Tag: Anxiety

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The Effectiveness and Mechanisms of Action of App-Based Interventions for Improving Mental Health and Workplace Well-Being: Randomized Controlled Trial

Background: Depression is the most common mental health disorder worldwide and frequently leads to workplace absence. As face-to-face treatment can be difficult to access, app-based interventions are a popular solution, although their effectiveness in working populations and their mechanisms of action are unclear. Deficits in executive function may contribute to the onset and maintenance of depression, and executive function training is proposed to improve symptoms by enhancing executive function. Responders to cognitive behavioral therapy (CBT) show improvements in executive function, suggesting that this may be one mechanism of action. Objective: This study investigated the effectiveness of app-based interventions (executive function or CBT-based) for reducing depressive and anxiety symptoms and improving workplace well-being, and assessed whether changes in executive function mediated improvements. Methods: A total of 228 participants (147 female participants) with mild-to-moderate symptoms of depression and anxiety were recruited online and randomly assigned to a waitlist control group, an executive function training group (NeuroNation app, Synaptikon GmbH), or a self-guided CBT group (Moodfit app, Roble Ridge LLC) for a 4-week intervention period. Participants assigned to the active intervention groups were asked to use their apps a minimum of 21 times during the intervention. Participants completed measures of depressive symptoms, anxiety symptoms, and workplace well-being, and a working memory task at baseline, postintervention, and follow-up (12 weeks). Results: Executive function training reduced anxiety (β=−2.79; =.004) and depressive (β=−2.77; =.02) symptoms at follow-up but not at postintervention, and it did not affect workplace well-being. There were no reductions in depressive or anxiety symptoms in the self-guided CBT group, though workplace well-being was improved at postintervention (β=3.72; =.02) and follow-up (β=4.46; =.02). Improvements in executive function did not mediate intervention-related changes in symptoms or workplace well-being. Self-reported adherence rates were high (executive function training: 48/54, 89%; self-guided CBT: 52/54, 96%), although attrition was high at follow-up (58% missing). Conclusions: These results suggest that app-based executive function training may be effective at managing symptoms of anxiety and depression in a working population, while self-guided CBT apps may improve workplace well-being. However, improving executive function did not appear to be a mechanism of action of either intervention. Trial Registration: ISRCTN 12730006; https://www.isrctn.com/ISRCTN12730006
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Emotional Training via Telerehabilitation After Surgical Treatment for Facial Palsy: Prospective, Assessor-Blinded, 2-Arm Pilot Cohort Study

Background: Peripheral facial nerve palsy is a debilitating condition that may necessitate surgical intervention. Although motor rehabilitation is considered essential, the most effective approach has not yet been determined. Objective: This study aimed to evaluate the feasibility and effectiveness of emotional training, a novel telerehabilitation-based treatment, on motor, functional, and psychological outcomes in patients with unilateral facial palsy following triple innervation surgery. Methods: A prospective, assessor-blinded, 2-arm pilot cohort study was conducted at the rehabilitation unit at University Hospital San Paolo, Milan, Italy, from January to October 2024. Participants (N=16) received 1 treatment session every 2 weeks over 20 weeks, each lasting 45 minutes, according to standard clinical procedures in place at the rehabilitation unit. Participants were nonrandomly assigned to either an in-person group (n=8) or an online group (ie, telerehabilitation; n=8) based on their ability to attend in-person sessions. The primary outcomes assessed at baseline (T0) and after treatment (T1) included facial symmetry (Sunnybrook Facial Grading System; SFGS), facial disability (Facial Disability Index; FDI), and anxiety levels (Beck Anxiety Inventory). Results: Statistical analysis revealed significant improvements at T1 for both groups in the FDI social and well-being function subscale, Beck Anxiety Inventory, SFGS resting symmetry score, SFGS symmetry of voluntary movement score, SFGS composite score, SFGS with bilateral masseter contraction symmetry of voluntary movement score, and SFGS with bilateral masseter contraction composite score (<.001 for all). Only the FDI physical function subscale showed a differential improvement at T1 for the in-person group treatment (ANOVA for time × treatment: =14.356; =.002; Holm-Bonferroni post hoc test: <.001). Finally, a strong positive correlation was observed between the time elapsed from surgery to rehabilitation and SFGS composite score improvement at T1 (=0.94; =.005). Conclusions: These results suggest that the online emotional training protocol is as feasible and effective as the in-person emotional training protocol in improving facial motor function, reducing anxiety, and enhancing facial expression spontaneity in patients who had undergone surgery for peripheral facial palsy. These findings support the validity of telerehabilitation approaches as a feasible, accessible, and sustainable alternative to conventional in-person therapy for facial nerve recovery.
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<![CDATA[DT120, a pharmaceutical-grade formulation of LSD, shows rapid, lasting anxiety relief—single dose, no therapy—with 48% remission at 12 weeks.]]>
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Sociodemographic factors, anxiety and attitudes toward generative artificial intelligence among nurses

BackgroundAlthough generative artificial intelligence offers substantial potential benefits in healthcare, negative attitudes and elevated anxiety among nurses may hinder its effective integration into clinical practice. Evidence regarding the psychological impact of generative artificial intelligence on nurses remains limited.ObjectiveThis study examined the relationships among sociodemographic characteristics, anxiety, and attitudes toward generative artificial intelligence among nurses.MethodsA cross-sectional correlational design was employed. Data were collected from 312 hospital nurses using online questionnaires assessing sociodemographic characteristics, attitudes toward artificial intelligence, and artificial intelligence-related anxiety. Data were analyzed using IBM Statistical Package for the Social Sciences (SPSS) Statistics software version 28.ResultsHigher levels of artificial intelligence-related anxiety were associated with less favorable attitudes toward artificial intelligence. Sociodemographic characteristics and anxiety scores collectively explained 49.4% of the total variance in attitudes toward artificial intelligence. Gender, experience with artificial intelligence, use of artificial intelligence in nursing care, awareness of artificial intelligence applications in healthcare, hours spent on the internet, age, and professional experience accounted for 24.7% of the variance in negative attitudes toward generative artificial intelligence.ConclusionAnxiety and experiential factors play a central role in shaping nurses’ attitudes toward generative artificial intelligence. Increasing nurses’ exposure to and awareness of artificial intelligence in nursing practice may reduce anxiety and support its acceptance and appropriate use.
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<![CDATA[Definium’s CMO says FDA talks stay aligned with their plans for advancing DT120 ODT for the treatment of depression, anxiety, and now PTSD.]]>
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Impact of extremely low frequency electromagnetic fields exposure on sleep quality and mental health in a Tunisian power plant: a cross-sectional study

IntroductionExtremely low-frequency electromagnetic fields (ELF-EMFs) are ubiquitous in our daily life. They may have an impact not only on physical health but also on mental health.ObjectivesTo assess the impact of occupational exposure to the ELF-EMFs on sleep quality, depression, anxiety and stress among workers at the Tunisian Electricity and Gas Company (TEGC).MethodsThis was a cross-sectional study. The study population included two groups: an exposed group (EG), consisting of power plant employees, and a non-exposed group (NEG), consisting of administrative workers. Exposure to ELF-EMFs was assessed via spot measurements using a magnetometer. Sleep quality, depression, anxiety and stress were assessed by the French versions of the Pittsburgh Sleep Quality Index (PSQI) and the Depression, Anxiety and Stress Scale (DASS-21).ResultsSeventy-seven participants in the EG and 88 participants in the NEG were included in the study. The median value of the ELF-EMFs was 5.86 μT at the power plant [min 0.1, max 40.34 μT]. According to the PSQI global score, 64.9% of the EG had poor sleep quality versus 29.5% of the NEG. Depression was registered in 24.7% of EG and in 3.4% of NEG. Anxiety was noted in 23.4% of the EG and in none of the NEG. Stress was found in 46.8% of the EG and none of the NEG. After multivariate analysis, ELF-EMF exposure was significantly associated with poor sleep quality and depression.ConclusionThe present study revealed that ELF-EMFs can affect sleep and mental health. Further studies are needed to explain the mechanism involved.
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Associations of psychological distress, gaming motives and internet gaming disorder in adolescents: a network analysis

Background and objectiveThe rapid popularization of the Internet among Chinese adolescents has resulted in the emergence of a public major concern known as Internet Gaming Disorder (IGD). As demonstrated by previous studies, an association has been demonstrated among emotional distress, gaming motives and IGD. Nevertheless, the specific pathways connecting these constructs remain to be elucidated. The present study aims to explore the network structure characterizing the interactions among these three constructs and to identify potential targets for psychological interventions.MethodsThis was a cross-sectional survey conducted in city of Hangzhou. A total of 3,795 middle school students were included in the analysis. The 21-item Depression Anxiety Stress Scale (DASS-21), the Motives for Online Gaming Questionnaire (MOGQ), and the Chinese version of the Ten-Item Internet Gaming Disorder Test (IGDT-10) were used to assess emotional distress, gaming motives and IGD symptoms, respectively. Network analyses were performed using R4.5.1 software to explore the interrelationships among emotional distress, gaming motives and IGD symptoms, and identify the core symptoms and bridge symptoms.ResultsIn the depression combined network model, the presence of bridge symptoms was indicated by no initiative (D2), gaming for escape or mood relief (IGD8) and fantasy motive (fan). In anxiety combined network model, the bridge symptoms included coping motive(cop), gaming for escape or mood relief (IGD8), withdrawal (IGD2), mouth dryness (A1), and fear of embarrassment (A4). The bridge symptoms in the stress combined network model were gaming for escape or mood relief (IGD8), difficulty winding down (S1), withdrawal (IGD2), nervous energy expenditure (S3), and coping motive (cop).ConclusionThe present study explored complex network structure among psychological distress, gaming motivation, and IGD. and suggested fantasy and coping motive as bridges connecting psychological distress and IGD. Besides, our research identified no initiative, mouth dryness, difficulty winding down, fear of embarrassment, and nervous energy expenditure as the best targets for intervention to reduce IGD.
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Adult attachment and intimate relationship satisfaction among university students: the chain mediating roles of appreciation and sense of giving

BackgroundSatisfying intimate relationships are fundamental to young adults’ psychological well-being. Although adult attachment theory provides a robust framework for understanding relationship quality, the mechanisms linking higher attachment anxiety and avoidance to lower relationship satisfaction remain underexplored. This study tested a chain mediation model in which appreciation (both expressed and felt) and sense of giving sequentially mediate the link between insecure attachment and relationship satisfaction.MethodsA cross-sectional survey was conducted with 536 university students (mean age = 21.67 years; 55.8% female) currently in romantic relationships. Participants completed validated self-report questionnaires assessing higher attachment avoidance and anxiety, appreciation (appreciating one’s partner and feeling appreciated), sense of giving, and relationship satisfaction. Chain mediation analyses were performed using the SPSS PROCESS macro with 5,000 bootstrap resamples to evaluate the significance of indirect effects.ResultsAttachment significantly and negatively predicted relationship satisfaction. In the first chain mediation model, higher levels of both attachment avoidance and anxiety were negatively associated with appreciation of one’s partner. Appreciation, in turn, was positively associated with a greater sense of giving, which was subsequently linked to higher relationship satisfaction. After controlling for demographic and relational covariates, the key findings remained robust. The sequential indirect effect (Attachment → Appreciating → Giving → Satisfaction) was significant for both higher attachment avoidance (effect = -0.17, 95% CI [-0.22, -0.14]) and anxiety (effect = -0.07, 95% CI [-0.10, -0.03]). Similarly, the sequential indirect effect through feeling appreciated (Attachment → Feeling Appreciated → Giving → Satisfaction) was significant for both higher avoidance (effect = -0.10, 95% CI [-0.14, -0.07]) and anxiety (effect = -0.09, 95% CI [-0.12, -0.06]).ConclusionInsecure attachment was negatively associated with intimate relationship satisfaction through a sequential pathway involving appreciation and sense of giving. These cross-sectional findings suggest that appreciation processes may represent a promising intervention target. Clinical or preventive strategies enhancing the expression and perception of appreciation could potentially improve relationship satisfaction among young adults with insecure attachment orientations.
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Cyclothymic and anxious affective temperament in perinatal depression: findings from an exploratory cross-sectional study

IntroductionThe perinatal period represents a vulnerable period in which women may experience high psychic distress due to psychological, biological and social changes. The prevalence of perinatal depression (PND) is estimated around 15%-20% during pregnancy and 16%-18% after childbirth. Although several risk factors have been investigated in the PND development, few studies explored the role of affective temperaments, well known to exert a role in any mood disorders. The aim of our study was to explore which is the most represented affective temperamental profile in PND as well as which is its role in the development and severity of depressive symptoms during perinatal period.MethodsAll pregnant women admitted at the Perinatal Mental Health Outpatient Service, Unit of Clinical Psychiatry, University Hospital of Marche, Polytechnic University of Marche, Ancona, Italy, between April 2021 and July 2025, were screened for PND through Edinburgh Postnatal Depression Scale (EPDS) and a semi-structured clinical interview (SCID-5-CV). Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS-M) was administered to all pregnant women. ResultsThe PND prevalence was 33.1%. PND was significantly associated with higher cyclothymic (B = 0.356, p = 0.001) and anxious TEMPS-M scores (B = 0.247, p = 0.026) and a positive psychiatric history (B = 5.245, p < 0.001) (R = 0.6, R2 = 0.36, F(3,129) = 24.189, p < 0.001). Logistic regression indicated that cyclothymic (Exp(B)=1.118, p=0.008), hyperthymic (Exp(B)=0.911, p=0.049), anxious temperaments (Exp(B)=1.109, p=0.029), presence of medical comorbidities (Exp(B)=0.224, p=0.003) and psychiatric history (Exp(B)=5.144, p=0.001) were independent predictors of PND.DiscussionAffective temperaments, particularly cyclothymic and anxious profiles, and prior psychiatric history are predictors of perinatal depression. Incorporating temperament assessment alongside standard screening tools such as the EPDS may improve early identification of women at risk, supporting tailored preventive and therapeutic strategies.