BackgroundPerceived stress is a significant risk factor for depression among healthcare professionals. While this fundamental relationship is well-documented, the potential mediating mechanisms—specifically the role of psychological flexibility and its distinct components—in buffering the impact of perceived stress on depression within the nursing community remain poorly understood.MethodsThis cross-sectional study recruited 3,920 nurses from three tertiary Grade A public hospitals in Xi’an, China, using convenience sampling, of whom 3,611 were included in the final analysis. Data were collected online using the Chinese versions of Cohen’s Perceived Stress Scale and the Comprehensive Assessment of Acceptance and Commitment Therapy Processes, as well as the Patient Health Questionnaire-9. Pearson correlation analyzes and mediation analysis were conducted to examine the associations among perceived stress, psychological flexibility, and depression.ResultsDepression was positively correlated with perceived stress (r = 0.63, p < 0.01). Mediation analysis indicated that perceived stress was significantly associated with depression both directly (b = 0.47, 95% CI: 0.45 to 0.49) and indirectly via psychological flexibility (b = 0.12, 95% CI: 0.11 to 0.13) and its components, including acceptance and cognitive defusion (b = 0.14, 95% CI: 0.13 to 0.15), and values and committed action (b = 0.06, 95% CI: 0.04 to 0.08). The indirect association through mindfulness and self-as-context was not significant (b = 0.01, 95% CI: 0.00 to 0.02).ConclusionsPsychological flexibility and some of its components were involved in partial indirect associations between perceived stress and depression among Chinese nurses. These findings suggest that psychological flexibility may help understand how perceived stress is statistically associated with depression in this population. Given the cross-sectional design, however, the results should be interpreted as statistical associations rather than evidence of causal relationships.
Beyond empirically supported treatments: a new contextualized evidence framework for evidence based psychology
Over the past three decades, criteria for Empirically Supported Treatments (ESTs) have strengthened methodological rigor in psychotherapy research by prioritizing randomized controlled trials and systematic evidence synthesis. However, prevailing frameworks remain largely centered on efficacy under controlled conditions, offering limited operational guidance for integrating contextual factors that critically shape real-world effectiveness. We propose the Contextualized Empirically Supported Treatment Framework (C-EST), a normative and operational model that integrates certainty of evidence with structured appraisal of contextual domains essential for clinical decision-making, guideline development, and policy. Building on the Tolin criteria, GRADE, GRADE-CERQual, and the GRADE Evidence-to-Decision approach, C-EST embeds assessment of empirical certainty within five interconnected domains (1): empirical evidence (2), critical appraisal of the body of evidence, (3) functional and cultural impact, (4) contextual factors, including values, acceptability, feasibility, and equity, and (5) transparency and living evidence. Rather than relying on binary classifications (“supported” vs. “unsupported”), the framework enables nuanced judgments such as “supported with contextual concerns,” explicitly documenting boundaries of applicability. Using Cognitive Behavioral Therapy for depression and psychological interventions for postpartum depression as illustrative cases, we demonstrate how contextual appraisal refines, rather than weakens, established evidence classifications. By aligning internal validity with external, cultural, and equity relevance, C-EST transforms evidence evaluation from a static designation into a dynamic decision-support tool. Integrating contextual evidence is not an ethical add-on but a methodological imperative to ensure that psychological treatments are not only efficacious, but applicable, equitable, and responsive to diverse real-world mental health needs.
A bidirectional relationship between atrial fibrillation and depression: epidemiology, mechanisms, and clinical implications
Atrial fibrillation (AF) represents a common cardiac arrhythmia that carries substantial morbidity and mortality risks, whereas depression serves as a significant psychological factor affecting cardiovascular health. Recent findings underscore a reciprocal relationship between AF and depression, suggesting that depression may heighten the likelihood of developing AF, while AF may, in turn, worsen depressive symptoms. This review aims to provide a thorough examination of the epidemiological features that underpin this relationship, focusing on population-based research that clarifies prevalence rates and associated risk factors. Furthermore, it delves into the intricate biological and psychosocial mechanisms that connect these two conditions, which include dysregulation of the autonomic nervous system, inflammation, neurohormonal pathways, and behavioral influences. The clinical ramifications of this reciprocal association are also addressed, highlighting the necessity for integrated screening and management approaches to enhance patient outcomes. By consolidating existing research, this article seeks to enrich the understanding of the relationship between AF and depression, as well as to assist clinicians in optimizing therapeutic strategies tailored to address this dual burden.
<![CDATA[Clinicians explore transdiagnostic anhedonia—reward learning, loneliness, and digital rewards—offering practical ideas to personalize treatment.]]>
Stress Management and Meditative Movements for Asian Americans With Depression and Physical Symptoms
Conditions: Depression / Major Depressive Disorder; Mental Health (Depression)
Interventions: Behavioral: Stress Management and Resiliency Training with Qigong/Tai Chi; Behavioral: Healthy Living Program
Sponsors: Massachusetts General Hospital; National Center for Complementary and Integrative Health (NCCIH)
Not yet recruiting
Interventions: Behavioral: Stress Management and Resiliency Training with Qigong/Tai Chi; Behavioral: Healthy Living Program
Sponsors: Massachusetts General Hospital; National Center for Complementary and Integrative Health (NCCIH)
Not yet recruiting
The Efficacy of Psilocybin Therapy for Depression in Parkinson’s Disease
Conditions: Depression; Parkinson’s Disease (PD)
Interventions: Drug: Psilocybin (drug); Drug: Psilocybin (drug)
Sponsors: Yale University; Michael J. Fox Foundation for Parkinson’s Research
Not yet recruiting
Interventions: Drug: Psilocybin (drug); Drug: Psilocybin (drug)
Sponsors: Yale University; Michael J. Fox Foundation for Parkinson’s Research
Not yet recruiting
EEG Prediction and Clinical Efficacy of tDCS in Major Depression
Conditions: Depression – Major Depressive Disorder
Interventions: Device: High-dose home-tDCS; Device: Conventional home-tDCS
Sponsors: Ionclinics & Deionic SL; Hospital Universitario Doctor Peset; Universidad Europea de Valencia
Not yet recruiting
Interventions: Device: High-dose home-tDCS; Device: Conventional home-tDCS
Sponsors: Ionclinics & Deionic SL; Hospital Universitario Doctor Peset; Universidad Europea de Valencia
Not yet recruiting
Effects of Transcutaneous Vagal Nerve Stimulation on Post-Surgical Return to Consciousness, Delirium, and Depression
Conditions: Post Operative Delirium; Cognitive Impairment; Vagus Nerve Stimulation; Depression
Interventions: Device: Transcutaneous vagal nerve stimulation; Device: Sham (No Treatment)
Sponsors: Northwestern University
Recruiting
Interventions: Device: Transcutaneous vagal nerve stimulation; Device: Sham (No Treatment)
Sponsors: Northwestern University
Recruiting
Efficacy and Safety of Transcranial Temporal Interference Stimulation for Depression
Conditions: Major Depressive Disorder (MDD)
Interventions: Device: Active Transcranial Temporal Interference Stimulation Targeting Left ALIC; Device: Active Transcranial Temporal Interference Stimulation Targeting Left sgACC; Device: Sham Transcranial Temporal Interference Stimulation
Sponsors: Yonggui Yuan
Not yet recruiting
Interventions: Device: Active Transcranial Temporal Interference Stimulation Targeting Left ALIC; Device: Active Transcranial Temporal Interference Stimulation Targeting Left sgACC; Device: Sham Transcranial Temporal Interference Stimulation
Sponsors: Yonggui Yuan
Not yet recruiting
<![CDATA[Investigational depression drugs target SIRT6 epigenetics, histamine H3, and AMPA.]]>

