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Aim Methods Results Conclusion Clinical Trial Registration A new closed‐loop functional magnetic resonance imaging method called multivoxel neuroreinforcement has the potential to alleviate the subjective aversiveness of exposure‐based interventions by directly inducing phobic representations in the brain, outside of conscious awareness. The current study seeks to test this method as an intervention for specific phobia.In a randomized, double‐blind, controlled single‐university trial, individuals diagnosed with at least two (one target, one control) animal subtype‐specific phobias were randomly assigned (1:1:1) to receive one, three, or five sessions of multivoxel neuroreinforcement in which they were rewarded for implicit activation of a target animal representation. Amygdala response to phobic stimuli was assessed by study staff blind to target and control animal assignments. Pretreatment to posttreatment differences were analyzed with a two‐way repeated‐measures anova.A total of 23 participants (69.6% female) were randomized to receive one (n = 8), three (n = 7), or five (n = 7) sessions of multivoxel neuroreinforcement. Eighteen (n = 6 each group) participants were analyzed for our primary outcome. After neuroreinforcement, we observed an interaction indicating a significant decrease in amygdala response for the target phobia but not the control phobia. No adverse events or dropouts were reported as a result of the intervention.Results suggest that multivoxel neuroreinforcement can specifically reduce threat signatures in specific phobia. Consequently, this intervention may complement conventional psychotherapy approaches with a nondistressing experience for patients seeking treatment. This trial sets the stage for a larger randomized clinical trial to replicate these results and examine the effects on real‐life exposure.The now‐closed trial was prospectively registered at ClinicalTrials.gov with ID NCT03655262. [ABSTRACT FROM AUTHOR]

We aimed to use real-world data to characterize the burden of psychiatric comorbidities in young people with eating disorders (EDs) relative to peers without EDs. This retrospective cohort study used a large federated multi-national network of real-time electronic health records. Our cohort consisted of 124,575 people (14,524 people receiving their index, first-ever, ED diagnosis, compared to 110,051 peers without EDs initiating antidepressants). After 1:1 propensity score matching of the two cohorts by pre-existing demographic and clinical characteristics, we used multivariable logistic regression to compute the adjusted odds ratio (aOR) of psychiatric diagnoses arising in the year following the index event (either first ED diagnosis or first antidepressant script). Over 50% of people with EDs had prior psychiatric diagnoses in the year preceding the index EDs diagnosis, with mood disorders, generalized anxiety disorder (GAD), post-traumatic stress disorder (PTSD), specific phobia (SP), attention-deficit hyperactivity disorder (ADHD), and autism spectrum disorder (ASD) being the most common. Adjusted analyses showed higher odds for mood disorders (aOR = 1.20 [95% CI = 1.14–1.26]), GAD (aOR = 1.28 [1.21–1.35]), PTSD (aOR = 1.29 [1.18–1.40]), and SP (aOR = 1.45 [1.31–1.60]) in the EDs cohort compared to antidepressant-initiating peers without EDs, although rates of ADHD and ASD were similar in both cohorts. This large-scale real-time analysis of administrative data illustrates a high burden of co-occurring psychiatric disorders in people with EDs. [ABSTRACT FROM AUTHOR]

Background There are limited data on the risk of new-onset anxiety disorders in patients with hidradenitis suppurativa (HS). Objectives To compare the risk of new-onset anxiety disorder in patients with HS and controls, and to describe risk factors for the development of anxiety in patients with HS. Methods We carried out a retrospective cohort analysis of a US electronic health records database between 2011 and 2020. Adults newly diagnosed with HS at a dermatology or primary care visit and control participants were included. The primary outcome was a new diagnosis of generalized anxiety disorder, phobic disorders, panic disorder or unspecified anxiety. Cox proportional hazards regression was used to compare the crude risk of any anxiety disorder between groups and to assess the independent association with HS while controlling for potential demographic, clinical and healthcare-related confounders. Results Among 9597 patients with HS and 959 493 controls, the incidence rate (IR) of anxiety was 5.74 and 3.86 per 100 person-years (PY), respectively. The crude risk among all patients was 48% higher for those with HS vs. controls [hazard ratio (HR) 1.48, 95% confidence interval (CI) 1.40–1.55]. When stratified by index encounter type, patients with HS had 2.43 (95% CI 2.13–2.77) times the risk of anxiety disorder than dermatology controls and 1.46 (95%CI 1.38–1.55) times the risk than primary care controls. The adjusted HR for patients with HS vs. controls was 1.11 (95% CI 1.05–1.17) overall, 1.26 (95% CI 1.07–1.48) in the dermatology subgroup and 1.07 (95% CI 1.01–1.13) in the primary care subgroup. Risk factors for an incident anxiety diagnosis among patients with HS included depression (HR 1.69, 95% CI 1.48–1.93), female sex (HR 1.41, 95% CI 1.23–1.60), younger age (HR 0.87 per 10-year increase, 95% CI 0.84–0.90), White race, in the Medicaid insurance programme (HR 1.22, 95% CI 1.07–1.40), tobacco smoking (HR 1.16, 95% CI 1.03–1.31) and having one or more emergency department visits in the year before a HS diagnosis. Absolute IRs of anxiety disorders were highest among patients with HS who were aged 18–29 years (7.10 per 100 PY), female (6.34 per 100 PY) and White (6.79 per 100 PY). Conclusions HS is independently associated with an increased risk of anxiety disorders. An increased risk remains but is attenuated when confounders are controlled for. The relative risk may be particularly high in patients managed by dermatologists. [ABSTRACT FROM AUTHOR]

We assessed social preferences toward vertebrates, invertebrates, and plants in a biodiversity hotspot in Chile. We asked respondents (n = 662) to rank species based on their preferences and to select one subset to protect and another subset to remove. We identified four species clusters based on preferences: charismatic animals, plants, less popular animals, and animals that cause phobia/rejection. Preferences to protect were higher in the charismatic animal cluster, whereas preferences to remove were concentrated in the phobic cluster. Stakeholders with environmental occupations selected species to protect from the "less popular animals" and "animals causing phobia" clusters more often than other stakeholders, whereas society in general tended to select species from the "charismatic animals" cluster. Our results suggest that factors different from conservation priorities – like charisma – guide social preferences for biodiversity, and this needs to be considered when planning management actions. [ABSTRACT FROM AUTHOR]

Introduction: Skin barrier dysfunction is an important component of atopic dermatitis (AD) pathophysiology. Topical corticosteroids (TCSs) are the mainstay therapy, but steroid phobia is emerging due to potential side effects. We aimed to determine the short-term effect of clobetasone butyrate on patients with AD. Methods: This investigator-blinded, randomised, moisturiser-controlled study evaluated patients with stable mild-to-moderate AD. Clobetasone butyrate ointment plus aqueous cream (Aq) or Aq alone was applied on randomised sites twice daily for 6 weeks. The itch score, modified Eczema Area and Severity Index (M-EASI) and epidermal biophysical parameters were assessed at baseline and 1 h, 3 h, 2 weeks and 6 weeks after application. Results: Sixteen patients, among whom 14 (87.5%) were women and two (12.5%) were men, participated in the study. There were no significant differences in pH, transepidermal water loss (TEWL) and hydration between TCS + Aq and Aq from 1 h to 6 weeks. A non-significant trend of pH increment was observed with TCS + Aq from baseline to 6 weeks. TEWL and hydration improved at 6 weeks for both treatment arms. The difference in TEWL from baseline was significant with Aq (P=0.01). The M-EASI at 6 weeks was comparable between the two arms. TCS + Aq improved itch and erythema better than Aq (P=0.02). No cutaneous adverse effects were observed at both sites. Conclusion: Short-term application of clobetasone butyrate with Aq is safe with no significant changes in epidermal biophysical parameters while controlling the symptoms and signs of eczema faster than Aq alone. [ABSTRACT FROM AUTHOR]

Background: Nurses are increasingly demanded to achieve gold-standards of care with fewer resources. Dealing effectively with stress experienced in their daily-work-life is thus crucial. This study is based on the Demands-Resources-and-Individual-Effects (DRIVE) Nurses Model and applied the person-centred approach with a twofold objective: 1. to identify patterns of coping strategies (Problem-Focused; Seek-Advice; Self-Blame; Wishful-Thinking; Escape/Avoidance) adopted by nurses to deal with perceived stress; 2. to explore potential differences in perceived Demands (Effort), Resources (Rewards, Job-Control, Social-Support), and Psychopathological Symptoms (Anxiety, Phobic-Anxiety, Obsessive–Compulsive, Somatization, Depression, Interpersonal-Sensitivity, Hostility, Psychoticism, Paranoid-Ideation) according to the emerged patterns. Method: This cross-sectional study was reported by using the STROBE Checklist. Overall, 265 nursing professionals completed self-report measures. Non-hierarchical k-means-cluster-analysis was employed to derive patterns of coping. MANOVAs were used to test differences in Demands, Resources, and Psychopathological Symptoms according to the emerged patterns. Results: Three stable and meaningful patterns of coping were identified and labelled as Active/Solution-Oriented, Dysregulated/Emotion-focused, and Passive/Disengaged. Nurses belonging to Dysregulated/Emotion-focused group emerged to be at higher risk (higher effort/psychopathological suffering; lower resources) – followed by Passive/Disengaged group – in comparison with nurses belonging to Active/Solution-Oriented group. Conclusion: Fostering nurses' awareness of their latent coping patterns and supporting active approaches/emotional regulation strategies for stress management should represent a key goal when defining interventions promoting nurses' health within/beyond the healthcare settings. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions The real‐world effectiveness of exposure‐based therapies for youth depends on the willingness and ability of young people to tolerate confronting their fears, which can be experienced as highly aversive and create problems with treatment engagement and acceptance. Recently, neuroscientific research on the nonconscious basis of fear has been translated into novel exposure interventions that bypass conscious processing of feared stimuli and that thus do not cause phobic youth to experience distress. We present a review of these unconscious exposure interventions.A PRISMA‐based search yielded 20 controlled experiments based on three paradigms that tested if fear‐related responses could be reduced without conscious awareness in highly phobic, transition‐age youth: 14 randomized controlled trials (RCTs), 5 fMRI studies (1 was also an RCT), 4 psychophysiological studies (3 were also RCTs), and 1 ERP study. We conducted meta‐analyses of outcomes where feasible.Unconscious exposure interventions significantly (1) reduced avoidance behavior (range of Cohen's d = 0.51–0.95) and self‐reported fear (d = 0.45–1.25) during in vivo exposure to the feared situation; (2) reduced neurobiological indicators of fear (d = 0.54–0.62) and concomitant physiological arousal (d = 0.55–0.64); (3) activated neural systems supporting fear regulation more strongly than visible exposure to the same stimuli (d = 1.2–1.5); (4) activated regions supporting fear regulation that mediated the reduction of avoidance behavior (d = 0.70); (5) evoked ERPs suggesting encoding of extinction memories (d = 2.13); and (6) had these effects without inducing autonomic arousal or subjective fear.Unconscious exposure interventions significantly reduce a variety of symptomatic behaviors with mostly moderate effect sizes in transition‐age youth with specific phobias. fMRI and physiological findings establish a neurophysiological basis for this efficacy, and suggest it occurs through extinction learning. Unconscious exposure was well tolerated, entirely unassociated with drop out, and is highly scalable for clinical practice. However, a number of limitations must be addressed to assess potential clinical impacts, including combining unconscious exposure with exposure therapy to boost treatment acceptance and efficacy. [ABSTRACT FROM AUTHOR]

Trypophobia is a relatively common aversion to clusters of holes. There is no consensus yet on which emotions are involved in Trypophobia nor in its functional utility. This report investigates the role of disgust using contamination tasks in two studies, which contrast people with an aversion to trypophobic stimuli to those without. In Study 1, participants reported their emotional reactions to imagined contamination of trypophobic images. In Study 2, participants evaluated physically present trypophobic, disgust, fear, and control stimuli. The capacity of these stimuli to contaminate other objects was established using a chain of contagion task. Across both studies, contamination was present, however, only those with an aversion to trypophobic stimuli evidenced contamination on the chain of contagion task, a hallmark of disgust responding. Elevated levels were not only reported for disgust, but also alongside fear/anxiety. Participant reports suggest an underlying disease avoidance mechanism in Trypophobia, with trypophobic participants demonstrating an exaggerated response to such stimuli involving disgust and fear/anxiety, which is also seen in small animal phobia, BII, and C-OCD. Implications, particularly for treatment are discussed. [ABSTRACT FROM AUTHOR]

Background: The center of pressure (COP) excursion parameters are recognized as risk factors for the etiology and development of patellofemoral pain (PFP). The purpose of the present study measures the effect of pain exacerbation on COP excursion, and the correlation between pain intensity and COP excursion in women with PFP during single leg squat (SLS). Methods: Sixty patients with PFP participated in this cross-sectional study. The outcome measures were included pain intensity and COP excursion which evaluated in pre and post pain exacerbation during SLS. The COP parameters were evaluated during single leg squat in 60° of knee flexion. A paired t-test and MANOVA was used to compare pain intensity and COP excursion between the two conditions, respectively. Furthermore, A Pearson's correlation matrix was used to examine the relationship between pain intensity with COP excursion. Results: Statistical analysis showed that pain intensity (t = − 16.655, p < 0.001) and COP excursion (Wilks' Lambda = 0.225, p < 0.001) with medium effect size increased after PFJ loading. In addition, an excellent positive correlation was observed between increased in pain intensity and COP excursion (P < 0.001, r > 0.80). Conclusion: After PFJ loading, women with PFP presented increases in the pain intensity, COP excursions, and sway velocity. In addition, there was an association between the increase in pain intensity and COP excursions. Clinicians aiming to improve postural control of patients with PFP could use kinesio taping as a short-term intervention and balance training to improvements in postural control at medium and long-term. Furthermore, emphasizing psychological factors to reducing kinesiophobia can be useful to restoring proper movement pattern, reducing pain and improving symptoms. [ABSTRACT FROM AUTHOR]

Objective: This trial examines the efficacy of the pain neuroscience education on clinical outcomes in patients with arthroscopic rotator cuff repair. Design: A total of 36 participants undergoing arthroscopic rotator cuff repair were assigned to either the experimental group (n = 18) or control group (n = 18) in this randomized study. A 6-wk-long conventional physiotherapy programwas administered for both groups. In addition, a pain neuroscience education protocol was administered for the experimental group for a whole period of 6 wks (1 session/week, 15-60 mins per session). The primary outcomes were to compare pretreatment and posttreatment scores of the experimental versus control groups on the pain and disability. Our secondary outcomes included the comparisons of scores on the catastrophizing, anxiety, depression, kinesiophobia, and quality of life. The participants were assessed both at baseline and posttreatment. Results: The improvement in pain catastrophizing, anxiety, depression, and kinesiophobia was greater in the experimental group (P < 0.05). The improvement was similar in both groups in terms of the rest of outcome measures. Conclusions: This study showed that the pain neuroscience education improved only psychological aspects of the chronic pain in arthroscopic rotator cuff repair. Therefore, adding pain neuroscience education to the conventional program might be useful to improve pain catastrophizing, anxiety, depression, and kinesiophobia in patients with arthroscopic rotator cuff repair. [ABSTRACT FROM AUTHOR]

Objective: Specific phobia is a common anxiety disorder, but the literature on associated brain structure alterations exhibits substantial gaps. The ENIGMA Anxiety Working Group examined brain structure differences between individuals with specific phobias and healthy control subjects as well as between the animal and blood-injection-injury (BII) subtypes of specific phobia. Additionally, the authors investigated associations of brain structure with symptom severity and age (youths vs. adults). Methods: Data sets from 31 original studies were combined to create a final sample with 1,452 participants with phobia and 2,991 healthy participants (62.7% female; ages 5–90). Imaging processing and quality control were performed using established ENIGMA protocols. Subcortical volumes as well as cortical surface area and thickness were examined in a preregistered analysis. Results: Compared with the healthy control group, the phobia group showed mostly smaller subcortical volumes, mixed surface differences, and larger cortical thickness across a substantial number of regions. The phobia subgroups also showed differences, including, as hypothesized, larger medial orbitofrontal cortex thickness in BII phobia (N=182) compared with animal phobia (N=739). All findings were driven by adult participants; no significant results were observed in children and adolescents. Conclusions: Brain alterations associated with specific phobia exceeded those of other anxiety disorders in comparable analyses in extent and effect size and were not limited to reductions in brain structure. Moreover, phenomenological differences between phobia subgroups were reflected in diverging neural underpinnings, including brain areas related to fear processing and higher cognitive processes. The findings implicate brain structure alterations in specific phobia, although subcortical alterations in particular may also relate to broader internalizing psychopathology. [ABSTRACT FROM AUTHOR]

Aims: Inpatient falls among older adults are a relentless problem, and extant inpatient fall prevention research and interventions lack the older adults' perspectives and experiences of their own fall risk in the hospital. Theory‐guided research is essential in nursing, and the purpose of this paper was to describe the process of developing a theoretical framework for a phenomenological nursing study exploring older adults' lived experiences of being at risk for falling in the hospital. Method: Based on philosophical nursing underpinnings, the Health Belief Model (HBM) was selected as the theoretical model. The limitations of the model led to expansion of the model with established concepts associated with accidental falls among older adults. Results: The HBM was selected as the guiding model due to its ability to capture a broad range of perceptions of a health threat. The HBM was expanded with the concepts of embarrassment, independence, fear of falling, dignity and positivity effect. The addition of these concepts made the theoretical framework more applicable to age‐related developmental behaviours of older adult and more applicable to nursing research. Conclusion: The Expanded HBM theoretical framework may guide future nursing research to develop fall prevention interventions to decrease fall rates among hospitalized older adults. Patient or Public Contribution: No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to determine the relationship between kinesiophobia, physical activity level (PAL), and quality of life (QoL) in patients with osteoporosis (OP) and osteopenia (OPN). Materials and Methods: The study included 41 patients with OP and 41 with OPN. Kinesiophobia was assessed using the Tampa scale of Kinesiophobia, PAL using the International Physical Activity Questionnaire-Short Form, and QoL using the European Osteoporosis Federation QoL questionnaire. Results: The study was completed with 80 patients (40 patients in each group. Although there was a significant difference between the two groups in kinesiophobia (p=0.027), no significant difference was observed in terms of activity levels (p=0.103). In addition, a significant correlation was observed between kinesiophobia and PAL and all sub-parameters of QoL in patients with OP (p<0.05). A significant correlation was observed between kinesiophobia and PAL in patients with OPN (p<0.001, r=-0.544) however no significant correlation was observed between kinesiophobia and QoL (p>0.05). Conclusion: Kinesiophobia was found to be high in patients with OP and OPN, which negatively affected the PAL and QoL of patients with OP. Considering the positive effects of exercise on these patients, the evaluation and treatment of kinesiophobia have become increasingly important. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to determine the relationship between sarcopenia and fracture risk in older adults and to investigate the effects of increased fracture risk in individuals with sarcopenia on the fear of falling, fall risk, kinesiophobia, and quality of life (QOL). Materials and Methods: The study involved 132 participants. Sarcopenia risk was assessed using the SARC-F questionnaire, fracture risk with the Fracture Risk Assessment Tool, QOL with the "World Health Organization Quality of Life Scale" short form, presence of kinesiophobia with the TAMPA Kinesiophobia scale, and fall risk with the "Berg Balance scale" and "International Fall Effectiveness scale". Results: The study included 102 women (77.3%) and 30 men (23.7%). The average age of the individuals was 70.83±6.98. There was a risk of sarcopenia in 55.5% of patients, and those at risk of sarcopenia had a 33.3% risk of hip fracture and 22.2% risk of both hip and major fracture. With regard to the risk of sarcopenia, it was observed that the fall and fracture risks increased, and the QOL decreased (p-value <0.05). Fracture risk and sarcopenia risk were higher in women, increased with age, and negatively correlated with body mass index and education level (p-value <0.05). It has been observed that both fracture risk and sarcopenia risk with fracture risk increased the risk of falls, kinesiophobia, and decreased QOL (p-value <0.05). Conclusion: Appropriate treatment and early intervention of these conditions in sarcopenic individuals with isarcopenia and increased fracture risk may provide clinical benefits to reduce the risk of falls and fractures and improve QOL. [ABSTRACT FROM AUTHOR]

Although numerous technology-based assistive devices are available for use by people with intellectual disabilities, device adoption rates of are often low. The current research examined reasons for non-adoption among two samples of people with mild intellectual disabilities focusing on transportation: an area of great concern for individuals with intellectual disabilities. The influences on adoption or non-adoption of the perceived benefits of assistive devices were assessed together with the effects of device complexity, transportation self-efficacy, desire for self-determination regarding transport, technophobia, and the desire to be seen to "fit in" with wider society when wearing a device. Interviews were conducted with 44 people attending a support venue in southwest London. Outcomes to the interviews were employed in the formation of a questionnaire distributed to a wider national sample of people with mild intellectual disabilities. Interview and survey questions were created using Tourangeau's investigation method. Responses to the survey were subjected to a logistic regression analysis. Technophobia, transportation self-efficacy and desires for self-determination and to "fit-in" exerted powerful impacts on device adoption. Campaigns and activities designed to increase adoption rates need to recognise these important influences. Encouraging people with intellectual disabilities to adopt assistive technologies is highly desirable because of the latter's ability improve a person's quality of life. Government and manufacturers as well as carers have critical roles to play in securing device adoption. Training of individuals and their carers in device features and application is essential. [ABSTRACT FROM AUTHOR]

Objective: The relationship between the quality of diet and sleep, cognitive function, and fear related to coronavirus disease-2019 (COVID-19) among older adults in Turkey during the pandemic remains unclear. This study aimed to investigate the correlation between diet quality, cognitive function, sleep quality, and levels of coronaphobia in individuals aged 65 and above, to understand the impact of COVID-19. Materials and Methods: Sleep quality, diet quality, coronaphobia, and cognitive status of 72 older individuals were evaluated using the Pittsburgh sleep quality index, healthy eating index 2010, Montreal cognitive assessment scale, and coronavirus-19 phobia scale, respectively. Results: The participants had poor diet quality (54.2%), poor sleep quality (62.5%), obesity (41.7%), higher levels of coronaphobia, and cognitive impairment. There was a moderate negative relationship between sleep quality and coronaphobia and between cognitive status and coronaphobia (p=0.00); and a weak positive relationship between diet quality and cognitive status (p<0.05). However, no relationship was found between sleep quality and diet quality, and between coronaphobia and diet quality (p>0.05). Conclusion: Our study highlights the significant challenges faced by older adults during the COVID-19 pandemic, including poor nutrition quality, sleep disturbances, coronaphobia, and cognitive impairment. Our findings suggest a potential interplay between nutrition quality, sleep patterns, and cognitive function among older adults, with those experiencing coronaphobia exhibiting additional cognitive and sleep-related concerns. We advocate the implementation of targeted interventions aimed at mitigating cognitive impairment, addressing nutritional deficiencies, and improving sleep quality among older adults, irrespective of COVID-19 infection status, to enhance overall well-being during these challenging times. [ABSTRACT FROM AUTHOR]

A recent wave of academic research has highlighted the wide-ranging and negative impacts that stigma against kink has on kinksters. As scholarship continues to explore prejudice and discrimination around kink, this article argues that fresh insight can be found by drawing on adjacent work around other stigmatized sexualities. Over the previous decades, scholars in sexuality studies and queer studies have developed a powerful conceptual framework of “phobias” and “normativities” for thinking about the marginalization of sexual differences. This framework has its origins in the concepts of homophobia, heteronormativity and homonormativity, but its naming conventions and analytical insights have since been extended to address reproduction, romantic love, monogamy, gender identity, etc. This article argues that this conceptual framework should be expanded once again, this time to encompass kink. Building on the nascent use of this conceptual framework within kink scholarship, this article defines and expands on the concepts of kinkphobia and vanilla-normativity, and introduces the new concept of kink-normativity. This article demonstrates how these concepts can help us better talk about and think through the marginalization of kink. [ABSTRACT FROM AUTHOR]

Background and Purpose: Knowledge of the factors affecting pain intensity and pain sensitivity can inform treatment targets and strategies aimed at personalizing the intervention, conceivably increasing its positive impact on patients. Therefore, this study aimed to investigate the association between demographic factors (sex and age), body mass index (BMI), psychological factors (anxiety and depression, kinesiophobia and catastrophizing), self‐reported physical activity, pain phenotype (symptoms of central sensitization, and nociceptive or neuropathic pain), history of COVID‐19 and pain intensity and sensitivity in patients with chronic non‐specific low back pain (LBP). Methods: This was a cross‐sectional secondary analysis with 83 participants with chronic non‐specific LBP recruited from the community between August 2021 and April 2022. BMI, pain intensity (Visual Analog Scale), pain sensitivity at the lower back and at a distant point [pressure pain threshold], catastrophizing (Pain Catastrophizing Scale), kinesiophobia (Tampa Scale for Kinesiophobia), anxiety and depression (Hospital Anxiety and Depression Scale), pain phenotype (Central Sensitization Inventory and PainDetect Questionnaire), physical activity (International Physical Activity Questionnaire), and disability (Roland Morris Disability Questionnaire) were assessed. Multiple linear regression analyses with pain intensity and sensitivity as the dependent variables were used. Results: The model for pain intensity explained 34% of its variance (Adjusted R2 = −0.343, p < 0.001), with depression and anxiety (p = 0.008) and disability (p = 0.035) reaching statistical significance. The model for pain sensitivity at the lower back, also explained 34% of its variance (Adjusted R2 = 0.344, p < 0.001) at the lower back with sex, BMI, and kinesiophobia reaching statistical significance (p < 0.05) and 15% of the variance at a distant body site (Adjusted R2 = 0.148, p = 0.018) with sex and BMI reaching statistical significance (p < 0.05). Discussion: This study found that different factors are associated with pain intensity and pain sensitivity in individuals with LBP. Increased pain intensity was associated with higher levels of anxiety and depression and disability and increased pain sensitivity was associated with being a female, higher kinesiophobia, and lower BMI. [ABSTRACT FROM AUTHOR]

Background: Specific phobias impact over 400 million people worldwide. Digitalizing mental health could alleviate the burden. Still, although the corporate-driven Metaverse is expanding rapidly, there needs to be more momentum in harnessing virtual reality exposure therapy uptake. Objective: This study aims to conceptualize, develop, and deploy a free Virtual Reality Exposure Therapy (VRET) application specifically designed for treating acrophobia and claustrophobia. This pilot study, which holds the promise of a future where mental health is more accessible and effective, explores the feasibility of leveraging transdisciplinary collaboration among specialists to create a safe, accessible, and effective VRET solution. Methods: We conducted a Delphi heuristic approach involving bioethicists, neuroscientists, and tech developers. Second, we reviewed the existing psychological theories and therapeutic strategies for addressing phobias in VR. Third, we conceptualized a thematic analysis-derived framework for a safe, adaptive-gamified free exposure to virtual reality acrophobia and claustrophobia (SAFEvR ACT). Finally, we provide an overview of the iterative improvements made during 12 workshops and 76 weekly briefings on developmental implementations. Results: We developed the SAFEvR ACT into a proof-of-concept application freely deployed on the MentalVerse app platform. Our safety-focused approach can benefit from prevalidation perspectives within future randomized control trials. Conclusions: The resulting application derived from the SAFEvR ACT framework represents a blueprint to counter the current lack of iVR mental health uptake by offering a free VRET alternative. Future research should aim towards developing similar free platforms to lessen mental health burdens and gather quantitative data. We conclude with a call to action to researchers to fine-tune our current approach and take a stand for free digital mental health within MentalVeRse.app. [ABSTRACT FROM AUTHOR]

There exists a significant need of screening, measuring, and assessing phobic reactions to the negative effects and consequences of coronavirus disease 2019 (COVID‐19) across the world. For this purpose, the C19P‐S has b een developed and adapted to several languages and cultures including Turkish, Russian, Arabic, English, Korean, and soforth. This study aimed to adapt the scale into Japanese. Convenience sampling was used in the recruitment of the participants. The sample involved 310 Japanese‐speaking natives from different prefectures of the country (MeanAGE = 49.97; SD = 13.07). The scale is a self‐report instrument, which includes 20, 5‐point Likert‐type items. The scale assesses the levels of COVID‐19 phobia in four areas: Psychological, Somatic, Economic, and Social. The validity (content, construct, convergent, and discriminant) and reliability (internal consistency) analyses were conducted. Multivariate analysis of variance (MANOVA) was used for group comparisons. MANOVA results show that women scored statistically higher in the psychological area. Furthermore, the participants with a lower educational level scored higher than those with a higher level in the somatic area. Among other scales measuring fear and anxiety, the C19P‐S Japanese (C19P‐SJ) is the first measurement tool specifically designed and adapted for evaluating coronaphobia. It is suggested that the individuals with psychiatric diagnoses be included to measure and support the construct validity of the scale. [ABSTRACT FROM AUTHOR]

The current study adapted the Coronavirus 19 Phobia Scale into Arabic and tested the psychometric properties of the adapted version on 469 Arabic‐speaking individuals (mean age = 29.57 years old; SD = 10.39; range = 9–71 years old). After confirmatory analysis found supporting evidence for the four‐factor structure, consequent analysis on convergent and discriminant validity and reliability of the Arabic version are also supported. A 2 × 2 between‐groups factorial multivariate analysis of variance was used to investigate individual differences in coronaphobia. Results show that there is no significant interaction effect between gender and marital status, λ = 0.973, F (8,460) = 1600, p = 0.121, partial η2 = 0. 014; however, the main effect for gender is statistically significant, λ = 0.925, F (4,464) = 9.367, p < 0.001, partial η2 = 0.075, power = 1.000, where women score higher than men on all coronaphobia factors. In addition, the main effect for marital status is also significant, λ = 0.923, F (4,464) = 4.701, p < 0.001, partial η2 = 0.039, power = 0.998, where singles score higher than married couples on only two coronaphobia factors: Psychological and economic. Based on the findings, we conclude that the effects of coronaphobia have similarities across nations as well as differences unique to the Arabic populations. [ABSTRACT FROM AUTHOR]

Fear is an emotion triggered by the perception of danger and motivates safety behaviors. Within the context of the COVID-19 pandemic, there were ample danger cues (e.g., images of patients on ventilators) and a high need for people to use appropriate safety behaviors (e.g., social distancing). Given this central role of fear within the context of a pandemic, it is important to review some of the emerging findings and lessons learned during the COVID-19 pandemic and their implications for managing fear. We highlight factors that determine fear (i.e., proximity, predictability, and controllability) and review several adaptive and maladaptive consequences of fear of COVID-19 (e.g., following governmental health policies and panic buying). Finally, we provide directions for future research and make policy recommendations that can promote adequate health behaviors and limit the negative consequences of fear during pandemics. [ABSTRACT FROM AUTHOR]

Background: Nomophobia or no-mobile-phone phobia, defined as the fear of being unable to use or being unreachable via one's mobile phone. The pervasive concern has varied bio-psychosocial and clinical implications in an individual's life. Nomophobia is currently in an exploratory phase. Methods: A scoping review was conducted to systematically map the relevant evidence and literature on nomophobia. The review of scholarly literature spanning from January 2010 to May 2023 employed a narrative synthesis methodology to succinctly encapsulate the research findings. Additionally, it encompassed a meticulous examination and visual representation of studies, detailing both the frequency of investigation into specific variables and the instances in which said variables exhibited a statistically significant association with nomophobia. Results: A thorough examination of 92 studies revealed a total of 133 variables spanning demographic, lifestyle-related, academic, smartphone-related, psychosocial, and clinical domains. Notably, 42.86% of these variables have only been investigated in a single research study, underscoring the imperative for replication to enhance the generalizability, validity, and applicability of research findings. Moreover, the review identifies Nomophobia Questionnaire (NMP-Q) by Yildirim and Correia as the most widely used tool for measuring the severity of nomophobia. Conclusion: There is a crucial need for homogeneity and consistency in reporting nomophobia scores and establishing corresponding gradations indicative of functional ramifications or clinical severity of nomophobia. The findings elucidate significant research gaps in existing literature on nomophobia, hold implications for further synthesis of data, and contribute to a comprehensive understanding of nomophobia; ensuring superior diagnostic accuracy and precision, and facilitating successful delivery of targeted interventions. [ABSTRACT FROM AUTHOR]

Off-label metreleptin treatment resulted in cognitive, emotional and behavioral improvements of patients with anorexia nervosa, who presented with hypoleptinemia. We now report a case study of a 16-year-old female patient with atypical anorexia nervosa who was treated off-label with metreleptin for 11 days. She had lost 21 kg over 6 months. Her body mass index at referral for inpatient treatment was 20 kg/m2, her serum leptin level was just within the normal range (2.4 ng/ml). Dosing resulted in prominent improvements of mood and weight phobia entailing a comparatively brief inpatient treatment. The observed improvements are similar to those observed in patients with AN, suggesting overlapping mechanisms with respect to clinical effects induced by elevations of absolute or relative hypoleptinemia. Randomized controlled trials are warranted for both eating disorders. [ABSTRACT FROM AUTHOR]

Objectives: Inequities in physical health outcomes exist for people with mental health and substance use conditions and for Indigenous populations (Māori in Aotearoa New Zealand). These inequities may be partly explained by poorer quality of physical healthcare services, including discrimination at systemic and individual levels. This study investigated the experiences of people with mental health and substance use conditions accessing physical healthcare and differences in service quality for non-Māori relative to Māori. Methods: A cross-sectional online survey of people with mental health and substance use conditions in New Zealand asked about four aspects of service quality in four healthcare settings: general practice, emergency department, hospital and pharmacy. The quality domains were: treated with respect; listened to; treated unfairly due to mental health and substance use conditions; mental health and substance use condition diagnoses distracting clinicians from physical healthcare (diagnostic and treatment overshadowing). Results: Across the four health services, pharmacy was rated highest for all quality measures and emergency department lowest. Participants rated general practice services highly for being treated with respect and listened to but reported relatively high levels of overshadowing in general practice, emergency department and hospital services. Experiences of unfair treatment were more common in emergency department and hospital than general practice and pharmacy. Compared to Māori, non-Māori reported higher levels of being treated with respect and listened to in most services and were more likely to report 'never' experiencing unfair treatment and overshadowing for all health services. Conclusion: Interventions to address discrimination and poor-quality health services to people with mental health and substance use conditions should be tailored to the physical healthcare setting. More needs to be done to address institutional racism in systems that privilege non-Māori. [ABSTRACT FROM AUTHOR]

BACKGROUND: Specific stabilisation exercises (SSE) can combat the debilitating effects of chronic non-specific low back pain (CLBP), improve disability, pain and fear-avoidance beliefs (FAB). OBJECTIVE: To elicit the determinants of outcome in patients with CLBP with associated FABs after treatment with SSE. METHOD: Twenty-nine patients (20 females) with CLBP were classified using FAB questionnaire into high or low Work and Physical Activity (PA) subscales. After 4-week treatment, evaluations were done for pain, disability and lumbar spine active range of motion (AROM). Data was analysed exploratory-descriptively with a significance level set at p < 0.05. RESULTS: Participants were aged 55.24 ± 11.91 years. They scored 19 (65.5%) and 5 (17.2%) respectively on Work and PA subscales. The post-intervention evaluation showed significant differences in all outcomes, but no significant difference between patients with high or low FAB scores for both subscales. PA scores correlated significantly with pain while work scores correlated significantly with disability. Participants' gender predicted disability, pain and AROM with moderate to large effect sizes. CONCLUSION: SSE can potentially improve disability, pain and range of motion for patients with chronic low back pain regardless of FABQ status. Gender and baseline patient status are potential determinants of outcome of treatment using SSE. [ABSTRACT FROM AUTHOR]

This article explores the intersectional perspectives of parents of transgender children in Aotearoa (New Zealand). The substantial body of research on parent experiences in this area has largely focused on parents who are white North American middle-class cisgender women. We seek to extend this research by taking an intersectional approach and examining the perspectives of a group of participants of different genders, sexual orientations, and cultural backgrounds. We asked 20 participants in Aotearoa who self-identified as gender-affirming parents to draw their experience of parenting a transgender child and discuss this with us in interview. The research resulted in rich visual and verbal depictions of gender-affirming parenting, drawing from the intersectional perspectives of Māori, Pākehā, Pacific, Asian, queer, straight, female, male and non-binary parents. Using visual and verbal discourse analysis, we explore how the participants constructed their experience from their uniquely situated perspectives, both specific and multilayered. We argue that the parents' perspectives reveal both challenges and strengths, reflecting the burdens of intersectional oppression, while also fostering the parents' capacity for engaging in discursive resistance to advance their children's interests. [ABSTRACT FROM AUTHOR]

Objective: This study is part of the ODIN‐migraine (Optimization of Diagnostic Instruments in migraine) project. It is a secondary, a priori analysis of previously collected data, and aimed to assess the psychometric properties and factor structure of the Cogniphobia Scale for Headache Disorders (CS‐HD). We aimed to construct a German‐language version and a short version. Background: Cogniphobia is the fear and avoidance of cognitive exertion, which the patient believes triggers or exacerbates headache. High cogniphobia may worsen the course of a headache disorder. Methods: The 15‐item CS‐HD was translated into German and back translated in a masked form by a professional translator. Modifications were discussed and carried out in an expert panel. A cross‐sectional online survey including the CS‐HD and further self‐report questionnaires was conducted in a sample of N = 387 persons with migraine (364/387 [94.1%] female, M = 41.0 [SD = 13.0] years, migraine without aura: 152/387 [39.3%], migraine with aura: 85/387 [22.0%], and chronic migraine: 150/387 [38.8%]). Results: Exploratory factor analysis resulted in two clearly interpretable factors (interictal and ictal cogniphobia). Confirmatory factor analysis yielded an acceptable to good model fit (χ2(89) = 117.87, p = 0.022, χ2/df = 1.32, RMSEA = 0.029, SRMR = 0.055, CFI = 0.996, TLI = 0.995). Item response theory‐based analysis resulted in the selection of six items for the short form (CS‐HD‐6). Reliability was acceptable to excellent (interictal cogniphobia subscale: ω = 0.92 [CS‐HD] or ω = 0.77 [CS‐HD‐6]; ictal cogniphobia subscale: ω = 0.77 [CS‐HD] or ω = 0.73 [CS‐HD‐6]). The pattern of correlations with established questionnaires confirmed convergent validity of both the CS‐HD and the CS‐HD‐6. Conclusion: Both the CS‐HD and the CS‐HD‐6 have good psychometric properties and are suitable for the assessment of cogniphobia in migraine. Plain Language Summary: Cogniphobia is the fear of cognitive exertion, in which the patient believes effortful thinking triggers or exacerbates headache. The Cogniphobia Scale for Headache Disorders (CS‐HD) provides an assessment of this headache specific‐fear. A German version and a six‐item short form of the CS‐HD were developed from an online sample of 387 persons with migraine, and our results showed that this version was suitable. [ABSTRACT FROM AUTHOR]

Objective To investigate the influencing factors of female vaginal penetration phobia in 134 cases with unconsummated marriage' and provide empirical evidence for the sexual treatment of female vaginal penetration phobia. Methods A total of 134 women who failed to complete their marriage at a Grade III hospital in Nanjing from November 2019 to February 2023 were selected by convenience sampling method. A cross-sectional investigation was conducted using the general data questionnaire, the self-made fear factor questionnaire, the diagnostic criteria of Genito-pelvic pain/penetration disorder and the diagnostic criteria of phobias in the 5th edition of DSM-5. Results Single factor analysis showed that there were statistically significant differences in hearing others describe the pain of sexual intercourse for the first time, strict family education, bad feelings of sexual intercourse for the first time, vaginismus, painful sexual intercourse, sexual experience and sexual knowledge (P < 0.05). Analysis of binary Logistic regression demonstrated that listening to others describe the pain of first intercourse, the bad feeling of first intercourse and vaginismus were the important influencing factors for sexual intercourse fear (P < 0.05). Conclusion The fear factors of GPPPD patients cover sexual experience, sexual knowledge, vaginismus, painful intercourse, strict famiiy education, bad feeling of first intercourse, and hearing others describe the pain of first intercourse, which contributes to GPPPD occurrence. Therefore, sex therapists should focus on diferent fear risk factors, and give patients Plissit intervention model, relaxation training, cognitive behavioral therapy, systematic desensitization therapy, sexy focused training and other treatments, so as to reduce the pain of sexual intercourse, overcome the fear of sexual intercourse, enhance the intimate relationship between husband and wife, and finally achieve sexual and famiiy harmony. [ABSTRACT FROM AUTHOR]

A primary goal of rehabilitation is to produce optimal health-related quality of life outcomes, which includes returning patients to their desired level of activity. Injury-related fear, kinesiophobia, and fear-avoidance beliefs are psychological factors that negatively impact health-related quality of life and are associated with decreased levels of physical activity. Conversely, increased levels of self-efficacy have been linked to favorable rehabilitation outcomes. To promote full recovery and optimal health-related quality of life, the rehabilitation process should consider addressing self-efficacy and injury-related fear (e.g., kinesiophobia, fear-avoidance beliefs). Therefore, the purpose of this paper is to introduce a theoretical framework which integrates self-efficacy theory and the Fear-Avoidance Model to mitigate injury-related fear and optimize patient outcomes following musculoskeletal injury. The intention of this theoretical framework is to provide clinicians with psychosocial interventions to improve self-efficacy and prevent the progression of injury-related fear at varying times throughout the rehabilitation process. [ABSTRACT FROM AUTHOR]

Nonpharmacological methods are used in the management of pain and kinesiophobia following total knee arthroplasty. The aim of this double-blind randomized controlled trial was to examine the effect of foot reflexology on pain and kinesiophobia in patients following total knee arthroplasty. A total of 40 patients (20 in the control group and 20 in the intervention group) were randomly assigned to either of two groups for the study. The intervention group was exposed to foot reflexology. Postoperative Visual Analog Scale scores decreased faster in the intervention group compared to the control group (F = 80.417; p < .001; η² = 0.685). The Western Ontario and McMaster Universities Osteoarthritis Index scores decreased in the intervention group over time, while they increased in the control group (p < .05). While a gradual increase was observed in the Tampa Scale for Kinesiophobia scores in the control group, there was a decrease in the intervention group (F = 84.860; p < .001; η² = 0.696). The amount of analgesics used was lower in the intervention group (p < .05). Foot reflexology can be applied as an effective and safe method to manage pain and kinesiophobia in total knee arthroplasty patients. [ABSTRACT FROM AUTHOR]

BACKGROUND: The stress due to the COVID-19 pandemic has influenced the physical, mental, and social well-being of humans worldwide. OBJECTIVE: To evaluate the relationship between the fear of COVID-19 and mental state of female employees during the COVID-19 pandemic. METHODS: A cross-sectional study was conducted involving 726 participants. Data was collected using the Personal Information Form, fear of COVID-19 scale, and brief symptom inventory. RESULTS: The fear experienced by women during the social isolation and quarantine period was associated with depression, anxiety, somatization, obsessive-compulsive disorder, interpersonal sensitivity, hostility, phobic anxiety and paranoid experiences. CONCLUSION: Women, young people, the elderly and single individuals were most likely affected psychologically during the pandemic. Thus, interventions and psychological evaluations are recommended at an early stage to minimize this effect. Such interventions must be implemented considering the strategic planning and coordination of risk groups. [ABSTRACT FROM AUTHOR]

Introduction: Topical corticosteroid (TCS) phobia may negatively impact treatment adherence. Currently, there are few studies exploring trust and knowledge of TCS use among pharmacy staff. The objective of this work was to examine TCS knowledge and possible phobia among Danish pharmacy staff. Methods: A questionnaire, based on Topical Corticosteroid Phobia (TOPICOP©) questionnaire, was developed and rephrased to fit pharmacy staff. The questions were Likert scales and numerical rating scales (NRS) (0–10). In October/November 2021, 64 pharmacies were invited. If the pharmacies agreed to participate, a researcher visited the pharmacies and distributed the questionnaires. Results: A total of 244 pharmacy workers from 59 pharmacies participated. The majority (95.4%) responded that they were aware of side effects of TCS; however, misconceptions regarding side effects were found in up to 34% of participants. Regarding TCS use, 40% sometimes advised the patients to wait as long as possible before initiating treatment with TCS. Confidence in dispensing TCS to patients was high, with a mean of 8.45 (NRS). Conclusion: Danish pharmacy staff generally reported high confidence in TCS use. Misconceptions regarding side effects were common, and there was a tendency to giving advices on TCS treatment that may indicate low confidence in TCS. Thorough education of pharmacy staff is needed to improve the knowledge of TCS. [ABSTRACT FROM AUTHOR]

Purpose: This study investigate urban migrant dwellers' gender and age differences in response to the specific phobia of COVID-19 and hesitancy toward vaccines in the slum settlements. Design/methodology/approach: The study anchored on the two-factor model proposed by Mowrer (1939) and used a quantitative design approach with a convenience sampling method for data gathering among 362 urban migrants residing and working in the cities of Ghana. The study used the Mann–Whitney U test and the regression analysis for the analysis. Findings: The result showed that there is a significant difference between males and females in their understanding of economic phobia, thoughts on social phobia and perception level of vaccine hesitancy. Additionally, there is a significant difference between age groups in their level of thoughts of psychological phobia, economic phobia and thoughts of vaccine hesitancy. Finally, the specific of phobias of COVID-19 are significant predictors of vaccine hesitancy. Research limitations/implications: This research is slum-specific, which implies that the outcome cannot be generalized to other geographical settings. Practical implications: The study demonstrates how a pandemic manifests itself to dwellers in slums. The outcome of the study sheds light on how policymakers appreciate the dynamics of the pandemic in a developing country, which may guide future responses to pandemics. Originality/value: The outcome of the study sheds light on how policymakers appreciate the dynamics of the pandemic in a developing country, which may guide future responses to pandemics. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to measure whether admittance in the quarantine ward due to COVID-19 can affect one's mental health. Nowadays, many countries worldwide are battling with the threat of the COVID-19 contagion, and it is difficult to understand how the pandemic leaves psychological impacts on one's well-being. Design/methodology/approach: This research used qualitative and quantitative approaches to assess the psychological impacts of quarantine due to COVID-19. Population of the present study were 250 patients who were admitted in quarantine centres of Pakistan. The data analysis was conducted through univariate analysis using (ANVOVA) software. Findings: This study found that patients who were quarantined due to the COVID-19 infection displayed multiple psychological symptoms such as a lack of self-control, anxiety, low general health and vitality, depression and negative well-being. Practical implications: There is an urgency to provide psychological treatments to each afflicted person and their family members to establish a healthy community. Originality/value: This research investigates whether admittance in the quarantine ward due to COVID-19 can affect mental health in Pakistan. [ABSTRACT FROM AUTHOR]

Coronaphobia represents the fears and phobias attributed to the COVID-19 virus and pandemic. The COVID-19 Phobia Scale, previously validated as a four-factor structure, is a widely used multidimensional measure to assess coronaphobia. The current study scrutinized various competing factor structures of this instrument to identify the optimal psychometric representation of coronaphobia. Adults (N = 412) ranging in age from 19 to 84 years completed the COVID-19 Phobia Scale. Several theoretically plausible factor structures of coronaphobia were tested and compared using confirmatory factor analysis: four-factor structure, one-factor structure, higher-order factor structure, and five-factor bifactor structure. The one-factor structure showing an overarching factor of COVID-19 phobia revealed the poorest fit to the data. The five-factor bifactor structure that allowed every item to double-load on the COVID-19 general phobia factor alongside one of the COVID-19 specific phobia factors (psychological phobia, psycho-somatic phobia, economic phobia, or social phobia) produced the strongest fit indices and was superior to the widely accepted four-factor structure. The five-factor bifactor structure demonstrated multi-group measurement invariance across gender, race, age, and state urbanization. Furthermore, the general phobia factor and the psycho-somatic phobia factor from the five-factor bifactor structure uniquely predicted present moment state anxiety using structural equation modeling. This psychometric investigation underscores that coronaphobia is experienced as a general pandemic fear that is simultaneously experienced with specific domains of pandemic fears. Theoretical and methodological insights are offered for conceptualizing and measuring coronaphobia and understanding how pandemic phobias differ from traditional phobias. [ABSTRACT FROM AUTHOR]

Context: The relationship between physical activity (PA) and fear of pain with movement (ie, kinesiophobia) during concussion recovery is unknown. Kinesiophobia may limit PA, while PA after concussion may reduce kinesiophobia. Our purpose was to examine the correlation between PA and self-reported kinesiophobia during concussion recovery for adolescents with and without persistent symptoms. Design: Prospective cohort study of children ages 10–18 years within 14 days of concussion. Methods: Participants rated kinesiophobia using the Tampa Scale of Kinesiophobia (TSK) at initial (≤14 d postconcussion) and return to play (RTP) assessments, and wore activity monitors between assessments. Our primary outcome was TSK score change from initial to RTP assessments. We grouped participants based on whether they experienced persistent symptoms (symptoms ≥28 days) or not (symptoms <28 days) and calculated correlation coefficients (Pearson r for normally distributed and Spearman rho for nonnormally distributed variables) between PA variables and TSK change scores. Results: Among the 41 participants enrolled, 44% developed persistent symptoms (n = 18; age = 14.5 [2.0] y; 50% female; symptom duration = 57.3 [6.2] d; RTP = 66.8 [6.4] d) and 56% did not (n = 23; age = 14.9 [1.8] y; 48% female; symptom duration = 15.2 [1.5] d; RTP = 21.7 [1.9] d). For the persistent symptoms group, greater TSK change scores (mean = −2.5 [5.7] point change) were significantly and moderately correlated with higher daily step count (r = −.60, P =.008) and exercise frequency (r = −.63, P =.005), but were not correlated with exercise duration (ρ = −.12, P =.65). Among the no persistent symptoms group, TSK change scores (mean = −6.0 [5.0] point change) were not correlated with step count (r = −.18, P =.41) or exercise duration (ρ =.10, P =.67), and the correlation with frequency was low and not significant (r = −.34, P =.12). Conclusions: Regular PA during concussion recovery, regardless of duration or intensity, may help reduce kinesiophobia for those experiencing persistent symptoms. [ABSTRACT FROM AUTHOR]

Context: Athletes with a history of sport concussion (SC) have an increased risk of musculoskeletal injury (MSK); however, the underlying mechanisms have yet to be determined. The purpose of our study was to evaluate kinesiophobia in college athletes with or without a time-loss MSK within 180 days of unrestricted return to play following a SC. Design: This was a retrospective cohort study within a sports medicine facility. Methods: Participants were eligible if they were diagnosed with a SC, completed the Tampa Scale of Kinesiophobia (TSK), and completed an unrestricted return to play. Fifty-six college athletes (40 men and 16 women) with an average age of 19.5 (1.25) years, height of 183.5 (10.45) cm, and mass of 94.72 (24.65) kg, were included in the study. MSK participants were matched to non-MSK participants 1:1. Demographic and TSK outcome scores were compared using independent t tests. The proportion of participants in each group who scored above the clinical threshold (TSK ≥ 37) was compared using a chi-square analysis. Alpha was set at α =.05. Results: The MSK group (31.2 [6.30]) reported similar TSK scores to the matched group (28.9 [3.34]; t54 = 1.70, P =.10, d = 0.45 [ − 0.08 to 0.97]). A greater proportion of athletes who were diagnosed with an MSK-reported scores above the cutoff (χ2[1] = 6.49, P =.01). Conclusions: Athletes diagnosed with SC had similar kinesiophobia values regardless of MSK status. However, a higher proportion of athletes with a time-loss MSK injury reported a TSK score greater than the clinical cutoff. Our results suggest that factors such as kinesiophobia should be considered following a SC. [ABSTRACT FROM AUTHOR]

Context: Neuromuscular function is altered acutely following concussion and theoretically linked to the subsequent postconcussion musculoskeletal injury risk. Existing research has only examined voluntary muscle activation, limiting mechanistic understanding. Therefore, our study aimed to examine voluntary and involuntary muscle activation between college-aged, concussed individuals when symptom-free and healthy matched controls. Design: Prospective, cross-sectional cohort laboratory study. Methods: Concussed and healthy participants (n = 24; 58% male, age: 19.3 [1.1] y, mass: 70.3 [16.4] kg, height: 177.3 [12.7] cm) completed the superimposed burst (SB) neuromuscular assessment on their dominant limb within 72 hours after self-reporting asymptomatic (22.4 [20.2] d postinjury). Unnormalized and bodyweight-normalized quadriceps maximal voluntary isometric contraction torque (in newton meters), unnormalized and bodyweight-normalized electrically stimulated SB torque, pain (numeric 1–10) during SB, and the central activation ratio (in percentage) were assessed via the SB. Parametric and nonparametric analyses, 95% confidence intervals (95% CIs), and Hedges g (parametric) and Spearman ρ (nonparametric) effect sizes were used to examine group differences (α =.05). Results: The maximal voluntary isometric contraction torque (concussed: 635.60 N·m [300.93] vs control: 556.27 N·m [182.46]; 95% CI, −131.36 to 290.02; P =.443; d = 0.33), SB torque (concussed: 203.22 N·m [97.17], control: 262.85 N·m [159.07]; 95% CI, −171.22 to 51.97; P =.280; d = −0.47), and central activation ratio (concussed: 72.16% [17.16], control: 70.09% [12.63]; 95% CI, −10.68 to 14.83; P =.740; d = 0.14) did not differ between the concussed and control groups regardless of bodyweight normalization (P ≥.344). Pain during the SB was significantly higher with a medium effect for participants with a concussion versus healthy controls (concussed: median = 7, control: median = 5; P =.046; ρ = −0.42). Discussion: These findings suggest concussed participants do not have statistically altered voluntary or involuntary quadricep neuromuscular function once asymptomatic compared with controls. Therefore, the elevated postconcussion musculoskeletal injury risk may not be attributed to lower-extremity muscle activation. Concussed participants displayed greater pain perception during the SB, which suggests somatosensory or perception changes requiring further examination. [ABSTRACT FROM AUTHOR]

Context: To determine (1) whether physical function and fear of movement are prospectively associated with the risk of females developing patellofemoral pain (PFP) and (2) whether they change following development of PFP. Design: Prospective observational study. Methods: A total of 114 asymptomatic females (18–22 y old) completed assessment of physical function (forward step-down test and single-leg hop for distance) and fear of movement using the Tampa Scale for Kinesiophobia at baseline and 2-year follow-up. Presence of symptoms of PFP was monitored bimonthly. Results: Ninety participants (retention rate = 79%) completed the 2-year follow-up assessment, with 27 (24% of the cohort) developing PFP. Physical function, including forward step-down test (P =.659) and single-leg hop for distance (P =.825), and fear of movement (P =.479) were not associated with the risk of developing PFP. Females who developed PFP presented with reduced forward step-down repetitions (mean difference = 2.8; 95% confidence interval, 0.2 to 5.3) and single-leg hop for distance (10.2; 95% confidence interval, 2.7 to 17.7 cm) at 2-year follow-up. There was no statistically significant difference between those who did and did not develop PFP for fear of movement (−3.4; 95% confidence interval, −7.0 to 0.2). Conclusions: Physical function and fear of movement were not associated with the risk of developing PFP in young females. However, the change over time in the step-down and single-leg hop for distance tests may suggest that, even in the early stages of PFP, young females present impaired physical function compared with females who did not develop symptoms. Fear of movement may develop due to persistent PFP, and does not appear to be a risk factor or key feature in females with PFP of short symptoms duration. [ABSTRACT FROM AUTHOR]

The relationship between inflammatory dietary patterns and the risk of depression/anxiety has not been clearly established due to differences in study populations, geographic regions, sex, and methods of calculating the inflammatory index. We drew upon a prospective cohort in the UK Biobank and calculated the energy-adjusted dietary inflammatory index (E -DII). The follow-up time was defined from the date of completing the last dietary survey questionnaire to the date of diagnosis of depression, anxiety, phobic anxiety, other types of anxiety, death, loss to follow-up, or the respective censoring dates for England (September 30, 2021), Scotland (July 31, 2021), and Wales (February 28, 2018). The final follow-up times end on September 30, 2021, July 31, 2021, and February 28, 2018, for England, Scotland, and Wales, respectively. During the follow-up process, if a participant develops the condition, dies, or is lost to follow-up, the follow-up is terminated. We used Cox regression to evaluate the connection between E -DII and depression/anxiety. We employed restricted cubic spline curves for nonlinear relationships. We also conducted mediation analyses to explore whether biological age mediated the relationship between E -DII and depression. Additionally, we investigated whether genetic susceptibility modified the relationship between E-DII and depression through interaction modeling. In the final analysis, we included a total of 151,295, 159,695, 165,649, and 160,097 participants for the analysis of depression, all types of anxiety, specific phobia anxiety, and other types of anxiety, respectively. For every one-unit increase in E -DII, the risk of experiencing depression and anxiety increased by 5 % and 4 %, respectively. We identified a "J"-shaped nonlinear relationship (P for nonlinear = 0.003) for both depression and anxiety. A significant association with an elevated risk of depression was observed when E -DII exceeded 0.440, and an increased risk of anxiety was noted when E-DII was more than −0.196. Mediation analysis demonstrated that PhenoAge age acceleration (AA) (For depression, proportion of mediation = 9.6 %; For anxiety, proportion of mediation = 10.1 %) and Klemera-Doubal method Biological Age (KDM AA) (For depression, proportion of mediation = 2.9 %; For anxiety, proportion of mediation = 5.1 %) acted as mediators between E -DII and the development of depression and anxiety (P < 0.05). Diets with pro-inflammatory characteristics are associated with a heightened risk of depression and anxiety. Furthermore, the association of pro-inflammatory diets and depression is mediated by biological age. • Survival analysis with dose-response examined diet's link to depression/anxiety. • Investigating how biological aging mediates inflammation-related diet's impact on depression and anxiety. • Further studies were conducted based on the genetic susceptibility of the participants. • An analysis based on data from a large cohort. [ABSTRACT FROM AUTHOR]

Background: Patients presenting with dental pain are common in general practice, despite dental infections being most appropriately managed with dental treatment to address the cause of the infection. Although antibiotics are not appropriate for the management of localised toothache without signs of systemic spread, general practitioners (GPs) often prescribe antibiotics and analgesics for the management of dental pain. The aim of this study was to explore GPs' perceptions and management of dental presentations in Australia. Methods: Twelve semi-structured interviews were conducted with GPs across Victoria, Australia, between October 2022 and January 2023. Data were thematically analysed. Results: The study found that dental pain was the most common presenting complaint for patients attending general practice with a dental problem. Five major themes were identified in this study: knowledge, beliefs about capabilities, emotion, environmental context and resources, and social influences/social professional role and identity. In terms of knowledge and capabilities, GPs would advise patients to seek dental care, as they are aware that antibiotics would not resolve the underlying issue. Challenges for GPs included limited training in oral and dental treatment, as well as emotions, such as patient anxiety and phobia resulting in patients seeking dental care through a GP rather than a dentist. Barriers due to the context, such as access to dental care, long waiting lists within the public dental system and cost, were some of the reasons patients present to general practice rather than a seeing a dentist. Furthermore, issues that influenced GPs' antibiotic prescribing included patients' expectations for antibiotics to treat their dental pain, as well as dentists advising their patients to attend their GP for antibiotics prior to dental treatment. Conclusions: This study identified factors that influenced GPs' management of patients with dental conditions. To address these issues, it is imperative to develop interventions addressing patients' knowledge around oral health, as well as providing improved access to dental care for these patients. Patients with dental pain often seek treatment from general practitioners (GPs), even though the problem often requires dental treatment rather than antibiotics and/or pain relief medications. This study looked at GPs' management of patients with dental problems, and identified barriers as to why patients would see a GP instead of a dentist. Understanding these reasons will help develop interventions to better educate patients in oral health, and provide better access to dental care to patients with oral conditions. [ABSTRACT FROM AUTHOR]

Fears and phobias are a common mental health concern for youth, and particularly for autistic youth. The following review briefly summarizes the extant literature on specific phobias and specific phobias in autistic youth. The evidence base is briefly highlighted pointing to the strong base behind behavioral and cognitive-behavioral treatments and techniques. A broad discussion of key evidence-based treatment findings is presented, leading up to the impactful work of Thomas H. Ollendick in researching Öst's One-Session Treatment (OST) with children and adolescents. OST for child specific phobias is discussed, and particular emphasis is given to this treatment's ongoing adaptation for use with youth on the autism spectrum. [ABSTRACT FROM AUTHOR]

Chronic traumatic neck pain has a high prevalence of post-traumatic stress symptoms (PTSS). However, whether PTSS moderates treatment effects is unknown. This study investigated: 1) whether PTSS was associated with patient-reported outcomes and clinical test results at baseline; 2) whether PTSS moderated the effect of a multimodal physiotherapy intervention of exercise therapy and patient education; and 3) whether adherence to the intervention differed across PTSS groups. Secondary data analysis from a randomized controlled trial on chronic neck pain with 12-month follow-up was conducted. Patients were divided into three groups (NT = non-traumatic, LT = traumatic low PTSS, HT = traumatic high PTSS) based on self-reported onset of pain and the Impact of Event Scale. The baseline data were used to analyze the association of PTSS with patient demographics and scores of physical and mental health-related quality of life, depression, neck-related disability, kinesiophobia, and clinical tests. Baseline, 4-month and 12-month follow-up data were analyzed to investigate possible moderating effects on outcomes. Data on adherence were collected at four months. 115 participants were included (NT n = 45; LT n = 46; HT n = 24). The HT group reported lower mental health scores and more depressive symptoms at baseline. PTSS did not significantly moderate the treatment effect on any outcomes. The HT group tended to have lower adherence to the multimodal physiotherapy intervention than the LT group. For patients with traumatic neck pain, high levels of PTSS are associated with poorer psychological outcomes but do not affect the outcomes of multimodal physiotherapy intervention. [ABSTRACT FROM AUTHOR]

We conducted a systematic review with meta-analysis to examine the short- and long-term effects of virtual reality training (VRT) on pain, range of motion (RoM), kinesiophobia and perceived function in patients with chronic neck pain (CNP). We searched the PubMed, Scopus, and PEDro databases for studies assessing effect of VRT against conventional therapy in CNP patients. Separate analyzes were performed for short-term (immediately after the intervention) and long-term (at follow-up) outcomes. Risk of bias was assessed with PEDro scale and the quality of evidence was assessed according to GRADE guidelines. We found 11 studies, 8 of which were eligible for meta-analysis. Most studies had good methodological quality (6–8 points on the PEDro scale). The analysis showed significant differences in favour of VRT for neck disability index (long-term), kinesiophobia (long-term), and neck flexion RoM (short-term). No significant differences were found for pain intensity in the short- and long-term assessments. Heterogeneity between effect sizes was high in most analyzes, and the quality of evidence was low. Low quality evidence suggests that VRT may contribute to long-term improvements in perceived function and kinesiophobia in CNP patients compared with conventional training programs. However, VRT and conventional training programs have similar effects on overall neck RoM and pain intensity. [ABSTRACT FROM AUTHOR]

Nomophobia, often known as a 21st-century disorder, is a recent condition that has received considerable attention, with numerous studies conducted to better understand it since it was first introduced in 2008. To better understand the present research status and prospects to assist practitioners, policymakers, and funding agencies in protecting the population from nomophobia-related harm, a bibliometric study of nomophobia-related publications was conducted. We used Scopus and dimensions.ai to perform a search between 2008 and 2022. The HistCite, R software, and VOSviewer were used to analyze the data and extract relevant keywords indexed in medical databases using mesh heading phrases. Between January 2008 and April 2022, 1,781 papers, 30 datasets, two grants, six patents, four clinical trials, and five policy documents were identified. The bulk of the articles included in this review were published after 2017 with the majority written in English. Most of the research focuses on determining the prevalence of nomophobia in various populational groups, such as students, clinical samples, and the general adult population. Several studies examined the possible association between nomophobia symptoms and other psychiatric or physical health issues, such as changes in sleep, learning and attention, academic performance, coping strategies, etc. The current body of research knowledge of nomophobia in the main includes epidemiologic and diagnostic effort that has provided mixed results regarding its assessment and prevalence rates, and appreciable data on its treatment and prevention are lacking. [ABSTRACT FROM AUTHOR]

Due to its impact on mental health and well‐being, fear of happiness is beginning to receive more attention in research. This study, conducted in Hungary, explored the relationship between fear of happiness, perfectionism, loneliness, hopelessness, and academic burnout. Participants aged between 18 and 35 years (N = 1,148, M = 22 years, SD = 4.5) completed an online questionnaire that included self‐report measures of these constructs. In the present study, males showed higher levels of fear of happiness and perfectionism than did females. Analyses also revealed that both adaptive and maladaptive perfectionism, academic burnout, loneliness, and hopelessness were positively related to fear of happiness. In multiple regression analysis, gender had a positive and age had a negative role in the levels of fear of happiness. Maladaptive perfectionism, academic burnout, loneliness, and hopelessness were positive predictors, while adaptive perfectionism almost reached statistical significance. These findings highlight the predictive role of previously unexplored variables in fear of happiness. [ABSTRACT FROM AUTHOR]

Insomnia as a disorder on its own or as a symptom of other mental disorders can lead to significant distress and lower quality of life. By exacerbating negative affect and emotion dysregulation, poor sleep and insomnia can contribute to the initiation and maintenance of mental disorders. The aim of this cross-sectional study was to investigate the relationship between insomnia severity and overall psychiatric symptoms (anxiety, depression, obsessive-compulsive symptoms, somatization, phobic anxiety, hostility, interpersonal sensitivity, paranoid ideation, and psychoticism), and the mediational roles of worry and rumination in this relationship. The data was collected from a community sample of 1444 participants (females 69.39%, Mage = 27.95, SD = 9.37) who completed self-report measures of insomnia severity, worry, rumination, and psychiatric symptoms. The mediational roles of worry and rumination were tested with mediation analysis using the PROCESS Macro. It was found that insomnia severity (β = 0.20, p <.001) significantly predicted psychiatric symptoms directly and via worry and rumination (β = 0.33, p <.001), meaning that worry and rumination partially mediated the relationship between insomnia severity and psychiatric symptoms. The findings were similar after controlling for smoking status, daily screen time, coffee consumption in the evening, weekly exercise frequency, and pre-sleep screen time. Interventions targeting the reduction of insomnia severity and maladaptive emotion regulation strategies (e.g., worry and rumination), as well as the enhancement of adaptive emotion regulation strategies (e.g., positive refocusing and mindfulness), may alleviate the adverse effects of insomnia on psychiatric symptoms. [ABSTRACT FROM AUTHOR]