In our view, human development, well-being, mental health, nature, culture, and society are co-evolving systems that interact in complex and dynamic ways. We are therefore seeking new quantitative and qualitative empirical studies, comprehensive reviews and thought-provoking perspective articles inspired by theoretical or practical dilemmas, preferably in a comparative way, through individual, socio-cultural, historical, or institutional perspectives. MORE ABOUT THE JOURNAL
Semmelweis University – Institute of Mental Health
Why Do Adolescents Use Social Media? Validation of the Croatian version of Motives to Use Social Networking Sites Scale
Introduction: Motivation for social media use is a multidimensional construct; however, most existing questionnaires focus solely on motives and do not distinguish between active and passive use. To address this, the Motives to Use Social Networking Sites Scale (MOTUS; Reimann et al., 2023) was developed, integrating motivational aspects and usage modes. Aim: This study examined the construct and convergent validity of the MOTUS scale in Croatian high school students. The original eight-factor model was tested with confirmatory factor analysis (CFA), and measurement invariance across gender was assessed with multigroup CFA. Associations with social media, loneliness, and fear of missing out were analysed for convergent validity. The Average Variance Extracted (AVE) and the Heterotrait– Monotrait (HTMT) ratio were also calculated to further evaluate the MOTUS scale. Reliability was assessed with Cronbach’s α and Macdonald’s ω. Methods: Participants were 853 adolescents aged 14–19 (M = 16.21, SD = 1.07; 69.6% women). In addition to MOTUS, they completed the Fear of Missing Out Scale (FoMO), De Jong Gierveld Loneliness Scale and estimated daily time on social media. Results: The eight-factor model showed acceptable fit after removing one item with cross-loadings (CFI = .916, TLI = .900, RMSEA = .061, SRMR = .074). Measurement invariance supported configural, metric, and scalar equivalence across gender. Convergent validity was confirmed through significant correlations between MOTUS subscales, time on social media, and FoMO. Conclusions: The MOTUS scale shows acceptable psychometric properties for assessing motives and usage modes of social media in Croatian adolescents.
Copyright (c) 2025 European Journal of Mental Health
Editorial – Foreword to the 2025 Special Compilation on “Family Therapy and Family Studies in Supporting Mental Health"
Harmonious and resilient relationships within couples and fa­milies contribute to the well­being and life satisfaction of indi­viduals as well as to the strength of societies. Conversely, chronic challenges and difficulties in close relationships and family func­tioning can make individuals and wider communities vul nerable (Li et al., 2025; Walsh, 2016). Systemic family therapy, com­bined with informal support from family members and their communities, can be an effective intervention in child and fami­ly protection (Hertlein, 2023). The Special Call titled “Family Therapy and Family Studies in Supporting Mental Health” was announced in 2024 following a significant period of population stress in recent years, during which family resilience and support were of paramount importance globally due to health crises, natural disasters, geopolitical conflicts, wars, and economic hardships. The peer reviewed and edited articles were published throughout the year, and we are now publishing the entire Spe­cial Compilation at the beginning of the academic year. In addi­tion to other publications in our journal, this 2025 Special Compilation features five articles. In this short editorial fore­word, we – a sociologist and a psychologist – aim to present some interdisciplinary thoughts on contemporary family life, family studies, and family interventions.
Enhancing User Empowerment and Agency through Co-Creation of a Nonattachment-Based Post-Traumatic Stress Reduction Intervention
Introduction: Individuals with post-traumatic stress typically experience feelings of helplessness, which are often exacerbated by current treatment approaches whereby clinicians tend to rely more on personal experiences than case-by-case, evidence-based care. Aims: This study aimed to address this issue by extending the framework of existing public healthcare interventions to co-create a new nonattachmentbased approach in collaboration with end users and clinicians. The practice of nonattachment involves intentionally releasing judgement of or attachment to events, relationships, and the self, while accepting life’s changes with openness and compassion. Methods: This study employed a three-stage co-creation process: 1) evidence review and stakeholder engagement, 2) co-creation of an initial intervention, and 3) prototyping. Twenty participants (17 with experience of post-traumatic stress and three clinicians) contributed to the intervention’s development over the three stages through one-to-one meetings and group discussions, which were recorded and analyzed using reflexive thematic analysis. Artificial intelligence was used to generate language featured in the final intervention. Results: Key themes identified through the thematic analysis were empowerment and agency, the importance of grounding, as well as normalization and validation. Co-creation input from participants focused primarily on the structure and format of the intervention, while input from clinicians focused on feasibility, barriers to adoption, and safety planning. The final intervention took the form of an online program comprised of 8 self-guided modules integrating nonattachment and mindfulness principles, allowing users to control how and when they interact with the content. Conclusions: To our knowledge, this co-created protocol is the first intervention for post-traumatic stress to be principally grounded in ancient Eastern nonattachment principles. Future studies can now evaluate the intervention to determine its feasibility in post-traumatic stress settings.
Self-Oriented and Socially Prescribed Perfectionism Among Hungarian Professional Folk Dancers
Introduction: Those characterized by high levels of self-oriented or socially prescribed perfectionism strive to meet high expectations. Dancers are prone to perfectionism and related negative psychological factors. Aims: In this study, we investigated how perfectionism among Hungarian professional folk dancers is related to certain psychological factors. Methods: Ninety-six professional dancers completed an online survey (47.9% male, 52.1% female, mean age: 29.91 years, SD = 8.46). To measure perfectionism, we utilized Hewitt and Flett’s Multidimensional Perfectionism Scale. We carried out a moderation analysis based on linear regression to measure the associations between the perfectionism subscales and various psychological variables and examine whether the two subscales moderated each other’s effects. Results: Higher levels of socially prescribed perfectionism were associated with higher perceived stress, burnout, weaker concentration, and lower coachability. On the other hand, self-oriented perfectionism showed fewer associations; however, these were indicative of a better mental state: those with higher self-oriented perfectionism showed lower levels of burnout, better concentration, and higher coachability. We also found that the two dimensions of perfectionism moderate each other’s effects. In the case of concentration and coachability, self-oriented perfectionism may mitigate the detrimental effects of socially prescribed perfectionism. In contrast, in the case of perceived stress, self-oriented perfectionism may actually exacerbate the harmful effects of socially prescribed perfectionism. Conclusions: The results showed significantly more dysfunctions associated with socially prescribed perfectionism. On the other hand, self-oriented perfectionism was associated with adaptive psychological outcomes.
Necessary Condition Analysis on the Relationship between Fear of Missing Out, Social Networking Addiction, and Psychological Well-Being
Introduction: With the growth of technology and increasing accessibility to various platforms, concerns surrounding the impact of technology on individuals’ well-being are also on the rise. Researchers are making significant efforts to understand this constantly evolving phenomenon. Aims: The current study aims to investigate the interrelationships between fear of missing out (FoMO), social networking addiction (SNA), and psychological well-being (PWB), as well as the relation between SNA scores and sociodemographic variables. Methods: This study employs a recently developed data analysis approach called Necessary Condition Analysis (NCA) to observe essential conditions within SNA, PWB, and FoMO. The study’s main objective is to determine whether low/high levels of FoMO and SNA correspond to high/low levels of PWB. To address this objective, a convenience sample of 449 participants aged 17–40 years was selected. Statistical analyses were conducted using the NCA package to investigate the relationships between these variables. A chi-square test was also performed to assess the associations between sociodemographic variables and probable SNA cases based on the established cut-off scores. Results: The results indicated that high levels of FoMO are necessary for high levels of SNA (Effect Size (d) = .15 and p < .001), and high levels of PWB were found to be necessary for low levels of FoMO (d = .23 and p < .001) and SNA (d = .16 and p = .01) and vice versa. It was also observed associations between the demographic variables of gender, marital status, and residence, and SNA. Conclusions: This research contributes to the current discussions concerning the influence of social media on personal well-being and the field of media psychology. The findings obtained can help in guiding the development of interventions and strategies aimed at promoting psychological welfare within digitally interconnected communities.
The Relationship between Lutheran Pastors’ Well-Being and Depression and the Professional Support Available to Them: A Quantitative Study in the Hungarian Lutheran Church
Introduction: Several studies confirm the unfavorable physical and mental health status of church pastors. These findings have often been linked to the level of social support they receive. Aims: The purpose of this study is to provide insights into the relationship between the mental health of Hungarian Lutheran pastors and the availability of professional support. We examined which form of support shows the strongest association with their well-being and depression. Methods: The quantitative research was conducted in 2022 in the Hungarian Lutheran Church. 54.0% of pastors (N = 148) completed the survey. Mental health status was measured using the WHO-5 Well-Being Index (WBI-5) and the 9-item Beck Depression Inventory (BDI). Three kinds of professional support were measured in the questionnaire: supervision, spiritual direction, and peer group support. Results: The results clearly indicate a significant association between increasing levels of support utilized by pastors and improved well-being [χ² (3, N = 139) = 28.75, p < .001]. In the binary logistic regression analysis, the odds of being classified in the non-normal category of the BDI decreased by approximately 60.0% if pastors had a supervisor or spiritual director [χ² (3, N = 132) = 15.33, p = .002, Nagelkerke R2 = 15.1%]. Conclusions: Our results suggest that professional support has a stronger association with pastors’ mental health status than any sociodemographic characteristics. The authors conclude that it is important to establish professional support systems for clergy to strengthen their ministry within the Hungarian Lutheran Church.
Navigating Global Family Diversity: Theory, Research, and Implications for Policy – A Narrative Review
Introduction: Families, as foundational social institutions, are undergoing significant transformations worldwide. Understanding these shifts is critical for researchers and policymakers seeking to support family well-being. Aims: This study examines global family trends across marriage, cohabitation, divorce, parent-child relationships, and kinship patterns. It integrates theoretical perspectives with empirical data to assess both converging and diverging family dynamics. Methods: We conducted a narrative review of peer-reviewed studies in multiple languages, utilizing translation tools where necessary. Studies were selected based on thematic relevance and geographic representation, focusing on research published since 2010 while allowing flexibility in underrepresented regions. Results: Findings indicate that while family transformations are driven by modernization, economic development, and shifting gender norms, cultural and religious factors ensure distinct regional family patterns. Conclusions: Family structures continue to evolve in response to global and local influences. Policies supporting family stability, social cohesion, and mental well-being are essential for sustaining strong family systems. Future research should further explore the role of policy in mediating family transitions across diverse cultural contexts.
The Role of Majority Status in Shaping Self-Esteem: A Comparative Study of Muslim and Christian College Students in Indonesia
Introduction: Self-esteem is an adaptive trait that boosts well-being. The relationship between religiosity and self-esteem is complex, with mixed results from empirical studies. Culture and dimensions of religiousness may influence this relationship. Aim: The main purpose of this study is to understand the connection between religiousness and self-esteem in two different conditions: as a majority and as a minority. Methods: This study’s participants are college students who identify as Muslim or Christian. They are from two regions in Indonesia: Jabodetabek (Java Island), where Muslims are the majority; and East Nusa Tenggara and North Sulawesi (outside of Java), where Muslims are in the minority. Most of the respondents were between 18 and 25 years old. The survey was conducted online. Results: No significant differences emerged in religiousness and self-esteem between Muslims and Christians in both Java and regions outside of Java. However, students outside Java Island exhibited higher religiousness and self-esteem, irrespective of their religious affiliation. Conclusion: This study indicated that religiosity is a social value, with some exceptions.
Artificial Intelligence (AI) in the Family System: Possible Positive and Detrimental Effects on Parenting, Communication and Family Dynamics
Introduction: This perspective article reflects on how innovative technologies, including artificial intelligence (AI) systems like smart voice agents and chatbots, may transform family dynamics and communication. Despite the extensive research on AI’s impact in mental healthcare and education, its influence on family systems remains underexplored. This perspective article aims to draw attention to the possible positive and detrimental effects of using AI in families, highlighting the necessity of fostering AI literacy in this setting. Areas covered: The article delves into integrating AI within family therapy models, focusing on how AI redefines family boundaries, roles, communication, rituals, and narrative creation. It explores AI’s potential to enhance parent training programs and its impact on children’s social and cognitive development. Expert opinion: AI presents both opportunities and challenges for family systems. It can enhance communication, support role negotiation, and promote family cohesion, but it also raises ethical and privacy concerns. The balance between utilizing AI to support family values and avoiding the detrimental effects of over-reliance is crucial. Conclusion: Integrating AI into family systems offers significant potential benefits, but it must be managed carefully to ensure it aligns with family values and strengthens family bonds. Fostering AI literacy within families is essential to navigate the complexities and harness the advantages of AI technologies.
Coparenting Relationship Scale (CRS): Validation and Psychometric Properties of the Hungarian Version
Introduction: This study aims to investigate the validity and psychometric properties of the Hungarian version of the Coparenting Relationship Scale (CRS-HU), a measurement designed to assess different dimensions of coparenting. Only a few validation studies can be found, even though CRS is a widely used measurement. Methods: Currently, no assessment instruments exist in Hungarian that measure coparenting relationships and practices; therefore, we adapted CRS and designed a validation study to investigate mothers’ coparenting characteristics (N = 381). We checked the construct validity using confirmatory factor analysis (CFA), then to assess convergent and discriminant validity, we examined correlations between the coparenting questionnaire factors and other similar constructs. We also examined the relationship between CRS-HU and different background variables using Kruskal-Wallis and Mann-Whitney tests. Results: Our main results showed that the internal consistency in the Hungarian version of CRS and its subscales is good or excellent (Cronbach’s apha = .75–.89). The seven-factor structure had a poor model fit in CFA, however, the brief version of the CRS-HU (RMSEA = .057; CFI = .962) and six subscales separately (RMSEA = .031–.066; CFI = .978–.999) demonstrated a good model fit. Conclusions: The brief version of Hungarian CRS and the different subscales are valid and feasible measures for assessing coparenting and its dimensions. Thus, CRS can be effectively used at last in our culture, as well.
The Marriage and Family Therapy Practice Research Network: Current Findings and a Call for Collaboration
Introduction: Mental health problems continue to rise throughout the world while access to care remains problematic due to low affordability and limited therapist availability. With the mental health crisis only getting worse, clinicians and researchers must work together to improve client outcomes. The Marriage and Family Therapy Practice Research Network (MFT-PRN) was established to improve client care and foster collaborative research in systemic therapy. This project balances research rigor and clinical flexibility, making it accessible and beneficial for practitioners, clients, and researchers. Areas covered: This paper will address the above issues by discussing how the MFT-PRN brings researchers and clinicians together, through routine outcome monitoring (ROM) and providing assessments that track client progress across sessions, allowing clinicians to create better treatment plans. We will also discuss how the MFT-PRN facilitates researcher collaboration by sharing data collected across diverse settings. Expert opinion: Professional experience and research findings suggest that using the MFT-PRN enhances therapy outcomes, reduces treatment length, and improves couple and family relationships. The MFT-PRN has facilitated research that leads to improved client care in areas such as therapeutic alliance, teletherapy efficacy, and the impact of adverse childhood experiences on anxiety. Conclusion: By bringing practitioners and researchers together, the MFTPRN contributes significantly to advancing marriage and family therapy.
Using the Woolley Motivation Typology to Heal Infidelity With Emotionally Focused Therapy
Introduction: Infidelity is a common challenge in couple therapy and requires nuanced understandings and interventions tailored to the underlying motivations of the affair. Areas covered: This paper offers a practical framework for addressing infidelity by integrating Woolley’s (2011) motivation-based typology of affairs into the practice of Emotionally Focused Therapy (EFT) and the Attachment Injury Repair Model (AIRM). The typology categorizes infidelity into three broad categories, and seven specific types based on motivations, offering a lens through which couple therapists can focus their approach. Expert opinion: This article provides both general and specific treatment recommendations for each of the motivational types, which can help clinicians more effectively assist in ending affairs, reducing blaming, healing emotional wounds, creating safe emotional connection, and preventing future infidelity. Conclusion: This article helps fill these gaps by laying out how the Woolley (2011) motivational typology can be used to guide treatment.
Psychometric Properties of the Hungarian UCLA Loneliness Scale Among Adolescents: A Search for the Meaning of Loneliness in the Young Population
Introduction: Loneliness has been considered a major public health and policy concern, with substantial physical and mental health impacts. The University of California and Los Angeles Loneliness Scale (UCLA-LS) is one of the most widely used scales for measuring loneliness but it does not have robust psychometric properties among adolescents. Aims: To evaluate the psychometric properties of the Hungarian UCLA-LS among adolescents. Methods: The sample includes a total of 2508 students, 57.3% females, aged between 14 and 21 years. Studying psychometric properties, internal reliability and criterion-related validity were measured. The sample was randomly divided into two parts to examine the factorial structure: one part was used for exploratory factor analysis (EFA) and the other was used for confirmatory factor analysis (CFA). Results: The UCLA-LS showed good internal consistency. Its total score and the single-item measure showed a small correlation, and also indicated a significant moderate association with hopelessness and self-reported well-being. Based on the EFA, we identified two factors with 51.7% of the total variance explained. In the CFA, the two-factor model demonstrated a good fit. Conclusions: The findings suggested that the Hungarian UCLA-LS can be a reliable and valid tool for adolescents to measure some dimensions of loneliness. We confirmed the non-normal, relatively skewed distribution of the scale. We can conclude that the UCLA-LS measures a trait characteristic of loneliness. In the adolescent population, it is recommended to use further measures of loneliness to gain more information about the frequency and nature of the multi-faceted mental representation of loneliness.
Copyright (c) 2024 European Journal of Mental Health
Substance Use Among Lawyers and Law Students: A Scoping Review
Introduction: Lawyers are uniquely vulnerable to substance use and disorders due to the use of different substances mainly because of the demanding and adversarial nature of the legal profession. Substance use often begins during law school years. Aims: This study aims to examine substance use and disorders due to the use of different substances. Methods: A scoping review was adopted to collect literature from January 2000 to November 2023. The review followed the Arksey and O’Malley framework. Literature was retrieved from CINAHL Complete, PubMed, PsycINFO, Web of Science, and Scopus. A total of 1,808 studies were retrieved and 14 were included for the final synthesis. The combined sample size was 16,722, comprising 15,150 lawyers and 1,572 law students. Data was extracted into a data matrix and then synthesized into the results. Results: Many lawyers and law students have experienced substance use disorders or problematic use. Alcohol and tobacco were the most used substances among them. Suicide due to substance use was also detected. Findings reveal the use of illicit substances, demographic disparities in substance use, and unprofessional behavior such as substance use during working hours. The role of support systems in battling substance use was critical among lawyers and law students. Even though few lawyers sought help for substance use related issues, treatment was effective. Conclusions: Substance use is pervasive in the legal profession. Although various health promotion and education interventions have been carried out to address this problem, the scale of the problems
Integration of Perinatal Mental Health into Maternal and Child Care: Progress and Challenges from the World Health Organization's Perspective
Introduction: Perinatal mental health is essential for maternal and child well-being, and its promotion has the potential to improve health outcomes while reducing social and healthcare costs in both the short and long term. The World Health Organization (WHO) is making efforts to integrate mental health into maternal and child health services on a global scale. Areas covered: Since 2001, the WHO has addressed mental health in its documentation, emphasizing the importance of safeguarding child health and supporting caregivers. However, perinatal mental health has primarily been developed within maternal and child health care strategies. The publication of the “Guide for Integration of Perinatal Mental Health in Maternal and Child Health Services” (2022) marks a significant advancement through providing specific recommendations for implementing perinatal mental health within healthcare systems. Expert opinion: Despite these advances, integrating perinatal mental health into healthcare systems faces challenges, including the integration of care for fathers and families, training healthcare professionals, and considering women’s lived experiences. Barriers include gender and age discrimination, mental health stigma, and deficiencies in healthcare infrastructure, particularly in low- and middle-income countries (LMICs). Conclusion: Comprehensive maternal and child health care has the potential to improve maternal and child well-being while reducing long-term costs. To enhance perinatal mental health globally, it is essential to integrate it at all levels of healthcare, incorporating user experiences, strengthening professional training, and ensuring adequate resources within healthcare systems.
The Effect of Adverse and Positive Childhood Experiences, Attachment, and Emotional Support on Adult Mental Health
Introduction: Adverse childhood experiences (ACEs) can contribute to significant health issues in adulthood. Aims: The present study seeks to understand the role of attachment and positive childhood experiences (PCEs) in the association between ACEs, self-rated emotional support and mental health. Methods: An online panel survey gathered data from 4,940 Slovenian adults aged 18 to 75. Simultaneous multiple regression path analysis (PROCESS) was used to test two moderation and mediation models. Results: Results indicate that ACEs were weakly associated with higher rates of anxious attachment and reduced self-rated mental health. Anxious attachment mediated the relation between ACEs and self-rated emotional support and self-rated mental health. PCEs were weakly negatively associated with anxious and avoidant attachment and interacted with ACEs in their effect on emotional support in adulthood. The strongest associations were found in the negative pathways between the two attachment styles (anxious and avoidant), emotional support, and self-rated mental health. Conclusions: These findings can guide (therapeutic) interventions for individuals with a history of child adversity: interventions could focus on addressing insecure attachment, involve a person’s social network as well as recognize and support the potential role of positive childhood experiences as protective factors.
adverse and positive childhood experiences
From Family Conflicts to Suicide Risk Through Deliberate Self-Harm Online Content in Adolescents and Young Adults
Introduction: Family conflicts are considered a risk factor for deliberate self-harm (DSH) and even suicidal thoughts and behaviors. Research also shows that adolescents are increasingly engaging in online DSH activities. However, studies on this topic are scarce. Aims: This study’s first goal is to replicate the effect of family conflicts on suicidal ideation (SI) and, according to the gateway theory, include DSH diversity as a step preceding SI. Second, we aim to consider online activities in understanding suicidal risk. We start by describing online DSH activities, and propose a sequential mediation model in which family conflicts predict DSH and SI through online DSH activities. Methods: The convenience sample of this cross-sectional study consisted of 357 adolescents and young adults between 12 and 22 years old who completed a self-report questionnaire measuring family conflicts, online DSH activities, identification with DSH-related content creators, DSH, and suicidal ideation. Results: The results showed that 85.3% of our community sample used the internet for DSH-related purposes. Results also revealed an independent mediation effect of DSH diversity on the relationship between family conflicts and SI, and a sequential mediation effect of online DSH activities, identification, and DSH diversity. Conclusions: Engaging in online DSH activities is only predictive of DSH or SI if adolescents perceive a shared identity with this community of creators. The findings might yield implications regarding the design of prevention strategies that include a further supervision of online platforms and psychological interventions that incorporate the family system and peers.
Factor Structure and Internal Consistency Reliability of the Croatian Version of the Family Adaptability and Cohesion Evaluation Scale (FACES) IV Package: A Preliminary Study
Introduction: A family operates as a dynamic system comprising various subsystems and is continually interacting with its environment. Therefore, it is essential to comprehend the underlying principles of family functioning. One of the most commonly used models for describing family functioning is the Circumplex Model of Marital and Family Systems (Olson & Gorall, 2003). Aims: In this study, we aimed at examining the factor structure and internal consistency reliability in the Croatian version of the Family Adaptability and Cohesion Evaluation Scale IV Package, which measures family functioning through family cohesion and flexibility at the balanced and unbalanced levels, as well as family communication and family satisfaction. Methods: Confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) were performed using a convenient sample of 528 participants. Results: CFA revealed that the Croatian version of the FACES IV Package does not fit the theoretical model of the original factor structure in this preliminary study. The exceptions were the Family Communication Scale and Family Satisfaction Scale, which showed satisfactory parameters. The results of the EFA of FACES IV showed a 5-factor model solution. Conclusions: The Croatian version of the FACES IV Package is not completely suitable for use in the national context. Thus, given these preliminary findings, further testing on a more representative or clinical sample is recommended.
Media-Induced Secondary Traumatic Stress: The Case of the Kahramanmaras Earthquake in Turkey
Introduction: Trauma manifests in a variety of ways and disrupts the lives of individuals. This is particularly the case in an age when communication technologies are permeating everyday practices, and mass media is an essential means of communication. A review of the international literature on disasters reveals that the measurement tools used in the research on the association between Secondary Traumatic Stress (STS) and the media are limited. Aims: The main aim of this study is to measure the STS levels in the audience of the media content regarding the Kahramanmaras-centered earthquake and to examine the factors associated with it. Methods: First, a measurement tool on the subject was developed, and then its psychometric properties were investigated. Exploratory factor analysis, confirmatory factor analysis, validity, and reliability analyses were conducted throughout the studies (N = 30 for Study I; N = 265 for Study II; N = 283 for Study III). Results: A 17-item, four-factor (intrusion, anxiety, media distrust, and avoidance), valid and reliable scale was created. Moreover, depression was found to have a partial mediating effect on the significant relationship between media exposure related STS and psychological well-being (β = –.22, SE = .027, 95% CI [–.25, –.19]). Conclusions: The results revealed the multi-dimensional impact of STS on people indirectly exposed to trauma as well as the uniqueness of the scale.
Development and Validation of the Hungarian Short ECR-R in a Large Nationally Representative Study and a Large Community Study of Mothers Raising Young Children
Introduction: The Hungarian version of the 36-item self-report Experiences in Close Relationships – Revised (ECR-R-HU) questionnaire assessing adult romantic attachment has been published recently. Short versions provide a useful tool for large-scale research and in the clinical field as well. Aims: The present study reports developing and validating the short form of the Hungarian version of the ECR-R (ECR-R-HU-SF). Methods: The development of the short form, data reduction, and item selection were performed in a nationally representative adult (18+) community sample (N = 958; Study 1). The newly developed ECR-R-HU-SF was then tested and validated in a different national study representative of children aged 3–36 months, using data from respondent mothers with diverse sociodemographic backgrounds (N = 980; Study 2). Results: In Study 1, using randomly split subsamples, the ECR-R-HU-SF retained 8 items and confirmed the original two-factor structure of the measure. The subscales showed very good reliability and correlated highly with their corresponding original long versions. Psychometric properties, construct (convergent) validity, sociodemographic associations, and mean population scores for the short-version subscales (Avoidance, Anxiety) were compared with those of the long version. In Study 2, subscales were highly reliable, and scores correlated in the expected directions with related constructs (depressive mood, perceived stress). Conclusions: In summary, the ECR-R-HU-SF is a valid instrument that can be used as an effective screening tool for measuring adult romantic attachment.
Emotion Recognition and Differentiation in Cannabis Abstainers Over Time: Assessing the Role of Mental Health Problems and Cannabis Withdrawal
Introduction: Cannabis is the second most widely-used substance in India, after alcohol. Several researches show how cannabis use can impair emotion recognition capacity, but relatively few researchers have explored this among cannabis abstainers. Aims: The present study’s authors aimed at assessing emotion recognition, emotion differentiation, self-reported anxiety, depression, stress, withdrawal intensity and impact in a sample of men who abstain from cannabis. Methods: Heavy cannabis users (N = 70 males) were assessed via questionnaires regarding their cannabis use frequency, their age at onset of usage, anxiety, depression, and stress levels as well as their performance on computerised tasks of emotion recognition and discrimination within 24 hours of their admission (T0), then after 15 days of abstinence (T1), and finally after 30 days of abstinence (T2). At T1 and T2, they were also assessed for withdrawal intensity and the impact of withdrawal on daily activities. Results: Findings revealed that, with abstinence, successive improvement in emotion recognition and emotion differentiation developed, even after accounting for declines in psychological distress from T0 to T1. However, from T1 to T2, further declines in psychological distress and withdrawal impact mainly accounted for this improvement. Happiness was the best recognised and well-differentiated emotion while the poorest discrimination was observed for anger. Conclusions: This study’s findings corroborate and significantly add to the limited existing literature, demonstrating improved emotion recognition and differentiation due to initial cannabis abstinence, but later this improvement proceeds with a decline in distress and withdrawal impact.
Mental Health Literacy Level Of University Students Enrolled In Health Departments: A Descriptive Study in Turkey
Introduction: Good mental health literacy (MHL) enables an individual to access, understand, and use information in a way that promotes and maintains good mental health and facilitates early referral to mental health services. The literature reports that MHL levels among adolescents are gradually increasing, but still remain at low/moderate levels, and that this situation bears a negative impact on both individual and societal health. Aims: The Authors of this study aim to determine the level of MHL among university students engaged in the field of health, the factors that influence this level, and the differences between the various fields. Methods: The sample of this cross-sectional study consisted of 1,227 students enrolled in a university health department between 1 December 2022 and 20 January 2023. Data were collected online using a questionnaire designed by the researchers, and applying the MHL Scale (MHLS). We used descriptive statistics, one-sample t-test, one-way ANOVA test, multiple comparison tests (Tukey) and multiple linear regression in the statistical analysis. Results: The mean MHLS score of health faculty students was moderate (15.88, SD = 3.30). Female students, students aged >20 years and medicine, dentistry or nursing students had higher MHLS scores than others (p < .050). Conclusions: We observed that university students in the health sector did not have the desired or expected level of MHL. Improving MHL has the potential to facilitate early intervention, ensuring effective community mental health promotion and support; therefore, educational programs should be developed for this group.
Stigma and Discrimination Among Professionals in Portuguese Integrated Continuing Care Units: Stigma and Discrimination in ICCUs
Introduction: Stigma surrounding mental illness (MI) poses a significant obstacle to treatment access, hinders recovery, and may lead to suboptimal care. Breaking the chains of prejudice and embracing tolerance are essential steps in fostering understanding and compassion for those living with MI. Aims: This study aims to describe the levels of stigma and discrimination against individuals suffering from MI among professionals in Portuguese Integrated Continuing Care Units (ICCUs). Methods: A quantitative, observational, cross-sectional study involving 163 participants utilized a sociodemographic questionnaire, alongside two assessment instruments – the Attribution Questionnaire (AQ-27) and Community Attitudes Toward Mental Illness (CAMI). Results: Results revealed significant differences in stigma levels based on education (pprejudice = .001; ptolerance = .007) and occupation (pprejudice = .025), higher stigma being associated with lower education levels and specific healthcare occupations (medical assistant). Additionally, a positive correlation was found between age and stigma perception (r = -236, pprejudice = .002; r = -167, ptolerance = .033). Conclusions: The findings underscore the urgent necessity for targeted anti-stigma interventions within Portuguese integrated continuing care units, focusing on mitigating education-based disparities, and addressing specific healthcare occupations that exhibit heightened stigma. Effectively combating stigma among professionals is crucial for fostering a more inclusive and compassionate environment in these care settings.
The Psychological Immune Competence Inventory: A Pilot Validation Study in Slovakia
Introduction: Psychological immunity refers to an individual’s potential to cope with psychological risk factors, as well as to promote and maintain mental health and well-being. The method of its measurement is the Psychological Immune Competence Inventory (PICI), which appears to have good psychometric parameters. Despite the use of translated versions in various foreign studies, the authors have found no studies verifying its factor structure or reliability. Aims: In this article, our objective is to present the results of the PICI pilot validation in Slovakia. The Slovak version of PICI was expected to have psychometric properties comparable to those of the original version. Methods: We collected data from a research sample of 213 healthcare students (162 women and 51 men) aged 19 to 35 years (M = 21.18; SD = 2.81), and validated the internal structure of the inventory using Structural Equation Modeling (SEM) via employing the DWLS estimation method. The convergent validity of individual factors was further verified by correlation with personality traits, psychopathological symptoms, preferred coping strategies and trait emotional intelligence. Results: The results of the second-order confirmatory analysis indicate an acceptable fit of the original model to our data. The convergent validity of the observed individual psychological immunity factors was also supported. Conclusions: The Slovak version of PICI showed promising psychometric properties. The research serves as a reference to Slovak standardization. Nevertheless, further validation is recommended in a representative sample.
Psychological Immune Competence Inventory
Daily Variation in Sleep Duration, Affect and Emotions in Croatian Youth: An Ambulatory Assessment
Introduction: Sleep habits are related to mood stability and mental health, and adolescence may be an appropriate time to address disturbed sleep patterns because it is a critical period for the onset of psychological problems. Aims: This study had two aims, namely: to explore associations between objectively measured sleep duration and positive and negative affect, as well as specific positive and negative emotions at the within-person and between-person levels in Croatian adolescents. Methods: In the present eight-day study, 102 Croatian adolescents with an average age of 15 years reported how they felt once a day, while sleep duration was objectively measured by collecting data from an accelerometer on participants’ smartphones. Results: Multilevel analyses showed that adolescents express more positive affect (Est. = 0.10, p < .050) and feel less distracted (Est. = -0.12, p < .050) and happier (Est. = 0.11, p < .050) on days when they sleep longer, with a multiverse analysis suggesting that these results are moderately robust. In addition, they express higher levels of negative affect, stress and distraction on school days, and boys seem to experience more positive and fewer negative emotions. Conclusions: A better understanding of daily variations in sleep duration, sleep quality, and affect would promote the development of individualized, particularly smartphone-based, sleep interventions. Such interventions could be a valuable tool for preventing mental health problems in adolescence.
Financial Strain and Prenatal Depression Among Pregnant Women in Ibadan, Nigeria: Mediating Pathways of Intimate Partner Violence, Food Insecurity, and Social Support
Introduction: Although mothers’ mental health is receiving more attention, little remain known about the impact that financial strain may have on the mental health of expectant mothers. This is crucial in low- and middle-income countries because vulnerable populations are disproportionately affected by high rates of poverty, insufficient social safety nets, and unstable economies. Aims: This study examined the potential role that financial strain may play in prenatal depression while also taking into account the potential mediating roles of food insecurity, intimate relationship violence, and social support. Methods: To gather the data, a cross-sectional survey of 519 pregnant women in the second and third trimesters were selected methodically from a pool of women awaiting routine antenatal care from one primary health care center in each of the five urban local government areas of Ibadan metropolis. The Edinburgh Postnatal Depression Scale was used to measure prenatal depression. Using parallel and serial mediation models, the relationship between the variables – financial strain, intimate partner violence, food insecurity, social support, and prenatal depression – was examined. Results: Of the participants in this study, 28.1% reported having symptoms of depression during their pregnancy. The results also show that prenatal depression and financial strain are related, with each of the three mediators operating in a parallel and sequential causal order. The results of the mediation point to a causal chain with moderate effects. Conclusions: Interventions should evaluate the effects of integrating mental health services and social needs assessments into antenatal and primary health care.
Moral Suffering in Frontline Social Care Workers: A Study of Moral Injury and Moral Distress
Introduction: Moral suffering (MS) is psycho-emotional harm derived from a conflict between one’s circumstances and one’s deeply held moral values. It includes the constructs of moral distress (MD) and moral injury (MI) and is characterized by constraints or mandates preventing the perceived morally correct event. Evidence has demonstrated the application of MS in helping professions, and research has linked MS to a deterioration of mental health, self-identity, worldview, and job-performance. Aims: In this study, we examined the relationship between MD, MI, burnout, and external/internal constraints in Frontline Social Care Workers (FSCWs) in the UK. Methods: We employed a quantitative, cross-sectional correlational design, recruiting 119 FSCWs (female = 91.6%, tenure 1–2 years = 27.4%) using convenience sampling. Participants completed an online survey including the Moral Injury Events Scale and the Copenhagen Burnout Inventory. Measures for MD, external constraints (stress, time, and resources), and internal constraints (psychological safety and preparedness) were informed by previous research. Results: Participants reported a significant prevalence of moderate-to-high MD (25.4%), MI (33.3%), and burnout (64.9%), and we found significant relationships between the constructs and dimensions. Constraints were significant predictors of MS (explaining 35.3% of MD variance and 30.1% of MI variance), with stress, time, and psychological safety making the strongest contributions. Conclusions: FSCWs can be examined as a unitary population experiencing morally challenging circumstances that may result in MS and burnout. Improved MS measures, increased awareness, and policy shifts are necessary to redefine the paradigm of work-related distress, taking systemic constraints and the potential for moral harm into account.
Contrasting the Treatment-Related Perceptions of Parents and Their Children: Using Data from Child and Adolescent Brief Mental Health Services Recipients in Canada
Introduction: Discrepancies between parental and child perceptions of problems and their therapeutic expectations can negatively impact mental health treatment efficacy. Aims: We sought to explore concordance and discrepancy in families receiving brief, client-centered, and strengths-based mental health services, specifically by contrasting parents’ and children’s perceptions of the child’s presenting issues; treatment expectations; and levels of concern pre- and post-treatment. We also examined the psychometric properties of a therapeutic scaling question on the level of concern, by examining associations with scores from the Strengths and Difficulties Questionnaire. Methods: Using a mixed-methods approach, we examined data from openand closed-ended questions, some used as part of the treatment. This included brief descriptions of perceived presenting issues and treatment expectations, and levels of concern on a scale of 1 to 10. Results: Parent and child descriptions of issues were judged generally congruent 66% of the time. Respectively, minor and major non-congruence was observed 25% and 9% of the time. In terms of treatment expectations, parents were more likely to express a desire to understand the issues and improve communication in the family. Children were more likely to express no expectancies or respond with simple statements (e.g., feel better). Parents initially rated their children’s problems as more severe than did their children. We found that the scaling question demonstrated a modest association with the level of concern from the Strength and Difficulties Questionnaire (SDQ). Conclusions: Even though most parents and their children broadly agree on presenting mental health issues for which they seek counseling, important differences manifest in how they perceive them and what they want accomplished during sessions. Practitioners need to consider, assess, and accommodate such discrepancies.
child and adolescent mental health services
The Role of Emotion Dysregulation In Problematic Alcohol Use and Coping with Problems
Introduction: Emotional factors are often specified as playing an important role in the context of problematic alcohol use and alcohol addiction. Aims: This study focused on examining the relationship between difficulties in emotion regulation, perceived personal problems, and problematic alcohol use. Methods: 374 participants from the general population in Slovenia and Croatia (34.8% men, 65.2% women) with an average age of 44.28 years (range: 26 to 74 years) completed the Alcohol Use Disorders Identification Test (AUDIT), Individual Problems and Strengths Scale (IPS) and Difficulties in Emotion Regulation Scale – Short Form (DERS-SF). Results: A higher level of problematic alcohol use positively correlated with difficulties in emotion regulation and the assessment of individual problems (p ≤ .010). Multiple linear regression analysis demonstrated that higher AUDIT scores were positively associated with two dimensions of difficulties in emotion regulation: impulse control difficulties (β = 0.22, p = .008) and lack of emotional awareness (β = 0.15, p = .010). Difficulties in emotion regulation completely mediated the effect of individual problems on problematic alcohol use (indirect effect: 0.18, CI [–.06, –.31]; p < .001): higher levels of individual problems contribute to higher levels of problematic alcohol use through the effect of difficulties in emotion regulation. Conclusions: The findings indicate the vulnerability of individuals with difficulties in emotion regulation to problematic alcohol use. Difficulties in emotion regulation are an important factor to consider for understanding the development, maintenance, and treatment of alcoholism and problematic alcohol use.
The Role of Social Comparison and Online Social Support in Social Media Addiction Mediated by Self-Esteem and Loneliness
Introduction: The diversity of information on social media provides a ubiquitous possibility for social comparison. Online social comparisons have both detrimental and beneficial effects; besides lowering one’s self-esteem, heightening loneliness and addiction, they also bring together people with similar interests which may offer a form of social support. Aims: This study examines a path model for understanding the link between social comparison and social media addiction while examining online social support, loneliness, and self-esteem. Methods: Hungarian university students (N = 201, 70.6% women, aged between 18 and 30 years, SD = 2.77) completed an online survey in the spring of 2022. Results: The final path model suggests that social comparison can directly contribute to social media addiction. This link was mediated by loneliness and self-esteem, resulting in a path with different outcomes: a) social comparison may strengthen loneliness (β = .22, p < .001) which can lead to lower self-esteem (β = .60, p < .001), and b) social comparison may have a negative effect on self-esteem (β = -.22, p < .001) which can reduce social media addiction (β = -.26, p < .001). In addition, social comparison may help obtain online social support (β = .15, p < .050) which can reduce loneliness (β = -.41, p < .001) but increase the likelihood of addiction (β = .26, p < .001). Conclusions: These findings draw attention to the double-edged sword of social comparison and online social support: we need to learn to consciously manage online social comparison tendencies.