Background/Objectives: Maternal postpartum depressive symptoms and the COVID-19 pandemic have both been identified as potential risk factors for socioemotional difficulties in children. This study aimed to assess behavioral outcomes in young children born to mothers previously screened for postpartum depressive symptoms, comparing cohorts evaluated during and after the pandemic using the Child Behavior Checklist (CBCL 1½-5). Methods: An observational follow-up cohort study was conducted on 52 mother-child dyads derived from a previously established maternal cohort screened with the Edinburgh Postnatal Depression Scale (EPDS). Two cohorts were defined according to the child's birth period: during-pandemic (January-April 2022) and post-pandemic (October-November 2023) groups. Behavioral outcomes were assessed using CBCL 1½-5. Group differences were tested using parametric or non-parametric methods for continuous variables and χ2 or Fisher's exact tests for categorical variables. Exploratory regression models and sensitivity analyses were also performed. Results: Children assessed in the post-pandemic cohort showed a lower prevalence of non-normal internalizing scores than those assessed in the during-pandemic cohort, whereas externalizing outcomes and Total Problems did not significantly differ between groups. In exploratory models, a child's age showed a near-significant association with internalizing outcomes, suggesting that developmental stage at assessment may have contributed to the observed cohort difference. Maternal SARS-CoV-2 infection at delivery was not associated with children's behavioral outcomes. Conclusions: These findings suggest a possible difference in internalizing behavioral profiles between children assessed in during-pandemic and post-pandemic cohorts. However, this pattern should be interpreted cautiously because the cohorts differed substantially in age at follow-up, and age-related factors may have affected symptom detectability. Continued longitudinal follow-up will be important to clarify whether the observed differences persist over time.

This cross-sectional study aimed to quantify hope levels in adolescents with chronic musculoskeletal pain (CMP) and examine patient-reported outcomes associated with hope.

This was an exploratory, cross-sectional, secondary analysis of baseline data from a prospective, single-center longitudinal study of 60 youth presenting for an initial evaluation at a pediatric subspecialty pain clinic. Subjects were English-speaking 12-17-year-olds with a diagnosis of CMP, primarily female and non-Hispanic White, with diffuse pain, median pain duration of 2 years, and moderate to severe physical dysfunction. Subjects completed surveys measuring hope (Children's Hope Scale [CHS]) and patient-reported mental, physical, and overall health. Associations between hope scores (total and each subscale) and patient-reported outcomes were evaluated using Spearman rank correlations.

The median CHS score was 20.0 (IQR: 16.5-25.0), indicating slight hope. Patient hope was negatively correlated with depression (r = -0.61), anxiety (r = -0.49), psychological distress (r = -0.52), functional disability (r = -0.43), and pain interference (r = -0.37), but not pain intensity. Adolescents' hope was positively correlated with resilience (r = 0.74) and overall health (r = 0.55; all p < 0.01).

Hope is correlated with various patient-reported health measures in youth with CMP. Although causal inferences are not possible due to the cross-sectional nature of this study, the results suggest that hope may be an important coping mechanism in pediatric chronic pain. Future efforts to incorporate existing resilience coaching programs into usual care may improve hope and health-related quality of life in youth with CMP.

Emotion regulation and attachment styles are interrelated and are critical factors in psychopathology and treatment outcomes, particularly in youths with suicidal behavior receiving psychiatric inpatient care. This study examined the influence of emotion regulation and attachment style on psychiatric hospitalization duration among adolescents admitted due to suicidal ideation or behavior.

Participants included 79 Israeli adolescents (mean age 15.35 years, 87.3% female) admitted to a tertiary psychiatric inpatient unit following a suicidal crisis. Data was collected using the Difficulties in Emotion Regulation Scale (DERS), the Experience in Close Relationships Scale (ECR), the Screen for Child Anxiety-Related Emotional Disorders (SCARED), the Patient Health Questionnaire (PHQ-9), and the Columbia-Suicide Severity Rating Scale (C-SSRS). Data were analyzed using correlation and multiple regression analyses.

Analysis revealed that greater emotion regulation difficulties predicted longer hospitalization duration (β = 0.41, p < 0.001), while avoidant attachment style was associated with shorter hospitalization duration (β = -0.35, p < 0.001). Notably, the level of suicidality as well as psychopathology symptoms (depression and anxiety) did not predict hospitalization duration.

These findings underscore the important role of emotion regulation and attachment style in determining treatment duration in suicidal adolescents, beyond the severity of psychopathology and suicidality, suggesting their unique contribution to treatment planning. Clinical interventions targeting emotion regulation and attachment styles could enhance inpatient care effectiveness, offer a more personalized treatment approach and potentially reducing hospitalization duration.

Background: Psychological stress is a common concern among university students, which is also pronounced among nursing students due to the academic and clinical demands of their training. Persistent stress can negatively affect students' mental well-being, academic performance, and professional development. Social support has been identified as an important protective factor. However, evidence on the relationship between perceived social support and stress among nursing students in Middle Eastern educational contexts remains limited. Methods: A cross-sectional survey was conducted among nursing students. The survey included the Multidimensional Scale of Perceived Social Support (MSPSS) and the 10-item Perceived Stress Scale (PSS-10), along with sociodemographic and academic characteristics. Multivariable linear regression was used to examine the association between perceived social support and perceived stress after adjusting for age group, sex, program type, living arrangement, and employment status. Differences in stress across levels of social support were also examined using analysis of variance (ANOVA). Results: A total of 182 nursing students participated in the study. The mean perceived social support score was 4.95 (SD = 1.42), while the mean perceived stress score was 15.49 (SD = 2.82). We found that higher perceived social support was significantly associated with lower perceived stress (β = -1.9, 95% CI: -3.4 to -0.44), indicating that a one-point increase in the MSPSS score was associated with a 1.9-point decrease in perceived stress. Other sociodemographic factors were not significantly associated with stress. ANOVA indicated significant differences in stress across social support levels (F(2,179) = 6.91, p = 0.001). Conclusions: Perceived social support was significantly associated with lower levels of perceived stress among nursing students. These findings highlight the potential importance of strengthening supportive social environments to promote psychological well-being in nursing education.

Self-criticism is a transdiagnostic factor associated with psychological distress and poorer outcomes in traditional psychotherapy, yet recent evidence suggests it may facilitate change in preventive and low-intensity interventions. This study examined the role of self-criticism in adherence, working alliance, and outcomes within NoiBene, a guided self-help program designed to promote well-being and prevent psychological distress among non-clinical university students.

A total of 455 participants (82% female; M = 23.5 years) completed measures of internalized and comparative self-criticism, and key psychological processes (e.g., emotional awareness, rumination, worry, perfectionism, psychological inflexibility, and assertiveness) were assessed before and after the intervention. Adherence and working alliance were measured only after the intervention.

Contrary to evidence from clinical settings, severe self-criticism was not associated with increased dropout or weaker alliance. Instead, individuals with severe self-criticism exhibited the greatest improvements across multiple domains, suggesting a higher potential for therapeutic gain. Moreover, participants with moderate levels of both internalized and comparative self-criticism showed higher dropout and lower adherence.

These findings indicate that, in preventive guided self-help contexts, self-criticism does not necessarily hinder engagement and outcomes and may, under certain conditions, function as a catalyst for change. Implications for tailoring digital preventive interventions and addressing dropout risk are discussed.

Background: This study aims to psychometrically validate the abbreviated version of the Connor-Davidson Resilience Scale (CD-RISC-10) in Peruvian nurses, evaluating its convergent validity through its association with perceived stress and empathy. Methods: A cross-sectional psychometric study was conducted in 374 Peruvian nurses to evaluate the psychometric properties of CD-RISC-10 through confirmatory factor analysis (CFA). Furthermore, concurrent validity was assessed through correlational analysis using Spearman's rho coefficient to evaluate the relationships among resilience, perceived stress, and empathy. Results: The CFA supported the predominantly one-dimensional model showing an adequate fit when the residual covariance between Items 4 and 7 was specified after correlating the residuals of Items 4 and 7 (CFI = 0.978, TLI = 0.971, RMSEA = 0.080, and SRMR = 0.044). Ordinal Cronbach's alpha of 0.89 and McDonald's omega of 0.81 were obtained. Concurrent validity showed significant correlations with perceived stress (rho = -0.53, p < 0.001) and empathy (rho = 0.31, p < 0.001). Conclusions: The CD-RISC-10 has adequate psychometric properties in Peruvian nurses. Future studies are needed to evaluate its factorial invariance between clinical specialties and establish normative thresholds.

Background: The full-scale Russian invasion of Ukraine in 2022 triggered the largest displacement crisis in Europe in recent decades. Displacement may affect both clinical outcomes and mental health among people living with HIV (PLHIV). Evidence comparing displaced PLHIV with host-country patients within the same healthcare system remains limited. This study aimed to compare epidemiological characteristics, clinical staging, and mental health outcomes between war-displaced Ukrainian PLHIV and Slovak PLHIV receiving care in the same clinical setting, with particular attention to sex-specific differences. Methods: This cross-sectional study included 137 PLHIV receiving care at the HIV/AIDS Centre, University Hospital Bratislava, Slovakia (69 from Ukraine and 68 from Slovakia). Anxiety and depressive symptoms were assessed using the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) scales. Scores were categorized into three severity groups (0-4, 5-9, ≥10). Results: Age distribution was comparable between cohorts (p = 0.2438). Transmission patterns differed substantially: heterosexual transmission predominated among Ukrainian participants, whereas men who have sex with men (MSM) transmission predominated among Slovak men (p < 0.001). Ukrainian patients were more frequently classified in CDC stage C, while Slovak patients more often presented in stage A. The combined antiretroviral therapy coverage was 100% in both cohorts and viral suppression rates were high (HIV RNA < 200 copies/mL: 91.3% in Ukraine vs. 94.1% in Slovakia). Overall anxiety and depressive symptom severity did not differ significantly between cohorts (GAD-7 p = 0.4145; PHQ-9 p = 0.7661). However, within the Ukrainian cohort, women demonstrated higher depressive symptom severity compared with men (p = 0.0478). Conclusions: War-displaced Ukrainian PLHIV achieved comparable biomedical outcomes to host-country patients within a structured healthcare system. However, depressive vulnerability emerged at the intersection of gender and displacement. These findings highlight the importance of integrating gender-sensitive mental health screening and psychosocial support into routine HIV care for displaced populations.

Objectives: We aimed to evaluate the reliability and validity of the Arabic version of the Chronic Heart Failure Health-Related Quality of Life Questionnaire (CHFQOLQ-20) among patients with heart failure in Jordan. Methods: A cross-sectional study was conducted among 399 adults with heart failure recruited from a tertiary hospital in Jordan (median age 68 years; 55.9% male). The CHFQOLQ-20 was translated using forward-backward procedures. Construct validity was examined using confirmatory factor analysis (CFA) and a multidimensional Partial Credit Model. Differential item functioning by sex and internal consistency were assessed. Results: CFA supported the original four-domain structure (physical, cognitive, mental, and general health), with all items showing significant factor loadings. Item-level analyses demonstrated acceptable model fit, ordered response thresholds, and minimal sex-related bias. Physical health scores were lower than other domains. Conclusions: The Arabic CHFQOLQ-20 is a valid, reliable, and multidimensional measure of HRQoL in patients with heart failure, supporting its use in clinical practice and research.

Background: Social anxiety in adolescence is a prevalent mental health concern characterized by intense fear of negative evaluation in social situations. The Social Anxiety Questionnaire for Adolescents (CASO-N24) is a Spanish-language instrument requiring validation in Peruvian populations. Objective: This study aimed to validate the CASO-N24 in Peruvian adolescents aged 12-17 years, extending its application beyond the original 9-15-year range, and examine its psychometric properties including factorial structure, measurement invariance, nomological validity, and internal consistency. Methods: A stratified probability sample of 710 adolescents (352 males, 358 females; M = 14.82 years, SD = 1.45) from four northern Peruvian educational centers completed the CASO-N24 and ASQ-14. Exploratory and confirmatory factor analyses, multigroup invariance testing by age and gender, nomological validity assessment, and reliability estimation (Cronbach's α and McDonald's ω) were conducted using polychoric correlations and robust estimation methods. Results: The six-factor structure was replicated, explaining 47.13% of variance with factor loadings ranging 0.48-0.78. Model fit indices were excellent (GFI = 0.981, AGFI = 0.976, NFI = 0.971, SRMR = 0.046). Complete measurement invariance was achieved across age groups (12-15 vs. 16-17 years). Partial invariance by gender was observed, with differential item functioning identified in item 17. Nomological validity was confirmed through moderate-to-high correlations with ASQ-14 (males: r = 0.622; females: r = 0.604). Internal consistency was adequate (total scale ω = 0.95; subscales ω = 0.69-0.82). Conclusions: The CASO-N24 demonstrated robust psychometric properties for assessing social anxiety in Peruvian adolescents aged 12-17 years, supporting its multidimensional structure and utility for early detection in school settings while highlighting gender-specific response patterns warranting clinical consideration.

Background: Artificial intelligence (AI) is increasingly embedded in routine primary care, yet how the levels of integration might affect its acceptability is unknown, especially in relationship-based service models where patients expect visible human stewardship. Prior experimental studies often treat AI adoption as a binary condition, leaving the "intensity gradient" of automation and the role of model specialization under-explored. We examine whether increasing AI integration in the clinical encounter erodes patients' intention to seek care from family doctors in China, and whether labeling the AI as a medical-specific model buffers such erosion. Methods: We conducted a nationwide online survey experiment in China (N = 2790). Participants were randomly assigned to vignettes that varied by (i) the level of AI integration (low, medium, high) and (ii) the AI type (general-purpose vs. medical-specific large language model), with a human-only care scenario as a reference. Care-seeking intention from family doctors was assessed immediately after exposure. We estimated treatment effects using OLS regression with heteroskedasticity-robust standard errors, and examined the buffering hypothesis through an interaction term between AI integration intensity and AI type. Results: Care-seeking intention declined steadily as AI integration increased (p < 0.001), with the sharpest drop under high-intensity AI integration where clinical decisions were delegated to the AI system. Across all intensity levels, framing the system as a medical-specific AI consistently resulted in higher care-seeking intention than a general-purpose model. However, the interaction between AI intensity and the AI type was not statistically significant (p = 0.508). Conclusions: Patient acceptance of AI in primary care depends not only on whether AI is involved, but on how deeply AI is positioned in the encounter. Medical-specific AI labeling may enhance acceptance across all AI integration levels. The findings underscore the need to preserve human clinical agency in AI-embedded primary care. The results contribute to research on healthcare systems, digital health, and AI-patient interaction.