Prenatal Diagnosis of Vasa Previa in the Second Trimester of Pregnancy Based on Non-typical Ultrasound Findings: A Case Report and Mini-Review of the Literature.

Vasa previa is a rare disorder of the placenta. The absence of a prenatal diagnosis is associated with increased perinatal morbidity and mortality. In our patient, ultrasound findings, although atypical, successfully established the prenatal diagnosis of vasa previa in the second trimester of pregnancy. Despite the fact that the placenta was not low-lying, that it was not possible to visualize the site of umbilical cord insertion into the placental tissue, and that vasa previa was not directly visualized, the presence of blood flow near and around the internal cervical os, as seen on transvaginal Doppler ultrasound in the second and third trimesters of pregnancy, raised serious suspicion of their presence. With the completion of the 36th gestational week, it was decided to proceed with a scheduled cesarean section. One week earlier, a course of corticosteroids was administered. The cesarean section was performed without complications. After placental delivery, the presence of velamentous umbilical cord insertion was noted, with umbilical vessels coursing unprotected by the placental tissue or umbilical cord within the fetal membranes. The puerperant and the newborn were discharged from the obstetrics clinic of the General Hospital of Trikala in excellent condition. This paper highlights the importance of transvaginal color Doppler ultrasound in the prenatal diagnosis of vasa previa, which, while posing little risk to the mother, can often be fatal to the fetus.

Fibroepithelial Polyp of the Vagina With Torsion: A Difficult Diagnosis Based on Clinical and Morphological Findings of the Vaginal Lesion.

Vaginal fibroepithelial polyps are rare benign tumors of the mucosa of the anterior vaginal wall. In extremely rare cases, they may originate from the posterior vaginal wall or be complicated by torsion. Our case concerns a 63-year-old patient who presented to the gynecology outpatient clinic of the General Hospital of Trikala with minor vaginal bleeding. On vaginal examination, a large pedunculated painless hemorrhagic polypoid mass was noticed, originating from the posterior vaginal wall. A torsion of the pedunculated vaginal tumor was suspected, leading to its surgical excision with clear resection margins. Due to extensive tissue necrosis, accurate histological identification of the vaginal neoplasm was not possible. Histological examination excluded vaginal malignancy. Based predominantly on the clinical and morphological features of the vaginal lesion, a diagnosis of vaginal fibroepithelial polyp with torsion was made, acknowledging its limitations. The patient was discharged from the clinic the same afternoon following the surgery. Three months later, no recurrence of the lesion in the vaginal wall was noted. Following the case presentation, this paper provides a brief literature review of this rare entity, focusing on the diagnostic and therapeutic approaches.

Waist Circumference and Body Mass Index as Predictors of Disability Progression in Multiple Sclerosis: A Systematic Review and Meta-Analysis.

Background: While obesity has been shown to elevate the risk of developing multiple sclerosis (MS), there is a lack of strong evidence regarding its role in the disability progression and status of MS patients. Methods: This systematic review and meta-analysis aimed to provide comparative estimates of WC and BMI in patients with MS (PwMS) and to investigate potential associations between the waist circumference (WC) and body mass index (BMI) and demographic and specific MS characteristics. Adhering to PRISMA guidelines, a detailed search of the MEDLINE PubMed, Cochrane Library, and Scopus databases was conducted. Results: A total of 16 studies were included. The pooled mean WC and BMI among PwMS was estimated to be 87.27 cm (95%CI [84.07; 90.47]) and 25.73 (95%CI [25.15; 26.31]), respectively. Meta-regression models established a significant bidirectional relationship between WC and the Expanded Disability Scale (EDSS) (p < 0.001) but not between BMI and EDSS (p = 0.45). Sensitivity analyses showed no association between WC and age (p = 0.48) and a tendency between WC and disease duration (p = 0.08). Conclusions: Although WC measurements classify PwMS as normal weight, BMI measurements classify them as overweight. Therefore, WC should complement BMI evaluations in clinical practice. Additionally, our findings highlight the significant association between abdominal fat, as indicated by WC, and disease progression. Considering the heightened risk of cardiovascular comorbidity and mortality among PwMS, we recommend integrating both WC and BMI as standard anthropometric measurements in routine clinical examinations and targeted prevention strategies for PwMS.

Interstitial Ectopic Pregnancy Associated With Painless and Severe Vaginal Bleeding: A Rare, Atypical Clinical Presentation.

Interstitial ectopic pregnancy is rare (2%-4% of ectopic pregnancies). The atypical clinical presentation of interstitial ectopic pregnancy associated with massive vaginal bleeding is extremely rare and makes early preoperative diagnosis even more difficult. The presentation of our case concerns the early diagnosis and surgical treatment of a patient with an interstitial ectopic pregnancy without rupture, which presented atypically with painless, severe vaginal bleeding. A 27-year-old fourth-term pregnant woman presented with massive painless vaginal bleeding. Secondary amenorrhea was calculated at eight weeks and four days. Transvaginal ultrasound and transvaginal Doppler ultrasound combined with the quantification of beta-chorionic gonadotropin hormone raised the suspicion of interstitial ectopic pregnancy. Intraoperatively, the presence of a large swelling of the right horn of the uterus was established, and a wedge resection was performed with the removal of the corresponding fallopian tube. Three weeks after surgery, the serum beta-chorionic gonadotropin hormone value was zero. In this paper, the rarity of interstitial ectopic pregnancy, the difficulties related to early and correct preoperative diagnosis, and the selection of the appropriate available therapeutic procedures are emphasized, the correct application of which can significantly contribute to reducing the morbidity and mortality of these patients.

Interactions between fatigue and urinary quality of life in patients with Multiple Sclerosis.

INTRODUCTION: Neurogenic bladder as well as fatigue related symptoms are common in patients with Multiple Sclerosis (MS) and have a significant impact on the patients' Quality of Life (QoL). The aim of this study is to investigate the relationship between fatigue related symptomatology (FRS) and Urinary Quality of Life (UQoL). METHODS: A total of 120 consecutive MS patients were recruited from the Outpatient Clinic of Demyelinating Diseases (Second Dept. of Neurology, Attikon University Hospital Greece). Participants were then asked to complete the Modified Fatigue Impact Scale (MFIS) and the Short Form Qualiveen questionnaire. Demographic and bladder function related characteristics (incontinence, urinary frequency, use of intermittent catheterization) were collected. RESULTS: The physical and cognitive dimensions of MFIS had a moderate to high correlation with SF Qualiveen (r = 0.403, p <.000), (r = 0.329, p <.000).Multiple linear regression produced a fitted model (R2 = 0.150, F(3,111) = 5.554, p =.001) in IC use (ß = 1.086, p =.036) and the physical dimension of MFIS (ß = 0.66, p =.046) significantly predicted the SF Qualiveen score. CONCLUSION: UQoL had a moderate correlation with both physical and cognitive dimensions of fatigue. Patients with MS who experience lower levels of physical fatigue and/or manage their neurogenic bladder symptomatology (mainly with the use of intermittent catheterization) appear to have higher levels of UQoL. Due to the versatile and subjective nature of both fatigue related and neurogenic bladder symptoms, more focused studies utilizing objective evaluation tools (e.g urodynamic urine bladder study) are necessary.

Neuropsychological profiles comparison between Multiple Sclerosis patients and Multiple Sclerosis patients with overlapping features of Systemic Lupus Erythematosus.

AIM: Multiple sclerosis (MS) and Systemic Lupus Erythematosus (SLE) are autoimmune disorders that may lead to cognitive impairment. This study aimed to compare the neuropsychological profiles of patients with MS, and MS and coexisting SLE features. METHODS: We included a total of 90 participants, divided into 3 groups: 30 patients with clinically definite relapsing remitting MS, 30 with coexisting MS and incomplete SLE (overlap group) and 30 healthy controls (HC). All participants underwent neuropsychological assessment with the Montreal Cognitive Assessment (MoCA), Symbol Digit Modalities Test (SDMT), Paced Auditory Serial Addition Test (PASAT), and Selective Reminding Test (SRT). RESULTS: Both groups scored lower on the MoCA compared to the HC (p < .001). The overlap group showed the lowest performance on the SDMT and PASAT compared to the other two groups (p < .01), while the MS group scored similarly to the HC in the PASAT (p > .05). Regarding the learning rate and long-term recall, the overlap group had lower scores compared to both the MS and HC (p < .001), but it outperformed both groups in the retention efficacy score (p < .001). The MS group did not differ significantly from the HC in these memory domains (p > .05). CONCLUSION: The overlap group exhibited a broader range of impairments, including slower processing speed, decreased working memory, reduced learning rate, and long-term retrieval deficits. Their retention ability remained intact. The coexistence of MS with SLE pathology had additive impacts on cognitive function.

Modulating the Gut Microbiome in Multiple Sclerosis Management: A Systematic Review of Current Interventions.

This review attempted to explore all recent clinical studies that have investigated the clinical and autoimmune impact of gut microbiota interventions in multiple sclerosis (MS), including dietary protocols, probiotics, fecal microbiota transplantation (FMT), and intermittent fasting (IF). Methods: Thirteen studies were held between 2011 and 2023 this demonstrated interventions in gut microbiome among patients with MS and their impact the clinical parameters of the disease. These included specialized dietary interventions, the supply of probiotic mixtures, FMT, and IF. Results: Dietary interventions positively affected various aspects of MS, including relapse rates, EDSS disability scores, MS-related fatigue, and metabolic features. Probiotic mixtures showed promising results on MS-related fatigue, EDSS parameters, inflammation; meanwhile, FMT-though a limited number of studies was included-indicated some clinical improvement in similar variables. IF showed reductions in EDSS scores and significant improvement in patients' emotional statuses. Conclusions: In dietary protocols, clinical MS parameters, including relapse rate, EDSS, MFIS, FSS, and MSQoL54 scales, were significantly improved through the application of a specific diet each time. Probiotic nutritional mixtures promote a shift in inflammation towards an anti-inflammatory cytokine profile in patients with MS. The administration of such mixtures affected disability, mood levels, and quality of life among patients with MS. FMT protocols possibly demonstrate a therapeutic effect in some case reports. IF protocols were found to ameliorate EDSS and FAMS scores. All interventional means of gut microbiome modulation provided significant conclusions on several clinical aspects of MS and highlight the complexity in the relationship between MS and the gut microbiome.

Rehabilitation on cerebellar ataxic patients with multiple sclerosis: A systematic review.

Multiple Sclerosis (MS) is a chronic inflammatory, autoimmune disease of the Central Nervous System with a vast spectrum of clinical phenotypes. A major aspect of its clinical presentation is cerebellar ataxia where physiotherapy and treatment modalities play a significant role on its management. This systematic review aims to investigate the physiotherapeutic rehabilitation techniques regarding the management of cerebellar ataxia due to MS and secondary to stratify each protocol as part of a multi structural personalized rehabilitation approach based on the gravity of the symptoms. A Pubmed Medline, Scopus and Web of Science research was performed using the corresponding databases. The results were screened by the authors in pairs. In our study, six (6) non-pharmacological interventional protocols, 3 Randomized Controlled Trials and 3 pilot studies, were included with a total of 145 MS patients. Physiotherapeutic techniques, such as NDT-Bobath, robotic and visual biofeedback re-education protocols and functional rehabilitation techniques were included. In most cases cerebellar ataxic symptoms were decreased post-treatment. The overall quality of the studies included was of moderate level (level B). Rehabilitation in cerebellar ataxia due to MS should be based on multicentric studies with the scope of adjusting different types of treatments and physiotherapeutic techniques based on the severity of the symptom.

The Prevalence of Diabetes Mellitus Type II (DMII) in the Multiple Sclerosis Population: A Systematic Review and Meta-Analysis.

Introduction: The interactions between Diabetes Mellitus type II (DMII) and Multiple Sclerosis (MS) lead to higher levels of fatigue, higher risk of physical disability, faster cognitive decline, and in general a lower quality of life and a higher frequency of depression compared to the general population. All of the above accelerate the disability progression of patients with MS, reduce the patients' functional capacity, and further increase their psychological and economic burden. Methods: This systematic review and meta-analysis aims to calculate the prevalence of DMII in the MS population. Following PRISMA guidelines, a thorough search of the Medline Pubmed, Cochrane Library, and Scopus databases was performed, focusing on the frequency of DMII in the MS population. Results: A total of 19 studies were included in the synthesis. The results of the main meta-analysis of random effects using R studio 3.3.0 for Windows and the Meta r package showed that the prevalence of DMII in the MS population is 5% (95% CI [0.03, 0.07], 19 studies, I2 = 95%, pQ < 0.001). Additional subgroup analysis based on region showed a difference of 4.4% (I2 = 95.2%, pQ < 0.001), psubgroupdifference = 0.003) between European and non-European participants, while demographic- and MS-specific characteristic (EDSS, Disease Duration) did not seem to affect the prevalence of DMII in the MS population (p = 0.30, p = 0.539, p = 0.19, p = 0.838). No publication bias was discovered (Egger's p test value: 0.896). Conclusions: Even though the prevalence of DMII in the MS population is lower than 10% (the reported prevalence of DMII in the general population) the interactions between the two conditions create significant challenges for MS patients, their caregivers, and physicians. DΜΙΙ should be systematically recorded in the case of MS patients to clearly delineate any potential relationship between the two conditions. Additionally, more structured studies investigating the interactions of MS and DMΙΙ as well as the direction of the causation between those two conditions are necessary in order to gain a deeper insight into the nature of the interaction between MS and DMII.

Surgical treatment of a rare case of atypical polypoid adenomyoma of the uterus in a menopausal patient: a case report.

Atypical polypoid adenomyoma is a rare benign tumor of the uterus that usually affects women of reproductive age and has an increased risk of progression into endometrial cancer. The pathogenetic mechanism has not been completely clarified. Due to the rarity of the tumor, current experience regarding the diagnostic and therapeutic approach is limited. For menopausal patients, hysterectomy seems to be the main treatment option. Our case concerns an asymptomatic menopausal patient with a vaginal delivery in her obstetric history and no hereditary history of gynecological cancer who came to the outpatient clinic for a gynecological examination. Transvaginal ultrasound revealed the presence of a large, round solid mass with increased vascularity within the endometrial cavity. A diagnostic dilation and curettage of the endometrium was performed. Histological examination of the endometrial biopsy showed an atypical polypoid adenomyoma, and it was decided to perform a total abdominal hysterectomy with bilateral adnexectomy. Histological examination of the surgical specimen of the uterus revealed no residual disease, no coexisting foci of atypical endometrial hyperplasia or endometrial cancer. The postoperative course was uneventful. The patient remains to this day under regular follow-up. The present case report highlights the significant difficulties involved in the preoperative diagnosis of atypical polypoid adenomyoma of the uterus and the difficult differential diagnosis from atypical endometrial hyperplasia and endometrial cancer, particularly in menopausal patients. At the same time, it is pointed out that despite its rarity, the early diagnosis of atypical polypoid adenomyoma, especially in young women, must be the main concern of the modern gynaecologist, in order to design the optimal treatment aimed at preserving fertility while avoiding the risk of recurrence of damage or malignant progression into endometrial cancer.

The Effect of Neuromuscular Electrical Nerve Stimulation in the Management of Post-stroke Spasticity: A Scoping Review.

Stroke is a cerebrovascular disorder characterized by the sudden onset of symptoms and clinical signs caused by either vascular infraction or hemorrhage. One of the main symptoms in the majority of post-stroke patients is spasticity. The main therapeutic options of spasticity in post-stroke patients include pharmacological interventions, rehabilitation techniques, and surgery. This review aims to explore the effectiveness of Neuromuscular Electrical Stimulation (NMES) for post-stroke spastic hemiparetic limb (upper and lower). Thorough research of the PubMed Medline database was performed. Records were limited to clinical studies published between 01/01/2010 and 01/01/2022. The results were screened by the authors in pairs. The search identified 26 records. After screening, nine records met the inclusion-exclusion criteria and were assessed. There were seven studies for spastic upper limbs and two for spastic lower limbs. The approaches investigated the effectiveness of electrical stimulation on post-stroke spastic upper or lower limb. Spasticity was measured through the modified Ashworth scale (MAS) and electromyographic recordings (EMG). In most cases, spasticity was decreased for at least two weeks post-intervention. In conclusion, NMES can be used either solo or in combination with different physical therapy modalities in order to produce optimal results, taking into consideration the specific needs and limitations of each individual patient. Based on the existing literature, as well as the limitations of the included studies, the authors believe that future studies on the subject of NMES in the management of post-stroke spasticity should focus on carefully examining each electrical parameter.

Job crafting mediates the relation between creativity, personality, job autonomy and well-being in Lebanese nurses.

AIM: To better understand the functionality of job crafting and its relationship with personality and job autonomy in the context of non-Western health care as an adaptive problem-solving work behaviour that is related to creativity. BACKGROUND: Job crafting could be a strategy nurses use to solve problems as health care organisations become more unpredictable. METHODS: This cross-sectional study sampled 547 nurses from seven hospitals in Lebanon. Data were analysed using structural equation modelling (SEM). RESULTS: The job crafting dimensions of increasing structural job resources and increasing challenging job demands partially mediated the relationship between creativity and subjective well-being, and they fully mediated the relationship between job autonomy and subjective well-being. Creativity, job autonomy, and agreeableness were related to the approach job crafting dimensions, and two of these job crafting dimensions were in turn related to subjective well-being. CONCLUSION: Creative nurses tend to job craft more and this is associated with their subjective well-being. Nurses high on extraversion and emotional stability experienced higher subjective well-being. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing administration and leaders may want to create an environment fostering creativity and encouraging approach-oriented job crafting.

Autobiographical recall of mastery experiences is a mechanism of self-affirming under social identity threat.

Autobiographical memories are relevant to many areas of psychological functioning. So far, however, there is no evidence whether personal memories can also be instrumental for self-affirmation. We conducted two experiments, varying national identity threat among U.S. Americans recruited through MTurk. In Study 1, participants spontaneously recalled autobiographical memories after being exposed to varying levels of threat. When the threat was identity-relevant, those who spontaneously recalled mastery autobiographical memories had higher collective self-esteem than those who did not. In Study 2, we instructed participants to recall either mastery autobiographical memories or routine memories. When the threat was identity-relevant, collective self-esteem was again higher for mastery recall compared to routine recall, moderated by national identification and self-esteem. We also found a general, self-affirmative effect of autobiographical memories, regardless of threat relevance or recall content. Findings provide a first empirical demonstration that autobiographical recall can enhance self-affirmation in identity threat situations.

Improving the Assessment of Implicit Motives Using IRT: Cultural Differences and Differential Item Functioning.

Researchers have long been interested in studying differences in implicit motive between different groups. Implicit motives are typically measured by scoring text that respondents have written in response to picture cues. Recently, research on the measurement of implicit motives has made progress through the application of a dynamic Thurstonian item-response theory model (DTM; Lang, 2014 ) that captures 2 basic motivational processes in motivational research: motive competition and dynamic reduction of motive strength after a motive has been acted out. In this article, the authors use the DTM to investigate differential item functioning (DIF) in implicit motive measures. The article first discusses DIF in the context of the DTM. The authors then conduct a DIF analysis of data from a study that used a picture set of the Operant Motive Test (OMT; Kuhl & Scheffer, 2002) with participants from Cameroon, Germany, and Costa Rica. Results showed no evidence of DIF in 9 pictures and some evidence for DIF in 3 pictures. The authors show a partial invariance model can be specified and use this partial invariance model to study latent mean differences between Cameroon, Germany, and Costa Rica. The discussion focuses on the use of IRT DIF methods in future research on implicit motives.

Implicit motives and basic psychological needs.

The present article starts with discussing similarities and differences between conceptualizations of human needs in self-determination theory (SDT; Deci & Ryan [1985], Intrinsic motivation and self-determination in human behavior; Deci & Ryan [2000], Nebraska symposium on motivation: Perspectives on motivation) and motive disposition theory (MDT; McClelland, Human motivation, 1985). The second section focuses on the two-process model of psychological needs (Sheldon [2011], Psychological Review, 118: 552), which aims to integrate the two approaches, whereas the third section highlights some aspects of both theories that are still decoupled or even contradictory, but nevertheless still have a high potential to be linked. These three aspects are (a) the noncorresponding concepts of implicit power motive (MDT) and basic need for autonomy (SDT); (b) the differentiation of needs into hope and fear components, which is theoretically embedded in MDT, but not in SDT; and (c) MDT researchers' differentiation into an implicit and explicit motivational system, which is not included in SDT. Particularly, the last section highlights the potential for areas in which further integration is possible, which provides a foundation for comprehensive and exciting research on human motivation.

Collective References and Identity Threat among Lebanese and Lebanese-Armenians in the Context of Continuous Intergroup Conflict / Referencias Colectivas y Amenazas a la Identidad entre Libaneses y Libaneses-Armenios en el Contexto de Conflicto Intergrupal Continuo

Abstract How people deal with adversity, in terms of threats to their social or ethnic identity has been extensively investigated. However, most studies have focused on samples (e.g. minority groups) from prototypical Western contexts. It is unclear how individuals perceive and deal with identity threats within non-Western plural contexts characterized by intergroup conflict. We therefore assess whether self-affirmation by recalling a past success can buffer against identity threat in the plural, non-Western context of Lebanon. In two studies we investigate how threats are negotiated at a national (Lebanon) (Study 1) and ethnic minority (Armenian) level (Study 2). In Study 1, we show that in a context characterized by a history of intergroup conflict, a superordinate national identity is non-salient. When investigating the content of memories of a sectarian group in Study 2, we find a hypersalient and chronically accessible ethnic identity, a pattern specific to Armenian Lebanese. We suggest that this hyper-salience is employed as a spontaneous identity management strategy by a minority group coping with constant continuity threat. Our findings point to the importance of expanding the study of identity processes beyond the typically Western contexts and in turn, situating them within their larger socio-political and historical contexts.

Resumen Ha sido ampliamente investigado el cómo luchan las personas con la adversidad, en términos de amenazas a su identidad social o étnica. Sin embargo, muchos estudios se han enfocado en muestras prototípicas de contextos Occidentales (p.ej. grupos minoritarios). Es poco claro cómo los individuos perciben y luchan con amenazas a su identidad dentro de contextos plurales no-occidentales caracterizados por el conflicto intergrupal. Por ello, evaluamos si la auto-afirmación a través del recuerdo de un hecho pasado puede mediar en contra de la amenaza a la identidad en el contexto plural, no-occidental de Líbano. A través de dos estudios investigamos cómo las amenazas son negociadas a nivel nacional (Líbano) (Estudio 1) y a nivel de una minoría étnica (Armenia) (Estudio 2). En el estudio 1 se muestra que, en un contexto caracterizado por la historia de conflicto intergrupal, una identidad nacional superordinada es no-saliente. Cuando se investigó el contenido de las memorias de un sector del grupo en el estudio 2, se encontraron identidades étnicas híper-salientes y crónicamente accesibles, un patrón específico a los Libaneses-Armenios. Se sugiere que esta híper-saliencia sea empleada como una estrategia de manejo de identidad espontánea por un grupo minoritario que se enfrenta a una amenaza continua y constante. Los hallazgos señalan la importancia de ampliar el estudio de los procesos de identidad más allá de los contextos típicos Occidentales, y a su vez, situarlos dentro de contextos sociopolíticos e históricos más grandes.

Ethnic, Familial, and Religious Identity of Roma Adolescents in Bulgaria, Czech Republic, Kosovo, and Romania in Relation to Their Level of Well-Being.

This study examines ethnic, national, familial, and religious identity and well-being of 632 Roma minority and 589 majority adolescents (age: M = 15.98 years, SD = 1.34) in Bulgaria, the Czech Republic, Kosovo, and Romania. Results indicated that Roma showed lower endorsement of national identity but stronger religious identity than their majority counterparts. Path models showed positive associations of familial and religious identities with well-being, whereas Roma identity was negatively associated with well-being, particularly for Roma in Bulgaria and Kosovo (countries with a less active policy toward improving conditions of Roma). In the latter countries, Roma ethnic identity is less relevant and weakly associated with psychological well-being of youth.

Childhood context explains cultural variance in implicit parenting motivation: results from two studies with six samples from Cameroon, Costa Rica, Germany, and PR China.

We investigated the effect of the childhood context variables number of siblings (study 1 and 2) and parental SES (study 2) on implicit parenting motivation across six cultural samples, including Africa (2xCameroon), Asia (PR China), Europe (2xGermany), and Latin America (Costa Rica). Implicit parenting motivation was assessed using an instrument measuring implicit motives (OMT, Operant Multimotive Test; Kuhl and Scheffer, 2001). Replicating and extending results from previous studies, regression analyses and structural equation models show that the number of siblings and parental SES explain a large amount of cultural variance, ranging from 64% to 82% of the cultural variance observed in implicit parenting motivation. Results are discussed within the framework of evolutionary developmental psychology.

Collective identity and well-being of Bulgarian Roma adolescents and their mothers.

In Europe and specifically in Bulgaria, Roma represent the largest indigenous ethnic minority exposed to severe discrimination, social exclusion, poverty, and compromised well-being. To improve their conditions, identifying sources of psychological well-being for Roma is theoretically relevant and practically important. This study investigated the relation between ethnic, familial, and religious identities as salient collective identity components for psychological well-being among 194 Roma adolescents (age: M = 16.11 years, SD = 1.36) and their mothers (age: M = 35.95 years, SD = 3.54). The results indicated that in line with marginalization models of acculturation, Roma youth and their mothers showed a low endorsement of both Bulgarian mainstream and Roma ethnic identity. The average scores of well-being were also low. For both groups, familial identity was stronger compared to Roma, Bulgarian, and religious identity. A path model showed that collective identity was a positive predictor of well-being in both adolescents and mothers and that the mothers' collective identity was a predictor of adolescent well-being. Bulgarian mainstream identity had the strongest relationship with collective identity. It is concluded that, for Roma youth and their mothers, family is an important identity domain as it represents the most salient identification source that is not challenged in their environment.

Collective identity and wellbeing of Roma minority adolescents in Bulgaria.

In Europe and particularly in Bulgaria, Roma represent the largest low-status minority group that is subjected to marked public intolerance and discrimination. This study examined links among Roma (N = 207) and Bulgarian (N = 399) adolescents' ethnic, familial, and religious identities as salient identity aspects for their psychological wellbeing. Results indicated that, as expected, Roma youth reported lower levels of wellbeing than Bulgarian youth. The latter revealed a weaker religious identity than Roma youth, whereas no ethnic group differences emerged regarding Bulgarian or familial identity. Furthermore, we observed that collective identity was higher in older participants of both groups. Finally, a multigroup analysis using structural equation modeling showed that collective identity was a positive predictor of wellbeing for both Roma and Bulgarian adolescents. Findings demonstrated differences in salience as well as structural communalities regarding ways in which collective identity affects wellbeing of youth from two ethnically diverse communities.