Neurophysiological Correlates of Near-Wins in Gambling: A Systematic Literature Review.

Identification of specific patterns of brain activity related to problem gambling may provide a deeper understanding of its underlying mechanisms, highlighting the importance of neurophysiological studies to better understand development and persistence of gambling behavior. The patterns of cognitive functioning have been investigated through electroencephalography (EEG) studies based on the near-win/near-miss (NW) effect. The main goal of the present study was to evaluate the neurophysiological basis of NWs and their modulation by gambling problems through a systematic review of event-related potentials (ERP) studies elicited by feedback events. The review followed the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA). A total of 15 studies were included, 12 comprising non-problem gamblers (NPGs) and three comparing problem gamblers (PGs) with matched controls. For the P300 component, the win outcome elicited a larger amplitude than the other outcomes (NW and loss), followed by the NW outcome, which elicited a larger amplitude than loss in some studies. For feedback-related negativity (FRN), the loss outcome evoked a more negative amplitude in several studies, despite eliciting a similar amplitude to NW outcomes in others. For PGs, the NW outcome evoked a higher amplitude of P300 than loss, while NPGs showed a similar amplitude to both outcomes. The present review gathered information from different sources and provides a consistent view of the different studies. However, studies lack systematic and robust methodologies, leading to inconsistent results and making it difficult to reach any definitive conclusions.

The mediating and moderating effects of psychological distress on the relationship between social media use with perceived social isolation and sleep quality of late middle-aged and older adults.

OBJECTIVES: Older adults are more likely to have poor sleep quality and be socially isolated. The present study examined the potential benefits and disadvantages of social media use (SMU) with respect to sleep quality and perceived social isolation among Iranian late-middle-aged and older adults with focus a on both the mediating and moderating role of psychological distress. METHODS: A population-based cross-sectional study was conducted among 900 older community-dwellers living in Shiraz using a structured questionnaire. Social media use was assessed by estimating the frequency of social networking site visits per week. Data concerning self-rated physical health, chronic medical and mental health conditions, perceived social isolation, sleep quality, and psychological distress were also collected. Multiple linear regression was used to identify independent variables associated with outcomes. Then, mediation and moderation models were used to examine the potential mediating and moderating effects of psychological distress and SMU on their relationships with the study variables. RESULTS: Higher social media use was associated with better sleep quality and less perceived social isolation. Nevertheless, the relationships between SMU and participants' sleep quality and perceived social isolation were largely mediated by their level of psychological distress. Furthermore, SMU had a significant moderating effect in the relationship between the psychological distress and the levels of perceived social isolation, so that participants with higher frequency of SMU per week felt less loneliness. CONCLUSIONS: The study findings suggest that SMU has a positive buffering effect regarding late middle-aged and older adults' mental health mainly through moderation of their perceived social isolation. The mediating role of psychological distress in research examining the relationship between SMU and older adults' mental health outcomes should be considered in future research.

Suicidal behaviours and associated factors among medical students in Bangladesh: a protocol for systematic review and meta-analysis (2000-2024).

INTRODUCTION: Suicidal behaviour is common among medical students, and the prevalence rates might vary across various regions. Even though various systematic reviews have been conducted to assess suicidal behaviours among medical students in general, no review has ever assessed or carried out a sub-analysis to show the burden of suicidal behaviours among Bangladeshi medical students. METHODS AND ANALYSIS: The research team will search the PubMed (Medline), Scopus, PsycINFO and Google Scholar databases for papers published between January 2000 and May 2024 using truncated and phrase-searched keywords and relevant subject headings. Cross-sectional studies, case series, case reports and cohort studies published in English will be included in the review. Review papers, commentaries, preprints, meeting abstracts, protocols and letters will be excluded. Two reviewers will screen the retrieved papers independently. Disagreements between two reviewers will be resolved by a third reviewer. Exposure will be different factors that initiate suicidal behaviours among medical students. The prevalence of suicidal behaviours (suicidal ideation, suicide plans and suicide attempts) in addition to the factors responsible, and types of suicide method will be extracted. Narrative synthesis and meta-analysis will be conducted and the findings will be summarised. For enhanced visualisation of the included studies, forest plots will be constructed. Heterogeneity among the studies will be assessed and sensitivity analysis will be conducted based on study quality. Included studies will be critically appraised using Joanna Briggs's Institutional critical appraisal tools developed for different study designs. ETHICS AND DISSEMINATION: The study will synthesise evidence extracted from published studies. As the review does not involve the collection of primary data, ethical approval will not be required. Findings will be disseminated orally (eg, conferences, webinars) and in writing (ie, journal paper). PROSPERO REGISTRATION NUMBER: CDR 42023493595.

The global prevalence of mental health disorders among runaway and homeless youth: A meta-analysis.

A meta-analysis was performed to identify the pooled prevalence of mental health disorders (MHDs) among runaway and homeless youth (RHY). Relevant studies published between December 1, 1985, and October 1, 2023, were identified in the PubMed, Scopus, Web of Science, and Cochrane Library databases. A preliminary screening of 11,266 papers resulted in the inclusion of 101 studies. The pooled-prevalence estimates were obtained using a random-effects model. The findings showed varying lifetime prevalence rates of MHDs: 47% (conduct disorders and psychological distress), 43% (depression), 34% (major depressive disorders), 33% (post-traumatic stress disorder), 27% (personality disorders), 25% (attention-deficit/hyperactivity disorder), 23% (bipolar disorders), 22% (anxiety), 21% (oppositional defiant disorders), 15% (anorexia), 15% (adjustment disorders), 14% (dysthymia), 11% (schizophrenia), 9% (obsessive-compulsive disorders), and 8% (gambling disorder). The current prevalence rates were: 31% (depression), 23% (major depressive disorder), 23% (anxiety), 21% (post-traumatic stress disorder), 16% (attention-deficit/hyperactivity disorder), 15% (bipolar disorder), 13% (personality disorders), 13% (oppositional defiant disorders), 8% (schizophrenia), and 6% (obsessive-compulsive disorders). Regular screening and the implementation of evidence-based treatments and the promotion of integration and coordination between mental health services for adolescent minors and young adults with other service systems are recommended.

Cognitive, Metacognitive, Motivational, and Emotional Predictors of the Intensity of Internet Gaming Disorder among Adolescents.

Internet gaming disorder (IGD) is multifaceted and can have significant negative consequences. The present study examined the contribution of cognitive, metacognitive, motivational, and emotional factors as predictors for IGD severity. In a cross-sectional study, 703 Iranian adolescents (36.8% females, mean age = 16.98 years [SD = 1.23]) completed an online survey. Hierarchical regression analysis showed that the cognitive, metacognitive, motivational, and emotional factors predicted 7.8%, 17.4%, 1.4%, and 1.9% of the variance in IGD symptoms, respectively. The findings indicated that the cognitive factors including some maladaptive cognitions, such as cognitive salience, regret, and perfectionism, and metacognitive factors including some maladaptive metacognitions (negative metacognitions regarding the uncontrollability of online gaming and negative metacognitions regarding the dangers of online gaming) were significant predictors of IGD severity, highlighting their importance in understanding and predicting problematic gaming behaviors. Although contributing to the variance in IGD, motivational factors (escape, coping, and skill development) and emotional factors including emotion regulation (especially reappraisal) played relatively smaller roles compared to cognitive and metacognitive factors. Of the examined predictive factors, metacognitions were the most important predictor of IGD severity. Exploratory moderator analyses showed significant interactions between three predictors of IGD (reappraisal, negative metacognitions, and cognitive salience) with loneliness, stress, anxiety, and depressive symptoms. Reappraisal was the most frequent predictor and had a significant interaction with these variables. Other predictors independently impacted IGD irrespective of the level of loneliness, stress, anxiety, or depressive symptoms. Based on these findings, special attention to metacognitive, cognitive, emotional, and motivational factors is suggested in the treatment of IGD.

Problematic Internet use among adults: A longitudinal European study. / Uso problemático de internet entre adultos: Un estudio europeo longitudinal.

There are few cross-cultural studies utilizing longitudinal analysis to explore problematic internet use (PIU), and almost none among adults. The present follow-up study compared three waves across 12-month period every six months and observed the natural course and trajectory of PIU in a European multi-country sample of adults from 11 countries (Finland, Germany, Italy, Spain, France, Switzerland, Hungary, Poland, UK, Norway, Belgium). A total of 139 participants (45.5% females) provided data across all three waves with an average age of 26.14 years (SD = 5.92). There were longitudinal effects in PIU, with statistical differences between at-risk users compared to healthy users in Waves 1 and 2, and Waves 1 and 3. The analyses of variance showed a longitudinal effect of waves on the PIU symptoms. PIU was significantly affected by time and type of user, with those classed as at-risk having higher scores than healthy users, although PIU decreased over time. In addition, the type of PIU detected in adults contained mild addictive symptoms. In conclusion, this study demonstrated that PIU was generally low among European adult population and tended to decrease over the one-year period, what contrasts with adolescent population findings.

Existen pocos estudios transculturales que utilizan análisis longitudinales para explorar el uso problemático de internet (PIU), y apenas existen estudios en población adulta. El presente estudio de seguimiento ha comparado tres observaciones a lo largo de un período de 12 meses, una cada seis meses. Se observó el curso natural y la trayectoria del PIU en una muestra europea de adultos de 11 países (Finlandia, Alemania, Italia, España, Francia, Suiza, Hungría, Polonia, Reino Unido, Noruega, Bélgica). 139 participantes (45,5 % mujeres) con una edad promedio de 26,14 años (DE = 5,92) proporcionaron datos en las tres observaciones. Se detectaros efectos longitudinales en el PIU, con diferencias estadísticas entre usuarios en riesgo en comparación con usuarios sanos en las observaciones 1 y 2, y las correspondientes a las observaciones 1 y 3. Los análisis de varianza mostraron un efecto longitudinal de las observaciones en los síntomas del PIU. Se halló que el PIU fue significativamente afectado por los factores del tiempo y del tipo de usuario, y aquellos participantes clasificados como en posible riesgo de PIU obtuvieron puntuaciones más altas que los usuarios sanos, aunque el PIU disminuyó con el tiempo en ambos grupos. Además, el tipo de PIU detectado en adultos contenía una sintomatología adictiva leve. En conclusión, este estudio demostró que el PIU fue generalmente bajo entre la población adulta europea y, además, tendió a disminuir durante el período de un año, lo que contrasta con los resultados en población adolescente.

A comprehensive measure assessing different types of problematic use of the internet among Chinese adolescents: The Assessment of Criteria for Specific Internet-use Disorders (ACSID-11).

BACKGROUND: Problematic use of the internet (PUI) is prevalent, particularly among adolescents and young adults. Given the limited measures to assess specific types of PUI, which encompasses a broad spectrum of activities such as online gaming, social media use, pornography use, shopping, gambling, and web-streaming, Muller et al. (2022) developed the Assessment of Criteria for Specific Internet-use Disorders (ACSID-11) to comprehensively assess different types of PUI (i.e., gaming, shopping, social media use, gambling, and pornography use). The present study aimed to validate the Chinese ACSID-11 among adolescents incorporating cross-cultural adaptations. METHODS: Using forward-backward translation method, a culturally adapted version of the ACSID-11 was prepared. Then, a cross-sectional online survey was administered between September 8 and September 26, 2023. Adolescents, using a convenience sample (N = 11,492; mean age = 16.42 years [SD ± 0.91]; 59.1% male), were recruited from six schools to complete the translated ACSID-11, Internet Gaming Disorder Scale-Short Form (IGDS9-SF), Bergen Social Media Addiction Scale (BSMAS), and Smartphone Application Based Addiction Scale (SABAS) via an online platform. Pearson correlation coefficients assessed convergent/discriminant validity. Factor structure and measurement invariance were examined through confirmatory factor analysis (CFA) and multi-group CFA. Cronbach's alpha and McDonald's omega tested internal consistency. RESULTS: Associations between the ACSID-11 components and other scales supported convergent validity (i.e., ACSID-11 gaming scale with IGDS9-SF [0.37 ≤ r ≤ 0.41]; social networks use scale with BSMAS [0.24 ≤ r ≤ 0.31]) and discriminant validity (i.e., online gambling scale with BSMAS [0.16 ≤ r ≤ 0.19] and with SABAS [0.11 ≤ r ≤ 0.13]). A four-factor solution indicated good fit with comparative fit index (CFI) ranging from 0.982 to 0.958. The ACSID-11 was measurement invariant across sexes (∆CFI = -0.001 to 0.000) and different levels of related addictive behaviors (∆CFI = -0.001 to 0.000). Both Cronbach's alpha and McDonald's omega (0.63 to 0.97) were acceptable for both frequency and intensity of responses. CONCLUSIONS: The ACSID-11 is an appropriate scale to assess different kinds of PUI among Chinese adolescents and students. Psychometric assessment of the measure in other cultures and among clinical samples is recommended.

Perceived Impact of Gambling Advertising can Predict Gambling Severity among Patients with Gambling Disorder.

There is growing evidence that gambling advertising disproportionately affects those experiencing more severe gambling harm. Such association has been studied by recruiting gamblers using online panels, by analysing registered users' data from gambling websites, and through surveys and focus group interviews. However, it is thought that these methods tend to overestimate gambling severity. The present study employed a sample of gamblers with a verified gambling disorder diagnosis (N = 210, 7.1% females, Mage = 39.4 years) recruited for a period of under two years at a large public hospital. It examined the relationship between self-reported impact of gambling advertising, gambling preference (strategic versus non-strategic) and gambling modality (online versus in-person). The results indicated that higher perceived impact of gambling advertising predicted higher gambling severity, which supports previous findings obtained from non-clinical settings. However, contrary to what was expected, strategic gambling and online gambling were not associated with higher perceived impact of gambling advertising, even though these groups are believed to be exposed to more gambling marketing and advertising from gambling operators. The study aligns well with available scientific evidence proposing further restrictions on gambling advertising regulation due to their disproportionate impact on those already experiencing gambling harm.

The effect of social support and resource support on emotional exhaustion, insomnia, and suicidal ideation among allied health trainees and post-graduate year doctors in Taiwan.

BACKGROUND: COVID-19-related stigmatization refers to COVID-19-related judgements by others that devalue the individual. Such stigmatization towards healthcare workers may cause psychological burden and negative consequences. Such stigmatization may have particularly overwhelmed allied health trainees (AHTs) and post-graduate year doctors (PGYDs) because they just started their medical career. Social support and resource support have been reported to benefit psychological health and reduce stigmatization. Therefore, the present study used a cross-sectional study design to investigate the association between perceived stigma, self-stigma, psychological distress, and negative outcomes (including emotional exhaustion, insomnia and suicidal ideation) among AHTs and PGYDs in Taiwan. METHODS: An online survey distributed between July and December, 2022 received 522 responses. Variables were assessed using the 21-item Depression, Anxiety and Stress Scale, Insomnia Severity Index and a series of self-designed questions to assess social support, resource support, perceived stigma, self-stigma, emotional exhaustion, and suicidal ideation. RESULTS: Structural equation modeling showed that perceived stigma was associated with self-stigma (standardized coefficient [ß] = 0.428, p < 0.001), and self-stigma was associated with psychological distress (ß = 0.197, p < 0.001), as well as being associated with emotional exhaustion, insomnia, and suicidal ideation (ß = 0.349, 0.556 and 0.212, all p-values < 0.001). While social support and resource support were negatively associated with perceived stigma (ß= - 0.175 and - 0.152, p < 0.01), additional associations were found between social support and emotional exhaustion (ß= - 0.093, p < 0.001), as well as between resource support and insomnia (ß= - 0.120, p < 0.001). CONCLUSIONS: The results showed that COVID-19 related stigmatization was correlated to the detrimental consequences of emotional exhaustion, insomnia and suicidal ideation. Clear paths regarding the associations of social support and resource support with the three negative associations were found as the possible solutions. Strategies to reduce the stigmatization and these negative outcomes, or improve the psychological health will benefit AHTs and PGYDs in maintaining a healthy mental status.

The Fear of COVID-19 Scale: Psychometric properties and measurement invariance across 10 months.

The coronavirus disease 2019 (COVID-19) has led to various negative consequences including fear. The Fear of COVID-19 Scale (FCV-19S) has been widely used in diverse cultures, but no study has ever investigated its longitudinal measurement invariance and predictive validity. Therefore, we examined its longitudinal measurement invariance and predictive validity over 10 months. A sample of Chinese undergraduates (N = 682; first wave 842; 682 second wave) completed the FCV-19S as well as measures assessing depression, anxiety, and stress. Exploratory and confirmatory factor analyses were conducted along with measurement invariance testing. The results showed that the bifactor model fitted well, and significantly predicted stress and anxiety, but not depression. The FCV-19S demonstrated partial measurement invariance (i.e. configural and metric invariances) across time. These findings suggest that the Chinese version of FCV-19S is a reliable tool and could be used in evaluating the severity of fear of COVID-19 among Chinese young adults.

Religiosity, Financial Risk Taking, and Reward Processing: An Experimental Study.

The present study investigated the extent to which financial risk-taking (FRT) perspectives and religiosity influenced an individual's performance on financial decision-making tasks under risk and/or uncertainty. It further investigated the potential to measure this interaction using electro-encephalogram (EEG) assessments through reward-related event-related potentials (P3 and FRN). EEG data were collected from 37 participants undergoing four decision-making tasks comprising the Balloon Analogue Risk Task (BART), Iowa Gambling Test (IGT), Mixed-Gamble Loss-Aversion Task (MGLAT), and MGLA-Success Task (MGLAST). The present study found that BART performance may be affected by an interaction of FRT perspectives and religiosity. The physiological effects of task feedback were also distinguished between religious and non-religious individuals objectively with EEG data. Overall, while religiosity and FRT may not significantly influence IGT and MGLA performance, and interact with BART in a complex way, physiological reaction towards feedback after BART performance appears to be strongly affected by religiosity and FRT perspectives.

Female education ban by the Taliban: A descriptive survey study on suicidal ideation, mental health, and health-related quality of life among girls in Afghanistan.

BACKGROUND: Following the Taliban's resurgence, Afghan girls were probited from attending school and university, likely causing adverse psychological effects. Therefore, the present study investigated depression, suicidal ideation, and quality of life (QoL) among Afghan girls banned from education by the Taliban. METHODS: A survey study assessed depression, suicidal ideation, and QoL among 426 females prohibited from attending secondary schools, high schools, and universities by the Taliban. The study used the CES-D 20 Scale to assess depression, and the WHOQOL-Bref Questionnaire to assess QoL. Associations between variables were tested with chi-square tests, and predictors of QoL were analyzed through multivariate regression analysis. RESULTS: Among the 426 participants, 87.6% exhibited depression symptoms and 49.8% reported suicidal thoughts. Significant predictors of overall QoL included monthly family income (B = 0.147, P = 0.001), recent others' behavior toward participants (B = -0.247, P < 0.001), physical illness (B = 0.110, P = 0.011), experiencing a recent traumatic event (B = 0.108, P = 0.015), depression (B = -0.159, P < 0.001) and suicidal ideation (B = -0.187, P < 0.001). CONCLUSIONS: In Taliban-ruled Afghanistan, the results indicated that female students who have been prohibited from studying in classes have a high prevalence of depression and suicidal ideation. Having depression and suicidal ideation significantly predicted decreased quality of life among female students.

Prevalence and socio-economic determinants of growth and developmental delays among Iranian children aged under five years: A cross sectional study.

BACKGROUND: The main cause of growth and development delays remains unknown, but it can occur as an interaction between genetic, environmental, and socio-economic factors. OBJECTIVE: The aim of the study was to investigate the prevalence and social determinants of growth and developmental delays among children aged under five years in Qazvin, Iran. METHODS: A cross-sectional study was conducted between January 2019 to December 2020 with participation of 1800 mothers with children aged 4-60 months who were referred to comprehensive health centers in Qazvin city, Iran. Structural and intermediate social determinants of health were assessed including: parents and children socio-demographic characteristics, families' living and economic status, parents' behavioral factors, household food security, mother's general health, and perceived social support. Children's growth was assessed based on their anthropometric assessment and their development was assessed using their age-specific Ages and Stages Questionnaire. Data were analyzed using univariable and multivariable logistic regression models using SPSS software version 24 and Stata version 14. RESULTS: The prevalence of developmental problems in each domain were 4.28% for personal and social delay, 5.72% for gross motor delay, 6.5% for communication delay, 6.72% for fine motor delay, and 8% for problem-solving delay. The prevalence of weight growth delays was 13.56% and height growth delays was 4.66%. Communication, gross motor, and problem-solving delays were higher among children whose fathers' smoked cigarettes. Fine motor delays were lower among mothers with education status of high school diploma and university degree vs. the under diploma group. Personal and social delay was significantly higher among families with fair economic status and lower among children when their fathers were employed (vs. unemployed). Weight and height growth delays were higher among mothers who had experienced pregnancy complications and household food insecure families, respectively. CONCLUSION: There are different predictors of growth and developmental delay problems among Iranian children aged under five years including fathers' smoking, families' economic status, and household food insecurity as well as history of mothers' pregnancy complications. The present study's findings can be used to screen for at-risk of growth and developmental delays among children and could help in designing and implementation of timely interventions.

Chronic Procrastination Among Iranians: Prevalence Estimation, Latent Profile and Network Analyses.

Procrastination is the deliberate, unjustified postponing of an intended course of action despite its costs or unfavorable effects. The present study used a self-report online survey and collected data from a large convenience sample of the general adult population (N = 2,076; females = 55.73%; Mage = 35.1 years [SD ± 12.7]) with diverse demographics. Following the ring-curve distribution, the results indicated a 15.4% prevalence rate of procrastination among the Iranian community, which was significantly higher among women and divorced individuals and lower among nomadic individuals and those with higher academic degrees. A latent profile analysis demonstrated two distinct profiles, one for procrastinators (high scores on chronic procrastination, psychological distress, neuroticism, and extraversion; and low scores on general self-efficacy, self-esteem, satisfaction with life, openness, agreeableness, and conscientiousness) and one for non-procrastinators (demonstrating a reverse pattern compared to procrastinators). Moreover, additional network analysis suggested that the examined networks were invariant across procrastination status and gender. The results indicate that procrastination differs by demographic characteristics and is associated with a unique psychological profile. However, none of the aforementioned key study variables were considered a potential vulnerability for procrastinators due to the finding that all variables were peripheral and none were central in the examined networks. Therefore, relying on the differences in mean scores on psychometric scales does not appear to be an optimal way of determining the most important variables in a therapeutic context when treating procrastination.

Exploring the interplay of emotional intelligence, psychological resilience, perceived stress, and life satisfaction: A cross-sectional study in the Turkish context.

BACKGROUND: Emotional intelligence and life satisfaction are essential components for good psychological well-being. Studies examining the elements contributing to emotional intelligence and its relationships with different psychological constructs are likely to positively contribute to mental health. Therefore, the present study examined the mediating roles of perceived stress and psychological resilience in the relationship between emotional intelligence and life satisfaction. METHODS: The study sample comprised 780 university students (62.3% females) studying at universities in different regions of Türkiye. An online survey included the Emotional Intelligence Scale, Satisfaction with Life Scale, Psychological Resilience Scale, and Perceived Stress Scale. A multifactorial complex predictive correlational design was used. RESULTS: The results showed that emotional intelligence was (i) positively correlated with life satisfaction and psychological resilience, and (ii) negatively correlated with perceived stress. In the final model, perceived stress and psychological resilience played a mediating role in the relationship between emotional intelligence and life satisfaction. The findings suggest that higher emotional intelligence may lower perceived stress and appears to have a positive effect in relation to life satisfaction and psychological resilience. CONCLUSION: Individuals working in the field of mental health need to help individuals increase their level of EI, which may help reduce the level of perceived stress and increase psychological resilience and life satisfaction.

Impact of COVID-19-Induced Academic Stress on Insomnia and Suicidal Ideation among Taiwanese Health Trainees and Junior Doctors.

BACKGROUND Clinical training for allied health trainees (AHTs) and postgraduate-year (PGY) doctors needed to go online during the outbreak of coronavirus disease 2019 (COVID-19), which may have caused academic stress and consequent outcomes among this cohort. MATERIAL AND METHODS To evaluate academic-related stress, clinical confidence, psychological distress, and insomnia, an online survey-based study was conducted among Taiwanese AHTs and PGY doctors between July and December, 2022, during the COVID-19 pandemic. The survey included the 21-item Depression, Anxiety, and Stress Scale (DASS-21), the Insomnia Severity Index (ISI), and self-designed questions. It was distributed using convenience sampling and snowball sampling and was completed by 522 participants. RESULTS Structural equational modelling showed that academic stress was negatively associated with clinical confidence (standardized coefficient [ß]=-0.382, p<0.001). Clinical confidence was negatively associated with psychological distress (ß=-0.397, p<0.001), which was associated with insomnia (ß=0.648, p<0.001). Additionally, clinical confidence and psychological distress were the significant mediators. Results indicated that higher academic stress was associated with higher level of insomnia via the mediation of clinical confidence and psychological distress. CONCLUSIONS Academic stress related to changes in clinical training may have led to insomnia among AHTs and PGY doctors during the pandemic. Factors to reduce academic stress should be investigated to promote good mental health while providing sufficient clinical training, especially during events that can cause increased stress (eg, epidemics, pandemics).

Suicidal thoughts and behaviors among untreated illicit substance users: a population-based study.

OBJECTIVES: Research regarding the contribution of specific psychoactive substances to suicidality has yielded equivocal results. The present study examined the prevalence and factors associated with suicidal thoughts and behaviors among a population-based sample of untreated illicit substance users. METHODS: A total of 616 illicit substance users who were recruited from high-risk areas of Shiraz using snowball sampling participated in the study. Eligible participants were individuals aged 18 years and older who regularly used one illicit psychoactive substance (e.g., opioids, heroin, cannabinoids, stimulants, hallucinogens) for at least one year and who had received no treatment for their drug use during the past year. Data were collected regarding socio-demographic characteristics, mental history, and substance use habits. Data regarding suicidal thoughts and behaviors were assessed using the Beck Suicidal Ideation Scale (BSIS) and self-reports of previous suicide attempts. Multiple logistic regression analysis was used to identify independent variables associated with suicidality. RESULTS: Among the participants, 23.6% reported having had suicidal thoughts during the past week and 6.7% reported having attempted suicide during the past year. Methamphetamine was reported as the primary substance of use among approximately half of the participants who attempted suicide during past year (49.2%). Multiple logistic regression analysis showed that current suicidal thoughts were independently associated with having no job, a history of mental health condition, previous suicidal attempts, concurrent use of more than one substance, and using methamphetamine and heroin as the primary substances. Suicidal thoughts were not associated with increased odds of regular opium and cannabis use. CONCLUSION: Both methamphetamine and heroin use are significantly associated with current suicidal thoughts. Evaluation of the risk of suicidality by physicians and mental health care professionals in both community and outpatient settings would be especially appropriate among those individuals using these psychoactive substances.

Burnout Mediates the Association between Workplace Bullying and Mental Health Problems of Health Practitioners in Cancer Units.

Background: Medical health practitioners, particularly those working in cancer units, are vulnerable to poor psychological outcomes. The present study was designed to examine the influence of workplace bullying on the mental health of medical and paramedical staff by testing workplace burnout as a mediating factor. Methods: Utilizing a cross-sectional survey, 220 Muslim medical staff officers from the cancer units of three hospitals in Lahore, Pakistan, were assessed for workplace bullying, mental health, and workplace burnout using the standardized psychometric measures (i.e., Negative Act Questionnaire; Depression, Anxiety, Stress Scale; and Maslach Burnout Inventory). Data were collected from 2019-2020. Results: Workplace bullying and workplace burnout were directly related to mental health problems, including depression, anxiety, and stress symptoms. Moreover, workplace burnout significantly mediated the paths between workplace bullying and mental health (i.e., depression, anxiety, and stress symptoms), suggesting that workplace burnout increases vulnerability to other mental health issues. Conclusion: A need for counseling and suitable management strategies to support medical staff working in cancer units is required.

Assessing intrinsic capacity in Taiwan: Initial psychometric properties of the Integrated Care for Older People Screening Tool for Taiwanese (ICOPES-TW).

BACKGROUND: The World Health Organization (WHO) proposed the concept of intrinsic capacity (comprising composite physical and mental capacity) which aligns with their concepts of healthy aging and functional ability. Consequently, the WHO promotes the Integrated Care for Older People (ICOPE) framework as guidance for geriatric care. Consequently, each government should have a screening tool corresponding to ICOPE framework to promote geriatric care. The present study examined the initial psychometric properties of the Taiwan version of ICOPE (i.e., ICOPES-TW). METHODS: Older people (n = 1235; mean age = 72.63 years; 634 females [51.3%]) were approached by well-trained interviewers for participation. A number of measures were administered including the ICOPES-TW, WHOQOL-AGE (assessing quality of life [QoL]), Clinical Frailty Scale (assessing frailty), Barthel Index (assessing basic activity of daily living [BADL]), and Lawton Instrumental Activities of Daily Living Scale (assessing instrumental activity of daily living [IADL]). RESULTS: The ICOPES-TW had a two-factor structure (body functionality [eigenvalue = 1.932] and life adaptation [eigenvalue = 1.170]) as indicated by the results of exploratory factor analysis. Internal consistency of the ICOPES-TW was low (Cronbach's α = 0.55 [entire ICOPES-TW], 0.45 (body functionality factor), and 0.52 (life adaptation factor). ICOPES-TW scores were significantly (i) positively correlated with age (r = 0.321), IADL (r = 0.313), and frailty (r = 0.601), and (ii) negatively correlated with QoL (r=-0.447), and BADL (r=-0.447), with all p-values < 0.001. CONCLUSION: The ICOPES-TW could be a useful screening tool for healthcare providers to quickly evaluate intrinsic capacity for Taiwanese older people given that it has moderate to strong associations with age, BADL, IADL, QoL, and frailty.