Mobile-based mindfulness meditation intervention's impact on mental health among young male judo athletes in South Korea: a quasi-experimental study.

Young athletes commonly encounter various mental health challenges due to the distinct pressures inherent in sports environments. This study investigates the effectiveness of mobile-delivered mindfulness meditation interventions in alleviating mental health indicators of depression, perceived stress, and anxiety, and enhancing self-esteem and resilience among young male judo athletes in South Korea. Pre- and post-test questionnaires were completed by 53 judo athletes. Participants were then allocated to the intervention group (N = 27; Mage = 13.77 [SD = 1.11]), which used a mobile meditation software program, or the control group (N = 27; Mage = 13.56 [SD = 1.05]). Data analysis compared intervention and control group scores using multiple statistical methods, including independent sample t-tests, paired sample t-tests, and 2 (time) × 2 (group) repeated measures analysis of variance. Following the intervention, the mindfulness group exhibited significant enhancements in the mental health indicators of depression (GMD = 2.74 [95% CI 0.90-4.56], Cohen's D = 0.84), perceived stress (GMD = 0.35 [95% CI 0.002-0.70], Cohen's D = 0.56), and anxiety (GMD = 0.2 [95% CI 0.001-0.40, Cohen's D = 0.56]. Self-esteem also had a significant increase (GMD = 0.55 [95% CI - 0.22 to - 0.88], Cohen's D = 0.95). The findings of this study underscore the potential benefits of mobile-delivered mindfulness meditation interventions in addressing mental health challenges among young male judo athletes. The significant enhancements observed in scores on measures of depression, perceived stress, anxiety, and self-esteem among participants in the mindfulness group highlight the effectiveness of such interventions in promoting mental health in sports settings.

Evaluation and refinement of Self-Directed Learning Readiness Scale for medical students.

PURPOSE: This study evaluated the underlying subdomain structure of the Self-Directed Learning Readiness Scale (SDLRS) for medical students and refined the instrument to measure the subdomains to provide evidence for construct validity. Developing self-directed learners is a well-recognized goal amongst medical educators. The SDLRS has been frequently used, however, lack of construct validity makes it difficult to interpret results. METHODS: To identify the valid subdomains of the SDLRS, items were calibrated with the graded response model (GRM) and results were used to construct a 30-item short form. Short-form validity was evaluated by examining the correspondence between the total scores from the short form and the original instrument for individual students. RESULTS: A five-subdomain model explained the SDLRS item response data reasonably well. These included: (1) initiative and independence in learning, (2) self-concept as an effective learner, (3) openness to learning opportunity, (4) love of learning, and (5) acceptance for one's own learning. The unidimensional GRM for each subdomain fits the data better than multi-dimensional models. The total scores from the refined short form and the original form were correlated at 0.98 and the mean difference was 1.33, providing evidence for validation. Nearly 91% of 179 respondents were accurately classified within the low, average, and high readiness groups. CONCLUSION: Sufficient evidence was obtained for the validity and reliability of the refined 30-item short-form targeting five subdomains to measure medical students' readiness to engage in self-directed learning.

Cultural adaptation and Sepedi translation of the Activities-specific Balance Confidence scale.

BACKGROUND:  The Activities-specific Balance Confidence (ABC) scale is a widely used measure to identify older adults with balance difficulties. However, its applicability in the diverse South African context is hindered by cross-cultural and linguistic differences. Limited research exists on the use of the ABC scale in native South African languages. OBJECTIVES:  This study aimed to translate and culturally adapt the ABC scale into Sepedi, evaluate its reliability and determine self-perceived balance confidence among elderly individuals in a rural community. METHOD:  The ABC scale was translated and culturally adapted into Sepedi. Two trained raters administered the Sepedi version of the ABC (ABC-S) scale to 32 individuals aged between 60 and 88 years. Test-retest reliability and inter-rater reliability were determined, with one rater re-administering the scale 2 weeks later. RESULTS:  Ten items from the original ABC scale were modified because of cultural, semantic or contextual inappropriateness. The ABC-S scale demonstrated very good intra- and inter-rater reproducibility, with an average intraclass correlation coefficient (ICC) of 0.85 and 0.81, respectively. The self-perceived balance confidence among elderly Sepedi individuals, as evaluated by the ABC-S scale, was high, with an average score of 81.3 and a range of 58.1 to 95.9. CONCLUSION:  The ABC-S scale is a reliable measurement tool to investigate balance confidence in Sepedi-speaking older adults.Contribution: The ABC-S scale is a valuable screening tool for the identification of balance difficulties in Sepedi-speaking older adults as well as research settings.

The Relationship Between Childhood Trauma and Body Image, Self-Esteem and Eating Attitudes in Patients undergoing Bariatric Surgery. / Bariatrik Cerrahi Aday Hastalarinin Çocukluk Çagi Travmalari ile Beden Algisi, Benlik Saygisi ve Yeme Tutumlari Arasindaki Iliski.

OBJECTIVE: Psychiatric evaluation of candidate patients before bariatric surgery (BS) has an important place in the success of the treatment. In this study, it was aimed to examine the relationship between childhood trauma (CT) and body image, self-esteem and eating attitudes of individuals who applied for BS. METHOD: A total of 87 BS candidate patients with morbid obesity, 57 women and 30 men, were included in the study. Sociodemographic Information Form, Childhood Trauma Questionnaire (CTQ), Body Perception Scale (BPS), Rosenberg Self-Esteem Scale (RSES), and Eating Attitude Test (EAT-40) were used as data collection tools in the study. RESULTS: CT was detected in 47.1% of the cases. RSES (t=3.296; p<0.01) and BPS (t=3.267; p<0.01) scores were found to be significantly higher in those with a history of CT. A positive and significant relationship was found between EAT-40 and CTQ -sexual abuse (SA) sub-dimension (r=0.570; p<0.01). A significant relationship was found between all subdimensions of CTQ and RSES. A significant relationship was found between CTQ physical neglect (PN), emotional neglect (EN), and emotional abuse (EA) sub-dimensions and BPS. In addition, CTQ total score was found to significantly and negatively predict self-esteem (ß=- 4.432; p<0.001) and body image (ß=-3.700; p<0.001). CONCLUSION: In our study, it was found that those with CT were dissatisfied with their bodies and had lower self-esteem. Questioning CT in the psychological evaluation of pre-BS cases may contribute to the understanding of the etiology of obesity and may play an important role in planning the follow-up after BS.

Self-perceived oral health and orofacial appearance in older adults - an 18-year follow-up study in Karlskrona, Sweden.

OBJECTIVES: To analyze whether self-perceived oral health and orofacial appearance change with increasing age. METHODS: This longitudinal study is based on data from a questionnaire used in the Swedish National Study of Aging and Care. The sample comprises 160 participants 60 years of age at baseline 2001-2003. The same participants were re-examined at 66-, 72-, and 78 years of age. To analyze whether perceptions of oral health and orofacial appearance changed with increasing age, Cochran's Q test was conducted. Statistical significance was considered at p ≤ 0.05, and the calculated value Q must be equal to or greater than the critical chi-square value (Q ≥ 7.82). Significance values have been adjusted for the Bonferroni correction for multiple tests. RESULTS: Self-perceived mouth dryness, both day (Q = 7.94) and night (Q = 23.41), increased over the 18-year follow-up. When divided by gender, significant differences were only seen for mouth dryness at nighttime. A decrease in sensitive teeth was perceived with increasing age, and an increase in self-perceived satisfaction with dental appearance, and a decrease in self-perceived problems with dental gaps between the ages of 60 and 78. These changes were, however, not statistically significant. Men experienced a higher proportion of discomfort with discolored teeth at age 78 than at 60 (Q = 9.09). CONCLUSIONS: Self-perceived oral health and orofacial appearance were relatively stable, with few changes over an 18-year follow-up.

Concerns about fertility, social appearance, and relationships in young adults with polycystic ovary syndrome.

BACKGROUND: Polycystic Ovary Syndrome (PCOS), affecting 1-11% of reproductive-age women, is characterised by many symptoms that cause important concerns especially in young adults. OBJECTIVE: This study aimed to evaluate the concerns about fertility, social appearance, and relationships in young adults with PCOS. METHODOLOGY: This descriptive study included 140 young female adults aged 18-26, who were diagnosed with PCOS, agreed to participate in the onlineresearch through social media between July and December 2022 in Turkey. Data were collected using the 'Participant Interview Form' and the "Social Appearance Anxiety Scale (SAAS). RESULTS: The mean age of the participants was 22.1 ± 2.1. As the most common symptoms, 78.6% experienced menstrual irregularities, 16.4% were overweight, 7.1% were obese, 67.1% had hirsutism and 65.7% had acne. Most of the participants expressed concerns about future infertility (72.9%), and worried about being unable to conceive due to PCOS in the future (sometimes = 61.4%). Over eighty percent of the participants expressed some level of dissatisfaction with their physical appearance. They commonly believe that their self-esteem, emotionalstate, social relationships and partner relationships could be negatively affected by PCOS. SAAS scores were significantly increased by low income, high BMI, hirsutism, dissatisfaction with physicalappearance, low self-esteem, emotional problems and concerns related to social and partner relationships (p < 0.05). CONCLUSION: Young adults have common concerns about the potential negative impacts of PCOS on fertility, social appearance, and relationships. Health professionals should be aware of their counselling needs about the possible physical and psycho-social effects of PCOS and provide continuous care and support.

Ethnic Racial Identity Development and Self-Esteem among Native American Adolescents: The Mediating Role of Peer Belonging.

While ethnic racial identity (ERI) development is associated with a variety of psychological well-being outcomes, the mechanisms through which this association operates is yet to be fully explained. During adolescence, social belonging is a developmentally salient process that can play a key role in how ERI impacts well-being. We sought to explore the mediating role of belonging to peer networks in the association between ERI and self-esteem among Native American adolescents. In this cross-sectional, mediational study, we used survey data from 317 Native American students attending a reservation high school (46.9% female; M age =16). Students' levels of ERI development were measured by combining items from two scales pertaining to ethnic identity development and racial identity. We employed a structural equation modeling approach to explore the mediating role of peer belonging in the association between ERI and self-esteem. Results suggest that our 4-item index of peer belonging was an acceptable measure of this construct. Further, the significant indirect effect of peer belonging explains a notable portion (ß=.22, p ≤ .05) of the total effects of ERI on self- esteem (ß=.54, p ≤ .05). This finding suggests that higher levels of ERI achievement contribute to higher levels of peer belongingness, which in turn lead to improved self-esteem among students. Implications for research and practice are discussed.

A modified persian version of the self-stigma of depression scale among the Iranian population: a methodological study in 2023.

INTRODUCTION: This cross -sectional research evaluated the psychometric properties of the Self-Stigma of Depression Scale (SSDS) among Iranian people. METHODS: This methodological study was conducted among 881 people in 2023, Iran. The method of proportional stratified sampling was used to select participants. To evaluate the validity, face, content, construct, convergent, and discriminant were evaluated. The reliability of SSDS was assessed with the McDonald's omega coefficient, Cronbach α coefficient, and test- retest (Intraclass Correlation Coefficient). RESULTS: In confirmatory factor analysis, the factor loading of all items of SSDS was more than 0.5, and two items had low factor loading. After deleted these items, goodness of fit indexes (such as GFI = 0.945, RMSEA = 0.067, AGFI = 0.917, CFI = 0.941, RFI = 0.905) confirmed the final model with 14 items and four factors of social inadequacy (3 items), help-seeking inhibition (4 questions), self-blame (3 questions), and shame (4 questions). In the reliability phase, for all items of SSDS, Cronbach α coefficient was 0.850, the McDonald omega coefficient was 0.853, and the intraclass correlation coefficient was 0.903. CONCLUSION: The Persian form of SSDS was approved with 14 items and four factors: social inadequacy, help-seeking inhibition, self-blame, and shame. This tool can be used to check the status of self-stigmatization of depression in different groups.

How Dietary Choices and Nutritional Knowledge Relate to Eating Disorders and Body Esteem of Medical Students? A Single-Center Cross-Sectional Study.

Eating disorders and body image concerns are increasingly prevalent issues among young individuals, with medical students being particularly vulnerable due to heightened stress levels. This study enrolled 879 medical students to investigate these concerns. The KomPAN questionnaire was utilized to assess dietary habits and knowledge, the Body Esteem Scale (BES) to evaluate body satisfaction, and The Eating Attitudes Test (EAT-26) to identify eating disorders. A higher level of nutritional knowledge was found to be statistically significantly associated with attempts at excessive calorie restriction among women (ß = 0.0864) and negatively among men (ß = -0.2039). Moreover, it was negatively associated with self-control of food intake only among men (ß = -0.2060). Furthermore, a higher BMI was associated with attempts of excessive calorie restriction in both women and men (ß = 0.1052 and ß = 0.1656, respectively) and negatively with self-control of food intake (ß = -0.0813 and ß = -0.1453, respectively). A higher BMI was associated with poorer body esteem across all variables in both genders, except for upper body strength among men. Nutritional knowledge did not correspond with any of these variables, while dietary quality was positively associated with physical condition in women and with physical condition, physical attractiveness, and upper body strength in men. Our study findings suggest that dietary interventions could be improved by considering gender-based behavioral differences and focusing on portion control for individuals with a higher BMI. Caution is warranted in extrapolating the results to the general population due to the specific nature of the study population.

Exploring the influence of self-identification on perceptual judgments of physical and social causality.

People tend to overestimate the causal contribution of the self to the observed outcome in various situations, a cognitive bias known as the 'illusion of control.' This study delves into whether this cognitive bias impacts causality judgments in animations depicting physical and social causal interactions. In two experiments, participants were instructed to associate themselves and a hypothetical stranger identity with two geometrical shapes (a circle and a square). Subsequently, they viewed animations portraying these shapes assuming the roles of agent and patient in causal interactions. Within one block, the shape related to the self served as the agent, while the shape associated with the stranger played the role of the patient. Conversely, in the other block, the identity-role association was reversed. We posited that the perception of the self as a causal agent might influence explicit judgments of physical and social causality. Experiment 1 demonstrated that physical causality ratings were solely shaped by kinematic cues. In Experiment 2, emphasising social causality, the dominance of kinematic parameters was confirmed. Therefore, contrary to the hypothesis anticipating diminished causality ratings with specific identity-role associations, results indicated negligible impact of our manipulation. The study contributes to understanding the interplay between kinematic and non-kinematic cues in human causal reasoning. It suggests that explicit judgments of causality in simple animations primarily rely on low-level kinematic cues, with the cognitive bias of overestimating the self's contribution playing a negligible role.

The effect of self-compassion on social media addiction among college students - The mediating role of gratitude: An observational study.

In contemporary society, social media pervades every aspect of daily life, offering significant benefits such as enhanced access to information, improved interconnectivity, and fostering community among its users. However, its usage, particularly when excessive, can lead to negative psychological outcomes, including the prevalence of social media addiction (SMA) among adolescents. While extensive research has been conducted on the phenomenon of SMA, there is a notable paucity of studies examining the link between individual levels of self-compassion and susceptibility to SMA. This study aims to investigate the correlation between self-compassion and SMA in college students, while also examining the potential mediating influence of gratitude. The study sampled 1131 college students who engaged in an anonymous online survey. This survey utilized the Chinese translations of the Self-Compassion Scale, Gratitude Questionnaire, and SMA Scale. For data analysis, validated factor analysis was performed using IBM® SPSS® AMOS™ version 23. Correlation analyses were carried out with IBM® SPSS® version 22.0, and the PROCESS macro (Model 4) was employed to assess path and mediation effects. Higher levels of positive self-compassion were found to mitigate the effects of SMA, while elevated levels of negative self-compassion were associated with an increase in such addiction. The study further revealed that gratitude played a partial mediating role in the relationship between self-compassion and SMA. Specifically, positive self-compassion can reduce symptoms of SMA by enhancing levels of gratitude, whereas negative self-compassion may worsen these symptoms by diminishing gratitude. Positive self-compassion is instrumental in fostering personal growth among college students, with gratitude serving as a significant mediator in reducing SMA.

Out of the loop: Taking a one-week break from social media leads to better self-esteem and body image among young women.

This study experimentally tested the effects of taking a one-week break from social media (SM) on body image and self-esteem among young women. Female undergraduate students (N = 66) were randomly assigned to either take a one-week break from SM or continue their normal use (control condition). State self-esteem and body satisfaction were measured at baseline (Time 1) and one week later (Time 2). As predicted, participants in the break condition reported higher body satisfaction and higher state self-esteem (total, performance, social, and appearance domains) at Time 2 than did those in the control condition, controlling for Time 1 scores. The benefits of taking a break from SM on body satisfaction were especially pronounced for women with higher baseline levels of thin-ideal internalization. The findings demonstrate the short-term benefits of taking a break from SM for one week on self-esteem and body image among young women.

Testing for longitudinal bidirectional associations between self-compassion, self-criticism, and positive body image components.

Previous cross-sectional studies have reported associations between self-compassion, self-criticism, and positive body image, yet prospective studies establishing the temporal order of these relationships are missing. The present study sought to clarify the nature of these associations by investigating possible longitudinal bi-directional links between self-compassion, self-criticism, and three components of positive body image (body appreciation, functionality appreciation, and body image flexibility). Data were analyzed from 2982 adult women who completed survey instruments at baseline (T0), four-month follow-up (T1), and eight-month follow-up (T2). Attrition rate ranged from 0-56% across time-points. Cross-lagged panel models were computed to test for bidirectional associations. We found evidence of reciprocal, negative associations between self-criticism and the three components of positive body image across the three time-points. We also found evidence that T0 self-compassion predicted increased body image flexibility and functionality appreciation at T1 (paths were non-significant from T1 to T2), whereas T0 body appreciation predicted increased T1 self-compassion (but was non-significant from T1 to T2). Findings suggest that compassionate and uncritical ways of responding to the self may be relevant precursors and outcomes to positive body image, depending on the timing of assessment, highlighting viable targets for intervention.

Translation and validation of a Romanian version of the Breast Appreciation Scale (BrAS).

The 9-item Breast Appreciation Scale (BrAS; Swami et al., 2022) is a recently developed instrument that assesses a woman's positive breasted experiences. To date, however, the psychometric properties of the BrAS have only been investigated in English-speaking women. Here, we report on the translation and validation of a novel, Romanian version of the BrAS. A total of 555 cisgender women from Romania completed a Romanian translation of the BrAS along with additional measures of body image and psychological well-being. Exploratory and confirmatory factor analysis identified a stable unidimensional model of the BrAS, with all nine items retained. Additionally, the Romanian BrAS evidenced complete invariance (i.e., through to latent mean invariance) across mothers and non-mothers, though mothers had higher observed scores than non-mothers. Evidence of convergent, concurrent, and incremental validity was very strong when based on observed BrAS scores, but slightly weaker when based on latent BrAS scores. In particular, greater latent breast appreciation was significantly associated with higher body appreciation, lower breast size dissatisfaction, and higher self-esteem. Overall, these results suggest that the psychometric properties of the Romanian BrAS are robust and that the instrument can be effectively deployed in this linguistic context.

Childhood maltreatment, shame, and self-esteem: an exploratory analysis of influencing factors on criminal behavior in juvenile female offenders.

OBJECTIVE: This study aimed to investigate the relationships between childhood maltreatment, shame, and self-esteem among juvenile female offenders and to explore the potential influencing factors on their criminal behavior. METHODS: Using a stratified cluster sampling method, 1,227 juvenile female offenders from 11 provinces in China were surveyed using the Childhood Trauma Questionnaire (CTQ), Self-Esteem Scale (SES), and a self-developed Shame Questionnaire for Juvenile Offenders. Data were analyzed using descriptive statistics, correlation analysis, chi-square tests, t-tests, and structural equation modeling with mediation analysis. RESULTS: (1) Childhood maltreatment have a significant potential influencing factors on criminal behavior; (2) Childhood maltreatment was positively correlated with self-esteem(ß = 0.351, p < 0.001); (3) shame (ß = 0.042, p < 0.001) mediate the relationship between Childhood maltreatment and self-esteem (childhood maltreatment → shame → self-esteem (95% Cl: 0.033, 0.052)). CONCLUSION: This study demonstrates that childhood maltreatment is a significant predictor of criminal behavior among juvenile female offenders. childhood maltreatment can directly influence of self-esteem, which can also affect juvenile female offenders'self-esteem indirectly through shame. The findings suggest that shame are important variables that mediate the effect of the juvenile female offenders'childhood maltreatment on their self-esteem.

Reliability and validity of the short version of the childhood abuse self report scale in Chinese college students.

BACKGROUND: The reliability and validity of the current scale for measuring childhood abuse in China are worrying. The development of the Short Version of the Childhood Abuse Self Report Scale (CASRS-12) helps to change this situation, but the effectiveness of the tool has not yet been tested in Chinese participants. This study aims to test the reliability and validity of the CASRS­12 in Chinese college students. METHODS: A total of 932 college students were investigated, of whom 418 were investigated for the first time, and only the CASRS­12 was filled out. In the second survey, 514 participants filled out the CASRS­12, Depression Scale, Self-esteem Scale and Subjective Well-being Scale in turn. After 4 weeks, 109 participants were selected for retest. RESULTS: Each item of the CASRS­12 had good discrimination. Exploratory factor analysis and confirmatory factor analysis (χ2/df = 4. 18, RMSEA = 0. 079, CFI = 0. 95, TLI = 0. 94, IFI = 0. 95, NFI = 0. 94) all supported the four-factor structure of the scale, and the cumulative contribution rate of variance was 76.05%. Cronbach's α coefficient and retest reliability were 0.86 and 0.65, respectively. Childhood abuse was positively correlated with depression (r = 0. 42, p < 0.01), and negatively correlated with self-esteem (r=-0. 33, p < 0.01) and subjective well-being (r=-0. 32, p < 0.01). CONCLUSION: The Chinese version of CASRS­12 meets the measurement standard and could be used to measure the level of childhood abuse of Chinese college students.

The mediating effects of hope on the relationships of social support and self-esteem with psychological resilience in patients with stroke.

PURPOSE: To explore the mediating effect of hope in the relationships between social support and self-esteem with psychological resilience among patients with stroke survivors in early rehabilitation. METHODS: A cross-sectional study design was adopted. Data from a cross-sectional survey of 210 patients undergoing early stroke rehabilitation were analyzed using structural equation modeling. The variables of interest were measured using the Connor Davidson Resilience Scale, the Social Support Rating Scale, the Herth Hope Index, and the Self-Esteem Scale. This article reports according to the STROBE checklist. RESULTS: A positive relationship was found between social support and psychological resilience (ß1 = 0.548), which was mediated by hope (ß2 = 0.114), and social support had significant direct effect on resilience (ß3 = 0.434). A positive relationship was also found between self-esteem and psychological resilience (ß4 = 0.380), which was mediated by hope (ß5 = 0.200), and self-esteem had significant direct effect on resilience (ß6 = 0.179). CONCLUSION: According to the results of this study, some strategies can be incorporated into the rehabilitation process to enhance psychological resilience, such as cultivating individual personality characteristics and improving patients' social relationships. In the future, we need to explore methods for improving psychological resilience among patients with stroke in combination with their risk factors to improve their quality of life and reduce the incidence of post-stroke depression.

Association between self-perception of the neighborhood environment and sleep problems in older Brazilian adults: findings from ELSI-Brazil.

This study aimed to investigate associations between neighborhood perception and sleep problems in older Brazilian adults. A cross-sectional study was conducted with 5,719 community-dwelling older adults (≥ 60 years) from the Brazilian Longitudinal Study of Aging (ELSI-Brazil, 2019-2021). The outcomes were self-reported sleep problems: poor sleep quality, daytime sleepiness, primary insomnia complaints, difficulty staying asleep, and waking up at dawn. The exposure variables were questions about the perception of participants about the physical and social environment of the neighborhood. Logistic regression was used in data analysis. Garbage, rubbish, or tall grass on the streets and the desire to move were associated with higher odds of poor sleep quality. Concern about falling due to damaged sidewalks, concern about having difficulties taking transportation, and concern about having difficulties crossing the street were associated with higher odds of all sleep problems. Sound/noise of buses and cars was associated with higher odds of some sleep problems. Perceiving the neighborhood as a good place to live was associated with lower odds of daytime sleepiness and primary insomnia complaints. Trusting most people in the neighborhood and perceiving that kids and younger people treat adults with respect were associated with lower odds of daytime sleepiness, primary insomnia complaints, and waking up at dawn. Being a good place for kids to play and raise teenagers was associated with lower odds of daytime sleepiness. These results can assist public administrators in creating urban planning policies aimed at improving neighborhood environments as a means of health promotion.

Student-run free clinics may enhance medical students' self-confidence in their clinical skills and preparedness for clerkships.

INTRODUCTION: Student-run free clinics (SRFCs) offer medical students a unique opportunity to develop their clinical, diagnostic, and social skills while providing care to medically underserved communities. This study aims to evaluate the value of SRFC involvement on students' self-reported confidence in various clinical domains and satisfaction with their medical education. METHODS: We conducted a single-center retrospective pre-post assessment at an urban academic institution among second- to fourth-year medical students. We administered a 25-item questionnaire capturing the scope of clinic involvement and assessing self-reported confidence in multiple clinical domains following a one-year-long participation in student-run free clinics. RESULTS: Fifty-six students completed the survey. Participation in SRFCs significantly increased self-reported confidence in patient history-taking (p < 0.001), performing oral presentations (p < 0.001) and physical exams (p < 0.001). Students also reported significantly greater confidence in working with translators (p < 0.001) or as part of an interprofessional team (p < 0.001) and understanding the needs of the population served (p < 0.001). Students also found SRCs to significantly improve their confidence in preparedness for clerkships (p < 0.001). SRFC involvement can improve medical students' confidence in their clinical and interpersonal skills and enhance preparedness for clerkships and working with diverse patient groups. CONCLUSION: SRFCs are a useful tool in the medical school curriculum that help bridge the gap between classroom learning and clinic and may encourage practice in medically underserved communities. SRFCs also integrate classroom material and clinical practice, although standardized evaluation metrics need to be developed. SRFCs should be incorporated as a learning experience by medical schools nationwide.

Grandiose narcissism associates with higher cognitive performance under stress through more efficient attention distribution: An eye-tracking study.

Narcissism is a part of the Dark Triad that consists also of the traits of Machiavellianism and psychopathy. Two main types of narcissism exist: grandiose and vulnerable narcissism. Being a Dark Triad trait, narcissism is typically associated with negative outcomes. However, recent research suggests that at least the grandiose type may be linked (directly or indirectly) to positive outcomes including lower levels of psychopathology, higher school grades in adolescents, deeper and more strategic learning in university students and higher cognitive performance in experimental settings. The current pre-registered, quasi-experimental study implemented eye-tracking to assess whether grandiose narcissism indirectly predicts cognitive performance through wider distribution of attention on the Raven's Progressive Matrices task. Fifty-four adults completed measures of the Dark Triad, self-esteem and psychopathology. Eight months to one year later, participants completed the Raven's, while their eye-movements were monitored during high stress conditions. When controlling for previous levels of psychopathology, grandiose narcissism predicted higher Raven's scores indirectly, through increased variability in the number of fixations across trials. These findings suggest that grandiose narcissism predicts higher cognitive performance, at least in experimental settings, and call for further research to understand the implications of this seemingly dark trait for performance across various settings.