All Articles

Eli Sharon

School of Government & Society, Family Studies, The Academic College Tel Aviv-Yaffo, Israel

Faculty of Health Professions, Ono Academic College, Israel

This article asserts that effective therapy with LGBTQ+ clients should evolve beyond basic "gay friendly" practices to require deeper clinical engagement. It argues that therapists can actively cultivate precise empathy, which is predicated on a more detailed familiarity with the client's unique experiences, particularly those shaped by internalized homophobia. This skillful approach involves refining a therapist's cognitive complexity and utilizing relevant diagnostic tools to accurately diagnose and treat the often-subtle, debilitating impact of minority stress. Ultimately, this targeted, empathetic strategy is vital for establishing and strengthening the therapeutic alliance.

Ai-Li W. Arias^1,2,3,5*, Michael A. Cummings^1,2,3,5, George J. Proctor^1,3,4,5

¹Department of Psychiatry and Neuroscience, University of California, Riverside, CA, USA

²Department of Psychiatry & Human Behavior, University of California, Irvine, Neuropsychiatric Center, Orange, CA, USA

³Psychopharmacology Resource Network, Clinical Operations Division, California Department of State Hospitals (DSH), Sacramento, CA, USA

⁴Department of Psychiatry, Loma Linda University School of Medicine, Loma Linda, CA, USA

⁵Department of State Hospitals - Patton, Patton, CA, USA

Clozapine is the only antipsychotic with demonstrated efficacy for treatment-resistant schizophrenia and mania, and aggression, suicide, or psychogenic polydipsia related to schizophrenia. Sialorrhea, a common adverse effect, is frequently a barrier to clozapine treatment. Anticholinergic agents have limited efficacy and increase risk for constipation, bowel impaction, or ileus. Interval injection of select salivary glands with botulinum neurotoxin (BT) has proven to be a superior alternative treatment for clozapine-induced sialorrhea (CIS). This mini-review describes the viability and logistics for establishing a successful botulinum treatment clinic, including adequate staff, training, educating treatment providers about the availability and effectiveness of botulinum treatment for sialorrhea, and development of a clinic protocol (e.g., procedural elements and relevant rating scales). Finally, botulinum treatment was determined to be cost-effective. Evidence for botulinum treatment of CIS includes Level I data.

Ziyu Su¹, Lixia Yang^1*, Haoran Dong¹, Xindi Wang¹, Lu Wang², Minhui Yang³, Sepali Guruge⁴

¹Department of Psychology, Toronto Metropolitan University, Toronto, Canada

²Department of Geography and Environmental Studies, Toronto Metropolitan University, Toronto, Canada

³Dalla Lana School of Public Health, University of Toronto, Toronto, Canada

⁴Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, Canada

This study investigates the stress experiences and coping strategies among older Chinese immigrants in Canada during the COVID-19 pandemic. Data was collected through focus group interviews and analyzed using the Transactional Model of Stress and Coping (TMSC). The results showed that participants (N=25; 14 female, 11 male; age 65 and above) faced three main sources of stress during the pandemic: personal life disruption (e.g., hindered family reunions and financial pressure), emotional distress (e.g., fear, uncertainty, and distress), and structural obstacles (e.g., travel restrictions and anti-Chinese discrimination). In addition, participants reported generally three types of coping styles: cognitive coping (e.g., maintaining a positive mindset and redefining risks), behavioural coping (e.g., adhering to the pandemic prevention regulations and maintaining daily activities), and social coping (e.g., participating in online social activities and establishing mutual assistance networks). The results call for culturally sensitive policies and measures in future public health crises to address the specific stressors and coping resources of older immigrants.

Sally Mukatash Pauls^1*, Aubrey Baccari², Brian Henriksen²

¹Department of Pharmacy, Lutheran Hospital of Indiana, Fort Wayne, Indiana, USA

²Fort Wayne Medical Education Program, Fort Wayne, Indiana, USA

Background: Medications for Opioid Use Disorder (MOUD) with buprenorphine/naloxone improves opioid-use-disorder (OUD) outcomes, yet sustaining engagement is challenging. Pharmacist integration within MOUD teams enhances safety and adherence. We evaluated a pharmacist-augmented MOUD model embedded in a family-medicine residency clinic.

Methods: Adults with OUD treated between October 2020 and July 2024 formed a retrospective cohort. Eligibility required ≥ 1 clinic visit; polysubstance use excluded. Descriptive statistics summarized cohort characteristics; single-sample t-tests compared local outcomes with a published physician–pharmacist trial (Wu et al.). Variables included demographics, psychiatric comorbidities, induction site, Clinical Opiate Withdrawal Scale scores, urine drug screens (UDS), visit cadence, and retention rate.

Results: Fourteen of 30 screened patients met criteria (50% male; mean age 43 y). A clinical pharmacist participated in all MOUD visits. Induction was on-site for 78.6%, and 85.7% had ≥ 1 psychiatric comorbidity. Negative-UDS consistency was 85.7% versus 95.1% in Wu et al. (p = 0.21). The retention rate was 35.7% versus 88.7% in Wu et al. (p < 0.0001) but lay within the wider U.S. range of 19–64%. Two patients (14.3%) achieved remission after a median of six visits; three (21.4%) remained engaged ≥ 3 months.

Conclusions: Embedding pharmacists in a residency-based MOUD program yielded high medication adherence and UDS consistency comparable to collaborative-care trials, but retention lagged. Enhanced behavioral-health integration and provider continuity may bolster long-term engagement while preserving pharmacist-driven safety benefits.

Keith Robert Head

LMSW, Master^'s in Social Work (MSW), West Texas A & M University, USA

Master of Business Administration (MBA), Bottega University, USA

The rapid rise of generative AI systems, particularly conversational chatbots such as ChatGPT and Character.AI, has sparked new concerns regarding their psychological impact on users. While these tools offer unprecedented access to information and companionship, a growing body of evidence suggests they may also induce or exacerbate psychiatric symptoms, particularly in vulnerable individuals. This paper conducts a narrative literature review of peer-reviewed studies, credible media reports, and case analyses to explore emerging mental health concerns associated with AI-human interactions. Three major themes are identified: psychological dependency and attachment formation, crisis incidents and harmful outcomes, and heightened vulnerability among specific populations including adolescents, elderly adults, and individuals with mental illness. Notably, the paper discusses high-profile cases, including the suicide of 14-year-old Sewell Setzer III, which highlight the severe consequences of unregulated AI relationships. Findings indicate that users often anthropomorphize AI systems, forming parasocial attachments that can lead to delusional thinking, emotional dysregulation, and social withdrawal. Additionally, preliminary neuroscientific data suggest cognitive impairment and addictive behaviors linked to prolonged AI use. Despite the limitations of available data, primarily anecdotal and early-stage research, the evidence points to a growing public health concern. The paper emphasizes the urgent need for validated diagnostic criteria, clinician training, ethical oversight, and regulatory protections to address the risks posed by increasingly human-like AI systems. Without proactive intervention, society may face a mental health crisis driven by widespread, emotionally charged human-AI relationships.

Angela Trombley^1*, Paul Trombley^2,3

¹Assistant Professor, Western Carolina School of Nursing, Cullowhee, NC, USA

²Diplomate of the American Board of Pediatrics, USA

³Diplomate of the American Board of Psychiatry and Neurology in Child and Adolescent Psychiatry, USA

Background: Depressive disorders in children and adolescents have been associated with lifelong health implications and risk factors. Concurrently, rates of depression, overweight and obesity in pediatrics have markedly worsened since the COVID-19 pandemic. Sleep and inflammation have also been described as altered in depressive and overweight or obese status, suggesting an intertwined relationship. This clinical practice review examines these intertwined roles while exploring health care disparities, holistic care, and interdisciplinary approaches.

Methods: The methodology of this review followed a narrative format by examining and summarizing trends related to pediatric depression with existing literature and expert synthesis.

Results: Selected articles provided a broad overview of key concepts contributing to a deeper understanding of research topics. Relevant clinical insights into the complex and interwoven concepts of pediatric depression, obesity, and inflammation answered the research question by informing clinical practice with a culturally sensitive, holistic, and integrated health care approach.

Conclusions: Significant findings underscored the need for healthcare providers to understand the complex relationships between depression, obesity, inflammation, and sleep, to avoid healthcare disparities and risk for negative lifelong consequences. This article is intended for all the disciplines involved in the care of pediatric populations.

Sokratis Sokratous^1*, Giorgos Alexandrou¹, Rafailia Zavrou¹, Elena Rousou¹, Nikolas Sokratous², Maria Karanikola¹

¹Department of Nursing, Cyprus University of Technology, Limassol, Cyprus

²General Oncology Hospital of Kifisia – Saints Anargyroi, Greece

Background: Previous studies have indicated a causal link between stressful life experiences and mental health. However, little is known about the impact of the frequency and seriousness of recent stressful life events on clinical mental discomfort among university students. This study explored the mental health status of undergraduate students in Cyprus. It examined the association between the number and severity of stressful life events and clinical symptoms of mental distress.

Methods: This was a cross-sectional, descriptive, correlational study conducted using convenience sampling, with a total of 1,500 undergraduate students participating. Descriptive statistics for sociodemographic characteristics, mental distress symptoms, and life events of the participants were calculated and expressed in frequencies, mean values, and standard deviations. One-way analysis of variance and independent sample t-tests were conducted to compare the General Health Questionnaire – 28 (GHQ-28) subscales with groups based on the number of events and total score in Life Events Scale for Students (LESS).

Results: After adjusting for sociodemographic characteristics using logistic regression analysis, gender remained the only variable significantly associated with mental distress symptoms before and after controlling for stressful life events, with women being 1.6 times more likely to report clinical levels of distress than men (95% CI: 0.98–2.46). However, a statistically significant association was observed between gender and mental distress symptoms. Specifically, women had a higher level of mental distress than men.

Conclusion: Individual characteristics, stress, negative life events, and psychological distress were interconnected. Collaboration among teachers, students, parents, and mental health professionals is essential to create a supportive and nurturing school environment.

John S. Lyons^1*, Olga A. Vsevolozhskaya²

¹Center for Innovation in Population Health, Department of Health Management and Policy Administration, College of Public Health, University of Kentucky, Lexington, KY, USA

²Center for Innovation in Population Health, Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY, USA

Lena M. Obara^1*, Gi Un Shin², Anna K. Balakrishnan², Ebuka Ukoh², Stephanie A. Otieno³, Susan S. Witte², Samantha C. Winter²

¹Rutgers, The State University of New Jersey, USA

²Columbia University, USA

³Columbia Global Center, Nairobi, Kenya

Objective: Women living in informal settlements face psychosocial stressors with limited access to mental health resources. Understanding their coping strategies is crucial to informing mental health interventions that address structural inequities and promote resilience in low-resource urban settings. This study examines the coping mechanisms employed by women in Kibera and Mathare, two of Nairobi’s largest informal settlements, to manage daily stressors.

Methods: The study utilized cross-sectional data from the baseline survey of a longitudinal cohort study that examined the impact of climate change on mental health among women residing in informal settlements in Nairobi, Kenya. The sample included 800 participants (400 from each settlement) to assess eight categories of coping strategies: emotional avoidance, self-care, substance use, mental health support, social support, religiosity, participation in family activities, and media dependence. It applied Latent Class Analysis (LCA) to identify distinct subgroups of coping.

Results: A four-class model was favored based on the Bayesian Information Criterion (BIC). The largest class (51%) relied on emotional avoidance, the second largest (31%) on religiosity, the third (10%) on social support, and the fourth (8%) on health care support and family activities. Most women used emotion-focused coping strategies at 83%, while a minority of 17% adopted problem-focused coping strategies.

Implications: This study provides valuable insights into developing mental health support systems and policies that aim to assist women residing in informal settlements. The common tendency among residents to avoid expressing emotions and to rely on religious coping strategies highlights the urgent need for accessible mental health support within these communities. Community-based interventions that incorporate peer support models, culturally relevant psychoeducation, and faith-based approaches can effectively close existing care gaps. To reduce mental health disparities in under-resourced urban areas, it is important to implement scalable structural solutions that increase access to problem-focused coping resources and connect them with formal mental health services.

Nima Moradizadeh^1*, Jeanett Bauer², Dina Stenborg¹, Lone Baandrup^1,3

¹Department Bispebjerg-Gentofte, Mental Health Centre Copenhagen, Mental Health Services of the Capital Region in Denmark

²Mental Health Services of the Capital Region in Denmark

³Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Denmark

Background and Objectives: Acute and transient psychotic disorders (ATPDs) constitute a frequent reason for acute hospitalization. The aim of this study was 1) to describe the value of an extended diagnostic evaluation program for first episode ATPDs and 2) to describe the short-term prognosis of transitioning to schizophrenia or affective disorder in relation to the initial symptom profile.

Methods: We collected medical record data from patients with consent, aged 18-65 years, and admitted due to ATPDs (ICD-10: F23.X) to an emergency psychiatry department in Copenhagen, Denmark. The extension of the diagnostic evaluation program included magnetic resonance imaging (MRI), examination of cerebrospinal fluid by lumbar puncture (LBP), and electroencephalography (EEG) if clinically indicated.

Results: A total of 53 patients were included. Twenty-nine (55%) were men, the mean age was 25.56 years (SD = 10.71), and the mean length of hospitalization was 32.74 days (SD = 15.39). Clinical evaluations using MRI, LBP, and EEG did not reveal abnormal findings of diagnostic significance. The clinical symptom profile was diverse but could broadly be classified as polymorphic, schizophrenia-like, or unspecified. A pattern towards short-term transitioning to affective disorder was observed among patients who initially presented with fluctuating moods. The majority of patients (53%) maintained their initial diagnosis of ATPD upon discharge.

Conclusions: The extended evaluation program was not of additional diagnostic value in this sample of patients with ATPDs. We observed a diverse clinical symptom profile and described patterns that were suggestive of short-term prognosis. However, further research with larger sample sizes and extended follow-up periods is needed to confirm and expand these results.

Fatima Ehsan^*, Munira Abbasi

Riphah International University, Islamabad, Pakistan

Burnout, stress, and mental health challenges are increasingly common among dental students. Despite their prevalence, structured self-care remains an overlooked element in healthcare education. Research shows that poor self-care among medical professionals contributes to long-term psychological distress and can negatively affect patient care. However, institutional curricula often lack systematic and culturally relevant interventions to address this issue.

There is a growing need to embed proactive self-care education early in professional training. Doing so can promote resilience, emotional well-being, and sustainable career growth. To address this gap, a mixed-method study was conducted at Riphah International University. The study evaluated the impact of a Personal Development Plan (PDP) intervention on first-year dental students.

This commentary critically examines the study’s methodology, highlights its strengths and limitations, and explores its broader implications for medical and dental education. It also outlines future directions for research and policy reform to ensure that self-care becomes an integral part of healthcare training.

Jayashabari Shankar

Massachusetts Institute of Technology (MIT), Cambridge, MA, USA

This commentary critically engages with Tawa et al.’s development and validation of the Post-Pandemic Wellness (PPW) scale, a psychometrically grounded instrument designed to measure wellness across four dimensions: positive reframing, economic stress, social stress, and existential impact. The authors’ multi-time point validation (2021 and 2024) adds rigor and temporal relevance to their findings, revealing both consistencies and evolutions in post-pandemic mental health trajectories across demographic groups. While the PPW subscales show high internal consistency and statistical integrity over time, notable differences emerge in the mediation pathways previously linking race and depression, particularly among Asian American participants. The disappearance of these effects in the 2024 data invites further inquiry into how sociopolitical shifts modulate psychological stress. This commentary explores how existential stress may not only predict distress but also correlate with resilience, drawing on existing literature on post-traumatic growth. Limitations in the study’s design—including under examined intersections of age, race, and gender, and its reliance on self-reported online data—suggest directions for future research. Expanding the scale to distinguish between negative and adaptive existential responses and incorporating mixed-methods approaches—such as in-depth interviews or focus groups stratified by racial-gender identity—would enhance its applicability. Finally, while the scale offers significant diagnostic promise, its generalizability to clinical populations or minoritized subgroups with limited digital access may be constrained.

Elizabeth Macias¹, Joanna F. Mackie^2*

¹Birmingham Community Charter High School, Van Nuys, California, USA

²Department of Population Health Sciences, University of Central Florida, College of Medicine, Orlando, Florida, USA

Many studies explore the experience of family caregiving from various perspectives within the adult population. However, little attention has been focused on adolescent caregivers, who are sometimes known as a “hidden” population. An adolescent caregiver is typically an individual who is younger than 19 years old and provides substantial assistance with physical tasks, mental or cognitive tasks, or other supports for a family member with some type of physical or mental health disability, short- or long-term. Similar to the adult caregiving population, adolescent caregivers tend to be female. Among studies that include adolescents, very few consider race/ethnicity and the specific cultural expectations for Hispanic adolescent women, who may face greater expectations to provide caregiving compared with other groups. This opinion piece describes some of the unique mental health vulnerabilities of adolescent Hispanic women caregivers and the social-emotional tradeoffs they must make in order to balance participation in typical adolescent responsibilities and activities and providing care for a family member. We conclude by calling for more research into these experiences to develop a better understanding of the supports that could mitigate the increased mental health risks of caregiving and ultimately support all family members in thriving.

Hoang An Nguyen^1,3,4†, Bao Chau Duong^1,3†, Truc Anh Thuy Le^1,3, Cat Anh Le^1,3, Thuc Quyen Huynh^1,2,3, Van Nhi Tran^1,3, Phuong Thao Nguyen^1,2,3, Thi Thu Hoai Nguyen^1,2,3*

¹International University, Ho Chi Minh City, Vietnam

²Research Center for Infectious Diseases, International University, Ho Chi Minh City, Vietnam

³Vietnam National University, Ho Chi Minh City, Vietnam

⁴School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China

†These authors contributed equally to this work

Purpose: To investigate the factors contributing to stress, anxiety, and depression among Vietnamese students before and during their thesis process.

Methodology: A Cross-sectional online survey was conducted with questionnaire comprised three parts: (1) demographics, (2) thesis status, expectation, and potential factors influencing stress, anxiety, and depression, and (3) The Depression, Anxiety, and Stress Scale (DASS-21) assessment. The collected data was analyzed using Mann-Whitney U test, Fisher’s Exact test, and Path analysis to explore relationships among the surveyed variables to stress/anxiety/depression condition.

Results: Among participants, 180 were pre-thesis students, 83 were peri-thesis students, and 212 had completed the thesis. Six factors were identified as significantly influencing stress, anxiety, and depression among pre-thesis students. They included “Pressure from discrimination”, “Pressure from unexpected incidents”, “Good pedagogical skills of thesis advisor”, “Stopping grade-improvement courses when doing thesis”, “Dealing with illnesses that are being treated”, and “Student’s expectations for their future thesis”. Perceived discrimination would directly increase stress score (β=0.16, p-value<0.001), and was directly influenced by factors such as (1) “Pressure from unexpected incidents”, (2) “Good pedagogical skills of thesis advisor”, and (3) “Stopping grade-improvement courses when doing thesis”. Anxiety scores were increased by “Current illnesses” and “Stopping grade-improvement courses when doing thesis” (β= 0.13, p-value=0.002 and β=0.15, p-value<0.001, respectively). Only “Student’s expectations for their future thesis” increased the severity of depression. For the peri-thesis group, strong “Academic supports from thesis-conducting institute” and a “Good attitude of thesis advisor” enhanced the likelihood of receiving administrative supports, thereby decreasing stress, anxiety, and depression scores (β=-0.31, p-value=0.008; β=-0.39, p-value<0.001; and β=-0.42, p-value=0.008, respectively).

Conclusions: Thesis-conducting environment, students’ expectations of future advisors and schedules might directly and indirectly impact stress, anxiety, and depression levels among students in pre-thesis and peri-thesis stages.

Faith Carini-Graves

Hillside Children's Center: Youth ACT, USA

Youth Assertive Community Treatment (Youth ACT) is a rising novel community based care model for youth with pervasive psychiatric illness. This type of intensive treatment follows specific principles which include an interdisciplinary team, small caseloads, 24/7 access to the team, and treatment given in the patient’s home or community. A variety of studies have reviewed outcomes and generally report that patients have statistically significant improvements in symptoms. However, much is still not well understood about how this model works, how it is applied, or about the clinical significance of the models. There have been relatively few case studies written outlining how patients respond to the Youth ACT interventions. To better understand Youth ACT, how it works, and what patients may benefit from this level of treatment, a clinical scenario is discussed. This clinical scenario involves a 15-year-old male youth with bipolar 1 disorder, psychosis and ongoing substance use. This case is indicative of the severe psychiatric symptoms that the Youth ACT teams address in the community. After case presentation, outcomes are discussed and significant clinical improvement is reflected upon.

Scott M. Barrera^*, Kristin Perrone, Stephanie Simon-Dack

Ball State University, IN, USA

Introduction: The purpose of this study was to examine the effect of cultural affirmations on the neural activity of Latinx individuals. Latinx participants viewed threatening stimuli after completing a cultural affirmation intervention. We also examined the impact of identity salience on the effectiveness of cultural affirmations.

Method: To understand relationships between these variables, 28 Latinx participants (19 female) viewed photos of angry and neutral white, non-Latinx, faces while event-related potentials (ERPs) were recorded before and after engaging in a cultural affirmation writing task.

Results: Scalp map assessment showed large effects for N2 in the frontal region. Repeated measures ANOVA indicated average N2 amplitudes were higher following the cultural affirmation, specifically in the right hemisphere. As predicted, the relationship was no longer significant when identity salience was controlled.

Discussion: After engaging in cultural affirmations, Latinx participants’ N2 amplitudes increased, indicating the affirmation increased the availability of preconscious social categorization resources to allocate to the angry and neutral white, non-Latinx, faces. However, when identify salience was controlled, there were no changes in available neural resources.

Conclusion: Theoretical and clinical implications are discussed as well as future directions for researchers on how cultural affirmations may be utilized among Latinx individuals with consideration to identity salience.

Momoh Lawal Hussaini^1*, Madueke Akachukwu²

¹General Education Department, School of Arts and Sciences, American university of Nigeria, Yola, Nigeria

²Communication and Multimedia Design Department, School of Arts and Sciences, American University of Nigeria, Yola, Nigeria

This study examined the influence of internet addiction on the psychological well-being of students in the American University of Nigeria (AUN), Yola, Adamawa State, Nigeria in the post Covid era. University students are particularly vulnerable to internet addiction due to the pressures of academic life, social expectations, and the widespread availability of digital technology. The study employs a quantitative cross-sectional survey design, which allows for the collection of data at a single point in time. The study administered 100 questionnaires due to the regulatory admission of students in line with the American styled education. A combination of convenience sampling and snowball sampling was employed to recruit participants for the study. Data analysis included descriptive statistics (means, percentages) and inferential statistics (Pearson’s r, regression, t-tests/ANOVA) performed using SPSS, with a significance level of p < 0.05. The results indicate that internet addiction negatively impacts all six dimensions of psychological well-being, with environmental mastery and self-acceptance showing the strongest correlations. A multiple regression analysis was conducted to determine whether internet addiction predicts psychological well-being dimensions. The regression model was statistically significant (F (6, 93) = 7.85, p < 0.001), with an R² of 0.45, indicating that internet addiction accounts for 45% of the variance in psychological well-being. Early intervention and support are essential for addressing internet addiction and promoting psychological well-being among university students. Essentially, the research demonstrates a clear link between internet addiction and compromised psychological well-being in university students. This therefore highlights the need for awareness, prevention strategies, and support systems to help students maintain a healthy balance between their online and offline activities.

Manu S Bala^2*, Nisha Dhanabalsamy^2,3, Bill Lucia¹

¹OptMyCare Inc, Texas, USA

²Texas Research Institute, Texas, USA

³PPG Healthcare PA, Texas, USA

Background: Value-based care systems are increasingly replacing fee-for-service models, as the latter has proven unsustainable. Mental health and their implications on patients are starting to get significant attention in the past decade. Unrecognized mental illness (MI) and their impact on chronic diseases could have a significant impact on disease progression and cumulative cost to the health system.

Study design: We have analyzed a large cohort of patients using OptMyCare’s risk stratification system. Predictive analytics using proprietary algorithms were implemented to estimate cost and disease progression in high-risk patients with and without MHD across the cohort. Cost modeling and outputs are resulted as cost per member across chronic conditions with & without MIs. The members with & without MIs were propensity matched for demographics, disease severity and SDOH.

Key Results: Members with MI in 8 of the 9 chronic conditions demonstrated a significant increase in cumulative cost. There was a 64% mean increase in claims cost per member with MIs.

Conclusion: Utilizing validated algorithms to identify high-risk MI members and implementing disease mitigation strategies targeted at chronic conditions in addition their MI could result in improved clinical outcomes and bend the cost curve.

Bakwanamaha Maha Alain^1*, Muhindo Vunyatsi Faustin², Kataka Asifiwe Olga¹

¹Faculty of Medicine, Catholic University of Graben, Butembo, Democratic Republic of the Congo

²Department of Gynecology & Obstetrics, Oicha General Referral Hospital, Oicha, Democratic Republic of the Congo

In the limited resources settings of sub-Saharan Africa generally and specifically in a region affected by armed conflict, diagnosis and management of congenital malformations pose significant challenges. This commentary on “Septate uterus discovery during an emergency cesarean section in the North Eastern of the Democratic Republic of Congo: A case report and review of the literature”, examines the diagnostic challenges, the impact of armed conflict on maternal health and the management strategies. In addition, it highlights the importance of accurate diagnosis and effective management in obstetric care and calls for building of research networking to improve the detection and treatment of congenital malformation in rural armed conflict zones with limited healthcare resources.

John Tawa, Milena E. Insalaco^*, Nancy Jiang^*, Alejandra Lorenzo^*

Department of Psychology and Education, Mount Holyoke College, South Hadley, MA, USA

^*Denotes Equal Authorship and Contribution

We developed a post-pandemic wellness scale (PPWS) to help understand some of the specific reasons why the pandemic may have differentially impacted the mental health of people from various sociodemographic groups. With an initial sample of 404 adults (74.3% White) collected in 2021 and in close proximity to the pandemic, we established adequate fit for a four-factor model of post-pandemic experiences including financial stress, social stress, and existential stress, and positive reframing experiences, which each predicted depression in the expected directions. In this initial sample, we found some evidence of race-based differences in post-pandemic experience as they related to mental health. In the interest of replicating these findings with more robust samples of non-White racial and ethnic groups, we collected a second sample of 462 adults (26% White) in 2024. Although we failed to replicate our race-based findings, we were able to verify the fit of the four-factor model. Moreover, some exploratory findings related to participant demographics were consistent across sample cohorts, including the influences of age and gender on post-pandemic experiences. In addition, all four PPWS subscales continued to predict depression in the expected directions. Thus, in two samples assessed in proximity to and more distally from the fallout of the coronavirus pandemic, we find evidence for the psychometric stability and predictive validity of our scale for mental health. We expect this scale to be useful to future researchers and clinicians attending to the pervasive impact of the pandemic on mental health and wellbeing.

Loyiso Kosana¹, Hermanus B. Grobler^1,2*, Mpho Maotoana³

¹North-West University, South Africa

²KIMEP University, Republic of Kazakhstan

³University of Limpopo, South Africa

Objective: This study aimed to determine whether there was a significant relationship between premature ejaculation (PE) and anxiety symptoms amongst South African males. In addition, the study conducted a preliminary analysis to examine whether ethnicity and age acted as moderating variables.

Method: A quantitative, correlational design was used with 175 men between the ages of 18 and 70 years of age who had joined the Men’s Clinic International private Facebook group.

Results: Regarding hypothesis one, the results indicate a significant correlation between PE and anxiety symptoms. The second hypothesis was also accepted, namely that that the correlation between anxiety and PE is stronger in white and mixed compared to black ethnicity groups. The third hypothesis, namely that age was a moderating variable between premature ejaculation and anxiety symptoms, did not change the direction of the relationship, and was therefore rejected.

Conclusion: The study provides new information to professionals when it comes to understanding men who experience PE and present with anxiety symptoms.

Contribution of the study: When treating individuals with anxiety-related premature ejaculation, the importance of cultural appropriateness and sensitivity should be emphasized. Understanding how ethnicity and age contribute to the presentation and interpretation of the disorder can be used to explain and offer treatment methods that would not perpetuate negative connotations regarding psychotherapy. Psychotherapy will become a conducive space for males where there will be respect, decreased experience of shame, and enabling vulnerability. With this approach, the male experience and perspective to therapy may become positive. Once the anxiety-related premature ejaculation is successfully treated, men will be able to confidently refer others for further assistance.

In addition, this approach will further yield effective collaborations between mental health practitioners and medical clinics such as Men’s Clinic International. It will enable further research studies pioneered by physicians and psychologists with the aim to explore sexual dysfunctions at length. The vision will be to ensure updated definitions of sexual dysfunctions, in different contexts by considering age, ethnicity and possibly medical conditions.

Katelynd Campo

MSc, Canada.

An abundant amount of research on mental health and more specifically the social barriers faced by Individuals with Mental Health Disabilities (IMHD) exists regarding access to adequate housing/community and employment. What research lacks in precision concerns incidents of criminality amongst IMHD. Research has concluded decades over that IMHD are more at-risk of finding themselves in situations of inadequate employment and inadequate housing/community. To which, research has also found most often leads to increased chances of addiction, welfare dependency, negative peer associations/influences, lack of positive role models; situations of which in general lend greater opportunities for criminal involvement. This paper will in a literature review, seek to understand and analyze why IMHDs make-up an overrepresented population within the criminal justice system, and whether or not there is a correlation between criminality perpetuated by IMHD in relation to situations of inadequate housing/community and inadequate employment amongst said population.

Sana Vora^1*, Christopher M. King¹, Rachel Bomysoad¹, Jill Del Pozzo²

¹Department of Psychology, Montclair State University, Montclair, NJ, USA

²Icahn School of Medicine at Mount Sinai, New York, NY, USA

Higher education students have experienced increased stressors and behavioral health problems during the COVID-19 pandemic. The current study further investigated such phenomena in a sample of university students collected between June 2020 to December 2021. Students (N = 1,441) from a Mid-Atlantic public university were recruited via email lists and a psychology department research participant pool. The participants completed an online survey with items pertaining to demographic factors, biopsychosocial stressors, and measures of behavioral health functioning. All variables were examined descriptively, and regression analyses were used to examine hypothesized cross-sectional relationships between demographic factors and biopsychosocial stressors, on the one hand, and behavioral health functioning, on the other. Experiencing notable levels of biopsychosocial stressors was common, though a linear trend across semesters was not observed with respect to behavioral health functioning. Gender was the most consistent demographic predictor of behavioral health functioning, whereas the most common biopsychosocial stressor predictors for behavioral health functioning were stress/worry, social isolation, discrimination, and prior mental health services. Results corroborate and extend prior research evidencing notable levels of biopsychosocial stressors and behavioral health problems reported by higher education students during the COVID-19 pandemic. Implications for campus administrators and behavioral health providers concern vulnerabilities for a range of pandemic-time challenges being experienced by their constituents to which to attend.

Kathryn Burrows

National Coalition of Independent Scholars, Portland, Oregon, USA

Henrique M. Lapo¹, Mara Patrícia T. Chacon-Mikahil^1,2, Amanda V. Sardeli^1,2,3*

¹Laboratory of Exercise Physiology, Scholl of Physical Education, University of Campinas SP, Brazil

²Gerontology Program – Scholl of Medical Sciences, University of Campinas, SP, Brazil

³Department of Inflammation and Ageing, University of Birmingham, Birmingham, UK

Objective: Although heart rate variability (HRV) has been a useful and accessible tool to monitor recovery from athletes’ training, it is not clear if it reflects changes in psychophysiological factors. The aim of these study is to identify, through a systematic review and meta-analyses, whether the psychophysiological factors are associated with alteration in heart rate variability (HRV) in sports.

Methods: We searched in four databases (PubMed; Scopus; Cochrane; Web of Science) for studies assessing the association of root mean square of successive differences between normal heartbeats (RMSSD) with a variety of psychophysiological outcomes in athletes of any modality.

Results: After initial search, we selected 12 studies with 27 study arms for analysis. First, we combined 19 study arms in a meta-analysis testing the correlation between HRV and the psychophysiological factors at baseline (Meta 1). Second, we combined 9 study arms in a meta-analysis testing the correlation between HRV and changes in psychophysiological factors within a training period (Meta 2). We analyzed the following psychophysiological factors: stress, sleep deprivation, fatigue, muscular soreness, mood, and hormonal changes (cortisol). summary, there was no significant association between the HRV and the psychophysiological factors in both meta-analyses (Meta 1: r = 0.084, P = 0.167; I² = 20%, P-value for heterogeneity = 0.215; and Meta 2: r = 0.268, P = 0.131, I² = 65.2%, P-value for heterogeneity = 0.003).

Conclusion: We were not able to confirm the association between HRV and any psychophysiological factors by meta-analysis, but it could be due to inherent limitations of this type of analyses. To test whether this associations truly exist, future meta-analysis will need to include studies with much larger sample size and standardize the methods between studies to reduce heterogeneity. Longitudinal studies will be fundamental to understand the causal relationship between these factors to ultimately improve training monitoring tools for better recovery in athletes.