Pub Date : 2025-10-01DOI: 10.1016/j.ijchp.2025.100631
Filipa Freire-Santos , Dicle Karacadag , Yasmin Vieira , Mónica Sobral , Vera Mateus , Raquel Guiomar , Perianen Ramasawmy , Andrea Antal , Ana Ganho-Ávila
Combining virtual reality-focused mindfulness (VR-FM) and transcranial direct current stimulation (tDCS) can enhance cognitive performance, offering new insights for scientific research and clinical applications. We aimed to examine the effects of a single session of VR-FM, a single session of tDCS, and their combination on sustained attention, attention control, and inhibitory control.
We conducted a double-blind, controlled, randomized study (N = 107) with five groups: VR-FM or VR-mind wandering, paired with active (2 mA for 20 min) or sham tDCS with the anode over F3 and cathode over F4, and a no-intervention control group. Non-specific skin conductance response (nsSCR) was collected during virtual reality, and cognitive performance was measured with Sustained Attention to Response Task (SART) and the Emotional Stroop (EST) after intervention. Differences between groups were not statistically significant in cognitive tasks (all p>.05) but we found a main effect of group in nsSCR (F (3, 66) = 4.07, p = .010, η² = 0.156), with significant differences between VR-FM + tDCS active and VR-MW + tDCS sham (p = .014).
Single sessions of VR-FM and tDCS did not significantly impact cognitive performance. However, reduced autonomic activation might be associated with mindfulness. Future studies should include several sessions and consider other individual conditions to understand the factors involved.
{"title":"The impact of transcranial direct current stimulation combined with virtual reality-based mindfulness on attention and inhibitory control in healthy individuals","authors":"Filipa Freire-Santos , Dicle Karacadag , Yasmin Vieira , Mónica Sobral , Vera Mateus , Raquel Guiomar , Perianen Ramasawmy , Andrea Antal , Ana Ganho-Ávila","doi":"10.1016/j.ijchp.2025.100631","DOIUrl":"10.1016/j.ijchp.2025.100631","url":null,"abstract":"<div><div>Combining virtual reality-focused mindfulness (VR-FM) and transcranial direct current stimulation (tDCS) can enhance cognitive performance, offering new insights for scientific research and clinical applications. We aimed to examine the effects of a single session of VR-FM, a single session of tDCS, and their combination on sustained attention, attention control, and inhibitory control.</div><div>We conducted a double-blind, controlled, randomized study (<em>N</em> = 107) with five groups: VR-FM or VR-mind wandering, paired with active (2 mA for 20 min) or sham tDCS with the anode over F3 and cathode over F4, and a no-intervention control group. Non-specific skin conductance response (nsSCR) was collected during virtual reality, and cognitive performance was measured with Sustained Attention to Response Task (SART) and the Emotional Stroop (EST) after intervention. Differences between groups were not statistically significant in cognitive tasks (all <em>p</em>>.05) but we found a main effect of group in nsSCR (<em>F</em> (3, 66) = 4.07, <em>p</em> = .010, η² = 0.156), with significant differences between VR-FM + tDCS active and VR-MW + tDCS sham (<em>p</em> = .014).</div><div>Single sessions of VR-FM and tDCS did not significantly impact cognitive performance. However, reduced autonomic activation might be associated with mindfulness. Future studies should include several sessions and consider other individual conditions to understand the factors involved.</div></div>","PeriodicalId":47673,"journal":{"name":"International Journal of Clinical and Health Psychology","volume":"25 4","pages":"Article 100631"},"PeriodicalIF":4.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145270089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.ijchp.2025.100650
Ji-Won Chun , Jihye Choi , Arom Pyeon , Minkyung Hu , Hyun Cho , Jung-Seok Choi , Kook-Jin Ahn , Jong-Ho Nam , Inyoung Choi , Dai-Jin Kim
Background
Adolescence is characterized by ongoing neurocognitive maturation, particularly in regions that support social–emotional processing and cognitive control. Despite extensive research on emotion regulation, the developmental trajectories of critical neural networks—such as the salience network and the dorsolateral prefrontal cortex (DLPFC)—remain incompletely understood.
Methods
We prospectively enrolled 30 adolescents (12–18 years), 35 early adults (19–24 years), and 35 adults (25–34 years). While undergoing functional magnetic resonance imaging, participants performed an emotional discrimination task on facial expressions. The imaging data were analyzed to assess the neural activity across the emotional conditions, and a generalized psychophysiological interaction approach was applied to examine salience network connectivity.
Results
Adolescents exhibited lower behavioral performance than adults. Regarding brain activation, the dorsal anterior cingulate cortex (dACC) and bilateral insula—key components of the salience network—seemingly differentiated adolescents from early adults and adults. In contrast, DLPFC activity distinguished adults from the two younger groups. Functional connectivity analyses revealed that adolescents either over-sustained or under-recruited dACC–insula connectivity during emotional transitions, correlating with poorer behavioral performance.
Conclusion
These findings underscore distinct developmental trajectories for the salience network and the DLPFC, with adolescents showing heightened vulnerability in social–emotional processing and cognitive control.
{"title":"Neurodevelopment of the functional connectivity of the salience network in facial emotion recognition from adolescence to adulthood","authors":"Ji-Won Chun , Jihye Choi , Arom Pyeon , Minkyung Hu , Hyun Cho , Jung-Seok Choi , Kook-Jin Ahn , Jong-Ho Nam , Inyoung Choi , Dai-Jin Kim","doi":"10.1016/j.ijchp.2025.100650","DOIUrl":"10.1016/j.ijchp.2025.100650","url":null,"abstract":"<div><h3>Background</h3><div>Adolescence is characterized by ongoing neurocognitive maturation, particularly in regions that support social–emotional processing and cognitive control. Despite extensive research on emotion regulation, the developmental trajectories of critical neural networks—such as the salience network and the dorsolateral prefrontal cortex (DLPFC)—remain incompletely understood.</div></div><div><h3>Methods</h3><div>We prospectively enrolled 30 adolescents (12–18 years), 35 early adults (19–24 years), and 35 adults (25–34 years). While undergoing functional magnetic resonance imaging, participants performed an emotional discrimination task on facial expressions. The imaging data were analyzed to assess the neural activity across the emotional conditions, and a generalized psychophysiological interaction approach was applied to examine salience network connectivity.</div></div><div><h3>Results</h3><div>Adolescents exhibited lower behavioral performance than adults. Regarding brain activation, the dorsal anterior cingulate cortex (dACC) and bilateral insula—key components of the salience network—seemingly differentiated adolescents from early adults and adults. In contrast, DLPFC activity distinguished adults from the two younger groups. Functional connectivity analyses revealed that adolescents either over-sustained or under-recruited dACC–insula connectivity during emotional transitions, correlating with poorer behavioral performance.</div></div><div><h3>Conclusion</h3><div>These findings underscore distinct developmental trajectories for the salience network and the DLPFC, with adolescents showing heightened vulnerability in social–emotional processing and cognitive control.</div></div>","PeriodicalId":47673,"journal":{"name":"International Journal of Clinical and Health Psychology","volume":"25 4","pages":"Article 100650"},"PeriodicalIF":4.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145568206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.ijchp.2025.100656
Bing Yan , Xin Cui , Lei Chen , Xiangzhen Miao , Hailin Jiang , Yu Wang , Fuchun Wang
Background
Heart rate variability (HRV), a vital indicator of autonomic nervous system function, is frequently altered in patients with insomnia. While substantial evidence suggests a link between HRV changes and insomnia, previous studies have been limited by small sample sizes and cross-sectional designs, making it impossible to determine whether HRV changes are a cause or consequence of insomnia. Understanding this causal relationship is crucial for developing targeted interventions for sleep disorders.
Objective
To investigate the potential bidirectional causal relationship between HRV and insomnia using two-sample Mendelian randomization (MR) analysis.
Method
We obtained genome-wide association study (GWAS) summary statistics for three HRV traits (pvRSA/HF, RMSSD, and SDNN) from IEU Open GWAS database and insomnia data from FinnGen database (5763 cases and 445,483 controls). Bidirectional MR analyses were performed using multiple methods including inverse variance weighted (IVW), MR-Egger, weighted median, and mode-based approaches. Sensitivity analyses were conducted to assess heterogeneity and horizontal pleiotropy.
Results
MR analysis of HRV on insomnia revealed significant causal effects, specifically for pvRSA/HF (OR = 1.437, 95 % CI: 1.147–1.801, p = 0.002) and SDNN (OR = 1.910, 95 % CI: 1.092–3.342, p = 0.022). These associations remained robust across multiple MR methods and sensitivity analyses. In the reverse direction, MR analysis of insomnia on HRV found no significant causal effects on any HRV traits, suggesting unidirectional causality from HRV to insomnia.
Conclusions
This study provides genetic evidence that altered HRV may causally increase insomnia risk, while insomnia does not appear to causally affect HRV. These findings suggest that regulating HRV might help alleviate insomnia symptoms and improve sleep quality, and highlight the potential of HRV as a therapeutic target in sleep disorders.
心率变异性（HRV）是自主神经系统功能的重要指标，在失眠患者中经常发生改变。虽然有大量证据表明HRV变化与失眠之间存在联系，但之前的研究受限于小样本量和横截面设计，因此无法确定HRV变化是失眠的原因还是结果。了解这种因果关系对于开发针对睡眠障碍的有针对性的干预措施至关重要。目的通过双样本孟德尔随机化（MR）分析，探讨心率变异与失眠之间潜在的双向因果关系。方法从IEU Open GWAS数据库和FinnGen数据库（5763例和445,483例对照）中获取3个HRV特征（pvRSA/HF、RMSSD和SDNN）的GWAS汇总统计数据。双向磁共振分析使用多种方法进行，包括逆方差加权（IVW）、MR- egger、加权中位数和基于模型的方法。进行敏感性分析以评估异质性和水平多效性。结果HRV对失眠有显著的因果关系，特别是pvRSA/HF （OR = 1.437, 95% CI: 1.147 ~ 1.801, p = 0.002）和SDNN （OR = 1.910, 95% CI: 1.092 ~ 3.342, p = 0.022）。这些关联在多种MR方法和敏感性分析中仍然很强大。相反，失眠对HRV的MR分析发现，任何HRV特征都没有显著的因果关系，表明HRV与失眠之间存在单向因果关系。结论：本研究提供了基因证据，表明HRV的改变可能会导致失眠风险的增加，而失眠似乎不会导致HRV的变化。这些发现表明，调节HRV可能有助于缓解失眠症状和改善睡眠质量，并突出了HRV作为睡眠障碍治疗靶点的潜力。
{"title":"What comes first: Heart rate variability changes or insomnia? A causal investigation using Mendelian randomization","authors":"Bing Yan , Xin Cui , Lei Chen , Xiangzhen Miao , Hailin Jiang , Yu Wang , Fuchun Wang","doi":"10.1016/j.ijchp.2025.100656","DOIUrl":"10.1016/j.ijchp.2025.100656","url":null,"abstract":"<div><h3>Background</h3><div>Heart rate variability (HRV), a vital indicator of autonomic nervous system function, is frequently altered in patients with insomnia. While substantial evidence suggests a link between HRV changes and insomnia, previous studies have been limited by small sample sizes and cross-sectional designs, making it impossible to determine whether HRV changes are a cause or consequence of insomnia. Understanding this causal relationship is crucial for developing targeted interventions for sleep disorders.</div></div><div><h3>Objective</h3><div>To investigate the potential bidirectional causal relationship between HRV and insomnia using two-sample Mendelian randomization (MR) analysis.</div></div><div><h3>Method</h3><div>We obtained genome-wide association study (GWAS) summary statistics for three HRV traits (pvRSA/HF, RMSSD, and SDNN) from IEU Open GWAS database and insomnia data from FinnGen database (5763 cases and 445,483 controls). Bidirectional MR analyses were performed using multiple methods including inverse variance weighted (IVW), MR-Egger, weighted median, and mode-based approaches. Sensitivity analyses were conducted to assess heterogeneity and horizontal pleiotropy.</div></div><div><h3>Results</h3><div>MR analysis of HRV on insomnia revealed significant causal effects, specifically for pvRSA/HF (OR = 1.437, 95 % CI: 1.147–1.801, <em>p</em> = 0.002) and SDNN (OR = 1.910, 95 % CI: 1.092–3.342, <em>p</em> = 0.022). These associations remained robust across multiple MR methods and sensitivity analyses. In the reverse direction, MR analysis of insomnia on HRV found no significant causal effects on any HRV traits, suggesting unidirectional causality from HRV to insomnia.</div></div><div><h3>Conclusions</h3><div>This study provides genetic evidence that altered HRV may causally increase insomnia risk, while insomnia does not appear to causally affect HRV. These findings suggest that regulating HRV might help alleviate insomnia symptoms and improve sleep quality, and highlight the potential of HRV as a therapeutic target in sleep disorders.</div></div>","PeriodicalId":47673,"journal":{"name":"International Journal of Clinical and Health Psychology","volume":"25 4","pages":"Article 100656"},"PeriodicalIF":4.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.ijchp.2025.100639
Muzi Liang , Jin Zhou , Peng Chen , Wenjing Wu , Yalan Song , Guangyun Hu , Qu Hu , Zhe Sun , Yuanliang Yu , Yuyan Liang , Alex Molassiotis , M. Tish Knobf , Zengjie Ye
Purposes
To explore if pretreatment brain function/structure connectome could explain the response to a psychosocial intervention on resilience in breast cancer.
Methods
Between February 2018 and October 2021, women newly diagnosed with breast cancer were retrospectively enrolled from the Be Resilient to Breast Cancer (BRBC) trial and received a supportive-expressive therapy intervention. Baseline Resting-state Functional Magnetic Resonance Imaging (rs-fMRI) combined with Diffusion Tensor Imaging (DTI) were administered and resilience was scored by 10-item Resilience Scale specific to Cancer (RS-SC-10) at baseline and after the intervention (6 months). Response to the supportive intervention on resilience was defined as > 0.5 standard deviation (SD) improvement at 6 months compared to baseline mean resilience score.
Results
A total of 105 patients received intervention. At 6 months, the resilience score improved in 62.9 % (N = 66), defined as the Response group. Amygdala (53 %) and Hippocampus (15 %) in rs-fMRI and CorpusCallosum_ForcepsMinor (96 %) in DTI were recognized as the main significant brain regions associated with treatment response.
Conclusion
These preliminary data suggest that neuro-markers of brain function/structure connectome from MR imaging might be useful in evaluating response to behavioral interventions on resilience.
目的探讨预处理脑功能/结构连接组是否可以解释心理社会干预对乳腺癌恢复力的影响。方法：在2018年2月至2021年10月期间，从BRBC （Be Resilient to breast cancer）试验中回顾性招募了新诊断为乳腺癌的女性，并接受了支持表达治疗干预。基线静息状态功能磁共振成像（rs-fMRI）联合弥散张量成像（DTI），并在基线和干预后（6个月）采用10项癌症弹性量表（RS-SC-10）对恢复能力进行评分。对心理弹性的支持干预的反应被定义为6个月时与基线平均心理弹性评分相比改善了>； 0.5标准差（SD）。结果105例患者接受干预。在6个月时，弹性评分提高了62.9% (N = 66)，定义为反应组。rs-fMRI中的杏仁核（53%）和海马体（15%）以及DTI中的胼胝体（96%）被认为是与治疗反应相关的主要重要脑区。结论磁共振成像的脑功能/结构连接组神经标志物可用于评估行为干预对心理弹性的影响。
{"title":"A novel brain functional-structural hybrid analysis to explain the effect of a 6-month psychosocial intervention on resilience in breast cancer","authors":"Muzi Liang , Jin Zhou , Peng Chen , Wenjing Wu , Yalan Song , Guangyun Hu , Qu Hu , Zhe Sun , Yuanliang Yu , Yuyan Liang , Alex Molassiotis , M. Tish Knobf , Zengjie Ye","doi":"10.1016/j.ijchp.2025.100639","DOIUrl":"10.1016/j.ijchp.2025.100639","url":null,"abstract":"<div><h3>Purposes</h3><div>To explore if pretreatment brain function/structure connectome could explain the response to a psychosocial intervention on resilience in breast cancer.</div></div><div><h3>Methods</h3><div>Between February 2018 and October 2021, women newly diagnosed with breast cancer were retrospectively enrolled from the <em>Be Resilient to Breast Cancer</em> (BRBC) trial and received a supportive-expressive therapy intervention. Baseline Resting-state Functional Magnetic Resonance Imaging (rs-fMRI) combined with Diffusion Tensor Imaging (DTI) were administered and resilience was scored by 10-item Resilience Scale specific to Cancer (RS-SC-10) at baseline and after the intervention (6 months). Response to the supportive intervention on resilience was defined as > 0.5 standard deviation (SD) improvement at 6 months compared to baseline mean resilience score.</div></div><div><h3>Results</h3><div>A total of 105 patients received intervention. At 6 months, the resilience score improved in 62.9 % (<em>N</em> = 66), defined as the Response group. Amygdala (53 %) and Hippocampus (15 %) in rs-fMRI and CorpusCallosum_ForcepsMinor (96 %) in DTI were recognized as the main significant brain regions associated with treatment response.</div></div><div><h3>Conclusion</h3><div>These preliminary data suggest that neuro-markers of brain function/structure connectome from MR imaging might be useful in evaluating response to behavioral interventions on resilience.</div></div>","PeriodicalId":47673,"journal":{"name":"International Journal of Clinical and Health Psychology","volume":"25 4","pages":"Article 100639"},"PeriodicalIF":4.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.ijchp.2025.100643
Lucas M. Loureiro , Elodie Bertrand , Eelco van Duinkerken , Jerson Laks , Valeska Marinho , Iris Bomilcar , Renata Naylor , Gloria Wong , Aimee Spector , Daniel C. Mograbi
Background
There are growing numbers of people with dementia (PwD) globally, a syndrome with well documented impact on brain structure and connectivity that lead to cognitive impairment. Cognitive Stimulation Therapy (CST) is a non-pharmacological intervention for dementia with a strong evidence-base indicating positive effects on cognition and mood. There is, however, a lack of data on the effects of CST on brain structural and functional changes. This study aimed to analyze the impact of CST on brain cortical differences through the symmetrized percentage change (SPC) of surface area, thickness and volume measured through magnetic resonance imaging (MRI).
Methods
Structural MRI was collected from 17 PwD who received CST and 11 treatment as usual (TAU) controls pre- and pos-intervention. The SPC of cortical structure was calculated for each participant. Freesurfer’s general linear model was used, and the resulting statistical maps were thresholded at p < .01. The maps were then corrected for multiple comparisons using Monte Carlo Z simulation with 10.000 iterations. The family wise error cluster-level correction for multiple comparisons threshold was set at p < .05 and p-values were further corrected using the Bonferroni method to correct for both hemispheres.
Results
There were no statistically significant differences between CST and TAU groups regarding age, sex or years of education. Relative to TAU, the CST group exhibited a decrease in surface area in the left rostral middle frontal region (PFWE = 0.019, Cohen’s δ of 1.764), in addition to an increase in thickness in the right supramarginal (PFWE = 0.012, Cohen’s δ of -2.063) and postcentral regions (PFWE = 0.038, Cohen’s δ of -2.11). No differences in volume SPC were found between groups. A statistically significant correlation was also found between cognition and the right supramarginal gyrus thickness (p = .017).
Conclusion
This is the first study on the effects of CST on brain surface area, thickness, and volume. Our results indicate a change in cortical structure associated with CST. Reduced cortical thickness in the rostral middle frontal region may be related to the effects of CST on mood and stress. Increased thickness in the right supramarginal and postcentral regions may be due to increased abilities of phonological processing, verbal working memory, and somatosensory processing. More data, with larger samples, are needed to support these findings.
{"title":"Structural brain changes in people with dementia receiving Cognitive Stimulation Therapy: Preliminary findings","authors":"Lucas M. Loureiro , Elodie Bertrand , Eelco van Duinkerken , Jerson Laks , Valeska Marinho , Iris Bomilcar , Renata Naylor , Gloria Wong , Aimee Spector , Daniel C. Mograbi","doi":"10.1016/j.ijchp.2025.100643","DOIUrl":"10.1016/j.ijchp.2025.100643","url":null,"abstract":"<div><h3>Background</h3><div>There are growing numbers of people with dementia (PwD) globally, a syndrome with well documented impact on brain structure and connectivity that lead to cognitive impairment. Cognitive Stimulation Therapy (CST) is a non-pharmacological intervention for dementia with a strong evidence-base indicating positive effects on cognition and mood. There is, however, a lack of data on the effects of CST on brain structural and functional changes. This study aimed to analyze the impact of CST on brain cortical differences through the symmetrized percentage change (SPC) of surface area, thickness and volume measured through magnetic resonance imaging (MRI).</div></div><div><h3>Methods</h3><div>Structural MRI was collected from 17 PwD who received CST and 11 treatment as usual (TAU) controls pre- and pos-intervention. The SPC of cortical structure was calculated for each participant. Freesurfer’s general linear model was used, and the resulting statistical maps were thresholded at <em>p</em> < .01. The maps were then corrected for multiple comparisons using Monte Carlo Z simulation with 10.000 iterations. The family wise error cluster-level correction for multiple comparisons threshold was set at <em>p</em> < .05 and p-values were further corrected using the Bonferroni method to correct for both hemispheres.</div></div><div><h3>Results</h3><div>There were no statistically significant differences between CST and TAU groups regarding age, sex or years of education. Relative to TAU, the CST group exhibited a decrease in surface area in the left rostral middle frontal region (P<sub>FWE</sub> = 0.019, Cohen’s δ of 1.764), in addition to an increase in thickness in the right supramarginal (P<sub>FWE</sub> = 0.012, Cohen’s δ of -2.063) and postcentral regions (P<sub>FWE</sub> = 0.038, Cohen’s δ of -2.11). No differences in volume SPC were found between groups. A statistically significant correlation was also found between cognition and the right supramarginal gyrus thickness (<em>p</em> = .017).</div></div><div><h3>Conclusion</h3><div>This is the first study on the effects of CST on brain surface area, thickness, and volume. Our results indicate a change in cortical structure associated with CST. Reduced cortical thickness in the rostral middle frontal region may be related to the effects of CST on mood and stress. Increased thickness in the right supramarginal and postcentral regions may be due to increased abilities of phonological processing, verbal working memory, and somatosensory processing. More data, with larger samples, are needed to support these findings.</div></div>","PeriodicalId":47673,"journal":{"name":"International Journal of Clinical and Health Psychology","volume":"25 4","pages":"Article 100643"},"PeriodicalIF":4.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145364127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.ijchp.2025.100629
Zhihui Lan , Ji-Tao Li , Lin-lin Zhu, Yankun Wu, Tian Shen, Youran Dai, Yun-Ai Su, Tianmei Si
Background
Anxious depression (AD), a common neurophysiological subtype of major depressive disorder (MDD), is often accompanied by immune dysregulation and volumetric alterations in brain structures. However, the intrinsic relationships between inflammatory markers and brain structural changes in AD patients remain unclear.
Methods
Participants were categorized into three groups: the AD group (n = 43), the non-anxious depression group (NAD, n = 68), and healthy controls (HC, n = 53), matched for age, sex, and education level. Serum levels of interleukin-1 beta (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor alpha (TNF-α) were measured across the groups. All participants underwent T1-weighted magnetic resonance imaging (MRI) scans, and voxel-based morphometry (VBM) analysis was performed to assess gray matter volume (GMV). Correlation analyses were conducted to investigate potential associations between inflammatory markers and GMV in the AD group.
Results
Compared to HCs, patients with MDD exhibited significantly elevated serum IL-6 levels. Additionally, AD patients demonstrated reduced GMV in the right putamen, right superior temporal gyrus (STG), and right cuneus compared to both NAD and HC groups. Notably, reduced GMV in the right STG was significantly correlated with serum IL-1β levels and depression severity within the AD group.
Conclusions
These findings provide preliminary psychoradiological evidence for the pathophysiological mechanisms underlying this MDD subtype and possible explanations for the differences in clinical features and prognosis between AD and NAD.
背景：危险型抑郁症（AD）是重度抑郁症（MDD）的一种常见的神经生理亚型，常伴有免疫失调和脑结构体积改变。然而，炎症标志物与AD患者脑结构变化之间的内在关系尚不清楚。方法根据年龄、性别和受教育程度将参与者分为三组：AD组（n = 43）、非焦虑性抑郁组（NAD, n = 68）和健康对照组（HC, n = 53）。测定各组血清白细胞介素-1β (IL-1β)、白细胞介素-6 （IL-6）和肿瘤坏死因子α (TNF-α)水平。所有参与者都接受了t1加权磁共振成像（MRI）扫描，并进行了基于体素的形态测量（VBM）分析，以评估灰质体积（GMV）。进行相关性分析以调查AD组炎症标志物与GMV之间的潜在关联。结果与hcc患者相比，MDD患者血清IL-6水平显著升高。此外，与NAD组和HC组相比，AD患者表现出右侧壳核、右侧颞上回（STG）和右侧楔叶的GMV减少。值得注意的是，在AD组中，右侧STG GMV的降低与血清IL-1β水平和抑郁严重程度显著相关。结论这些发现为该MDD亚型的病理生理机制提供了初步的心理放射学证据，并可能解释AD和NAD在临床特征和预后方面的差异。
{"title":"Peripheral pro-inflammatory cytokine levels are associated with brain structural atrophies in patients with anxious depression","authors":"Zhihui Lan , Ji-Tao Li , Lin-lin Zhu, Yankun Wu, Tian Shen, Youran Dai, Yun-Ai Su, Tianmei Si","doi":"10.1016/j.ijchp.2025.100629","DOIUrl":"10.1016/j.ijchp.2025.100629","url":null,"abstract":"<div><h3>Background</h3><div>Anxious depression (AD), a common neurophysiological subtype of major depressive disorder (MDD), is often accompanied by immune dysregulation and volumetric alterations in brain structures. However, the intrinsic relationships between inflammatory markers and brain structural changes in AD patients remain unclear.</div></div><div><h3>Methods</h3><div>Participants were categorized into three groups: the AD group (<em>n</em> = 43), the non-anxious depression group (NAD, <em>n</em> = 68), and healthy controls (HC, <em>n</em> = 53), matched for age, sex, and education level. Serum levels of interleukin-1 beta (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor alpha (TNF-α) were measured across the groups. All participants underwent T1-weighted magnetic resonance imaging (MRI) scans, and voxel-based morphometry (VBM) analysis was performed to assess gray matter volume (GMV). Correlation analyses were conducted to investigate potential associations between inflammatory markers and GMV in the AD group.</div></div><div><h3>Results</h3><div>Compared to HCs, patients with MDD exhibited significantly elevated serum IL-6 levels. Additionally, AD patients demonstrated reduced GMV in the right putamen, right superior temporal gyrus (STG), and right cuneus compared to both NAD and HC groups. Notably, reduced GMV in the right STG was significantly correlated with serum IL-1β levels and depression severity within the AD group.</div></div><div><h3>Conclusions</h3><div>These findings provide preliminary psychoradiological evidence for the pathophysiological mechanisms underlying this MDD subtype and possible explanations for the differences in clinical features and prognosis between AD and NAD.</div></div>","PeriodicalId":47673,"journal":{"name":"International Journal of Clinical and Health Psychology","volume":"25 4","pages":"Article 100629"},"PeriodicalIF":4.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145222891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.ijchp.2025.100632
Jifu Wang , Feng Ding , Shuailei Lian , Lin Yu
Background
Attentional bias toward high-energy foods may increase appetite, leading to overconsumption and overweight. Physical exercise has been shown to reduce such bias, however, limited research has investigated its effects and underlying mechanisms.
The present study aimed to explore whether acute resistance exercise modulates attentional bias toward food-related stimuli among young overweight women.
Methods
Forty-three overweight female college students were randomly assigned to either an experimental group (n = 20; BMI = 25.25 ± 0.84) that performed 41 min of moderate-intensity resistance exercise or a control group (n = 23; BMI = 25.52 ± 1.01) that completed a reading task. Attentional bias was assessed using a dot-probe task with high- and low-energy food images after the exercise or control session, with the behavioral (reaction time, accuracy, attentional engagement/disengagement index) and neurophysiological (N2, P3) measures.
Results
Compared to the control group, the exercise group had a significantly lower attentional engagement index for the low-energy food cues and significantly shorter peak latency of N2 and P3 during the dot probe task. Within the experimental group, the N2 peak amplitude was significantly lower in the high-energy vs. low-energy condition when there were incongruent food cues.
Conclusion
These results indicate that the onset of attentional engagement and attentional orientation toward food cues occurred significantly earlier after resistance exercise. This study provides novel insights into the neurocognitive mechanisms underlying resistance exercise-induced modulations of attentional processing of food-related stimuli in overweight females, offering both theoretical contributions to exercise cognition and practical implications for weight management interventions.
{"title":"Effect of resistance exercise on attentional bias toward food in overweight female college students: An event-related potential study","authors":"Jifu Wang , Feng Ding , Shuailei Lian , Lin Yu","doi":"10.1016/j.ijchp.2025.100632","DOIUrl":"10.1016/j.ijchp.2025.100632","url":null,"abstract":"<div><h3>Background</h3><div>Attentional bias toward high-energy foods may increase appetite, leading to overconsumption and overweight. Physical exercise has been shown to reduce such bias, however, limited research has investigated its effects and underlying mechanisms.</div><div>The present study aimed to explore whether acute resistance exercise modulates attentional bias toward food-related stimuli among young overweight women.</div></div><div><h3>Methods</h3><div>Forty-three overweight female college students were randomly assigned to either an experimental group (<em>n</em> = 20; BMI = 25.25 ± 0.84) that performed 41 min of moderate-intensity resistance exercise or a control group (<em>n</em> = 23; BMI = 25.52 ± 1.01) that completed a reading task. Attentional bias was assessed using a dot-probe task with high- and low-energy food images after the exercise or control session, with the behavioral (reaction time, accuracy, attentional engagement/disengagement index) and neurophysiological (N2, P3) measures.</div></div><div><h3>Results</h3><div>Compared to the control group, the exercise group had a significantly lower attentional engagement index for the low-energy food cues and significantly shorter peak latency of N2 and P3 during the dot probe task. Within the experimental group, the N2 peak amplitude was significantly lower in the high-energy vs. low-energy condition when there were incongruent food cues.</div></div><div><h3>Conclusion</h3><div>These results indicate that the onset of attentional engagement and attentional orientation toward food cues occurred significantly earlier after resistance exercise. This study provides novel insights into the neurocognitive mechanisms underlying resistance exercise-induced modulations of attentional processing of food-related stimuli in overweight females, offering both theoretical contributions to exercise cognition and practical implications for weight management interventions.</div></div>","PeriodicalId":47673,"journal":{"name":"International Journal of Clinical and Health Psychology","volume":"25 4","pages":"Article 100632"},"PeriodicalIF":4.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145270091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.ijchp.2025.100646
Alexandra Hinterberger , Esther-Sevil Eigl , Aniko Szeko , Pavlos I Topalidis , Manuel Schabus
Background
Insomnia is highly prevalent, yet few receive cognitive behavioral therapy for insomnia (CBT-I) due to limited treatment availability. Unguided digital CBT-I offers an accessible alternative to traditional face-to-face therapy. Research in this area often relies on either subjective sleep measurements (e.g., sleep diaries) or controlled single-night lab studies. This study examines the effectiveness of a novel app-based CBT-I program combining therapy with continuous subjective and objective sleep tracking via a heart rate (HR) sensor in a naturalistic setting.
Methods
Eighty-eight participants (56.8 % female) aged 20–85 years (M = 49.9 ± 13.10) completed an 8-week app-based CBT-I intervention with continuous sleep tracking (sleep diaries and HR sensor), followed by a 2-week follow-up. Assessments at baseline, post-intervention, and follow-up included sleep related problems, psychological strain, quality of life, and dysfunctional beliefs.
Results
Insomnia prevalence dropped from 92 % at pre-intervention to 67 % at follow-up. Improvements were observed in subjective sleep quality (p < .001, r = 0.59), dysfunctional beliefs (p < .001, r = 0.48), quality of life (p’s < .002, r’s > 0.33), psychological strain (p < .001, r = 0.43), depression (p = .010, r = 0.27), and anxiety (p = .003, r = 0.32). While sleep diary data showed improvements in various sleep parameters, objective data revealed statistical trends towards a reduced total sleep time (TST; p = .083, r = 0.19), driven by sleep restriction, and light sleep (p = .089, r = 0.18). Using continuous sleep monitoring we additionally found relevant changes during the intervention levels for subjective wake after sleep onset, sleep efficiency as well as objective TST.
Conclusion
Findings support the effectiveness of app-based CBT-I and suggest that continuous objective sleep tracking over weeks can reveal previously undetected sleep and well-being improvements in real-world settings.
背景：失眠非常普遍，但由于治疗方法有限，很少有人接受认知行为治疗（CBT-I）。无指导的数字CBT-I为传统的面对面治疗提供了一种可访问的替代方案。这一领域的研究通常依赖于主观睡眠测量（如睡眠日记）或受控的单夜实验室研究。本研究考察了一种基于应用程序的新型CBT-I项目的有效性，该项目将治疗与在自然环境中通过心率（HR）传感器持续的主观和客观睡眠跟踪相结合。方法年龄20 ~ 85岁的88名参与者（56.8%为女性）（M = 49.9±13.10）完成了为期8周的基于app的CBT-I干预，并持续进行睡眠追踪（睡眠日记和HR传感器），随访2周。基线、干预后和随访的评估包括睡眠相关问题、心理压力、生活质量和功能失调的信念。结果睡眠患病率由干预前的92%下降到随访时的67%。主观睡眠质量（p < 0.001, r = 0.59）、功能失调信念（p < 0.001, r = 0.48）、生活质量（p < 0.002, r 's > 0.33）、心理紧张（p < 0.001, r = 0.43）、抑郁（p = 0.010, r = 0.27）、焦虑（p = 0.003, r = 0.32）均有改善。虽然睡眠日记数据显示各种睡眠参数有所改善，但客观数据显示，受睡眠限制和轻度睡眠（p = 0.089, r = 0.18）的影响，总睡眠时间（TST; p = 0.083, r = 0.19）有所减少。通过持续的睡眠监测，我们还发现在干预水平期间主观醒后、睡眠效率和客观TST的相关变化。研究结果支持基于应用程序的CBT-I的有效性，并表明连续数周的客观睡眠跟踪可以揭示现实环境中以前未被发现的睡眠和健康改善。
{"title":"Continuous sleep tracking in digital CBT-I: Efficacy and insights from a naturalistic-environment study","authors":"Alexandra Hinterberger , Esther-Sevil Eigl , Aniko Szeko , Pavlos I Topalidis , Manuel Schabus","doi":"10.1016/j.ijchp.2025.100646","DOIUrl":"10.1016/j.ijchp.2025.100646","url":null,"abstract":"<div><h3>Background</h3><div>Insomnia is highly prevalent, yet few receive cognitive behavioral therapy for insomnia (CBT-I) due to limited treatment availability. Unguided digital CBT-I offers an accessible alternative to traditional face-to-face therapy. Research in this area often relies on either subjective sleep measurements (e.g., sleep diaries) or controlled single-night lab studies. This study examines the effectiveness of a novel app-based CBT-I program combining therapy with continuous subjective and objective sleep tracking via a heart rate (HR) sensor in a naturalistic setting.</div></div><div><h3>Methods</h3><div>Eighty-eight participants (56.8 % female) aged 20–85 years (M = 49.9 ± 13.10) completed an 8-week app-based CBT-I intervention with continuous sleep tracking (sleep diaries and HR sensor), followed by a 2-week follow-up. Assessments at baseline, post-intervention, and follow-up included sleep related problems, psychological strain, quality of life, and dysfunctional beliefs.</div></div><div><h3>Results</h3><div>Insomnia prevalence dropped from 92 % at pre-intervention to 67 % at follow-up. Improvements were observed in subjective sleep quality (p < .001, r = 0.59), dysfunctional beliefs (p < .001, r = 0.48), quality of life (p’s < .002, r’s > 0.33), psychological strain (p < .001, r = 0.43), depression (p = .010, r = 0.27), and anxiety (p = .003, r = 0.32). While sleep diary data showed improvements in various sleep parameters, objective data revealed statistical trends towards a reduced total sleep time (TST; p = .083, r = 0.19), driven by sleep restriction, and light sleep (p = .089, r = 0.18). Using continuous sleep monitoring we additionally found relevant changes during the intervention levels for subjective wake after sleep onset, sleep efficiency as well as objective TST.</div></div><div><h3>Conclusion</h3><div>Findings support the effectiveness of app-based CBT-I and suggest that continuous objective sleep tracking over weeks can reveal previously undetected sleep and well-being improvements in real-world settings.</div></div>","PeriodicalId":47673,"journal":{"name":"International Journal of Clinical and Health Psychology","volume":"25 4","pages":"Article 100646"},"PeriodicalIF":4.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145467337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.ijchp.2025.100648
Justin Hachenberger , Maia ten Brink , Denny Kerkhoff , Sebastian Baron , Manuel Schabus , Sakari Lemola
This study aimed to investigate the bidirectional relationships between affective wellbeing and sleep, and to explore the moderating effects of depressive and insomnia symptoms. Data from two studies, involving 178 participants in total aged 18–29 years, were analyzed. Over 14 days, participants completed daily surveys assessing affective wellbeing and wore ECG chest belts for heart rate variability monitoring to derive objective sleep indices. Multilevel models were used to examine within-subject associations between affective states and subsequent sleep, and vice versa, while considering depressive and insomnia symptoms as moderators. Higher positive affect than usual in the evening was associated with shorter total sleep time, shorter rapid eye movement sleep, and lower number of awakenings and stage shifts than usual in the following night. Regarding sleep predicting morning’s affective wellbeing, longer slow-wave sleep was linked to higher positive affect than usual, while longer rapid eye movement sleep and higher sleep efficiency than usual predicted lower negative affect than usual. Also, higher subjective sleep quality than usual was associated with higher positive and lower negative affect than usual the next morning. No evidence for moderation effects of insomnia and depressive symptoms for the bidirectional within-subject associations between sleep and affect was found. The findings underscore the complex interplay between sleep and affective wellbeing, particularly highlighting that the subjective perception of one’s sleep appears to be relevant for the next morning’s affective states.
{"title":"Exploring the bidirectional within-subject relationship between sleep and affective wellbeing: Insights from an intensive longitudinal study","authors":"Justin Hachenberger , Maia ten Brink , Denny Kerkhoff , Sebastian Baron , Manuel Schabus , Sakari Lemola","doi":"10.1016/j.ijchp.2025.100648","DOIUrl":"10.1016/j.ijchp.2025.100648","url":null,"abstract":"<div><div>This study aimed to investigate the bidirectional relationships between affective wellbeing and sleep, and to explore the moderating effects of depressive and insomnia symptoms. Data from two studies, involving 178 participants in total aged 18–29 years, were analyzed. Over 14 days, participants completed daily surveys assessing affective wellbeing and wore ECG chest belts for heart rate variability monitoring to derive objective sleep indices. Multilevel models were used to examine within-subject associations between affective states and subsequent sleep, and vice versa, while considering depressive and insomnia symptoms as moderators. Higher positive affect than usual in the evening was associated with shorter total sleep time, shorter rapid eye movement sleep, and lower number of awakenings and stage shifts than usual in the following night. Regarding sleep predicting morning’s affective wellbeing, longer slow-wave sleep was linked to higher positive affect than usual, while longer rapid eye movement sleep and higher sleep efficiency than usual predicted lower negative affect than usual. Also, higher subjective sleep quality than usual was associated with higher positive and lower negative affect than usual the next morning. No evidence for moderation effects of insomnia and depressive symptoms for the bidirectional within-subject associations between sleep and affect was found. The findings underscore the complex interplay between sleep and affective wellbeing, particularly highlighting that the subjective perception of one’s sleep appears to be relevant for the next morning’s affective states.</div></div>","PeriodicalId":47673,"journal":{"name":"International Journal of Clinical and Health Psychology","volume":"25 4","pages":"Article 100648"},"PeriodicalIF":4.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145520114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.ijchp.2025.100645
Rachel R. Jin , Li Liang , Horace Tong , Menglu Chen , Tatia M.C. Lee
Background
Stress promotes affective, neural, endocrine, and immune responses. The glymphatic system, essential for waste clearance and immune homeostasis, protects the brain against adverse neurobiological changes. However, it remains unclear how the glymphatic system changes during acute stress, coordinates with multi-level stress responses, and relates to psychological resilience in humans.
Methods
We recruited 84 healthy middle-aged adults (mean age 29.26 ± 2.91, 50 males) without major physical, neurological, or psychological conditions. Glymphatic system function was assessed via the coupling between global blood-oxygen-level-dependent and cerebrospinal fluid signals (gBOLD-CSF coupling) before, immediately after, and 60 min after the Montreal Imaging Stress Task. Mood states, neural responses (BOLD signal changes), acute and awakening cortisol responses, and psychological resilience (Connor-Davidson Resilience Scale) were measured. We compared gBOLD-CSF coupling changes over time using repeated-measures ANOVA, and investigated their associations with affective, neural, endocrine responses, and resilience with linear models and network analysis.
Results
gBOLD-CSF coupling was stronger at baseline and after recovery compared to immediately after stress. Changes in gBOLD-CSF coupling were associated with stress-related negative affect and prefrontal neural response. The cortisol response to acute stress was related to gBOLD-CSF coupling response to stress, depending on the level of the cortisol awakening response. The glymphatic system emerged as a central mediator of multi-organ stress response. Finally, post- to pre-stress changes in gBOLD-CSF coupling were associated with psychological resilience.
Conclusions
The glymphatic system transiently fluctuates during acute stress, synergizing with affective, neural, and endocrine networks, playing significant roles in stress response and psychological resilience.
{"title":"The relationship between glymphatic system, multi-level stress response, and psychological resilience","authors":"Rachel R. Jin , Li Liang , Horace Tong , Menglu Chen , Tatia M.C. Lee","doi":"10.1016/j.ijchp.2025.100645","DOIUrl":"10.1016/j.ijchp.2025.100645","url":null,"abstract":"<div><h3>Background</h3><div>Stress promotes affective, neural, endocrine, and immune responses. The glymphatic system, essential for waste clearance and immune homeostasis, protects the brain against adverse neurobiological changes. However, it remains unclear how the glymphatic system changes during acute stress, coordinates with multi-level stress responses, and relates to psychological resilience in humans.</div></div><div><h3>Methods</h3><div>We recruited 84 healthy middle-aged adults (mean age 29.26 ± 2.91, 50 males) without major physical, neurological, or psychological conditions. Glymphatic system function was assessed via the coupling between global blood-oxygen-level-dependent and cerebrospinal fluid signals (gBOLD-CSF coupling) before, immediately after, and 60 min after the Montreal Imaging Stress Task. Mood states, neural responses (BOLD signal changes), acute and awakening cortisol responses, and psychological resilience (Connor-Davidson Resilience Scale) were measured. We compared gBOLD-CSF coupling changes over time using repeated-measures ANOVA, and investigated their associations with affective, neural, endocrine responses, and resilience with linear models and network analysis.</div></div><div><h3>Results</h3><div>gBOLD-CSF coupling was stronger at baseline and after recovery compared to immediately after stress. Changes in gBOLD-CSF coupling were associated with stress-related negative affect and prefrontal neural response. The cortisol response to acute stress was related to gBOLD-CSF coupling response to stress, depending on the level of the cortisol awakening response. The glymphatic system emerged as a central mediator of multi-organ stress response. Finally, post- to pre-stress changes in gBOLD-CSF coupling were associated with psychological resilience.</div></div><div><h3>Conclusions</h3><div>The glymphatic system transiently fluctuates during acute stress, synergizing with affective, neural, and endocrine networks, playing significant roles in stress response and psychological resilience.</div></div>","PeriodicalId":47673,"journal":{"name":"International Journal of Clinical and Health Psychology","volume":"25 4","pages":"Article 100645"},"PeriodicalIF":4.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145467336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号