path analysis model demonstrated an excellent fit indicating χ² = 0.007 (p = 0.933), CFI and TLI = 1.000, RMSEA = 0.000, SRMR = 0.001. Fear of COVID-19 negatively indirectly impacted depressive symptoms (β = −0.07, p = 0.017), while physical activity had a positive direct effect (β = 0.16, p = 0.004). Fear of COVID-19 directly influenced social frailty (β = 0.18, p = 0.003) but had a negative direct impact on physical activity (β = −0.37, p = 0.000). However, fear of falling did not show a significant relationship with the other study variables. Conclusions: Depressive symptoms entail physical and psychosocial consequences. Physical activity has a positive effect on depressive symptoms. Fear of COVID-19 increases social frailty, while increasing physical activity reduces this fear. Future research should evaluate longitudinal effects and investigate evidence-based public health interventions or tailored cognitive–behavioral interventions to reduce pandemic-related fear and prevent mental health sequelae. Full article

Emotional intelligence (EI) and its meta-cognitive counterpart, meta-emotional intelligence (MEI), have increasingly been recognized as key factors in helping students understand, regulate, and reflect on their emotional experiences. MEI expands upon EI by incorporating meta-cognitive beliefs and awareness about one’s own emotional functioning, thereby influencing both emotional regulation and positive behavioral choices. This study examined the relationship between MEI and the knowledge of positive behavioral rules among 198 students aged 9 to 12. Participants completed the IE-ACCME-B, which assesses meta-emotional beliefs, emotional self-conceptualization, and emotional abilities, along with the PBIS-KGVE, a tool developed ad hoc to measure knowledge, generalization, and value-based understanding of school rules. Findings highlight that almost all considered variables are intercorrelated, with meta-emotional beliefs being the best predictor of the students’ knowledge, generalization, and value-based interpretation of behavioral rules. These results suggest the opportunity to establish interventions focused on meta-emotional beliefs to enhance behavioral rule knowledge and foster prosocial development within educational contexts. Full article

This study investigates how smartphone app usage diversity (SAUD)—defined as the breadth of applications individuals actively engage with—relates to quality of life, and how these effects are conditioned by age and digital literacy. Drawing on Uses and Gratifications Theory and Cognitive Load Theory, we conceptualize SAUD as having both beneficial and detrimental potential, depending on users’ cognitive and demographic characteristics. Using cross-sectional, self-reported data from the annual nationwide surveys on smartphone overdependence in South Korea, we analyzed a final sample of 20,967 adults (48.4% male, 51.6% female; M_age = 46.0, SD = 13.7; age range 20–69). Results demonstrate that SAUD is positively associated with quality of life among younger and digitally literate users, but negatively associated among older adults and those with lower digital literacy, suggesting the presence of conditional effects. The hypothesized three-way interaction between SAUD, age, and digital literacy was not supported. These findings extend the literature by moving beyond simplistic time-based metrics of smartphone use, offering a more differentiated understanding of mobile technology’s impact on well-being. Practically, the study highlights the need for tailored digital literacy programs and policy interventions that recognize demographic and cognitive diversity in technology engagement. Future research should incorporate longitudinal designs and objective behavioral data to further validate these insights. Full article

Background: Displaced individuals endure challenges, including conflict, forced migration, family separation, human rights violations, limited access to essential services, and increased exposure to violence and abuse. These hardships significantly impact their mental health, often leading to heightened trauma-related symptoms. Methods: We used a cross-sectional correlational design in refugee camps, homes, and centers across Jordan and Spain. 200 refugees with confirmed status in the past ten years were recruited. Demographic data were collected via a demographic form, the PTSD-8 Inventory assessed traumatic symptoms, and data analysis included descriptive statistics, independent t-tests, one-way ANOVA, and Chi-square tests. Results: Most participants had a secondary education, were unemployed, and had low incomes. PTSD symptoms were prevalent, with rates of recurrent thoughts (63.5%), re-experiencing events (57.5%), nightmares (50.5%), sudden reactions (56.5%), activity avoidance (53.5%), avoidance of specific thoughts or feelings (56.5%), jumpiness (53.5%), hypervigilance (53.5%), feeling on guard (41.5%), and general avoidance (43.5%) rated from rarely to most of the time. All symptoms were significantly more frequent among refugees in Jordan than in Spain. Conclusions and Recommendations: Intrusive thoughts were more frequent among females, urban residents, and unemployed individuals. Avoidance behaviors were higher in married and unemployed individuals. Hypervigilance was more prevalent among females, married individuals, and those with lower incomes. Regionally, females and married individuals in Jordan exhibited more intrusive thoughts and avoidance. In Spain, intrusive thoughts and hypervigilance were more common among females and the unemployed. The findings highlight the urgent need for targeted mental health interventions, particularly in refugee camps like those in Jordan, where PTSD symptom rates were significantly higher. Programs should prioritize trauma-focused therapies, such as Cognitive Behavioral Therapy, while adopting gender-sensitive approaches to address the heightened vulnerability of women and unemployed individuals. Given the strong link between unemployment and symptom severity, livelihood support and vocational training should be integrated into psychosocial care. Policymakers in host countries like Jordan could benefit from adopting integration strategies similar to Spain’s, which may contribute to lower PTSD prevalence. Additionally, community-based awareness initiatives could improve early symptom recognition and access to care. Future research should explore longitudinal outcomes to assess the long-term impact of displacement and resettlement conditions on mental health. Full article

Global estimates show a 17.9% prevalence of neuropsychiatric disorders in individuals recently hospitalized with COVID-19. Cognitive behavioral therapy (CBT) has been proposed as a nonpharmacological strategy to mitigate these effects. This study examined the potential effects of CBT on anxiety, depression, post-traumatic stress disorder (PTSD), and quality of life (QoL) in post-COVID-19 patients. This prospective, nonrandomized, single-center clinical trial involved 15 patients (mean age 53.4 years) who underwent weekly CBT sessions for six weeks. Between-group differences in anxiety and depression scores were non-significant (p > 0.05); however, significant intragroup improvements were observed in anxiety (p = 0.01), depression (p = 0.01), and PTSD (p = 0.01) after the intervention. Thus, CBT was associated with reduced anxiety, depression, and PTSD as well as improved quality of life in post-COVID-19 patients. Improvements in QoL were noted mainly in the domains of functional capacity, vitality, emotional aspects, and mental health. While these findings suggest that CBT may be beneficial for post-COVID-19 patients, the small sample size, absence of a control group, and short follow-up period limit the strength of our conclusions. Therefore, the results should be considered preliminary, and further randomized controlled trials with larger sample sizes are warranted. Full article

Background/Objectives: The gut microbiome is increasingly recognized as a key modulator of central nervous system function through the gut–brain axis. Dysbiosis has been associated with neuropsychiatric disorders such as depression, anxiety, impulsivity, cognitive decline, and addiction. This review aims to synthesize mechanistic insights and therapeutic perspectives on how gut microbiota influence mood regulation, decision-making, and cognitive processes. Methods: A comprehensive narrative review was conducted using peer-reviewed articles retrieved from PubMed, Scopus, and Web of Science up to August 2025. Studies were included if they explored microbiota-related effects on behavior, mood, cognition, or decision-making using human or animal models. Emphasis was placed on molecular mechanisms, microbiome-targeted therapies, and multi-omics approaches. Results: Evidence indicates that gut microbiota modulate neurochemical pathways involving serotonin, dopamine, GABA, and glutamate, as well as immune and endocrine axes. Microbial imbalance contributes to low-grade systemic inflammation, impaired neuroplasticity, and altered stress responses, all of which are linked to mood and cognitive disturbances. Specific microbial taxa, dietary patterns, and interventions such as probiotics, prebiotics, psychobiotics, and fecal microbiota transplantation (FMT) have shown promise in modulating these outcomes. The review highlights methodological advances including germ-free models, metagenomic profiling, and neuroimaging studies that clarify causal pathways. Conclusions: Gut microbiota play a foundational role in shaping emotional and cognitive functions through complex neuroimmune and neuroendocrine mechanisms. Microbiome-based interventions represent a promising frontier in neuropsychiatric care, although further translational research is needed to define optimal therapeutic strategies and address individual variability. Full article

Background/Objectives: Accumulating evidence suggests that cognitive training can induce functional reorganization of intrinsic connectivity networks involved in higher-order cognitive processes. However, few interventions have specifically targeted language, an essential domain tightly interwoven with memory, attention, and executive functions. Given their foundational role in communication, reasoning, and knowledge acquisition, enhancing language-related abilities may yield widespread cognitive benefits. This study investigated the neural impact of a new structured, language-based cognitive training program on neurotypical older adults. Methods: Twenty Brazilian Portuguese-speaking women (aged 63–77 years; schooling 9–20 years; low-to-medium socioeconomic status) participated in linguistic activities designed to engage language and general cognitive processing. Behavioral testing and resting-state functional Magnetic Resonance Imaging (fMRI) were conducted before and after the intervention. Results: Functional connectivity analyses revealed significant post-intervention increases in connectivity within the frontoparietal network, critical for language processing, and the ventral attentional network, associated with attentional control. Conclusions: The observed neural enhancements indicate substantial plasticity in cognitive networks among older adults, highlighting the effectiveness of linguistic interventions in modulating critical cognitive functions. These findings provide a foundation for future research on targeted cognitive interventions to promote healthy aging and sustain cognitive vitality. Full article

Febrile seizures (FS) are a common childhood neurological event associated with an increased risk of long-term cognitive and emotional deficits, though the precise mechanisms remain elusive. Using a rat model, we investigated the long-term effects of FS induced on postnatal day 10, assessing outcomes in young adulthood (P45-55). We report region-specific neuronal loss in the hippocampus, more extensive in the ventral segment. Molecular analysis revealed a broad downregulation of genes encoding ionotropic and metabotropic glutamate receptors and excitatory amino acid transporters. These alterations were most severe and persistent in the ventral hippocampus and medial prefrontal cortex. Behaviorally, rats with neonatal FS exhibited a hyperanxious phenotype, characterized by reduced locomotor and exploratory activity and impaired habituation to a novel environment. In contrast, spatial working memory and social behavior remained intact. Our results provide the first comprehensive evidence that neonatal FS trigger long-term, region-specific disruptions of the glutamatergic system within hippocampal–prefrontal circuits. These findings identify vulnerable molecular targets and precise neurobiological mechanisms that may underlie the heightened risk of anxiety-related disorders following early-life FS, suggesting new avenues for therapeutic intervention. Full article

Background: Sexual dysfunction (SD) is a common yet under-recognized consequence of traumatic brain injury (TBI), with significant implications for physical health, psychological well-being, interpersonal relationships and social reintegration. Although TBI research has largely focused on cognitive, motor and behavioral outcomes, the impact of SD remains insufficiently addressed in both clinical practice and rehabilitation programs. Objectives: This review aims to synthesize current evidence on the prevalence, mechanisms and management of SD following TBI, while emphasizing the importance of gender-sensitive and multidisciplinary approaches to care. Methods: A narrative review was conducted by searching PubMed, Scopus and Web of Science for English-language articles published between 2000 and 2025 using combinations of the following keywords: traumatic brain injury, sexual dysfunction, neuroendocrine dysfunction, psychological sequelae and rehabilitation. Priority was given to peer-reviewed clinical studies, systematic reviews and expert consensus guidelines that addressed neurological, endocrine, cognitive, psychological and social aspects of SD in TBI survivors. Exclusion criteria included case reports with insufficient clinical detail and non-peer-reviewed sources. Articles were screened for relevance to both pathophysiological mechanisms and therapeutic strategies. Results: The etiology of post-TBI SD is multifactorial, involving direct neurological injury, hypothalamic–pituitary dysfunction, emotional and cognitive impairments, as well as psychological challenges such as stigma and relationship strain. Men and women may present distinct symptom profiles; for instance, men more frequently report erectile dysfunction and hypogonadism, whereas women more commonly experience challenges with arousal, lubrication and psychological stress. Effective interventions include pharmacotherapy, hormone replacement therapy, psychotherapy and rehabilitative approaches designed to restore intimacy and quality of life. Optimal outcomes are achieved through multidisciplinary collaboration among neurology, endocrinology, psychiatry, psychology and rehabilitation medicine. Conclusions: Sexual dysfunction should be recognized as a critical component of TBI sequelae rather than a secondary concern. Routine screening, gender-sensitive assessment and the integration of individualized, multidisciplinary care pathways are essential to improving patient outcomes. Advancing clinical awareness and standardization in this area holds the potential to significantly enhance the holistic recovery and reintegration of TBI survivors. Full article

Schools constitute strategic settings for shaping eating behaviors among youth. Given the profound environmental, health, and social challenges associated with current food systems, there is an urgent need to explore dietary patterns that simultaneously support human well-being, ecological sustainability, and ethical principles. This comprehensive review provides a contemporary overview of the role of plant-based diets as an instrumental pathway to a healthier and more sustainable future by examining (i) environmental and social impacts of current food systems; (ii) the effects of plant-based diets on health; (iii) determinants of plant-based diet implementation in schools, including barriers and facilitators to their adoption; and (iv) the development of future-oriented dietary guidelines. Transitioning to plant-based diets, combined with sustainable agricultural practices, can reduce resource use and promote ecological sustainability. Promoting plant-based diets can also encourage the development of a more responsible and equitable social culture. Plant-based diets consistently provide metabolic, cardiovascular, and anti-inflammatory benefits across diverse populations, contributing to healthy weight and glycemic regulation. Well-planned plant-based diets may also improve cognitive function and promote psychological well-being. The integration of plant-based diets in schools is limited by barriers such as children’s food preferences, habitual eating patterns, peer influence, time and resource constraints, limited knowledge, cultural attachment to meat, and low family involvement. Conversely, facilitators including experiential learning, nutrition education, teacher and family engagement, social norms, ethical or environmental motivations, and institutional support promote acceptance and implementation. Ongoing research is required to refine dietary recommendations, assess long-term health outcomes, and ensure nutritional adequacy across pediatric populations. Continued evaluation of school-based interventions and policy frameworks will be essential to optimize the integration of plant-based diets and to monitor their health, ethical, and environmental impacts. Full article

With billions of users worldwide, social media has become a powerful force in shaping lifestyle behaviors, including physical activity (PA), particularly among young adults. This narrative review examined the growing role of social media–driven interventions in promoting PA among young adults at risk of obesity. We analyzed the application of behavior change theories, including Social Cognitive Theory, the Theory of Planned Behavior, the COM-B, and specific behavior change techniques, alongside the role of intersectionality in shaping intervention effectiveness. Platform-specific strategies across Instagram, TikTok, YouTube, and Facebook were summarized, highlighting engagement mechanisms, personalized content delivery, and behavior change approaches that influence behavioral, physiological, and motivational outcomes. Despite these opportunities, challenges such as ethical concerns, misinformation, accessibility barriers, and quality control issues remained significant. Finally, future directions were outlined, including integration with wearables, AI-driven multi-platform strategies, co-designed interventions, and policy frameworks to optimize digital health promotion. In conclusion, social media offers considerable potential as a cost-effective, accessible tool for promoting PA and preventing obesity in young adults, though effectiveness is limited by misinformation, unregulated content, and poor quality control. Full article

Positive childhood experiences (PCEs) are increasingly recognized as critical factors that promote resilience, emotional regulation, and flourishing in children, especially in the context of adversity. This narrative review explores the conceptual development, empirical evidence, and theoretical frameworks underpinning the role of PCEs in early childhood development. A critical assessment of the existing literature focuses on how PCEs function as promotive and protective factors and evaluates the strengths and limitations of current measurement tools. Drawing on theories from resilience science, developmental psychopathology, positive psychology, and ecological systems theory, this review highlights the complex, multidimensional nature of PCEs and their interplay with parenting styles, socioeconomic status, and the social drivers of health. Despite compelling evidence that PCEs influence cognitive, emotional, relational, and behavioral outcomes across the lifespan, there is no dedicated validated tool for prospectively measuring PCEs in preverbal or preschool-aged children. This gap limits our ability to design and test interventions to mitigate adverse childhood experiences and to assess their developmental impact in real time and subsequent periods. We conclude that future research should focus on creating culturally sensitive, developmentally appropriate instruments to measure PCEs in early life, essential for advancing equity, optimizing child health, and promoting wellness across diverse populations. Full article

Background/Objectives: Pausing is a multifaceted phenomenon relevant to motor and cognitive disorders, particularly Parkinson’s Disease (PD). Thus, examining pauses as a metric for linguistic planning and motor speech difficulties in PD patients has gained significant attention. Here, we examined the production of silent and filled pauses (indexing difficulties at various linguistic processing levels) during narrative tasks to investigate the interplay between pausing behavior and informativeness/productivity measures. Methods: Individuals’ pausing patterns during narratives were analyzed relative to their syntactic context (within and between sentences expressing motor and non-motor related content), in 29 patients in the mild-to-moderate stage of PD, and 29 age-matched healthy speakers. The interaction between communicative metrics (informativeness and productivity), motor symptoms, cognitive capabilities, and pausing behavior was explored to characterize the mechanisms underlying pause production and its influence on discourse content. Results: PD patients’ pausing profile was characterized by an overall reduced number of pauses, longer silent pauses and fewer/shorter filled pauses, particularly before words that extend or specify the semantic content of sentences. Contrary to what was observed in healthy speakers, both the duration of silent pauses and the total number and duration of filled pauses could explain a significant proportion of variance in informativeness measures. Silent pause duration significantly correlated with measures of lexical access, indicating that cognitive processes influence pause production, while motor speech and cognitive challenges may also interact. Conclusions: Current results have significant implications for understanding discourse difficulties linked to PD and for formulating intervention strategies to improve communication efficacy. Full article