Frontiers in Psychology

Background: Sports betting is one of the most popular, rapidly evolving, and attractive forms of gambling. It is associated with an increased risk of gambling-related harms, including relationship difficulties, crime, and physical and mental health problems. Understanding the subjective experiences of sports betting is essential for accurately defining problematic betting and avoiding the overpathologization of the behavior. Hence, this study explored the perceptions and experiences of young men involved in sports betting in Addis Ababa, Ethiopia. Methods: We employed a qualitative study design using a phenomenological approach. In-depth interviews were conducted with thirteen purposively selected participants in Addis Ababa. Participants were adults aged 18 years or older who had engaged in sports betting within the past 12 months. They were recruited from sports betting houses. All interviews were transcribed verbatim and translated into English. The data were imported into OpenCode software and analyzed using reflexive thematic analysis, in which themes were actively generated through an iterative and interpretative process by the research team. Findings: The data resulted in five major themes: reasons for engagement in sports betting, unique and attractive features of sports betting, experiences of problematic betting, subjective harms of sports betting, and coping and recovery. Young men engaged in sports betting for financial gain, peer influence, and as a way of spending time and coping with boredom. Participants described several features that made sports betting particularly appealing, including ease of access, the ability to bet with small amounts of money, reduced interpersonal confrontation, opportunities to gamble on football, the chance to test sporting knowledge, diverse betting options, and frequent rewards and reinforcement. Experiences suggestive of problematic betting included preoccupation and extensive planning, successive betting and increased risk-taking after losses, unsuccessful attempts to quit, concealment of betting behavior, social and occupational impairment, and negative emotional experiences. Conclusion: Sports betting emerged in participants' accounts as a growing behavioral practice among young men in Addis Ababa, Ethiopia, raising concerns about gambling-related harms. While often initiated as a leisure activity, participants' narratives suggested patterns that extended beyond casual engagement and shared features commonly associated with problematic gambling. Future studies should include women and employ large-scale quantitative designs to examine the population burden and distribution of sports betting-related harms and to inform appropriate prevention and intervention strategies.

Background: Psychological health is an important aspect of health and well-being among adults with irritable bowel syndrome, yet the interrelationships among individual vulnerabilities, social experiences, perceived stress, and psychological health outcomes remain poorly understood. Objective: To characterize psychological health and examine direct and indirect associations of childhood adversity and adult attention-deficit/hyperactivity disorder-related symptoms within an adapted Stress Process Model. Design: Cross-sectional secondary analysis. Setting: The United States All of Us Research Program. Participants: 2,417 adults with electronic health record-documented irritable bowel syndrome and complete data on the primary analysis variables and covariates. Methods: Separate structural equation models examined childhood adversity and adult attention-deficit/hyperactivity disorder-related symptoms in relation to perceived stress, anxiety and depressive symptoms, and positive psychological well-being, with loneliness and perceived social support as psychosocial pathways. Models adjusted for sociodemographic and social-context factors. Results: The median age was 54.39 years; 80.7% were female and 84.4% were White. Moderate-to-high perceived stress was reported by 56.2%, at least moderate anxiety symptoms by 21.0%, and at least moderate depressive symptoms by 24.3%. Higher ACE-8 scores were associated with greater perceived stress, anxiety symptoms, and depressive symptoms and lower psychological well-being ({beta} = 0.063, 0.089, 0.116, and -0.100, respectively); corresponding associations for higher ASRS-6 scores were {beta} = 0.299, 0.355, 0.390, and -0.260. Loneliness-specific indirect associations were positive for perceived stress, anxiety, and depressive symptoms (ACE-8: {beta} = 0.023-0.034; ASRS-6: {beta} = 0.043-0.075) and negative for psychological well-being (ACE-8: {beta} = -0.039; ASRS-6: {beta} = -0.089; all p < .001). Social support-specific indirect associations were not significant in the ACE-8 model and were small and significant only for anxiety and depression in the ASRS-6 model ({beta} = 0.003-0.004). Conclusions: Psychological health among adults with irritable bowel syndrome was associated with interconnected individual and social factors within an adapted Stress Process Model. Childhood adversity and adult attention-deficit/hyperactivity disorder-related symptoms showed direct and indirect associations with psychological health, with loneliness emerging as the most consistent social factor. These findings support prospective investigation of individual vulnerabilities and social experiences in psychological health. The cross-sectional design does not establish temporal ordering or causal mediation.

Interest in mentoring remains widespread within the scientific community, as mentorship is considered crucial to developing the scientific workforce. A longstanding focus on the positive aspects of mentorship obscures the reality that some mentoring relationships may be ineffective, counterproductive, or harmful. Progress has been limited by the absence of a scale capable of measuring both the positive and negative mentoring experiences of doctoral students. We addressed this need by developing a new scale: the Mentoring Experiences in Research and Graduate Education (MERGE). Results of three sequential multi-method studies (total N = 1,308) provide evidence for: (a) the content and response process validity of the MERGE; (b) a six-factor structure capturing the range of mentoring experiences; (c) negative mentoring experiences as empirically distinct from the absence of positive mentoring; (d) convergent, discriminant and criterion-related validity of the MERGE, with each factor demonstrating unique patterns of association with outcomes; and (e) the incremental validity of the MERGE in predicting outcomes beyond an existing measure of mentoring competence. We conclude by discussing implications for the use of the scale in doctoral education, including both theory advancement and applied practice.

Background: Childhood trauma is a well-established risk factor for adverse mental health outcomes, yet large-scale cross-national evidence from the Arab region remains limited. This study examined the prevalence of childhood trauma and its associations with multiple transdiagnostic outcomes across 17 Arab countries. Methods: A cross-sectional online survey was conducted between September and October 2025 among 6,181 adults from 17 Arab countries. Childhood trauma was assessed using the Childhood Trauma Questionnaire-Short Form (CTQ-SF). Transdiagnostic mental health outcomes included depression, anxiety, posttraumatic stress symptoms (PTSS), maladaptive behavior, and social/functional impairment. Descriptive statistics, Pearson correlations, and multiple linear regression analyses were performed via IBM SPSS Statistics. Confirmatory factor analysis and structural equation modeling were conducted via R (Lavaan) to evaluate a second-order latent construct representing global childhood trauma. Results: Childhood trauma was widely reported across the sample, with physical neglect and emotional neglect emerging as the most frequently endorsed domains. All trauma domains were significantly associated with poorer mental health outcomes (p < .001). In regression analyses adjusted for demographic factors, emotional abuse emerged as the strongest predictor of depression ({beta} = .472, p < .001) and PTSS ({beta} =.439, p < .001). Structural equation modeling supported a second-order global trauma construct, which showed strong associations with depression ({beta} = .70), anxiety ({beta} = .64), PTSS ({beta} = .68), maladaptive behavior ({beta} = .68), and social impairment ({beta} = .67). This latent factor showed strong associations with all mental health outcomes, explaining substantial variance in depression (R2 = .52), anxiety (R2 = .43), and PTSS (R2 = .48). The structural model demonstrated borderline-to-acceptable fit (CFI = .899, TLI = .890, RMSEA = .058, SRMR = .085), supporting the hypothesized latent structure while indicating scope for further model refinement. Conclusions: Childhood trauma is highly prevalent across the Arab region and is strongly associated with multiple dimensions of psychological distress, highlighting the urgent need for trauma-informed prevention, screening, and early intervention programs in the Arab region.

Free recall of naturalistic stimuli, such as films and stories, reveals what people remember and how they organize it. Scoring such recall requires matching each recalled utterance to the encoded stimulus, and doing this manually often makes large studies impractical. Existing automated methods mostly return similarity or aggregate scores rather than explicit matches between recalled and stimulus content. Here we introduce an open-source, model-agnostic pipeline that uses a large language model (LLM) to divide the stimulus and the recall into information units and to match units between the two texts. The output is a table of unit-to-unit matches with accuracy labels, from which standard analysis scripts compute recall measures. We validated the pipeline with four LLMs (Claude Sonnet 4.5, GPT 5.4, Gemini 2.5 Pro, and Gemini 2.5 Flash) on three datasets. On typed recall of four short stories, agreement between each model and two trained raters ({phi} = .73-.79) was close to the agreement between the raters themselves ({phi} = .77). A second run reproduced each model's matches ({phi} = .91-.97) more closely than the raters agreed with each other. On spoken recall of 10 films, every model attributed recall to the correct film with high agreement. On uncorrected speech-to-text recall of a television episode, agreement varied more across models. The median cost was under $1 per participant for every model. These results suggest that the pipeline can serve as a reliable, low-cost alternative to manual scoring of free recall.

Music is a central component of psychedelic settings, yet little experimental work has examined how psilocybin and musical composition influence music-evoked emotional responses in healthy volunteers. This exploratory, double-blind, placebo-controlled study assessed these effects during the plateau phase of psilocybin and the corresponding time window in placebo sessions following oral administration of psilocybin (0.26 mg/kg) or placebo. The study consisted of two parts. In Part 1 (n = 19), a pilot stage, the first half of participants rated music-induced affective valence for eight compositions representing different genres/subgenres (Rock/Punk, Metal/Industrial Metal, Metal/Industrial Metal, Classical/Baroque, Electronic/Dub, Folk/Nordic Folk, Electronic/Techno, Electronic/Trance, Electronic/Psytrance) using a visual analogue scale (VAS). Based on Part 1, the classical composition with the highest overall affective valence and the psytrance composition with the largest psilocybin-placebo contrast (i.e., the composition most responsive to psilocybin) were selected for Part 2 (n = 17), in which the second half of participants assessed emotional responses to music using the Geneva Emotional Music Scale (GEMS-9). Psilocybin increased wonder, transcendence, and joyful activation across both contrasting compositions. Relative to each other, the classical composition elicited greater peacefulness, tenderness, and nostalgia, whereas the psytrance composition elicited greater tension across both psilocybin and placebo conditions. A composition x condition interaction was observed for sadness: under psilocybin, sadness increased during the classical composition and decreased during the psytrance composition. These findings suggest that psilocybin and contrasting musical compositions independently influence different aspects of music-evoked emotional responses, with limited interaction effects, and point to potential implications for protocol design and music selection in psychedelic settings.

Neuromarketing mainly seeks to enhance the prediction of marketing stimuli success, such as commercials and movie trailers, by integrating neurophysiological measures with traditional behavioral measures. In the current study, the authors tested whether neural activity could predict consumer valuation and how preferences change after watching commercials, both immediately and over time. Participants (n=161) watched images of products followed by commercials advertising those products while their neural activity was recorded using electroencephalograph (EEG). They watched the product images again a week later without EEG recordings. Immediately after each stimulus exposure, participants stated their willingness to pay (WTP) for the product and how much they liked the commercial. Standard EEG measures showed weak and inconsistent relationships with behavior and yielded near-chance predictions. In contrast, deep learning models applied to the raw neural data achieved substantially higher predictive accuracy, successfully predicting both immediate and delayed WTP and ad liking. Importantly, the authors were able to successfully predict preferences for new participants and/or new products the models were not trained on. However, accuracy declined as generalization demands increased. Moreover, prediction performance declined as value differences narrow. Together, these findings show that neural responses carry reliable and temporally persistent information about consumer valuation and its evolution over time.

Numerous studies have been conducted to investigate touch on the hand and forearm, but less is known about the rest of the body, particularly the torso and breasts, which play an important role in affective touch. We conducted psychophysical tests on three skin sites on the torso: upper breast, nipple-areola complex (NAC), and under the breast, as well as on two control sites: palm and forearm. We studied touch pleasantness and intensity by applying gentle caress-like strokes using a soft brush, and measured temperature and tactile detection thresholds. The results show an inverted U-shaped relationship for pleasantness over increasing stroking velocity for all skin sites, although we found some differences between sites, particularly at 30 cm.s-1, where participants found stroking on the NAC to be more intense and women additionally found it to be less pleasant. For temperature detection, we found that the NAC was more sensitive in men. For tactile detection, we mainly observed that the areola was far less sensitive than the other areas. Together, these results provide insights into tactile perception in the torso on a fundamental level, which can be applied to understanding how to regain sensations after mastectomy.

Musical aesthetic experience can reveal students' cognitive, aesthetic, and emotional responses to music. However, how professional vocal training alters brain functions in female college students with varying levels of musicianship to promote these is unknown. Here we applied fMRI, psychological measures and Goldsmiths musical sophistication index (Gold-MSI) assessments to study 27 non-music major female college students consisting of instrument group (normal pitch accuracy with instrumental training), general group (normal pitch accuracy without instrumental training) and poor-pitch group (poor pitch accuracy and without instrumental training). After 1 year of one-on-one instructional practice, we found that professional vocal training enhanced information processing related to musical cognition and pleasure during musical aesthetic experiences across all three groups, involving improvements in motor control of vocalization, auditory feedback processing, musical memory and attention together with musical pleasure. Specifically, instrument group showed activation of reward circuits, general group exhibited activation of laryngeal motor control circuits, and poor-pitch group displayed activation of sensory/sensorimotor/motor control circuits. Both pre- and post-training, the instrument group exhibited higher connectivity than the other two groups in the left amygdala-dorsal anterior cingulate cortex (dACC) and the right posterior superior temporal gyrus (pSTG)-left insula pathway. After professional vocal training, the general group showed higher connectivity in the left amygdala-dACC, whereas the poor-pitch group demonstrated increased connectivity in the right pSTG-left insula and dACC-nucleus accumbens pathways. Surprisingly, professional vocal training activated the bed nucleus of the stria terminalis (BNST), a subcortical emotion center, and connectivity with the medial prefrontal cortex associated with musical information processing. Thus, vocal training can significantly improve musical cognition and aesthetic pleasure, and facilitates neural modulation in the brain's emotional centers.

Making choices about whether and when to engage cognitive effort is a common feature of human everyday experience with important consequences for academic, career, and health outcomes. Yet, despite its importance, little is understood about the neurochemical mechanisms that underlie individual differences in the willingness to engage in cognitively effortful activities. To examine this question, we employed a multi-modal neuroimaging approach in which participants performed the Cognitive Effort Discounting paradigm (Cog-ED) while simultaneous PET-fMRI was acquired. We assessed both individual differences in dopamine-D2 receptor availability and brain activity during decision-making. In addition, the same participants performed a parametric working memory task (N-Back) and reported the cognitive effort associated with their daily life activities through a seven-day Ecological Momentary Assessment (EMA) protocol. The findings suggest a central role for caudate dopamine-D2 receptors in modulating cognitive effort-related motivation. People with higher caudate dopamine-D2 receptor availability had better working memory function, heightened sensitivity to effort costs, and greater modulation of brain activity during effort valuation. These laboratory findings also translated directly to daily life: higher levels of caudate dopamine-D2 receptors were associated with greater engagement in cognitively effortful activities. Together, the results suggest that how individuals determine the motivational value of cognitively effortful activities strongly depends on the dopamine system.

Objective: Mindfulness is a robust predictor of mental health, yet the psychometric properties of the short-form Five Facet Mindfulness Questionnaire (FFMQ-15) have not been examined in Iranian populations. This study evaluated the psychometric properties, factor structure, and diagnostic utility of the FFMQ-15 among medical sciences students. Participants: A total of 348 students (178 females, 170 males) from Kermanshah University of Medical Sciences participated. Methods: Participants completed the FFMQ-15, Penn State Worry Questionnaire (PSWQ), Difficulties in Emotion Regulation Scale (DERS), and Emotion Regulation Questionnaire (ERQ). Data were analyzed using exploratory and confirmatory factor analyses, composite reliability, and ROC curve analysis. Results: Both EFA and CFA supported the five-factor model, revealing a culturally unique item loading pattern. The FFMQ-15 demonstrated strong convergent and discriminant validity. ROC analysis indicated acceptable diagnostic accuracy for distinguishing high- and low-worry groups (AUC = 0.72, 95% CI: 0.66-0.78). Conclusions: The FFMQ-15 demonstrated acceptable psychometric properties in Iranian medical students. The non-reactivity facet exhibited cultural variability, suggesting that cross-cultural adaptation is essential. The instrument shows promise for screening in high-stress educational settings.

Motor imagery and overt action are proposed to share common planning mechanisms while relying on distinct processes during movement performance. To investigate how repetition affects physical and imagined movements, participants physically or mentally drew paths while avoiding barriers. The barrier orientations were either repeated or different across consecutive trials, and the modality (execution or imagery) of the trials either changed or remained the same for two consecutive trials. Reaction time and movement time were analysed as measures of movement planning and task performance, respectively. Imagined movements produced longer reaction times and movement times than physical movements. Repetition of orientation reduced reaction times in both physical and imagined trials, indicating that trajectory repetition facilitated movement preparation. In contrast, previous trial type influenced reaction times only for physical movements, which were only initiated faster when preceded by another physical trial. Different effects emerged for movement time. Physical movements were faster when the same trajectory was repeated no matter the previous trial type, whereas imagined movements were unaffected by orientation and instead showed shorter durations when preceded by another imagined trial. The findings indicate that physical and imagined movements rely on more similar trajectory representations during the planning stage, but diverge during task performance. While physical movements appear to benefit from the persistence of previously generated movement trajectories, imagined trials seems more influenced by modality-specific cognitive processes. These results provide behavioural support for the Motor-Cognitive model and contribute to understanding how movement repetition influences overt and imagined actions.

Background Tobacco use during adolescence is an important public-health concern because early initiation increases the likelihood of continued tobacco use and dependence. This study assessed the prevalence of tobacco smoking and factors associated with ever smoking among high school students in Harar town, eastern Ethiopia. Methods A school-based cross-sectional study was conducted among 467 students in grades 9-12 from selected public and private high schools in Harar town. Data were collected using a self-administered questionnaire adapted from the Global Youth Tobacco Survey. Descriptive statistics and binary logistic regression were used. Variables were entered into a multivariable logistic regression model based on the prespecified analytical approach, and adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were estimated. Statistical significance was declared at p<0.05. Results Among 467 students, 64 (13.7%; 95% CI 10.9-17.1%) reported ever smoking tobacco, while 25 (5.4%; 95% CI 3.7-7.8%) were current smokers. In the SPSS multivariable logistic regression model, grade 11 (AOR 10.61, 95% CI 3.52-31.97) and grade 12 (AOR 12.18, 95% CI 3.95-37.53), alcohol drinking (AOR 2.60, 95% CI 1.25-5.40), khat chewing (AOR 9.57, 95% CI 4.04-22.65), and access to tobacco (AOR 3.18, 95% CI 1.58-6.43) were independently associated with ever smoking. Male sex, age [&ge;]18 years, and grade 10 were not statistically significant in the adjusted model. Conclusion Ever smoking was reported by approximately one in seven students and current smoking by about one in twenty. Alcohol drinking, khat chewing, access to tobacco, and higher grade were independently associated with ever smoking. School- and community-based tobacco prevention should address substance use and the availability of tobacco products around schools.

Objective: Women with premenstrual syndrome (PMS) experience affective lability, irritability, depressed mood, and anxiety during the late luteal phase of the menstrual cycle. Stress reactivity may contribute to the development of these symptoms, yet neural correlates remain unexplored. We examined neural, behavioral and endocrine stress responses across menstrual cycle phases in women with and without PMS. Methods: 26 women with PMS and 24 women without PMS participated in two fMRI sessions, during the mid-follicular (days 5 to 11) and late-luteal phases (days -7 to -1). Participants completed the Montreal Imaging Stress Task (MIST). Subjective stress ratings and salivary cortisol were collected at six time points before and after stress induction. Stress-related brain activation was assessed using whole-brain and region-of-interest analyses. Results: Subjective stress ratings increased as expected from before to after the MIST, with no group or phase differences. Salivary cortisol was significantly higher during the mid-follicular phase, with no group effect or significant pre-post MIST difference. While the stress task elicited activation patterns in stress-related regions, whole-brain analysis revealed no significant effects of group (PMS vs. no PMS) or menstrual cycle phase (follicular vs. luteal) on the neural stress response. Considering premenstrual symptom severity as a predictor revealed significant group-by-symptom severity interactions in the right inferior frontal gyrus and the right superior temporal gyrus. Conclusion: Using a within-subject repeated-measures design, we found neural responses to psychosocial stress to be stable across menstrual cycle phases. Individual differences in symptom severity may nevertheless be associated with differences in stress-related brain activation.

Humans often communicate meaningfully during existential transition, yet the structure of final communications before death remains poorly understood. Suicide notes provide rare behavioral records, but two questions remain unresolved: whether note-leavers represent the broader population of suicide decedents, and whether notes follow systematic narrative structures. We analyzed a nationwide police-investigated registry of 102,922 suicide deaths in South Korea from 2013 to 2020, including 38,044 notes. Note-leavers differed systematically from non-leavers across demographic, situational and behavioral characteristics, indicating that note production reflects a selective communicative act within the suicidal process. Modeling notes as sequential narratives, we identified consistent patterns across opening, middle and closing sections, organized around apology and shame, love and gratitude, and practical directives concerning post-mortem affairs. Emotional trajectories also varied by age and gender. These findings provide population-scale evidence that suicide notes are structured final communications shaped by social relationships and demographic context under extreme circumstances.

Background: Adolescent mental health problems have risen alongside increasing sleep disruption and widespread social media use (SMU). However, the mechanisms linking these factors remain unclear. This study concurrently examined objectively measured sleep and SMU in relation to psychopathology to test whether SMU moderates the sleep-mental health association and to characterize day-to-day bidirectional relations among sleep, affect, mood, and SMU during the school year. Methods: Eighty-five adolescents (ages 12-18) completed 14 days of wrist actigraphy, smartphone-based ecological momentary assessments of mood and affect, and objective SMU duration tracking. Cross-sectional models tested whether SMU moderated associations between sleep and psychopathology, and multilevel daily models examined within-person lagged associations among sleep, SMU, and affect, controlling for age and sex. False discovery rate correction was applied. Results: Shorter average sleep duration and greater variability in sleep duration between weekdays and weekends were associated with higher psychopathology symptoms, primarily externalizing problems. SMU duration neither moderated nor directly predicted psychopathology or sleep. Within-person analyses showed that longer-than-usual sleep predicted more positive and less negative affect and lower next-day SMU, though these associations did not survive correction for multiple comparisons. Conclusions: Sleep disruption showed consistent associations with adolescent psychopathology, whereas the amount of time spent on social media did not. These findings suggest that duration-based measures of SMU may incompletely capture adolescents digital experiences and highlight the need for more granular, context-sensitive indicators of online behavior in understanding youth mental health.

Financial well-being (FWB) encompasses objective and subjective financial status and may influence health. We developed and validated a parsimonious FWB index using data from 23,006 Health and Retirement Study (HRS) participants aged 50 years and older from 2006 to 2022. The FWB-5 Index was derived using correlated two-factor confirmatory factor analysis accounting for household clustering. Indicators included household wealth, household income-to-poverty ratio, monthly financial strain, satisfaction with one's financial situation, and perceived financial mastery. We assessed convergent and discriminant validity using the Consumer Financial Protection Bureau Financial Well-Being (CFPB-FWB) Scale and Satisfaction with Life Scale, respectively. Associations with pre-baseline socioeconomic factors and subsequent depressive symptoms and health conditions were examined to assess construct and predictive validity. Model fit indices supported the two-factor structure (robust comparative fit index = 0.99; robust root mean square error of approximation = 0.05). Correlations were stronger with the CFPB-FWB Scale (Spearman P = 0.80) than with life satisfaction (Spearman P = 0.43). Associations with socioeconomic factors and subsequent health outcomes were in the hypothesized directions. These findings support the FWB-5 Index as a parsimonious measure for examining financial well-being and its associations with health across HRS waves, including those predating the CFPB-FWB Scale.

Adolescent suicidal ideation is a critical public health issue, yet empirical evidence on its prevalence and associated factors among adolescents in northern Bangladesh remains limited. This study estimated the 12-month prevalence of suicidal ideation and examined its associated factors among school-going adolescents in Nilphamari District, Bangladesh. A cross-sectional survey was conducted between May and June 2026 among 365 adolescents aged 13-19 years across eight secondary schools and colleges. Self-administered questionnaires assessed suicidal ideation alongside validated tools for depression (PHQ-9), anxiety (GAD-7), and perceived social support (MSPSS). Factors associated with suicidal ideation were examined using multivariable logistic regression. The 12-month prevalence of suicidal ideation was 30.7% (112/365; 95% CI 26.0%-35.7%). In the primary multivariable model, moderate depression (AOR = 6.05, 95% CI 1.03-35.38; p = 0.046) and moderately severe depression (AOR = 6.86, 95% CI 1.05-44.62; p = 0.044) were associated with higher odds of suicidal ideation compared to minimal depression. However, this association was not statistically significant in a sensitivity analysis using the PHQ-8 score after excluding Item 9 (AOR = 1.06, 95% CI: 0.96-1.17; p = 0.228). Loneliness "often" showed the strongest association with suicidal ideation (AOR = 10.59, 95% CI: 2.53-44.35; p = 0.001). Suicidal ideation was also associated with truancy of 6-9 days (AOR 4.44, 95% CI 1.24-15.90; p = 0.022), truancy of [&ge;]10 days (AOR 3.77, 95% CI 1.34-10.59; p = 0.012), intentional self-harm (AOR = 2.51, 95% CI: 1.17-5.41; p = 0.018), and physical harm exposure (AOR = 2.63, 95% CI: 1.24-5.57; p = 0.012). Maternal secondary education was associated with lower odds of suicidal ideation (AOR = 0.34, 95% CI: 0.12-0.99; p = 0.048). Suicidal ideation was common among school-going adolescents in northern Bangladesh, affecting nearly one in three participants. Early school-based identification and support for adolescents experiencing mental-health and psychosocial difficulties, together with family engagement and strengthened suicide-prevention services, are warranted.

Objective: The Alimetry Gut-Brain Wellbeing (AGBW) Survey is a validated 10-item scale developed to assess mental health in patients with chronic gastroduodenal symptoms. While the original scale demonstrated strong psychometric properties overall, as part of an ongoing commitment to continuous instrument optimization, this study evaluated a revised, unidirectional version of the scale (AGBW-II) to enhance measurement precision. Methods: The psychometric properties of the revised AGBW-II were evaluated via an anonymous online questionnaire in a sample of 161 patients with chronic gastroduodenal symptoms. Score distributions, factor analysis, reliability, and validity were analyzed and compared with data from the validation study of the original scale (n= 311). Results: The AGBW-II total and subscale scores demonstrated robust reliability and validity, outperforming the original AGBW Survey. Notable improvements in the reliability and validity of the stress subscale were observed following item rewording. Confirmatory factor analysis verified the three-factor model separating the depression, stress, and anxiety subscales, with the AGBW-II showing improved model fit indices. Conclusions: The revised, unidirectional AGBW-II demonstrated improved reliability and validity, while maintaining the underlying psychometric properties of the original scale. Consequently, the AGBW-II provides a reliable, valid, and brief mental health assessment for patients with chronic gastroduodenal symptoms.

BackgroundPersistent postural-perceptual dizziness (PPPD) is a chronic functional dizziness disorder characterized by unsteadiness, hypersensitivity to motion and visually complex environments. Although increasingly investigated, the role of the different factors involved remains unclear. This study aims to comprehensively characterize PPPD across clinical, biological, and behavioral domains. MethodsData from 18 PPPD patients and 20 age- and sex-matched healthy control volunteers (HC) were analyzed, including clinical and psychological questionnaires, a neuropsychological battery, salivary markers, posturography under different conditions, and gait analysis under single- and dual-task demands. ResultsPatients reported greater depressive symptoms, higher perceived stress, and reduced quality of life than HC, but showed no neuropsychological deficits and comparable past psychological trauma and personality traits. Salivary stress marker levels were similar to HC. Gait analysis revealed a slower, cautious gait in patients, which worsened without vision, with no differences in automaticity (stride time variability). Postural assessments showed greater sway and enhanced low-frequency oscillations, exacerbated by absence of visual input in PPPD. Visual reliance for postural control correlated negatively with subjective symptom severity, but not other symptom-related measures. ConclusionPPPD patients have lower mood and increased perceived stress, with no increase in biological stress markers compared to HC. Cognition, personality, and exposure to past trauma might be less relevant than previously hypothesized. Patients show visual dependence for gait and postural control, likely a maladaptive compensatory mechanism. These findings support interventions targeted at reducing visual dependence and at improving mood, rather than interventions focusing on psychological trauma. SummaryO_LIWhat is already known on this topic - PPPD (Persistent Perceptual Postural Dizziness) is a functional dizziness disorder characterized by different biopsychosocial factors, often investigated in isolation. C_LIO_LIWhat this study adds - PPPD patients have higher depression and perceived stress scores, lower quality of life, but show no differences in past trauma, personality traits, and biological stress markers, compared to healthy controls. They also show a reliance on vision both for gait and for postural control, with increased low-frequency oscillations in the anteroposterior direction. Visual dependence is likely maintained by its perceived role in symptom reduction. C_LIO_LIHow this study might affect research, practice or policy - These findings support rehabilitation strategies aimed at reducing reliance on vision and increasing reliance on vestibular inputs, but not interventions focusing on past traumatic experiences. C_LI