Individuals who identify as a sexual or gender minority experience health related disparities in suicidal ideation, behavior, and attempts. Although past research has demonstrated that specific stressors may be unique to sexual or gender minorities contributing to suicidal ideation (e.g., minority stress), little work has been dedicated to understanding the role specific coping styles play in their associations with suicidal ideation among individuals who identify as a sexual or gender minority. The present study sought to address this gap in research and evaluate the unique associations of avoidant, emotional, and problem focused coping on suicidal ideation after accounting for theoretically relevant covariates. Participants included 372 individuals who identified as either a sexual or gender minority (Mage = 20.76, 83.3 % identified as female, 47.8 % White or Caucasian, 16.1 % Southeast Asian, 7.8 % Black or African American, 7.8 % multi-racial, 7 % other, 4.6 % East Asian, 2.7 % American Indian/ Alaska Native, 0.5 % Native Hawaiian or Other Pacific Islander). Results indicated that avoidant and emotional coping were associated with severity in suicidal ideation and suicidal cognitions, but avoidant coping was the only coping style that statistically significantly predicted greater likelihood of non-zero suicidal ideation/ cognition endorsement. Moreover, problem focused coping was the only style associated with less severe suicidal ideation and cognition. Overall, the present findings are the first to demonstrate unique associations of coping styles with suicidal ideation in the context of individuals who identify as a sexual or gender minority.

Bereavement following suicide and fatal overdose is associated with posttraumatic stress disorder (PTSD) and prolonged grief (PG). However, information about plausible explanations for these associated symptoms is scarce. Leveraging data from two assessment points, we examine the prospective roles of stigmatization, guilt, shame, and avoidant coping on PTSD and PG symptom severity and whether these relations are similar across groups.

We analyzed data (N = 212) from suicide- and overdose-bereaved adults who completed two waves of data collection (T1 and T2; six months apart) as part of a larger study of traumatic loss. Multigroup path analysis with serial mediation was used to estimate models of PTSD and PG symptomatology. Stigmatization (T1) and guilt (T1) were modeled as predictors, while shame (T1) and avoidant coping (T2) were modeled as mediators explaining PTSD (T2) and PG symptoms (T2).

Prospective relations between T1 stigma, T1 guilt, T2 PTSD and T2 PG symptoms were mediated by T1 shame and serially mediated by T2 avoidant coping. Multigroup analyses indicated similar relations across suicide and overdose-bereaved adults, but a stronger effect from T2 avoidant coping on outcomes for overdose bereaved adults.

Online self-report and use of a convenience sample are limitations.

Our results suggest shame and avoidance may help explain elevated symptoms of PTSD and PG in the context of suicide and overdose bereavement. Accordingly, transdiagnostic interventions that concurrently target shame-related cognitions and behavioral avoidance may be promising and warrant further attention.

Friendship provides women with a plethora of benefits, including reduced physiological and psychological distress. Little is known regarding what happens when women experience the death of their closest women friends. Thus, this study qualitatively described the bereavement of seven women who experienced the death of a close woman friend and tested an integrative model predicting prolonged grief and posttraumatic growth with 148 women grieving the death of a close woman friend. Findings from directed content analysis highlighted grief reactions, disenfranchising interactions related to social support, ways of coping, growth after loss, and ongoing challenges. Results from a path analysis indicated that avoidant emotional coping was a key mediator and predictor of prolonged grief, while problem-focused coping served as a key mediator and predictor of posttraumatic growth. The findings can be used to advance research, clinical practice and intervention efforts for women who are grieving the death of a woman friend.

Resilience is a psychological process that encompasses various facets of personality traits, behaviour, as well as coping, and it enhances the adjustment to adversities faced. Although a lot of interest has been devoted to the protective effects of resilience in handling affective disorders, little is known about the relationship between resilience and chronic fatigue, which is a common and potentially disabling sequel in survivors of aneurysmal subarachnoid hemorrhage (aSAH). Ninety-six good outcome patients with chronic post-aSAH fatigue answered the Resilience Scale for Adults (RSA) which assesses 6 distinct aspects of resilience. They also answered the Fatigue Severity Scale (FSS), Mental Fatigue Scale (MFS), Beck Depression Inventory (BDI-II), Beck's Anxiety Inventory (BAI), and the Brief COPE. The RSA scores were related to fatigue, emotional burden and coping. The prevailing resilience factor was "Social Resources". Patients with the highest scores for fatigue and emotional symptoms scored significantly lower for the factors "Perception of Self", "Perception of Future" and "Family Cohesion". Patients with clinically significant depression scored low across most RSA factors, with the weakest factors being "Perception of Self" and "Perception of Future". Resilience factors were positively associated with adaptive problem focused coping strategies, and in particular with the emotional coping strategy "Acceptance", whereas they correlated negatively with maladaptive avoidant coping. strategies. There is a close interaction between high resilience, adaptive coping strategies and lower burden of chronic fatigue and emotional symptoms.

Optimism and pessimism are stable, overarching dispositions that influence mental health, especially in stressful life situations, such as cancer survival. They have been associated with more specific coping strategies. This study sought to investigate a theoretically-based model of their interplay in shaping depressive and anxiety symptoms to inform prevention and intervention efforts.

The registry-based study included 689 survivors of malignant melanoma. We assessed sociodemographic and disease-related variables, optimism/pessimism (LOT-R), coping strategies (BC), depressive (PHQ-9), and anxiety symptoms (GAD-7). A structural equation model was conducted to analyse the hypothesized associations, modelling coping strategies (denial/self-blame, seeking external support, active coping) as mediators of the relationship of optimism/pessimism with depressive and anxiety symptoms. As a sensitivity analysis, gender-stratified models were tested.

The proposed model fit the data well. In the full sample, optimism was directly related to depression and anxiety, and the effects of optimism and pessimism were mediated via denial/self-blame. This indirect effect accounted for 60.8% of the total effect of pessimism on depression, and for 79.55% on anxiety. Stratified analyses showed different patterns of associations by gender, in the sense that the mediation effect was more relevant among men.

This study shows the relevance and need of gender-sensitive psychosocial-care. Especially in men, psychosocial interventions should target maladaptive coping strategies. Within women, fostering optimism seems to be particularly important. As the model did not fit as well for women, more gender-sensitive research is needed to understand potentially different risk/protective factors and needs of support.

The COVID-19 pandemic and rapid shift to online learning have had ongoing impacts on nursing students' wellbeing and resilience. We are yet to fully understand the implications for this emerging workforce in the post-pandemic era. The aims of this mixed methods study were to investigate wellbeing, coping and resilience of undergraduate nursing students in the pandemic; explore relationships between these variables and investigate predictors of wellbeing and coping, including differences between domestic and international students; explore how students experienced and managed adversity; understand how their mental distress and wellbeing were influenced by resilience resources used to deal with adversity, and identify implications for nurse wellbeing as they enter the workforce in the post-pandemic era.

A convergent mixed methods design was used. An online survey investigated wellbeing (COMPAS-W), psychological distress (DASS-21), coping (Brief COPE) and resilience (ARM-R) was completed by n = 175 undergraduate nursing students. Semi-structured interviews with n = 18 students explored how they navigated challenges. Descriptive, correlational, and regression analyses, and thematic analysis, were conducted. Mixed methods analysis was used to integrate both sets of findings.

Students reported high levels of mental distress, yet also moderate levels of wellbeing and resilience. Key findings included domestic students reporting significantly greater stress than international students, and wellbeing being predicted by lower mental distress and increased problem-focused coping. Students coped with challenges by being proactive, drawing on a range of coping strategies, and seeking technical and emotional support. From a social-ecological resilience perspective, access to and engagement with a range of personal, environmental and relational resources served as protective factors for their wellbeing.

This study provides valuable new insights into protective factors for nurses during a period of extraordinary challenge. In the post-pandemic era, there is a need to strengthen the wellbeing and retention of new graduates now entering the workforce from university. Implementation of targeted strategies to strengthen graduates' peer relationships and sense of belonging at work, and wellbeing and resilience education, are needed. Longitudinal follow-up of graduates' wellbeing is recommended.

This secondary analysis aimed to (i) describe psychological resources and distress in women with takotsubo syndrome (TS) and (ii) explore whether such factors affect blood pressure (BP) responses to acute mental stress.

Participants were 47 women consecutively enrolled in an ongoing study examining the prognostic significance of stress reactivity in TS. Psychological resources (resilience and adaptive coping) and distress [depression, anxiety, post-traumatic stress disorder (PTSD), and perceived stress] were self-reported using validated questionnaires <12 weeks after TS. Using a standardized protocol, systolic BP (SBP) and diastolic BP (DBP) (mmHg) were measured every 5 min during baseline (10 min), mental stress (10 min), and recovery (20 min). Associations of psychological resources and distress (high vs. low composite scores), respectively, with BP during mental stress and recovery (change from baseline), were examined using one-way analyses of covariance (covariates: age and anti-hypertensive medications). Given the study's exploratory nature, results are shown as effect sizes. On average, women (Mage = 64.3 years) had high perceived stress, anxiety, and PTSD symptoms and low resilience. Women with high (vs. low) psychological distress displayed less complete SBP (d = 0.57) and DBP (d = 0.33) recovery to baseline. Women with low (vs. high) psychological resources demonstrated lower SBP responses during mental stress (d = -0.26) alongside a more complete SBP recovery (d = 0.30).

Female survivors of TS with high psychological distress exhibited impaired BP recovery following acute mental stress. While the prognostic significance of impaired BP recovery from mental stress remains to be determined in longitudinal studies, this finding could help identify TS survivors at risk for recurrence.

Autism spectrum disorder (ASD) is a neurodevelopmental condition that significantly affects children's development, posing a significant challenge in pediatric healthcare. Early parent-mediated interventions (PMIs) aim to improve a child's social communication skills through joint engagement in daily activities. However, widespread access to this type of intervention is heavily limited due to implementation barriers and logistical challenges. The use of technology may offer promising alternatives to reach more families. This randomized controlled trial will assess the efficacy of an innovative e-coaching program designed to provide parents of young children with ASD with effective strategies via an online learning platform combined with personalized debriefings. It will compare e-coaching to standard Pediatric Autism Communication Therapy and to the absence of a PMI, with all three arms combined with community assistance as usual, in a cohort of 99 families with preschool children with ASD. The primary outcome will be the quality of parent-child interaction, measured through behavioral assessments and simultaneous dual gaze recording with head-mounted eye-tracking during semi-structured standardized play sessions. Secondary outcomes will include the child's developmental level and parental well-being. If validated, e-coaching could be disseminated to reach more families and have a positive impact on their quality of life.

While data demonstrate psychosocial support services as effective mechanisms for improving the psychological well-being of breast cancer survivors (BCS), reviews indicate more research is needed to confirm this finding. The current study examined the relationship between psychosocial support service utilization (PSSU) on adaptive coping (AC) and post-traumatic growth (PTG) among BCS.

Seventy-two Non-Hispanic Black and Non-Hispanic White BCS completed a survey assessing socio-demographic/clinical characteristics, PSSU (none, one type, multiple types), AC, and PTG. Analysis of covariance was used to examine the relationship between PSSU and AC/PTG indices.

Seventy-two percent of all respondents indicated utilizing one or more psychosocial support services. Among all respondents, as PSSU increased, all measures of AC and PTG significantly increased (p < 0.05). Analyses within race/ethnic groups showed similar patterns.

This study provides evidence of the positive relationship between PSSU and psychological well-being among a diverse group of BCS.

Child health behaviors and weight status may be affected by caregivers' perception and experience of stress. However, little is known about the influence of caregiver coping strategies on childhood overweight and obesity, particularly among non-Hispanic Black caregivers. This study examined associations among specific caregiver stress types (i.e., general, parenting, race-related), child weight status, and health-related behaviors (i.e., intake of fruits and vegetables, consumption of fast food, engagement in physical activity) as well as the moderating effect of caregiver coping strategies. In addition to general coping, the study examined the role of religious coping. This cross-sectional study included 157 non-Hispanic Black caregiver and child (aged 3-7 years) dyads; all caregivers identified as Christian Protestant. Logistic regression models were fit to explore the associations among caregiver stress and child outcomes and to investigate moderation effects of caregiver coping. Models were adjusted for sociodemographic covariates. Association between parenting stress and child weight status was significantly moderated by acceptance coping while the relationship between general stress and child sugary drink intake was moderated by emotional coping. The combination of three stress types was significantly associated with increased child fast food intake. Future research should examine specific coping strategies to address varying levels and types of stress experienced by caregivers from minoritized backgrounds.

Objective: This study examined the associations between COVID-19-related financial strain and the stress, mental health, physical health symptoms, and health behaviors of American university students. Participants: Online data were collected from 485 participants between May 2020 and March 2021. Participants were majority female and majority white. Methods: Participants reported on stress (COVID-19 health stress and work stress), mental health (depression, anxiety, loneliness, social support, and subjective well-being), physical health symptoms, and health behaviors (sleep latency, alcohol consumption, alcohol coping, other substance use, exercise, COVID-19 health behaviors). Results: Both Pearson's correlations and Bayesian correlation indicated more stress and worse mental health, health symptoms, and health behaviors for students who experienced more financial strain. Conclusion: Pandemic-related financial strain could have enduring negative effects for students, many of whom already experience financial challenges. This work highlights a need to allocate resources to promote college student health during and after the COVID-19 pandemic.

People living with HIV (PLWH) have an increased risk for lifetime trauma and mental health difficulties. However, no studies have evaluated stress-related genes in relation to early-life adversity, lifetime trauma, or post-traumatic stress disorder (PTSD) in PLWH.

Using bisulfite pyrosequencing, we evaluated DNA methylation (DNAm) in intron 7 of FKBP5, a glucocorticoid feedback regulator, and in the promoter of SLC6A4, the serotonin transporter gene, in whole blood of a random sample of 70 PLWH recruited from an HIV program, and 51 individuals 2 years later (n = 48 at both time points). Exploratory regression analyses were conducted with DNAm in relation to trauma exposure, mental health symptoms, and coping strategies.

Higher DNAm at one site of SLC6A4 was associated with lower levels of anxiety (B = -0.62 (SE = 0.23), p = 0.0109), depression (B = -0.06 (SE = 0.03), p = 0.0435), and PTSD symptoms at baseline (B = -0.03 (SE = 0.01), p = 0.0374). DNAm at FKBP5 was negatively associated with measures of anxiety (B = -0.30 (SE = 0.07), p = 0.0001) and depression symptoms (B = -0.2 (SE = 0.10), p = 0.0103). Various coping strategies were also associated with sites in both genes across time points, e.g. self-blame and substance use.

Our findings generate intriguing hypotheses linking mental health symptoms and DNA methylation, to be replicated with larger samples.

To examine the impact of coping styles in older adults with asthma on the prospective relationship between depressive symptoms and asthma outcomes, and how their perceptions of social support influenced their coping styles.

Adults 60 and over with asthma were recruited and interviewed about their experiences of asthma, depression, and other psychosocial factors over three time points (Baseline, 6-month, and 12-month visits). Structural equation models examined the mediating roles of coping styles in the relationship between depressive symptoms (assessed by BDI-II) and asthma outcomes (i.e., asthma control, asthma quality of life, asthma-related distress, asthma-related hospitalizations, and oral corticosteroid use) and the mediating role of perceived social support in the relationship between depressive symptoms and coping style.

455 participants were included in this study. Overall, 33.9% of the study population self-identified as Black and 32.8% as Hispanic. Depressive symptoms at baseline predicted less spiritual coping at 6 months (β =  - 0.15, p = 0.03), more negative coping at 6 months (β = 0.44, p < .0001), and worse asthma outcomes at 12 months (β = 0.31, p < .0001). None of the coping styles significantly mediated the relationship between depressive symptoms and asthma outcomes. Perceived social support mediated the relationship between depressive symptoms and positive coping, such that more depressive symptoms predicted less perceived social support, which in turn resulted in less positive coping engagement (β =  - 0.06, p = 0.03).

This study demonstrates that in older adults with asthma depressive symptoms impact perceived social support, coping strategy selection (including spiritual coping), and subsequent asthma outcomes.

The psychosocial evaluation plays an essential role in the multidisciplinary assessment of pediatric patients for thoracic organ transplantation or ventricular assist device (VAD) placement. However, there is considerable practice variation with regard to the content and process of the evaluation, with no known recent published guidelines. Furthermore, the pediatric evaluation necessarily differs from the adult evaluation in a number of substantive ways, including caregiver roles and decision-making. A writing committee of 25 multidisciplinary experts in pediatric cardiothoracic transplantation/VAD was established, who conducted a comprehensive literature review which resulted in the development of this consensus-based framework. This framework, which is a collaborative effort of the International Society for Heart and Lung Transplantation (ISHLT), the International Pediatric Transplant Association (IPTA), the Pediatric Heart Transplant Society (PHTS), the Advancing Cardiac Therapies Improving Outcomes Network (ACTION), and Transplant Families, represents the first known framework specific to both the content and process of the psychosocial evaluation for pediatric cardiothoracic transplantation/VAD. Attention was paid to relevant ethical, cultural and health equity considerations inherent in the pediatric evaluation process. Rather than provide a proscriptive evaluation process, the goal was to create a flexible framework to encourage consistency across centers, while also acknowledging the complexities inherent in evaluating children and their families for cardiothoracic transplant and VAD.

Previous research linked counternormative tendencies (e.g., conspiracy beliefs, cyberbullying, and catfishing) to narcissism-a personality trait characterized by difficulties in experiencing psychological threats. We argue that avoidance coping with stress favours attitudes and behaviours that allow for deflecting from stressful events and releasing one's stress at the expense of others. Thus, we hypothesized that avoidance coping might explain why narcissism favours counternormative tendencies. We conducted four studies (total N = 2643) in the United States and Poland to examine avoidance coping as a mediator of the relationship between narcissism and counternormative tendencies: conspiracy beliefs (Studies 1-4), willingness to conspire (Studies 2-4), cyberbullying (Studies 3-4) and catfishing (Study 4). All studies found a consistent positive indirect relationship between various forms of narcissism and counternormative tendencies via avoidance coping. These findings suggest that counternormative tendencies might reflect using maladaptive coping strategies.

We explored patients' and families' interest in, predictors of, and considerations regarding genetic testing for monogenic causes of dementia in a diagnostic setting.

This mixed-methods study evaluated 519 consecutive Alzheimer Center Amsterdam patients for monogenic testing eligibility. Among those qualifying, differences between testers and non-testers were analyzed. Thirty-three patients completed questionnaires. Additionally, we conducted 21 semi-structured interviews with 15 patients and 18 relatives. Verbatim transcripts were analyzed inductively.

Of 138 (27%) eligible patients (46% female, age 61 ± 8 years, Mini-Mental State Examination [MMSE] 22 ± 6), 75 (54%) underwent genetic testing. Testers had better cognition, higher quality of life, and more often undetermined diagnoses than non-testers (all p < 0.05). Decisions were guided by intuitive, value-driven judgments: testers sought to provide heredity information to relatives, enhance actionability, and reduce uncertainty, while non-testers worried about psychosocial impact on family, or unfavorable timing.

The substantial interest in genetic testing for monogenic causes of dementia underscores the need for further research into the implications of disclosing test results to memory clinic patients.

Half of memory clinic patients' who met eligibility criteria proceeded with genetic testing. Those tested were more likely to have an undetermined diagnosis, better cognition, and higher quality of life. Decisions were motivated less by deliberation of factual information, and more by quick, intuitive judgments. Motivations pro included providing information, enhancing actionability, and resolving uncertainty. Motivations con comprised concerns about the emotional burden and disruptive impact on their family.

The stress reaction is an integrated response to a change in the environment that enables each individual to adapt to demand. While this response is physiologically coordinated by the brain, its phenomenology is expressed in the field of psychology and psychopathology. This interrelation between neurophysiological mechanisms and psychological processes is complex as dynamic interpersonal, biological, and psychocognitive systems interact with contextual and environmental factors to shape adaptation over the life constraints.

This article aims to present the actors of the adjusted stress response, such as coping and coping flexibility, mindfulness and resilience, and their respective neurophysiology.

A model of the relationship between resilience, mindfulness and coping was proposed for optimizing adaptation to stress response.

These focuses are prerequisites for understanding and supporting human adaptation in the everyday environment and promoting efficient management of stress for mental and physical health.

Methods: Students completed an online survey about pandemic-related disruptions, depressive symptoms, mindfulness, coping, and demographics.

Results: Students whose families had more financial difficulties reported more disruptions. Depression and avoidant coping were positively correlated with distress, while mindfulness was inversely correlated with distress and depression. Disruptions, family financial status, depressive symptoms, mindfulness, and avoidant coping significantly predicted distress, controlling for university site and student sex, age, race, and ethnicity in multiple regression analyses. Avoidant coping significantly moderated (amplified) the effect of disruptions on distress. Conclusions: College student well-being can be supported through Campus programming that includes mindfulness practices and alternatives to avoidant strategies for coping with stress.

This study comprehensively examined the psychometric properties of the Brief Mishel Uncertainty in Illness Scale for patients (MUIS-P) managing advanced cancer and their caregivers (MUIS-Cg).

The MUIS-P and MUIS-Cg scales were developed based on the Mishel Uncertainty in Illness Scale-Adult. We conducted a secondary analysis to test the acceptability, factor structure, reliability, and validity of the brief uncertainty scales for patients with advanced cancer (N = 484) and their caregivers (N = 484) using data from a randomized clinical trial.

The 9-item MUIS-P and MUIS-Cg show goodness of fit for a two-factor structure (unpredictability and ambiguity) with adequate to acceptable internal consistency (Cronbach's alpha 0.66-0.78 for patients and 0.70-0.72 for caregivers and McDonald's omega 0.72-0.84 for patients and 0.76-0.79 for caregivers). The MUIS-P and MUIS-Cg scores correlated with negative appraisals of illness/caregiving, hopelessness, and avoidant coping, demonstrating convergent validity. The discriminant validity of the MUIS-P and MUIS-Cg was evidenced by their significant correlations with self-efficacy and active coping. The baseline MUIS-P and MUIS-Cg scores were significantly associated with quality of life, hopelessness, depression, distress, and avoidant coping at the 3-month follow-up, indicating their strong predictive validity.

This study comprehensively evaluated the psychometric properties of the MUIS-P and MUIS-Cg, laying a foundation for their use in research and clinical practice among patients and caregivers managing demanding symptoms and care.

Palliative care (PC) improves quality of life (QOL). However, PC is currently delivered 'too little, too late' in heart failure (HF). Timely interventions to enable and reach patients with HF and their caregivers, with PC (TIER-HF-PC) is a novel, nurse coach-led model of PC that integrates PC into HF care. We will compare the effectiveness of TIER-HF-PC against usual care for improving patient and caregiver health outcomes. We will also evaluate implementation outcomes (such as care experience) of TIER-HF-PC.

In TIER-HF-PC, patients undergo regular distress screening. The intensity of PC treatments will be tiered based on the severity of problems detected. Minimally, all patients will receive PC education resources. Patients with moderate-intensity needs will receive PC health coaching. Patients with high-intensity needs will receive a PC physician consultation, on top of PC health coaching. Patients in usual care are not screened but can be referred to a PC physician based on cardiologist discretion.We will recruit 240 English- or Mandarin-speaking patients with HF and up to 240 caregivers from 3 sites across 2 cardiac centres. Patients will be randomised in a 1:1 ratio to TIER-HF-PC or usual care. We will use an intention-to-treat approach for data analysis. Our primary outcome is patient QOL on the Kansas City Cardiomyopathy Questionnaire at 24 weeks. Secondary outcomes include patient healthcare utilisation, caregiver QOL and cost-effectiveness. All participants who received PC treatments will receive a service evaluation survey. Additionally, a sample of these participants and their treating healthcare staff will be purposively recruited for in-depth semistructured interviews on their TIER-HF-PC experience. Interviews will be thematically analysed. We will evaluate protocol fidelity through case notes and study process audits.

This study was approved by the SingHealth Institutional Ethics Review Board-review number: 2024-2213. Results of the study will be disseminated when data analysis is complete.

NCT06244953.

We evaluated the psychometric properties of the Turkish version of the Adaptive Coping with Disease Scale (ACDS) questionnaire for Turkish patients with cancer.

A total of 175 patients with cancer aged 18 to 65 years were referred to a university hospital in Ankara, Türkiye. The patients, selected by convenience sampling in 2024, completed the Descriptive Form and Turkish versions of the ACDS questionnaire. The construct validity of the scale was assessed through confirmatory factor analysis and exploratory factor analysis. Pearson's correlation analysis was conducted to evaluate the relationships between item-total scores and item-subscale total scores. The reliability of the scale was determined using Cronbach's alpha coefficient. In addition, the scale language validity and test-retest reliability were evaluated. The data were analyzed using the IBM SPSS Statistics and AMOS 25.

The scale demonstrated high validity (content validity index = 0.97, interclass coefficient = 0.721, P < .001), indicating high stability and consistency of test scores over time. The comparative fit index confirmed the six-factor structure of the ACDS scale, excluding item 13. The Kaiser-Meyer-Olkin coefficient was 0.738, and Bartlett's test yielded a value of 2305.623 (P < .001). Fit indices indicated a good model fit (χ²/degrees of freedom = 1.98, root mean square error of approximation = 0.074, comparative fit index = 0.815). The scale exhibited acceptable internal consistency, with an overall Cronbach's alpha of 0.78. The total explained variance ratio was 57.14%.

The Turkish version of ACDS in patients with cancer is a reliable and valid questionnaire that can be used in clinics and research.

Nurses can use the ACDS to assess the level of disease-related stress experienced by patients with cancer. In addition, they can guide the patients to develop effective coping methods and a better quality of life.

In the digital age, there is an emerging area of research focusing on digital well-being (DWB), yet conceptual frameworks of this novel construct are lacking. The current conceptualization either approaches the concept as the absence of digital ill-being, running the risk of pathologizing individual digital use, or follows the general subjective well-being framework, failing to highlight the complex digital nature at play.

This preregistered study aimed to address this gap by using a network analysis, which examined the strength of the relationships among affective (digital stress and web-based hedonic well-being), cognitive (online intrinsic needs satisfaction), and social (online social connectedness and state empathy) dimensions of DWB and their associations with some major DWB protective and risk factors (ie, emotional regulation, nomophobia, digital literacy, self-control, problematic internet use, coping styles, and online risk exposure).

The participants were 578 adults (mean age 38.7, SD 13.14 y; 277/578, 47.9% women) recruited from the United Kingdom and the United States who completed an online survey. Two network models were estimated. The first one assessed the relationships among multiple dimensions of DWB, and the second examined the relationships between DWB dimensions and related protective and risk factors.

The 2 resulting network structures demonstrated high stability, with the correlation stability coefficients being 0.67 for the first and 0.75 for the second regularized Gaussian graphical network models. The first network indicated that all DWB variables were positively related, except for digital stress, which was negatively correlated with the most central node-online intrinsic needs satisfaction. The second network revealed 2 distinct communities: digital competency and digital dependency. Emotional regulation emerged as the most central node with the highest bridge expected influence, positively associated with emotion-focused coping in the digital competency cluster and negatively associated with avoidant coping in the digital dependency cluster. In addition, some demographic differences were observed. Women scored higher on nomophobia (χ24=10.7; P=.03) and emotion-focused coping (χ24=14.9; P=.01), while men scored higher on digital literacy (χ24=15.2; P=.01). Compared with their older counterparts, younger individuals scored lower on both emotional regulation (Spearman ρ=0.27; P<.001) and digital self-control (Spearman ρ=0.35; P<.001) and higher on both digital stress (Spearman ρ=-0.14; P<.001) and problematic internet use (Spearman ρ=-0.25; P<.001).

The network analysis revealed how different aspects of DWB were interconnected, with the cognitive component being the most influential. Emotional regulation and adaptive coping strategies were pivotal in distinguishing digital competency from dependency.

Elite para athletes report a high incidence of sports injuries. Research suggests that athletes' strategies to manage adversities may influence the sports injury risk, but knowledge about para athletes' coping behaviours and their association with injuries is limited. The aim was to describe the distribution of coping behaviours in Swedish elite para athletes by sex, age, impairment, sport and to examine associations between coping behaviours and the probability of reporting a prospective sports injury during a 52-week study period.

Eighty-three para athletes participating in the 'Sports-related injuries and illnesses in Paralympic sport study' completed the Brief COPE Inventory. Over the following 52 weeks, athletes reported any sports injuries they sustained. The analysis of coping behaviours comprised descriptive statistics and linear regression, and associations between coping behaviour and the probability of being injured were examined by logistic regression analyses.

The most frequently used coping behaviours were acceptance, active coping and planning. The most common less-useful coping behaviour was self-blame. Athletes with more active coping behaviours were less likely to report an injury, and using humour as coping behaviour was associated with a higher probability of injury among young athletes. Also, athletes with physical impairment reported a higher use of active coping and emotional support compared with athletes with visual impairment, and athletes participating in individual sports used acceptance as a coping behaviour to a larger extent than athletes in team sports.

Use of active coping in Swedish elite para athletes was associated with a lower likelihood of reporting an injury. Young athletes using humour as a coping strategy had a higher likelihood of reporting an injury. The results suggest that support of active coping behaviours and a sport context fostering help-seeking behaviours should be considered in future prevention measures.

Psychosocial and cultural determinants have a special influence on the development, manifestation and prognosis of common mental disorders such as anxiety and depression. The objectives of this study were to define the psychosocial profile of the people most vulnerable to the development of these health problems, analyse the symptomatology and health determinants that may influence these from a gender perspective, and evaluate the quality of life and coping strategies among the adult population with this diagnosis in a rural area of Catalonia (Spain).

An observational, cross-sectional, and analytical study was conducted on 180 people diagnosed with anxiety or depression. Patients completed an ad hoc sociodemographic questionnaire, the Brief Symptom Checklist (LSB-50), the Quality of Life Scale (EQ-5D-5L) and the Brief Cope Inventory (COPE-28).

Women aged 45-64 with a low socioeconomic profile may be more vulnerable to common mental disorders, although psychiatric symptomatology was more pronounced in men. Women were more likely to have problems with mobility (aOR= 2.93, p = 0.039) and daily activities (aOR = 2.75, p = 0.033), as well as lower self-perceived health scores (p = 0.002). Women used active coping, venting and seeking social support as coping strategies, while men used behavioural disengagement.

It has been observed that the people most susceptible to developing depression and anxiety disorders may have a specific profile. Although a greater number of women have these common mental disorders, men tend to have more noticeable symptomatology. The coping strategies most used also differ according to gender.

Nonsuicidal self-injury (NSSI) is a common phenomenon; a recent meta-analysis of studies conducted among non-clinical adolescents reported a global lifetime prevalence rate of 22.0%. NSSI results in significant impairment and is associated with negative outcomes later in young adulthood. There is, however, a dearth of research on the occurrence of NSSI in Singapore's youth population. Past studies examining NSSI behaviours among youths in Singapore were conducted using clinical samples, which tend to report a higher prevalence compared to community samples. The present study aims to establish the prevalence of NSSI and examine its associated sociodemographic and psychosocial correlates in the general youth population.

This study included 2600 youths aged 15-35 years who participated in the National Youth Mental Health Study, a nationwide cross-sectional survey of the mental health status of youths in Singapore. The Deliberate Self-Harm Inventory and Depression Anxiety Stress Scales Short Form were used to assess NSSI behaviours and mental health symptoms. Data on coping strategies, perceived social support and resilience were also collected.

The lifetime prevalence of NSSI among youths in Singapore was 25.0%, and the 12-month prevalence was found to be 6.8%. The median age of onset for lifetime NSSI was 14 years. Significantly higher odds of lifetime NSSI were observed among youths aged 15-29 years, females, and youths with lower educational attainment. Youths with severe and extremely severe symptoms of depression and anxiety and those with greater use of avoidance coping strategy were associated with higher odds of lifetime NSSI. Higher resilience scores were associated with lower odds of lifetime NSSI.

1 in 4 youths in Singapore had engaged in self-injurious behaviour at least once in their lifetime. Screening and early intervention programs could be targeted at the more vulnerable youth groups such as those in early- and mid- adolescence. Potential areas for future research and interventions could include resilience building and educating youths on adaptive coping strategies. The limitations of the cross-sectional study design and the use of self-reported data should be considered when interpreting the study findings.

The cause of ischaemic stroke at a young age remains unknown in 30% of cases, highlighting the need to identify hidden causes and risk factors in young patients. Transient and chronic risk factors may interact with the inflammatory and haemostatic systems, potentially driving key mechanisms in the pathogenesis. The 'Observational Dutch Young StrokE study-Extended' (ODYSSEY-nEXT) aims to enhance our understanding of these complex interactions through detailed phenotyping of the immune and haemostatic system and explore their relationship with long-term prognosis.

The ODYSSEY-nEXT is a multicentre prospective controlled cohort study of patients aged 18-50 years with a first neuroimaging-proven ischaemic stroke or transient ischaemic attack and healthy controls. We aim to include a total of 200 patients and 60 controls between January 2023 and January 2027. Blood samples will be collected within 72 hours after the index event and at 3 months to assess inflammatory and haemostatic markers. In a subgroup of 20 patients, whole blood analysis will be performed to investigate ex vivo immune cell functionality, the capacity of platelets to release granules and thrombin generation. All patients will complete a questionnaire about trigger and risk factors. Advanced intracranial and extracranial vessel wall imaging with MRI will be performed within a week. Long-term prognosis will be monitored through annual questionnaires about recurrent events for ten years.

This study was approved by the Medical Ethical Committee region 'Oost-Nederland' (NL77518.091.21) and will adhere to the Declaration of Helsinki and its later amendments. Participants have to provide written informed consent, but in cases where the patient cannot sign due to physical limitations as a result of the stroke, such as paresis, verbal consent is obtained from the patient and a legal representative will be asked to sign the consent form on their behalf. The findings of this study will be disseminated to healthcare professionals and the scientific community through peer-reviewed publications and to participants through accessible formats such as summary reports or newsletters.

NCT05853796.

The wellbeing of health care workers (HCWs) has been an ongoing challenge, especially within low and middle-income countries (LMICs) such as South Africa. Evidence suggesting that HCWs are increasingly stressed and burned out is cause for concern. Nurses in particular have been impacted physically, mentally and psychosocially during the recent COVID-19 pandemic. This may leave a disproportionate consequence, affecting various aspects of their wellbeing, thereby justifying a need for a more holistic investigation of the wellbeing of South African nurses and their coping mechanisms during the peak of the pandemic.

This was a cross-sectional study design. Online self-reported questionnaires were administered in six hospitals, sampled purposively and conveniently from three South African provinces. Using STATA 18.0, the Wilcoxon Ranksum test at 5% alpha compared the wellbeing and coping mechanisms of nursing staff and nursing management during COVID-19's peak. Univariable and multivariable linear regression analyses were performed to determine factors associated with burnout in nurses, at a 95% confidence interval (CI). Validated scales measuring burnout, coping, resilience, as well as mental and physical health were utilised.

Of 139 participants, 112(97.4%) were females, with 91(82%) and 20(18%) being nursing staff and management respectively. The median age of the participants was 43.3 years (n = 112), with a practising duration of 12 years (n = 111). There was a significant difference in the burnout score between nursing staff and nursing management (p = 0.028). In the univariable linear regression model, burnout was significantly (p < 0.05) associated with the Brief COPE Inventory (BCI), Conor-Davidson Resilience Scale (CDRS), Global Mental and Health Scale (GMHS), Global Physical and Health Scale (GPHS) and Hospital Anxiety and Depression Scale (HADS), as well as occupation. In the multivariable linear regression model, burnout was significantly associated with the CDRS [Coeff.=0.7, 95%CI 0.4; 0.9], GMHS [Coeff.=-2.4, 95%CI -3.2; -1.6], GPHS [Coeff.2.1, 95%CI 1.3; 2.9], and HADS [Coeff.=0.7, 95%CI 0.2; 1.2].

Investigating multiple aspects of wellbeing in this study, it's shown that coping and resilience may not be key factors in promoting the wellbeing of South African nurses. However, effective mental health interventions are crucial and should be prioritised to mitigate burnout during future health emergencies. Future studies examining the associations between general health, coping and resilience may help generate further evidence towards holistic interventions aimed at promoting nurses' wellbeing.

Not applicable.

Using network analysis (NA), this study examined interrelationships between advocacy of scientifically unsubstantiated beliefs (i.e., Paranormal and Conspiracy Endorsement) and positive wellbeing outcomes (i.e., Coping, Meaning in Life, Self-Esteem, and Satisfaction with Life). A total of 1,667 participants completed study measures. Analysis revealed that Paranormal Belief (PB) and Self-Esteem were central variables. Although not directly connected, common relationships existed with Search for Meaning in Life and Avoidant Coping. PB was most strongly linked (positively) with Conspiracy Endorsement, the Cognitive-Perceptual dimension of schizotypy, Search, and Avoidant Coping. Connections indicated that PB potentially mediated relationships between Schizotypy, Search, and Avoidant Coping. Self-Esteem was most strongly linked positively with the Presence of Meaning in Life, Active Coping, and Satisfaction with Life, and negatively with Avoidant Coping and Search. Network examination also revealed that Self-Esteem bridged relationships between Coping (Active and Avoidant), Meaning in Life (Search and Presence), and Satisfaction with Life. While the correlation between PB and Self-Esteem was small, the significance of these nodes suggested that their indirect interaction (through Search and Avoidant Coping) influenced factors related to positive wellbeing. This implied that the connection between PB and enhanced Self-Esteem positively impacted wellbeing. Conversely, PB associated with low Self-Esteem reflected poorer psychological health. Therefore, subsequent research should test this notion using specific belief facets.

The rise in smartphone use and the resulting dependence has led to the emergence of nomophobia, a term describing the anxiety or discomfort experienced when individuals are without their mobile phones. This study aimed to examine the prevalence of nomophobia among adults in Cyprus and explore its relationship with demographic characteristics, reasons for smartphone use, and coping styles.

In line with this aim, participants were 300 adults from Cyprus recruited by convenience and snowball sampling methods. The data were collected via an internet-based questionnaire that examined participants' level of nomophobia, reasons for phone use, time spent on their phones, and coping styles. The study utilized a Personal Information Form, the Nomophobia Questionnaire (NMP-Q), and the Brief Coping to Problems Experienced Inventory (Brief COPE) to gather data.

The results suggest that (a) nearly all participants (99.3%) exhibited some level of nomophobia, with more than half of our sample (51.3%) experiencing moderate levels, (b) younger adults, women, and individuals with lower education levels were more prone to nomophobia, (c) communication and social media were positively related to nomophobia, and (d) maladaptive and avoidant coping strategies exacerbated the severity of nomophobia.

The findings highlight the growing concern of nomophobia and stress the need for educational programs promoting healthier smartphone habits.

Background: Nurses experiencing second victimization after a patient safety incident face challenges in developing effective coping strategies. Active coping can lead to constructive practice changes within a just culture. However, no theoretical model has yet tested the relationships among a just culture, second victim variables, coping strategies, and practice changes. Methods: A nationwide online survey was conducted using proportional quota sampling based on region, representing 0.7% of nurses in tertiary hospitals across various Korean regions as of August 2022. Partial least squares structural equation modeling (PLS-SEM) was used to develop the hypothesized model, determine the model fit, and test research hypotheses. Descriptive statistics, model fit, and path analysis were performed using SPSS and Smart-PLS. Results: The final analysis included 461 clinical nurses. Six significant pathways were identified: A just culture positively influenced constructive changes in nursing practice through second victim experience and avoidant coping (B = 0.07, p < 0.001). In the absence of a just culture, constructive changes decreased (B = -0.12, p < 0.001). The just culture negatively influenced defensive changes in nursing practice through second victim experience (B = -0.24, p < 0.001). The just culture negatively influenced defensive changes in nursing practice through second victim experience and avoidant coping (B = -0.10, p < 0.001). Without the just culture, defensive changes in nursing practice increased (B = 0.19, p < 0.001). The just culture reduced avoidant coping through second victim experience (B = -0.25, p < 0.001). Conclusions: This study provides pathways to increase constructive nursing practice changes and decrease defensive nursing practice changes in nurses who have experienced a patient safety incident. Implications for Nursing Management: The just culture needs to be established in a nursing practice setting and healthcare organizations. This study, using a representative sample through proportional quota sampling, provides reliable and valid evidence for nursing practice and healthcare organizations regarding the just culture, second victim experiences, and patient safety.

Haemodialysis may affect the changes in the patient's relationship with the family, and eventually cause some psychological distress to the patient and affect the health-related quality of life. This study examines the effectiveness of the dyadic psychoeducational intervention on patients' quality of life and psychosocial health, as well as caregiver burden and psychosocial outcomes among caregivers.

This is a parallel, two-arm, assessor-blind, randomised controlled trial with a repeated-measures design. A total of 80 haemodialysis dyads (patient and family caregivers) randomly assigned to the intervention group or control group with usual care (N = 40 dyads per group). The intervention included 4-week dyadic psychoeducational intervention. At before intervention (T0), immediately after intervention (T1), 1 month after intervention (T2) and 3 months after intervention (T3), patients' quality of life ana caregiver burden (primary outcomes), and other secondary outcomes (i.e., dyads' coping, depression and anxiety symptoms, and social support) were evaluated. Generalized Estimated Equation was used to test the intervention effect of the dyadic psychoeducation intervention, and intentional-to-treat analysis was used for all analyses.

Effects of dyadic psychoeducational intervention: The result of adjusting the GEE model shows that dyadic psychoeducational intervention can effectively improve patients' quality of life (T1: β = 8.51, p < 0.001; T2: β = 9.03, p < 0.001; T3: β = 8.82, p < 0.001), patients' anxiety (T1: β = -2.35, p = 0.022; T2: β = -2.84, p = 0.002; T3: β = -2.85, p = 0.001) and caregivers' anxiety (T2: β = -1.67, p = 0.012; T3: β = -2.57, p = 0.004), patients' depression (T2: β = -2.39, p = 0.017; T3: β = -2.71, p = 0.006), caregiver burden (T2: β = -6.95, p = 0.007; T3: β = -6.34, p = 0.008), caregiver depression (T2: β = -2.01, p = 0.015; T3: β = -1.85, p = 0.015).

The dyadic psychoeducational intervention can improve the psychosocial outcomes of haemodialysis dyads. This intervention provides effective ways and measures for the relevant psychological education intervention and provides new ideas and evidence for clinical nursing research.

This study was retrospectively registered as a randomized controlled trial in the ClinicalTrials Registry. Registration Date: April 16, 2024.

NCT06203730.

We assessed social connection, self-efficacy, and coping as mediators in a peer support intervention for depressed low-income and minoritized older adults.

Convergent mixed methods analysis of data collected in an RCT with at-risk older adults (N = 149) comparing the effectiveness of PEERS, an 8-week peer support, self-care intervention on depression to telephone calls providing social interaction for the control group. Assessments occurred at baseline, postintervention, and every 3 months up to 12 months. Mediation effects of loneliness, self-efficacy, and coping were analyzed using longitudinal mixed effects modeling after z-score standardization, complemented by semi-structured interviews. We report results in regression coefficients, i.e. in standard deviation units.

Loneliness had an indirect effect on depression in both intervention (-0.32 [95% CI: -0.48, -0.19]) and control groups (-0.16 [95% CI: -0.27, -0.04]). Self-efficacy had an indirect effect of -0.17 (95% CI: [-0.24, -0.05]) at postintervention and -0.20 (95% CI: [-0.30, -0.08]) at 12 months for the PEERS group. Adaptive coping had an indirect effect with -0.15 (95% CI: [-0.26, -0.06]) at postintervention and -0.15 (95% CI: [-0.32, -0.04]) at 12 months for the PEERS group, No evidence of mediation for self efficacy nor coping was found for the control group. Qualitative results indicated reduced loneliness, improved coping and behavior change among intervention participants. Control group participants reported social support from telephone calls but did not mention improved self-efficacy and coping skills.

Social engagement and peer support intervention have a common pathway, e.g. alleviation of loneliness in reducing depression, but the PEERS intervention can also decrease depression by improving self-efficacy and adaptive coping.

Dual process models represent a useful framework for explaining physical activity (PA) in that behavior is explained by reflective (i.e., conscious, effortful) and automatic (i.e., unconscious, effortless) determinants. Yet the distinct momentary reflective and automatic determinants associated with PA adoption and maintenance are unclear.

Older adults (N = 202; ≥60 years) wore accelerometers to measure PA (i.e., moderate to vigorous intensity PA [MVPA], step counts) and completed brief mobile phone prompts assessing general reflective (i.e., demands, deliberation, self-efficacy, self-control, stress coping, emotion regulation), behavior-specific reflective (i.e., PA intentions, self-efficacy, planning), and automatic determinants (i.e., affect, physical and social context, functional stability of one's routine) as part of three, 2-week waves of data collection spaced over one year. Multilevel modeling was used to examine the within- and between-person associations between these determinants and subsequent PA.

There were within- or between-person differences between general reflective, behavior specific, and automatic determinants and PA by adopter and maintainer status. General reflective determinants tended to be more predictive of step counts compared to MVPA. Within-person behavior-specific reflective determinants (i.e., intentions, self-efficacy, plans) were positively associated with PA behavior but associations tended to be more positive among PA maintainers. Automatic determinants were more predictive of the amount of PA as opposed to the likelihood of PA occurring.

Reflective and automatic determinants, as well as the levels at which these determinants operate (i.e., between vs within), need to be considered when attempting to explain and predict the adoption and maintenance of PA.

The Estudio de la Vida Bajo Estres (My Life Under Stress [MI-VIDA] Study) aims to investigate risk and resilience factors associated with the development of PTSD in a trauma-exposed sample of more than 500 Colombian residents exposed to this country's armed conflict. The study utilised a longitudinal case-control design capturing psychosocial data over 18 months, in addition to baseline DNA samples for a parallel genomic analysis. This paper specifically provides an overview of the design and methodology of the wider investigation, and reports baseline characteristics including sociodemographic information and mental health outcome prevalences from this hard-to-reach and under-researched population. Results of baseline analysis suggested that one third (34.88%) of this trauma-exposed sample screened positively for PTSD. Participants endorsed high numbers of potentially traumatic experiences including Forced Displacement (88.61%), Exposure to Severe Human Suffering (53.91%), Combat Exposure (53.02%), and Physical Assault (51.78%). Participants also reported relatively high levels of mental ill-health including depression (29.90%) and anxiety (27.56%). The number of traumas experienced, and the reported comorbid difficulties were generally higher among those who screened positive for PTSD. These preliminary analyses detail the baseline characteristics, and the relative burden of mental ill-health in this trauma-exposed sample. The wider study comprising longitudinal measurement of these conditions has the potential to make a significant contribution to the understanding of risk and resiliency factors for posttraumatic stress in this unique Latin American context.

The online version contains supplementary material available at 10.1007/s10862-025-10203-1.

To gain a deeper understanding of Black older adults' (aged ≥65 years) experiences with adverse childhood experiences (ACEs), including racism, and their use of active coping throughout their life course.

Qualitative interviews were conducted with 21 Black older adults followed by administration of the First 18 Years Survey (measuring ACEs) and the John Henryism Active Coping Scale. Qualitative data were analyzed using thematic narrative analysis. Quantitative data were analyzed using descriptive statistics. Qualitative and quantitative data were integrated using a triangulation process.

Four major themes emerged from the qualitative data. Participants reported experiencing pervasive racism throughout their lives. Quantitative results indicated participants experienced fewer ACEs and made high use of active coping. Triangulation indicates qualitative findings and explains the quantitative results.

Although participants faced ACEs including racism, they found strategies to help them actively cope. [Research in Gerontological Nursing, 18(2), 57-67.].

Anxiety and fatigue are common problems in patients receiving chemotherapy. Unrelieved stress is a potential cause for the co-occurrence of these symptoms.

The aims of this study were to identify subgroups of patients with distinct state anxiety and morning fatigue profiles and evaluate for differences among these subgroups in demographic and clinical characteristics, as well as measures of global, cancer-specific, and cumulative life stress and resilience and coping.

Patients (n = 1335) completed measures of state anxiety and morning fatigue 6 times over 2 cycles of chemotherapy. All of the other measures were completed prior to the second or third cycle of chemotherapy. Latent profile analysis was used to identify the state anxiety and morning fatigue profiles.

Three distinct joint profiles were identified: Low Anxiety and Low Morning Fatigue (59%), Moderate Anxiety and Moderate Morning Fatigue (33.4%), and High Anxiety and High Morning Fatigue (7.6%). Patients in the 2 highest classes were younger, were less likely to be married/partnered, and had a higher comorbidity burden. All of the stress scores demonstrated a dose-response effect (ie, as anxiety and morning fatigue profiles worsened, stress increased). Patients in the 2 highest classes reported higher rates of emotional abuse, physical neglect, physical abuse, and sexual harassment.

More than 40% of these patients experienced moderate to high levels of both anxiety and morning fatigue. Higher levels of all 3 types of stress were associated with the 2 highest profiles.

Clinicians need to perform comprehensive evaluations of patients' levels of stress and recommend referrals to psychosocial services.

Health related quality of life (HRQOL) is a patient-reported metric (PRM) that provides a holistic measure of health that is not addressed in traditional outcome measures. The acute responsiveness of HRQOL after pediatric/congenital cardiac catheterization procedures has not, to our knowledge, been studied.

A single-center prospective cohort study was performed, longitudinally evaluating HRQOL and other PRM in school-age children and adolescents (ages 8-18) undergoing diagnostic and interventional cardiac catheterization procedures prior to their scheduled procedure, and then 1 day, ∼1 month, and ∼3 months after the procedure. Differences between HRQOL at baseline and at 1- and 3-month follow-up were evaluated using paired Student's t-tests.

A total of 70 patient-parent/guardian dyads were studied. The participating patients were 13±3 years old, 51% female, and 74% non-Hispanic white, with 54% undergoing a diagnostic procedure. The trajectory of cardiac-specific HRQOL as measured through Pediatric Cardiac Quality of Life Inventory differed for patients undergoing diagnostic and interventional procedures. Following diagnostic procedures, there was no significant change in cardiac-specific HRQOL (P > .05). After interventional procedures, patient-reported cardiac-specific HRQOL increased at both 1-month (4.3±11, P = .04) and 3-months (5.9±11.4, P = .02), though the same changes were not seen in parent/guardian-reported cardiac-specific HRQOL (P > .05). PROMIS measures of physical function, psychological symptoms, and social function were associated with baseline cardiac-specific HRQOL (all P < .05), but no associations were seen between other patient-reported outcomes and baseline HRQOL or change from baseline to 3-month follow-up.

Across a range of transcatheter interventional procedures, patient-reported cardiac-specific HRQOL improved in short term follow up, though these changes were not seen in parent/guardian reported measures. Incorporating these patient-centered metrics into evaluation of transcatheter therapies may provide more accurate measures of comparative effectiveness.

ABSTRACTIn the current study, we examine associations between exposure to violence and antiretroviral medication adherence in persons with HIV (PWH) in a southern city in the United States. We include investigation of a variety of violence exposures including childhood sexual abuse, physical abuse, witnessing family violence, lifetime violence exposures and current stress related to violence experiences, as well as neighborhood violence exposure. We examined associations between violence exposures and adherence and mediational pathways between these variables including mental health symptoms - specifically depressive, anxiety, and posttraumatic stress symptoms - as well as coping strategies. Results suggest that physical abuse in childhood was associated with ART non-adherence, no other reported violence experiences were associated with adherence. Of the mediational paths analyzed between violence and ART adherence, only coping with substance use was significant. In post hoc analyses, we examined the mental health symptoms of depression, PTSD and anxiety as mediators between violence exposures and substance use coping. Depressive symptoms were the only significant mediational pathway. Implications for interventions to address histories of violence, depressive symptoms, coping with substance use and adherence are discussed.

The stress literature suggests that coping strategies are implicated in mental health outcomes. However, the longitudinal relationship between coping strategies and mental health in the autistic adult population has not yet been examined. This 2-year longitudinal study examined the predictive role of both baseline and change in coping strategy use over time (i.e., an increase or decrease) on anxiety, depression, and well-being after 2-years in 87 autistic adults aged 16 to 80 years. Controlling for baseline mental health, both baseline and increase in disengagement coping strategies (e.g., denial, self-blame) predicted higher anxiety and depression, and lower well-being, while an increase in engagement coping strategies (e.g., problem solving, acceptance) predicted higher well-being. These findings extend the current coping literature in autistic adults, offering insight into mental health support and intervention options.

Research on learners' reactions to failure finds negative emotions may present an obstacle for learning; a painful experience of failure may result in disengagement and avoidance. However, research on styles of emotion regulation and learning from failure is scarce. Self-determination theory's (SDT) conception of adaptive and maladaptive emotion regulation differentiates among three styles of regulation: integrative emotion regulation (IER), suppressive emotion regulation (SER) and amotivated emotion regulation.

Two studies were conducted, one cross-sectional and one longitudinal, to test the associations between IER and learning from failure among adolescents.

Study 1 comprised 184 adolescents (mean age = 16.55; SD = 1.2). Study 2 comprised 565 adolescents (8-12 graders). The main analysis was based on 192 adolescents' perceptions of failing math grades.

Study 1 surveyed adolescents on their emotion regulation styles, adaptive and maladaptive coping practices when dealing with failure and tendency to learn from failure. Study 2 was longitudinal and focused on failure in math. We approached participants twice, before and after the math test.

In both studies, IER was related to adaptive coping practices and the tendency to learn from failure. In Study 2, adaptive coping practices mediated relations between IER and learning from failure in math and learning from failure mediated relations between IER and future engagement. These findings suggest that styles of emotion regulation play an important role in learning from failure.