A suicide epidemic exists among young U.S. veterans, with risk especially elevated in the first year of transition for the 200,000 servicemembers exiting the military annually. The VA Veteran Sponsorship Initiative (VSI) is a public-private-partnership between federal and community partners that aims to decrease suicides by providing a VA-certified volunteer peer sponsor and connection to community services. Onward Ops is a key community-based national program that enrolls, matches and manages the relationship between servicemembers and sponsors. A prior randomized controlled trial showed that the effectiveness of community interventions can be enhanced when augmented by an Onward Ops sponsor. In preparation for national implementation, we conducted a quasi-experimental, matched-cohort pilot to evaluate the feasibility of an adapted VSI protocol and then assessed effectiveness. The adaptations were executed using the Framework for Reporting Adaptations and Modifications-Enhanced between April 2021 and April 2023. The formative results supported the feasibility of the adaptations to enable proactive enrollment on military installations and expand data infrastructure, partnerships, peer sponsors, and VA clinical services. We then assessed the effectiveness for outcomes not studied in the original VSI trial for active-duty soldiers who enrolled between April and December 2023. After nearest-neighbor matching, the sample included 551 VSI participants and 551 soldiers transitioning as usual. The point-probability contrast or risk differences from the conditional logistic regression model indicated that the VSI caused a statistically significant increase in VA primary care utilization of 0.198 and a statistically significant decrease in suicide attempts of -0.019, both assessed 10 months post-military discharge. The study demonstrated the utility of public-private-partnerships, peer-sponsorship programs and enhanced VA services to support servicemembers during transition.

Individuals with serious mental illness (SMI) face profound and largely preventable physical health inequities shaped by social and structural conditions, representing a major public health concern related to avoidable health inequalities. Because many receive everyday support in community mental health (CMH) systems, these services represent a crucial arena for understanding how such inequities are encountered and made sense of in practice. The study examines how physical health is understood within German CMH practice. Five group discussions with 30 CMH workers were analysed using an interpretive qualitative approach. The analysis identified five professional logics through which physical health becomes part of CMH support: trusting relationships that both enable and limit action; psychological stability as a core mandate; physical health positioned between recognition and delegation; fragile motivation combined with an ethics of restraint; and health promotion situated between aspiration and structural constraint. The findings show that helping relationships, everyday environments, and organisational structures create specific conditions for health-related support. Strengthening these interconnected levels may enable CMH to integrate physical health more systematically, offering insights relevant to international CMH contexts facing similar relational and structural challenges.

Introduction: Workplace mobbing is a psychosocial risk factor associated with adverse mental health outcomes, including depression, anxiety, and suicidal ideation. Accurate assessment of this phenomenon is essential for both research and applied settings; however, validated brief instruments in Spanish remain limited. The Luxembourg Workplace Mobbing Scale (LWMS) is a short measure with sound psychometric properties that allows efficient evaluation of exposure to workplace mobbing. Objective: Translation and validation of the LWMS into Spanish in adults. Methods: A total of 345 adults (51.3% women) participated, completing a sociodemographic questionnaire and psychological instruments. Statistical analyses were conducted using structural equation modelling and item response theory. Results: The LWMS demonstrated adequate content validity; a unidimensional structure (CFI = 0.99, RMSEA = 0.04 [90% CI: 0.001, 0.092], SRMR = 0.02); and reliability (ω = 0.79, H = 0.86 and r_xx = 0.78). In addition, significant associations were found with depressive symptoms (r = 0.37, p = 0.001), generalised anxiety (r = 0.38, p = 0.001), and suicidal ideation (r = 0.27, p = 0.001). Item 2 showed the highest discrimination and information, and the scale proved to be accurate at higher levels of workplace mobbing. Conclusions: The Spanish version of the LWMS shows solid evidence of validity and reliability, supporting its use as a brief and precise instrument for assessing workplace mobbing in adult populations. Its strong psychometric performance and clinical relevance make it suitable for research, screening, and preventive interventions in occupational settings.

Pregnancy represents a major identity transition, yet most perinatal assessments focus primarily on emotional symptoms rather than on how women integrate the maternal role into their broader identity and life context. Difficulties in maternal role integration may constitute an early vulnerability factor for psychological distress. This study aimed to develop and validate the Maternal Role Integration Questionnaire-pregnancy version (MRIQ-P), a brief instrument designed to assess maternal identity and role balance during pregnancy, and to examine its clinical relevance for perinatal mental health.

A sequential mixed-methods design was employed. Phase 1 involved focus groups with pregnant women (n = 17) and cognitive debriefing to generate and refine items. Phase 2 included expert evaluation of content validity. In Phase 3, the MRIQ-P was psychometrically validated in a sample of pregnant women (n = 256), randomly divided into exploratory (n = 83) and confirmatory (n = 173) subsamples. Exploratory and confirmatory factor analyses were conducted, along with reliability analyses, tests of convergent, discriminant, incremental, and measurement invariance validity.

Analyses supported a bifactor structure comprising a general factor of maternal role integration and two specific dimensions: Maternal Identity and Balance of the Maternal Role. The final 8-item version demonstrated excellent internal consistency for the total score (α = 0.96) and subscales (α = 0.98 for Maternal Identity and α = 0.98 for Balance of the Maternal Role), as well as measurement invariance across primiparous and multiparous women. Higher maternal role integration was associated with greater self-esteem, positive affect, and life satisfaction, and with lower anxiety, depression, prenatal distress, and maternal ambivalence. Importantly, MRIQ dimensions explained additional variance in antenatal depression and dispositional guilt beyond established psychological predictors, supporting its incremental and potential clinical utility.

The MRIQ is a brief, psychometrically robust, and clinically relevant instrument for assessing maternal role integration during pregnancy. By capturing identity- and role-related processes that are not directly addressed by symptom-based screening tools, it may contribute to early identification of vulnerability and to more comprehensive perinatal psychological assessment in healthcare settings.

Bipolar disorder is characterized by extreme mood fluctuations that may create emotionally inconsistent caregiving environments for children. Although children of caregivers with bipolar disorder are at elevated risk for psychosocial difficulties, less is known about how parental bipolar symptoms (PBSs) relate specifically to identity development. The present study investigated associations between perceived PBSs and identity outcomes among emerging adults, examining parental attachment as a potential mediator. College students (N = 399) completed an anonymous online survey assessing identity development, attachment to parents, and perception of PBSs. PBSs were positively associated with identity distress, disturbed identity, and lack of identity, and negatively associated with identity consolidation. Mediation analyses indicated that parental attachment partially or fully mediated the relationships between PBSs and each identity variable, suggesting that higher levels of PBSs were associated with less secure attachment, which in turn were linked to greater identity difficulties. These findings highlight the role of parental mental health and attachment in shaping identity development and underscore the importance of accessible mental health care for youth navigating identity formation in the context of caregiver psychopathology. Clinical implications and future directions are discussed.

Background/Objectives: Prior research suggests that it is possible to improve health outcomes in children with adverse childhood experiences (ACEs) through multi-component interventions that promote protective factors. We designed the Families Implementing Resilient Systems Together (FIRST) study to address the gaps in research on the potential effectiveness of screening for specific ACEs through pediatric practice. Methods: As part of our clinical quality improvement efforts to improve patient care for children impacted by ACEs, we trained a random sample of pediatricians on strategies to promote protective factors and encouraged them to make referrals to community health workers (CHWs) and parenting education resources. This manuscript describes our clinic data on practice changes associated with the FIRST physician training, and our data collection plan for our research study. Results: Physician training resulted in attitudinal shifts and measurable behavioral changes. Trained providers made referrals to CHWs for approximately 5-10% of well-child care visits. The majority (84%) of referrals were for multiple risk factors, most commonly ACEs and socioeconomic concerns. The most common ACEs were parental divorce/separation, parent-child verbal abuse, and caregiver mental health problems. Conclusions: FIRST training improves counseling, education and referrals for children exposed to ACEs. Our research study will evaluate the impact of the FIRST intervention and address important questions about associations between specific ACEs, protective factors, and biomarkers of toxic stress.

Skin-to-skin contact (SSC) between mother and infant is known to promote breastfeeding initiation and early bonding. However, evidence regarding the sustained effects of daily SSC during the postpartum period on breastfeeding outcomes and maternal mental health remains limited. This study aimed to evaluate the effects of structured daily SSC on breastfeeding outcomes, lactation status, and maternal postnatal mental health in a real-world clinical setting.

A quasi-experimental design was used to compare mothers who performed daily SSC (SSC group) with those receiving care as usual (control group). Data were collected on postpartum Day 1, Day 3, Week 2, and Week 4. Primary outcomes included exclusive breastfeeding duration, continued breastfeeding duration, and lactation status. Multiple linear regression analyses adjusted for baseline breastfeeding intention and maternal age.

A total of 50 mother-infant dyads were included (SSC: n = 40; control: n = 10). The SSC group was associated with longer exclusive and continued breastfeeding durations and better lactation status (p < 0.05). Depressive symptoms did not differ significantly between groups, although both groups showed decreasing trends over time. After adjustment, daily SSC remained significantly associated with longer exclusive breastfeeding duration (adjusted β = 9.18 days, p = 0.034) and continued breastfeeding duration (adjusted β = 10.57 days, p = 0.001).

Daily SSC is a simple and feasible intervention that may be associated with improved breastfeeding outcomes and lactation performance. Incorporating structured SSC into routine postpartum care may support breastfeeding sustainability and maternal recovery.

Irritable bowel syndrome (IBS) and mental health disorders represent common and significant health concerns in pediatric populations.

This study aimed to evaluate psychological and social risk factors associated with IBS in children and to identify correlations with their gastrointestinal symptoms.

Children aged 4 to 18 years diagnosed with IBS according to Rome IV criteria were eligible for inclusion. Both patients and parents completed a comprehensive questionnaire detailing gastrointestinal symptom characteristics. Additionally, all children underwent psychological assessment.

The study included 24 children with IBS, with a mean age of 12.7 ± 3.4 years. Anxiety was present in 54.2% of cases, and depression in 12.5%. Comparing children with IBS and anxiety to those without these, no statistically significant differences emerged regarding the duration and frequency of abdominal pain; however, abdominal pain intensity was significantly higher in children without anxiety (p = 0.04). The duration of IBS symptoms did not significantly differ in children with or without anxiety (p = 0.21). Impaired emotional self-regulation was identified in 54.2% of participants, and 41.6% exhibited vegetative symptoms in response to stress. Furthermore, 70.8% of parents and/or children reported experiencing a negative family event.

The findings suggest that psychological characteristics and adverse family events are important risk factors associated with pediatric IBS. These factors should be systematically considered as integral components of clinical assessment and management.

Introduction: Adolescent suicide behavior is a global concern and a leading cause of morbidity and mortality in this age group. Pharmaceutical ingestion is a frequent method of suicide attempts, requiring toxicology and psychiatric interventions. This study analyzed data from a pediatric tertiary hospital to elucidate the trends, demographics, and methods used. Methods: This retrospective study was conducted at a single tertiary pediatric hospital in Romania and included adolescents aged 10-18 years admitted for suicide attempts between 2014 and 2024. Data extracted from electronic medical records included age, sex, residence, suicide method, psychiatric history, and clinical outcomes. Temporal trends were analyzed using regression-based methods, and group comparisons were performed using chi-square tests, with statistical significance set at p < 0.05. Results: The study included 1840 adolescents, with a significant increasing trend over time (p < 0.0001), but with a transient decline in 2020. The female-to-male ratio was 5.4:1 (p < 0.0001). The median age of the patients was 15.2 years. The suicide attempt methods were pharmaceutical poisoning (95%), chemical ingestion (4%), and violent methods (1%). Females were more prone to pharmaceutical poisoning, while males were associated with chemical ingestion and violent methods (p < 0.0001). Previously documented psychiatric disorders were present in 32.8% of patients, while 9.6% had a history of prior suicide attempts. Two fatalities (0.1%) were recorded, both involving defenestration. Conclusions: Hospital-treated suicide attempts among Romanian adolescents increased over time, mainly affecting females through pharmaceutical poisoning. Adolescents without prior psychiatric diagnoses reveal gaps in early identification and prevention. These findings highlight important patterns among hospital-treated adolescents and may inform targeted prevention efforts.

The psychosocial needs of families involving a child with a life-limiting or life-threatening condition are well recognized. However, evidence-based interventions that address the needs of the entire family remain scarce, even though family health can be maintained and supported if interventions encompass each individual family member, as well as the family as a unit. The aim was to evaluate the family talk intervention (FTI), regarding family communication, and psychosocial health, for families involving a child with a life-limiting or life-threatening condition.

This pre-post study without a control group involved families of children with a life-limiting or life-threatening condition receiving FTI at a pediatric hospital and a hospice in Sweden. The study is registered at clinicaltrials.gov (ID NCT05020158, date of registration: 23 August 2021). FTI is a family-based intervention with the goal of facilitating family communication about illness-related topics, e.g., prognosis, support parenting, and making all children's needs visible. In total, 105 participants from 29 families were included. Surveys measuring self-assessed family communication and satisfaction, anxiety, resilience, parenting skills, and children's mental problems were answered at three time points: baseline (before intervention), at the end of the intervention, and six months later. Changes over time were analyzed using linear mixed-effects models.

Significant improvements were reported in family communication, family satisfaction, parenting skills, and levels of anxiety over time. Children's mental health problems were reduced over time regarding emotional symptoms, conduct problems, peer relationship difficulties, and hyperactivity. No changes were found regarding resilience.

The results suggest that FTI contributes to improved family communication and psychosocial health for families involving a child with a life-limiting or life-threatening condition. This highlights the value of a systemic approach that actively involves all family members.