Factors associated with mortality among laboratory-diagnosed drug-resistant tuberculosis patients on treatment, KwaZulu-Natal Province, 2017-2019.

Introduction: tuberculosis (TB) remains a leading cause of death in South Africa. KwaZulu-Natal (KZN) is one of the provinces with a high burden of TB/drug-resistant TB cases and deaths. We determined predictors for mortality among drug-resistant TB patients on treatment in KZN province. Methods: we conducted a retrospective cohort study using secondary data from the Electronic Drug-Resistant Tuberculosis Register. We used a modified Poisson regression model with robust standard errors to determine predictors for drug-resistant TB mortality. Results: of the 7,692 eligible patients, 1,234 (16.0%) died. Males predominated (707, 57.3%) and the median age was 36 years (Interquartlile Range: 29-45 years). The majority (978, 79.2%) were HIV-TB co-infected with 911 (93%) on antiretroviral treatment (ART). The predictors included HIV-TB co-infection without ART (aIRR 3.4; 95% CI: 2.3-5.1), unknown ART status (aIRR: 1.8; 95% CI: 1.4-2.3), aged ≥60 years (aIRR: 2.1; 95% CI: 1.6-2.7), previous drug-resistant TB (aIRR: 1.5; 95% CI: 1.2-1.8) and exposure to second-line drugs (aIRR: 1.7; 95% CI: 1.4-2.0). Other predictors were hospitalization during treatment initiation (aIRR 2.5; 95% CI 2.0-3.1), initiation in other treatment facilities (aIRR: 2.2; 95% CI: 1.6-2.9) and rifampicin-resistant (aIRR: 1.2; 95% CI: 1.1-1.4). Bedaquiline fumarate was a significant protective factor against death (aIRR: 0.5; 95% CI: 0.4-0.5). Conclusion: older age, HIV co-infection without ART, hospitalization for treatment initiation, exposure to second-line drugs and a previous episode of drug-resistant TB were predictors for DR-TB mortality. Early treatment initiation and provision of antiretroviral treatment for all co-infected patients may reduce DR-TB mortality in the Province.

Ambulatory assessment of suicidal ambivalence: The temporal variability of the wish to live and the wish to die and their relevance in the concurrent and prospective prediction of suicidal desire.

INTRODUCTION: Suicidal ambivalence is increasingly understood as the result of the interplay of two conflicting motivational orientations, the wish to die (WTD) and wish to live (WTL). However, research is scarce regarding the nature of their relationship, their temporal structure, and their relevance in predicting suicidal desire. METHODS: Fifty psychosomatic/psychiatric inpatients (17 reporting suicide attempts) took part in an intensive longitudinal design with 10 signal-contingent prompts per day over 10 days; assessing WTD, WTL, and suicidal desire. We calculated mean values and variability of WTD, WTL, suicidal ambivalence, and suicidal desire and tested mixed-effects models of suicidal desire. RESULTS: The mean number of answered prompts was 40.98 (SD = 21.68). Repeated-measures correlation of WTD and WTL was r = -0.60. Patients with a history of suicide attempts reported higher WTD, lower WTL, more suicidal ambivalence, stronger suicidal desire, and showed higher variability in all constructs. At the same assessment, WTD was the strongest statistical predictor of suicidal desire. Only WTL and the interaction of WTD and WTL predicted suicidal desire prospectively. CONCLUSION: Wish to die and WTL are likely two distinct (although correlated) constructs that should not be reduced to a single ambivalence score. A stronger focus on WTL holds potential for suicide research and practice.

Protective Factors of Nurses' Mental Health and Professional Wellbeing During the COVID-19 Pandemic: A Multicenter Longitudinal Study.

Objective: Using a salutogenic approach, this study aimed to identify similarities in the protective factors of nurses' psychological Quality of Life (QoL) and professional wellbeing (PWB) in four countries and to assess their variability over time during the COVID-19 pandemic. Methods: This multicentric study used a longitudinal design with three measurements points: Autumn 2021, spring 2022, and autumn 2022. The study consisted in a self-administered online questionnaire addressed to nurses working in hospitals. Across all measurement times, 3,310 observations were collected in France, 603 in Switzerland, 458 in Portugal, and 278 in Canada. The outcomes were psychological QoL and PWB, and several potential protective factors were used as determinants. Results: Analyses revealed few changes over time in the outcomes. Across all countries, psychological QoL was associated positively with resilience and perceived social support, whereas PWB was associated positively with the ability to provide quality work and support from colleagues and superiors. Conclusion: The findings of this study highlighted the potential of several factors protective of nurses' psychological QoL and PWB. These should be fostered through policies and measures to support nurses.

Psychological Factors Protecting Against Suicidality in Older Adults: A Systematic Review.

OBJECTIVE: Suicide rates in older adults are often the highest of any age group, particularly among high income countries. However, there is a limited understanding of the factors that could protect against suicidality in older age. This systematic review aimed to identify and evaluate the psychological factors that protect against suicidality in older age. METHOD: An a priori protocol was established and registered on PROSPERO (CRD42022343694). EMBASE, MEDLINE, PsycINFO, Web of Science and Scopus were searched. Papers were quality assessed using the Quality Assessment with Diverse Studies (QuADSs) tool. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Seventeen papers were included and narratively synthesised. RESULTS: The initial searches identified 10,673 records, resulting in the screening of 5441 records after the removal of duplicates. The protective factors identified were (1) meaning/purpose in life, (2) reasons for living, (3) coping styles, (4) psychological wellbeing, (5) life satisfaction, (6) personality factors, (7) cognitive functioning, and (8) sense of belonging. The factors with the most empirical support were meaning in life, followed by psychological wellbeing and coping responses, such as primary control strategies, and personality traits, such as positive affect and agency. There was also evidence to suggest that the influence of some protective factors, for example meaning in life, may depend upon stage in older life and gender. CONCLUSION: This review identified several psychological factors that have been found to protect against suicidal ideation in older adults, representing potential treatment targets for reducing suicide in older adults. Recommendations for future research includes greater use of longitudinal and case-control designs, measuring outcomes across the continuum of suicidality and using samples that allow comparison between younger and older adults and within the spectrum of old age.

Racial and Ethnic Variations in Resilience Factors Among Sexual and Gender Minority Midlife and Older Adults.

BACKGROUND AND OBJECTIVES: This study explores resilience factors among sexual and gender minority (SGM) midlife and older adults, identifying historical/environmental, psychological, social, and behavioral predictors, and examining variations across racial/ethnic subgroups. By adopting a resilience-focused perspective, this research contributes to understanding strengths in the SGM community in the context of aging. RESEARCH DESIGN AND METHODS: Using weighted survey data from Aging with Pride: National Health, Aging, and Sexuality/Gender Study, this research investigates distinct risk and protective factors associated with resilience among SGM midlife and older adults. Subgroup variations were assessed using regression models. Factors moderated by race/ethnicity were integrated into final interaction models. RESULTS: Hispanic and Black individuals showed significantly higher resilience than non-Hispanic Whites. Lifetime victimization and day-to-day discrimination were negatively associated with resilience. Positive associations were found for higher income, identity affirmation, larger network size, greater social participation, increased physical activity, and sufficient food intake. Interaction models revealed nuanced patterns by subgroups; education negatively impacted resilience among Black individuals, while income positively influenced Hispanic individuals' resilience. The Other racial/ethnic group demonstrated unique associations between optimal sleep and resilience. DISCUSSION AND IMPLICATIONS: This study shifts from a deficit-based to a resilience-focused approach among SGM midlife and older adults, revealing key strengths within diverse subgroups. Results underscore the significance of recognizing racial/ethnic differences in factors promoting resilience and posing risks for SGM midlife and older adults. Tailoring interventions to address the intersectional needs of SGM aging populations is essential for enhancing their abilities to bounce back from adverse events.

HIV knowledge and protective factors among racial-ethnic minority youth: Moderation by Ethnic identity and LGBQ+ identity.

Due to systemic racism and homophobia, Lesbian, Gay, Bisexual, and Queer (LGBQ+) youth of color are disproportionately affected by HIV (human immunodeficiency virus) / AIDS (acquired immunodeficiency syndrome) and viral hepatitis (VH). Innovative approaches that acknowledge strengths such as ethnic identity need to be examined to understand specific protective factors that can support LGBQ+ youth of color. This study aimed to examine the moderating effects of ethnic identity and LGBQ+ identity on indicators of HIV knowledge (i.e., VH knowledge, sexual negotiation skills, and perception of sexual risk). Youth who identified as Hispanic/Latinx, African American/Black, and mixed racial-identity (N = 564) were included in the delimited sample. Using linear regression modeling, results showed that there was a positive association between sexual negotiation skill, sexual risk perception, ethnic identity and HIV knowledge. Ethnic identity displayed a positive and significant moderating effect between predictors and HIV knowledge. Three-way interactions between predictors by ethnic identity x LGBQ+ interaction showed equally interesting associations with HIV knowledge. Study implications include the need for strengthening ethnic identity and pride among LGBQ+ youth of color within HIV prevention programming.

Framework restoration on Tang Dynasty garden as a multiple-histories environment: Regions, ecology, architecture, and human behavior.

From a multiple-histories perspective, this paper attempts to restore the feature framework of Tang Dynasty gardens by describing the environment panorama of that era. Tang Dynasty gardens have their own unique and complex environment features, which is crucial for understanding Chinese classical gardens. This research developed a massive text mining method of historical-document to detect all garden-related elements in Tang poetry. By sorting out these elements, it has been restored the original appearance of Tang Dynasty gardens and summarized its feature framework. The resulting model included 199 factors, 173 of which are correlating with gardens. Among the 173 factors, 129 are risk factors and 44 are protective factors. This paper restores the feature framework of Tang Dynasty gardens from the following four points, namely regions, ecology, architecture and human behavior. Understanding the Tang Dynasty gardens would help understand the development context of Chinese classical gardens, and should provide new paths for contemporary environment creation.

Examining community-level protection from Alaska Native suicide: An Indigenous knowledge-informed extension of the legacy of Michael Chandler and Christopher Lalonde.

Chandler and Lalonde broadened the scope of inquiry in suicide research by providing theoretical grounding and empirical support for the role of community, culture, and history in understanding Indigenous youth suicide and reimagining its prevention. Their work pushed the field to consider the intersectional process of individual and collective meaning-making in prevention of Indigenous suicide, together with the central role culture plays in bringing coherence to this process over time. Their innovation shifted the research focus to include the shared histories, contexts, and structures of meaning that shape individual lives and behaviors. We describe here a new generation of research extending their pathbreaking line of inquiry. Recent work aims to identify complex associations between community-level structures and suicidal behavior by collaborating with Alaska Native people from rural communities to describe how community protective factors function as preventative resources in their daily lives. Community engagement and knowledge co-production created a measure of community protection from suicide. Structured interviews with rural Alaska Native community members allowed use of this measure to produce relevant, accessible, and actionable knowledge. Ongoing investigations next seek to describe their mechanisms in shaping young people's lives through a multilevel, mixed-methods community-based study linking community-level protection to protection and well-being of individual youth. These efforts to understand the multiple culture-specific and culturally mediated pathways by which communities build on their strengths, resources, and practices to support Indigenous young people's development and reduce suicide risk are inspired by and expand on Chandler and Lalonde's remarkable legacy.

Protocol for a randomized controlled trial of an internet-based prevention intervention for young children at-risk for functional abdominal pain.

BACKGROUND: Chronic pain often clusters in families, where parents and their offspring both experience chronic pain conditions. Young children of parents with irritable bowel syndrome (IBS) represent an at-risk group for the development of abdominal pain, disability, and excess health care visits in later childhood. Parental solicitous responses to children's expressions of discomfort and maternal modeling of their own illness behavior contribute to a greater focus on somatic sensations, leading to illness behaviors in children. This randomized controlled trial will test the effectiveness of an early preventive web-based psychosocial intervention (REACH)[TM] vs. an educational web-based safety comparison condition delivered to parents with IBS to alter parental responses and lead to improved child health and decreased health care costs. METHODS: Parents with IBS who have children ages 4-7 years are recruited via community-based approaches (e.g., social media advertisements, school electronic distribution, research networks) and health care providers. The target sample is 460 parents randomized to REACH, a web-based social learning and cognitive behavior therapy (SLCBT) intervention or an educational web-based safety comparison condition (EC). Participants will be assessed at baseline, 6-week (immediate post-intervention), 6-month, 12-month, and 18-month follow-up periods (months post-completion of intervention). The primary outcome is change in parental solicitous/protective behaviors. Secondary outcomes include parent risk and protective factors, child health and symptom outcomes, and health care utilization and cost savings. DISCUSSION: This study adapts a validated, parent-delivered intervention to treat chronic pain in children to a web-based application designed to prevent the development of chronic pain in very young, high-risk children. If successful, this strategy can both prevent adverse sequelae of this condition from developing as well as be widely accessible. Furthermore, the availability of a prevention model for parent training could result in significant short- and long-term health benefits across a broad spectrum of conditions. TRIAL REGISTRATION: ClinicalTrials.gov NCT05730491. Registered on February 15, 2023.

Risk and protective factors for revictimization from intimate partner violence: A systematic review.

PURPOSE: Intimate partner violence is a global public health problem that mainly affects women rather than men. It has been associated with negative physical and mental health outcomes, including experiences of revictimization. This systematic review describes the risk and protective factors associated with revictimization in female victims of intimate partner violence. METHODS: We searched for articles published between 1995 and 2024 in the Scopus, Web of Science, and PsycINFO databases. In total, 925 studies that met the inclusion criteria were reviewed, of which 38 were evaluated as eligible, and 12 were finally included in the review. RESULTS: Among the risk factors were mental health problems, some demographic characteristics of the victims, previous experiences of violence, and coping and attachment styles. Economic independence, empowerment, and restraining orders were protective factors. CONCLUSIONS: Based on the results, we present some practical implications for health and public policy as well as recommendations for directing future research into revictimization.

Traumatic stress symptoms in civilians after the 2020 Nagorno-Karabakh war: The protective role of self-compassion and emotional intelligence.

Exposure to war is linked to negative mental health outcomes. Self-compassion and emotional intelligence may foster post-war adjustment processes differently depending on the time since the event happened. This study examines post-traumatic stress symptoms (PTSS) in civilians exposed to the 2020 Nagorno-Karabakh war shortly after and 6 months post-conflict, while investigating self-compassion and emotional intelligence's protective role. War-exposed civilians self-reported on PTSS, self-compassion, and trait emotional intelligence at two phases. Results showed greater PTSS shortly after war relative to 6 months later. Lower self-compassion scores were related to more PTSS at the first phase, whereas lower emotional intelligence was associated with more symptoms 6 months later. These data show how war-exposed Armenians coped, highlighting individual characteristics' effects, and suggest varying resource utilization during post-war adjustment. Specifically, self-compassion may be a protective factor shortly after war, whereas emotional intelligence may protect individuals against having adverse health outcomes later on.

The perceived social support of parents having bipolar disorder impacts their children's mental health: a 10-year longitudinal study.

BACKGROUND: The offspring of parents with bipolar disorder (OBD) are at higher risk of developing psychopathology than the offspring of parents with no affective disorder (control). In addition to genetic predisposition, childhood adversity and a stressful family environment are important risk factors for the OBD. Protective factors in parents, such as social support and coping strategies, may buffer the effects of stress on at-risk children. This study tested whether parents' social support and coping style attenuated the link between risk status (OBD vs. control) and psychopathology in offspring. METHODS: During offspring's middle childhood, parents underwent a diagnostic interview and completed social support and coping style questionnaires. Sixty-nine OBD (39 female) and 69 control (29 female) offspring between ages 13 and 29 completed a diagnostic interview approximately 10 years later. RESULTS: Parents' social support satisfaction moderated the link between offspring risk status and their development of substance use disorder (SUD) symptoms (F(1,131) = 5.90, p = .017). Parents' social network size moderated the link between offspring risk status and their development of anxiety and depression symptoms in an unexpected direction (F(1,131) = 5.07, p = .026). No effects of parents' coping style were found. CONCLUSIONS: Among the OBD, having parents with greater social support satisfaction and, unexpectedly, a smaller social network buffered their development of SUD and depression and anxiety symptoms by early adulthood. Parents' social support may thus have a protective function for children in these high-risk families.

Protective factors for the risk of suffering intimate partner violence in help-seeking women survivors from a social organization in Chile.

Objective: Intimate partner violence (IPV) is a major public health problem in Latin America. The present study investigates the protective factors that contribute to minimizing the risk of exposure to IPV analyzing different variables in a sample of Chilean women victims of IPV. Methods: We used data from the Cicatrices Foundation, a nonprofit Chilean organization providing psychological support to IPV victims. Relevant variables for IPV prevention were identified analyzing a database containing all the information reported by victims during a structured interview. A final sample of 444 women suffering IPV was used in the present study. Results: Logistic regression analysis was calculated in order to make predictions related to IPV protective factors, showing that having a support network (OR = 2.85), treatment compliance (OR = 2.05) and being younger (OR = 0.95) increased the probability of not living with the aggressor. Another logistic regression analysis was calculated in order to predict IPV victims´ health taking medication intake as an indicator. A significant association was observed between this variable and working outside (p = 0.002) and between mediation intake and age (p < 0.001), with an OR of 1.987 and 0.93, respectively. Working outside and being younger were identified as protective factors against consuming medication. Conclusion: To the best of our knowledge, this is one of the first studies conducted in Chile on the prevention of IPV in a sample of victims seeking for help. Our results will contribute to guide policy makers, researchers and other women in the prevention of potential risks for IPV.

Causal association of circulating immune cells and lymphoma: A Mendelian randomization study.

Background: Malignant lymphoma (ML) is a group of malignant tumors originating from the lymphatic hematopoietic system. Previous studies have found a correlation between circulating immune cells and ML. Nonetheless, the precise influence of circulating immune cells on ML remains uncertain. Methods: Based on publicly available genetic data, we explored causal associations between 731 immune cell signatures and ML risk. A total of four types of immune signatures, median fluorescence intensities, relative cell, absolute cell, and morphological parameters were included. Primary analysis was performed using inverse variance weighting (IVW) to assess the causal relationship between circulating immune cells and the risk of ML. Sensitivity analysis was conducted using Cochran's Q test, the Mendelian randomization Egger regression intercept test, and leave-one-out analysis. Results: ML had a statistically significant effect on immunophenotypes. Twenty-three immunophenotypes were identified to be significantly associated with Hodgkin lymphoma risk through the IVW approach, and the odds ratio values of CD64 on CD14- CD16+ monocyte [2.31, 95% confidence interval (CI) = 1.41-3.79, P1 = 0.001], IgD+ CD24+ B-cell %lymphocyte (2.06, 95% CI = 1.13-3.79, P1 = 0.018), B-cell %lymphocyte (1.94, 95% CI = 1.08-3.50, P1 = 0.027), CD24+ CD27+ B-cell %lymphocyte (1.68, 95% CI = 1.03-2.74, P1 = 0.039), and CD14+ CD16- monocyte %monocyte (1.60, 95% CI = 1.15-2.24, P1 = 0.006) ranked in the top five. Eleven immunophenotypes were identified to be significantly associated with non-Hodgkin lymphoma risk, CD86 on granulocyte (2.35, 95% CI = 1.18-4.69, P1 = 0.015), CD28-CD8+ T-cell absolute count (1.76, 95% CI = 1.03-2.99, P1 = 0.036), CCR2 on myeloid dendritic cell (CD24+ CD27+ B cell, 95% CI = 1.02-1.66, P1 = 0.034), CD3 on effector memory CD8+ T cell (1.29, 95% CI = 1.02-1.64, P1 = 0.012), and natural killer T %lymphocyte (1.28, 95% CI = 1.01-1.62, P1 = 0.046) were ranked in the top five. Conclusion: This study presents compelling evidence indicating the correlation between circulating immune cells and lymphoma, thus providing guidance for future clinical research.

KLOTHO KL-VS heterozygosity is associated with diminished age-related neuroinflammation, neurodegeneration, and synaptic dysfunction in older cognitively unimpaired adults.

INTRODUCTION: We examined whether the aging suppressor KLOTHO gene's functionally advantageous KL-VS variant (KL-VS heterozygosity [KL-VSHET]) confers resilience against deleterious effects of aging indexed by cerebrospinal fluid (CSF) biomarkers of neuroinflammation (interleukin-6 [IL-6], S100 calcium-binding protein B [S100B], triggering receptor expressed on myeloid cells [sTREM2], chitinase-3-like protein 1 [YKL-40], glial fibrillary acidic protein [GFAP]), neurodegeneration (total α-synuclein [α-Syn], neurofilament light chain protein), and synaptic dysfunction (neurogranin [Ng]). METHODS: This Alzheimer disease risk-enriched cohort consisted of 454 cognitively unimpaired adults (Mage = 61.5 ± 7.75). Covariate-adjusted multivariate regression examined relationships between age (mean-split[age ≥ 62]) and CSF biomarkers (Roche/NeuroToolKit), and whether they differed between KL-VSHET (N = 122) and non-carriers (KL-VSNC; N = 332). RESULTS: Older age was associated with a poorer biomarker profile across all analytes (Ps ≤ 0.03). In age-stratified analyses, KL-VSNC exhibited this same pattern (Ps ≤ 0.05) which was not significant for IL-6, S100B, Ng, and α-Syn (Ps ≥ 0.13) in KL-VSHET. Although age-related differences in GFAP, sTREM2, and YKL-40 were evident for both groups (Ps ≤ 0.01), the effect magnitude was markedly stronger for KL-VSNC. DISCUSSION: Higher levels of neuroinflammation, neurodegeneration, and synaptic dysfunction in older adults were attenuated in KL-VSHET. HIGHLIGHTS: Older age was associated with poorer profiles across all cerebrospinal fluid biomarkers of neuroinflammation, neurodegeneration, and synaptic dysfunction. KLOTHO KL-VS non-carriers exhibit this same pattern, which is does not significantly differ between younger and older KL-VS heterozygotes for interleukin-6, S100 calcium-binding protein B, neurogranin, and total α-synuclein. Although age-related differences in glial fibrillary acidic protein, triggering receptor expressed on myeloid cells, and chitinase-3-like protein 1 are evident for both KL-VS groups, the magnitude of the effect is markedly stronger for KL-VS non-carriers. Higher levels of neuroinflammation, neurodegeneration, and synaptic dysfunction in older adults are attenuated in KL-VS heterozygotes.

Inadequate mentoring in undergraduate research experiences: Exploring protective factors.

This study examines instances of negative mentoring among undergraduate researchers within STEM education, and specifically, the common yet subtle issue of inadequate mentoring characterized by a faculty mentor's failure to provide their mentee with adequate research, educational, career-related, or emotional support. Using data from the Mentor-Relate survey of 514 participants in the National Science Foundation Research Experiences for Undergraduates program, we identify prevalent patterns of inadequate mentoring and examine protective factors against it. Results indicate that inadequate research support is the least prevalent form, while inadequate educational and career guidance is more common, and inadequate emotional support is the most prevalent. Enhanced faculty mentoring skills emerge as a protective factor, with culturally responsive mentoring and gender concordance also playing significant protective roles. Less hierarchical mentoring structures, such as multiple faculty mentors, offer better emotional support. These findings underscore the importance of comprehensive mentor training and culturally sensitive practices to mitigate inadequate mentoring in undergraduate research experiences. By promoting inclusive and supportive mentoring environments, institutions can maximize the transformative potential of undergraduate research experiences for all participants.

Assessing Additive Interactions between Protective Factors Using Relative Risk Reduction Due to Interaction.

Background and Objectives: In the context of disease prevention, interaction on an additive scale is commonly assessed to determine synergistic effects between exposures. While the "Relative Excess Risk due to Interaction" represents the main measure of additive interaction between risk factors, in this study we aimed to extend this approach to assess additive interaction between factors known to prevent the event's occurrence, such as medical interventions and drugs. Materials and Methods: We introduced and described the "Relative Risk Reduction due to Interaction" (RRRI) as a key measure to assess additive interactions between preventive factors, such as therapeutic interventions and drug combinations. For RRRI values closer to 1, the combination of exposures has a greater impact on reducing the event risk due to their interaction. As a purely illustrative example, we re-evaluated a previous investigation of the synergistic effect between statins and blood pressure-lowering drugs in preventing major adverse cardiovascular events (MACE). Moreover, simulation studies were used to empirically evaluate the performance of a robust Poisson regression model to estimate RRRI across different scenarios. Results: In our example, the drug combination revealed a positive additive interaction in further reducing MACE risk (RRRI > 0), even if not statistically significant. This result is more straightforward to interpret as compared to the original one based on the RERI. Additionally, our simulations highlighted the importance of large sample sizes for detecting significant interaction effects. Conclusion: We recommend RRRI as the main measure to be considered when exploring additive interaction effects between protective exposures, such as the investigation of synergistic effects between drug combinations or preventive treatments.

Grit and the Relationships among Psychological Distress and Suicidality in Female Patients with Breast Cancer.

Purpose: The risk of suicide is approximately two times higher in patients with breast cancer compared to the general population. Suicide risk factors are widely investigated but research on the protective factors is lacking. We investigated whether each subscale of grit, consistency of interest and perseverance of effort, could serve as a protective factor against suicidality. Materials and Methods: Participants were recruited at the Stress Clinic for Cancer Patients, a psycho-oncology clinic at Asan Medical Center from May 2019 to March 2021. A total of 140 female patients with breast cancer completed self-administered questionnaires including Grit scale, Distress thermometer, and Mini International Neuropsychiatric Interview (MINI) suicidality module. We used PROCESS macro for analyzing the mediation model to identify the protective factors for suicidality. Results: Our findings showed that perseverance of effort showed statistically non-significant associations with psychological distress (p=0.403) and suicidality (p=0.945), however, consistency of interest decreased suicidality through psychological distress (ß = -0.015, 95% confidence interval = -0.035, -0.002). Conclusion: The result shows that consistency of interest can be a protective factor against suicidality by reducing psychological distress.

Exploring changing trends in depression and anxiety among adolescents from 2012 to 2019: Insights from My World repeated cross-sectional surveys.

AIM: Research has indicated a rise in the prevalence of depression and anxiety among adolescents over the past three decades. However, the factors underpinning increases in mental health difficulties remain poorly understood. This study examines psychological, social and environmental risk and protective factors that may explain changes in depression and anxiety among adolescents. METHODS: Data were taken from two nationally representative My World Surveys of adolescents aged 12-19 years in 2012 (N = 5,490) and 2019 (N = 9,844). Survey data on depression and anxiety and a range of potential risk (e.g., alcohol use, psychotic symptoms) and protective factors (e.g., resilience, self-esteem) were assessed at both time points. Multiple group analyses assessed whether the predictive ability of risk/protective factors changed from wave 1 to wave 2. RESULTS: Results showed that the prevalence of depression and anxiety increased significantly between 2012 and 2019, particularly among females. Predictors accounted for between 37% and 61% of the variance in outcomes across waves. While some risk/protective factors were consistent predictors of depression and anxiety at both waves (e.g., bullying, discrimination, optimism), reporting female gender and having higher formal help-seeking tendencies more strongly predicted anxiety at wave 2, while lower self-esteem and lower resilience (personal competence) strongly predicted both depression and anxiety at wave 2. CONCLUSION: Findings highlight the need to prioritize adolescent mental health service provision, especially in females. Self-esteem and resilience are potentially important targets for supporting adolescent mental health. Further research is required to understand the causal factors associated with increases in anxiety and depression.

[Risk factors and protective factors for substance abuse among adolescents].

The article presents a brief descriptive review aimed at identifying risk factors and protective factors of drug abuse among adolescents in three important areas - personality, family and society. Individual risk factors are described: high impulsivity, rebelliousness, violation of emotional balance, alexithymia. Family risk factors were prenatal smoking of the mother, and her poor psychological status, low education of parents, the presence of family members who use psychoactive substances. Among the risk factors in society was the presence of peers who abuse drugs in the environment of a teenager. Protective factors are also identified: individual optimism, the desire to preserve their health, etc.