To determine the association between intimate partner violence and alexithymia in pregnant women treated at two hospitals in Cusco, 2025.

A cross-sectional analytical study was conducted, which included 286 pregnant women treated in the outpatient clinics of Gynecology and Obstetrics at Hospital Antonio Lorena and Hospital Regional del Cusco between February and April 2025. Direct interviews were applied using the Toronto Alexithymia Scale (TAS-20) and the Woman Abuse Screening Tool (WAST). Statistical analysis was performed using the generalized linear model (GLM) with Poisson distribution, logarithmic link function, and robust variance, calculating adjusted prevalence ratios (aPR).

286 pregnant women were included. 71.7% presented alexithymia and 55.6% reported intimate partner violence (IPV). The study reveals that the prevalence of alexithymia was 50% higher in pregnant women with IPV (aPR: 1.50; 95% CI: 1.26-1.79; p<0.001), adjusted for origin, educational level, employment status, economic situation, number of gestations, and pregnancy planning.

Intimate partner violence was significantly associated with a higher prevalence of alexithymia in pregnant women treated at two hospitals in Cusco. Pregnant women exposed to violence showed a 50% higher prevalence of alexithymia, even after adjusting for sociodemographic and obstetric variables.

Sleep is essential for health, yet a large proportion of the population reports sleep complaints. The ASLEEP (Preventing and Treating Insomnia Symptoms in Mid-Life and Older Adults) intervention is conceptualized as an eCBT-I (digitally delivered cognitive behavioral therapy for insomnia) intervention aiming to prevent and treat insomnia in individuals aged 50 years and over through a novel, tiered approach. The first step, a basic course delivered via iPad through a dedicated app, includes educational videos grounded in sleep education and sleep hygiene advice, a 7-day digital sleep diary, and a postcourse digital sleep report providing personalized feedback on sleep efficiency via email.

The objective of this study was to assess the feasibility and acceptability of the ASLEEP basic course among adults aged 50 years and over, including participant engagement, acceptability of the course content, and delivery of study activities, through PROTECT Norge (Platform for Research Online to Investigate Genetics and Cognition in Ageing Norge), an online research infrastructure.

A single-arm multimethod feasibility and acceptability study was conducted as a nested study within PROTECT Norge. Data comprised preintervention questionnaires on sleep and mental health, intervention compliance tracking, and 2 postintervention focus group interviews. Questionnaire and compliance data were analyzed descriptively, and focus group data were analyzed using systematic text condensation.

Of 150 invited individuals, 18 expressed interest. Ten participants were included in the study, all of whom completed the intervention and subsequently took part in 2 focus group interviews, with 5 participants in each group. Participants included 6 women and 4 men aged 54 to 78 years. Preintervention data showed that 7 participants reported subthreshold insomnia and 3 reported no insomnia. Sleep diary compliance during the ASLEEP basic course was 99.3%. The systematic text condensation analysis revealed three main categories: (1) motivation for participation in the ASLEEP study, (2) benefits of the ASLEEP intervention, and (3) promoting and hindering factors of delivering a fully digitalized intervention.

The ASLEEP basic course was well-received and provided participants with a new understanding of sleep through increased knowledge and awareness. Technological insecurity was experienced by some of the participants, but it was mitigated by technical support. Improving app stability and expanding device compatibility could enhance accessibility and optimize ASLEEP's future delivery. The PROTECT Norge platform demonstrated good feasibility in recruitment, participant management, and compliance monitoring, supporting the successful delivery of the study.

Negative interpretation bias, the tendency to interpret ambiguous situations as negative or threatening, is associated with reports of intense and more frequent negative affect. However, there is a relative paucity of work seeking to determine whether this cognitive bias might account for individual differences in affective responses to positive content. Given the wealth of benefits associated with positive emotional experiences, such as greater psychological wellbeing and better physical health, this investigation tested the influence of negative interpretation bias on emotion responses to evocative positive film clips as positive emotion-eliciting contexts. Negative interpretation bias was indexed using a novel word matching task. In each investigation, careful consideration of dispositional or trait-level influence on interpretation bias (i.e., dispositional negativity) was considered. Investigations conducted across three samples of college students at a large, Midwestern public university reveal complexity to this question: in one study, a small significant indirect effect of negative interpretation bias on the association between dispositional negativity and self-reported affect following positive emotionally-evocative films was found, while in the two subsequent studies, no significant mediation was found. Certain contextual factors, such as the explicit or discrete nature of the clip presentation as well as more stable tendencies toward positive emotional responsivity and the capacity to self-report emotional experiences, appear to be important. Finally, the novel task was found to be reliable and demonstrated convergent validity with established indicators. Future work should continue to clarify the conditions under which negative interpretation bias may influence responses to positive emotional contexts, given the importance of positive emotionality for lifelong physical and mental health.

Chronic musculoskeletal pain (CMSKP) in adolescence is associated with physical, psychological, social, and academic impairment and increased risk for chronic pain in adulthood. Although physical activity interventions are an evidence-based approach for managing pediatric chronic pain, many adolescents with CMSKP avoid physical activity due to fear of increased pain, low confidence in physical functioning, and other pain-avoidance behaviors. Resilience-focused interventions targeting self-efficacy, motivation, and mental flexibility may improve engagement in valued activities despite pain. This study describes the design and protocol of the Pain REsilience Promotion for Youth (PREP-Y) intervention, a resilience-focused physical activity intervention for adolescents with CMSKP.

This single-site, pilot phase 2, single-group, non-randomized clinical trial will enroll 40 adolescents aged 12-17 years with CMSKP from Nationwide Children's Hospital in Columbus, Ohio, USA. Participants complete questionnaires, objective physical functioning assessments, and physical activity monitoring using activPAL devices as baseline measures. Participants then complete 4 virtual resilience-focused intervention sessions targeting pain resilience, self-efficacy, motivation, and adaptive coping related to physical activity. Garmin watches are used to track activity during the intervention period. Follow-up assessments occur post-intervention and at 3 months post-intervention. Primary outcomes include feasibility and acceptability, assessed through recruitment, retention, attendance, intervention fidelity, and completion of study measures. Exploratory outcomes include physical activity, sedentary behavior, pain-related functioning, pain catastrophizing, kinesiophobia, self-efficacy, and resilience-related constructs.

The study was approved by the Nationwide Children's Hospital Institutional Review Board. Findings will inform a future randomized clinical trial. This manuscript reflects protocol version 5.0 dated 23 March 2026.

ClinicalTrials.gov NCT06923891.

Depression remains a critical mental health challenge among young people in low-resource settings, where financial, structural, and social barriers frequently limit care access. Digital approaches, including Tele-Support Psychotherapy (TSP), have emerged as promising, scalable alternatives to Standard in-person Mental Health Services (SMHS), yet evidence comparing their implementation remains limited. This study explored facilitators and barriers influencing the feasibility, acceptability and engagement of youths with TSP versus SMHS for depression treatment in Kampala District, Uganda. A qualitative phenomenological study was conducted among youth aged 15-30 years enrolled in a randomized controlled trial evaluating both interventions. Data were collected through semi-structured key informant interviews and focus group discussions with participants and lay counselors and analyzed using deductive thematic analysis guided by the Consolidated Framework for Implementation Research (CFIR). In the parent trial, 95 of 154 participants (61.69%) in the TSP arm and 15 of 146 (10.27%) in the SMHS arm engaged with their assigned intervention; these figures provide contextual background for these qualitative findings. Key facilitators for both interventions included strong social support networks and higher income levels. Technological challenges, such as unreliable mobile phone connectivity, hindered TSP, while high costs and limited awareness were barriers to SMHS. Government policies both supported trust in digital interventions and, in some cases, constrained access while lay-counselor attributes, including on-phone session flexible scheduling and rapport-building skills facilitated TSP. TSP presents a viable alternative to SMHS, particularly for youth facing financial and logistical barriers to accessing facility-based mental health services. However, optimizing its delivery requires addressing technological constraints, ensuring consistent government support, and integrating mental health literacy initiatives. Findings underscore the need for flexible and contextually tailored models that leverage technology and address individual and systemic barriers to enhance mental health service access in resource-constrained settings.

Postpartum depression (PPD) is a common mental health condition affecting mothers, infants, and families, with higher prevalence in middle-income countries. Despite its burden, PPD remains under-screened in Lebanese public hospitals, particularly in disadvantaged areas like Tripoli.

To assess nurses' knowledge, attitudes, and practices regarding PPD and explore facilitators, and barriers influencing the potential implementation of systematic PPD screening.

A mixed-methods study was conducted in a Lebanese public university hospital, combining a quantitative survey with qualitative focus group discussions involving nurses and managers. Descriptive analyses were applied to survey data, and thematic analysis was used for qualitative findings.

Most nurses were aware of PPD (92.9%) and "baby blues" (92.9%), but only 21.4% were aware of standardized screening tools. Correct identification of key symptoms was reported by 71.4%, while only 35.7% correctly identified all risk factors and 28.6% recognized appropriate combined management (psychotherapy and antidepressants). Regarding attitudes, all participants (100%) agreed that PPD screening should be part of routine postnatal care, and 92.9% recognized its seriousness and the role of nurses in early detection. However, only 78.6% felt confident identifying PPD signs. In terms of practice, only 28.6% consistently assessed mothers' emotional well-being before discharge. Qualitative findings suggested a generally positive attitude toward the potential implementation of screening, while also highlighting perceived barriers, including insufficient training, unclear role delineation, inadequate referral pathways, time constraints, and weak internal communication regarding mental health services.

The findings suggest that challenges to the potential implementation of PPD screening may be related to capacity and organizational support than to resistance among participants. Strengthening training, integrating standardized screening into routine postnatal care, clarifying roles and referral pathways may facilitate the implementation of PPD screening. Given the exploratory nature of this single-center study, further research is needed to assess the transferability of these findings to other maternity care settings in Lebanon.

Divorce is an important social issue that has destructive consequences for both the individual and the family. It is a multi-dimensional and complex phenomenon that occurs under the influence of various factors, so this research was conducted to explain the reasons for divorce among young couples in the West of Iran with a qualitative approach. This research was carried out with a qualitative approach and conventional content analysis. Purposeful and snowball sampling were used to identify the participants. Semi-structured interviews were used to collect data and continued until theoretical saturation was reached. In this research, 16 key informants and 32 main participants were present. For data analysis, Graneheim and Lundman method was used. Also, to increase the quality of the research, Guba and Lincoln's four criteria were observed. 212 primary codes, 24 subcategories, and 3 categories came from the analysis of the interviews. Categories and sub-categories include 1- individual factors (sexual problems, mental-psychological disorders, spouse's behavioral characteristics, individualism, physical appearance problems, Formation of a positive understanding of divorce consequences, having defective relationships before marriage, drug use), 2- socio-cultural factors (de-tabooing of divorce, women-oriented social changes, media and social networks, lack of a suitable support system, inappropriate spouse choosing, economic challenges, modeling of divorce), 3- family factors (job's impact on family life, improper communication with spouse's family, accumulation of negative feelings in marital life, issues related to children, cheating on spouse, inefficient relationships, heterogeneity of lifestyle, violence, inability to manage challenges). The results indicate that divorce is a complex, multi-dimensional phenomenon influenced by individual, social, cultural, and family factors. Prevention requires multi-level interventions, including educating couples on sexual issues and communication skills, promoting responsible marital roles, preventing superficial marriages, reducing stigma around seeking psychological help, managing personality and lifestyle differences, guiding families on conflict resolution, and providing access to counseling and mental health services before and after marriage.

People in contact with the criminal justice system outside institutional settings have high levels of mental health and substance use problems, contributing to adverse outcomes. Help-seeking behaviour is an important component of optimising access to effective treatment and support that is under-explored in this population. Empirical investigation into the influences on help-seeking for stigmatised health conditions is needed to inform efforts to facilitate help-seeking.

This study established the individual, relational, and contextual influences on help-seeking for mental health and substance use problems among people in contact with the criminal justice system living in the community, and examined the applicability of existing models and frameworks for understanding help-seeking behaviour in this population.

We applied framework analysis to qualitative data from a mixed-methods social network analysis study. Our framework drew on help-seeking behaviour and healthcare access models to determine initial categories for help-seeking influences (desire, ability, and context).

Help-seeking was confirmed to result from an interaction between 'desire to seek help', 'ability to seek help', and 'help-seeking context'. We show that help-seeking is not an individual behaviour, but strongly affected by relational influences that operate between individuals, across social networks, and via cultural norms. High levels of criminal justice involvement, and mental health and substance use problems in the social networks of people in contact with the criminal justice system shape these influences.

Optimising help-seeking for mental health and substance use problems among people in contact with the criminal justice system living in the community requires critical engagement with, and application of, existing models to ensure sufficient appreciation of relational and contextual influences. Research is needed to develop and test multi-level policy/practice interventions that go beyond individual factors.

People who use opioids (PWUO) experience a disproportionately high burden of suicidal risk. Syringe services programs (SSPs) are a critical point of contact for this population, providing low-threshold, harm-reduction services. However, gaps persist in understanding suicidal risk among individuals attending SSPs and the extent to which such risk is associated with mental health service utilization in this setting. This study aimed to assess the prevalence and specific risk factors for suicidal ideation (SI) in PWUO, as well as their use of and barriers to accessing mental health services.

We conducted a cross-sectional survey between April and June 2024 among PWUO (N = 199) who were utilizing services in the SSP in New Haven, Connecticut. We used the ninth item from the Patient Health Questionnaire (PHQ-9) scale, which assesses passive thoughts of death and self-harm in the past two weeks, as a proxy measure for the SI. Additionally, participants reported their use of and barriers to accessing mental health services in the past six months. Bivariate and multivariable logistic regression were conducted to examine factors associated with SI.

Approximately 84% of participants met the criteria for opioid dependence, and more than two-thirds (71.9%) were currently receiving medication for opioid use disorder. Over one-third of the sample reported SI in the past two weeks (34.7%). Additionally, over one-third of participants (36.2%) reported unmet mental health needs, and 84.4% reported experiencing at least one barrier to accessing mental health services. Individuals with depressive symptoms (aOR: 5.4; 95% CI: 2.5-11.7) were more likely to report SI, while those who were aware of naloxone (aOR: 0.2; 95% CI: 0.1-0.6) were less likely to report SI in the past two weeks.

Our study showed a high prevalence of SI among SSP clients who use opioids and a low use of mental health services due to access barriers. These findings support incorporating a brief suicide risk screening and referral options within SSPs and other settings serving PWUO and addressing key access issues like cost and transportation that can prevent timely linkage to mental health services.

This study explored how adolescent mothers in Pakistan experience the transition to motherhood and the mental health challenges that arise during this period.

A focused ethnographic study was conducted with 25 adolescent mothers in Matiari, Sindh. Data were collected through semi‑structured interviews, participant observations, and artifact elicitation. Meleis' Transition Theory informed the study focus and development of the interview guide. Reflexive thematic analysis guided interpretation, informed by an intersectional lens.

Five themes described mothers' experiences: early educational disruption and redirected aspirations; continuous caregiving with uneven support; barriers to maternal healthcare access; emotional distress and psychological strain; and identity transformation. These intersecting challenges contributed to significant mental health strain and highlighted persistent gaps in access to supportive, adolescent-responsive maternal care.

Adolescent mothers navigate motherhood with substantial emotional and practical burdens yet demonstrate meaningful resilience. Findings highlight the need for adolescent‑responsive mental health support, accessible care, routine and confidential distress screening, referral pathways, and supportive educational and community‑based interventions tailored to underserved rural settings.